If you’ve ever gotten a massage, chances are that your massage therapist recommended drinking plenty of water to keep your body hydrated. But have you ever wondered how massage and hydration are connected and how much water you should drink before and after your treatment?
The Science Behind Hydration
When your muscle tissues are healthy, they are spongy and supple; however, unhealthy muscle tissues are tough and tight. This tightness often builds up from stress, tension, overuse, and injury. This is an important basic concept to understand because soft tissue allows blood to flow and lymph nodes to drain properly.
These biological processes relate to massage because massage therapists are trained to untighten and de-stress unhealthy muscle tissue. Massage increases blood flow in tired muscles and uses up water stored in the body. This process can lead to dehydration if you aren’t consuming enough water throughout the day.
Hydrating Before a Massage
Many people don’t realize that drinking water before your massage is just as important as staying hydrated after your treatment is over. Drinking water before massage is a good idea because it makes your muscles softer and more pliable, which leads to a more relaxing and comfortable massage.
Being hydrated before a massage can also prevent you from feeling achy after getting a massage. Both drinking water and getting a massage eliminate toxins from the body, so when practiced together, the effects of your massage become even more beneficial.
Hydrating After a Massage
Drinking water after massage is very important because the kneading and working of your muscles are naturally dehydrating. Massage helps pump fluids from your soft tissues into your circulatory system and your kidneys, so you need to replenish that lost water by drinking more than you normally would.
How Much Water Should You Drink?
The standard recommended eight glasses of water per day works well for most people on most days, but consider adding another glass or two to your routine on massage days. Another recommended calculation is to divide your body weight in pounds by half and drink that number of ounces of water. This calculation suggests that a 150-pound person should drink about 75 ounces of water per day.
Symptoms of Dehydration
In general, most people don’t drink enough water throughout the day, and your body’s water needs increase on days you get a massage. Dehydration can be easily avoided if you know the symptoms to look for and make a conscious effort to drink more water on massage days.
These are some of the most common symptoms of dehydration.
Ingredients: 1/4 Cup Extra Virgin Olive Oil 1/3 Cup Soy Sauce 1/3 Cup Honey 1/4 Tsp Ground Black Pepper 2 Cloves of Garlic Minced 1-2 lbs Chicken Breasts Cut into Bite-sized Chunks 2-3 Bell Peppers Seeded and Cut into Bite-sized Chunks 1 Red Onion Cut into Bite-sized Chunks Any Other Kabob Vegetables You Enjoy (eg. Tomato, Mushrooms)
In a large mixing bowl whisk together marinade
Add chicken and vegetables to the marinade ensuring
that they are thoroughly coated. Place in refrigerator for 2 hours.
Pre-heat grill to medium (about 350-400 degrees).
Drain chicken and vegetables from the marinade and
place on skewers.
Grill for 12-15 minutes. Some vegetables will cook
faster than others so keep an eye on them.
[June 17, 2013, Rensselaer, NY] – Fibromyalgia, a painful condition affecting approximately 10 million people in the U.S., is not imaginary after all, as some doctors have believed. A discovery, published this month in PAIN MEDICINE (the journal of the American Academy of Pain Medicine), clearly now demonstrates that fibromyalgia may have a rational biological basis located in the skin.
Fibromyalgia is a severely debilitating affliction characterized by widespread deep tissue pain, tenderness in the hands and feet, fatigue, sleep disorders, and cognitive decline. However, routine testing has been largely unable to detect a biological basis for fibromyalgia, and standard diagnosis is based upon subjective patient pain ratings, further raising questions about the true nature of the disease. For many years, the disorder was believed to be psychosomatic (“in the head”) and often attributed to patients’ imagination or even faking illness. Currently approved therapeutics that provide at least partial relief to some fibromyalgia patients are thought to act solely within the brain where imaging techniques have detected hyperactivity of unknown origin referred to as “central sensitization.” However, an underlying cause has not been determined, leaving many physicians still in doubt about the true origins or even the existence of the disorder.
Now, a breakthrough discovery by scientists at Integrated Tissue Dynamics LLC (Intidyn), as part of a fibromyalgia study based at Albany Medical College, has provided a biological rationale for this enigmatic disease. The small biotechnology research company, founded by neuroscientists Dr. Frank L. Rice and Dr. Phillip J. Albrecht, reports on a unique peripheral neurovascular pathology consistently present in the skin of female fibromyalgia patients which may be a driving source of the reported symptoms.
“Instead of being in the brain, the pathology consists of excessive sensory nerve fibers around specialized blood vessel structures located in the palms of the hands,” said Dr. Rice, President of Intidyn and the senior researcher on the study.
“This discovery provides concrete evidence of a fibromyalgia-specific pathology which can now be used for diagnosing the disease, and as a novel starting point for developing more effective therapeutics.”
Nerve Endings Come In Many Forms
Three years ago, Intidyn scientists published the discovery of an unknown nervous system function among the blood vessels in the skin in the journal PAIN.
As Dr. Rice explained, “we analyzed the skin of a particularly interesting patient who lacked all the numerous varieties of sensory nerve endings in the skin that supposedly accounted for our highly sensitive and richly nuanced sense of touch. Interestingly however, this patient had surprisingly normal function in day to day tasks. But, the only sensory endings we detected in his skin were those around the blood vessels”. Dr. Rice continued, “We previously thought that these nerve endings were only involved in regulating blood flow at a subconscious level, yet here we had evidencs that the blood vessel endings could also contribute to our conscious sense of touch… and also pain.”
Now, in collaboration with renowned Albany Medical Center neurologist and pain specialist Dr. Charles E. Argoff, the study primary investigator, and his collaborators Dr. James Wymer also at Albany Medical College and Dr. James Storey of Upstate Clinical Research Associates in Albany, NY, clinical research proposals were funded by Forest Laboratories and Eli Lilly. Both pharmaceutical companies have developed FDA-approved medications with similar functions (Serotonin/Norepinephrine Reuptake Inhibitors, SNRI) that provide at least some degree of relief for many fibromyalgia patients.
“Knowing how these drugs were supposed to work on molecules in the brain,” Dr. Albrecht added, “we had evidence that similar molecules were involved in the function of nerve endings on the blood vessels. Therefore, we hypothesized that fibromyalgia might involve a pathology in that location”. As the results demonstrate, they were correct.
To analyze the nerve endings, Drs. Rice, Albrecht, and postdoctoral researcher Dr. Quanzhi Hou, used their unique microscopic technology to study small skin biopsies (less than half the size of a pencil eraser) collected from the palms of fibromyalgia patients, who were being diagnosed and treated by Drs. Argoff, Wymer, and Storey. The study was limited to women, who have over twice the occurrence of fibromyalgia than men. What the team uncovered was an enormous increase in sensory nerve fibers at specific sites within the blood vessels of the skin. These critical sites are tiny muscular valves, called arteriole-venule (AV) shunts, which form a direct connection between arterioles and venules (see diagram).
As Dr. Rice describes their function, “We are all taught that oxygenated blood flows from arterioles to capillaries, which then convey the deoxygenated blood to the venules. The AV shunts in the hand are unique in that they create a bypass of the capillary bed for the major purpose of regulating body temperature.”
A Thermostat for the Skin
In humans, these types of shunts are unique to the palms of our hands and soles of our feet which work like the radiator in a car. Under warm conditions, the shunts close down to force blood into the capillaries at the surface of the skin in order to radiate heat from the body, and our hands get sweaty. Under cold conditions, the shunts open wide allowing blood to bypass the capillaries in order to conserve heat, and our hands get cold and put on gloves.
According to Dr. Albrecht, “the excess sensory innervation may itself explain why fibromyalgia patients typically have especially tender and painful hands. But, in addition, since the sensory fibers are responsible for opening the shunts, they would become particularly active under cold conditions, which are generally very bothersome to fibromyalgia patients.”
A role in regulating blood flow throughout the body.
Although they are mostly limited to the hands and feet, the shunts likely have another important function which could account for the widespread deep pain, achiness, and fatigue that occurs in fibromyalgia patients. “In addition to involvement in temperature regulation, an enormous proportion of our blood flow normally goes to our hands and feet. Far more than is needed for their metabolism” noted Dr. Rice. “As such, the hands and the feet act as a reservoir from which blood flow can be diverted to other tissues of the body, such as muscles when we begin to exercise. Therefore, the pathology discovered among these shunts in the hands could be interfering with blood flow to the muscles throughout the body. This mismanaged blood flow could be the source of muscular pain and achiness, and the sense of fatigue which are thought to be due to a build-up of lactic acid and low levels of inflammation fibromyalgia patients. This, in turn, could contribute to the hyperactvity in the brain.”
Dr. Albrecht also points out that alterations of normal blood flow may underlie other fibromyalgia symptoms, such as non-restful sleep or cognitive dysfunctions. “The data do appear to fit with other published evidence demonstrating blood flow alterations to higher brain centers and the cerebral cortex of fibromyalgia patients” he stated. Senior Research Chair of the Alan Edwards Center for Pain Research at McGill University, Dr. Gary Bennett, commented after seeing the results that “It is exciting that something has finally been found. We can hope that this new finding will lead to new treatments for fibromyalgia patients who now receive little or no relief from any medicine.”
This discovery of a distinct tissue pathology demonstrates that fibromyalgia is not “all in your head”, which should provide an enormous relief to fibromyalgia patients, while changing the clinical opinion of the disease and guiding future approaches for successful treatments.###
About Integrated Tissue Dynamics LLC (Intidyn)
Integrated Tissue Dynamics LLC, located in Rensselaer, NY amid the Capital region’s Technology Valley, provides flexible and scalable pre-clinical and clinical research and consulting capabilities on skin and nerve related chronic pain afflictions in collaboration with the pharmaceutical industry, government agencies, academia, and a network of pain specialists throughout the United States. The Intidyn ChemoMorphometric Analysis (CMA) platform can be used to detect chemical and structural changes in the skin and other tissues related to chronic pain, numbness, and itch associated with a wide variety of afflictions, including diabetes, shingles, complex regional pain syndrome, carpal tunnel syndrome, sciatica, fibromyalgia, psoriasis, chemotherapy, unintended side effects of pharmaceuticals, and others.
How to Support Further Research on Fibromyalgia and Other Types of Chronic Pain
Tax deductable donations to support the research of a nationwide network of pain specialists, which includes Drs. Argoff and Wymer at Albany Medical College, can be made to the Clinical Pain Research Program at the University of California San Diego, an American Pain Society Center of Excellence, by contacting the UC San Diego Office of Development (giving.ucsd.edu; 858-534-1610; specify area of research) or UC San Diego Center for Pain Medicine (anes-cppm.ucsd.edu; 858-657-7072). This network, referred to informally as the Neuropathic Pain Research Consortium, includes top neurologists, anesthesiologists, and research scientists at leading universities and pain treatment centers in California, Illinois, Maryland, Massachusetts, Minnesota, New York, Utah, Washington, and Wisconsin.
Albrecht PJ, Hou Q, Argoff CE, Storey JR, Wymer JP, Rice FL (2013). Excessive Peptidergic Sensory Innervation of Cutaneous Arteriole-Venule Shunts (AVS) in the Palmar Glabrous Skin of Fibromyalgia Patients: Implications for Widespread Deep Tissue Pain and Fatigue.
Pain Medicine, May 20. doi: 10.1111/pme.12139 [Epub ahead of print].
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.
BLAUSEN.COM (2014). “MEDICAL GALLERY OF BLAUSEN MEDICAL 2014”. WIKIJOURNAL OF MEDICINE 1 (2). – CC BY 3.0.
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.
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.
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).
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
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.”
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.
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.
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.
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.