Massage News - July 2013

Massage News - July 2013

The evolution of throwing

Humans are the only species that are able to throw objects incredibly fast and with great accuracy. Darwin noted that the unique throwing abilities of humans, which were made possible when bipedalism emancipated the arms, enabled foragers to hunt effectively using projectiles. Researchers from George Washington University and Harvard University, led by Neil Roach investigated when, how and why humans evolved the ability to generate high-speed throws. Their study was publsihed in the June edition of Nature.

Using experimental studies of humans throwing projectiles the authors showed that our throwing capabilities largely result from several derived anatomical features that enable the storing and releasing energy in the tendons and ligaments crossing the shoulder. This energy is used to catapult the arm forward, creating the fastest motion the human body can produce, and resulting in very rapid throws.

The authors showed that this ability to store energy in the shoulder is made possible by three critical changes in our upper bodies that occurred during human evolution:

the expansion of the waist, a lower positioning of the shoulders on the torso, and the twisting of the humerus. All of these key evolutionary changes first appear together approximately 2 million years ago in the species Homo erectus.

Roach, N.T., Venkadesan, M., Rainbow, M.J., Lieberman, D.E. 2013. Elastic energy storage in the shoulder and the evolution of high-speed throwing in Homo. Nature.

http://cashp.gwu.edu/ntroach/the-evolution-of-throwing/

Fibromyalgia Mystery Finally Solved?

Researchers have found the main source of pain in Fibromyalgia patients, and contrary to what many believe, it does not stem from the brain. The findings mark the end of a decades-old mystery about the disease, which many doctors believed was conjured in patients’ imaginations. Up until recently, many physicians thought that the disease was “imaginary” or psychological, but scientists have now revealed that the main source of pain stems from a most unlikely place- excess blood vessels in the hand.

To solve the Fibromyalgia mystery, researchers zeroed in on the skin from the hand of one patient who had a lack of the sensory nerve fibers, causing a reduced reaction to pain. They then took skin samples from the hands of Fibromyalgia patients and were surprised to find an extremely excessive amount of a particular type of nerve fiber called arteriole-venule (AV) shunts.

Up until this point scientists had thought that these fibers were only responsible for regulating blood flow, and did not play any role in pain sensation, but now they’ve discovered that there is a direct link between these nerves and the widespread body pain that Fibromyalgia sufferers feel.

The breakthrough also could solve the lingering question of why many sufferers have extremely painful hands as well as other “tender points” throughout the body, and why cold weather seems to aggravate the symptoms. In addition to feeling widespread deep tissue pain, many Fibromyalgia patients also suffer from debilitating fatigue.

Neuroscientist Dr. Frank L. Rice explained: “We previously thought that these nerve endings were only involved in regulating blood flow at a subconscious level, yet here we had evidences that the blood vessel endings could also contribute to our conscious sense of touch… and also pain,” Rice said. “This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation fibromyalgia patients. This, in turn, could contribute to the hyperactivity in the brain.”

Read the research in more detail: http://www.intidyn.com/Newsroom/Fibromyalgia%20Pathology%20for%20lay%20people%202013-06-24.pdf

Does massage relieve pain in the active phase of labour?

The study, conducted by researchers in Brazil and published in the Australian Physiotherapy Association’s Journal of Physiotherapy , found health professionals should encourage massage to assist women in labour as it “reduced the severity of pain in labour”. Researchers also found massage provides the birthing woman with direct contact with another person during the active stage of labour, providing emotional support, and they also discovered there were no adverse effects on the path of delivery or the newborn.

The study involved 46 women pregnant at 37 weeks gestation with a single fetus, with spontaneous onset of labour, 4-5cm of cervical dilation, intact ovular membranes and no use of medication after admission to hospital. In the experimental group, physiotherapists provided participants with a 30 minute lumbar massage during the active phase of labour while a physiotherapist attended the control group of participants for the same period but only answered questions.

The primary outcome was pain severity measured on a 100mm visual analogue scale. Secondary outcomes included the Short Form McGill Pain Questionnaire, pain location, and time to analgesic medication use. After labour, a blinded researcher also recorded duration of labour, route of delivery, neonatal outcomes, and the participant’s satisfaction with the physiotherapist during labour.

At the end of the intervention, pain severity was 52mm in the experimental group and 72mm in control group, which was significantly different with a mean difference of 20mm . The groups did not differ significantly on the other pain-related outcome measures. Obstetric outcomes were also similar between the groups except the duration of labour, which was 6.8hr in the experimental group and 5.7hr in the control group, mean difference 1.1hr. Patients in both groups were satisfied with the care provided by the physiotherapist.

The authors concluded that massage reduced the severity of pain in labour, despite not changing its characteristics and location.

J Physiother. 2013;59(2):109-16. doi: 10.1016/S1836-9553(13)70163-2. Massage reduced severity of pain during labour: a randomised trial. Moderate pressure massage therapy can decrease pain for rheumatoid arthritis patients

Touch Research Institute at the University of Miami School of Medicine, announced the results of a new study that concludes moderate pressure massage therapy can decrease pain for rheumatoid arthritis patients.

Additionally, the study found that rheumatoid arthritis patients experienced perceived greater grip strength and greater range of motion in their wrists and large upper joints, including elbows and shoulders, after receiving moderate pressure massage therapy for one month. The study’s overview and results were published in the 2013 19 edition of Complementary Therapies in Clinical Practice Journal.

“Rheumatoid arthritis is a chronic disease that causes joints to become swollen, tender and stiff. While there is no cure to date, we do know now that moderate pressure massage therapy can help relieve pain and improve the quality of life for patients,” said C.G. Funk, vice president of industry relations and product development for Massage Envy. “The findings will be utilized to better educate our therapists, members, guests and the public on how to best incorporate massage into an overall wellness plan.”

Led by Tiffany Field, Ph.D., of the Touch Research Institute, the study examined the effects of moderate pressure versus light pressure massage therapy on 42 adults with rheumatoid arthritis in the upper limbs. The adults were randomly assigned to a moderate pressure or a light pressure massage therapy group. A therapist massaged the affected arm and shoulder once a week for a four-week period and also taught the participant self-massage to be done once daily. By the end of the one-month period, results of the study demonstrated the moderate pressure massage group had less pain, increased grip strength, increased wrist flexion, increased elbow flexion and increased shoulder abduction.

The study also found that participants in both groups experienced a reduction in depressed mood and anxiety.

“As patients with rheumatoid arthritis work with their doctors to determine the best treatment option, we recommend discussing routine massage therapy given the positive effects found in our study,” said Field.

“In addition to physical activity, such as yoga, moderate pressure massage therapy along with self-massage techniques can help manage the pain and stress that occurs from various forms of arthritis.”

Field T., Diego M., Delgado J., Garcia D., Funk CG., Rheumatoid Arthritis in Upper Limbs Benefits from Moderate Pressure Massage Therapy. Complementary Therapies in Clinical Practice. 2013 May;19(2):101-3. doi: 10.1016/j.ctcp.2012.12.001.

Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis?

Owing to the change in paradigm of the histological nature of epicondylitis, therapeutic modalities as exercises such as stretching and eccentric loading and mobilisation are considered for its treatment.

OBJECTIVE: To assess the evidence for effectiveness of exercise therapy and mobilisation techniques for both medial and lateral epicondylitis.

METHODS: Searches in PubMed, Embase, Cinahl and Pedro were performed to identify relevant randomised clinical trials (RCTs) and systematic reviews. Two reviewers independently extracted data and assessed the methodological quality.

RESULTS: One review and 12 RCTs, all studying lateral epicondylitis, were included. Different therapeutic regimes were evaluated: stretching, strengthening, concentric/eccentric exercises and manipulation of the cervical or thoracic spine, elbow or wrist. No statistical pooling of the results could be performed owing to heterogeneity of the included studies. Therefore, a best-evidence synthesis was used to summarise the results. Moderate evidence for the short-term effectiveness was found in favour of stretching plus strengthening exercises versus ultrasound plus friction massage.

Moderate evidence for short-term and mid-term effectiveness was found for the manipulation of the cervical and thoracic spine as add-on therapy to concentric and eccentric stretching plus mobilisation of wrist and forearm. For all other interventions only limited, conflicting or no evidence was found.

CONCLUSIONS: Although not yet conclusive, these results support the belief that strength training decreases symptoms in tendinosis. The short-term analgesic effect of manipulation techniques may allow more vigorous stretching and strengthening exercises resulting in a better and faster recovery process of the affected tendon in lateral epicondylitis.

Br J Sports Med. 2013 May 24. Does effectiveness of exercise therapy and mobilisation techniques offer guidance for the treatment of lateral and medial epicondylitis? A systematic review. Hoogvliet P, Randsdorp MS, Dingemanse R, Koes BW, Huisstede BM. The effect of hand massage on preoperative anxiety in ambulatory surgery patients

Anxiety in patients awaiting surgery and diagnostic procedures in an ambulatory department can affect the patient’s physiological and psychological well-being and outcome.

A study was conducted a quasi-experimental study at a midwestern US community hospital to determine the effects of hand massage on patient anxiety in the ambulatory surgery setting. The authors also investigated whether adding the hand massage procedure affected the timing and flow of procedures.

The results indicated that hand massage reduces anxiety for patients awaiting ambulatory surgery and outpatient procedures. Participants who received hand massage experienced lower anxiety levels than those who received customary nursing care. In addition, the performance of hand massage did not affect the flow or timing of procedures. Hand massage is an easy procedure for nurses to learn and administer, and it is within the scope of perioperative nursing practice.

AORN J. 2013 Jun;97(6):708-17. doi: 10.1016/j.aorn.2013.04.003. The effect of hand massage on preoperative anxiety in ambulatory surgery patients. Brand LR, Munroe DJ, Gavin J.

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