Here is a selection of research on the effectiveness of acupuncture in treating headaches.

In a 2005 randomized trial, Linde et al studied the effects of acupuncture, sham acupuncture and a control on 302 patients with migraine headaches. The study found the acupuncture and sham acupuncture produced a greater reduction in moderate to severe headaches.

A study by Hansen & Hansen in 1985 showed that classical Chinese acupuncture was more effective than the sham acupuncture placebo in relieving headaches.

A study by Vincent in 1989 found that acupuncture was more effective than the sham acupuncture placebo in treating chronic migraine headaches.

A systematic review by Melchart et al in 2001 included, among others, 16 trials comparing acupuncture to sham acupuncture. The review found that true acupuncture was reported to be significantly superior to sham acupuncture.

Related posts:

1. Research: Acupuncture & Tennis Elbow
2. “Sham Wow!!!” or The Problem with Acupuncture Research
3. Research: Acupuncture & Diabetes

A 2004 systematic review conducted by Dr. Trinh of McMaster University showed strong evidence to support the treatment of lateral epicondyle pain with acupuncture.  The systematic review included 6 high quality studies.  All studies showed that acupuncture provided relief for lateral epicondyle pain.  Five of the six studies showed that acupuncture was more effective than the control.

Related posts:

1. Research: Acupuncture & Headaches
2. Research: Acupuncture & Diabetes
3. Tennis Elbow

Tennis Elbow

These days the average person that has tennis elbow doesn’t even play tennis.  What used to be a term reserved for athletes can now be achieved by painting too many coats of paint on your wall, typing on your computer, and other non grand slam activities.  If you are feeling pain in your outer elbow that gets worse with pressure or use (typing, stretching, holding or gripping), then you may have tennis elbow even if you don’t know what 30 love means.

Tennis elbow or lateral epicondilytis refers to  pain on the outside of the elbow.   The syndrome is typically a tendinitis or overuse injury whereby the insertion of the the wrist extensor muscles (the muscles that bring the back of your hand towards your body) becomes inflamed. Typically the inflammation leads to the formation of fascial scar tissue which attempts to heal and strengthen the injured area, but instead often ends up forming a thick inflexible mass that glues the injured tendon to the surrounding tendons.  When these tendons become stuck together movement of the wrist becomes painful.

There are other factors related to tennis elbow.  The term tennis elbow originated from the frequency of this injury among tennis players.  As you can imagine, in tennis a backhand puts a lot of stress on the wrist extensors which can become fatigued easily.  It is the constant repetitive use of muscles that tires the muscles to the point that they become inflamed.  Tennis elbow is quite common for office workers because of the use of the computer and the the continuous strain that typing puts on the wrist extensor muscles.

Often in tennis elbow injuries, there is also the presence of a nerve impingement called thoracic outlet syndrome.  With the nerve supply for the wrist extensor muscles being decreased, the health of the muscle deteriorates to the point that it becomes more susceptible to injury from something as simple as typing.  This is why it’s important when treating tennis elbow to also look for the presence of thoracic outlet syndrome.

Research has shown that tennis elbow can be healed through regular massage, fascial release, stretching and acupuncture.

Related posts:

1. Video: Stretch for Tennis Elbow
2. Research: Acupuncture & Tennis Elbow
3. The Benefits of Sports Massage

A 1997 study conducted by the University of Manchester appeared in Diabetes Research and Clinical Practice Volume 39, Issue 2, February 1998, Pages 115-121.

The study followed 46 diabetic patients with chronic painful peripheral neuropathy and studied the long term effects of acupuncture.  63% of the patients were already following the standard medical treatment for painful neuropathy.  Patients received 6 treatments of acupuncture over 10 weeks.  By the end of the study, 77% showed significant improvement in their symptoms.  After the study, the patients were followed for another year, during which 67% were able to stop or reduce their medications significantly.  21% noted that their symptoms had cleared completely.

Related posts:

1. Research: Acupuncture vs Conventional Medicine for Lower Back Pain
2. Research: Acupuncture & Headaches
3. Research: Plantar Fasciitis and Acupuncture

Massage Therapy or acupuncture can help relieve your chronic pain or give you a solitary moment of relaxation,  relieving the stress of working in Toronto. Registered Massage Therapy, acupuncture and cosmetic acupuncture work by using the body’s own natural healing powers to turn back the clock and leave you feeling healthier and younger.

As a Registered Massage Therapist (RMT), I offer a variety of treatments at my Toronto Massage Therapy & Acupuncture Clinic to give you the pain relief, healing or relaxation that you are looking for:

Massage Therapy Services:

• Relaxational Stress Relief Massage Therapy

• Deep Tissue Therapeutic Massage Therapy

• Myofascial Release Technique (MRT) & Rolfing

• Sports Massage

• Combination Massage Therapy & Acupuncture sessions

Acupuncture Services:

• Evidence-Based Medical Acupuncture

• Cosmetic Acupuncture for facial rejuvenation

• Combination Acupuncture & Massage Therapy Sessions

Massage Therapy & Acupuncture Clinic in Central Toronto

Massage therapy or acupuncture sessions take place in a comfortable, safe environment where your health and well being is always put first. I am available at my massage therapy & acupuncture clinic conveniently located in Toronto’s friendly Greektown on the Danforth between Pape & Donlands.  There is subway access, bus access, street parking and Green P Parking, .  Also, I am a short ride from Riverdale’s Gerrard, Dundas and Queen street neighbourhoods.

Convenient Hours

My hours are very flexible and I am available Sundays and public holidays by request.

Had a really stressful day in Toronto? Try an in home massage where the massage and healing is brought to the safety and comfort of your own home or hotel.

Insurance Coverage

As I am an RMT, my receipts are accepted by extended health benefits plans offered through your workplace.  Your treatment could be 100% free depending on your plan.

If you have any questions about massage therapy or acupuncture or would like a free consultation, feel free to contact me.

In the meantime, be sure to browse the Toronto Massage & Acupuncture Resource Centre located in the margin.   There are lots of videos, exercises, stretches and healthy tips for you.  Some of my newest articles and updates are listed in my blog below.

Ken Shim, HBBA, RMT, CAMA

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1. The Beauty of Combining Massage & Acupuncture
2. Massage Therapy and the HST
3. In Home & Hotel Massage Service

My favourite method of treating is becoming the combination massage & acupuncture session.  From what I have seen, it gives a better chance of success for relieving chronic or acute pain and also gives a more pain free, comfortable release compared to massage therapy alone.

In a typical combination Acupuncture & Massage session, I do a half hour acupuncture treatment followed by a half hour massage.  There are some real benefits to this such as:

1. An Easier, Gentler Treatment Experience. This sounds counter-intuitive.  How can poking somebody with needles be gentler than massaging?  I start with acupuncture because it does a great job of setting the tone for the treatment.  The acupuncture treatment triggers a chain reaction that releases endorphins, analgesics and anti inflammatories into the problem areas.  After the needles are out, typically the client is more relaxed, the pain is lessened, the inflammation is reduced and the muscles have decreased spasm.  At this point, the client will not feel as much pain and discomfort from the massage.  After the needles have done the bulk of the work lessening the acuteness of the pain, the massage can be gentler focusing on flushing out toxins and stretching the muscles back to their normal length.
2. The client benefits from each technique’s unique strengths. There is no one approach or technique that does all for all people.  Massage is excellent for  increasing circulation to an area.  Stretching techniques are great for returning short muscles back to their normal length.  Fascial techniques are perfect for getting rid of fascial restrictions or scar tissue.  Reflexive neurological techniques are wonderful for releasing stubborn muscle spasms. And acupuncture is great at reducing inflammation, speeding up the healing process, decreasing pain and working deep muscles that are difficult to access.  Through a combined approach, the client has the best chance of achieving health.
3. Acupuncture decreases inflammation. When a client is in acute pain there is usually some  inflammation in the area.  The inflammatory response releases neuro transmitter chemicals which heighten any pain response.  This means that the painful area can be tricked into feeling extreme pain from even a light touch, which makes it difficult with massage to get at the root of the problem until later treatments.  Acupuncture, on the other hand, goes deep directly to the problem area and starts reducing the inflammation right away allowing the massage treatment more freedom in targeting the problem areas.
4. The combination approach allows me the freedom to give the most effective treatment that I can. I have found a few different approaches that are absolutely ideal for treating certain conditions.  For example, in acute pain between shoulder blades caused by rhomboid muscle spasm, a 3 minute application of reflexive stretching techniques can resolve most of the acute pain almost immediately.  Likewise, directed acupuncture techniques can often cause an immediate decrease in acute pain in certain types of SI joint dysfunction.
5. Acupuncture can induce profound relaxation and stress relief. I have found that more people fall asleep on my table during acupuncture sessions vs massage sessions.  Acupuncture initiates a strong release of endorphins in most people causing deep relaxation and stess relief.  There are specific points I can target for stress relief sessions that bring about a very peaceful feeling and sets the stage perfectly for the massage session.
6. Affordable.  The price of a 1  hour treatment of combined acupuncture & massage is $80 including GST.  The average for Toronto for those services separately is around $110.  As an RMT, I can bill any modality or treatment that falls under my scope of practice as “massage”.  Typically I bill combination treatments as massage therapy, which can be helpful for people that have extended health benefits for massage but not acupupuncture.  This practise is endorsed by the CMTO and insurance companies.

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1. Toronto Massage Therapy, Acupuncture & Cosmetic Acupuncture Clinic
2. Ken’s Approach to Acupuncture
3. What is Cosmetic Acupuncture?

Since becoming a massage therapist, I have quickly found the limits my body can go before it needs help. The work is tiring and physically demanding and burns out many RMT’s by the 5 year mark. This is why I religiously follow a program of postural awareness, stretching exercises, epsom salt baths, weight training and most important of all: yoga. Yoga has done wonders for helping me maintain my core strength and flexibility and decreasing lower back pain. I plan on writing more on these topics in the near future, but for now I’d like to give props to my yoga teacher, Julia. She can be found on her website: http://www.yoga-vibe.com/

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3. How to Travel Without Low Back Pain

The weekend road trip to Montreal seemed like such a great idea until 500km later when I stepped out of the car and found my entire low back in spasm. I almost couldn’t straighten up and was starting to walk with a limp.  Oh how I was almost tempted to go into some downward dog yoga poses right there in the parking lot in order to relieve the pain.  Luckily I didn’t have to resort to that.  Just walking it off a bit and moving around loosened it up.  But it did remind me of a common complaint from my clients and also a condition I lived with for a few years.  Most importantly, it inspired me to write a blog post to help out all those summer travelers.

One big reason why people start to suffer from low back pain on long car rides is inactivity.  Our bodies are not meant to be immobile for hours on end.  Our muscles need to move about, contract and stretch in order to remain functional.  Inactivity decreases blood circulation, waste removal and nerve conduction to the muscles resulting in muscles that are irritated and sore.

If immobility is the cause of pain, then surely some motion must be the cure.  From suffering years of low back pain, I developed these exercises that always did the trick for me on car or plane rides.  Try some of these on your next journey and you will see the improvement.

Tips for Preventing Back Pain

• Stop frequently.  You can take a breath of fresh air, enjoy the scenery, grab a snack, etc, etc.  But most importantly, you are stretching out those muscles and moving them in a natural fashion and boosting blood circulation.
• Keep hydrated.
• If you’re stuck in a car seat, wiggle a little.  Crank up the tunes and start jiggling!  It’s good for your health!  You might not be inspired enough to break out into a full blown fist pumping dance session, but some slow gentle motion can greatly help you stay loose. Here’s how:

Mobilize Your Lower Back

1. Start by raising your left hip then lower it.  Then raise your right hip then lower it.
2. Then try twisting your left hip forward then back, followed by the right.
3. Arch your lower back so that your bum sticks out a bit more.  Next round your lower back.

Exercise Your Gluteal Muscles

1. Now you can start working your gluteal muscles.  First of all, you want to squeeze both glutes together.  If you do this right you might feel yourself lift off the seat a bit.
2. Next try squeezing just the left gluteal muscles.  It might help to push your left foot into the floor at the same time almost as if you are trying to raise that left hip off the seat.  Now try the right and alternate back and forth.
3. If you are feeling especially adventurous, turn the volume up to 11 and just dance without any shame.

Safety First

1. A few things to remember for safety sake:  To avoid accidents it is not recommended to do these exercises if you are driving.  To avoid being locked up, try these moves by yourself first so that you feel comfortable enough doing them in a way that doesn’t attract too much attention in public (the key is slow, small movements).

It might seem a bit strange at first, but with some practise it will become second nature on those long trips.  And by the way, I did these exercises on the ride back from Montreal and was amazed at how I felt no traces of back pain when I stepped out of the car in Toronto.

If you find the pain too intense or long lasting, you might need a massage or acupuncture treatment.

Related posts:

1. How To Relieve the Discomfort of Airplane Travel
2. Video: Stretch for piriformis related low back pain or sciatica
3. Video: Pilates Abs Routine

What is fascia?  If you’ve ever cooked chicken, you’ve probably noticed it. The thin, transparent, filmy material that covers the chicken meat.  Our muscles are covered in fascia.  Fascia covers every muscle and keeps the muscle together.  Fascia covers and protects every single muscle bundle or fascicle that makes up the muscle.  Fascia also covers every single muscle fibre or muscle cell that makes up the bundle,  It is like the framework or scaffolding that the muscle operates within.  Fascia holds and supports the muscle together giving it shape, form and function.  It also helps the muscles slide over each other with less friction.  The body is made up of over 600 muscles that layer over each other and criss cross each other.  Each muscle needs to slide over, under or beside its surrounding muscles without interference in order to function properly.

Fascia has a few interesting properties too.

• It is pound for pound stronger than steel.  In other words, unless you know how to treat it correctly it can and will be very difficult to get it to release.
• Fascia is also the material that makes up tendons and ligaments.
• It is not contractile.  That is, it doesn’t contract or relax the way a muscle does.
• It can shrink or expand but we have little control over that.  It also seems to be emotional.  In times of emotional stress, fascia contracts and tightens around the muscle it is trying to protect.
• When a muscle is hurt, as in a car accident or athletic injury, the muscle and fascia often tears.  This tear eventually heals the same way that a skin cut can heal.  However, the same way that the skin can be left with a thick, inflexible, sensitive scar, the muscle and fascia can also scar.

The last point is why fascial work can be so important to healing sports injuries and traumatic injuries.  An inflexible scar in a muscle can do a few things:

• It can remain short, tight and inflexible causing pain whenever the muscle tries to stretch to its full strength.  You might even notice a sharp almost tearing feeling when you try to stretch.
• The scar can become adhesed or glued to the fascia of surrounding muscles.  This acts as a monkey wrench in the system.  None of the muscles that are adhesed can function pain free in their normal ranges with this.  For example, if a scar forms between your quads and your adductor/groin muscles you might notice that you don’t have the same strength or flexibility with either quad exercises or adductor exercises.  The reason is that those muscles are essentially glued together and pulling on each other each time you use them.

So now we know that fascia is everywhere; it’s stronger than steel; it can scar; it can become glued to other muscles.  And for many people, it is the key to solving chronic pain from old injuries. I’ll have posts in the future about how I can treat fascial restricitons with active fascial release, rolfing, myofascial release technique and acupuncture.

Related posts:

1. The Benefits of Sports Massage
2. Tennis Elbow
3. Ken’s Approach to Massage Therapy

One of the most important and long lasting ways to get rid of neck and shoulder pain is to change your posture.  I am sure that you have all heard it from your massage therapist, but, how can you change your posture after it’s been that way for decades?  The body has already been trained and it’s game over, right?

Wrong!  Using the right fascial massage techniques, stretches and strength training can re-educate your body to develop and accept a new posture.  With postural re-education you will find more permanent results than simply trying to pull your shoulders back.

Pace Yourself

Firstly, understand that the change has to be gradual.  It can be next to impossible to change postural habits overnight.  Clients often feel like they have to change their posture instantly and that they are “failing” every time that they catch themselves falling into their old slouches.  I ask them to instead try to have good posture for a total of an hour a day for the first week and then gradually increase it.  This way they can understand that it is a gradual process and that they have a really good chance of succeeding.  Most will be able to do more than an hour a day and feel great about it.

Strength Training for Posture

The other approach is to start strengthening your muscles. Posture is only partly habit.  The rest of your posture depends on muscle balance.  The chest muscles (pectoralis major and pectoralis minor) pull the shoulder blades forward, while the back muscles (rhomboids, trapezius and latissimus dorsi) pull the shoulder blades back and toward the spine.  Most people are stronger in the chest than they are in the back, which is why they slouch forward.  Re-balancing your postural muscles involves stretching out the pectoral muscles and strengthening the back muscles.

Start training your back muscles.

By strengthening the upper back muscles, specifically the muscles that bring your shoulder blades together, you will find that your body with its balanced muscles will naturally and automatically go into the correct posture.  You won’t have to think about posture or make any real effort again.  The key exercises for strengthening these back muscles are lat pulldowns and rowing motions.

Focus on Endurance

The problem with pulling your shoulders back is that these muscles get tired as they lack endurance.  An 8 hour work day is a long time for these muscles to be working against the powerful chest muscles.  When strengthening your postural back muscles, build endurance by lowering the weight and working up to sets of 16 or more reps.

Take it Easy on Your Chest

Most people that work out love spending time on their pecs.  Guys love the strong, masculine look that big pecs give, while women like how it firms and lifts the breasts.  Remember though, that strong, short, tight pec muscles are a big reason for our bad posture.  These muscles shorten with repeated slouching and hunching over our computers.  Strengthening these muscles further shorten them and worsen our posture.  You can still work on your chest in a workout, but you will need to change your approach:

1. Lower the weight you are using.
2. If you can, leave the bench press alone and work the pec fly machine.  The pec fly works the pecs through its full range of motion including the stretched out end range.
3. Stretch your pecs before and after every set.  Pec stretches will lengthen the pec muscles and keep them from going into spasm.

A Second Look at the Elliptical

Most people use the elliptical by powering through with their legs while their arms limply hold onto the handles and swing. This is good for cardio training and working the legs, but if you want to improve your posture and get rid of your neck pain, try using the elliptical in the following way.

1. The key is to focus on what you are doing with your upper body.  Try to shift all the work from the legs to the upper body.  It may be difficult at first and you may need to alternate between focusing on the upper body and focusing on the lower body.
2. There are 2 phases: pulling the handle back and pushing the handle forward.  To work your postural muscles, put all your effort into the pulling back phase while using the pushing forward phase to rest.
3. When working the upper body, don’t let your arms do all the work.  Focus on your shoulder blade.  It should be either moving outward or pulling inward toward the centre of your back.  The more your shoulder blades are moving, the more you are working your postural muscles.
4. When you pull back on the handle, try to pull your shoulder blade toward your spine.  This works the rhomboid, lats, and middle and lower traps: the postural muscles that pull your shoulders back.
5. During the rest phase when the handle is going forward, don’t put too much effort on the arm, but try to distract your shoulder blade and slide it out and forward for a nice stretch.
6. This exercise works great because there is a lot of repetition which builds  endurance in your postural muscles.  When those back muscles become as strong as or stronger than the front muscles your shoulders will automatically start pulling your shoulders back on their own.

Good posture, naturally.

Related posts:

1. Video: Shoulder Exercises for Improving Posture & Decreasing Chronic Pain
2. Video: Chest/Pectoral Stretch for Neck & Shoulder Pain
3. Learning to Sit: Posture & Ergonomics for Work & School