Is massage safe when you are pregnant?

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

Recently a client asked me "is having heel pain first thing in the morning, just one of those things you have to put up with as you get older"?. What are the causes of Heel Pain? There are two major causes of heel pain, firstly a grumbling Achilles Tendon and secondly Plantar Fasciitis.  This week I am going to focus on Plantar Fasciitis.  Plantar Fasciitis is inflammation of the Plantar Fascia or the strong band of tissue on the sole of your foot that stretches from your heel to your toes that supports the arch of your foot and acts as a shock absorber when you walk.  The usual site of the pain with Plantar Fasciitis  is on the sole of the foot, see diagram below. How can I tell if my heel pain is Plantar Fasciitis? Plantar Fasciitis is characterised by the gradual onset of soreness and aching under the heel at its mid-point, which spreads forward along the inner side of the arch of the foot.   The ache or pain is often for the first few steps when you get out of bed every morning or after sitting at your desk for a long period of time. What causes Plantar Fasciitis

• Sedentary Lifestyles
• Being overweight
• Wearing shoes with too little arch support or cushioning
• Vigorous take off's, landings are fast turns during weight bearing sports.
• Wearing high heels too much.
• Excessive foot eversion (your weight is too much on the outside of your foot).

• Stand about 40 cm away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
• Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, then relax. Repeat six times. Try to do this exercise twice a day.
• Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Try to do this once a day.
• Sit on a chair with your knees bent at right angles and your feet and heels flat on the floor. Lift your foot upwards, keeping your heel on the floor. Hold the position for a few seconds and then relax. Repeat about 10 times. Try to do this exercise five to six times a day.
• For this exercise you need an object such as a rolling pin or a drinks can. Whilst sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day. This exercise is best done without shoes on.

I previously explain what NMT or Neuromuscular Technique is.  In this blog post I want to focus on how NMT works. With NMT when the static pressure is applied to the muscle, a message is sent from the muscles (via the golgi tendons & the muscles spindles both of which are part of the nervous system) to the brain and then the muscle relaxes.  Within the muscles

• Golgi tendons respond to load or force on the muscle
• Muscle spindles respond to the length of the muscle