As we get into the summer outdoor season here in Ontario, it’s time for a reminder from your friendly neighbourhood RMTs about when to use HOT or COLD to treat muscle strains and sprains!
Muscle of the Month: Peroneals (Longus, Brevis and Tertius)
Your peroneals are the three muscles that sit on the outer side of your lower leg. They are also known as fibular muscles, as they run along your fibula, the outer bone in the lower leg. The three muscles are categorized by lengths: longus, the longest of the three; brevis, the shorter one; and tertius, the third of the peroneals that attaches to the lower third of the fibula.
Muscle of the month: Rhomboids
Weak or torn rhomboids are common these days. Hunching over our computers and mobile devices works against the rhomboids, causing them to lengthen, become weak, and form painful trigger points and muscular tension. As a massage therapist progresses through a client’s back muscles, the rhomboids can feel like taut ropes, snapping back at us.
Actions: Retraction of scapula (squeezing shoulder blades together), downward rotation of scapula, keeping scapula fixed to rib cage.
Common pain culprit: Hunching, poor posture, taut or excessively strong chest muscles.
There are two separate rhomboids (Major and Minor), though they have the same actions (see above). When the rhomboids are weak and overworked, it is common to see shoulder blade “winging” (the bottom edge of your shoulder blade appears to lift away from your ribs, like a wing), and a dropped shoulder. This is because the affected rhomboids are unable to contract and oppose other muscles that are overpowering them. Over time, the stretched rhomboid muscles develop trigger points, and become quite taut, giving rise to pain and even more dysfunction.
The fix: Improve posture.
Getting rid of the hunch and improving your posture will bring the rhomboids back to their rightful resting position, helping to alleviate pain. Here are a few tricks the RMTs at Body Poets give to clients:
Set an alarm throughout the day to remind you to sit up straight at your computer.
Sit as if there is a string attached to the centre of your head, gently pulling you straight.
Rotate your hands so that your palms are facing out, and squeeze your shoulder blades together.
Stretch your pectoral (chest) muscles throughout the day, so they don’t tighten up and overpower the rhomboids. Ask your RMT to show you how to do the “doorway stretch” or other pec stretches.
Muscle of the month: TMJ muscles
You might have heard the term TMJ being passed around lately. TMJ headaches, TMJ clicking, TMJ pain. But what exactly is TMJ and why is it causing pain? The TMJ is your jaw, or better known in the medical field as your temporomandibular joint (now that’s a mouth full!). The jaw is a complicated joint that is easily overused and can cause pain. Read on to discover if the muscles of your TMJ could be the cause of your headaches or jaw pain.
Masseter: The great restrictor
Actions: Closing an open jaw, clenching
Common Pain Culprits: Excessive grinding of teeth or clenching of jaw.
The masseter is the most superficial muscle of the jaw, and is easily felt by placing your fingers on your cheeks and clenching your jaw. The bulge of muscle that moves your fingers is your masseter. For those who clench their jaws during stressful situations or grind their teeth, this muscle is over-engaged, causing it to become irritated and to cause pain. Below are common pain patterns from trigger points in the masseter. Tooth, jaw and ear pain can all be caused by an irritated masseter. This muscle is also the strongest of the jaw muscles, so when it becomes irritated, it can restrict the opening of the mouth far more than any other muscle.
Actions: Closing an open jaw, retracting the jaw.
Common pain culprit: Chewing
Found on either side of your head, the temporalis helps to create the shape of your head. Easily felt by massaging your temple area, the temporalis can be treated during a face massage. The temporalis attaches into the jaw, so in order to treat the entire muscle during TMJ dysfunction, intraoral massage will be necessary. Trigger points in this muscle can refer into the teeth, and can also cause temporal headaches (as seen below).
Actions: Deviating the jaw from side to side. The medial pterygoid also works to close the jaw.
Common Pain Culprit: Grinding teeth
Those who grind their teeth are at highest risk of aggravating these muscles. This is because the medial and lateral ptreygoids work together to shift the jaw from side to side, an action commonly seen during tooth grinding. Trigger points in the muscle can cause ear pain too, which might mask the real dysfunction.
If you have been diagnosed with TMJ dysfunction, or believe it to be an issue, talk with your RMT about TMJ massage. Acupuncture is also a useful modality to treat TMJ dysfunction. Don’t let your jaw cause any more pain: get treatment today!
Muscle of the Month: Levator Scapulae
The levator scapulae muscles lie on either side of your neck and attach to the upper portion of your shoulder blade. The levator scapula (lev scap) is cleverly named after its main action: elevating the scapula (your shoulder blade). It is commonly tight, though it often goes unnoticed since the lev scap is deep to the upper trapezius. (Remember the trapezius?! Refresh your memory here.) Trigger points in the lev scap have different referral patterns than those of the upper traps (see below) and can be the true indicator as to which muscle is the problematic one.
Actions – Elevates scapula and rotates scapula clockwise (when neck is in a fixed position). Laterally rotates and flexes head (when shoulder is fixed).
Common Pain Culprit – Head-forward posture (e.g. at a computer); holding heavy purses or bags.
When the levator scapula is in a lengthened position, as with either of the above pain culprits, and then we engage it, it will need to do excess work, resulting in strain. For example, when we carry something heavy in our arms and then try to lift our shoulders, commonly the lev scap can strain. Think about the times you’ve taken an extra bag of groceries instead of making two trips. That burn in your neck is the lev scap working too hard! When you then try to muscle all those groceries up onto the counter, that’s when strain can happen. Look at the trigger point referral pattern below and you will probably remember a time you’ve felt that exact same pain.
The fix: Stretch and strengthen, and adjust your posture. Stretching the lev scap when you have pain will help the muscle loosen and return to a proper resting state. Strengthening the lev scap is a good preventative measure to allow the muscles to work longer and more effectively, without the strain.
Stretch – A very basic levator scapula stretch, the “sniff your arm pit” stretch, looks like this: http://www.youtube.com/watch?v=o6umvnWaRm8
Strength – Basic lev scap strengthening can be done wtih dumbell shrugs.
Dumbell shrugs: hold a small weight in each hand and shrug your shoulders as high as possible. Hold for one count and release slowly. Start with three sets of five, and build up to three sets of 12-15 before moving to a heavier weight.
Adjust your posture – At your desk, think of a string with a balloon on top lifting the top of your head toward the ceiling. Keep your ears centred over your shoulders.
Ask your RMT for assistance assessing your posture and the length and strength of your lev scap, and with any of these exercises.