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19/8/2020 0 Comments

IASTM

What is IASTM?

IASTM, or Instrument Assisted Soft Tissue Mobilisation, is a type of soft tissue mobilisation technique applied using a tool or instrument. IASTM is used to treat soft tissue injuries to muscles, ligaments and tendons and myofascial trigger points. Myofascial trigger points are taut bands of muscle fibres, or nodules within the tissue. The common misconception is to refer to these as “knots”, however it is physiologically impossible to knot something taut that’s tied at both ends! hey compress underlying tissues which can cause abnormal movement, local and referred tenderness, muscle twitches and reduced range of motion.

How will IASTM help?

IASTM will help you by reducing pain, improving function and increasing range of motion through a deeper approach by precisely locating regions of pathology. It does this by:

Stimulating a natural healing process
Reducing fascial adhesions and restrictions
Promoting tissue repair
Improving nerve conduction
Improving fluid circulation
Mobilising scar tissue

What to expect from an IASTM session?

During an IASTM session you will experience up to eight techniques to achieve the treatment goal, whether that would be to improve fluid circulation or aid remodelling of tissue. At the beginning of an IASTM session the therapist will use the tool to scan the region, for example the hamstrings, to identify any specific areas of tightness or stiffness. The area will then be warmed up and once warm the other techniques will be applied to the areas identified during scanning. The techniques are applied for up to 90 seconds per region and then for approximately 10 minutes per site. Localised inflammation will be present after an IASTM session due to the pressure applied during the session, this encourages the healing process.

What conditions can IASTM help?

Muscle soreness
Ligament sprains
Chronic ankle instability
Tendinopathies
Carpal tunnel syndrome
Plantar fasciitis
ITB syndrome

Why have IASTM vs normal soft tissue massage?

IASTM can be performed as a sole treatment or within a normal soft tissue massage treatment session. It is a more targeted treatment to specifically focus on the injured tissue with the use of a tool.

If you would like to learn more about IASTM or more about what we do in general, please get in touch. Equally, if you would like to book an IASTM session then click here and we would be more than happy to help.

References

Cheatham SW. Does a light pressure instrument assisted soft tissue mobilization technique modulate tactile discrimination and perceived pain in healthy individuals with DOMS? Journal of Canadian Chiropractic Association. 2019;63(1):18-25.
Loghmani MT, Warden SJ. Instrument-assisted cross-fiber massage accelerates knee ligament healing. The Journal of Orthopaedic and Sports Physical Therapy. 2009;39(7):506-14.
Schaefer JL, Sandrey MA. Effects of 4-week dynamic balance training program supplemented with Graston instrument assisted soft tissue mobilization for chronic ankle stability. Journal of Sport Rehabilitation. 2012;21(4):313-26.
Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Medicine and Science in Sports and Exercise. 1999;31(4):531-35.
Burke J, Buchberger DJ, Carey-Loghmani MT, Dougherty PE, Greco DS, Dishman JD. A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. J Manipulative Physiol Ther. 2007;30:50–61.
Bitra, M. and Sudhan, S.G., 2019. Instrument Assisted Soft Tissue Mobilisation in the Management of Musculoskeletal Pain: A Literature Review with Implications for Clinical Practice Guidelines. Journal of Clinical & Diagnostic Research, 13(12).

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11/11/2019 0 Comments

Dry Needling. What is it and what does it do?

What Is Dry Needling?

Dry needling is an invasive technique, using a very fine needle inserted into the skin to release myofascial trigger points. Trigger points are a hypersensitive region within a muscle that can cause pain and can present as a tight band within the muscle or a nodule, commonly referred to as ‘knots’. These trigger points can cause pain at the area and often refer pain around the region of the trigger point too. Dry needling helps in the release of the trigger point and the pain or discomfort that can be felt because of it.

What to expect from a Dry Needling treatment

When having dry needling treatment, a very thin needle is used that is pre-sterilised and protected, and only used once. The needle is placed over the muscle and is quickly tapped into the muscle. When inserted, a small scratch may be felt but it should not be too painful. The muscle being treated will sometimes contract when a needle inserted, this is called a local twitch response and may be a little uncomfortable but is completely normal. After insertion a deep ache may be felt. The insertion of the needle will produce an inflammatory response, so redness, heat and swelling may occur. Once the needle is in the muscle, the therapist may move the needle up and down, side to side or twisting the needle round, which helps to stretch the muscle fibres being treated. Needles can be left in for anywhere between 5 to 20 minutes.

How does Dry Needling help?

During the dry needling process, chemicals released from the body cause healing effects and help with the reversal of ischaemia by relaxing the muscle and increasing the blood flow to the area and oxygen saturation of the muscle (Kubo et al.,2010). These chemicals can also inhibit pain signals from the body to the brain helping to reduce pain and increase relaxation. As the needle is twisted or moved when inserted, it stretches the fascial tissue. This all helps with the recovery of the muscle affected by the trigger point. Dry needling is a way to help release myofascial tension, ease pain (Morihisa et al., 2016, Kietrys et al., 2013), and support tissue healing.

What conditions can Dry Needling help?

By using dry needling in conjunction with other treatments, it can help with different conditions in which myofascial tension occurs, such as:

neck and shoulder pain (Calvo-Lobo et al., 2016),
tension headaches (Gildir et al., 2019),
plantar heel pain (Cotchett et al., 2014),
piriformis syndrome (Fusco et al., 2018)
tennis elbow (Shariat et al., 2018).

References
Calvo-Lobo C, Pacheco-da-Costa S, Martínez-Martínez J, Rodríguez-Sanz D, Cuesta-Álvaro P, López-López D. Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial. J Geriatr Phys Ther. 2016;41(1):1–13. doi:10.1519/JPT.0000000000000079
Cotchett, M., Munteanu, S., Landorf, K., Effectiveness of Trigger Point Dry Needling for Plantar Heel Pain: A Randomized Controlled Trial, Physical Therapy, Volume 94, Issue 8, 1 August 2014, Pages 1083–1094, https://doi.org/10.2522/ptj.20130255
Fusco P, Di Carlo S, Scimia P, Degan G, Petrucci E, Marinangeli F. Ultrasound-guided Dry Needling Treatment of Myofascial Trigger Points for Piriformis Syndrome Management: A Case Series. J Chiropr Med. 2018;17(3):198–200. doi:10.1016/j.jcm.2018.04.002
Gildir S, Tüzün EH, Eroğlu G, Eker L. A randomized trial of trigger point dry needling versus sham needling for chronic tension-type headache. Medicine (Baltimore). 2019;98(8):e14520. doi:10.1097/MD.0000000000014520
Kietrys, D., Palombaro, K.M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J.M., Tucker, M. (2013) 'Effectiveness of Dry Needling for Upper-Quarter Myofascial Pain: A Systematic Review and Meta-analysis ',Journal of Orthopaedic & Sports Physical Therapy, 43(9), pp. 620-634.
Kubo, K., Yajima, H., Takayama, M. et al. Eur J Appl Physiol (2010) 109: 545. https://doi.org/10.1007/s00421-010-1368-z
Morihisa R, Eskew J, McNamara A, Young J. DRY NEEDLING IN SUBJECTS WITH MUSCULAR TRIGGER POINTS IN THE LOWER QUARTER: A SYSTEMATIC REVIEW. Int J Sports Phys Ther. 2016;11(1):1–14.
Shariat, A., Noormohammadpour, P., Hossein Memari, A., Ansari, N., Cleland, J and Kordi, R. Acute effects of one session dry needling on a chronic golfer’s elbow disability. J Exerc Rehab, 2018, 14, 138-142

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10/5/2019 0 Comments

Common Golfing Injuries

Injuries can affect amateur and professional golfers, causing reduced performance or time away from playing and practising. The average amount of missed practice or competition is around 4.0–5.2 weeks (Murray et al., 2016). Therefore it is important to understand these injuries and what causes them in order to be able to treat and ultimately prevent them. This blog will discuss some of the most common injuries golfers may experience.

Lower back pain

One of the most common injuries golfers experience is lower back pain (Robinson et al., 2018). With the repetitive rotation of a golf swing and bent over stance players perform, the stress through the back is high. Torque (rotational force) created through the pelvis and lumbar spine can overload and strain muscles, ligaments and tendons of lower back. Although muscle and ligament injuries are most common, other injuries to the lower back include disc, degenerative arthritis and bone stress fractures. Back injuries are more common in amateur players then professionals and slightly more common in men than women (Batt,1992).

Golfers and Tennis Elbow

Another common injury in golfers is elbow tendinopathy. ‘Golfers elbow’ is also known as medial epicondylitis and is an overuse condition of the common flexor tendon situated on the medial aspect (inner side) of the elbow. ‘Tennis elbow’ a.k.a lateral epicondylitis affects the extensor tendons on the lateral side (outer side) of the elbow. Golfers can suffer from both these conditions, and more commonly tennis elbow! Due to the repetitive nature of swinging a golf club these tendons are put under stress and used repeatedly causing irritation and inflammation. It can also be due to faulty swinging technique and gripping too tightly.

Wrist Pain

Wrist pain is at high prevalence among golfers, especially those in their 30’s (Batt,1992). Injuries at the wrist include ligament sprains, tendonitis and possibility of fractures to the hamate bone (one of the carpal bones found in the hand and wrist). These tend to occur due to reduced range of motion and weakness at the wrist joint combined with the repeated, high speed swing placing stress through the wrist joint, and especially if players tend to over extend or cock their lead wrist.

Shoulder Pain

Shoulder pain, most commonly rotator cuff injuries, is one of the top injuries for golfers. The rotator cuff is a group of muscles that surrounds and supports the shoulder joint. During the back-swing and follow through of a golf swing these muscles are some of the most active in the upper body (McHardy et al., 2005). Rotator cuff injuries include tendinitis or tears and may involve the nearby bursa and can be caused by overload and repetitive movements or a poorly executed swing. Golfers with weak rotator cuff muscles and elderly players are more susceptible to rotator cuff injuries (Batt,1992). Shoulder impingement and damage to the acromioclavicular joint are also common.

Knee Injuries

Knee injuries, such as ligament strains and tears and meniscus (cartilage) tears are common injuries for golfers. Due to the twisting movement of a golf swing, rotational and compressive forces are placed on the knee joint. Most commonly the medial collateral ligament (found on the inner side of your knee) can be damaged. Osteoarthritis of the knee may also cause pain during a round of golf.

References
A D Murray, L Daines, D Archibald, R A Hawkes, C Schiphorst, P Kelly, L Grant, N Mutrie (2016) 'The relationships between golf and health: a scoping review',Br J Sports Med.10.1136(096625)
A McHardy, H Pollard (2005) 'Muscle activity during the golf swing', Br J Sports Med, 2005;39:799–804.(doi: 10.1136/bjsm.2005.020271).
M. E. Batt (1992) 'A survey of golf injuries in amateur golfers',BrJ Sp Med, 26(1)(63)
P Robinson, I Murray, A Duckworth, R Hawkes, D Glover, N Tilley, R Hillman, C Oliver, A Murray (2018) 'Systematic review of musculoskeletal injuries in professional golfers',Br J Sports Med,10.1136(099572 ).

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IASTM

What is IASTM?

How will IASTM help?

What to expect from an IASTM session?

What conditions can IASTM help?

Why have IASTM vs normal soft tissue massage?

References

Dry Needling. What is it and what does it do?

What Is Dry Needling?

What to expect from a Dry Needling treatment

How does Dry Needling help?

What conditions can Dry Needling help?

Common Golfing Injuries

Lower back pain

Golfers and Tennis Elbow

Wrist Pain

Shoulder Pain

Knee Injuries

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