At Inner Outer Health, many of our clients come in for massage and myotherapy seeking treatment for upper back and neck pain. The pain can result in headaches and migraines, and even referral pain or numbness down the arms.

A good percentage of these clients are working in environments that require them to have their arms forward and/or down - sitting at a computer, for example.  This can cause the back to slump and the shoulders to round forward, resulting in tight/shortened pectoral muscles, particularly the pectoralis minor.

This underappreciated muscle is the cause of so much of that pack and neck pain - but luckily, it's easy to stretch, and doing so regularly can help relieve stiffness and soreness everywhere!

Dr Jacob Harden from the USA has posted a fantastic pec stretch on Instagram that is guaranteed to help open up the chest area and alleviate sore shoulders, upper back and neck.

The key to success with this stretch is to make sure you do it every day.  We spend hours in the same position at work every day, so we need to reverse it with multiple stretch sessions throughout the day. Watch the video below!

Here’s how to do it:

• Find a broomstick or long pipe.
• Lay down on your back on an elevated surface such as a bed, table, massage table or weight lifting bench.
• Keep the spine in neutral alignment by ensuring that the ribs don’t rise up and the back doesn’t arch too much.
• First take a wide grip on the stick with boths hands, with the palms facing up.
• Whilst keeping your arms straight, slowly move the stick down towards the floor (above your head)
• If this doesn’t give a strong enough stretch bring the hands in closer to each other slightly and try again. Repeat this until you feel a good stretch.
• Once you have found the right position repeat the movement going up and down with your arms making sure you keep your neutral spine position.  
• Approximately 10 - 15 repetitions is recommended.

Watch the video and read the comments on the side of the video for more information.


For more information about pec stiffness and soreness, or if your pain is persistent, book in for a session with our amazing myotherapists today!

Are you struggling with aches and pains from carrying your growing baby?


Many parents of babies and young children are surprised by the degree of back, neck, hip, shoulder and wrist pain they experience on a daily basis, caused by simple tasks like picking the baby up from its crib, carrying the baby around, lugging heavy nappy bags, nursing, and even pushing a pram. And as your baby grows, the problems can get worse.

But luckily, there are some easy ways to improve your baby-lugging technique and as a result experience much less discomfort! In this post I’ll explore some back-friendly alternatives to the regular actions that are causing you pain, to help you strengthen and care for those crucial baby-wrangling muscles.

How to carry your baby:

The market is awash with ergonomic baby carriers and slings, and there are plenty of products designed to protect your back while you carry your bub. Reading reviews and talking to other new parents can be a great way to sort the wheat from the chaff and find the perfect baby carrier for you.

But what about when you’re just carrying the baby around the house or for short distances?

Research into indigenous cultures around the world conducted by Esther Gokhale indicates that all those fancy contraptions aren’t necessary - that instead, with good posture, and making sure to use major muscle groups to support the baby’s weight, babies can be comfortably carried for long periods in ways that strengthen your muscles and also aid the child’s posture.

• For babies under 6 months of age, she recommends carrying the baby on your side without jutting your hip out, and supporting the baby’s weight using your bicep rather than your wrist or hand, with the hand palm-upwards. Keeping your shoulders open and your spine straight in this position is important for your posture and your breathing, and the palm-up hand position improves circulation through the supporting arm. Switching sides when you begin to tire will ensure that you’re not overburdening one side. This position also encourages an upright spine in the child, which will lessen your load.
• For babies over 6 months, Gokhale suggests using a cloth wrap (or conventional baby carrier if you prefer) to carry the baby on your back, distributing the weight between your shoulders and hips and keeping the baby as close to your spine as possible. As the baby grows you will need to continually readjust the straps of your carrier or the position of your sling to make sure the weight is being borne comfortably.

How to pick up and put down your baby:

Take it nice and slow while you get used to the new motions, and pay attention to which muscles seem to be working the hardest. If you’re bending to pick up your baby from the floor, use your legs rather than your back to bear the load.

• Bend your knees and squat, keeping a straight back.
• Lift up your baby and pull it close to your body.
• Straighten your knees to stand.

This will prevent your from straining your back, neck and shoulders. Since this is a motion most parents do many, many times a day, every little bit adds up.

The method for putting your baby to bed is very similar.

• Hold the baby to your chest.
• Stand with your feet hip-width apart in front of the crib.
• Bend your knees before lowering the baby in your arms.
• Tuck your tailbone and tilt the pelvis to activate your core, and avoid twisting where possible.

To pick your baby up from the crib, perform the same action in reverse.

How to nurse:

Sit in a straight-backed chair rather than slumping on the couch, and try to keep an upright spine. Placing a rolled up towel or a pillow behind you can help. Bring the baby up to you, rather than hunching to reach the baby. Pillows and other methods for propping up the baby can assist with this.

Other helpful tips:

• Regular massage or myotherapy can help you to reset your body, relax your muscles and prevent long-term pain and injury from the day-to-day strain of carrying your child. These services are not a luxury - they are a crucial part of taking care of your body, which is just as important as taking care of your child’s health!
• Stretching can make a huge difference in counteracting pain and injury as well as improving your posture and baby-carrying technique.
• Use your baby, the weight you will be carrying most often, in your strengthening exercises! These simple exercises, using your baby’s weight to strengthen your core, back and legs, are an easy and practical way to fit some exercise into your busy parenting schedule, and to make sure your body is primed for the movements it performs most often.

Let us know in the comments if you’ve discovered any other tricks or tips that work for you. And don’t hesitate - book in for regular myotherapy and massage and take care of your body! Where would you, or your baby, be without it?

Do you suffer from knee pain? Did you know knee pain does not only affect sporting people but the aging population as well.

There can be multiple causes of knee pain. Some of these include:-

• Type of exercise you do (jogging etc)
• Over weight/obesity
• Hereditary reasons
• Referred pain from the back or hip
• Type of work
• Injuries
• Arthritis and
• More

Due to the shock absorbing nature of the knee, everyday wear and tear can take its toll on the joint. Not to mention the functionality of the knee makes it nearly impossible to immobilise and keep still.

Your knee is designed to absorb the pressure from gravity and your body to move the leg. Under this enormous pressure, the structures of the knee can be compromised. As you would know, it does not take much to dislocate or injure a knee enough and cause copious amounts of pain.

If this is sounds familiar to you or you know someone that does Myotherapy may be your solution.

As our society advances, so does our understanding of health care and the human body. It is for this reason that many people have now turned to a more holistic and preventative approach to their health, such as Myotherapy. Rather than taking medication that will only help once your health is already compromised. Myotherapy can be used to prevent injuries to the body, and aid the body to recover on its own.

Myotherapy can be used to treat a wide range of disorders including:

• Overuse injury such as tennis elbow or shin splints
• Sports injuries
• Tension headache
• Pain caused by poor posture
• Chronic back pain
• Joint pain, such as shoulder impingement syndrome
• Muscle sprains
• Stress

A lot of the time, people are only aware of a problem with their body once they are already in pain.  Regular myotherapy visits can help reduce the cause of muscle pain, tension and even injuries before they become problematic.

By targeting trigger points in the body your myotherapist can release pain and tension.

Trigger points are generalised as the irritability in muscles and their associated fascia. Trigger points are activated directly by overloading the muscle, overworking, fatigue and direct trauma. Myofascial trigger points can create different types of pain. It could be knife-like or stabbing, dull and achy, burning, numb or even tingly.

Trigger point pain can include headaches that are often diagnosed as tension, sinus or migraine, neck pain that radiates into the arm and forearm and into the lower back, thigh and leg.

Not only can a myotherapist treat you during a consultation, they can also teach you and show you many techniques to promote wellbeing and allow you to help yourself and strengthen your own body against illness and injury.

Click here to book and see for yourself.

Treatment for lower back pain is often pain medication is the first option people think about when treating back pain to get quick relief. This may be fine for short term, however until the cause is addressed and treated, the symptoms will continue to appear.

There are many different options for treating back pain, and depending on the cause, a combination of different therapies may be required. Since everybody is different, what works for one person may not work for the next, so it is important to find what works for you.

Trigger Points in Lower Back

Myotherapy is extremely helpful in reducing pain and tension through the body, as when muscles are tight, they can affect posture, and therefore tension throughout the whole body. Tightness through the psoas, quads, rectus abdominus, gluts and diaphragm tend to be muscles that are neglected in treating lower back pain. Working through these soft tissues with your myotherapy can bring about great results, even after one session.

Risk Factors for Developing Lower Back Pain
There are certain factors that can increase your risk of developing back pain, or aggravate it once you have it, including:

• Being stressed or anxious
• Poor posture
• Standing, sitting or bending down for long periods
• Lifting, carrying, pushing or pulling loads that are too heavy, or going about these tasks in the wrong way
• Having a trip or a fall
• Being overweight
• Weak core muscles
• Wearing incorrect shoes
• Sleeping on a mattress that is not suitable for you body
• Using the incorrect pillow - you should consider a pillow and sleep consultation at the clinic

Self Care for Lower Back Pain  
If you are suffering lower back pain, these are some of the things that your myotherapist can recommend to you to help, it if you can’t see a health professional straight away.

• Cool or Heat Therapy - Ice is best in the first 24 to 48 hours after an injury because it reduces inflammation. After 48 hours, you can switch to heat which will help to relax the muscles, as well as providing some pain relief. Whether you use heat or ice — take it off after about 20 minutes to give your skin a rest. If pain persists, talk with your myotherapist.
  
  

• Natural Pain Relieving Gels -  Sombra is a fast acting natural pain relieving gel that brings temporary relief to lower back pain and other forms of pain.
  
  

• Keep moving - As much as you may not feel like it, it is important to keep moving – keep doing your daily activities where possible. Moving will stop muscles and joints from stiffening up, which will only make the pain or discomfort worse. Only do what you can, don’t overdo it. Gentle movement such as walking and swimming are great ways to keep mobile. As you get better, increase your activity levels and your myotherapist will recommend exercises to help strengthen the muscles around your spine, pelvis and core muscles, as this will increase your back support.
  
  

• Stretch - Gentle stretching can really help your muscles to stay flexible and can help to reduce tightness. If you are sitting a lot, getting up to stretch your legs is important as inactivity (especially sitting for long periods) will only make your back pain worse. Or you can also try sitting on a firm chair instead if your soft couch.
  
  
• Watch your posture - Slumping makes it harder for your back to support your weight. Be especially careful of your posture when lifting heavy objects. Never bend over from the waist. Instead, bend and straighten from the knees.

Call Your Doctor If:

• You have weakness or numbness in your legs, or you have trouble standing or walking.
• You lose control over your bowels or bladder.
• Your low back pain is severe, doesn’t go away after a few days, or it hurts even when you’re at rest or lying down.

These could be signs of a nerve problem or other medical condition.

Preventing Lower Back Pain

It is good to take note of what you have been doing (or not doing!) that affects your back pain. Some ways to prevent lower back pain include:

Lower back pain does not have to take over your life. In many cases, there are ways to get the help and support you need, if you choose to find it. If you are suffering from lower back pain, why not try myotherapy and see for yourself how it can help you. You can make a booking online or you can call us on 9440 9453.

About Back Pain
Back pain is one of the most prevalent health conditions affecting at least one in ten Australians at any time. According to the Medical Journal of Australia, “up to eighty per cent of Australians will experience back pain at some point in their lives and 10% will experience significant disability as a result. Lifetime prevalence of low back pain is reported to be as high as 79.2% in Australian adults and 84% in adolescents”. One in four adults with back pain are reported to have fair to poor physical health, compared with one in nine of the general population. Back pain has been reported to double or even triple feelings such as sadness, worthlessness, hopelessness, as well as feeling like everything is an effort.

There is also a link between chronic pain and depression, and they commonly occur together. Depression is often associated with decreased function due to chronic pain, as people are unable to do the many things they would normally have been able to do without pain.

Back pain can refer to both upper and lower back pain. Upper back pain affects the mechanics of the lower back, so sometimes they will co-exist. This blog will focus on lower back pain.

What is Lower Back Pain?
Acute Back Pain vs Chronic Back Pain

Lower back pain can be experienced as pain or tension around the lower back area (lumbar spine) and can affect the spine, joints, ligaments and muscles as well as nerves.

The causes of lower back pain are varied, from either irritation to a nerve or muscle, to tightening of the myofascia (connective tissue covering a muscle) to physical damage or dysfunction of the spine… it can be either an acute or chronic condition, with different types of pain of varied intensities.

Generally acute back pain is considered pain lasting a few days up to 6 weeks, sub-acute back pain lasts 6 weeks to 3 months, and chronic back pain lasts longer than three months.

Anatomy of Lower Back
Lower Back Pain – Lumbar Facet Joint

Your back (spine) provides you with support, mobility and protects the spinal cord. The vertebrae articulate with each other via the facet joints along the spine, and are also separated from each other by a “shock absorber” known as an intervertebral disc.

The vertebrae are held together by ligaments, and create the site of attachment of the back muscles. Spinal nerves exit at the side of each vertebrae, which send messages to the muscles, organs and the brain.

The lower back refers to the lumbar spine area. It is a complex structure composed of the vertebrae (the bones of the spine), muscles, nerves, ligaments, and other soft tissues. Lower back pain can result from either injury and damage to any of these structures, or can also be caused by the spine and body being in mis-alignment due to tension in some muscles as well as the connective tissue (myofascial tissue / fascia).

Sometimes, it is actually not just muscular tightness, but fascial tightness that is the problem. Fascia is a web of connective tissue throughout our body that literally connects everything. It covers muscles, creates tendons and ligaments, covers organs and connects muscle to bone. It is a highly adaptable tissue, with elastic properties. Deep fascia can contract and is affected by the stress response. Fascia tightens, which creates tension. After the period of stress has passed, the fascia and muscles may remain in a state of tension, which can lead to damage, trigger points, adhesions and even create scar tissue over time.

 Commonly, the muscles that are responsible for creating pain in the lower back area, include:

• Psoas
• Quads – particularly Rectus Femoris
• Quadratus Lumborum
• Latissimus Dorsi
• Adductors
• Rectus Abdominus
• Gluteals

Fascia connects via Myofascial Lines or “Fascial Trains”, whereby muscle fibres that run the same direction connect via the fascia. Looking at the picture of the Superficial Back Line (one of 12 different Myofascial Lines”), you can see that fascia connects your head to your toes – literally! Fascial line tightness can contract not only the fascia covering the muscle, but can contract a whole line of fascia, creating overall tightness throughout the body, which creates musculoskeletal imbalances.

The thoracolumbar fascia is a diamond shape of connective tissue that is located directly over the lumbar spine area. It forms the attachment of the Latissimus Dorsi Gluteal muscles, and the Transverse abdominus muscle (core). This area can also become tight and contract, creating postural imbalances.

Causes
It’s sometimes hard to know exactly what causes back pain. It’s usually thought to be related to a muscle strain or mechanical dysfunction in one of the structures in your back, rather than just a nerve problem.

For many people with back pain, there isn’t any one specific underlying problem or condition that can be identified as the cause of the pain. Lower back pain can have many causes including:

Symptoms of Lower Back Pain
Symptoms of lower back pain can depend on the cause. Some common symptoms include:

• Muscle spasm and tightness
• Muscle cramps
• Stiffness
• Pain around the back and buttock areas
• Numbness
• Tingling
• Aches
• Muscle Spasm
• Locking joints creating a limited range of movement (ROM)
• Weakness

If you are experiencing these symptoms, book online now to see our Myotherapist today who can start treating you for your lower back pain.

In “Part 2″ our next blog will cover treatment options, self care and prevention of lower back pain, so stay tuned!

Ask yourself these questions:

1. When you wake up from sleep are your jaws clenched or your teeth sore?
2. Does your jaw lock, pop, grate, click or snap?
3. Do you have frequent headaches? How long do they last? What area of the head?
   
4. Do you have trouble opening and closing your mouth?
5. Have you ever had a whiplash injury or had a blow to the head or jaw?

From time to time, you may suffer from soreness or tightness of the jaw. If the pain continues to get worse or the tightness progresses to a place where eating, smiling or yawning is difficult, then there is a possibility that there is some dysfunction of the Temporomandibular Joint (TMJ). This can also be called TMJ Syndrome or TMJ disorder. It most often affects people aged 20-40, however anyone can be affected by TMJ problems at any age.

Did you know the muscles that move the TMJ are the same muscles you use to chew food (muscles of mastication), the masseter, medial pterygoid, lateral pterygoid and the temporalis muscles?  Your Myotherapist will address these muscles when you visit Inner Outer Health.

How do I locate the TMJ?

You can find this joint yourself by placing a couple of fingers in front of your ear, and open and close your mouth. You can also placing your index finger in your ear. When you do this action you will feel the TMJ move from under your fingers.

What is TMJ dysfunction/ TMJ Syndrome?

The best ways to describe this is to view the YouTube video below.

Symptoms of TMJ Dysfunction

Symptoms of TMJ can be very diverse, however the most common symptoms include:

• Migraine-like headaches where the pain is located around the side of the head or behind the eyes
• Headaches (usually tension or sinus)
• Neck-aches particularly at the base of the skull
• Vertigo / balance issues
• Ringing in the ears
• Ear pain
• Problems chewing or opening/closing the mouth
• Clicking or popping jaw
• Sore cheek muscles
• Stomach pain
• Lower back pain
• Poor posture
• Teeth grinding or jaw clenching
• Facial pain or tenderness
• Locking of the jaw
• Jaw mis-alignment or bite problems

Causes of TMJ Dysfunction

There are many possible causes for TMJ dysfunction, including neurological, muscular, vascular, problems with the joint itself or hysterical conversion . Other causes could include:

• Degenerative diseases - such as osteoarthritis or rheumatoid arthritis.
  
• Trauma - from things such as teeth grinding or clenching, which can cause inflammation around the TMJ and surrounding muscles.
  
• Age-related wear and tear
• Hypermobility – this occurs when the ligaments around the TMJ become lax.
  
• Stress - related muscular tightening. During periods of stress, we release adrenaline which is a hormone that tells your muscles to tighten, ready for action… however, over prolonged periods of time, if stress is chronic then muscular tightness may present in the facial muscles, especially around the jaw, accompanied by teeth clenching or grinding at night.
  

Generally speaking, pain or restriction around the jaw (joint or muscles) that occurs over an extended period of time can be termed dysfunctional.

Over time, the disc of the TMJ can wear and become very thin, or changes may occur to the disc due to dysfunction, which may create impaired movement of the joint. When there is dysfunction present, if it is not treated early on it could lead to disc degeneration and TMJ Syndrome.

TMJ dysfunction can be classed into three different categories:

1. Myofascial – generally presents as muscular pain or discomfort in the muscles surrounding the jaw. Myofascial Pain Dysfunction (MPD) Syndrome is also being included here, as muscles may be in various states of tension or spasm due to various causes. It is believed that there is a connection between Myofascial pain and psychological or emotional stress. Teeth grinding or clenching may also be present. In this case, TMJ pain may be secondary to these events.
2. Joint - issues such as disc displacement, dislocation of jaw, or injury to the bones around the joint.
   
3. Arthritis/degenerative joint disease – inflammatory joint disorder that can manifest in the TMJ.

Any one or more of these categories may be present at once. Most people have fairly mild cases of the disorder, whereas others may have persistent and chronic issues with their TMJ. Disc displacement is not uncommon.

How to Treat TMJ Syndrome

Often, jaw problems can resolve in several weeks to months. The TMJ.org site states that “less is best” when it comes to TMJ treatment.

If you have recently experienced TMJ pain and/or dysfunction, you may find relief with some or all of the following recommendations. Treatment for TMJ Syndrome / TMJ Dysfunction / TMJ Disorder can include:

• Physical therapy such as myotherapy to treat the muscular aspects of the TMJ dysfunction
  
• Dry needling
• Occlusal (bite) adjustment
• Oral appliances such as a dental plate or mouthguard to help protect teeth from grinding at night
• TMJ implants
• Dental or orthodontic care may be required to adjust bite and jaw alignment
• Sleeping position by reduce the amount of time sleeping on your side

Self Care

The following recommendations are ways that you can self-treat your TMJ disorder.

• Ice/ Cool Therapy - icing the area can decrease inflammation and also numb pain and promote healing. Keep an ice pack wrapped in a tea towel or clean cloth. Use ice for 10-20 minutes, then rest the area for 40 minutes, and repeat if necessary.
  
• Moist Heat – using a heat pack or a hot water bottle wrapped in a warm, moist towel can reduce pain, and improve function.
  
• Soft Diet – avoiding hard, crunchy, and chewy foods gives your jaw a chance to rest a little. Also avoid stretching your mouth to accommodate such foods as whole fruits.
  
• Relax Facial Muscles – relax your lips, and keep teeth apart as often as you can. Make an effort to be mindful of this.
  
• Relaxation Techniques – various forms of relaxation can help you to deal with the pain of TMJ dysfunction. Techniques such as deep, slow breathing can enhance relaxation and assist in pain management. Relaxation massage, yoga, meditation and floatation therapy can also be helpful in reducing stress and aiding relaxation.
  
• Jaw Exercises – to increase jaw mobility and promote healing, you can try slow, gentle jaw exercises. Your Myotherapist can recommend exercises for your jaw.
  
• Side Sleeping – when you are side sleeping try and alternate sides and use a supportive pillow between your neck and shoulder.
  
• Chew Gum – at all cost avoid chewing gum as can greatly aggravate the area.
  

At Inner Outer Health, we offer myotherapy which can help in the treatment of TMJ dysfunction by working through trigger points (knots) in the muscles around the jaw, neck, shoulders, and back and other techniques. Your Myotherapist can also give you specific exercises and stretches to do at home for your own self-treatment in between your sessions.

If you or someone you know is suffering from TMJ dysfunction, please share this information with them.