Why sometimes you need light pressure in a massage not just deep tissue?

Unfortunately no one totally understands what causes muscle cramps. Most authorities agree that in skeletal muscles they are frequently caused by the hyper-excitability of the nerves that stimulate muscles. Rather than thinking of a single cause of muscle cramps, I find it more helpful to think in terms of risk factors. A field study of 433 Ironman triathletes suggest that those so cramped had exercised harder than usual, had a family history of cramping and had previous tension or ligament damage. Because muscle cramps often occur due to muscle fatigue the problem may be related to nerve malfunction creates an imbalance between muscle excitation and inhibition which prevents the muscle from relaxing. (see Schwellnus et al 2004). In summary although muscle cramps are likely to be related to overexertion there are other contribution factors. References Shang G, Collins M and Schwellnus M (2001). Factors associated with self-reported history of exercise associated muscle cramps in Ironman Triathletes: A case-control study, The Clinical Journal of Sports Medicine 21(3): p204-210 Schwellnus MP, Nicol J, Laubscher R et al (2004). Serum electrolyte concentrations and hydration status are not associated with exercise associated muscle cramping in distance runners, British Journal of Sports Medicine 38(4): p488-492

I said in a previous post that scientists are interested in finding out how massage works.  So if we accept that massage reduces muscle pain, that leaves the question, "How does massage reduce muscle pain?". In 1965, Ronald Melzack and Patrick Wall outlined a scientific theory about psychological influence on pain perception; the ‘gate control theory’.  According to the gate control theory, pain signals are not free to reach the brain as soon as they are generated at the injured tissues or sites. They need to encounter certain ‘neurological gates’ at the spinal cord level and these gates determine whether the pain signals should reach the brain or not. In other words, pain is perceived when the gate gives way to the pain signals and it is less intense or not at all perceived when the gate closes for the signals to pass through. Cutaneous mechano-receptors are stimulated by touch (massage) and transmit information within large never fibres to the spinal cord.  These impulses block the passage of painful stimuli entering the same spinal segment along small, slowly conducting neurons. This theory gives the explanation for why someone finds relief by rubbing or massaging an injured or a painful area. For example, the pain gate theory explains "how"  a child feels better after mum or dad intuitively rub their knee when they have fallen over. In summary massage produces short term pain relief by being a particularly effective trigger for the pain gate process. References Melzack R, & Wall PD (1965). Pain mechanisms: a new theory. Science (New York, N.Y.), 150 (3699), 971-9  Moayedi M, & Davis KD (2013). Theories of pain: from specificity to gate control. Journal of neurophysiology, 109 (1), 5-12 Jacobs M. (1960) Massage for the relief of pain: anatomical and physiological considerations.  Physical Therapy Review, 40: 93-8 Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(3699):971–979. Wells PE, Frampton V, Bowsher D. (1988) Pain: Management and Control in Physiotherapy.  Heinemann Medical.  Chapter 13. Watson J. (1982) Pain mechanisms: a review.  1. Characteristics of the peripheral receptors.  Australian Journal of Physiotherapy.  27:135-43

Following on from my last article on elbow pain, I wanted to share with you some exercises for increasing the mobility and strength of your elbow joint.

1. Stand or lie down. Bend and straighten your elbow to its outer limits without creating pain. Repeat 5 to 10 times.
2. Sit with your forearm flat on a table and the palm of your hand against the table top. Then turn your forearm so that the back of your hand is resting on the table and then turn your forearm again so the palm of your hand is against the table.  Repeat 5 to 10 times.
3. Practice screwing and unscrewing a screw with a screwdriver, while holding your upper arm close to your body.   Repeat 5 to 10 times.
4. Hold a dumb-bell in your hand (or a can from your kitchen cupboard) and then bend and straighten the elbow joint.  Repeat 5 to 10 times.  You can gradually increase the weight to build strength.
5. Stand up and do press ups against a wall.  Ensure that you bend your elbow to the maximum and fully straighten your arms.  Repeat 5 to 10 times.
6. Hold a barbell in your hands (or a mop handle or broom handle), bend and straighten your elbow joint.  Repeat 5 to 10 times.

1. Flex one elbow joint to 90 degrees, then with your other hand resist your bent arm trying to touch your shoulder for 4 - 7 seconds and relax for 2 seconds.
2. Straighten your arm backwards and take hold of a banister or something similar with your outstretched hand and stretch for 6-8 seconds by bending your knees.