The Benefits of Massage

Massages feels amazing, especially after a grueling workout—and their benefits aren’t just skin deep. Soft tissue massage is exceptionally good for bone-weary athletes and people with inflammation-related chronic conditions like arthritis and muscular dystrophy, according to research from McMaster University. Vigorous exercise causes small tears in your muscle fibers, and your body’s natural repair process naturally leads to inflammation and soreness.

To see if massage truly aids recovery, the researchers biopsied volunteers’ legs over the course of three sessions—once while at rest, a second time after they’d vigorously exercised on a stationary bike and received a 10-minute massage on one thigh, and a third biopsy two and a half hours after the second to track the repair processes between the massaged and un-massaged legs.

Unsurprisingly, massage reduced the production of cytokines, which play a critical role in inflammation, and stimulated mitochondria—the tiny powerhouses inside your cells that convert glucose into energy for cell function and repair. So make sure to schedule regular massages; your muscles will adapt better to the demands of increased exercise.

Why Ice and Anti-inflammatory Medication is NOT the Answer

This is a reprint from Stone Athletic Medicine:


In July I posted a blog discussing The Overuse of Cryotherapy. The controversy surrounding the topic made it one of the most popular blogs I’ve written. What is surprising to me is that a controversy exists at all. Why, where, and when did this notion of anti-inflammation start? Ice, compression, elevation and NSAIDs are so commonplace that suggesting otherwise is laughable to most. Enter an Athletic Training Room or Physical Therapy Clinic nearly all clients are receiving some type of anti-inflammatory treatment (ice, compression, massage, NSAIDs, biophysical modalities, etc). I evaluated a client the other day and asked what are you doing currently – “Well, I am taking anti-inflammatories and icing.” Why do you want to get rid of inflammation and swelling? I ask this question for both chronic and acute injury!

The Stigma of Inflammation:

Editor in Chief of The Physician and Sports Medicine Journal (Dr. Nick DiNubile) once posed this question: “Seriously, do you honestly believe that your body’s natural inflammatory response is a mistake?” Much like a fever increases body temperature to kill off foreign invaders; inflammation is the first physiological process to the repair and remodeling of tissue. Inflammation, repair, and remodel. You cannot have tissue repair or remodeling without inflammation.  In a healthy healing process, a proliferative phase consisting of a mixture of inflammatory cells and fibroblasts naturally follows the inflammatory phase (1). Researchers headed by Lan Zhou, MD, PhD, at the Cleveland Clinic, found that in response to acute muscle injury, inflammatory cells within the damaged muscle conduct phagocytosis, contribute to accumulation of intramuscular macrophages, and produce a high-level of Insulin-like growth factor 1, (IGF-1) which is required for muscle regeneration (3). IGF-1 is a primary mediator of the effects of growth hormone and a stimulator of cell growth and proliferation, and a potent inhibitor of programmed cell death. Similarly, in 2010, Cottrell and O’Conner stated “overwhelmingly, NSAIDs inhibit or delay fracture healing” (2). And you want to stop this critical process of healing by applying ice, because inflammation is “bad”?

The Anecdotal Rationale for Ice:

Somewhere along the line the concept that ice facilitates healing became conventional wisdom. Sorry, that wisdom is wrong. I had someone tell me the other day, “We need to ice, because we need to get the swelling out.” Really? Does ice facilitate movement of fluid out of the injured area? No, it does not. The lymphatic system removes swelling. The Textbook of Medical Physiology says it best: “The lymphatic system is a ‘scavenger’ system that removes excess fluid, protein molecules, debris, and other matter from the tissue spaces. When fluid enters the terminal lymphatic capillaries, any motion in the tissues that intermittently compresses the lymphatic capillaries propels the lymph forward through the lymphatic system, eventually emptying the lymph back into the circulation.”  Lymphatic drainage is facilitated by contraction of surrounding muscle and changes in compressive forces that push the fluid back to the cardiovascular system. This is why ankle pumps work so well at removing swelling.

Inflammation is a necessary component in the first phase of phase of the healing process. Swelling is controlled by the body’s internal systems to attain homeostasis. If swelling is accumulated it is not because there is excessive swelling, rather it is because lymphatic drainage is slowed. The thought that ice application increases lymphatic flow to remove debris makes no sense. Gary Reinl, author of “Iced! The Illusionary Treatment option gave me a good analogy. Take two tubes of toothpaste, one is under ice for 20 minutes, the other is warmed to 99 degrees. In which tube will the toothpaste flow fastest?  It does not take an advanced physics degree to know that answer.

What might surprise you is that ice actually reverses lymphatic drainage and pushes fluid back to interstitial space. A study published in 1986 (yes, 1986, is old, but this is a foundational study) found when ice is applied to a body part for a prolonged period of time; lymphatic vessels begin to dramatically increase permeability. As lymphatic permeability increases fluid will pour from the lymphatics into the injured area, increasing the amount of local swelling (5). Ice can increase swelling and retard debris removal!

The Acronym RICE is Bogus:

The acronym RICE is bogus in my opinion. First, Rest is not the answer. Rest does not stimulate tissue repair. In fact rest causes tissue to waste and can cause abnormal gene transcription of collagen tissue. Evidence has shown that tissue loading through exercise or other mechanical means stimulates gene transcription, proteogenesis, and formation of type I collagen fibers (See studies by Karim Khan, Durieux, Mick Joseph, and Craig Denegar). Our body has all types of cells. When a cell is born it has no clue what type of cell it will eventually become. This infancy cell – for lack of a better term – is called a progenitor cell. Progenitor cells can be changed to a specific cell type. Load in tendon tells our body to turn a progenitor cell in to a tenocyte. Load in bone tells a progenitor cell to become an osteocyte. Ever wonder why myositis ossificans (calcification or bone growth in muscle) develops? The direct, repeated trauma turns progenitor cell currently living within muscle to an osteocyte. Subsequently, we develop bone growth within muscle.

The other reason RICE is bogus is obvious; Ice. Ice does nothing to facilitate collagen formation. Ice will not influence progenitor cell development. Ice does not regenerate tissue. Ice does not facilitate healing – it inhibits natural healing process from occurring. Ice does not remove swelling; it increases swelling and lymphatic backflow.

Closing thoughts:

Bottom line, ice and NSAIDs are over utilized. I am not saying never, but I am saying ice is not a magical cure all that fixes everything and is required for healing. It is not the gold standard that it has come to be. My goal with this blog is to get individuals to stop and think before immediately turning to ice and NSAIDs. Is it really the best option? Is it necessary for this injury at this stage? I understand it is not the only form of treatment clinicians use, but ice certainly is the most heavily used. Go ahead, I will wait while you look at your treatment logs.

My goal is to get this trend reversed one clinician and one patient at a time. Have you seen the video discussion between Kelly Starrett, DPT and Gary Reinl? If not I recommend you watch it. It’s fascinating. I am glad to have expert minds like Kelly and Gary in this fight with me.

I ask health care professionals to do one thing, just try it. Pick one client with chronic musculoskeletal pain, skip the ice, skip the NSAIDs and try to use light exercise as a repair stimulus. Then, try skipping the ice on a client with an acute mild injury. The outcomes might surprise you.


Cold Laser for All Animals and People

Cold laser therapy offers a wide range of options for tissue therapy, wound healing, pain management, and improved circulation. Cold laser therapy is a game changer for many pets suffering from painful injuries. This technology allows us to successfully treat many injuries including tissue damage, inflammation, wounds, and even scars with minimal invasion.

The technology has been used in Europe since 1970 to promote healing, but has only been approved by the FDA for use in the U.S. since 2002. It is only recently, though, that U.S. veterinarians have begun using it to treat many different conditions that affect pets today, such as fractures, ligament and tendon injuries, post-surgical incisions, arthritis, nerve injuries, sprains, muscle strains, abrasions, lesions, and more.

Cold laser therapy is non-invasive and makes use of light in order to stimulate activity or regeneration in cells in addition to increasing blood circulation. Unlike hot laser treatments that target tissue deep beneath the skin’s surface, cold laser therapy treats injuries or damage on or near the surface – without the risk of cutting or burning from the lasers. Most conditions require between three and eight treatments, though I have seen great improvement after the first laser session. Most animals enjoy their seession: many fall asleep or thoroughly relax. th


Could Your Horse Do Better at Shows?

If your horse has squeaky clean X-rays and MRI’s, does that mean the horse is pain free? You can ask the same question about your own body. The answer is, of course, no. If you play tennis or ski or ride or dance or even garden, you know you can hurt without being injured. The same goes for your horse.  What surrounds the skeleton is of more importance than the skeleton itself. Until fairly recently, the fascia has been largely ignored by most health care professionals, and cannot be seen in standard tests such as X-rays and MRIs.

The body work that I do on horses is meant to alleviate the pain and stress of horse sport. If the body is balanced and symmetrical, then the body can move gracefully, without distortion.  This restoration of the body can be done gently and thoroughly with a combination of myofascial release, stress point, and trigger point therapy,

Strains, due to injuries and accidents, get lodged in the body when a horse compensates movement during the healing process. Unless these compensations are fully released and realigned,  they eventually become chronic strains that limit coordinated movement and cause pain. Horses need massage just as much, if not more, than any human athlete, since they have to carry someone on their back! The benefits of massage are the same for horse or human, with increased suppleness, better range of motion, and quicker recovery from injury.  This therapy is so much more than a relaxation massage. It improves performance and longevity in whatever sport or casual use they are involved in.

My biggest thrill is to help an animal become pain free. They behave and perform differently. Their whole personality and energy can change. And the results of the massage can be long lasting.


Whole Body Treatment

The usual approach to treating sore muscles is to use liniment for a relaxing rubdown, or use a high tech blanket, or maybe do some leg stretches.  And if none of those techniques work, what is next?  Trigger points, or muscle knots, are small patches of contracted muscle fibers that cause aching and stiffness. When activated through strain or injury, they cause pain either at the site itself, or refer it somewhere else in the body.

Thousands of muscle fibers contract to create movement. Sometimes muscle fibers can tear, leading to tension, swelling, and heat. What may begin as a small numbers of fibers, barely noticeable, can become a progressive problem as the micro trauma spreads to adjacent muscle fibers.

Conscientious riders will be aware of the smallest change in movement or behavior and take action before the problem becomes a major injury.

When muscle fibers are injured, the surrounding area becomes shortened and tight. This uneven stress can be transferred through the fascia and cause additional pain and restrictions in other parts of the body as trigger points or stress points.  My job is to apply gentle pressure until the restriction is released, and free movement and balance are restored. Muscle tension, pain, postural imbalances, and improved circulation are all benefits of stress and trigger point therapy. As Jack Meagher always said, “That is called putting your finger on the problem!”


New Uses for Cold Laser

Cold laser therapy works by altering or stimulating cellular function. The light energy penetrates,  depending on the wavelength,  and affects cells and blood vessels.  The laser can block a nerve’s ability to send a pain signal to the brain, increasing blood flow or decreasing swelling. It may also significantly speed wound healing.

It’s noninvasive. When used correctly, it doesn’t have any side effects. It can be used weekly or monthly for pets with chronic pain, giving them better quality of life. In cases of severe pain caused by surgery or trauma, laser treatment can be used twice a day for a few days and then daily to diminish pain and speed healing.

Some exciting new areas of study for laser healing are range of motion, baldness, jaw clicking, Parkinson’s, Alzheimer’s, and  stress. treating stress, anxiety and depression with cold laser therapy. The protocol for stress combines ancient Chinese medicine and laser technology that’s used on acupressure points to boost  endorphins and dopamine. These chemicals naturally help your body reduce the physical effects of stress.

Lasers have been shown to speed healing time by about 50%. th


The Body Remembers

The nervous system remembers the pain and trauma of an injury. With your horse, you might see this as stiffness at the beginning of a workout, or extreme caution. When a rider tells me their horse just “doesn’t want to jump anymore”, I suspect muscle pain and get to work looking for it.

Trauma accumulates in the body, starting at birth. Have you considered how much trauma there is for a foal during the birth process? The results can set up tight muscle patterns that last a lifetime, unless manually removed.

Myofascial release aims to relax contracted muscles, improve blood and lymphatic circulation, and stimulate the stretch reflex in muscles. Often I stand back after just one bodywork session and see that the body is already reorganizing itself. The body looks less chopped up into sections and more of one flowing form.  During a session the body of the horse is educated in the process to move the way it is supposed to: in balance and without restrictions. If the connective tissue that covers every muscle, bone, nerve, blood vessel,  and organ in the body is free of restriction, the horse will move and behave in a completely different way.

Myofascial therapy relieves soft tissue restrictions that cause pain. Some causes of chronic muscle pain are easier to diagnose than others: trauma from birth or a fall, cumulative posture misalignment , a compressed nerve from poor saddle fit, etc.

When pain is caused by Myofascial tightness the diagnosis can be difficult, as fascia restrictions do not show up on MRI scans or X-rays. Yet, those restrictions can play a significant role in creating pain and malfunction in the structure of the back and legs. Every horse (and dog and human!!) should experience pain free movement that can result from having restrictions removed.


Preventing Injury in Your Riding Horse

What would your horse be like if all his muscles were in a state of relaxation, free from tension? Deep tissue massage, stress and trigger point therapy, and myofascial release
will help the connective tissue become more elastic, thereby allowing the muscle to  return to its natural shape.

It is very important for horses to maintain a comfortable and free range of motion.  If certain muscles are tight, other muscles in the body will compensate and take up the extra workload. They may be ridden like this for weeks, months or years, until the body can no longer call on extra resources because it does not have them. This ultimately leads to ruptures of soft tissues and thickening of the tendon and ligaments, which eventually can cause permanent dysfunction of the affected area.

Muscles attach to  bones in pairs of opposites, and cross one joint or more. Muscles free from tension will carry out the function of keeping joints in alignment.  This allows joint fluid to flow evenly within the joint, and this reduces unnatural wear and tear of joints.

Each muscle is attached to bone by tendons. Muscles are designed to take 90% of workload and tendons the other 10% The muscle is where the elasticity is. If the muscle is not functioning properly then the tendons will take more load and can eventually tear.

Equine massage therapy is a very powerful tool in injury prevention for horses.


Immediate Pain Relief

Cold laser treatments provide pets with relief from painful symptoms of a variety of medical conditions and diseases. These treatments are non-invasive and painless. Recovery time is greatly reduced.

Both laser therapy and acupuncture are based on traditional Chinese medicine’s concept of chi, or energy. Ancient theories about how chi moves through the body mirror modern medicine’s understanding of how the nervous system functions in the body. Both acupuncture and laser therapy pinpoint specific spots along the body’s chi (or nervous system) where there are blockages, which obstruct the flow of energy or information throughout the body. Blockages hinder the body’s ability to function at an optimal level and heal at an accelerated rate.

Both acupuncture and laser therapy have been shown to increase circulation throughout the body, reducing inflammation, relieving pain, and accelerating healing. These therapies offer pain management and treatment for conditions like immune-related disorders, skin conditions, arthritis, and reproductive disorders.

Low level laser therapy is being successfully used treat pain or stiffness associated with arthritis and other degenerative joint conditions, acute injuries, and post-operative recovery for surgical patients. It has been found to be an excellent, well-tolerated alternative to drugs. This type of laser treatment is different from surgical lasers that cut. This wavelength of light penetrates the skin without cutting or burning it. It stimulates the cells and blood vessels that lie just beneath the skin. It does this without causing any harm to the tissues.

The laser’s contact with injured or diseased tissue promotes the production of ATP, a substance essential to cellular reproduction and repair. This enhances the body’s natural healing abilities. Laser therapy strengthens injured tissues, which makes them less vulnerable to re-injury during the recovery process. It also reduces internal scarring, another potential source of pain and stiffness. Painkilling drugs can only mask the symptoms — they don’t treat the underlying issues.



How the Body Regulates Muscle Tension

Tendons connect muscles to bone. There are groups of cells within a tendon, where the fibers of the muscle meet the tendon, called Golgi tendon bodies. Made up of strands of collagen, the Golgi organ also contains nerve tissue. The major function of this organ is to sense muscle tension when a muscle is contracted, sending signals to the brain about how much force is being exerted.

Golgi tendon organs and muscle spindle cells work together to prevent injury to muscles. The more the muscle tries to stretch and the faster it tries to stretch, the more the Golgi tendon organs cause it to contract. 

These nerve cells and fibers can be influenced by massage. Golgi tendon organs react to sustained  pressure such as trigger point therapy and stress point therapy,  by telling the muscle to relax.


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