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Carpal tunnel Syndrome
Carpal Tunnel Syndrome for Medical Massage

Do you suffer with numbness, pain, and or tingling, in the hand or thumb, index, middle and half the ring finger? Do you use your hands repetitively or forcefully? Do you repetitively bend your wrist, have arthritis, especially the rheumatoid type, thyroid gland imbalance or hormonal changes associated with menopause and pregnancy? If so, you may have Carpal Tunnel Syndrome.


There is a group of small bones that make up your wrist and the base of your hand called “carpals.” To allow nerves and tendons to pass through to your fingers, there is a tunnel through these bones called the “carpal tunnel.” Through this tunnel pass nine tendons and a bundle of nerve fibers called the “median nerve.” There is limited room in this tunnel, and if anything happens to cause swelling of any of the tissues, the median nerve will be compressed, at first causing irritation, then over time causing actual nerve damage.


Many other conditions can have symptoms that are similar to those of Carpal Tunnel Syndrome but are treated differently. Therefore the first step to correct treatment is an exam by an experienced physician to determine the correct diagnosis.

Massage therapy is often used to treat CTS. It will focus on relieving pressure on the median nerve while increasing circulation. Furthermore, a person must be retrained in proper hand posture and biomechanical stress reduction to prevent exacerbation of the problem. Medical massage therapy is uniquely positioned to offer this therapy without the side effects of medications, local injections, or surgery.

Hands On HealthCare Massage Therapy has developed a protocol that has been life changing for many of our clients.  A 30 minute session may prevent surgery and just may be the answer you are looking for.

As always, please check with your physician or health care provider before seeking treatment.


Marla Kaplan-Pelle, LMT, CLT, MFRP, Director

Diaphragmatic Breathing
Diaphragmatic or Deep Breathing

Conscious, diaphragmatic breathing is like a massage for your internal organs!

You may find it difficult to follow these instructions and be tempted to breathe into your chest. Have patience. Unfortunately, most adults no longer “belly breathe.”  If you are fortunate to have an infant or young child you can observe, you will see, that we start out belly breathing and then I guess…. life gets in the way.

To begin

Relax your shoulders and when possible, Breathe in through your nose and Breathe out through your mouth.


Imagine that there is a balloon in your stomach


Inhale– fill up the balloon in your belly.


Exhale– deflate the balloon.


Start out very slowly and only try a few breaths at a time, but practice a few times a day. Breathing will change naturally as a result of structu

Guidelines for the Early Detection of Cancer
Cancer Awareness Ribbon Colors

The American Cancer Society recommends these cancer screening guidelines for most adults. Screening tests are used to find cancer before a person has any symptoms.

Breast cancer

Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so.

Women age 45 to 54 should get mammograms every year.

Women 55 and older should switch to mammograms every 2 years, or can continue yearly screening.


Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.


All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.


Women should also know how their breasts normally look and feel and report any breast changes to a health care provider right away.


Some women – because of their family history, a genetic tendency, or certain other factors – should be screened with MRIs along with mammograms. (The number of women who fall into this category is very small.) Talk with a health care provider about your risk for breast cancer and the best screening plan for you.

Colon and rectal cancer and polyps

Starting at age 50, both men and women should follow one of these testing plans:


Tests that find polyps and cancer


Colonoscopy every 10 years, or

CT colonography (virtual colonoscopy) every 5 years*, or

Flexible sigmoidoscopy every 5 years*, or

Double-contrast barium enema every 5 years*

Tests that mostly find cancer

Yearly fecal immunochemical test (FIT)**, or

Yearly guaiac-based fecal occult blood test (gFOBT)**, or

Stool DNA test (sDNA) every 3 years*


*If the test is positive, a colonoscopy should be done.

**The multiple stool take-home test should be used. One test done in the office is not enough. A colonoscopy should be done if the test is positive.

The tests that can find both early cancer and polyps should be your first choice if these tests are available and you’re willing to have one of them. But the most important thing is to get tested, no matter which test you choose. Talk to a health care provider about which tests might be right for you.


If you are at high risk of colon cancer based on family history or other factors, you may need to be screened using a different schedule. Talk with a health care provider about your history and the testing plan that’s best for you.

Cervical cancer


Cervical cancer testing should start at age 21. Women under age 21 should not be tested.


Women between the ages of 21 and 29 should have a Pap test done every 3 years. HPV testing should not be used in this age group unless it’s needed after an abnormal Pap test result.


Women between the ages of 30 and 65 should have a Pap test plus an HPV test (called “co-testing”) done every 5 years. This is the preferred approach, but it’s OK to have a Pap test alone every 3 years.


Women over age 65 who have had regular cervical cancer testing in the past 10 years with normal results should not be tested for cervical cancer. Once testing is stopped, it should not be started again. Women with a history of a serious cervical pre-cancer should continue to be tested for at least 20 years after that diagnosis, even if testing goes past age 65.


A woman who has had her uterus and cervix removed (a total hysterectomy) for reasons not related to cervical cancer and who has no history of cervical cancer or serious pre-cancer should not be tested.


All women who have been vaccinated against HPV should still follow the screening recommendations for their age groups.


Some women – because of their health history (HIV infection, organ transplant, DES exposure, etc.) – may need a different screening schedule for cervical cancer. Talk to a health care provider about your history.

Endometrial (uterine) cancer

The American Cancer Society recommends that at the time of menopause, all women should be told about the risks and symptoms of endometrial cancer. Women should report any unexpected vaginal bleeding or spotting to their doctors.


Some women – because of their history – may need to consider having a yearly endometrial biopsy. Please talk with a health care provider about your history.

Lung cancer

The American Cancer Society does not recommend tests to check for lung cancer in people who are at average risk. But, we do have screening guidelines for those who are at high risk of lung cancer due to cigarette smoking. Screening might be right for you if you are all of the following:

-55 to 74 years of age

-In good health

Have at least a 30 pack-year smoking history AND are either still smoking or have quit within the last 15 years (A pack-year is the number of cigarette packs smoked each day multiplied by the number of years a person has smoked. Someone who smoked a pack of cigarettes per day for 30 years has a 30 pack-year smoking history, as does someone who smoked 2 packs a day for 15 years.)


Screening is done with an annual low-dose CT scan (LDCT) of the chest. If you fit the list above, talk to a health care provider if you want to start screening.

Prostate cancer

The American Cancer Society recommends that men make an informed decision with a health care provider about whether to be tested for prostate cancer. Research has not yet proven that the potential benefits of testing outweigh the harms of testing and treatment. We believe that men should not be tested without first learning about what we know and don’t know about the risks and possible benefits of testing and treatment.


Starting at age 50, men should talk to a health care provider about the pros and cons of testing so they can decide if testing is the right choice for them.


If you are African American or have a father or brother who had prostate cancer before age 65, you should have this talk with a health care provider starting at age 45.


If you decide to be tested, you should get a PSA blood test with or without a rectal exam. How often you’re tested will depend on your PSA level.


Take control of your health, and help reduce your cancer risk.

Stay away from all forms of tobacco.

Get to and stay at a healthy weight.

Get moving with regular physical activity.

Eat healthy with plenty of fruits and vegetables.

Limit how much alcohol you drink (if you drink at all).

Protect your skin.

Know yourself, your family history, and your risks.

Get regular check-ups and cancer screening tests.


For more on what you can do to help reduce your cancer risk and other questions about cancer, please visit us online at, or call us anytime, day or night, at 1-800-227-2345.


Written by

The American Cancer Society medical and editorial content team



Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.



Last Medical Review: March 11, 2015 Last Revised: July 7, 2017

Headache Medical Massage at Hands On HealthCare Massage Therapy in Commack

Many headaches are caused by trigger points in the neck and head.

We have had many clients tell us what causes their headaches: sinuses, food, coffee, odors, hunger,  lack of sleep — the list goes on. But, how do these irritants cause headaches. That is, what actually mediates the pain, or makes a link between the causal factor and the pain itself. Obviously there is still much information missing. But very often, the pain itself comes from trigger points in the neck and head. And pain from trigger points in the neck and head can often be relieved.


There are three categories of headache people (oversimplifying): severe headache people, ordinary headache people, and no headache people:

No headache people may have very tight, even painful, muscles in their necks, but they seldom if ever get headaches.

Ordinary headache people are people who get a headache now and then — which is seldom severe enough to interfere significantly with work or activities, and which usually responds to over-the-counter pain relievers.

Severe headache people suffer tremendously. Not only do they suffer from the pain of the headaches, which is often disabling, but they suffer from loss of work, loss of the pleasure of leisure activities, and sometimes difficulty dealing with the impatience of others who don’t understand what they’re going through.

Sciatica or Back pain

Though there can be multiple reasons for sciatica pain, very often, it is caused by the piriformis muscle. The sciatic nerve innervates the back of the leg, runs under, over, or through the piriformis muscle. Often, tightness or entrapment in the piriformis can cause sciatica, which it can cause intense pain in the low back, buttocks, all the way down the back of the leg into the foot. This is commonly referred to as piriformis syndrome and can be a pain in the buttocks!  Often people do not stand with their weight evenly distributed between the two legs. Almost everyone tends to stand with the weight shifted to one leg or the other. And that means, piriformis, which outwardly rotates the hip, is working overtime. Driving, especially long distances, can aggravate this condition. One of the worst things you can do to a muscle is to leave it in a shortened position for a long period of time, Most people tend to drive with their knees apart, thus keeping the hips outwardly rotated. That’s one reason so many people experience low back or leg pain after long driving. Therefore, stop frequently, even if only to walk once around the car. Keeping your wallet out of your back pocket will also eliminate undo pressure on the sciatic nerve, especially when sitting. Massage Therapy can often eliminate the pain associated with Piriformis Syndrome. The muscles may need to be  re-educated and the associated trigger points addressed. This information is provided for informational purposes only and is not intended as medical advice. Always obtain qualified medical advice from your medical doctor before undergoing any treatment and for a proper diagnosis. DO NOT SELF DIAGNOSE!

We have developed a protocol for Piriformis Syndrome that has been life changing for many of our patients. A 30 minute medical massage session just might be your answer!

Sinusitis and Allergies
Medical Article for Sinusitis Allergies

Got Allergies? Got Pain?


Consider An Advanced Medical Massage Technique, Manual Lymph Drainage


Manual Lymph Drainage (MLD) is an excellent therapy for assisting the body to collect and move lymphatic fluid. It most often addresses edema (swelling caused by fluid retention). This very light and rhythmical massage is used to clear congestion. MLD techniques can make an enormous difference to one’s health and well-being.


The medical profession is primarily interested in MLD due to its ability to help manage problems of lymphedema. This condition manifests as severe swelling of a limb, or parts of the torso, which can cause discomfort and inconvenience to the sufferer. It is most notorious as the treatment following lymph node removal after breast cancer surgery.


MLD techniques address the tiny lymph collectors just under the skin, the intricate network of lymphatic vessels are stimulated gently to transport the lymph efficiently along the appropriate pathways. The lymph is cleansed by the clusters of nodes it meets along the way and the clean lymph eventually rejoins the bloodstream via the large veins in the cervical area. This can be done with the patient fully clothed or not.

Allergies, Sinusitis, Migraines, Chronic Headaches, TMJ, More


Allergies such as hay fever, reactions to pollen, mold spores or other foreign body invaders will often cause the body’s immune system to go into high gear as it over reacts. The result is irritation and inflammation of the sinuses. MLD techniques can often relieve or ease these symptoms and remove the congestive material from around the facial area.


Edema of the mucus membranes and an impaired immune system can cause chronic sinus congestion and sinusitis. These conditions respond well to MLD because it has the effect of reducing the edema of the membranes while also boosting the immune system.


A migraine attack characteristically has sudden onset pain, which becomes unbearably sharp and is usually accompanied by nausea and even vomiting. It can be triggered by many factors. In the disease picture, the physical processes that occur result in edema accumulating around the blood vessels in the head and neck area, therefore MLD techniques are often very effective in treating migraines, and for the same reasons, chronic headaches.


TMJ Disorders can be brought on by a variety of reasons and have a variety of symptoms. MLD techniques will not correct the problem, however the swelling caused by these disorders can often be reduced by MLD techniques and that alone, can be a welcome relief to those that suffer with TMJD.


MLD has also been successful in treating acne, strains and sprains, healing of flesh wounds, pain from chronic conditions such as arthritis, symptoms of chronic fatigue syndrome, constipation and much more. Clients who undertake a series of MLD treatments notice a dramatic improvement in their condition and additionally will usually find new energy, a feeling of lightness and improved skin texture. Additionally, because of the light, rhythmical strokes, the nervous system is calmed down and this lowers blood pressure, counters stress and improves sleep patterns.


As always, please seek medical advice….


Marla Kaplan-Pelle, Licensed Massage Therapist, Certified Lymphedema Therapist, MFRP, Director


Hands On HealthCare Massage Therapy and Wellness Day Spa, A Recommended Community Provider For Memorial Sloan-Kettering Cancer Center

Trigger Point Therapy
Trigger Point Massage Therapy


Ever wonder what can be done to help headaches, neck stiffness, carpal tunnel type symptoms, frozen shoulder, back pain, low back stiffness, shin splints?


Trigger points are accumulations of waste products around a nerve receptor.  Trigger points form in muscles which have been overused or injured due to an accident or surgery.  They can present themselves as sharp pain, dull ache, tingling, pins and needles, etc.


Active trigger points are those which cause discomfort. Latent trigger points wait silently in the muscle for a future stress to activate them.  It is common to attribute this discomfort to other conditions, instead of our tight muscles which harbor trigger points.


Trigger points are not visible with traditional medical testing such as MRI or X-ray. When trigger points are not treated, they will create satellite trigger points in the affected area. For instance, a trigger point in the trapezius may cause a trigger point to appear in the temple. The trigger point in the temple then may cause a trigger point to appear in the jaw. And, voilà! – a case of TMJ.


Trigger point massage is not a relaxing, “fluff and buff” technique. It requires the participation of the client to communicate the presence and intensity of pain and discomfort. The therapist and client work together as a team to maximize the effectiveness of the treatment.


It is common to find great improvement after one treatment. Repeated treatment may be necessary for those with chronic trigger points.  If you have any questions regarding Trigger Point Therapy or Massage Therapy, please contact Marla Kaplan- Pelle, LMT,MFRP, Director Hands On HealthCare Massage Therapy, P.C., 208 & 210 Commack Road,  Commack 631-462-HAND (4263)