One of the most common concerns that I hear is, “My shoulder hurts. I have difficulty raising my arm. Basic everyday movements cause me pain and discomfort”. Most times, it’s not the shoulder muscles (front, side, or rear deltoid muscles) it’s the rotator cuff muscles.
What are the rotator cuff muscles and what are their functions?
ln simple terms without getting to deep into medical terms, the rotator cuff is comprised of four muscles. These individual muscles join at the shoulder to form a “cuff” over the shoulder.
The four parts of the rotator cuffs are:
Supraspinatus- This muscle starts above the spine of the scapula or top of shoulder blade and inserts on the greater tuberosity of the humerus. The supraspinatus function is to externally rotate the shoulder joint away from the midline, abduct, and elevate the shoulder joint out to the side. It also works with other rotator cuff muscles to stabilize the head of the shoulder joint.
Infraspinatus- This muscle originates below the spine of the scapula and inserts onto the greater tubercle of the humerus. The infraspinatus also externally rotates the shoulder joint away from the midline of the body and stabilizes the head of the shoulder joint as well.
Teres minor- This muscle originates on the lateral part of the scapula just below the infraspinatus and inserts into the inferior aspect of the greater tuberosity of the humerus. The teres minor also externally rotates the shoulder joint away from the midline of the body and it also stabilizes the head of the shoulder joint.
Subscapularis- This muscle, deep in the shoulder blade, originates on the anterior surface of the scapula and sits directly over the ribs and inserts on the lesser tubercle of the shoulder joint. The subscapularis muscle depresses the top or head of the shoulder allowing you to move freely in the shoulder joint and during elevation of the arm. The subscapularis internally rotates the shoulder joint towards the midline of the body and it also stabilizes the head of the shoulder joint.
Basically, all four rotator cuffs work together to consolidate the humerus bone in the shoulder joint so when you lift your arm up the rotator cuff muscles pull the joint together and stabilize the shoulder joint. Whenever one or several of these tendons get overworked from repetitive movements or an imbalance, these tendons become inflamed or irritated; sometimes called “impingement syndrome”. This is not an overnight situation, it occurs over time.
How can Massage help rotator cuff tendonitis?
Massage in general, is one of the best methods for increasing blood flow to the injured area, therefore increasing the healing process. Massage therapy also helps to reduce scar tissue which over time restrict mobility of the joint. There are many modalities to help treat rotator cuff tendonitis. Upon a thorough assessment, a specific comprehensive care/treatment plan will be designed to meet the client’s goals and needs.
Plantar fasciitis causes pain in the bottom of the heel. The plantar fascia is a thick, web like ligament that connects your heel to the front of your foot. It supports the arch of your foot and helps you walk. Plantar fasciitis is one of the most common orthopedic complaints. Your plantar fascia ligaments experience a lot of wear and tear in your daily life. Normally, these ligaments act as shock absorbers, supporting the arch of the foot. Too much pressure on your feet can damage or tear the ligaments; the plantar fascia becomes inflamed and the inflammation causes heel pain and stiffness.
What are the symptoms of plantar fasciitis?
The major complaint of those with plantar fasciitis is pain on the bottom of the heel but some people experience pain at the bottom mid-foot area. This develops gradually over time. It usually affects just one foot, but it can affect both feet. Some people describe the pain as dull while others experience a sharp pain. Some people feel a burning or ache on the bottom of the foot extending outward from the heel. The pain is usually worse in the morning when you take your first steps out of bed or if you’ve been sitting or lying down for a while. Climbing stairs can be very difficult due to heel stiffness. After prolonged activity, the pain can flare up due to increased inflammation. Pain isn’t usually felt during the activity but rather just after stopping.
Tight Achilles tendons, which are the tendons attaching your calf muscles to your heels, may also result in plantar fascia pain. Wearing shoes with soft soles and poor arch support can also result in plantar fasciitis. Plantar fasciitis isn't typically the result of heel spurs.
There are many treatment options available. My services would include massage, reflexology, hydrotherapy, stretching, strengthening. In addition, change of shoes, arch supports, orthotics, night splints, anti-inflammatory agents and surgery could potentially help. Usually, plantar fasciitis can be treated successfully by tailoring a treatment to an individual's risk factors and preferences.
I would like to talk about another topic that I have experienced with my clients, high blood pressure.
There are so many health-related issues people should pay attention to, but few are more important and more immediate and easily remedied for most people than high blood pressure.
Through proper nutrition, supplementation, and an exercise program we have a chance to get our bodies back in balance. It is important to note that a multi-faceted approach will always be the most successful. No one thing will fix the problem. Certainly, not taking a pill which in most cases only serves to dehydrate you and doesn’t address the cause of the problem. That is why I would like to discuss the high blood pressure regiment that I use with my clients. It would be irresponsible of me not to start by saying that the single most effective factor in reducing blood pressure is weight loss. Now I understand that is not something you can do today but you can certainly get started by improving your diet and taking 10-minute walks after each meal. It is also important to point out that high blood pressure is not always weight related. So, what I put together is a list of the top 5 things you can do today that will reduce your blood pressure immediately.
1) sleep: lack of sleep is a major contributor to high blood pressure particularly sleep loss due to sleep apnea.
2) potassium: potassium is important for relaxing the blood vessels. The average person should be consuming 4700 mg milligrams of potassium every day. Therefore, I include plenty of spinach every day along a daily fruit and salmon a few days per week.
Most people are getting less than half the necessary potassium daily, this is big and absolute deal breaker for high blood pressure which also provides important cardiovascular benefits for the general population and athletes. (prevents muscle cramping). I guess Popeye was right about eating spinach every day.
You should always eat your vegetables with some protein and some fats. The protein stimulates gastric acid and lowers the stomach pH so the minerals are better absorbed. The fats are necessary to shuttle all those minerals into cells.
3) magnesium: magnesium is another critical element that plays a huge role in regulating blood pressure by relaxing the blood vessels and transporting potassium and calcium. Once again, in addition to potassium, spinach is a magnesium powerhouse along with sprouted almonds, some yogurt and sugar-free cacao.
4) Calcium: calcium helps contract and relax the blood vessels. Spinach has calcium.
Keep in mind that vitamin D3 drastically improves calcium absorption by as much 20-fold and of course we can’t talk about calcium without mentioning vitamin K2 which helps decalcify the arteries and prevents calcium deposition of soft tissue. Vitamin K2 is found in egg yolks and grass fed dairy such as butter and cheese. (Most egg allergies are caused by avidin and egg whites so try yolks if whole eggs don’t agree with you.)
5) Low thyroid: hypo thyroidism has a huge effect on blood pressure. Sodium restriction may can decrease systolic blood pressure by generally 2-5 points. Proper thyroid function is critical for blood pressure regulation. Therefore, I personally include iodine in my nutrition programs in a form of pure cranberry juice along with daily fruit to optimize liver function where 80% of iodine is converted. Sleep also plays a big role in thyroid function.
Consuming poly unsaturated fats can increase inflammation and slow thyroid function. Farmers feed animals soy and processed vegetable oils to slow their thyroid and increase estrogen to fatten their animals. So, it is important to avoid these foods. Now I know it seems remiss of me not to include sodium reduction as part of my quick fix, but the science doesn’t support sodium restriction for blood pressure control for most people. Dr. D Nikhil Antonio’s book “The Salt Fix” covers this research in detail. I have a link for a comprehensive study on sodium intake called “The Pure Study”, if anyone is interested.
Over 20 years ago, Dr. McCarran published when adults meet or exceed the recommended dietary allowance of calcium, potassium and magnesium, the ingestion of a diet high in sodium chloride is not associated with elevated arterial pressure. In fact, a higher sodium chloride intake in these adults is most likely associated with the lowest blood pressure in society. One of the many reasons adequate salt intake is important is for proper digestion and absorption of these important minerals. Salt is sodium chloride as in hydrochloric acid. Over restriction of salt impairs digestion. Now I know that some doctors prescribe medications for high blood pressure which are often diuretics. Diuretics dehydrate you and deplete potassium and magnesium from the body. So, if you take these, it’s even more important for you to get more of these nutrients in your diet and to work with your doctor to reduce or illuminate these drugs as your diet improves your blood pressure. Some health professionals often recommend taking supplements such as omega-3s, turmeric or over the counter drugs such as aspirin. All of these are blood thinners so if you choose to supplement with these, you shouldn’t combine them. I would recommend wild caught salmon and cod liver oil over omega-3s supplements. Either way, you still want to get adequate minerals from foods in your diet. Medicines and supplements only serve to mask or relieve the symptoms and do not address the underlying cause.
So, if you have high blood pressure, I cannot stress enough how important it is for you to implement all these tips immediately. Your family and love ones are depending on you.
At one time or another we have all experienced a stiff neck or a pinched nerve from sleeping in a bad position. Maybe, you strained your neck while weight training or possibly from sitting in front of your computer all day.
You are not alone. Many people hold a lot of their tension in their neck. According to an article from the Centers for Disease Control and Prevention, chronic neck pain and stiffness is likely caused by daily habits from poor posture, stress, or imbalance of weak or tightened upper back muscles.
On the other hand, a pinched nerve in the neck is caused when the nerve that goes from the spinal cord to the neck or arm is irritated or has pressure on it. This could be caused by a narrowing of the spinal joint because of osteoarthritis and wear and tear from repeated injuries. A pinched nerve can cause numbness, tingling, deep aching, or electrical shooting pain from the side of the neck all the way down to the fingers on one side.
Our necks are one tuff muscle group, their daunting task is literally to hold up the weight of a bowling ball all day. This delicate balance to support our 11 pound head requires these muscles and ligaments to constantly perform a wide variety of tasks including movement of the head and neck and assistance in swallowing.
So, what’s the fix? In many cases, from my experience, being more aware of your posture is the first step in correcting neck position, whether it is how you sleep or how you sit in the car or perform repetitive movements. Secondly, daily exercise and stretching is a simple task but very effective. Just like any other muscle, we need to strengthen and stretch our necks to improve function and mobility.
Massage therapy is a great option for chronic pain. There are many types of massage including a variety of strokes, pressure and specialized techniques to help increase circulation, improve range of motion and overall wellbeing.
A randomized trial reported in the Clinical Journal of Pain concluded:
“Patients who received 10 massages over the course of 10 weeks experienced significant improvement in their neck pain because of that treatment. Furthermore, none of the patients experienced any adverse reactions to the treatment, proving that massage is not only effective but also safe to help alleviate that pain in the neck.”
This information is not intended as a substitute for professional medical care.
Frozen Shoulder is also known as “adhesive capsulitis.” Sound scary? My goal is to present some basic understanding by providing a few theories about frozen shoulder and what massage can provide.
What is frozen shoulder?
The term “frozen shoulder” was first introduced by Ernest Amory Codman in 1934. Codman also identified the marked reduction in forward elevation and external rotation that are the hallmarks of the disease. Frozen shoulder is a specific condition that has a natural history of spontaneous resolution and requires a management pathway that is completely different from such distinct shoulder conditions as a rotator cuff tear or osteoarthritis. The shoulder joint is the most complex joint in the body. With frozen shoulder, the tendons of the shoulder become inflamed and create a stickiness around the joint which limits range of motion.
How does a frozen shoulder happen?
One theory that applies to frozen shoulder is the condition in which the tissue connecting muscle to bone that’s around the shoulder joint becomes inflamed. The process usually begins with an injury (such as a fracture) or inflammation of the soft tissues, typically due to overuse injuries such as bursitis or tendinitis of the rotator cuff. Inflammation causes pain that is worse with movement and limits the shoulder's range of motion. When the shoulder becomes immobilized, the connective tissue surrounding the shoulder joint (glenohumeral joint) capsule thickens and contracts, losing its normal capacity to stretch. The humerus has less space to move in and the joint may lose its lubricating synovial fluid. In advanced cases, bands of scar tissue (adhesions) form between the joint capsule and on the head of the humerus.
The second theory, that is very interesting, is related to a metabolic syndrome which means that the body cannot manage the fats and sugars in the blood, creating chronic inflammation not only in the shoulder joint but throughout the entire body. Since the shoulder joint is the most complex joint it tends to feel it first. Treating this dysfunction with massage techniques will truly improve range of motion and quality of life.
So how does massage help?
My approach is to have the client totally engaged in this process meaning that I have them use visualization techniques to amplify the work that is being done to them. I personally use visualization techniques in my training which has helped me tremendously throughout my competitive career.
Using myofascial stretching techniques allow the shoulder to loosen up muscles that might be restricted from any sort of postural discrepancies that could be triggered with a frozen shoulder.
Active and passive stretching are key components in releasing a frozen shoulder by working within the clients range of motion allowing a lengthening and softening of the tissue around the attachment site.
This combination of pressure and movement changes the way the neurological patterns control how the dysfunctional muscles are responding. Basically, creating a new muscle pattern without pain.
Eccentric active release techniques trick the neurological component into allowing the muscle to actually contract and move at the same time. This technique has proven to be effective when it comes to frozen shoulder. This concept of pressure while creating any eccentric force is one of the more effective tools used in manual therapy. Massage is one of the best methods for increasing blood flow to the injured area therefore increasing the healing process. Upon a thorough assessment, a specific comprehensive care/treatment plan will be designed to meet the client’s goals and needs.
I would like to talk about the science of the 10-minute walk and how I believe you can change your life. Throughout the years, I’ve had clients with health issues that conventional cardiovascular work would be difficult or even impossible to do such as walking on a treadmill, elliptical or even a Stairmaster.
Around 2015, I came across an interesting article about the benefits of 10-minute walks. Skeptical as I was, I started to dig deep into the research and actually found that doing 30 minutes of cardiovascular work whether it was in the gym or just walking around is almost impossible for most people because of time restraints. Now, I always say if something is important to you, you certainly will make the time to do it. But for some of my clients, time management is sometimes a problem. From my experience, clients that were walking on treadmills and doing other cardiovascular work at a commercial gym would see some results over a period of time and then gradually start skipping their training probably due to getting bored doing the same thing day in and day out.
The research stated the benefits of taking multiple, brisk, 10-minute walks throughout the day immediately after meals increases insulin sensitivity by up to 30%. This results in lowering blood sugars, reducing insulin and generally helping to improve the symptoms of type II diabetes. From my own experience, I have been doing my 10-minute walks faithfully for the past two years and I can say with certainty that my lean muscle mass has increased, my strength has improved and my body fat has stayed within a healthy range. I do not experience bloating after meals and my blood profiles are all in healthy range.
Similar studies have been performed in many countries over the last few years and they all come to the same conclusion. Research also showed that walking is twice as effective for high blood sugars as prescription medicines such as metformin. This research also suggests that multiple brief walks is better than one long walk at the end of the day. Steady state cardio is not only unsustainable because it’s boring and time-consuming but it’s also ineffective long-term due to diminishing returns and muscle wasting affects. The 10-minute walks have solved both of these problems, but they also provide additional benefits such as reducing stress, improving heart and bone health, burning calories and improving recovery. The walks also decrease delayed onset muscle soreness by increasing blood flow and oxygen throughout the body, so you can recover faster. Some of the other benefits of 10-minute walks are: they help decrease gas and bloating, they improve digestion, they increase insulin sensitivity and then improve nutrient partitioning. (Nutrient partitioning- shuttling the carbohydrates that you eat into glycogen storage in the leg muscles that you are exercising while you walk which is why blood sugars and insulin levels are lowered more quickly.)
It is difficult to undo long periods of inactivity such as sitting all day simply by exercising at the end of the day. Of course, it certainly helps but a much more effective approach is to move more frequently throughout the day. For me and many of my clients, I find the 10-minute walks are easier to commit to. I found it much easier to consistently take a quick walk after three of the meals a day then getting in my car and going to the gym to do cardio. The beauty of doing 10-minute walks is that you could do it anywhere at any time. For instance, on days that it’s raining you could walk either in the mall, or a supermarket which I have done many times. Sometimes I even walk around my house for 10 minutes. I know it sounds crazy! But I get it done and that’s the most important thing so what I’m trying to tell you is that doing these 10-minute walks are easy. Just commit to walking for five minutes and turn around and come back. Let’s do this!
I was told throughout my career that Soy products were loaded with estrogen and will raise your estrogen levels in your body. Now that I became a vegan, whole food plant base (WFPB) I felt it was time to do my own due diligence. So, for the last several months I dove deep in search of the truth. Understanding these claims would not only put my mind at ease but would help me share information with confidence with my clients, family and friends.
Here’s what I found. Soy contains phytoestrogens. These are compounds that look like estrogen but can actually have the opposite effect by blocking some of our bodies estrogen receptors and preventing real dietary sources of estrogen from binding.
The results of what I learned were hard to face. The foods that contain real estrogen are animal foods like chicken, eggs and dairy which can have a significant impact on our hormone levels.
As I continued my research, I found that simply drinking cow’s milk can increase a man’s estrogen levels by 26% in just one hour while dropping their testosterone levels by 18%.
Another hormone strongly connected to diet is “cortisol”, a stress hormone linked to reduced muscle mass and increased body fat.
Research has showed people who replaced animal foods with high carbohydrate plant foods experience an average drop in cortisol levels of 27%.
Now you have to understand that for the last 40 years of my career I was told I needed to eat meat, eggs and milk products to get big and strong. Everybody was eating that way. In fact, my last name Manzo means “Beef.” So needless to say, this was a hard pill to swallow. My takeaway- always be open, humble and continue to research and learn. Let’s eat some tofu!