As a licensed massage therapist, I specialize in chronic pain and injury management using deep tissue massage therapy. Most of my clients come in with a common complaint: pain in the low back, hips (primarily on one side), and/or shooting pain or numbness down the back of the leg.

More than two million Americans suffer either from back pain or a form of sciatica that is often misdiagnosed and improperly treated. Many suffer from pain for months or years without a proper diagnosis. I work with these symptoms so frequently that I have noticed some common characteristics with this all-too-common pain complaint.

The most common characteristic I find are aggravated trigger points (TrPs) in the piriformis muscle. Piriformis trigger points are often confused for a herniated disc, sciatica, or other back issues, and many sufferers undergo unnecessary and costly tests, injections, and surgeries.

What is the piriformis?

The piriformis muscle is a small external rotator of the hip whose function primarily is to turn the knee and foot outward. It lies deep within the gluteal muscles, originates from the sacral spine, and attaches to the greater trochanter of the femur – the big bony “bump” on the outside top of the thigh. The sciatic nerve passes beneath through an opening called the sciatic notch.

Function

In non-weight bearing activities, foot unloaded and hip extended, the piriformis rotates the thigh outward. When the hip is flexed at 90 degrees it aids in hip abduction.

In weight bearing activities, foot loaded, the pirifomis is often needed to control rapid medial rotation of the thigh – for example, as the foot strikes the ground during walking or running, the knee turns inward.

Piriformis Trigger Points (TrPs)

Symptoms

The myofascial pain component includes pain in the low back, groin, buttock, and hip. A TrP may cause the muscle to compress and irritate the sciatic nerve, causing the pain to travel along the course of the nerve. The pain may radiate down the back of the leg and into the hamstrings, the calf muscles, and possibly the foot. The pain may initially be confused with a hamstring strain. Weakness, stiffness and a general restriction of movement are also quite common. Tingling, numbness, or shooting pains down the leg can also be experienced. Symptoms tend to be aggravated by prolonged sitting or by intense activity.

Causes

Piriformis TrPs are predominantly caused by a shortening or tightening of the piriformis muscle. Piriformis TrPs are commonly associated with sports that require a lot of running, change of direction, or weight-bearing activity. Piriformis TrPs can result from acute overload (as when catching oneself from a fall), from repetitive overload (as with the rapid internal rotation of the weight bearing experienced by walkers and runners with poor biomechanics), or from sustained overload (as when holding the leg bent and turned outward for prolonged periods while driving a car or working at a desk). Sciatic pain from piriformis TrPs is also a common complaint during pregnancy.

The piriformis muscle is responsible for the symptoms of pain by projecting pain from activation of the TrPs and by nerve entrapment upon the sciatic nerve. Once TrPs are activated, the piriformis muscle begins to put pressure on the sciatic nerve. The sciatic nerve runs under (and sometimes through) the piriformis muscle on its way out of the pelvis. The piriformis muscle can squeeze and irritate the sciatic nerve in this area, leading to the symptoms of sciatica.

In today’s world we are hooked on computers, myself included. Most people spend their whole work day on the computer and then come home and play on it more for personal fun and social networking sites like one of my favorites, Facebook. The downfall of all this time on the computer is that we do not take the time to be aware of our posture using the computer, nor do we take a moment to step away and give our body and minds a much needed break, even if it is just for 5 minutes. With this, most of us find ourselves in a bit of pain from the all day use of the keyboard and the mouse. This pain could be in your upper shoulders, your forearms, wrists and for some in the fingers (ever feel that numbing sensation). Sometimes these muscle issues start showing up right away. Sometimes they may not be for years.

I’m sure if you take a good look at your computer set-up and your posture, you’ll quickly realize that things are not ergonomically correct. Yet there are some ways to help yourself have better posture and be more ergonomically correct. These simple measures can help deter you from compromising your body.

Receive regular massages

Acquire ergonomically correct products to support your wrists, arms, lower back and even for your legs.

Take breaks away from the computer. Even a quick 1 to 2 minute walk down the hall will refresh your body, get the blood flowing and even refresh your mind.

Bring the mouse and keyboard closer to your body so that your not reaching for either.

Take a few moments to stretch. Here are a few suggestions:
Doorway Stretch: Place your forearm against the frame of a doorway with elbow up. Step forward with the same leg that matches the forearm and lunge. Hold and gently come back. Switch sides.

Deltoid Stretch: Pull the right arm across the front of the body using the left arm. Make sure you stretched arm has the thumb facing down. Hold and then switch arms.

Tricep and Lat Stretch: Point your right elbow toward the ceiling, then lean the upper torso to the left. You may grab the elbow with the left hand for a further stretch. Hold and switch arms.

Wrist Stretch: Hold arm straight out with hand upside down. Gently pull down on the fingers to stretch. Switch hands.

I’m sure one of your first thoughts is how could I fit this into my day? Or I can’t do these, what if the boss sees me and thinks I’m being unproductive? Please realize that these simple things don’t take up much time and will help you be more productive. If your body is not in pain you will not be spending the time complaining about it, you will get more done and you’ll feel better. In the end it is your body and you only have one chance to take care of it.

In recent time, several electronic massage chairs had been introduced to the market in order to give optimum rest and comfort that would ease all your body pains and daily stresses in life. A lot of massage techniques had been incorporated to this type of equipment leading to its utmost popularity and efficiency. As technology continues to advance from time to time, new inventions had been made too. One of the latest and useful innovations done by experts is robotic and reclining chair massagers.

When you visit some shopping malls, hardware and even department stores, you would easily notice the different types of massage equipment with a lot of goodies to pamper every user. These recliners can offer so many health benefits to human beings. Its outside appearance might look so simple and ordinary but its features are actually amazing. This chair can give a complete body massage in a short period of time by just turning the settings on. Most of them are controlled by a wireless or hardwired remote so you won’t find it difficult to control in terms of duration, speed, strength and strokes. Its functions and operations are being displayed clearly in LCD.

There are manufacturers who preset the programs which make it automatic. There are also certain features in this hi-tech device that could be accessed only with the use of a remote control. Just by pressing a single button, you will definitely be able to experience an instant full body massage. There is no need for you to look for a good and quality spa and health clubs. This device has specific functions too. You can opt for a manual massage technique or a roller with kneading, acupuncture and compression and so on.

Upon looking to the product reviews, you will notice that the manufacturer was able to develop unique roller designs. Rollers re commonly used to give a back massage to the user. It usually targets the shoulder muscles, upper and lower back and the legs including the calf. Each type of roller has different mechanism of action. It will now vary according to the manufacturer’s design and purpose. In every mechanism, there is a particular movement. Rolling, tapping and kneading are the most common movements associated with these rollers. Therefore, upon purchase, you have to make sure that its function will surely meet your needs.

Another interesting high-end feature of chair recliners is the presence of body position sensors. It is not common to all massage equipment but some chairs have this kind of property. It enables the chair to determine where you are while lying or sitting in a recliner. Once you will about to move, the sensor will able to detect it and the program will change automatically. This is actually great but the cost can be expensive. Having a massage chair at home is really wonderful especially if you have the latest model. You can easily avail a therapy any time of the day as long as you have vacant schedules.

Trigger points can be a major cause of pain in the shoulder. They can also cause stiffness and loss of movement. There’s some good reasons why we get trigger points in the shoulder, and understanding how this joint works will help with successfully getting rid of shoulder trigger points.

The shoulder joint is one of the most mobile in the human body. It has an incredible range of motion – and is vital to how we function as human beings.

The way that the shoulder gets this great flexibility comes from the way the shoulder joint is constructed.

In most joints, there is a socket and ball arrangement, where the bone end has a smooth rounded ball-like end, covered with cartilage, and this fits into a rounded bowl or socket in the other bone. The ball rotates neatly inside the socket and that is how the joint moves.

The shoulder joint is slightly different though. Because it is so mobile, a deep socket for the humerus (the bone of the upper arm) to fit into would restrict its movement. So the shoulder has a very shallow cup, and the humerus keeps minimal contact with this cup as you move your arm around.

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So – how does this joint get stability and strength? This is where the muscles of the rotator cuff come into the picture. These four muscles (the supraspinatus, infraspinatus, teres minor, and subscapularis) do a subtle and difficult job.

As you go through a vast range of movement – from swinging a baseball bat to typing, they work together to balance the humerus in the joint. They need to constantly adjust their tension so that your arm bone will always sit in the joint socket at the optimum angle – even when you’re moving through a 200 degree movement.

So, once you have this picture in your mind, it’s easy to see why the shoulder joint can get so many trigger point and muscle problems.

Let’s recap – you have a series of muscles that need to do complex and difficult tasks. They’re working throughout the day. They need to compensate for very fine as well as very powerful movements (think writing vs. pressups.)

And when you combine this with the fact that a lot of us have bad posture it’s obvious why trigger points in the shoulder are very common and cause pain in many people.

So what can you do about shoulder trigger points? There’s two main areas to look at:

treating the triggers themselves. And
treating the underlying causes.

Let’s look at these in a bit more detail. Supposing you had a fall. You saved yourself by throwing out your arm and catching yourself just above the ground. That quick movement saved yourself from hitting your head, but the wrenched at your arm. This set off trigger points and pain in your shoulder. Figure out how to treat those trigger points and you’re cured.

Now, let’s look at a slightly different scenario. Supposing you work in an office. Every day, you sit for 8 hours in front of a computer. And as the day goes on, you start to slump forwards. Your spine is in an uncomfortable curve, and you compensate by hunching your shoulders and leaning your neck forwards.

You have pain in your shoulders, and when you examine them more closely, you find many trigger points in your upper trapezius and levator scapulae muscles. Now, you can and should go ahead and treat these triggers. But unless you look at the underlying problem and do something about it (like get a different chair, or a back rest, or take frequent breaks to adjust your posture) you’ll continue to get trigger points. They may go away for some time, but they’ll always come back.

Before 2008 and the creation of California’s statewide massage therapy certificate, life was difficult for corporate massage therapists in the greater Los Angeles area. Indeed, because the different municipalities of L.A. county required a municipal massage therapy license to practice legally, corporate massage therapists – who travel to offices (often located in separate municipalities) to provide onsite chair massage therapy – were limited in the areas they could work.

The creation of the California state massage therapy certificate in 2008, therefore, was a true game-changer – and lifesaver – for businesses and therapists in Los Angeles, as it ensures a simple, reliable verification of training, professionalism and legitimacy for area therapists, no matter their location in the state. In this way, the certificate is especially helpful in Los Angeles given L.A. county’s tremendous size; it is the most populous in the country, with an area larger than the size of some small states, and a population that would make it the eighth most populous state in America. Moreover, there are more than 88 incorporated cities in the county, meaning that before 2008 there was the potential for 89 (including the county) different massage licenses and professional qualifications for the therapists of L.A. County!

This made working in new areas difficult for corporate massage therapists as, if companies wanted massage at a different office location within the L.A. metropolitan area, therapists at one location would not be able to work legally at the other if it were located in a different municipal jurisdiction.

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Beside the legal aspects, the different licensing authorities in L.A. County made it difficult for therapists to prove their professionalism to new clients as often times different municipalities had different professional standards. For example, the massage technician permit in Long Beach requires a therapist to have had 500 training hours, a respectable number. In Glendale, however, the number required is a more paltry 150 training hours. Moreover, the qualifications and training requirements for therapists in many of the other cities in Los Angeles County, including L.A. itself, are very difficult to come by, making it difficult for employers to verify a therapist’s professional qualifications and for therapists to prove their sufficient training and skill.

Which is why having a statewide massage certification for therapists in California has made being a Los Angeles corporate massage therapist much easier. Indeed, the professional qualifications a California state certified therapist must have is clearly outlined on the California Massage Therapy Council’s Website and should serve as a clear and clearly accessible way for therapists to work legally and demonstrate their competency in the many municipalities of Los Angeles.