Rick shares: Research on Massage for Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

What is Carpal Tunnel Syndrome?

Carpal tunnel syndrome is a condition characterized by tingling, numbness and pain in the hand and fingers (particularly the thumb, index, middle and ring fingers). These symptoms are often the result of median nerve irritation in the wrist or forearm.


Why Give Massage Therapy A Try?

Massage therapy as a therapeutic intervention is being embraced by the medical community, it is simple to carry out, economical, and has very few side effects. One area that is being explored is the use of massage therapy for patients who suffer from carpal tunnel syndrome.

Randomized clinical trials have demonstrated that for some patients who suffer from carpal tunnel syndrome there is no significant differences in pain and functional outcomes at six and twelve months when surgical and conservative care are tested (Fernández-de-Las Peñas et al. 2017).

Why Does Massage Therapy Work?

The responses to massage therapy are complex and multifactorial – physiological and psychological factors interplay in a complex manner. Research has looked at both peripheral and central responses elicited by massage therapy treatments.

Pain Management
Massage has a modulatory affect on peripheral and central processes via input from large sensory neurons that prevents the spinal cord from amplifying the nociceptive signal. This anti-nociceptive effect of massage therapy can help ease discomfort in patients who suffer from carpal tunnel syndrome.

Peripheral Response
The median nerve passes through many structures and it may be exposed to mechanical irritation at many different points (Filius et al. 2017). Prolonged irritation may result in a reduction of intraneural blood flow. In turn, local hypoxia of a peripheral nerve leads to a drop in tissue pH that triggers the release of inflammatory mediators, known as “inflammatory soup”, this noxious substance can disrupt the normal function of nerves. Massage therapy may diminish intraneural edema and/or pressure by mobilizing the median nerve as well as associated vascular structures (Boudier-Revéret et al. 2017).

Carpal tunnel specific work may also involve specific soft tissue treatment to optimize the ability of mechanical interfaces to glide relative relative to the median nerve. Ongoing tissue hypoxia or inflammatory responses lead to molecular signaling that promote the development of fibrosis, this may contribute to further peripheral nerve dysfunction (Fisher et al. 2015). The application of appropriate shear force and pressure impart a mechanical stimulus that may attenuate tissue levels of fibrosis and TGF-β1 (Bove et al. 2016).

Infraspinatus Test in Carpal Tunnel Syndrome

 The infraspinatus provocation test ( Meder et al. 2017 ).


The etiology of myofascial triggerpoints are still not well understood, but that does not deny the existence of the clinical phenomenon.

A contemporary view of ‘myofascial trigger-points’ is presented by Shah, this categorizes ‘myofascial trigger-points’ by the a number of measurable characteristics: local and remote inflammation, local acidic milieu, local sensitization, local regions of hypoxia, local muscle stiffness (Shah et al. 2015).

Studies have demonstrated that assessing and treating the infraspinatus muscle may be an effective treatment option for a sub-group of patients with suffer from symptoms that present similarly to carpal tunnel syndrome (Meder et al. 2017).

Structures To Be Aware Of When Treating Carpal Tunnel Syndrome

Systematic reviews have also shown that manual therapy combined with multimodal care can improve symptoms, decrease disability and improve function for patients who suffer from carpal tunnel syndrome (Huisstede et al. 2017). Additionally, a recent randomized controlled trial in the journal Brain found that acupuncture improved the outcomes for carpal tunnel syndrome by remapping the brain (Maeda et al. 2017).

A massage therapy treatment plan should be implemented based on patient-specific assessment findings and patient tolerance. Structures to keep in mind while assessing and treating patients suffering from plantar heel pain may include neurovascular structures and investing fascia of:
• scalene muscles
• costo-clavicle space
• pectoralis minor
• biceps brachii muscle
• bicipital aponeurosis
• pronator teres
• transverse carpal ligament
• anterior interosseous membrane
• palmar aponeurosis
• infraspinatus
• lumbricals

Rick’s Chicken Recipe

Love fried chicken but don’t want all the fat? Try this recipe for all the flavour of your favorite food without deep frying!


4 large skinless boneless chicken breasts or 6 chicken thighs
1 tsp garlic powder
1 tsp poultry seasoning
1 tbsp dill
1 tsp paprika
1 tsp salt
1 tsp pepper
3 tbsp parmesan cheese
1 cup fresh bread crumbs

Note: Spices can be altered to suit your own taste.


  • Preheat oven to 400 degrees
  • Line baking sheet with parchment paper
  • Combine bread crumbs, cheese and spices in a bowl
  • Brush chicken with olive oil
  • Dip chicken in bread crumbs to cover
  • Lay breaded chicken on parchment lined baking sheet
  • Put breaded chicken in oven and bake 30 to 40 minutes until lightly browned

Rick shares: Why athletes should include massage in their fitness regimen

LifeBridge Health
July 23, 2018

By LifeBridge Health

Why athletes should include massage in their fitness regimen
The overexertion of muscles through rigorous physical training and exercise can affect athletes’ performance and increase their risk for injury. In between those strenuous workouts, the body could use some pampering.

Regular massage supports the relaxation and recovery process after workouts, helping to prevent injuries; reduce swelling, muscle stiffness and fatigue; and achieve peak performance. And there are numerous other potential benefits that are conducive to your overall health and well-being. Massage therapy helps to improve muscle flexibility (which helps prevent injuries like muscle pulls and tears) and shorten recovery time as well as relieve muscle tension and pain, a remedy for common issues like delayed-onset muscle soreness. But massage can benefit more than muscles. Tammy Taylor, massage/bodywork team leader and a certified neuromuscular therapist at LifeBridge Health & Fitness, says some research suggests that massage may also help:

  • Lower anxiety Increase range of motion
  • Improve your mood
  • Lower blood pressure
  • Enhance blood flow and alertness

Massage is good for the body either before, during or after athletic events. Sports massage incorporates Swedish (for improved circulation) and deep tissue techniques, among others. Athletes, or anyone who does strenuous exercises on a regular basis, should speak with a massage therapist about specific needs and concerns in order to determine how often massages are necessary and which techniques are most appropriate.

“Your injury or needs will determine the focus of the therapy,” Taylor says. “Often times, an athlete has a specific area in which they are experiencing pain, limited range of motion, etc. That area, in addition to the supporting muscles and connective tissue, is addressed.”

Taylor adds: “A full body massage at another time, maybe within a week or two, is also very helpful for the whole body compensates for an injury, and an injury heals more quickly when the rest of the body is free of limitations.”

Rick’s Ribs

picture courtesy recipeshub.com

With Ribfest around the corner and, since we’re in the middle of BBQ season, here’s what I’ve found works best for fall-off-the-bone ribs. I like the ribs I get at Costco, but you can buy a pair of full racks of ribs anywhere you prefer. One of the most important first steps when preparing ribs for cooking is to peel off the tough layer of fascia from the bone side of the ribs. It’s thin, translucent, and you need a good set of fingernails to get it started. Or, if you’re a massage therapist and have no fingernails, an accomplice or a pair of plyers will come in handy.

Once the fascia has been removed, pour:
2 cups water
1/2 cup cider vinegar
1/4 cup olive oil
into the pressure cooker. Roll up both racks of ribs and stand them in the pressure cooker. Cook at the high pressure setting for, at most, 5 minutes from when it gets up to steam (that’s for the meaty ribs I get from Costco – you might need to shorten the time slightly if your ribs are mostly bone). As soon as the five minutes are up, release the steam as quickly as is safe. Now it’s time to take it outside to the BBQ.

If you’re using a gas BBQ, preheat it and then turn it to the lowest setting. Cook time on the BBQ is about 25 minutes, turning twice. Put both racks on the BBQ meat side down. After around 8 minutes, turn them over for the first time and coat with your favourite BBQ sauce (I like President’s Choice Gourmet, but suit yourself). Don’t use a brush – ladel on a good thick layer and spread it around with the ladel. At around 16 minutes, turn them over the second time and pour on another thick layer of BBQ sauce. At 25 minutes, turn off the BBQ, carefully remove the ribs and tent them with aluminum foil for around 10 minutes. Enjoy with your favourite BBQ side dishes – salads, nachos, whatever.

If you don’t have (or don’t want to use) a pressure cooker, you can always go with the tried and true oven roasting method followed by time on the BBQ where you add the sauce (and the flavour). Wrap the ribs in foil, and place them in the oven at 300 degrees F for 45 minutes. Precooking them helps intensify the flavor and naturally brings out the juices, ensuring your ribs will be anything but dry.

Get Ready For Our 2nd Annual  Community Spring Bicycle Inspection & Tune-Up



100k ready to go b_zpseydd2ujc

Time to get the bikes out of storage and get them ready for the Summer Season ahead.

We invite you to drop by with your bicycles on Saturday May 14th 2016, as we are hosting our 2nd Annual Community Spring Bicycle Inspection and Tune-Up Day

Our own Dr. Phil will be riding the Century Distance for Forward Health, and proceeds will be donated to: The Foundation of The Guelph General Hospital and Rotary Clubs of Guelph. Every Dollar goes a long way to help in this worthy endeavor.

In addition there will be food and giveaways for everyone in attendance.

We’re excited to be teamed up on this day with GORBA  (Guelph Off-Road Bicycling Association), Rowe Farms Meats and Speed River Bicycle for the beginning of a season of safe riding, for all ages and abilities.

Location:  951 Gordon Street, in the parking lot.(Gordon Street and Kortright Road)

Date & Time:  Saturday May 14th, 2016, from 9am – 12noon

Looking forward to connecting you, your family and friends on this wonderful day.

The Forward Health Team

covered bridge ian and others_zpsjmadoa7x2015-07-05 11.47.13

If you have any further questions feel free to connect with us at info@forwardhealth.ca

“Circle of Care” – What Do You Mean?

Here at Forward Health we take a team approach to your treatment and we refer to that using what is becoming a popular term – “Circle of Care”. Perhaps a word or two of explanation might be in order. In the process, we can compare the traditional treatment-focused approach with the developing whole-patient approach.

Traditionally, medical practitioners of all stripes were taught the value and efficacy of their own particular specialty. Little emphasis was placed on learning how one’s area of expertise could inter-relate with any other type of treatment that might meet the needs of a patient outside the scope of that specialty. As an example, a podiatrist might focus on resolving a patient’s pain with orthotics and yet do or say nothing to encourage the patient to seek screening for possible allergy related issues that could be compounding the problem. In this practice, the medical profession is focused on their own particular expertise.

Your Forward Health Circle of Care

Of late, a growing number of medical professionals have come to recognize the need to focus on the whole patient and to find a way to work in conjunction with other practitioners. One development that has come out of this awareness is the process referred to as a circle of care. As the name suggests, this embodies a number of practitioners from a variety of fields combining their efforts to meet the needs of the whole patient – in effect encircling the patient with care. While initially this approach paved the way for a more complete treatment of the sum of a patient’s physical needs, more recent developments have begun to extend the circle of care to encompass a person’s physical, mental, emotional and spiritual self. Underlying all the various aspects of this new methodology is an effort to focus more fully on the needs of the patient rather than looking through the narrow lens of one particular area of expertise.

One practical aspect of the circle of care approach is the benefit to be derived from having a team of practitioners working together in the same environment. This allows for ongoing consultation and sharing in confidence the various aspects of, not only each patient’s needs, but also of their progress. Forward Health provides exactly that kind of environment and allows us to offer this exciting new approach to your overall well-being.