Author Archives: Carmine Cientanni

January 09 – Issue 4

Happy New Year to everyone. I hope you all had a terrific festive season and the new year has started with good steps! To introduce the current issue I would like to mention my new webpage. You may find me online at www.carmselitetherapy.co.uk and I would be very greatful for any feedback on the page…….and if I’ve made a typing error!!!

Free Massage

As a new year has now commenced and we all have to get used to writing 2009, the tendency to give things to people as you do in December generally goes. I have decided to reward loyal clients that have been regularly coming to visit for treatment. When an individual visits 10 times the next visit will be free of charge! To find out how many sessions you have attended feel free to ask to find out when you are entitled to a free massage! The free massage will be for 30 minutes.

Deep Tissue Massage Affects Blood Pressure and Heart Rate

Deep tissue massage can be described as massage that passes superficial muscle tissues and manipulates underlying muscles and fibres. Sports massage uses deep tissue massage regularly and a recent study was performed to analyse its effectiveness in improving blood pressure (BP) and heart rate (HR). In the study over 250 individuals that reported muscle spasms and strain of moderate to severe pain were recruited. BP and resting HR were recorded prior to testing as a baseline reading. Massages lasted between 45 and 60 minutes. The results showed the systolic and diastolic readings were significantly reduced following massages and heart rate was reduced by over 10 beats per minute on average.¹ These results suggest great benefits with deep tissue massage not only in short term relief from pain and a relaxing feeling, but long term health benefits. Reduction in BP and HR reduces risks of future possible cardiovascular diseases associated with elevated levels in BP and HR.

Hamstring Injuries

The hamstrings are a group of 3 muscles located at the back of the leg, above the knee. The muscles are the biceps femoris, semitendonosus and semimembranosus. The biceps femoris is the largest of the 3 and is the most commonly injured, usually through a strain. A strain is classified by the number of fibres in the muscle that have been damaged. A grade 1 strain would damage 5-20% of fibres in the effected area and return to activity with suitable rehabilitation would be within a week or two. A grade 2 strain effects around 20-60% of muscle fibres and you may have around a month to fully recover, whereas a grade 3 strain is a rupture of the muscle and damages from 60-100% of muscle fibres. If this happens the extent of time off activity varies between individuals and the action they take². Rehabilitation may take up to 6 months if an operation has been performed. Hamstring strains may occur as a direct impact injury or as an overuse injury which happens over a long period of time.

What Happens in an Injury? Part 2

As discussed in the previous edition, there are 4 stages to a soft tissue muscle injury. In this edition the second phase is discussed.  The Sub acute or proliferation stage is when the tissue begins to repair itself. After all the swelling from damaged tissue has occurred, repair begins with the removal of waste products, thus reducing swelling and the remodeling of muscle tissue. The production of scar tissue through collagen repairs the tissue and is achieved via 2 processes. The first forms the collagen (fibroplasia) and the second forms new local blood vessels (angiogenesis)³. As inflammation has ceased it is essential for the damaged area to follow a rehabilitation programme, even this early in an injury to encourage maximal strength and flexibility in the tissue. This will allow greater stability and may reduce the likeliness of an injury developing in the same area at a later date.  As the scar tissue is being produce stretching and active range of motion exercises in the damaged area will minimize the recovery time through increased vascular pathways (blood vessels to carry more blood). The exercise needs to be controlled to avoid pushing the muscle tissues over their limits and damaging them instead of repairing them. Performing movements that replicate the everyday requirements of the area allows the muscles to begin forming bonds in the relevant directions for increased strength.  If weight bearing movements (putting full body weight on the ground) are not achievable as there is too much pain from lack of strength, then movements should still be performed in a non weight bearing way. This will increase the joints range of motion so that more efficient movements can be performed when the damaged area is ready. Manual therapy through massage has been shown to assist in the proliferation phase, as it pushes any remaining waste products from the area and helps align new forming collagen in the correct manor. Research has also suggested that ultrasound may play a part in the remodeling phase as it stimulates fibroblasts which assist in the formation of collagen to help lay down the scar tissue needed for repair4.  The next issue will look at the final 2 stages in a muscle injury. The remodeling phase and the functional specific phase. 

Quick Facts!!!

“Chris Hoy’s success in the Olympics by winning 3 gold medals has been further rewarded with the national sports personality of the year.”

“The Hamstring muscles bring your heel to you buttock (knee flexion) and bring your leg behind you when you walk (hip extension).”

“All 3 hamstring muscles originate at the ischial tuberosity, more commonly known as the bum bone!”

References

1. Kaye, A.D., Kaye, A.J., et al, The Effect of Deep-Tissue Massage Therapy on Blood Pressure and Heart Rate, Journal of Alternative Medicine; 2008; Vol. 14; pp. 125-128.

2. Peterson, L. & Renstrom, P., Sports Injuries, 3rd edition, Taylor and Francis, London.

3. Dinsdale, N., Case Study: A Competitive Cyclist with Extreme Soft Tissue Trauma of the Lower Limb, SportEx Dynamics; 2008; Issue 17 (July); pp. 11-17.

4. Watson, T., Electrotherapy and Tissue Repair, SportEx Medicine; 2006; 29; pp. 7-13

October 08 – Issue 3

Welcome again to my newsletter updating the public on the latest news within the industry. With the Olympics being held in Beijing this Summer, I thought of reporting the success of the games, not to mention the terrific display of the British athletes.

Federation of Holistic Therapists Update

Recent developments in the FHT institutions have worked on formalizing the National Occupational Standards (NOS) for sports therapists. Jennifer Wayte has been working hard to outline exactly what each massage discipline should be doing to meet regulations. She has already produce specific curricula for sports massage and remedial massage. As the largest therapist group, the FHT is trying to get a link with the Olympic Committee as this will aid the status of all FHT members, along with opening new opportunities for its members. 

What Happens in an Injury? Part 1

Injuries are classed in 4 phases; The inflammatory/acute phase, the sub-acute/proliferation phase, the remodeling phase and the functional phase. The inflammatory phase is when the damaged blood vessels in the injured area bleed causing a natural and vital inflammatory reaction. Special cells called phagocytes are released into the injured area to aid the removal of waste products from the injury, such as dead cells. A short period of rest should follow the injury to allow this reaction to take place. Managing the swelling will assist the effectiveness of the repair. Following the PRICE regime is considered the most effective way. Protect the injured area from further injury and resting are the first things to do. Icing the injured area should follow. The ice slows down metabolism and blood flow (vasoconstriction), reducing the swelling and relieving pain. After the ice has been removed, the increase in blood flow (vasodilation) will help flush out the waste products and help reduce swelling. Compressing the injured area with a bandage will help disperse the fluid from the swelling and elevating the area above the heart will also help with the return of waste fluids towards areas where it can be excreted.¹ The inflammation phase usually lasts between 1 and 7 days, depending on the severity of the injury.

Groin Injuries

The groin is one of the most common area for sporting injuries, but also one of the most complicated to diagnose correctly. This is because of the amount of structures in the area. Muscles around the groin area include leg and back muscles, and in total there are over 10 prominent muscles that may get strained. The most common muscle to be injured is the adductor longus muscle on the inside of the leg. Other problems can be from the bones such as stress fractures and osteitis pubis (muscle tendons pulling the pubis area in the pelvis), but another common complaint could be hernia problems.² The most prominent symptom of hernias is pain in the groin area when coughing. If this is the case consult a doctor. Reasons for groin injuries may include unbalanced muscle pairings, age, sport, weak core muscles and overtraining, amongst other. Rehabilitation for groin injuries should concentrate on core strengthening and sport specific training.³

Quick Facts!!!

“Chris Hoy is Britain’s most successful athlete for 100 years in a single Olympics by winning 3 gold medals in Beijing.”

“Usain Bolt won 3 gold medals for Jamaica and in doing so he broke 3 World Records as well.”

“132 athletes managed to achieve more than 1 medals at the Beijing Olympics, Michael Phelps managed a record 8 golds for the USA.”

References

1. Dinsdale, N., A Competitive Cyclist With Extensive Soft Tissue Trauma of the Lower Limb, SportEx Dynamics, 2008, Issue 17 (Jul), pp. 8-10.

2. Peterson, L. & Renstrom, P., Sports Injuries, 3rd edition, Taylor & Francis, London.

3. Maffey, LL. & Emery, C., What are the Risk Factors for Groin Strain Injury in Sport? A systematic review of the literature, Sports Medicine, 2007, Vol. 37, pp. 881-894.

July 08 – Issue 2

 Welcome again to my newsletter updating the public on the latest news within the industry. The current issue will have a special concentration on pre-season training as many athletes from various sporting backgrounds will be starting pre-season very soon, if not already.  Also new in the current edition are small facts you may be interested in. If you would like to know something that hasn’t been included in this the current edition, send me an email with the topic and I will try and include it in the October issue.

Chocolate Helps Blood Pressure!!!

It’s true, recent findings by a group of scientists found that eating 100 grams of dark chocolate a day for an 15 day period significantly reduced blood pressure¹. It is believed that flavanols in cocoa are responsible for the drop in blood pressure found in the group tested. The test was a great success for all chocolate lovers, though further testing is needed to identify if there are the same benefits in milk chocolate and white chocolate. Larger, more diverse studies are also needed to further show the benefits that chocolate, and in particular, cocoa flavanols in the chocolate have. 

Periodisation, What is it?

Sports seasons can be split into different sections, each with its own specific objective. This usually consists of 3 phases; pre-season, competitive and off-season.             Many believe the pre-season phase to be the most important as it is preparing the athlete, or group of athletes for the main competitive phase. A bad pre-season can often lead to a bad start to a season. Pre-season follows a general principle called the S.A.I.D. principle, meaning Specific Adaptation to Imposed Demands. It is intended to prepare the bodies aerobic and anaerobic systems for the competitive season that follows. The athletes peak performance is not generally reached in this phase as competitive match play is always more demanding, but preparing the body as close to the intended intensity is of great advantage to the athletes. A good pre-season programme will be specific to the individuals in the sport and should be followed by a well constructed training programme in the competitive phase to maintain higher levels of performance².

Sporting Key Points For Pre-Season

  • Pre – Season should follow a good off – season programme that maintains suitable aerobic capacity.
  • Different sports require different types of training and within sports, different positions differ on demands as well.
  • Different body types recover at different rates. Have suitable recovery times between training sessions.
  • Don’t overwork individuals, injuries will occur. Injury prevention is key.
  • Use some fitness tests to compare base and progressing fitness levels. Make sure they are sport specific.
  • Be as close to competitive fitness before the competitive season begins.²

Can Massage Help?

Pre-season puts a huge demand on the body, as it follows the off-season phase and thus meaning a period of reduced intensity. The increase in intensity causes stresses on the body in which they have not adapted to. Sports massage can assist in minimising the risk of injury as micro-traumas occur within the muscles when exercising. Regular sessions of massage between training sessions can decrease recovery time and reduce the onset of muscle soreness. This allows the athlete to perform at a higher level when required to. The regularity of a massage depends on the level, intensity and quantity of training that the individual is performing. For example, elite athletes may have a sports massage every day, whereas a person who participates in exercise to keep healthy may wish to have a massage every 2 to 3 weeks².

SportExercise Decreases Risks of Fibromyalgia

Fibromyalgia is a syndrome of chronic fatigue and diffuse muscle pain and sleep problems. It has been suggested by Mannerkorpi and Henriksson that aerobic exercises performed at a low and moderate intensity, such as swimming, walking or cycling, could improve the symptoms and distress levels in individuals with fibromyalgia. This means that 30 minutes of regular activity, maybe 4 or 5 times a week, could not only reduce the risk of fibromyalgia, but also reduce the risk of the onset of cardiac problems in later life³.

Can Soap Cause Allergies?

Atopic Dermatitis, more commonly known as eczema, has risen in recent years. A suggestion for this may be the increase in use of strong soaps and exfoliants. The UCL Institute of Child Health recently published an article advising people that strong soaps and exfoliants used over-excessively strip the skins epidermis (outer layer), resulting in an allergic response. Professor Callard of the institute quoted “from a clinical viewpoint, it is important to stress that over-zealous washing, using harsh detergents and/or abrasive skincare products that can damage the skin, are likely to be at fault.” 

Quick Facts!!!

“Adults lose 2 to 3 litres of water a day at rest, via sweat, breathing and waste products.”

“During exercise you should drink 150 to 300 ml of water every 20 minutes.”

“Men need 11 to 13 cups of water a day to replace fluid loss whereas women need 8 to 9 cups a day.”

Some of you may know, I have recently been training to take part in a marathon challenge held at and around Colworth Park in Sharnbrook. The challenge involved completing 3 separate races over 3 days, totalling 26.2 miles in total. I completed the challenge in 3 hours and 41 minutes, running through fields, tracks and even behind Santa Pod race track! I decided to raise money for Keechs Cottage Childrens Hospice as well and have managed to raise over £300. If you wish to donate you may still do so at www.justgiving.com/carminecientanni

References

1. Grassi, D., Necozione, S., Lippi, C., et al, Cocoa reduces blood pressure and insulin resistance and improves endothelium-dependant vasodilation in hypertensives, Hypertension, 2005, Vol. 46; pp. 398-405.

2. SportEx Dynamics, April 2008, Issue 16; pp. 6-21.

3. Mannerkorpi K. and Henriksson, C., Non-pharmacological treatment of chronic widespread musculoskeletal pain, Best Practice and Research: Clinical Rheumatology, June 2007, Vol. 21 (No. 3); pp. 513-534.

4. UCL Institute of Child Health (www.ich.ucl.ac.uk)

April 08 – Issue 1

Welcome to the first edition of my quarterly newsletter aimed to inform you of recent news and updates in the sports massage and sports injury industry.

Massage reduces sleep disturbance

A study carried out in 2007 found that two massage sessions a week for 5 weeks, significantly reduced sleep disturbances amongst a group of individuals with a history of at least 6 months lower back pain and sleeping problems. Along with improved sleeping patterns and back pain, anxiety and depression were also reduced in the massage group compared with the control group.¹

Cheap trainers ‘just as good’

The University of Dundee conducted a study comparing trainers retailing at different costs. It suggests that cheap and moderately priced trainers are sometimes better than the more expensive trainers. They found no differences in pressure or comfort in trainers ranging from £40 – £75.² 

1.Lower back pain is reduced by massage therapy, Field, T. et al. , Journal of bodywork and movement therapies, 2007;11(2)Apr:21-24.

2. From International Therapist, 2007;79, Nov/Dec: 6