Gentle Ben's Massage

02/15/2019

🔈 QUADRATUS LUMBORUM - ANATOMY, FUNCTION AND RELEASE EXERCISE

🔒 QL ANATOMY
The Quadratus Lumborum Muscle which is present in the posterior abdominal wall situated deep inside the abdomen. This muscle is present dorsally to the iliopsoas muscle. This muscle courses from the iliac crest and attaches itself to the 12th rib and the transverse processes of 1st to 4th lumbar vertebrae. The quadratus lumborum muscle is rectangular in shape. The muscle gets its blood supply from the subcostal nerve and branches of the lumbar plexus. The quadratus lumborum muscle lies quite close to many vital organs of the body in the abdomen like the kidneys and colon.

🔒 QL FUNCTION
The main function of the quadratus lumborum is to provide stability to the body along with movement of the spine and pelvis. Since this muscle is used frequently day in and day out hence it is prone to strains and injuries resulting in quadratus lumborum pain. Certain activities like repetitive heavy lifting, sporting activities like rowing, golfing can strain the quadratus lumborum muscle. Treatment for quadratus lumborum strain is conservative with a period of rest along with using hot and cold therapy and back brace.

🔒 QL REFERRED PAIN
When muscle knots form in the Ql or it goes into spasm due to overload or injury, then it can give you real grief! Often this is more one-sided than the other also, giving you a real lopsided feeling and can make it seem like you have one leg shorter than the other or that your “pelvis is out” (which can’t really happen). The QL refers pain elsewhere and isn’t always felt at the muscle. The referred pain is generally felt in the outer hip and in the glutes and is often described as a deep ache but can be a sharp pain when moving. The trouble is that this muscle is very hard to stretch – but, it is quite easy to do a QL muscle release!

➡️ QL MUSCLE RELEASE

1. Position
Lie on your back and place a firm massage ball under your QL muscle, which you will find in-between the top of your pelvis and your bottom rib, off to each side of your spine.

2. Action:
Bring the knee on the same side as the ball up towards your chest, which puts pressure on the ball. Once you feel like you have the right spot (you will feel it!), holding onto your knee you can either:

1. Rock your knee out to the side and then in again and repeat, OR
2. Repeatedly bend your knee up and down towards your chest.
Slowly and gently work into it for 1-2 minutes on each side and feel free to move the ball up or down slightly to get the right spots.

Do this great myofascial release once a day for two weeks.

💡 Tip: Help prevent this recurring and giving you ongoing trouble by strengthening your QL and the surrounding muscle so that they can handle everything that is asked of them!

02/11/2019

🔈 HEADACHES AND MYODURAL BRIDGES

• Recent anatomical studies have found that the deep suboccipital (top of the neck) muscles are connected to the dura matter (the covering of the spinal cord) by ligaments.
• Pulling on a suboccipital muscle moves the dura matter, in cadavers.
• The suboccipital muscles often atrophy (waste away) in headache sufferers.

Can headaches be affected by using Active Release Techniques (ART) on the the suboccipital muscles: superior oblique, inferior oblique, re**us capitis posterior major and minor? The suboccipital muscles are important little muscles which control fine neuromuscular control of the head.

Recent studies have added to our knowledge of the possible connections between headaches and the myodural bridges:

Enix et al did microscopic evaluations to confirm that ligaments called the myodural bridges emanate from the suboccipital muscle bellies, and attach to the dura mater in 75% of specimens. These myodural bridges have a hypothetical role in human homeostasis, and they may contribute to certain neuropathological conditions as well. The presence of a neural component within the myodural bridges suggests that they may serve another function aside from simply anchoring the muscles to the dura mater. Such a connection may be involved in monitoring dural tension and may also play a role in certain cervicogenic pathologies (neck pain and headaches).

They noted that manual traction of the re**us major in cadavers resulted in gross dural movement from the spinal root level of the axis (C2) to the spinal root level of the first thoracic vertebra.
Fernández-de-Las-Peñas found that the greater the headache intensity, duration or frequency, the smaller the cross sectional area of the re**us minor and re**us major muscles. He also foundthat there was a correlation between hyper-tenderness and atrophy of the re**us minor. In these cases pressing on the re**us minor reproduced the patient’s headaches.

The re**us minor was also found to have atrophied by Hallgren, in chronic head pain sufferers. He proposed a theory that whiplash could lead to nerve damage which causes the re**us minor to atrophy. His photo in the picture shows the myodural bridge #4.

ART is a hands-on soft tissue treatment of ligaments, muscles, tendons, and nerves. It provides a quick way to make a tight muscle loose, as well as treating conditions such as: tennis elbow, frozen shoulder, shoulder tendinitis, and plantar fasciitis. The technique involves the therapist putting pressure on a tissue, while the patient stretches to move the tissue slowly out from under the contact. The treatment hurts a bit, but only in a way that makes the patient know it is working. The technique works by increasing the nervous system’s tolerance to stretch.

02/11/2019

🔈 LEVATOR SCAPULAE MUSCLE RELATED NECK PAIN

The Levator Scapulae muscles are located on either side of the neck. They originate on the four upper vertebrae of the cervical spine (neck) and insert, or attach, to the scapula, also known as the shoulder blade at the superior, medial border. These two muscles are involved in elevation, downward rotation and abduction of the scapulae. They are also involved in flexion and extension of the cervical spine(neck), turning of the neck slightly left and right, along with side bending of the neck left and right.

When you wake up in the morning with a crick in your neck, feel a burning pain on the top inner corner of your shoulder blade, or have trouble turning your head to look behind you while driving etc., the culprit may be a Levator Scapula muscle in spasm. The pain can be described as a throbbing, ache, or tightness, and usually presents from the top inner corner of the shoulder blade up along the neck.

🔒 What Causes Levator Scapula Spasm / Trigger Points?

A trigger point is a tight area within muscle tissue that causes pain in that area and/or other parts of the body. The trigger points are shown above as two dark red circles, with the pain referral area also shaded in. Muscle spasm is a tightening of a muscle usually, due to overuse or overstress. It can in itself cause pain and loss of mobility. The following events and activities are likely to activate, or reactivate, tension / pain and trigger points in the levator scapulae.

- whiplash from an automobile accident
- sleeping on the stomach with the head turned/or sleeping in an odd position
- chilling of the muscle during sleep from an air conditioner or draft from an open window
- working at a computer with the head turned for long periods
- holding a phone between the shoulder and ear
- carrying a heavy bag with a shoulder strap
- use of crutches that are too tall and elevate the shoulder
- emotional and mental stress
- Working with your arms raised above your head for prolonged periods of time can also irritate the Levator Scapula. To help reduce neck pain, stabilize your shoulder blade when you raise your arm.
- poor posture with a forward head position puts this muscle under continuous strain causing overuse.


Usually the condition settles after a few days if it is only a once off. Proper hands-on deep tissue massage and dry needling, when used together, can be great to settle the condition either in the short term, or if the condition has become more chronic. Also for the long term, correcting posture, stretching and strengthening of the upper back(particularly middle / lower traps, serratus posterior, rhomboids etc.) and the neck muscles(specifically the posterior neck muscles) can help prevent the condition from returning.

Posture is key to a healthy neck and spine. Try and sit up straight on a comfortable supportive chair, when at work or at home, allowing the shoulders to relax by using the arm rests of the chair. When at a computer, pull the screen close and try to get it up to eye level (say using books underneath it), so your head doesn’t have to be coming forward. The same applies when driving a car. Pull the seat in close to the steering wheel(within reason),and try to position yourself so the shoulders are relaxed and the head isn’t jutting forward. Activities like reading in bed, playing computer games for hours etc. can really tighten up the levator muscles and are a disaster for thoracic and cervical posture in the long term.

01/22/2019

🔈 ILIOPSOAS TIGHTNESS CAUSED BY INGUINAL LIGAMENT DISFUNCTION

🔒 ANATOMY & FUNCTION

The Inguinal Ligament is a constricted band of thick fibrous connective tissues which are present in the pelvic region of the body. These tissues arise from the external oblique and course through across the groin and attaches to the front part of the iliac spine. The inguinal ligament forms the floor of the inguinal canal and provides support to the passage of structures through the canal.

The inguinal ligament supports the muscles which course inferiorly to the fibers of the ligament, including the iliopsoas muscles. It also supports the femoral vein, artery, and nerve along with other blood vessels and nerves of the lower extremities as they course through the pelvic area. This support is important to maintain the flexibility of the hip and supply nutrients and blood supply to the lower extremities.

🔒 PAIN SYMPTOMS AND DIAGNOSIS

According to a peer-reviewed report published in the Ochsner Journal and the National Institutes of Health, inguinal ligament pain has several possible diagnoses:

➡️ Direct hernia where a bulge is able to be seen
➡️ Indirect hernia where a bulge is not able to be seen (sports hernia or athletic pubalgia)
➡️ Ligament and muscle strains affecting the adductors, lower abdominals, or ilipsoas muscles
➡️ Nerve entrapment (one of the possible complications of a sports hernia)
➡️ Hip joint issue

🔒 INGUINAL LIGAMENT PAIN TREATMENT

The ligament also helps to supports the iliopsoas muscles which includes the psoas major muscle that runs from your upper femur, through your pelvis, to your lower spine.

Because of its positioning, the ligament is responsible for helping to support the lower abdominal wall and prevent the groin from tearing.

When looking at muscle and ligament issues, there are two causes of the pain, and the first is much less serious.

➡️ Groin Strain
➡️ Sports Hernia

A groin strain is a more common type of injury where the muscles of the groin become overstretched or tear slightly as a result of sudden movement, such as sprinting or a quick shift during a game of soccer or basketball.

Groin strain treatment is relatively straightforward and follows the 3-point physical therapy approach:

💡Stretching
💡Mobility
💡Strengthening

With just stretching and no mobility work or strengthening exercises, you will not see lasting flexibility and pain relief - it will be only transient and short-term right after you get done. With just physical therapy exercises and no mobility, you will be unable to get into the proper positioning. This leads to poor form and incorrect movement patterns - which is how you got injured in the first place. Bottom line, make sure you do all three.

🔒 GROIN STRAIN EXERCISES

You can begin stretching your groin muscles right away. Stretch gently and avoid any pain. If you have pain while doing these exercises, you should not do them.

🛠 Hip adductor stretch: Lie on your back. Bend your knees and put your feet flat on the floor. Gently spread your knees apart, stretching the muscles on the inside of your thighs. Hold the stretch for 15 to 30 seconds. Repeat 3 times.

🛠 Side plank: Lie on your side with your legs, hips, and shoulders in a straight line. Prop yourself up onto your forearm with your elbow directly under your shoulder. Lift your hips off the floor and balance on your forearm and the outside of your foot. Try to hold this position for 15 seconds and then slowly lower your hip to the ground. Switch sides and repeat. Work up to holding for 1 minute. This exercise can be made easier by starting with your knees and hips flexed toward your chest.

🛠 Resisted hip flexion: Stand facing away from a door. Tie a loop in one end of a piece of elastic tubing and put it around the ankle on your injured side. Tie a knot in the other end of the tubing and shut the knot in the door near the floor. Tighten the front of your thigh muscle and bring the leg with the tubing forward, keeping your leg straight. Return to the starting position. Do 2 sets of 15.

01/07/2019