Back Clinic Therapeutic Massage Team. We all want to relax. In our hectic lives, it’s hard to find time for R&R. If you deal with this in your life, a massage is in order. Massage therapy is a general term that refers to various types of soft tissue manipulation for therapeutic purposes. It involves manually working on the body with gentle pressure or through the use of mechanical aids. Depending on the way the massage is applied, it can be used to provide relaxation and well-being.
Healthcare providers recognize massage therapy as a legitimate therapy for lower back pain. It utilizes manual manipulation to improve circulation, relax muscles, improve range of motion, and increase endorphin levels. This therapy usually follows some medical treatment. Types of therapy include neuromuscular, sports, and Swedish.
For example, Neuromuscular therapy, which is the most effective treatment for low back pain, consists of alternating levels of pressure applied to muscles to alleviate the muscle spasms. First of all, make sure to drink plenty of water following a massage. With massaging procedures, the tissues of your body will be stimulated, resulting in the release of toxins.
Drinking at least 10 glasses of water throughout the day will flush out the toxins. Aim to drink 2-3 glasses within the first hour or so and then at least 8 more within the next 24 hours. In the hour following the massage, drink several glasses and then continue with eight more in the next 23 hours.
For individuals managing osteoarthritis, could massage therapy provide added treatment benefits?
Osteoarthritis Massage Therapy
Osteoarthritis happens when the cartilage between the joints wears away, causing stiffness and pain. Massage therapy is a treatment used to relieve various types of pain symptoms.
There are many types of massage therapy, that healthcare providers utilize to manipulate the muscles and other soft tissues to relieve symptoms, relax muscles, increase circulation, reduce inflammation, release trigger points, and restore mobility, flexibility, and function. (Ergonomic Trends. 2023)
Professional therapists can help relieve osteoarthritis joint pain by relaxing the surrounding muscles and other soft tissues to release stiffness. (Adam Perlman, et al., 2019)
Massage Objectives and Types
Massage therapists use their hands and fingers, forearms, elbows, and/or instruments to manipulate the body’s soft tissues. Soft tissues support and surround body structures and include muscle, fat, tendons, and ligaments.
The goal of osteoarthritis massage therapy is to relax muscles and soft tissues, increase blood and oxygen circulation, warm the affected area/s, relieve pain, and restore mobility and function.
Depending on the location of the muscles being massaged, individuals may be seated or lie down on a specialized table.
The amount of pressure and direction of movement depend on the body area.
Therapeutic oils and/or massage creams may be used to increase the therapy.
Types include:
Swedish
The therapist uses long strokes, kneading, and friction on the muscles.
Joints are moved to increase flexibility.
Deep Tissue
The therapist uses deep finger or instrument pressure, focusing on muscles that are tight or knotted.
Trigger Point
Trigger points represent a source of radiating pain symptoms.
The therapist focuses pressure on these myofascial tissue points using various strokes to release them.
Shiatsu
The therapist applies rhythmic pressure with their thumbs, fingers, and palms to redirect and increase energy or chi/qi.
A massage session lasts around 30–60 minutes depending on the severity of the condition and the number of sessions the patient has undergone. Chronic pain patients usually go through a series of specialized sessions that focus on specific areas and gradually build.
Risk Factors
Certain precautions must be taken before getting osteoarthritis massage therapy. Although there are a few serious risks, certain individuals are not suitable candidates and should not receive massage therapy. The conditions include: (Medical Massage Therapy Resource & Reference. 2023)
Damaged nerves.
Damaged blood vessels.
Infection and inflammation in the area to be massaged.
Open wounds.
Fever.
Taking a blood thinner.
Deep vein thrombosis – blood clots.
Bleeding disorders.
Osteoporosis – weak and brittle bones.
Recent fractures – broken bones.
Tumors.
Cancer.
Individuals who have recently undergone surgery.
Individuals with a skin condition that is contagious, like warts or herpes, or noncontagious, like psoriasis, could be aggravated by touch or pressure.
Individuals who have cancer, fragile skin, heart problems, or dermatomyositis are recommended to discuss osteoarthritis massage therapy with their healthcare provider.
Research on the effects of massage therapy on various health conditions is ongoing. Massage therapy promotes relaxation while reducing stress, which can help with chronic joint issues like osteoarthritis.
Perlman, A., Fogerite, S. G., Glass, O., Bechard, E., Ali, A., Njike, V. Y., Pieper, C., Dmitrieva, N. O., Luciano, A., Rosenberger, L., Keever, T., Milak, C., Finkelstein, E. A., Mahon, G., Campanile, G., Cotter, A., & Katz, D. L. (2019). Efficacy and Safety of Massage for Osteoarthritis of the Knee: a Randomized Clinical Trial. Journal of general internal medicine, 34(3), 379–386. doi.org/10.1007/s11606-018-4763-5
Massage guns can help relieve aching muscles and prevent soreness when used before and after physical activity, work, school, and exercise. They provide massage therapy benefits by targeting muscles with rapid burst pulses. Massage guns can be percussive or vibration-based. Percussive therapy helps increase blood flow to a targeted area, which reduces inflammation and muscle tension, and breaks up knots/trigger points that may have formed in the tissues from added stress or intense physical activity. One of the benefits is that they come with interchangeable massage gun head attachments that target different muscle groups and provide different types of massage. There are many types of interchangeable massage heads, we go over the most common to give a general idea of how they work. If experiencing joint pain, injury, acute muscle pain, or other musculoskeletal disorders, make sure to get clearance from a doctor before using a massage gun.
Massage Gun Head Attachments
The variations of attachments/heads are designed and shaped differently to effectively apply the right amount of pressure to rejuvenate the body’s pressure points, soothe tissues, and release tight and sore muscles. The different heads are designed with a distinctive purpose based on the muscle groups targeted. This maximizes effectiveness and ensures maximum comfort and safety.
Ball Head
The ball attachment is for overall muscle recovery.
It provides a broad surface area and mimics the hands of a skilled massage therapist, delivering a soothing kneading sensation.
Made of durable material, the ball massage head can reach deep into the muscles.
Its round shape makes it more flexible to use anywhere, especially the large muscle groups like the quads and glutes.
U/Fork Shaped Head
A plastic, dual-pronged head also known as a fork head.
The attachment provides relief to areas like the shoulders, spine, neck, calves, and Achilles tendon.
Bullet Head
The plastic head is named as such because of its pointed shape.
This is recommended for tightness and discomfort in the joints, deep tissues, trigger points, and/or small muscle areas like the feet and wrist.
Flat Head
The multipurpose flat head is for full-body general massage.
It helps relieve stiffness and pain for total body muscle relaxation, including muscle groups closer to bone joints.
Shovel-Shaped Head
The shovel-shaped head is for the abdominal muscles and lower back.
The attachment provides stimulation to release stiff muscles.
Using The Right Head
Which head to use depends on the individual’s specific needs and preferences. Consider the following factors when selecting a massage gun head:
Targeted Areas
Identify the body areas requiring the most attention.
If muscle tightness or soreness is occurring in larger muscle groups, like the back or legs, the ball attachment is recommended.
For more precise areas like trigger points, the bullet head is recommended.
Heads can be used in conjunction – for example, a large surface area head is used to relax and loosen and relax a general area, then a more precise head is used to focus the massage on the actual tight spot or trigger point.
Massage Intensity
Massage intensity levels can be varied from a light massage to full force.
For a softer touch on sensitive muscles, flat head or forkhead attachments are recommended.
For deep muscle penetration and consistent pressure, the bullet head or shovel head attachments are recommended.
Specific Conditions
Consider any specific conditions or injuries previous and current.
For individuals recovering from an injury or with sensitive areas, it’s important to choose a massage gun head that provides the necessary relief without causing discomfort or worsening an injury.
Try Out Different Heads and Settings
Experiment with different massage head attachments and speeds to find the one that works best for the intended purpose.
Explore each to discover personal preferences.
Start with the lowest setting and gradually increase, based on comfort level.
Always consult with a qualified healthcare provider regarding any medical concerns before using a massage gun.
Choosing The Right Massage Head Attachment
References
Bergh, Anna, et al. “A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Soft Tissue Mobilization.” Animals: an open access journal from MDPI vol. 12,11 1440. 2 Jun. 2022, doi:10.3390/ani12111440
Imtiyaz, Shagufta, et al. “To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS).” Journal of Clinical and diagnostic research: JCDR vol. 8,1 (2014): 133-6. doi:10.7860/JCDR/2014/7294.3971
Konrad, Andreas, et al. “The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance.” Journal of sports science & medicine vol. 19,4 690-694. 19 Nov. 2020
Leabeater, Alana et al. “Under the Gun: The effect of percussive massage therapy on physical and perceptual recovery in active adults.” Journal of athletic training, 10.4085/1062-6050-0041.23. 26 May. 2023, doi:10.4085/1062-6050-0041.23
Lupowitz, Lewis. “Vibration Therapy – A Clinical Commentary.” International journal of sports physical therapy vol. 17,6 984-987. 1 Aug. 2022, doi:10.26603/001c.36964
Yin, Yikun, et al. “The effect of vibration training on delayed muscle soreness: A meta-analysis.” Medicine vol. 101,42 (2022): e31259. doi:10.1097/MD.0000000000031259
When looking at an anatomical poster/image of the human body, there are all kinds of muscles connected and overlapping, but when we go to feel around those areas, especially when pain symptoms are presenting, it can feel like one solid mass and not individual muscles. This is because of everyday wear and tear, strenuous activities, spasms, heat, dehydration, and stress that causes the muscles to stay in a slightly contracted state, continue to tighten, bunch up and stiffen becoming the new normal for that individual. People learn to go through life like this, never considering that there is something wrong until they experience a significant injury that can take much longer to recover and rehabilitate from. This is why massaging the body on a regular basis is important to maintain healthy relaxed and flexible muscles and prevent strains, pulls, and injuries.
Massaging the Body
Massage therapy including myotherapyis the practice of kneading or manipulating the body’s muscles and other soft tissues to improve neuromusculoskeletal well-being and health.
It is a form of manual, percussive, and mechanical therapy that includes holding, moving, and applying pressure to the muscles, tendons, ligaments, and fascia.
Massage therapy can be used to describe techniques that vary in touch, pressure, and intensity of the treatment applied.
Benefits
The immediate benefit of regularly massaging the body is feeling deep relaxation and calmness. This happens because massaging prompts the release of endorphins or the brain chemicals/neurotransmitters that produce the feeling of well-being. And the stress hormones like adrenalin, cortisol, and norepinephrine levels are reduced. Studies have shown that high levels of stress hormones can impair and damage the immune system. The physical benefits of massaging the body regularly include:
Alleviated muscle tension.
Improved and increased joint mobility and flexibility.
Increased blood and nerve circulation.
Lymphatic system toxin drainage.
Decreased release of stress hormones.
A relaxed state of mind.
Improved sleep.
Enhanced mental alertness.
Decreased anxiety.
Improved recovery and rehabilitation of soft tissue sprains and injuries.
Improved skin tone.
Massage Types
Depending on the severity of the pain, associated symptoms, and muscle tension a chiropractor and therapeutic massage team will use a variety of techniques and massage types to restore flexibility, mobility, and function. Types of massage include:
Swedish
One of the most popular forms of massage, this technique is designed to promote relaxation and increase and improve blood circulation.
Myofascial
Involves the assessment and treatment of soft tissue pain, injury, and dysfunction affecting movement and mobility.
Myofascial therapy releases tight soft tissue structures like the muscles, tendons, ligaments, and fascia.
Rehabilitative
This type treats and rehabilitates biomechanical dysfunction or injury.
Using specific and targeted mobilization techniques to restore normal health and function.
Lymphatic Drainage
This is a gentle whole-body treatment that relaxes the nervous system, releases toxins, and improves the immune system.
Sports
Sports massage is an application of massage and a blend of techniques to enhance performance and help overworked muscles recover quickly.
The type of technique or treatment applied is dependent on the nature of the stage of training or competition, sports injury or condition, and the assessment of the therapist.
Infant Massage
A gentle massage can help treat constipation, colic, and sleeping problems.
Studies have found that regular massage helps premature babies gain weight faster.
Reflexology
Reflexology is based on the application of pressure to specific points on the body.
Reflex points, which relate to body areas, can be found in the feet, hands, face, and ears.
These points respond to pressure, stimulating the body’s own natural healing process in the same way chiropractic activates natural healing through adjustments and realignment.
Aromatherapy
Essential oils made from selected flowers and plants are added to massage oil for a particular therapeutic property.
For example, the scent of peppermint is used for constipation problems.
Shiatsu
This massage technique aims to improve energy flow by working targeted points on the body.
The underlying principles of shiatsu are similar to those of acupuncture.
Individuals are able to experience an improved quality of life with the combined elements of chiropractic and massage therapy.
Fighting Inflammation Naturally
References
Cheung, Karoline, et al. “Delayed onset muscle soreness: treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. doi:10.2165/00007256-200333020-00005
Koren, Yogev, and Leonid Kalichman. “Deep tissue massage: What are we talking about?.” Journal of Bodywork and movement therapies vol. 22,2 (2018): 247-251. doi:10.1016/j.jbmt.2017.05.006
National Research Council (US) and Institute of Medicine (US) Panel on Musculoskeletal Disorders and the Workplace. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. Washington (DC): National Academies Press (US); 2001. 6, Biomechanics. Available from: www.ncbi.nlm.nih.gov/books/NBK222434/
Pachtman Shetty, Sarah L, and Sarah Fogarty. “Massage During Pregnancy and Postpartum.” Clinical obstetrics and gynecology vol. 64,3 (2021): 648-660. doi:10.1097/GRF.0000000000000638
Stecco, Antonio, et al. “Fascial Disorders: Implications for Treatment.” PM & R: the Journal of Injury, Function, and Rehabilitation vol. 8,2 (2016): 161-8. doi:10.1016/j.pmrj.2015.06.006
Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
Body stiffness is common, especially as the body ages. Stiffness can result from intense work, lack of physical exercise, or specific conditions. The reasons vary from individual to individual. Some feel stiff when they wake up, while others become stiff after stopping physical activity. For others, stiffness can result from practicing unhealthy postures, intense workouts, or something new that the body is beginning to get used to. There are several ways to prevent and treat stiffness, no matter the cause, including targeted physical movements, posture corrections, body decompression, chiropractic realignment, stretches, and therapeutic massage.
Body Stiffness
Knowing the cause of body stiffness and how to relieve it can help prevent and treat the condition so the body can function better. It’s vital to see a health care professional immediately if stiffness results from an injury, accompanied by pain, it does not go away with home treatments, or if an insect bite or infection could be the cause.
Individuals should speak to a healthcare professional for frequent stiffness that interferes with their quality of life.
Most of the time, stiffness can be treated at home and reduced through preventative measures.
Stay active but not too hard until the body gets used to the activity.
Various relief methods include a warm bath, massage shower, or self-massage.
Intense Work or Exercise
The muscles incur tiny tears when exercising or performing heavy labor, especially when the body is not used to the intensity or duration.
These tears are normal and help build larger and stronger muscles.
Individuals may feel stiff and sore for 24-72 hours as the body repairs itself.
Inflammation surrounding the joints/synovial fluid after heavy activity or repetitive movements is another cause.
Inactivity
Moving around generates the synovial fluid that lubricates the joints.
When body movement stops, like going to sleep or long periods spent sitting, working, or watching tv, fluid production slows down, resulting in body stiffness.
The lack of fluid after movement can make the body feel stiff when returning to activity.
Unhealthy Posture
The body can become stiff and sore when routinely holding the body in a way that strains the muscles, tendons, and ligaments.
Sitting or standing incorrectly from an unhealthy workstation setup or postural habits contributes to stiffness and musculoskeletal problems.
Medical Conditions
Medical conditions can cause stiffness like rheumatoid arthritis, Lyme disease, thyroid disease, strains and sprains, and low vitamin D levels.
See medical attention if you suspect any medical causes are behind the body stiffness.
Prevention
Depending on the reason behind body stiffness, there are ways to prevent it.
Warm-Up
Warming up before any physical activity loosens up the muscles before fully engaging.
Soreness will present and is part of the muscle repair process.
Properly warming up can help the repair go faster.
Mobility and Flexibility Breaks
Taking breaks from inactivity by getting up and moving around, walking, or performing mobility movements could increase the secretions of joint fluid, prevent stiffness, and relieve the effects of poor postural habits you may have been making.
Set a timer to break up periods of inactivity and move around.
Get up for 5 minutes every hour to move the muscles and get the blood flowing.
Stay Aware of Posture and Form
Postural awareness can help prevent muscle strain that leads to stiffness.
Adjusting the workspace and posture can help prevent stiffness.
The posterior chain: head, neck, torso, and legs are aligned with the feet flat on the floor and back supported.
Stay Active
Maintaining muscle movement maintains blood circulation, which can help reduce stiffness.
Exercise helps reduce inflammation, increases synovial fluid production, and helps strengthen the muscles.
Active Recovery
Participating in active recovery can help bring blood flow to the muscles and prevent inflammation.
Light cardiovascular activities include swimming, cycling, walking, or bodyweight movements.
Anti-Inflammatory Nutrition
Anti-inflammation nutrition like the Mediterranean diet, which includes healthy fats, plenty of fruits and vegetables, lean proteins, seafood, and whole grains, can help reduce aches and stiffness.
Getting enough vitamin D can reduce stiffness.
Chiropractic Flexibility Restoration
Chiropractic adjustments, decompression, MET, and therapeutic massage techniques can relieve muscle soreness and stiffness and restore body function. The chiropractic team will evaluate the individual, diagnose the cause/s, and develop a personalized treatment plan. The team will provide posture training, stretching the body, using a percussive massager or foam roller to break tight, stiff muscles and release adhesions of tissues.
Enhance Your Lifestyle
References
Mailey, Emily L et al. “Comparing the effects of two different break strategies on occupational sedentary behavior in a real-world setting: A randomized trial.” Preventive medicine reports vol. 4 423-8. 9 Aug. 2016, doi:10.1016/j.pmedr.2016.08.010
Schleip, Robert, and Werner Klingler. “Active contractile properties of fascia.” Clinical Anatomy (New York, N.Y.) vol. 32,7 (2019): 891-895. doi:10.1002/ca.23391
Shimoyama, Daisuke, et al. “Reliability of shoulder muscle stiffness measurement using strain ultrasound elastography and an acoustic coupler.” Journal of medical ultrasonics (2001) vol. 48,1 (2021): 91-96. doi:10.1007/s10396-020-01056-0
Trube, Niclas, et al. “How muscle stiffness affects human body model behavior.” Biomedical engineering online vol. 20,1 53. 2 Jun. 2021, doi:10.1186/s12938-021-00876-6
Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
Percussive massage guns have become a standard tool in osteopathy, physical and massage therapy, and chiropractic care. They provide rapid bursts of force into muscle tissues to quickly loosen and relax the muscles to alleviate soreness, stiffness and increase circulation. Percussive massager therapy devices can be a healthy part of an exercise and recovery routine. They allow individuals to give themselves quick, powerful massages anytime and anywhere. But they need to be used correctly to reap the benefits.
Percussive Massager
These devices can be found in stores and online. Many are on the market, making it tough to separate high-quality massagers from low-quality ones. With a little research and advice from a physical therapist or chiropractic professional, they can help the individual get the right one and training on how to use them to maintain a healthy musculoskeletal system.
Percussive Therapy
Massage guns utilize percussive therapy or vibration therapy, sometimes simultaneously. Percussion and vibration therapy are slightly different. They are soft tissue manipulation, which reduces muscle soreness and post-physical activity, and workout fatigue.
Vibration therapy uses vibration movements to relax the body, alleviate stress and improve circulation.
Vibration therapy applies force to targeted areas but with less intensity.
This type of soft tissue therapy is generally defined as reaching eight to 10 millimeters into the soft tissues.
Vibration therapy is often recommended for individuals with chronic pain conditions, overly sensitive muscles, or a medical condition that prevents them from using percussive therapy.
Percussive therapy involves the application of force to muscles and fascia to break up adhesions and increase circulation to sore and sensitive areas.
Percussive therapy extends deeper into the muscles and reaches deep into soft tissue, estimated to be about 60% deeper.
Using It Properly
It’s important to know how to use the machine to get the most out of a percussive massager. Using the massager incorrectly can lead to further injury or the development of new injuries.
Before Workouts
A pre-workout massage session can help warm up the body by increasing circulation and improving the range of motion of the muscles that will be engaged during the workout. Spend one to two minutes massaging each muscle group that will be worked out, plus 30 seconds on supporting muscle groups. For example, here is a pre-workout massage for a leg workout.
Sixty seconds on each quadricep.
Sixty seconds on each hamstring.
Thirty seconds on the lower back.
Thirty seconds on each calf.
Circulation increases in less than five minutes, and the muscles are ready for exercise. However, this does not replace proper warming-up like dynamic stretching and light cardio to increase heart rate.
After Workouts
After working out, a percussive massage can be part of the cool-down.
Post-workout percussive therapy can help return the body from a heightened state to a resting state.
Percussive therapy helps reduce inflammation, which helps reduce post-workout muscle soreness is thought to occur due to microscopic tears in muscle fibers and inflammation in the tissues.
Percussive therapy maintains increased circulation after a workout, providing oxygen and nutrients to tired muscles.
The massage helps relax the nervous system by reducing soreness and pain signals, similar to a TENS unit.
Sore Muscles
The muscles may still be sore a day or two after working out. This is called delayed-onset muscle soreness/DOMS.
A percussive massage can help but may not completely alleviate DOMS but it will provide temporary relief.
The massager’s speed and depth settings should be adjusted to where they don’t cause pain.
Sore muscles tend to remain sensitive, and it is recommended to use the lower settings.
Once a setting feels good, use the massager for one to two minutes on each sore area.
How Not to Use
Individuals are recommended to consult a doctor if not sure of percussive massage therapy and should avoid using a percussive massager on:
Musculoskeletal injuries – sprains and strains.
Bony areas.
Areas of severe or unexplained pain.
Sensitive areas.
Bruises or open wounds.
Individuals with arthritis, osteoporosis, fibromyalgia, or other musculoskeletal conditions.
Percussive massage devices are safe to use for muscle soreness and as a tool to improve fitness.
Individuals can safely use a percussive massager every day as long as they use proper techniques and don’t exceed the recommended usage time, usually provided with instructions on how long to use the device during a session. And some massagers have an automatic shut-off so the individual doesn’t exceed the recommended time.
Revitalize and Rebuild with Chiropractic
References
Cheatham, Scott W et al. “Mechanical Percussion Devices: A Survey of Practice Patterns Among Healthcare Professionals.” International journal of sports physical therapy vol. 16,3 766-777. 2 Jun. 2021, doi:10.26603/001c.23530
Dupuy, Olivier, et al. “An Evidence-Based Approach for Choosing Post-exercise Recovery Techniques to Reduce Markers of Muscle Damage, Soreness, Fatigue, and Inflammation: A Systematic Review With Meta-Analysis.” Frontiers in physiology vol. 9 403. 26 Apr. 2018, doi:10.3389/fphys.2018.00403
García-Sillero, Manuel et al. “Acute Effects of a Percussive Massage Treatment on Movement Velocity during Resistance Training.” International journal of environmental research and public health vol. 18,15 7726. 21 Jul. 2021, doi:10.3390/ijerph18157726
Hotfiel, Thilo, et al. “Advances in Delayed-Onset Muscle Soreness (DOMS): Part I: Pathogenesis and Diagnostics.” “Delayed Onset Muscle Soreness – Teil I: Pathogenese und Diagnostik.” Sportverletzung Sportschaden : Organ der Gesellschaft fur Orthopadisch-Traumatologische Sportmedizin vol. 32,4 (2018): 243-250. doi:10.1055/a-0753-1884
Imtiyaz, Shagufta, et al. “To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS).” Journal of Clinical and diagnostic research: JCDR vol. 8,1 (2014): 133-6. doi:10.7860/JCDR/2014/7294.3971
Konrad, Andreas, et al. “The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance.” Journal of sports science & Medicine vol. 19,4 690-694. 19 Nov. 2020
Muscle knots or trigger points are tissues/segments of muscle fibers stuck in a contracted state and balled up or become entangled. To the touch, they can feel like small bumps, nodules, or knots. They are primarily found in muscles, but they can also be found in tendons, fascia, periosteum, and ligaments. Tight muscles can limit flexibility, increase discomfort and pain symptoms, and cause further injury that can develop into chronic conditions. Trigger points can develop in all muscles and multiple muscles simultaneously. The Injury Medical Chiropractic and Functional Medicine Team can create a personalized treatment plan for trigger point alleviation.
Muscle Knots Trigger Points
When muscle fibers are stuck in contraction, blood circulation decreases in and around the affected area, and the necessary nutrients and oxygen cannot be delivered. The excessive accumulation of the chemicals – acetylcholine, and calcium leads to a lack of oxygen in the area, which causes muscle fiber contraction and spasms. As the muscle fibers overly contract, they form a knot. Waste materials build up in the fibers as the blocked circulation doesn’t allow removal. This irritates the trigger point, which reacts by sending out pain signals. The brain responds by telling the body not to use that muscle, causing the muscle to tighten, become weak, and lose range of motion. The other muscles have to work harder to compensate.
Trigger Point Types
Active and Latent
One type is an active trigger point.
The trigger point causes pain and discomfort even when the muscle or tissue rests.
The other type is latent, which means that the point does not cause pain or is sometimes even noticed until pressure is applied to the point or area.
Because key trigger point muscles are weakened, the muscles around that point need to work harder, causing multiple knots to form.
Referred pain happens when a satellite trigger point causes sensations in a different area from the point itself.
Causes
The main causes include the following:
Direct Trauma
Muscle trauma or injury can cause fibers not to heal properly, causing segments to stay deprived of oxygen and knotted.
Excessive and Extended Exercising
During exercise/physical activity, profound muscle strain and injury can occur from pushing too hard for too long without proper recovery and repair.
Maintaining Healthy Posture
Unhealthy postures can cause tension, stiffness, and aches and pains.
Stress and Fatigue
Emotional and physical stress takes a toll on the body, which can result in excessive muscle contraction.
Most of the time, it happens subconsciously without realizing that the body is tensing up.
This is why engaging in relaxation activities, including therapeutic massage, is important.
Inactivity
Lack of physical activity and a sedentary lifestyle can cause muscle spasms and over-contracting, leading to muscle knots.
Medical Conditions
Conditions that affect muscles, like arthritis and fibromyalgia or medications, can cause muscle spasms and the development of trigger points.
Chiropractic and Massage Therapy
Chiropractic and therapeutic massage is an effective treatment to relieve muscle knots and symptoms and restore the body to optimal function. Massage uses various techniques to increase blood circulation, break down inflexible scar tissue and stretch and loosen muscles. Pain and discomfort decrease by allowing the muscles to move and restoring blood flow.
Massage Therapy Chiropractic Care
References
Barbero, Marco, et al. “Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain.” Current Opinion in Supportive and palliative care vol. 13,3 (2019): 270-276. doi:10.1097/SPC.0000000000000445
Cheung, Karoline, et al. “Delayed onset muscle soreness: treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. doi:10.2165/00007256-200333020-00005
Money, Sarah. “Pathophysiology of Trigger Points in Myofascial Pain Syndrome.” Journal of Pain & palliative care pharmacotherapy vol. 31,2 (2017): 158-159. doi:10.1080/15360288.2017.1298688
Moraska, Albert F et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo-Controlled Trial.” American Journal of physical medicine & Rehabilitation vol. 96,9 (2017): 639-645. doi:10.1097/PHM.0000000000000728
Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
Massage is part of integrative medicine and can be used for various medical conditions. In massage therapy, a therapist rubs and kneads the body’s soft tissues, including muscle, connective tissue, tendons, ligaments, and skin. The therapist varies the amount of pressure and movement. Individuals often start feeling the effects right away. One of the benefits is increased temperature. Increased temperature amplifies blood flow and circulation, enabling muscular and connective tissues to release restriction, and muscle tightness, relieve tension, and improve movement. A massage therapist will use different techniques to increase the temperature to treat various conditions.
Increased Temperature
Some patients want to know why their muscles heat up or burn during a massage. Muscles burn because of the accumulation of waste in the cells. The waste products are released as a result of massage. The muscles release lactate, a byproduct of glucose. The effects of deep tissue massage are almost the same as the effects of exercise. During the massage:
The demand for oxygen in the tissues increases.
Because of this, blood flow circulation to these tissues increases.
This is necessary to supply oxygen and glucose.
It excretes waste substances and toxins.
Muscle heat or burn during massage differs for everybody. Some individuals don’t feel it at all. The session can be so intense that the muscles can’t clear the lactate/toxins fast enough, causing the burning sensation.
Fascia Circulation
The temperature of the fascia can also be increased. Fascia is the thick, fibrous layer of connective tissues beneath the skin that can often become restrictive. Increased temperature in the superficial and deep tissues releases, relaxes, and loosens tight, tense, shortened, and/or injured areas, allowing muscular tissues to increase in elasticity, flexibility, and relaxation. Heart rate is raised, improving circulation and increasing the delivery of oxygen and nutrients to the affected areas and the rest of the body.
Myofascial release involves slowly applying pressure to the area using flattened hands and fingers.
The slow, soft pressure increases the temperature of the fascia.
As the hands and fingers get deeper within, they slowly move around, spreading the fascia.
This releases the tightness and relieves the pain.
An individual’s posture can improve when the temperature is increased. Muscular tension and tightness can cause increased pain symptoms, not allowing healthy posture.
Muscle Burn Relief
Rehydrate
Drink plenty of water after the session is over.
Water maintains proper circulation for excreting waste products and nourishes the muscle cells with fresh nutrients and oxygen.
Avoid coffee and alcohol as they increase urination and blood osmolality and dehydrate the body.
Stretching
Stretching before and after a session can relieve muscle soreness.
Stretching exercises increase blood flow.
Stimulates the release of synovial fluid around the joints.
Sleep
Get plenty of rest after a session.
The body knows how to restore itself; during sleep, it reduces cortisol secretion.
It increases the stimulation of antioxidative hormones to go after free radicals.
Herbal Remedies
Herbal remedies like ginger, garlic, cloves, and cinnamon increase blood circulation, reducing pain and swelling.
They have anti-inflammatory properties that help with muscle burn and soreness.
After a session, a little peppermint or CBD oil can relieve the sore parts.
Chiropractic Success Story
References
Dion LJ, et al. Development of a hospital-based massage therapy course at an academic medical center. International Journal of Therapeutic Massage and Bodywork. 2015; doi:10.3822/ijtmb.v8i1.249.
Rodgers NJ, et al. A decade of building massage therapy services at an academic medical center as part of a healing enhancement program. Complementary Therapies in Clinical Practice. 2015; doi:10.1016/j.ctcp.2015.07.004.
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