- Hello, massage nerds.
Someone asked me recently if I could do some pathologies.
So I decided to start a series now
of pathologies of each body system.
So this was for you Cruz, thanks for the suggestion.
And I wanna start today
with muscular system pathologies, the most common ones,
and there's a few things that I like to talk about
before we start, because, you know, as massage therapists
we always got to think of the contraindications
and some tips that we must know and learn
because most people that walk in through our doors
usually have, you know, something going on,
and, you know, they're not just coming in most of the time
for a relaxation massage, even though that's very good.
Most people nowadays have several things going on.
So one of the things that you must always remember
with any of these is that, you know,
if they have inflammation and remember itis,
the, the suffix of itis, means inflammation or heat.
So if they're have inflammation,
you don't wanna work on them,
you wanna wait until the inflammation has, has gone down.
Also, if they've been in a car accident
or any type of an accident actually, you must wait 72 hours
for the simple reason that your body's still running
on adrenaline for, you know, for a day or two.
And you might not feel any, you know, real injuries until
after that, the adrenaline, you know, clears from your body.
So it's better that they get an okay from the doctor
get checked by the doctor,
and after 72 hours, you can start working on them.
And I wanna talk a little bit
about the difference between syndrome and disease,
just so that you guys can get an idea.
You know, some of them are syndromes,
some of it is a disease.
So a disease is a specific correlation,
a specific cause, like high glucose is a specific cause
for, you know, diabetes.
So you already know cause and effect,
so that's a disease.
And syndrome is a group of symptoms,
a group of patterns that take the body out of homeostasis.
So it interrupts homeostasis like in the instance
of fibromyalgia syndrome, myofascial pain syndrome.
So those are syndromes, okay,
because it's a group of symptoms.
So with all that being said,
let me start by talking to you about myasthenia gravis.
And I had a client with myasthenia gravis,
so I wanted to, it's not in the book
but I wanted to touch a little bit on that.
That is a neuromuscular condition.
Remember neuro muscular, if you break it down,
the prefix and the root word,
so it's the connection with the nervous system
and the muscle.
Now you have the sarcolemma, the sarcolemma is the,
the muscle cell membrane and it's got, you know,
the motor end plates where it's kind of curved
and then you have the nerve, okay.
The nerve releases acetylcholine
which is a neurotransmitter,
and then the sarcolemma receives that message.
And myasthenia gravis is where the breakdown happens,
right at that neuromuscular junction,
the muscle does not receive the message.
This only happens in a skeletal muscles only,
it does not happen in your heart
and in your smooth muscle.
Thank God, those are from the autonomic nervous system,
so they are not affected.
However, it does affect the lungs
because as you can, as you well know,
even though we do breathe automatically at night,
we do have some control over our breathing.
So it can cause, you know, damage to the lungs muscles,
and that's where it becomes very dangerous.
So, anyway, that's just a little bit
about myasthenia gravis.
So let me start now with the De Quervain's tenosynovitis,
and remember, anytime you see itis, is inflammation or fire.
So that means that the tendon is, you know, swollen here
and it's in particular, the tendon sheath.
And tendon sheath is a thin layer, you know,
around the tendon.
So that's swollen and it causes pain
and this happens on the radial side,
remember the radial side, in anatomical position,
is where your thumbs are.
So it happens right here
more or less at the carpometacarpal joint.
Actually, this is what's wrong with my hands
because of, after working for 32 hours
and using, over using my thumbs,
so it happens with repetitive motion and with injuries,
you know, I've, I've damaged mine.
So one of the things that you might wanna do is with this,
this is a cryo-stick is, you know, apply a little bit,
you know, of ice, you know, on the wrist and the thumb
because it does affect the abductor pollicis longus.
And I was just teaching my students
on how to break down the names of the muscles,
and I don't think I have time to go into all of that
but abductor means that, you know, abducts the, you know,
the muscle away from the midline, adductor would add it.
So this muscle right here gets very affected,
you know, with tenosynovitis.
So you might wanna start with a little bit of cryotherapy
to kind of, you know, relax the muscle a little bit.
So that's one thing that you can do.
So that would be the, the De Quervain's tenosynovitis.
Next is tension headaches.
They are due to stress, tension, hormonal, sinus,
they can be occipital, you know,
from the occipital bone or frontal, you know, or temporal.
So it depends where the headaches are, you know,
would you believe that it's anywhere from 60-80% of,
of mainly women that get migraine headaches, you know,
but most of them are tension headaches.
So you really wanna check the suboccipitals,
because the suboccipitals, you know, behind, you know,
the occiput, right below it,
are also known as ghost headaches.
So a lot of times when the suboccipitals are really tense,
it may cause some headaches.
Now also, you know, if you're, if you have sinus infection
or if your sinuses are swollen, you know,
that's also gonna give you a sinus headache
and hormonal, that has to do with hormones.
But what I, you know, advice to a lot of my clients
is to use ice because it prevents the blood flow
from pounding in your head.
And so I do try to apply a little bit of ice
or, you know, cryotherapy when they have tension headaches.
So next will be fibromyalgia, fibro, meaning the fiber,
myo meaning muscle, and algia means pain, syndrome.
So this is a group, you know,
a group of symptoms that causes fibromyalgias,
it's widespread pain, it's an,
you have, clients have tender spots,
they get very fatigued and, you know, stiffness.
So this you really have to take
into consideration your client,
every client's different.
Fibromyalgia and myofascial pain relief are similar,
you know, and I have also found
that every client is different every time they come in.
One day, you know, they can take a little more pressure,
another day they don't.
So get to know your client, find out, you know,
let them give you enough feedback as to how they feel
because you don't wanna over work it.
One day they might say, "Oh, I feel really good."
And you go a little deeper,
and there'll be sore for two or three days.
So be very careful with that,
you know, you wanna stay away from going in
and especially from some people that like to do deep tissue
you know, that's one of the things that I always teach is,
you know, I, I, you don't have to do deep tissue,
you have to be more specific.
So for, you know, fibromyalgia or myofascial pain syndrome
you wanna do more of a Swedish
and you also wanna do some trigger points
especially on the MPS because it's found and taut bands.
So they do have trigger points,
and you can address those trigger points.
Remember you stay always
within the pain tolerance of the client,
usually a four, a five and a six on a scale from 1-10.
You know, if you, if they say the pain is already a seven
or eight, please back off, you never wanna, you know,
do more than what the client can handle
because it will, you know, have severe consequences
after where they're really sore.
They might not wanna come back.
So low pressure is better.
And like I said, it varies from time to time,
and client to client.
Next is the Osgood-Schlatter disease.
So this is a direct cause, we know what causes it,
it's patellar from the knee cap, tendonitis,
tendonitis, you know, if you look at the suffix
and you know, and the the suffix itis means inflammation
and the prefix tendon, so it's inflammation of the tendon.
It's very common with teenagers, you know,
usually between the ages of 11-13,
but I've seen as, you know, as far as 15.
So it varies on age, but it's very common in male teenagers
because they're usually the ones playing sports.
You know, they're usually the ones
that are out there playing soccer, football,
running, jumping, so it's very common
and it is called Osgood-Schlatter disease,
and it's patellar tendinitis, so it's swollen.
Again, you know, if it's not too swollen,
I mean if it looks like a baseball,
then yes, refer it to the doctor,
but if it's not that bad,
you might wanna use some cryotherapy, you know,
whatever you have.
I just like to use the stick because it's a little bit,
you know, like for the, for the wrist and thumb,
but you can use whatever you have at your office.
It causes, it's caused by repeated stress or sports.
Next is number six, which will be the plantar fasciitis
plantar, meaning that it's from the planter part
of your foot, fasciitis is from the fascia
and it is from being swollen.
However, I did hear a doctor recently,
I even posted this on my Instagram,
that he said "We should rename the plantar fasciitis."
Because the band is so thick,
that it doesn't really get swollen,
it just gets really tight.
And it starts from the calcaneus, which is your heel bone,
and then it fans out, you know, all the way to your toes
and it's pulling, it can also cause, you know,
like the heel spurs and it it's just really a tight band.
So it's a thick band at the calcaneus
that fans out to the toes, and it's very painful,
it's very common.
I've had many clients that have this,
people that stand on their feet too long,
you know, athletes, people that work standing up all day
can be, you know, people that, you know,
sometimes wear heels.
So this is very painful.
One of the things I recommend to my clients
is to get a, just a 12 ounce bottle of water and freeze it
and then put your foot on it
and roll with your own pressure, you know,
that you can handle, is roll your foot
over that frozen water.
'Cause it does really help bring down the pain
and the swelling of the muscles.
So that's the plantar fasciitis.
Next is the shin splints.
Shin splints is, has to do with the tibia,
with the tibialis anterior actually.
So it's in the medial tibia, and tibialis anterior,
and it's very common with runners.
You know, usually, you know,
one side unilateral, uni meaning one, bi meaning two.
So however it can be bilateral, so it can affect both sides.
So it's right along the tibia,
and it's very important for you to really work out
and get into the tibialis anterior muscle,
the origin and the insertion.
So that's an important one.
Next will be strain and sprain.
So strain with a T, has to do with the muscles, you know,
and sprain is with ligaments.
So I just wanted to mention the difference
between sprain and strain.
For this, you know, for this pathology,
we're gonna be talking about strains,
'cause that has to do with tendons and with muscles.
So you have a type one strain and that's mild,
a type two which is moderate and then a type three.
And what that means is it has to do with a tendon.
You know, sometimes the tendon gets really pulled,
you know, taut and so if it's mild, you know,
they feel pain, you know, they,
it's what they call a pulled muscle.
So this like, they may feel a pulled muscle,
that's a type one, if there's a little bit of bruising,
you know, and it's really painful and swelling,
that's probably a type two.
However, when they tear that tendon right off, you know,
the bone or the muscle, that's a type three
and they get very bruised,
and that's usually when, you know, I mean,
they definitely have to go to the doctor for that one,
and we definitely can't touch that.
That's one thing to be very careful with guys,
if somebody comes in and that happened to me too,
I mean, what can I say after 32 years,
I think I've seen so much already,
but I had a client that had been in a motorcycle accident
and his muscle was purple and swollen,
and it was one of his adductors and he couldn't even walk
and he wanted me to work on it, but I knew better.
Thank God I knew better,
because I knew that if I started stretching it
and working on it and it was torn,
I was only gonna do more damage.
So be careful guys, you know,
find out if it's a type one, two or three strain.
So strain with a T has to do with tendons.
A sprain has to do with ligaments
and ligaments attach bone to bone,
and tendons attach bone to muscle.
Now let's move on to torticollis,
torticollis is a spasm of the SCM or sternocleidomastoid,
and it also the trapezius might be involved, the scalings,
and it's usually, and the splenius capitus.
Splenius capitus in the posterior part
is the mirror image of the SCM.
So, you know, sometimes people wake up,
is usually, usually unilateral,
you know, it's usually one side where you can't,
like when you're driving, you know,
you wake up like this and sometimes, you know,
people wake up like this and they can't turn their head.
You know, it's usually the SCM.
So you wanna make sure and work these muscles,
moist heat is very good for torticollis,
moist heat is very easy.
You just get a washcloth and use warm water,
not to burn themselves, but warm water,
wring it out and put it directly on the muscle,
that really helps the muscles relax.
You know, I'm old school,
so I usually try to do home stuff.
That's not cheap, I don't go for buying a lot of,
you know, things to help, you know,
same thing with the ice or cryotherapy.
So moist heat is good for that, you know, and,
you know, if you can't drive,
people they can't drive and turn their head,
'cause it hurts, very important for you to be very careful,
work the SCM, the sternocleidomastoid, the scalings,
and you must be trained for that,
because remember in the little triangle here,
we have blood vessels
so you don't want your client to pass out.
So you've gotta know what you're doing
but you can work, you know, the splenius capitus, trapezius
and all the muscles around there too.
So that will be torticollis,
and tendonitis, tendinosis and tenosynovitis.
Let's talk about that.
So tendonitis is inflammation of the tendon,
you know, if you split it, you know,
the root word is tendon, itis is the suffix.
So this is inflammation of the tendon,
tendinosis, osis is degeneration of the tendon,
where it starts getting frail, you know,
the, the tendon attaches the muscle to the bone
and, you know, maybe after repetitive motion or an injury,
it's like, it's like when you have a piece of thread,
you know, a thread or a yarn there starts frailing,
you know, or the end of your shoelaces
start frailing, coming apart.
That will be tendinosis, you know,
it's coming apart, it's becoming frail.
And a lot of times people need surgery,
you know, to fix this.
And the last one will be tenosynovitis,
and this is inflammation of the synovial sheath.
Remember this, you know,
that the tendon sheath surrounds, you know,
it's a thin layer that surrounds the tendon.
So this is tenosynovitis.
A lot of times, you know,
tend, tendinosis and tendonitis are misdiagnosed.
You know, it's difficult, you know,
if they don't have a medical doctor, you know,
that can really diagnose these things,
they've got to come in and tell you what it is, you know,
so that you can be careful.
And that's the difference between the three.
So tendonitis is inflammation of the tendon,
tendinosis is degeneration of the tendon,
and tenosynovitis is inflammation
of the synovial sheath around the tendon.
So these are some of the very common pathologies
of the muscular system.
And I do plan to do one for every or every body system.
So I think I'm gonna tackle the skeletal system next.
Oh, and for my students, next is the integumentary system,
so I'll be doing that.
So thank you for your support,
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and until the next time, create a great day.