TRIGGER FINGER. DOES KINESIOLOGY TAPE HELP?

Will kinesiology tape help Trigger Finger?

Trigger finger is not something we see very often in our clinic so when a client came in with it as one of their concerns we were intrigued.  I say "we" because even though one of us works with the client we often consult each other to get opinions and bounce ideas of one another.  

This was a regular client who had a recent shoulder surgery and the pinkie and pointer fingers of that hand were getting stuck in a flexed position at random times every day.  The client would have to take their other hand to "pop" the flexed fingers back straight.

What is Trigger Finger?

The Mayo Clinic describes trigger finger, also known as stenosing tenosynovitis, as a condition in which one of your fingers gets stuck in a bent position.  Your fingers may straighten with a snap - like a trigger being pulled and released.  

Trigger finger occurs when inflammation narrows the space within the sheath that surrounds the tendon in the affected finger.  If trigger finger is severe, your finger may become locked in a bent position.  

How to apply the Kinesiology tape?

Would using Kinesiology tape on the flexors of the forearm be better to relieve this condition or would taping the extensors be of more benefit?  The top of our forearm is where the muscles and tendons sit to extend or straighten our fingers.  Conversely, the muscles and tendons on the underside of our forearm have the action of flexing the fingers.  We know this client's overactive flexors seem to be the problem but kinesiology tape can be used to excite or stimulate under-active muscles or calm or inhibit the overactive muscles.  

In this client's case we had a choice to make.  Which would be better to try first in hopes of giving the most relief while the trigger finger heals. 

Here is the kinesiology tape application chosen.

Because this was something we've never tried before and after research, seems not many others have tried either, we went with our gut.  The extensors of the forearm seemed ineffective in straightening the fingers when the client made a fist.  In theory, the tape would assist the muscles and tendon attachments to extend the effected fingers and help with inflammation.  This is an oversimplified explanation of how kinesiology tape works.  To read about how the tape works visit http://www.massagelamesa.com/kinesiology-tape.html


Part of the reason for choosing to tape the extensors was practical in nature. We know well applied kinesiology tape can stay on for 4-5 days and we figured with hand washing and how often the hands are used this application would begin curling up around the edges on the fingers sooner, which it did.  Tape on the underside of the hand would curl even sooner.

The results

The client reported no significant change in how often the effected fingers "stuck" in flexion.  The client never reported pain when the fingers stuck so we can't say if the tape decreased pain which it has for many other taped clients. The advantage of taking pictures is to have a visual to duplicate the taping if it's a success and to make changes if the tape seemed ineffective.  We make notes and mark body diagrams in the office but the pictures have proven invaluable multiple times and this case was no different.  In looking at the picture there is an obvious change that could be made.  The tape could extend farther up the forearm toward the elbow to cover more of the bellies of the extensor muscle group.  The therapeutic zone of the kinesiology tape would then expand more on the forearm itself.  This may or may not make a difference but that's the fun of what we do.  We try new things, collaborate and keep our minds stimulated because the human body is amazing and it keeps us on our toes!          

         
 

MASSAGE AS TREATMENT FOR TENNIS ELBOW AND GOLFER'S ELBOW

What is the difference between Tennis elbow and Golfer's elbow?

Both are overuse injuries that are caused by any activity that requires repetitive motion of the arm and wrist.  The difference between the two are where the elbow is inflamed which in turn makes it hurt on either the inside or the outside of the elbow.

What is Tennis Elbow?

Tennis elbow or lateral epicondylitis is inflammation of the tendons of the elbow which cause pain on the outside of the elbow.  This overuse condition is commonly seen in painters, carpenters, plumbers, although we often see clients who've recently increased yard work or completed a gardening project when the pain starts.  Of course many people complain of the pain without any knowledge of one of these activities bringing on the symptoms.    

What is Golfer's Elbow?

Golfer's elbow or medial epicondylitis is inflammation of the tendons of the elbow which cause pain on the inside of the elbow.  The pain may present itself or increase when twisting the forearm, or when making a fist or shaking hands. Additional symptoms can include stiffness in the elbow or weakness in the hands or wrist.    

This condition can be caused by any activity that requires repeated twisting or flexing of the wrist.  In addition to golf, other activities may cause this condition such as racquet sports, baseball, weightlifting, or other similar activities. Repeated lifting, particularly when your elbow is extended and your palm is facing downward, can also cause Golfer's Elbow.  

Treatment for Tennis and Golfer's elbow

Immediate treatment should be ice and rest.  A topical analgesic like Biofreeze is a great temporary pain reliever which can be applied as many times as needed.  It may take several weeks (6 or more) of resting the elbow and wrist to feel a decrease in pain, and even longer until the symptoms are gone completely.  Tendons have a limited blood supply so they take longer to heal.  In addition, it's difficult to fully rest the effected arm because of use for activities of daily living.  Immobilizing the arm is not a desired course of treatment.  

80-95% of patients have success with nonsurgical treatment

Massage as treatment for Tennis Elbow and Golfer's elbow  

Chronic elbow tendonitis can be caused by forearm muscles that are hypertonic (too tight) from overuse. Stretching the forearms may help restore optimal tone to hypertonic muscles, but when that doesn't work massage is a good alternative. Massage strokes including striping of the flexors and extensor group of muscles works as well as Active Release Technique (ART).

Kinesiology taping for Tennis elbow and Golfer's elbow

We began kinesiology taping months ago and injuries like tendonitis respond really well to the taping method. This picture is one example of a taping for tennis elbow. The kinesiology tape doesn't cure the problem but does take some of the pain away and helps the area heal more quickly. To read more about how kinesiology tape works visit our website.

CUPPING. WHY WE'RE DOING IT.

Cupping releases tight fascia.  We're on-board!

Traditionally cupping, a 3000 year old Chinese alternative medicine treatment, isn't something a Western medicine minded massage clinic would consider using.  After the 2016 Summer Olympics showed athletes with strategically placed large circular bruises this cupping technique gained a lot of exposure. Let's look at the two different sides of cupping, Eastern and Western, and why cupping does have a place in a massage clinic that doesn't practice traditional Chinese medicine.  

Cupping.  Eastern vs. Western          

Cupping Therapy as practiced in Traditional Chinese Medicine.

Eastern theory believes energy or "qi" flows along channels in the body commonly called meridians.  When a person's qi is blocked pain results.  

Glass cups are used with a vacuum like suction either by pumping the air out or by the technique of applying rubbing alcohol to the inside of the cup and lighting it on fire to suck out the air before placing the cup on the client's skin. 

Through negative air pressure, cupping breaks the capillaries to let out stagnated blood, which is thought to be impeding the flow of qi. This begins the body's reaction of repair.  The glass cup can be left on one area for up to 15 minutes and when removed the cup leaves distinctive circular skin markings.  The body's metabolic process rebuilds the "bruised area", absorbing into the bloodstream for waste disposal and ultimately restoring the free flow of qi.  The markings created by the cups usually disappear within 5-7 days.

Cupping Therapy practiced with a Western Mindset.

Massage with a Western Medicine mindset is very clinically based with an anatomical focus of origin and insertion of each muscle and how to best create elasticity of tissues and greatest mobility of muscles and joints.  Cupping can help with this which is why we've added it to our tool-set.  

Using silicone cups which apply enough suction to lift the fascia but not enough to leave the skin bruised, massage therapists can either leave the cup stationary or move it over the skin.  A slight amount of oil on the skin allows this movement of the cup in a rotational force when linear applications aren't working.  Using the traditional method of hands to deliver massage strokes doesn't offer many options for a concentrated rotational lifting of fascia.  This fascial lifting separates the fascia from underlying muscle which allows for deeper massage strokes.

When fascia is tight it can take a lot of time to release it before deeper work can be achieved.  For a massage therapist who is working within a one hour time frame, the sooner the fascia releases the better for the outcome of the session. A Massage La Mesa regular client of 7 years, who has chronically tight fascia, had the same success with five minutes of cupping that normally took 20 minutes of hands on massage time.  This is great for achieving more during a session.  

Cupping assists in trigger point release.

Neuromuscular therapy (Trigger Point Therapy) is a well used modality to reduce pain and increase range of motion.  Neuromuscular therapy releases trigger points in a muscle.  By placing a silicone cup over the trigger point, or hypersensitive area, and leaving it for 20-40 seconds, a stubborn trigger point may release when hand or finger pressure isn't working.      

        

Is there any science behind cupping results?

Wikipedia is one source which says cupping is poorly supported by evidence and it's effectiveness is hard to determine because of the difficulty of creating a double-blind study.  Some say the positive effects of cupping are merely a placebo effect.  Although long term reduction in muscle and fascial tightness remains to be seen, massage therapists can benefit from using cupping for individual session goals.  When used as a "warm up" or a piece of the total massage session cupping can be a relaxing as well as therapeutic technique.        

    

RELAXATION AND STRESS RELIEF PLAY A KEY PART IN HEALING

RELAXATION AND STRESS RELIEF ARE IMPORTANT ELEMENTS IN MASSAGE THERAPY.

As we prepare to move our office a lot of thought is being put into how each massage room is going to look.  Some clients say it doesn't matter because they come for the massage not the decor.  As experienced massage therapists we disagree.  We know it does matter!  We want the rooms to look nice of course but it's more than that.  The sooner a client can relax, the better outcome we get from the massage.  

Relaxation improves massage results. 

Relaxation can be enhanced by appealing to as many of the five senses as possible during massage.  

• Touch.  The massage itself is perfect for that.  
• Smell.  Essential oils are part of each massage session.  
• Auditory.  We use mainly soft music without words during the massage.  
• Visual.  This takes us back to how the room looks.

We are visual creatures.  As we enter a room, whether it's our home or a place of business, we feel something.  Consciously or subconsciously, the way a space is laid out can make us uptight or put us at ease.  To help the body relax, a room should be clean and free of clutter.  Each piece in the room should serve a purpose and be laid out with attention to flow and functionality.   

The massage work itself always contains an element of relaxation.

Although we are a clinically based massage center, and some of the therapeutic techniques are uncomfortable, there is always an element of relaxation in each session.  No one can bear an hour of trigger point work without some "feel good" strokes mixed in.  Swedish massage is best used for relaxation and stress relief.  

Sympathetic and Parasympathetic nervous systems. Massage stimulates which?

Our bodies can move between two main states of being.  The sympathetic state and the parasympathetic state.  

• The sympathetic nervous system is our "fight or flight" response.
• The parasympathetic nervous system can be called the "rest and digest" response.    

Most people are in some level of sympathetic state just dealing with day to day stresses.  Massage has been shown to help the body shift into the parasympathetic state where the body gets the most benefit.    

The parasympathetic state is where your body can relax and heal. 

While stimulating this parasympathetic state, the body releases "feel good" hormones like serotonin and dopamine.  Blood pressure lowers and rate of respiration slows which is why some people get cold halfway through their massage.  Massage also lowers the stress hormone cortisol and lowers the excitatory hormones, epinephrine and norepinephrine. 

If we just look at these chemicals and what their role is in the body, it seems obvious we need to add relaxation into our daily routine.  If there is too much epinephrine or norepinephrine it can lead to feelings of anxiety.  Too little dopamine and serotonin can cause depression and other psychological problems.  If relaxation or massage induced relaxation is a way to fix these, who wouldn't try it?   

Massage lowers the stress hormone cortisol.

With the current overly-scheduled and overly-stimulated epidemic our society faces it's no wonder why 75%-90% of all doctor's office visits are related to stress.  As massage therapists we would be doing our clients a disservice if we treated only the muscle tissue when we have the chance to involve the person as a whole and treat the mind and emotional state too.  Stress relief and relaxation can benefit and aide the body on it's way to healing.  

Come see us at our new location beginning October 10th to see how the massage rooms turned out.