Those of you who know me, know that I’m probably one of the healthiest people you’ll meet. I eat well, I sleep well, I keep stress low, I exercise (sometimes I even run!). I take my vitamins. I get bodywork.

A couple of years ago my low back started hurting, then my hip. It was really painful. I got some massage. I had a mercedes benz health plan thru my partner’s job at the time. So I went to the chiropractor, the acupuncturist, the DO. I got the recommended XRays and MRI. It got a scary sounding diagnosis. In the end it was massage 2 times a week for 3 weeks that did the trick. No problem since then.

Until now. Now that I’ve been denied coverage because I had some pain and took care of myself. I’m one of the latest causualities in the pre-existing condition debate.

Perhaps there will be change soon. Senator Ron Wyden was among 13 others who voted the Baccus bill out of committee yesterday.

Talking about the ankle warrants a discussion of the foot as well, since the ankle exists to move the foot. But, you’ll have to tune in to the next newsletter for that story …

If asked to point to your ankle, you’d probably indicate the knobby bumps just above your feet. Anatomically, these are called malleoli (malleolus is singular) and they are simply the bottom part of the lower leg bones. These malleoli function like pulleys allowing muscles in the lower leg to move the foot.The ankle joint itself is the junction of three bones: the bottom of the fibula, the bottom of the tibia (shin bone) and the talus (a foot bone). The joint acts like a hinge – meaning it only moves up and down. The side to side motion you make is really a movement of the foot. Numerous ligaments bind the bones of the leg and foot together while allowing some movement.

By far the most common ankle injury is a sprain, in which a ligament is torn or overstretched. Other conditions in the neighborhood include shin splints and muscle cramps in the calves, both of which can respond well to massage treatment. A ruptured Achilles tendon is extremely painful and debilitating. After surgery and physical therapy, skilled massage can enhance the recovery.

Maintaining or regaining the function of your ankles allows you to safely propel yourself forward up Dog Mountain, take a jump shot, and pick up your (small) kids.

Originally published by Marsha Hansen, LMT in 2/06 newsletter.

When performing bicep curls with dumbells you would call the supinator into play as you curl the weights toward your chest. See the position of the palms? They’re supinated. Using a (manual) screwdriver requires strength and stamina in the supinator. Turning some doorknobs require the use of the supinator.

Trigger points in the supinator can be dificult to distinguish from trigger points in other forearm muscles. Pain is felt near the lateral part of the elbow and at the base of the thumb. The thumb may also present with a vague numbness.

My friend and colleague, Jim Dwyer, an attorney at Heiling Dwyer & Associates, is a great source for personal injury information. One of the things he likes to educate people about is revealing to your health care team any information about current and old similar injuries. That old back problem from college soccer, the car accident in ‘98, and the foot pain you were experiencing two months before the accident are all important to document.

“Honesty and candor are critical to a full recovery and a successful claim.”

Individual rotatore muscles attach the transverse process of one vertebra to the spinous process of another; this gives it a diagonal placement which causes the rotation when the muscle is put to use. The whole group of rotatores are placed from the lumbar to the cervical vetebrae. Along with two other groups of small spinal muscles, they make up the transversospinalis group.

People with very tight or contracted rotatores may appear to have a stiff back with very limited ability to make minute, subtle spinal movements. Trigger points in the rotatores refer pain close to the source; generally a client will describe pain right next to the spine. Often releasing tension in the deep spinal muscles can make chiropractic adjustment easier. Occasionally, a client will have a “spontaneous adjustment” after trigger points are released.

With its two short tendons attaching to the bottom end of the femur (thigh bone), the gastroc allows you to bend (flex) your knee. The long, inferior tendon was made rather famous by stories about a Greek warrior name Achilles. The Achilles tendon (more properly called the calcaneal tendon) crosses the ankle to attach to the heal bone (the calcaneus), allowing you to point your toe, also known as plantar flexion.

Many activities this holiday season may cause overuse in the gastrocs. Walking up stairs and escalators at the mall, inching along in traffic unable to use cruise control, and standing in line at the post office can create conditions that trigger points find attractive. Trigger points in the gastroc usually cause localized pain and pain in the arch of the foot.

Flying long distances can cause calf trouble for people at risk for deep vien throbmosis (DVT). Cramping in the calves can be caused by trigger points, poor circulation, or inadequate nutrition, especially calcium and magnesium.

Contracting the SC on one side will rotate and/or laterally flex (bring ear to shoulder) your neck on that same side. Looking up (extension) requires contraction of both SC simultaneously.

As a neck muscle the splenius capitis is susceptible to injuries such as whiplash. Trauma involving the neck or head can allow trigger points to develop in this muscle. Over or misuse of the muscle (especially related to posture) can also set the stage for trigger points.

Trigger points in the splenius capitis generally refer pain to the top of the head. Headaches of this nature can be relieved if trigger points are causing them and can be deactivated.

As a massage therapist, working on an area of inflamation is contraindicated – we’re not supposed to treat it. With MLD I’ll will learn – among other things – how to treat inflamation gently, effectively, and safely.

Learning to treat an area of inflamation within hours of onset, will allow me the ability to help clients enhance the recovery process. By adding this tool to my bag of tricks, I can help even more people who have had surgery or have been injured.

In order advocate for the patient as best I can, I bill the auto insurance company and communicate with the patient’s attorney and physicians. Here’s a tip (#286) from my experience:

Beware the IME. Your auto insurance company may request (require) you to have an “independent” medical exam (IME). Although perfectly legal and often standard practice, such a request is a red flag that demands your attention. If you do not already have a good personal injury attorney working for you, it’s time to get one. If you do have a PI attorney, alert him/her to the IME request so you can be guided properly through it. People on your medical team who are advocating for you will also want to know of this development.

If you have any questions about being treated with massage for recent MVA injuries, feel free to call me at 503.516.2108. Or visit this page within my website.