Light Therapy: Baking the pain away

Let the sun’s rays bake my pain away…

I am FINALLY on vacation after a long, hard year of doing what a New Yorker does best – hustling! Gratuitous amounts of massage meant that business has been very good, but inevitably that overwork had its downside a.k.a tendonitis. My workouts helped me push through and past my ¨magic number¨ of massages per day, but with all that repetative movement it was inevitable that I would develop an overuse injury. Nevertheless, in the weeks that led up to my Mediterranean vacay, I had been laying out in the sun every morning before work to both settle my mind and develop a ¨starter¨ tan. The added bonus was the heat of the sun hitting directly onto my upper back and shoulders really dissipated a lot of the pain and tension I felt from the previous day´s physical demands. Unbeknownst to me this heliotherapy I was giving myself is actually a therapeutic technique dating back to antiquity. A number of ancient cultures had an idea of the healing properties of light. Hippocrates, the father of modern medicine, prescribed sitting in the sun to heal a variety of illnesses. Herodotus, the ancient Greek historian, preached that the sun could help heal nerves and muscles. Many ancient Greeks built roofless buildings for the purpose of exposing themselves to the sun´s rays. Outside of ancient Greece, the Egyptians took it a step further and practiced bathing themselves in various colored light to cure diseases. Thousands of miles away in India, medical texts dating back to 1,500 BC also note the healing properties of light for skin disorders. Go even further to China and their medical texts from over 2000 years ago detail a range of color and light therapies for skin and mental illness.

A woman receiving light from a modern light therapy i.e. phototherapy box

So, seeing that the ancients had an inkling of what the sun could do for one´s health, modern medicine didn´t get the memo until the early 19th century, where Niels Ryberg Finsen, a Danish doctor of Icelandic decent, studied the medicinal affects of light rays. His impetus was the severe metabolic disease he suffered from whose symptoms  he experimented with sunbathing to relieve. He died a year after winning the Nobel for a phototherapeutic device he created that simulated sun light to treat several skin conditions. Thirty years later, scientists realized a lack of Vitamin D produced in the body by exposure to sunlight, was the main cause of a disease known as ¨Rickets¨ which leads to the weakening and softening of bones. Twenty years after that, researchers in Hungary used soft laser light to relieve arthritis pain. In later years, NASA scientists did a plethora of research on the manner that LED light affects plant biology in an effort to understand how to grow plants in space. What they found was a very small spectrum of light provided most of the energy needed to grow plants. From this research, more strides were made in the understanding of the healing properties of light within animal and human cells. Currently, two forms of phototherapy exist; Non targeted light therapy that comes from a box, like in the image of the woman above and targeted light therapy, which is administered by a laser. These forms are used with much success in the treatment of such skin disorders as psoriasis, non-severe acne, vitiligo, eczema, atopic dermatitis, polymorphous light eruption and lichen planus. They have also been effective at treating mood and sleep disorders like SAD (seasonal affective disorder), non seasonal depression and circadian rhythm disorders like delayed sleep phase disorder. Further medical research is being done with light therapy to address accelerated wound healing and pain management, which brings me back to my tendonitis. My experimentation with light therapy from its natural source (the sun) elicited the following note. On the days that I did not lay out because weather did not permit me to, I found that the pain and weakness in my anterior shoulder and neck would become mildly worse and last the full work day. The days that I did get about 45 mins of sun exposure, it felt more like a dull ache and only after doing 6 hours of massage at the end of my day. It is clear to me that the sun does heal. In the two weeks I will be bathing in its Mediterranean glory, my hope is to eradicate most of the pain and heal those weary tendons. I am looking forward to the day when the medical community finally approves its use for pain management. We need more natural and ancient approved manners to heal our bodies and minds.

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Trigger Points – the baggage our muscles hide!

Is this your back?

If the above image gives you the impression that a group of assassins  are ready to fire on you, stay with that feeling.  No one is immune. They hide in your muscles and sinews waiting for something or someone to activate them. Some gather in groups while others migrate to new territory, but more often than not they refer their pain elsewhere to trick you. They are trigger points.

A trigger point is defined as a hyper irritable spot within a taut band of skeletal muscle that elicits pain locally when compressed, but can also refer it elsewhere or be accompanied by muscle spasm. When touched, these spots can feel like hard nodules ( i.e. the “knots” we so often refer to in our backs and other body parts). It was Dr. Janet Travel, physician to the late president John F. Kennedy, that first came up with the term when she noticed that these points of pain tended to happen in predictable patterns that could be mapped out on the body. Her maps can be found in the 2 Volume book she wrote with David G. Simons, “Myofascial Pain and Dysfunction: The Trigger Point Manual.”

How do you know if you have one or more of these bad boys lurking in your tissues? There are a few characteristic symptoms which include sensitivity to pressure in a muscle, stiffness accompanied sometimes with a pulling sensation emanating from a particular point in the muscle, pain that refers from the point compressed to another area of the body and pain that has a dull, aching or burning quality to it.  Other symptoms sometimes experienced are various autonomic phenomena like dizziness, sweating and fever as well as headaches, numbness, loss of range of motion and dysfunction of the muscle involved. While the cause of trigger points remains a much disputed medical topic, it is safe to say that they most commonly occur when muscles are chronically overloaded, as in the case with occupational and exercise overuse, injury and poor posture. Also, chilling of a muscle (i.e. catching a draft or having an air-conditioner blow on you) and the position in which you sleep can also create these points. Sometimes these points are even triggered by emotional and stress related events.

Any qualified massage therapist (ME!) possesses the skills needed to deactivate these points and treat the surrounding tissues. In my opinion, your first course of action should be massage therapy. Thereafter, if the points do not resolve within a few treatment sessions, you should be referred to a chiropractor, osteopath or physical therapist, all of whom employ more aggressive treatment measures. The protocol used to address trigger points via massage is a combination of sustained compression of the point followed by cross fiber friction and deep strokes in the direction of the muscle fibers to clear out metabolic wastes and encourage the flow of blood into the affected area. I am a huge fan of a myofascial technique known as skin rolling. It literally involves me picking up your skin and rolling it along different angles between my fingers, almost like cookie dough. This is an important diagnostic tool for me to find these stuck points, especially if a client is unsure of the location of their discomfort. The sustained compression of these points temporarily stops the pain signal coming from the brain and the flow of blood to the area, so that when it is released, blood literally floods the point and washes wastes away. The first compression is always the worst because the pain level will be greatest then. It is super important to breathe through the 8-10 second count, as the point is held. On a scale of 1 to 10, the pain/discomfort should be around an 8. With each subsequent sustained compression (about 4 in total) the pain level will dissipate while the force of compression stays about the same. During these compressions, many clients will break into a sweat or become hyperemic (flushed) in the area of the trigger point. Sometimes there are twitches in the muscle or surrounding tissues near the point being worked on. Even stranger, the point can move while I am compressing and I literally have to chase it through its migratory path until I shut it down. Once the compressions are finished, the point is rubbed vigorously in a cross fiber pattern between 1 to 5 minutes and then all the fibers of the muscle get treated to a nice and slow, deep rub down. I like to then apply a bit of heat in the form of a heated dry towel (no more than 10-15 mins on) or a topical irritant like Tiger Balm.

Best case scenario, trigger points will get resolved in one intense session, but more often than not, multiple sessions are needed to deactivate years of evil. It’s extremely important to assess what is going on or has happened in your life, both physically and emotionally that, although your brain might have dismissed, your muscles and tissues beg you to notice. This awareness will help you focus your attention back onto yourself and deal with the baggage at hand because trust me, your muscles have better, more productive things to do than carry the weight of the world in their nooks and crannies.

Additional reference available at:

http://en.wikipedia.org/wiki/Trigger_point

NOTE **Read personal trainer, running coach and kayak instructor, Jeanne Andrus’s post about her experience with Trigger Points. I think it to be a helpful read:

Trigger Points