What is IASTM?
IASTM is a Deep Tissue and Fascia manipulation technique involving a specially design stainless steel
massage tool. IASTM allows the practitioner to work deeper into the bodies soft tissues rather than
using hands/thumbs and elbows. The stainless-steel tool also gives better feedback, meaning the
therapist can feel deeper restrictions and knots. The treatment is relativity painless and far
less time consuming then regular deep tissue massage.
How does it work?
The instrument becomes a diagnostic implement as it acts to magnify what is felt in the tissue aiding the therapist to quickly locate areas of restriction and pain. Once the area is located the tool enables clinicians to effectively breakdown scar tissue, fascial restrictions and adhesions and change muscle tonus. The shape and numerous angles of the tool allows the therapist to preform various actions such as pinpoint fiction work over scar or long strokes over a wide area like the hamstrings.
What is it used for?
It is used side by side with all other forms of treatment the therapist will used in his treatment plan for you. It is effective in releasing Myofascial tension, Scar tissue or adhesions, removing fluid and inflammation, increasing blood flow and promoting healing and recovery.
Other issues IASTM will help with include:
Carpal Tunnel Syndrome
Tennis elbow and Golfs Elbow
Lower Back Pain
Calf pain and Runner Retaliated Pain
Rotator Cuff Tendinosis
It is also a great way to speed up the healing progress, allowing the patient to get onto their
rehabilitation program faster. Therefore, shortening overall recovery times and speeding up
the treatment time, meaning the therapist can spend less time on braking down
stubbornareas and more time on other treatment options for you.
To find out More:
Contact Gavin Egan at PureBody Health
01371 859991 or firstname.lastname@example.org
Sports & Deep Tissue Massage
Would you like 50% off your next Sports Massage?
Contact us now to book your appointment!
PureBody Health is pleased to welcome aboard the Sports Therapy Team
our newest member of the squad, Tom Austin!
Tom is equipped with a widespread knowledge of human anatomy and is highly proficient in the treatment
and prevention of musculoskeletal injuries throughout the body.
Tom joins PureBody Health Sports Injury Clinic from Bournemouth University where he gained a BSc degree
and Active-IQ qualifications in Sports Massage Therapy. Other attributes include Therapeutic Elastic Taping,
First-Aid and various Coaching skills.
Tom spent a year in Marbella, Spain at a Physiotherapy clinic, where he experienced extensive practice in Sports Massage Therapy and Injury Rehabilitation. Tom has a sporting background in rugby and enjoys maintaining his own physique and biomechanical function in the gym.
Tom says’ “My passion and goal in life is to aid and assist the prevention and recovery for any individual who may have experienced or is at risk of experiencing a dysfunction or injury. I wish to have a direct impact on the
physical and mental well-being of my clients. I am fully aware that everyone is different and I thrive
from meeting these personal needs. If you are ever in need of a massage for
relaxation, pain reduction, improved performance or recovery,
then I welcome you to book a session with me”.
‘INTRODUCTION OFFER’ when you contact us to book your appointment!
So, would you like 50% off your next Sports Massage?
Mention ‘INTRODUCTION OFFER’ when making your next appointment and get 50% off your first
session with Tom. This offer stretches to your friends and family to so feel free to forward
this onto anyone you would like to treat this summer. Offer is valid during
August and September 2017 on Wednesday’s and Saturday’s only.
To book now
call 01371 859991
REMEMBER…Simply quote ‘INTRODUCTION OFFER’
when you contact us to book your appointment!
Offer ends 30th September 2017
If you thought our ‘Feel good Friday’ idea was good,
wait till you hear what’s on offer for you throughout July….
‘Feel FANTASTIC’ all this July with our offer of £10 OFF all Sports Massages
with the man taking Dunmow by storm… Gavin Egan!
In the words of Gavin himself…
“The truth is, our Feel Good Friday’s have been filling up fast
and we’ve been having to turn some of you away”
So this month come in any day of any week for a Sports Massage
and get £10 OFF!
Sports Massage is a great way of reducing tension in the body, eliminating muscular
aches and pains, decreasing feelings of tightness and stiffness whilst improving performance in physical activity.
Our clients are telling us that this guy is a genius.
Come and experience for yourself!
So only one thing for me to mention, there’s only 10 up for grabs!
Booked on a first come first served basis so call or email Mary now to secure your Feel Fantastic Sports Massage for July!
Not to be used with existing packages purchased.
Must be booked in July with Gavin Egan!
Please contact Gavin at PureBody Health Sports Injury Clinic on
01371 859991 or email@example.com
What is Dry Needling?
Dry Needling is utilised by a trained therapist to treat a vast number of myofascial and muscular injuries and complaints. Acupuncture needles are used to alleviate tight bands within an active muscle. A very fine single filament needle is inserted into the skin targeting muscle trigger points or knots. The needles used are so thin they typically cannot be felt as they break the skin and rarely cause bleeding. The use of needles as a form of treatment is an invasive procedure. However, it is very safe and is only carried out by qualified and trained therapists.
What are Trigger Points/Taught Bands?
Myofascial trigger points are an extremely common cause of pain often caused by overuse, increased stress,
poor posture or as a response to injury. Trigger points can be classified into two phases, active and latent.
The active phase of the trigger point is the one which produces intense pain symptoms often motivating people
to seek relief. We identify trigger points by the patient’s history and symptoms, pain pattern and by palpation.
Trigger points are painful when pressed or squeezed, they cause a shortening of the muscle fibres which can lead
to dysfunction, a characteristic called referred pain meaning that an active trigger point can refer pain in another
area of the body. Each trigger point has a specific referral pain that is reproduced when the trigger point
is activated by digital pressure or overuse.
A classic example of this is seen in the upper trapezes muscle. Many people complain about pain and tension
in the upper traps and neck area after a long day at work, or after a bout of housework or gardening etc.
Typically pain progression moves up the neck and into the base of their skull, in some cases it can cause
tension type headaches. The referral pattern for the upper traps are shown below in red with the
trigger points been shown by the marked X.
How do Trigger points occur?
- Repeated actions i.e. Housework/Work activities/Gardening.
- Sustained loading i.e. Gym work, Heavy lifting.
- Poor Posture.
- Tensing due to stress or depression.
- Inactivity and Sedentary lifestyles.
So, how does dry needling work and what does the science say?
Dry needling works by inserting the needle into the trigger point, which causes the muscle to grip onto the needle
in an attempt to resist the needle as a foreign body. This is called a localised twitch response or basically a large twitch.
This localised twitch response is necessary to deactivate the trigger point and to facilitate muscle relaxation.
This causes significant pain relief, decreased muscle tension and tightness as well as an increased range of motion.
A recent review of several studies found dry needling can be effective in providing immediate pain relief after treatment and at 4 weeks’ post treatment in patients with upper body muscle pain (Kietrys et al, 2013). There has not been enough research evidence to determine its effectiveness on lower body conditions. However, it is widely believed when performed correctly it will cause the same effect as it does in the upper body. The effectiveness of this treatment depends greatly on the skill of the therapist to accurately palpate myofascial trigger points as well as an extensive knowledge of the anatomical structures.
What am I going to feel?
Typically, one does not feel the needle go into the skin. However, once the trigger point has been located and a localised twitch has occurred, the type of sensation can differ from person to person. What is described mostly by patients is a strong muscle cramping once the twitch response has been elicited. Once you become accustomed to the sensation you will have no problem relaxing as deactivating trigger points are reducing symptoms, decreasing pain, restoring muscle length and improving function. After the treatment, there may be localised muscle pain similar to muscle pain associated with exercise induced muscle damage or DOMs. This tends to last no more than 24 hours.
Injuries & Benefits.
Dry needling is used for a wide variety of different injuries and conditions. It may be used once as part of your overall treatment plan or to help alleviate stubborn trigger points and tight bands of muscle.
Prior to treatment, your Sports Injury Clinic therapist will perform a thorough assessment to determine if you are a suitable candidate for the procedure. Dry needling will also be used with other forms of therapy, such as manual therapy, stretching, exercise or as part of your ongoing treatment plan. It can also be used on several occasions throughout your treatment for more chronic longstanding issues, these include but are not limited to the following:
- Trigger Point Release
- Postural Dysfunction
- Low Back Pain
- Aids in the treatment of Muscle Tears and Strains
- Shin Splints
- Planter Fasciitis
- Chronic Muscle Pain
- Rotator Cuff and Shoulder Pain
- Tension Type Headaches
- Tennis/Golfer Elbow
- Vast Number of Neck Issues/Whiplash
- Knee and Patellofemoral Pain Sciatica and Piriformis Syndrome
I have a medical condition or am taking medication… am I a good candidate to be needled?
There are a very few reasons that would cause you to be an unsuitable candidate for this treatment. Most patients can receive dry needling treatment as it is extremely safe. However, it is important to know therapists do not needle for the sake of it and needling is only one tool that is used as part of your treatment plan. Your PureBody Health therapist will be able to answer all questions and alleviate any concerns prior to this treatment.
The following lists are contraindications or where dry needling is not advised.
The relative contraindications are where caution needs to be taken but the treatment can
still be carried out safely, meaning dry needling will be conducted at the therapist’s discretion.
Absolute Contraindications (Dommerholt et al, 2013)
- In a patient with needle phobia.
- Patient unwilling – fear.
- Unable to give consent – communication, cognitive, age-related factors.
- Medical emergency or acute medical condition.
- Over an area or limb with lymphedema (risk of infection)
- Inappropriate for any other reason.
Relative Contraindications (Dommerholt et al, 2013)
- Abnormal bleeding tendency
- Compromised immune system
- Vascular disease
- Frail patients
- Patients with epilepsy
- Psychological issues
- Patient allergies
- Patient medication
- Unsuitable patient for any reason
Dry Needling is an excellent tool that is utilised in conjunction with other treatments to get you back to full fitness
and health. In most cases, it is a faster way to relieve trigger point type pain over the traditional trigger
point pressure massage.
Your therapist will assess you to determine if you are a good candidate for the treatment.
Please contact Gavin at PureBody Health Sport’s Injury Clinic on
01371 859991 or firstname.lastname@example.org
- Ana Mendigutia-Gómez, PT, PhD, Carolina Martín-Hernández, PT, Jaime Salom-Moreno, PT, PhD, César Fernández-de-las-Peñas, PT, PhD. Effect of Dry Needling on Spasticity, Shoulder Range of Motion, and Pressure Pain Sensitivity in Patients With Stroke: A Crossover Study
- Dommerholt J., Fernandez-de-las-Penas C. Trigger Point Dry Needling. An Evidenced and Clinical-Based Approach. Edinburgh: Churchill Livingstone-Elsevier, 2013
- Furlan AD, van Tulder MW, Cherkin D, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1.
Kietrys, D. M., Palombora, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain : a systematic review and meta-analysis. Journal of Orthopaedic Sports & Physical Therapy, 43 (9), 620634
One of the most common physical complaints is shoulder pain. Shoulder or ‘subacromial’ impingement syndrome is a common condition also known as Swimmer’s shoulder or Thrower’s shoulder. It is a condition whereby certain structures that pass through the shoulder joint are intermittently compressed or pinched with specific arm movements. This can subject the rotator cuff tendon to pain, inflammation, thickening or even partial tearing. This can also result in inflammation of the bursa located in the subacromial space, this is known as bursitis.
Your shoulder is comprised of three bones, your upper arm bone (humerus), your shoulder blade (scapula) and your collarbone (clavicle).
The supraspinatus tendon is one of the four rotator cuff tendons within the shoulder joint. It arises from the supraspinous fossa of the shoulder blade and travels beneath the acromion plate of the scapula (tip of the shoulder blade) to insert to the greater tubercle of the humerus. It is this tendon that is most commonly affected by impingement syndrome.
The area below the acromion is known as the sub-acromial space. Within this space there is a lubricating fluid sac known as a bursa between the supraspinatus tendon and the acromion that allows the tendon to move freely, and prevents friction when arm movements are performed.
Impingement syndrome in itself is not a diagnosis, but rather a clinical sign. Impingements syndrome is an umbrella term for a range of different pathologies which may include: bone spurs, rotator cuff tendinopathy or injury, labral tears, shoulder instability or biceps tendinopathy. Your sports injury specialist will help you to determine exactly what the cause of your complaint is.
Symptoms of Shoulder Impingement
Rotator cuff pain commonly causes local swelling and tenderness at the front of the shoulder; however, pain may also refer down the side of the shoulder and/or arm. You may also have pain and/or stiffness when attempting to move the arm, particularly when lifting the arm, or lowering the arm from an elevated position.
It is common in the early stages for individuals to avoid seeking treatment as symptoms originally may be mild such as:
- Mild pain that is present with activity and rest
- Pain located at the front of the shoulder that may radiate to the side of the arm
- Sudden, sharp pain with lifting or reaching
- Athletic populations may have pain with overhead movements such as swimming, throwing or serving a tennis ball.
It is important that the problem is addressed as soon as possible to prevent further damage to structures within the shoulder. The problem may become more chronic in nature, and complications may develop that ultimately increase the length of time required to rehabilitate your injury. More chronic symptoms may include:
- Pain at night – particularly when lying in bed on the affected side
- Loss of strength or range of motion
- Difficulty performing overhead tasks or other activities such as placing the arm behind your back, buttoning your collar or zippering a dress.
Causes of Shoulder Impingement
The subacromial space is a small gap between the acromion and humerus in which the rotator cuff tendon passes through. One of the most common causes of impingement is a reduction of the subacromial space, resulting in intermittent pinching of the tendon or inflammation of the bursa.
Mechanisms of subacromial space reduction:
- A type III acromion that possesses an anomalous process is said to increase the risk of impingement (Bigliani, 1986)
- Osteoarthritic changes of the Acromioclavicular joint (ACJ) or calcification of the Coracoacromial arch
- Poor scapula movement, in particular type I dyskinesis whereby the scapula adopts an anterior tilt (Struyf et al, 2011)
- Kinematic deviations such as superior migration of the humeral head due to rotator cuff weakness or tight capsular structures (Ludewig et al, 2002)
However, shoulder impingement can also develop secondary to a rotator cuff tear. Tearing of the rotator cuff tendon can cause inflammation and thickening of the tendon, which reduces the space in which the tendon is free to move as it passes through the shoulder joint.
Types of Shoulder Impingement
External impingement can be further categorised as primary or secondary:
Primary– Usually due to bony anomalies, such as a hooked acromion as aforementioned. This can sometimes be due to congenital or degenerative changes such as small bony spurs forming on the arch of the acromion.
Secondary– Due to poor scapula stabilisation which alters the position of the acromion. The most common cause of this is a muscle imbalance which consists of weakness of a muscle known as the serratus anterior in combination with pec minor tightness.
This occurs predominantly in the more athletic population. Repetitive movements of the arm, mainly 90 degrees of shoulder abduction combined with external rotation, commonly causes a narrowing of the subacromial space.
Stages of Shoulder Impingement
Stage 1: Commonly affecting patients younger than 25 years of age. Usually inflammation and oedema (swelling) is present. You may also have a painful arch of movement, but full range of motion. The condition is usually reversible with conservative management alone at this stage.
Stage 2: Commonly affecting patients 25-40 years of age. A continuation of stage 1. With the addition tendonitis of the rotator cuff tendon. There may be a small limitation of range of motion.
Stage 3: Commonly affecting patients > 40 years old. There may be disruption/tearing of the rotator cuff tendon. Prolonged pain and weakness, particularly with abduction and external rotation of the arm. Injection therapy or surgery may be implicated.
Treatment for Shoulder Impingement
The aims of treatment and rehabilitation for shoulder impingement syndrome at to achieve the following:
- Reduce Pain and Inflammation
- Restore a pain free Range of Motion (ROM)
- Correct length-tension relationships (muscle imbalances)
- Improve postural control
- Strengthen inhibited musculature and increase the capacity of the tendon to cope with activity
Self-help to reduce pain and inflammation
It is important to rest from all aggravating activities, particularly those that involve movements overhead. Your tendon needs the opportunity to recover, if you are performing activities that repetitively pinch or catch the tendon, you may cause further damage and worsen the condition.
NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen can be particularly useful in decreasing inflammatory episodes, however anti-inflammatory medication should only be taken in moderation. You should not take ibuprofen if you are asthmatic.
Apply ice to the affected area 15 minutes at a time, ideally every 2-3 hours. Do not apply ice directly to the skin.
This period of rest, anti-inflammatory medication and icing should be performed for one week.
Sports Massage– Sports massage can be particularly useful in the treatment of shoulder impingement. Your sports injury specialist can perform various techniques that help to reduce inflammation of the tendon, mobilise tight soft tissues that contribute to poor scapula posture and function and reduce trigger point formation.
Myofascial Release– It is common for individuals with shoulder impingement to develop tightness of the fascia (a continuous network of connective tissue) between the pectoral and deltoid musculature. This is a common cause of rounded shoulder posture, and therefore a predisposition to developing impingement symptoms. Your sports injury specialist will perform techniques to stretch the fascia and release tension from the tissues affected to permit improved posture.
Capsular Stretching & Joint Mobilisation-Tightness of the posterior capsule of the shoulder joint is commonly found in patients with shoulder impingement. This tightness causes the humerus to elevate and therefore reduce the sub-acromial space, thereby compressing the tendon. Your sports injury specialist may perform some manual therapy techniques that help to loosen the capsule and restore your joint alignment and function.
Proprioceptive Neuromuscular Facilitation– For those that read our previous issue, you may already be aware of the Proprioceptive neuromuscular facilitation (PNF) techniques are.
For those that may not be familiar- PNF techniques are a passive stretching technique that helps to override tension signals sent from the muscles through the central nervous system (CNS) to the brain. These techniques, not only help to improve your joint range of motion, but PNF techniques also help to improve posture, increase the tendon’s capacity to tolerate loading, and reduce pain.
Rehabilitation for Shoulder Impingement
Stretching of the shoulder joint is particularly important throughout all phases of rehabilitation. They should be performed regularly, ideally on a daily basis. It is important that full mobility is regained in order for your rehabilitation to be successful. This will also help to restore your biomechanical function of the shoulder joint and specifically the rhythm of the scapula, therefore preventing ongoing impingement.
Below we outline specific stretches that should be performed on a regular basis, ideally daily.
Place your arm in 90 degrees of abduction and bent the elbow to 90 degrees also. Fix your forearm to a fixed point, such as a doorframe, squat rack, Swiss ball or wall depending on where you are and what is available. Lean forward gently so that your chest surpasses your arm. Hold the stretch for 30 seconds and repeat three times. You should aim to lean forward more with each effort.
Anterior Deltoid Stretch
This is performed similarly to the pectoral stretch. However, instead of adopting the above position. You should aim to reach higher such as the top of the door frame. This will bias the stretch towards the deltoid musculature. Hold the stretch for 30 seconds and repeat three times.
Place your hand behind your lower back and maintain contact. Use your other hand to gently pull your elbow forward, you should feel a stretch towards the back of the shoulder. However, this may also feel like it is stretching other areas around the shoulder. Again, hold the stretch for 30 seconds and repeat three times.
This stretch is a personal favourite of ours here at PureBody Health. It is a simple, yet fantastic exercise that targets the posterior capsule of the shoulder. As aforementioned, tightness of this capsule may cause the humerus to elevate and contribute to impingement of the shoulder. Therefore, this stretch is aimed at preventing the superior migration of the humerus. This also helps to restore your internal rotation range of motion of the shoulder joint.
The following exercises are aimed at improving the function of the rotator cuff muscles that stabilise the shoulder joint and the scapula, as well as focusing on the upper back muscles that play an integral role in postural control. These exercises are particularly important in aiding the stretches in improving your shoulder joint alignment, function and biomechanics.
Early Stage Strengthening Exercises
Positional Isometrics- This type of strengthening exercise is particularly useful for increase the contractile ability of the rotator cuff tendons and facilitates an improved tolerance to loading and activity. They also help to improve your scapula stability.
Shoulder Abduction Isometric
Stand 6inches approximately from a wall, side on. Place the back of the hand against the wall, with the elbow locked out straight and apply a resistance against the wall, around 60-80% of your strength. Hold for 10 seconds, rest for 10 seconds and repeat 10 times.
Shoulder External Rotation Isometric
Perform as above but with the elbow bent to 90 degrees, instead of locked out straight. This will bias a different movement, and therefore a different rotator cuff tendon, known as your infraspinatus; that is responsible for externally rotating the shoulder.
- Extend your thoracic spine (upper back) and pinch the shoulder blades together.
- Raise both arms to at least 90 degrees out in-front of you, you should aim to reach as high as possible without losing the position of your shoulder blades.
For alternative exercise, check our Instagram page and follow us!
The above exercises should be performed twice daily, for one week and with no pain or symptoms before progressing onto the mid-stage rehabilitation exercises. If you experience pain with any of the above exercises, please consult your sports injury specialist.
Middle Stage Strengthening Exercises
External Rotation in Lying
- Lay on your unaffected side, place rolled up towel or cushion between your elbow and side. Your upper arm should rest on the towel, and keep the elbow fixed to your side. Your palm should be facing the floor
- Rotate your shoulder so as to move the arm towards the ceiling as far as possible
- The key to this exercise is the eccentric loading phase or the returning phase. This should be controlled and performed with a relatively slow tempo. Take 3 seconds to return to the starting position of the exercise. Start with a light weight, around 2kg and aim to perform 12-20 repetitions.
- This can also be performed in standing with a resistance band or cable machine.
Internal Rotation in Lying
- Lay with the affected arm at the bottom, with the forearm parallel to the floor. Rotate the arm in the opposite direction to the above exercise (towards the abdomen).
- Again, the eccentric phase of the exercise is particularly important and should be performed with good control and a relatively slow tempo. Take three seconds to lower the arm back to the starting position. Start with a light weight, around 2kg and aim to perform 12-20 repetitions.
- This can also be performed in standing with a resistance band or cable machine.
- Standing with your arm at your side. Lock the elbow out straight.
- Raise the arm laterally (sideways) without bending the arm, to 90 degrees and slowly lower back down to our side to the starting position. Start with a light weight, around 2kg and aim to perform 12-20 repetitions.
- This can also be performed in standing with a resistance band or cable machine.
Your sports injury specialist can also assist you with more advanced late stage rehabilitation. To discuss your symptoms, treatment or rehabilitation, please contact the PureBody Health Sports Injury & Rehabilitation Clinic Team!
Every Friday at PureBody Health is now ‘Feel Good’ Friday and to celebrate the start of the weekend we are offering £10 off all Deep Tissue Massage or Sports Massage appointments booked with Sports Therapist Dan Baker every single Friday.
For only £45 you can enjoy our signature specialist Sports Massage. A 60 minute deep tissue massage to cleanse the body and eradicate muscular aches and pains. Using a coconut oil based medium your skin is spoilt with organic goodness.
If this isn’t enough, we are now introducing a Feel Good Friday ‘loyalty card’. If you visit our clinic for a Massage service on Feel Good Friday (every Friday, every week!) you will be given a new loyalty card. The loyalty card will receive a stamp for each visit and you will receive the following:
Every 5 visits – a FREE 30 minute treatment
Every 10 visits – a FREE 60 minute treatment
Due to popular demand, appointments available on Fridays are limited so please book as early as you can to avoid disappointment.
Appointments can be booked by clicking here.
Here are some fantastic shots of our sports injury clinic practitioners in full flow – this time taking two post ankle break patients through some intense rehabilitation in the fitness studio at PureBody Health at very different phases of their recovery.
Patient 1 is six weeks out of cast and now begins his weight bearing exercise including balance, stability and ankle strengthening with Danny Baker.
Patient 2 is in cast for another three weeks but as a keen horse rider, is aware not to neglect her core and upper body strength. Here she is working on core control using a Swiss Ball as well as postural and scapular strengthening with Danny Gosshawk.
You should do everything you can when recovering from injury or surgery; be proactive, try to visit a specialist and you will get the best results possible.
We specialise in getting our patients not just off the couch without pain but returning to full physical activity or sport.
If you currently recovering from an injury or surgery and would like to find out more, please give us a call on 01371 874888 or contact us via the website here.