Low-level laser light is compressed light of a wavelength from the cold, red part of the spectrum of electromagnetic radiation. It is different from natural light in that it is one precise color; it is coherent (it travels in a straight line), monochromatic (a single wavelength) and polarized (it concentrates its beam in a defined location or spot). These properties allow laser light to penetrate the surface of the skin with no heating effect, no damage to the skin and no known side effects. Rather, laser light directs biostimulative light energy to the body’s cells which the cells then convert into chemical energy to promote natural healing and pain relief.
These are ways laser treatment has been found to help
Speeds Up Tissue Repair: Increased energy to the cells means increased cellular activity for all of the cell’s components that rely on this energy including collagen formation. Speeding up tissue repair means less scar tissue formation.
Increases Endorphins: Endorphins can produce analgesia (pain relief) and feelings of well-being. They are known as the bodies natural pain killers.
Increased Lymphatic Drainage: Studies have shown that cold laser therapy can increase the size of the lymphatic ducts thus facilitating protein waste removal.
Increased Blood Flow: to the tissues because of increased capillary formation. This helps healing. The laser affects deeper tissues as well including muscles and tendons.
Nerve Glides can help release a lot of the pain that comes from trauma and even arthritis. A lot of the pain may be originating from the nerves in a cascading effect which inflames surrounding soft tissue. The peripheral nerves in your arms and legs are mobile structures that can stretch when elongated. Injury and scar tissues can trap them but you can do special stretches called nerve glides to release these areas.
To see how your nerves move try this. Take your finger and touch your nose. Then bring your hand all the way out to your side and stretch it out as far as it will go. Next tilt your head away from your outstretched hand (if it’s your left hand, bend your head right). You will likely notice a pulling sensation in your hand and arm with your head bent. Now try to bring the head towards the hand, does it go away? This is a demonstration of nerve tension.
There is no muscle that goes all the way from your neck to the hand. Since bending your head away from the hand tightens the nerves that go from your neck to your hand, you feel pulling. If you feel pain, numbness and tingling, this is a problem you should tell your doctor about. Nerve glides can be used in multiple body areas not just the hand and neck. Nerve pain is referred to other body areas and you can get an idea of the patterns by looking at a dermatome map
Another example is that the nerve when inflamed looks like a thick lumpy rubberband, but as you stretch and glide the nerves, they thin out making an easier passage through the channels they move theough. If you stretch a rubber band it “thins” out.
The nerves in your body have a normal range of motion like the joints. Nerve glides are stretches that help get back that normal movement. Nerve glides must be done gently and should never increase pain. The goal is to free the area up and not to inflame it so in this case pain is not gain. Technique is critical. It is best to have an occupational therapist that specializes in neural education who can show you how to do these nerve glides. They will give you a sheet with the instructions on how to do these right and you can watch as you perform the nerve glides in the mirror to make sure your form is correct. Nerve glides are also known as nerve flossing or nerve stretching.
Detailed Treatment Strategies for the Prevention
and Treatment of Piriformis Syndrome
Piriformis syndrome is a condition in which the piriformis muscle becomes tight or spasms, and irritates the sciatic nerve. This causes pain in the buttocks region and may even result in referred pain in the lower back and thigh. Patients often complain of pain deep within the hip and buttocks, and for this reason, piriformis syndrome has also been referred to as “Deep Buttock” syndrome.
If you suffer from piriformis syndrome or are seeking to prevent its occurrence it is important to follow the information in this article. In addition, making stretching a part of your fitness regime will have a significant impact.
What is the Piriformis?
The piriformis is a small muscle located deep within the hip and buttocks region. It connects the sacrum (lower region of the spine) to the top of the femur (thigh bone) and aids in external rotation (turning out) of the hip joint.
Piriformis
As you can see from the diagram to the right, there are many muscles and tendons that make up the hip and buttocks region. The diagram shows the posterior (rear) view of the buttock. The piriformis is the horizontal muscle in the center of the picture running over the top of the sciatic nerve.
What Causes Piriformis Syndrome? Piriformis syndrome is predominantly caused by a shortening or tightening of the piriformis muscle, and while many things can be attributed to this, they can all be categorized into two main groups: Overload (or training errors); and Biomechanical Inefficiencies.
Overload (or training errors): Piriformis syndrome is commonly associated with sports that require a lot of running, change of direction or weight bearing activity. However, piriformis syndrome is not only found in athletes. In fact, a large proportion of reported cases occur in people who lead a sedentary lifestyle. Other overload causes include:
Exercising on hard surfaces, like concrete;
Exercising on uneven ground;
Beginning an exercise program after a long lay-off period;
Increasing exercise intensity or duration too quickly;
Exercising in worn out or ill fitting shoes; and
Sitting for long periods of time.
Biomechanical Inefficiencies: The major biomechanical inefficiencies contributing to piriformis syndrome are faulty foot and body mechanics, gait disturbances and poor posture or sitting habits. Other causes can include spinal problems like herniated discs and spinal stenosis. Other biomechanical causes include:
Poor running or walking mechanics;
Tight, stiff muscles in the lower back, hips and buttocks;
Running or walking with your toes pointed out.
Symptoms Pain (or a dull ache) is the most common and obvious symptom associated with piriformis syndrome. This is most often experienced deep within the hip and buttocks region, but can also be experienced anywhere from the lower back to the lower leg.
Weakness, stiffness and a general restriction of movement are also quite common in sufferers of piriformis syndrome. Even tingling and numbness in the legs can be experienced.
Treatment Piriformis syndrome is a soft tissue injury of the piriformis muscle and therefore should be treated like any other soft tissue injury. Immediately following an injury, or at the onset of pain, the R.I.C.E.R. regime should be employed. This involves Rest, Ice, Compression, Elevation, and Referral to an appropriate professional for an accurate diagnosis.
It is critical that the R.I.C.E.R. regime be implemented for at least the first 48 to 72 hours. Doing this will give you the best possible chance of a complete and full recovery.
The next phase of treatment (after the first 48 to 72 hours) involves a number of physiotherapy techniques. The application of heat and massage is one of the most effective treatments for removing scar tissue and speeding up the healing process of the muscles and tendons.
Once most of the pain has been reduced, it is time to move onto the rehabilitation phase of your treatment. The main aim of this phase is to regain the strength, power, endurance and flexibility of the muscles and tendons that have been injured.
Prevention Prevention is the key when it comes to piriformis syndrome. The more you can do to prevent it, the better off you’ll be. There are a number of preventative techniques that will help to prevent piriformis syndrome, including modifying equipment or sitting positions, taking extended rests and even learning new routines for repetitive activities. However, there are four preventative measures that I feel are far more important and effective.
First, a thorough and correct warm up will help to prepare the muscles and tendons for any activity to come. Without a proper warm up the muscles and tendons will be tight and stiff. There will be limited blood flow to the hip area, which will result in a lack of oxygen and nutrients for the muscles. This is a sure-fire recipe for a muscle or tendon injury.
Before any activity be sure to thoroughly warm up all the muscles and tendons that will be used during your sport or activity.
Second, rest and recovery are extremely important; especially for athletes or individuals whose lifestyle involves strenuous physical activity. Be sure to let your muscles rest and recover after heavy physical activity.
Third, strengthening and conditioning the muscles of the hips, buttocks and lower back will also help to prevent piriformis syndrome.
Fourth, (and most importantly) flexible muscles and tendons are extremely important in the prevention of most strain or sprain injuries. When muscles and tendons are flexible and supple, they are able to move and perform without being over stretched. If however, your muscles and tendons are tight and stiff, it is quite easy for those muscles and tendons to be pushed beyond their natural range of movement. When this happens, strains, sprains, and pulled muscles occur.
To keep your muscles and tendons flexible and supple, it is important to undertake a structured stretching routine. I’ve included two effective piriformis stretches below.
Sit with one leg straight out in front. Hold onto the ankle of your other leg and pull it directly towards your chest.
Lie face down and bend one leg under your stomach, then lean towards the ground.
Stretching is one of the most under-utilized techniques for improving athletic performance and getting rid of those annoying sports injuries. Don’t make the mistake of thinking that something as simple as stretching won’t be effective
———————————————————–
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit The Stretching Institute.
———————————————————–
Can scar tissue affect recovery & re-injury
of pulled muscles and sports injuries?
Have you ever had an injury that just won’t heal? And then when you think it has healed, you go and re-injure it again. You may have a problem with scar tissue.
So you’ve pulled a muscle? Over-stretched it, torn it, strained it, sprained it. Call it what you want. From an injury point of view, the initial healing process is all the same.
Sprains (ligament) and strains (muscle or tendon) are the most common type of soft tissue sports injury and are often caused by activities that require the muscles to stretch and contract at the same time. A lack of conditioning, flexibility and warm up can also contribute.
While most people are well aware of the importance of applying the R.I.C.E. regime to a sprain or strain in the first 48 to 72 hours, it’s after this that most people get stuck. Let’s start by having a look at what happens during those first 72 hours and then move onto what’s needed for a full recovery.
The First 72 Hours
Without a doubt, the most effective, initial treatment for soft tissue injury is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.
Where the R.I.C.E.R. regime has been used immediately after the occurrence of an injury, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.
The diagram below is a comparison of the same injury treated with the R.I.C.E.R. regime and without. The top row of pictures show the effects of a soft tissue injury when the R.I.C.E.R. regime is not used. While the bottom row of pictures show the effects of a soft tissue injury when the R.I.C.E.R. regime is used.
The first diagram in the series shows a rupture in the soft tissue immediately following an injury. 24 hours later, when R.I.C.E.R. has not been used, there is a large amount of uncontrolled bleeding and swelling. However, in the bottom diagram, the application of rest, ice, compression and elevation has significantly reduced the amount of bleeding and swelling.
Picture courtesy of Dr. Barry Oakes, MB, BS, MD, F.A.S.M.F.,Senior lecturer in the department of Anatomy, Monash University, Victoria, Australia
The Problem with Scar Tissue
When a muscle is torn, you would expect that the body would repair that tear with new muscle. In reality, this doesn’t happen. The tear, or rupture, is repaired with scar tissue. As you can see with the final diagram on the right hand side, when the R.I.C.E.R. regime is used, this limits the formation of scar tissue.
Now this might not sound like a big deal, but if you have ever suffered a soft tissue injury, you’ll know how annoying it is to keep re-injuring that same old injury, over and over again. Untreated scar tissue is the major cause of re-injury, usually months after you thought that injury had fully healed.
Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged soft tissue fibers in an effort to draw the damaged fibers back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it’s even possible to see and feel this bulky mass under the skin.
When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.
So what does this mean for the athlete? Firstly, it means a shortening of the soft tissues which results in a loss of flexibility. Secondly, it means a weak spot has formed within the soft tissues, which could easily result in further damage.
Lastly, the formation of scar tissue will result in a loss of strength and power. For a muscle to attain full power it must be fully stretched before contraction. Both the shortening effect and weakening of the tissues means that a full stretch and optimum contraction is not possible.
Getting rid of the Scar Tissue
To remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will do that.
Either find someone who can massage the effected area for you, or if the injury is accessible, massage the damaged tissues yourself. Doing this yourself has the advantage of knowing just how hard and deep you need to massage.
To start with, the area will be quite tender. Start with a light stroke and gradually increase the pressure until you’re able to use deep, firm strokes. The more you massage the effected area the harder and deeper you will be able to push. See a video demonstration and more tips here
Use deep, firm strokes, moving in the direction of the muscle fibers. Concentrate your effort at the direct point of injury, and use your thumbs to get in as deep as possible to break down the scar tissue.
A few final points before finishing up. Be sure to drink plenty of fluid during your injury rehabilitation. The extra fluid will help to flush a lot of the waste products from your body.
Also, I recommend you purchase a special ointment to use for your massage called “Arnica”. This special ointment is extremely effective in treating soft tissue injuries, like sprains, strains and tears. You can purchase this ointment at most health food shops and pharmacies.
To Stretch or not to Stretch
During this phase of the rehabilitation process NO STRETCHING should be used at all! This is not the time to start stretching. Concentrate on the R.I.C.E.R. regime and avoid all stretching or any activity that puts stress on the injured area. Stretching during this early stage of the rehabilitation process will only cause more damage to the injured tissues. Avoid stretching during the first 72 hours. Click here for a more detailed article on how to use stretching for injury rehabilitation.
———————————————————–
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit The Stretching Institute.
———————————————————–
Learn how to speed up your Recovery with the right type of Stretching.
Without a doubt, the most effective, initial treatment for soft tissue injury is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.
stretching pose (ehow.com)
The First 72 Hours
Where the R.I.C.E.R. regime has been used immediately after the occurrence of an injury, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.
However, during this phase of the rehabilitation process NO STRETCHING should be used at all! This is not the time to start stretching. Concentrate on the R.I.C.E.R. regime and avoid all stretching or any activity that puts stress on the injured area. Stretching during this early stage of the rehabilitation process will only cause more damage to the injured tissues. Avoid stretching during the first 72 hours.
The Next 10 to 14 Days
After the first 72 hours most of the initial swelling will have subsided and you can start with some gentle active rehabilitation techniques.
The most effective treatment at this stage is the use of heat and massage, but including light, gentle static and passive stretching exercises after your heat and massage treatment will help to dramatically speed up the recovery process. So what is static and passive stretching?
Static stretching is performed by placing the body into a position whereby the muscle (or group of muscles) to be stretched is under tension. Both the opposing muscle group and the muscles to be stretched are relaxed. Then slowly and cautiously the body is moved to increase the tension of the stretched muscle group. At this point the position is held or maintained to allow the muscles to lengthen.
Passive stretching is very similar to static stretching; however another person or apparatus is used to help further stretch the muscles. Due to the greater force applied to the muscles, this form of stretching is slightly more hazardous. Therefore it is very important that any apparatus used is both solid and stable. When using a partner it is imperative that no jerky or bouncing force is applied to the stretched muscle. So, choose your partner carefully, they must be responsible for your safety while stretching.
The important point to remember during this phase of the rehabilitation process is light, gentle stretching. Never, never, never do any activity that hurts the injured area. Of course you may feel some discomfort, but never push yourself to the point where you’re feeling pain. Be very careful with any activity you do. Pain is the warning sign; don’t ignore it.
The Next 2 to 5 Weeks
The aim of this phase of your rehabilitation is to regain all the fitness components that were lost as a result of the injury. Regaining your flexibility, strength, power, muscular endurance, balance and co-ordination will be the primary focus.
Without this phase of the rehabilitation, there is no hope of completely and permanently making a full recovery from your injury. A quote from a great book called “Sporting injuries” by Peter Dornan & Richard Dunn will help to reinforce the value of this phase of the rehabilitation process.
“The injury symptoms will permanently disappear only after the patient has undergone a very specific exercise program, deliberately designed to stretch and strengthen and regain all parameters of fitness of the damaged structure or structures. Further, it is suggested that when a specific stretching program is followed, thus more permanently reorganizing the scar fibers and allowing the circulation to become normal, the painful symptoms will disappear permanently.“
So what type of stretching is best to use during this phase? Stick with the static and passive stretching exercises described above, but also include PNF Stretching.
PNF stretching, or Proprioceptive Neuromuscular Facilitation, is a more advanced form of flexibility training that involves both the stretching and contraction of the muscle group being targeted. PNF stretching was originally developed as a form of rehabilitation, and for this purpose it is very effective. It is also excellent for targeting specific muscle groups, and as well as increasing flexibility, (and range of movement) it also improves muscular strength.
Looking Long Term
Once you’re over your injury and have started to regain the fitness components that were lost during the injury process, it’s time to focus on making the injured area stronger and more flexible that it was before the injury occurred. To do this, the best types of stretches to use are dynamic and active stretching exercises.
Dynamic stretching uses a controlled, soft bounce or swinging motion to move a particular body part to the limit of its range of movement. The force of the bounce or swing is gradually increased but should never become radical or uncontrolled.
Active stretching is performed without any aid or assistance from an external force. This form of stretching involves using only the strength of your opposing muscles to generate a stretch within the targeted muscle group. The contraction of the opposing muscles helps to relax the stretched muscles. A classic example of an active stretch is one where an individual raises one leg straight out in front as high as possible and then maintains that position with out any assistance from a partner or object.
Stretching is one of the most under-utilized techniques for improving athletic performance and getting rid of those annoying sports injuries. Don’t make the mistake of thinking that something as simple as stretching won’t be effective.
———————————————————–
Article by Brad Walker. Brad is a leading stretching and
sports injury consultant with nearly 20 years experience
in the health and fitness industry. For more articles on
stretching, flexibility and sports injury, please visit The Stretching Institute.
———————————————————–
Scar care can make a difference in how you heal. In Europe and Canada scar aftercare is taught following an injury or surgery. It is important that the scar is allowed to heal shut before any attempt is made to cover it with silicone or massage it.
Your doctor is the best one to advise you about the best time to start. If the scar becomes hot, oozes, or bleeds a lot get medical attention. If the area turns black, is extremely painful or very dark, smells,or has dark lines leading way from the wound get it checked by a doctor. Remember some emergency rooms have as high as a 30%return visit ratio so being seen in emergency does not necessarily mean all is well.
If dissolving stitches were used to repair the wound follow your doctors advice for care. The surgeon who repaired my hand and wrist suggested using antibiotic ointment with Zinc oxide until the wound healed and using hand sanitizer for the areas that contained pins. I was urged not to get it wet because the pins go into the bone and infection can become systemic if bacteria is allowed to enter.
Once the wound has healed gentle massage using cream, vitamin E, olive oil, evening primrose oil will keep the area lubricated and help soften it. I was advised to use small circular motions in both directions to break up adhesions and to promote circulation. Gentle but firm consistent pressure is needed. Getting over enthusiastic can re-injure tissue and cause inflammation.
Silicone pads cut to the wound size are very effective in taking away redness,and to reduce raised scars. It does take a few weeks to show results so be patient. The silicone pads can be bought as washable reusable patches that last about a month or as disposable patches that you use and throw away.Best results come from leaving the patches on about 12 hours at a time. They should not be used on open wounds because of the risk of infection. First aid tape can be used to keep the scar sheet in place. Avoid getting it wet. If you are allergic to silicone there are polymer patches that work the same way.
Silicone gel is good to use on areas like knuckles, elbows or the face. It is very important to protect the scarred area from sun exposure for at least two years to avoid damage to skin.
If you are unfortunate enough to experience a road rash scar keep it covered and moist until the skin underneath heals. Burn dressings available at a pharmacy work quite well. Keep it clean with saline and antibiotic ointment rather than using hydrogen peroxide or other harsh disinfectants that will burn and damage the skin underneath. If it is a large area using a cut up tube sock over the dressing can protect it. Remember to keep the dressing and the area clean to promote healing.
Diet makes a difference this is a good time to eat fruits and vegetables plus sufficient protein. Fish oil, vitamin C and antioxidants will help to promote healing.
This Post is for educational patient to patient purposes only and is not meant to treat, diagnose or take the place of medical care or advice.
Picture courtesy of Dr. Barry Oakes, MB, BS, MD, F.A.S.M.F.,Senior lecturer in the department of Anatomy, Monash University, Victoria, Australia