Frank A. Casucci III LMT

Sports and Medical Massage

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Ride to Recover

Knee pain…can it be Patellofemoral Pain Syndrome (PFPS)?

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome

Patellofemoral Pain Syndrome (PFPS) also known as runner’s knee, chondromalacia patellae, anterior knee pain and patellofemoral joint syndrome is a generic term used to describe patella pain at the front of the knee.

Symptoms

The onset of anterior knee pain is usually gradual.  Symptoms include an aching pain in the knee joint, particularly at the front of the knee around and under the patella. There is often tenderness along the inside border of the kneecap and swelling will sometimes occur after exercise.

Patellofemoral pain is often worse when walking up and down hills/stairs, during body weight loading of the lower extremities, jumping, squatting, kneeling, and sitting with knees flexed. Overuse further exacerbates Patellofemoral pain, as well as long car rides or sitting for long periods of time.

Other signs you may pick up on include a click or cracking sound when bending the knee.

What is patellofemoral pain?

PFPS occurs when the patella (kneecap) rubs on the femur bone underneath. It is often thought that incorrect tracking or rubbing of the patella over the femur bone is a significant factor and results in damage or irritation of the articular cartilage underneath the patella.

Patellofemoral pain is common in people who do a lot of sport and in particular adolescent girls. It can have a number of causes but damage to the cartilage itself cannot directly cause pain because there are no blood vessels or nerves involved. However it can lead onto other problems which in turn result in pain. These include synovitis (inflammation of the synovial membrane or joint lining), erosion of the cartilage and bone under the patella, soft tissues injury or irritation for example to the lateral retinaculum and the infra patella fat pad.

The initial cause of patellofemoral pain syndrome is likely to be overuse.

This may be from external factors for example a sudden increase in training, or performing high intensity jumping and knee bending, or it can be from internal factors such as poor patella tracking. Identifying the cause is an important part of treatment.

Biomechanics of PFPS

Taking a closer look at PFPS reveals the internal structures involved in this condition and their impact on pain in the anterior knee.

Of particular interest are :

Lower limb muscle imbalances

Overuse and repetitive weight-bearing activities

Arch variations (flat, high)

Wider hips and knock-knees (Q-angle)

Muscle imbalances may be responsible for poor patella alignment. Usually, the patella moves up and down as well as tilts and rotates through the trochlear groove in the distal femur as the knee flexes and extends. As compression between the patella and the groove increases pain can happen in and around the joint. Over time, this misalignment causes the cartilage to wear down as the patella and the head of the femur rub against one another. Much of the pain associated with this condition is due to the accumulation of inflammatory waste products from the friction, which leads to swelling and further damage to the joint’s synovial lining.

Patellofemoral Pain Syndrome Treatment

Patella pain treatment and rehabilitation is based around reducing symptoms, identifying the causes then re-training muscles which may have contributed to the injury.

Sports Massage can help loosen tight structures and muscles which may be contributing to the tightness and misalignment .  Kinesio taping is an excellent technique to control the position of the patella and relive pain symptoms.

Researchers have confirmed that massage intervention is a very effective solution for kneecap pain. 2014 Sep 3;7(3):25-31. eCollection 2014 Sep.

Approximately 90% of patellofemoral syndrome sufferers will be pain-free within six weeks of starting a sport massage rehabilitation program for patellofemoral pain syndrome.

You’ll find that in most cases, attempting to progress too soon can lead to re-injury and the frustration of a delay in your recovery.

 

Contact me today for an appointment or more information.

frank@casuccilmt.com

Can Men Get Osteoporosis?

Osteoporosis is not just a woman’s disease.

Men can get it too!

Men experience about half as many osteoporotic fractures as women. But when a man breaks his hip because of osteoporosis, he is more likely than a woman to be permanently disabled and twice as likely to die within a year.

Unfortunately, men are far less likely than women to get their bones checked. This is true even if they have a previously broken bone — any bone — from something as “nontraumatic” as tripping and falling from a standing height, a so-called fragility fracture.

“We need to pay a lot more attention to osteoporosis in men,” said  Dr. Robert A. Adler, an endocrinologist at the Veterans Affairs Medical Center in Richmond, Va., and Virginia Commonwealth University School of Medicine “It’s erroneous to think it’s a lady’s disease. And because many men and their doctors think that, men are less likely than women to be evaluated and treated after a low-trauma fracture.”

Men remain inadequately tested and treated after low-trauma fractures “even though their risk of a subsequent fracture is markedly increased,” said Dr. Sundeep Khosla, an endocrinologist at the Mayo Clinic College of Medicine, echoing Dr. Adler’s concerns. In fact, Dr. Khosla said, there is now evidence that even following a “high-trauma fracture,” as might happen in a car accident, they should have the strength of their bones checked.

“Aging men lose bone mineral density at a rate of approximately 1 percent per year, and one in five men over the age of 50 years will suffer an osteoporotic fracture during their lifetime,” Dr. Khosla wrote in The Journal of Clinical Endocrinology and Metabolism. “Almost 30 percent of all hip fractures occur in men.”

His advice: “Every man over 70 should have a bone density test, and if they have other risk factors, depending on which ones, they should be tested soon after 50.”

While there has been some progress in the recognition of osteoporosis in men—particularly the fact that almost one-third of hip fractures occur in men and that men are twice as likely to die within a year after hip fracture—much more work needs to be done. The realization of the risk of fracture and fatality has led to some increases in evaluation and treatment in men, but it is clear that many men have no attention paid to their fracture risk, despite obvious risk factors.  The serious consequences of fracture in high risk men need to be appreciated by both patients and clinicians.

Read full article now

Doing CrossFit two days in a row could get you sick!

xfit

Do you ever rest on purpose or just work out everyday

Which do you answer?

“A rest day is important for recovery for subsequent training sessions,” said Dr. Ramires Tibana, lead author of the study from the Catholic University of Brasilia, which was recently published in the online journal Frontiers in Physiology.

After examining a group of experienced CrossFit participants perform workouts such as kettle bells, tire flipping and ring pull-ups, researchers found that two consecutive days of the popular high-intensity workouts triggered a strong metabolic response and reduced the levels of anti-inflammatory cytokines, proteins produced by white blood cells.

Lack of rest suppresses normal immune function — potentially causing athlete’s fatigue, physiological stress and even illness, the researchers concluded.

“For non-athlete subjects who want to improve their health and quality of life through CrossFit training, we recommend that they decrease their training volume after two consecutive days of high intensity training to prevent possible immunosuppression,” Tibana said. “Other alternative recovery techniques are regenerative training (with low intensity and volume), MASSAGE and cryotherapy.”

by Chris Perez , NY POST  September 5, 2016 | 3:11pm

To read the research click here…….

 

Need an Excuse to Book a Massage? Research Shows it Reduces Inflammation

Most athletes can testify to the pain-relieving, recovery-promoting effects of massage. Now there’s a scientific basis that supports booking a session with a massage therapist: On the cellular level massage reduces inflammation and promotes the growth of new mitochondria in skeletal muscle. The research, involving scientists from the Buck Institute for Research on Aging and McMaster University in Hamilton Ontario appears in the February 1st online edition of Science Translational Medicine.

Read more..

Massage for Pain Relief

From an early age, we learn that the touch of a hand can ease pain. When a toddler bangs his knee in a tricycle accident, he’ll instinctively rub the sore spot. Likewise, an office worker with stiff shoulders will probably try to knead them. And if a dancer can’t shake the throbbing pain in her back, she just might schedule an appointment with a massage therapist.

The healing power of a well-placed hand is so apparent that just about every culture in history has used massage to relieve pain. Massage faded into the background with the arrival of modern medicine, but a growing number of people are turning (or returning) to hands-on relief. According to a 2008 survey by the American Massage Therapy Association, about 21 percent of adults had a massage at least once in the last year, and almost 25 percent have used massage therapy at least once for pain relief.

It may be an “alternative treatment,” but massage already has the respect of the medical community. As reported in Rheumatology, more than 70 percent of doctors say that they have referred their patients to massage therapists.

If you’re suffering from pain — brief or chronic — you may want to give massage a try. Minor aches and pains aside, you should have a doctor evaluate you to rule out other causes of pain (especially persistent or acute pain for which there’s no apparent cause); in some cases pain can signal a serious condition, such as cancer or scoliosis. Also, before you climb into the massage chair or lie down on the table, you’ll probably want answers to a few questions.

How does massage ease pain?

Massage seems to ease pain in several different ways. For starters, it can increase blood flow to sore, stiff joints and muscles, which are warmed by the extra circulation. As reported by the National Center for Complementary and Alternative Medicine, animal studies have found that massage also triggers the release of natural painkillers called opioids in the brain. (The report doesn’t explain how scientists massage the animals.) Animal studies also suggest that massage speeds up the flow of oxytocin, a hormone that relaxes muscles and encourages feelings of calmness and contentment. As an aside, oxytocin happens to be the same hormone that flows through women before labor. It relaxes the uterus and helps cement the bond between mother and infant, earning it the nickname “love hormone.” Massage may also change the way the brain senses pain. As Stanford neuroscientist Robert Sapolsky has said, the short, sharp sensations of a good massage can temporarily make the brain forget about other aches.

How effective is massage for pain relief?

There’s little doubt that a good rub-down can ease pain and tightness in stressed, overworked muscles. Now there’s growing evidence that it can also help relieve chronic (long-lasting) pain, especially the lower-back variety. A study of 262 patients published in the Archives of Internal Medicine found that massage was far superior to acupuncture or patient education for relieving back pain. After 10 weeks, 74 percent of patients said massage was “very helpful.” Only 46 percent for those who received acupuncture and about 17 percent of those who read a self-help book had the same response. Massage patients were also four times less likely than other patients to report being bedridden with pain. The authors concluded that “massage might be an effective alternative to conventional medical care for persistent back pain.”

In a true test of its value, massage has even been shown to ease the chronic pain and other miseries suffered by cancer patients. A study of more than 1,200 patients at Memorial Sloan-Kettering Cancer Center published in the Journal of Pain and Symptom Management found that massage reduces symptoms such as anxiety, nausea, and pain by about 50 percent.

All golf enthusiasts look for an edge

All golf enthusiasts look for an edge that can help them train more effectively, lower scores or overcome injuries quickly.

Most golfers will push their body to the limit to achieve greater speed, endurance or power in the swing. All this pushing puts stress on the muscles and requires a great deal of recovery in order to avoid injury and overuse trauma. Golfers have one of the highest risks of injury due to muscle overuse.

Sports Massage for Golf, can increase flexibility, speed recovery time after rigorous practice and decrease your chance of injury allowing you to achieve your true golf potential.

What are the risks of sitting too much?

Mayo Clinic Reports:

Research has linked sitting for long periods of time with a number of health concerns, including obesity and metabolic syndrome — a cluster of conditions that includes increased blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels. Too much sitting also seems to increase the risk of death from cardiovascular disease and cancer.

http://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/sitting/faq-20058005

Dormant Butt Syndrome May Be To Blame For Knee, Hip and Back Pain

COLUMBUS, Ohio – Millions of people in the U.S. suffer from knee, hip or back pain, and experts at The Ohio State Wexner Medical Center say dormant butt syndrome (DBS) may be the cause.

Dormant butt syndrome refers to the tightness of the hip flexors and weakness of the gluteal muscles. When gluteal muscles are weak, the muscles and joints around them absorb strain during exercise, often causing hamstring injuries, back pain, hip pain and knee injuries that could lead to surgery.

“The entire body works as a linked system, and a lot of times when people come in with knee or hip injuries, it’s actually because their butt isn’t strong enough,” said Chris Kolba, a physical therapist at Ohio State Wexner Medical Center. “The rear end should act as support for the entire body and as a shock absorber for stress during exercise. But if it’s too weak, other parts of the body take up the slack and often results in injury.”

Kolba coined the term “dormant butt syndrome” related to such injuries, which can be caused by tight hip flexors and can lead to everything from chronic pain in the lower back to injuries to the meniscus, often resulting in knee surgery.

However, DBS isn’t just caused by those who exercise improperly.

“It’s actually caused quite often by inactivity and the way we sleep,” Kolba said. “Sitting for periods throughout the day weakens the gluteal muscles and puts strain on other parts of our core, as does sleeping in the fetal position.”

Kolba says stretching, making a point to stand and walk as often as possible throughout the day and adding exercise to strengthen the gluteal muscles can help you avoid pain and injury in other parts of the middle to lower body.

Dormant Butt Syndrome

How to excel in your sport

Like a finely tuned sports car, athletes need to be in top physical form to excel in their sport. This requires regularly scheduled proactive maintenance, as you ramp up training.

The best way to help athletes perform is an effective massage maintenance program. Working together to decide on combined treatments depends on muscles usage and activity levels on any given training day.

Focusing in on particular muscle systems and working specific tissues goes a long way toward building optimal conditioning and the prevention of strain and injury. The objective is to help the athlete reach optimal performance through injury-free training.