⭐️TENDON PATHOLOGY CONTINUUM⭐️
Overuse tendinopathy is proposed to happen along a 3 stage continuum:
😊 Reactive Tendinopathy: A short term adaptation to overload (chronic low loads or acute direct trauma) that thickens the tendon, reduces stress and increases stiffness. The tendon has potential to revert to normal if the overload is sufficiently modified.
😐 Tendon Dysrepair (failed healing): The attempt to tendon heal, but with greater matrix breakdown. An increase in number of cells = separation of the collagen and disorganization of the matrix. May be an increase in vascular organization and associated neuronal ingrowth. This usually with chronic overload, but can appear across a spectrum. Frequency, volume and duration of load are important variables. Some reversibility of the pathology is still possible with load management and exercise to stimulate matrix structure.
☹️ Degenerative tendinopathy: A progression of matrix/cell changes, with areas of cell death. There are islands of degenerative pathology interspersed between other stages of pathology and normal tendon. There’s little capacity for reversibility of pathological changes but can still improve function with load modification.
“Adding or removing load is the primary stimulus that drives the tendon ⏩ or ⏪ along the continuum.” ... 💡! This falls inline with the @functionalrangerelease and @functionalrangeconditioning methods of load modification to promote healthy cellular adaptations, keeping these simple equations in mind:
1️⃣ Load > Capacity = INJURY
2️⃣ Load = Capacity = REHAB
3️⃣ Capacity >> Load = PREVENTION
122510 September, 2018
SHIT SHOW • My myelogram was canceled about an hour before it was supposed to happen despite the fact that they pre-medicated me with IV steroids. I’m only meant to be on steroids if I absolutely have to because it has caused bone and other issues for me, so this was a huge waste and of course has increased my body-wide pain (bones especially).
Then they decided to do some “migraine” nerve blocks 💉 in my head, despite me telling them this isn’t a typical migraine. They pretty much forced me into doing this because they want to make sure this isn’t just a bad “migraine flare,” so I did. I’ve had migraines for 15+ years and never been hysterically crying on and off all day from the pain. 😭😰 They injected a steroid in between my skull and skin, which surprise surprise, has only made the head pressure worse. 😡😫 Halfway through the blocks, they had me turn to the other side and I started crying because this stuff is so overwhelming. I consider myself “strong” but I can only take so much and today has been really emotional. 😭
It turns out the pain doctor who has been overseeing my medication is a resident or fellow. No disrespect, but they are notoriously so nervous to do anything other than exactly what they learn in their textbooks that it makes it hellish for patients. Thank god the doctor who did the injections (clearly more experienced) was willing to increase my pain medication and made it liquid instead of pill to make it easier to absorb. She also gave me a little bit of IV medication for breakthrough. I haven’t had the higher dose of meds yet, but I’m praying they help get me through so that I can wait until Friday for my myelogram without crying on and off all day. 🤞🏼
P.S. If you’re going to leave rude comments, don’t bother. The number of horrible things people have said are appalling. I will report and block you. A huge thanks to those of you who have been so supportive. It means more than you know.
327934 April, 2019
DISAPPOINTED • My neurologist made a couple suggestions to hopefully break this migraine/headache cycle. It gave me some improvement, but a very small amount. The course of that medication was 5 days and that ended yesterday (Tuesday). Then they decided they wanted to try a high dose of ketamine which we did yesterday and also added a small percentage of relief. Total I have gotten about 15% from when this started. The problem is I started out with a level 10, so my pain is still really severe.
My cardiologist made the recommendation to put me on a medication that will help build up my CSF volume around my brain. I guess my opening pressure was low when they did they did the LP of the myelogram, so I’m not sure if they’re going to follow through with his plan.
I’m at a bit of a loss; this pain is unbearable (it still goes up to a 10 during episodes) and I want relief but all those options mean being out of the hospital and seeing a couple specialists. The problem is I can’t get to the bathroom without being held up by a nurse and the wall next to me because I was going to faint. I’m going to take a shower and see how I do. If it causes another episode, we know there’s still something going. This is taking a huge toll on me emotionally and I’m not doing great. 😥
4597117 April, 2019
Massage therapy is defined as the manipulation of the soft tissues of the body, so I push the envelope to some degree when I say 𝙄 𝙙𝙤𝙣’𝙩 𝙩𝙧𝙚𝙖𝙩 𝙩𝙞𝙨𝙨𝙪𝙚𝙨.
I can’t magically heal you. 🔮 Your body does all the work when it’s given the breathing room to do so. Part of creating that space involves the reduction of pain.
How, though? What is pain?
Nociceptors are cells that detect potentially harmful stimulus and send signals to your brain so that it can register the sensation of pain and react accordingly. In chronic pain, these afferent neurons become sensitized or basically trained to feel pain constantly.
The gate control theory explains how other forms of stimuli can override these pain signals.
Have you ever been injured but didn’t actually feel pain? Usually, there’s a flood of adrenaline that’s dampening those pain signals in a process called synaptic inhibition.
In massage, rather than adrenaline, you’ll get a rush of endogenous opioid peptides and other neurotransmitters such as serotonin and dopamine that block pain signals.
Basically, natural morphine.
In this 60-120 minutes of pain relief, your body relaxes and enters a parasympathetic state, where healing and regeneration occur.
The benefits of massage can last for several days and its effects are cumulative—the more time you spend out of pain, the less afferent nerve sensitization you’ll experience.
This is an oversimplification of the pain process but it illustrates the role of massage in pain management fairly well.
Something else to think 🤔💭 about:
Pain perception is heavily influenced by our emotional states. Massage therapy, unlike opioid drugs, has the added benefit of providing platonic intimacy and social connection, which promote emotional well-being and are vital to mental health.
This not only helps with pain but with depression as well.
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In this video, I talk about a way to relieve the pain from a stubbed toe! -
Stubbing toes on furniture and the corners of walls really sucks! And it can linger for a while! -
Watch the video, and learn about my all-natural method of stopping that pain at the source.
****TW: neurological symptoms****
WORN DOWN • Each day has gone by with the intensity of these “episodes” getting worse and lasting longer in duration after its original onset on Thursday. The episodes seemingly start after something is pushed through my IV and within seconds I go from being somewhat okay to screaming in pain, holding onto the bedside rail inconsolable. Because of the IV connection, I can’t help but wonder if there’s a blood vessel issue in my brain, but I’m not sure. Once the pain starts, I have a large amount of discharge from my left nostril and eye, drool a lot, my face gets numb, the pressure builds more and more by the second and eventually I’m violently nauseous (along with other stuff).
It’s really frustrating for me because my body doesn’t do these things randomly. I’ve had severe pain after many surgeries and it turns out I had a collapsed lung, so much fluid filling my other lung that I was suffocating and had the worst post op ileus my GI has ever seen, just to name a few examples. The problem is getting them to take it seriously enough that they’ll actually test me the proper way to figure it out. They did a CT scan the first night I was here, before I had any episodes, but they haven’t done any imaging since then which I think is crazy. 🤕🧐
Finally, because of EDS and the fact that I haven’t seen the geneticist yet, I can’t help but wonder if I have a different subtype that affects my body differently than hEDS does. I had a bowel perforation of unknown origin in 2012 and ended up really sick. These are the things that I think about when new, severe symptoms start. 😐
NEW MEDICATION • I was started on a new medication yesterday that is supposed to help break this headache thing and then they’re also giving me a preventative to prevent more. The treatment itself is super hard to tolerate (vomiting/dry heaving, BP spikes and stays really high and my headache gets worse), so I’m really hoping it helps. I’m also going through a ton of IVs because they keep infiltrating and are then quite painful. I really miss having my port right about now.
This limbo is scary for me (and my family) because nobody truly knows what’s going on and given the severity of this, it’s nerve racking. Thanks for all the well wishes; I’ll get back to you soon.
3463012 April, 2019
Latest Instagram Posts
I know that any sort of ache or discomfort is very draining mentally, physically and emotionally. I get it! This past week I've been dealing with a headache off and on that I couldn't figure out. It wore me out. I'd get relief and then it would come back. In the moments, you just wish you could think enough to figure out the ROOT cause. Did my neck need an adjustment, was it something I was eating, was it a hormonal imbalance, was it the weather? So, I get pain.⠀
I'm so sorry to those of you who fight pain daily! My heart goes out to you! ❤️⠀
My husband has suffered from back pain but it's wonderful to have tools in our back pocket that we can turn to for some relief. I always look at underlying causes but in the meantime, I turn to practitioners and products I have in my house. ⠀
Here are some of the tools and products we use when we have some discomfort:⠀
✔️a red light therapy pad @celluma_led_therapy. We got ours after my husbands shoulder surgery about 5 years ago and this combined with other therapies listed has proven super effective.⠀
✔️a great chiropractor and acupuncturist⠀
✔️a variety of essential oils: PanAway, Valor, Wintergreen, Peppermint, Deep Relief Roll On, clove⠀
✔️Ache Away Roll On: 10 drops each of lemongrass, clove, and copaiba in 5 mL bottle, fill the remainder with fractionated coconut oil⠀
✔️Ache Away Capsules: 5 drops each - Copaiba, Frankincense, and Idaho Balsam Fir (when unavailable, use any spruce or cypress essential oil)⠀
✔️Cool Azul Pain Cream⠀
✔️Cool Azul Sports Cream⠀
This week I figured out my headache was from the stevia I started using. Nothing would take my pain away until I got rid of that. So glad I figured it out sooner than later. ⠀
Do you suffer with acute or chronic pain? What do you do?⠀
Posted @withrepost • @melissabarkerrmt Need a massage? Have an injury that just happened or an old injury still bothering you? Do you just need some time to yourself to relax? Do you Have benefits still needing to be used by end of year? If any or all of these apply to you then stop by @impacthealthcare where we can help you achieve these needs! And we DIRECT BILL!
Πόνος στη Γάμπα. Μυϊκός Σπασμός Γαστροκνημίου.
Ο πόνος στη γαστροκνημία (γάμπα), ο οποίος πολλές φορές συνοδεύεται απο πρήξιμο είναι μια άκρως ενοχλητική κατάσταση!
Άσκηση στο σπίτη ( Διάταση Γαστροκνημίου)
Οφέλη: Βελτιώνεις την αλτικότητα σου!
1. Τοποθέτησε τα χέρια σε μια σταθερή επιφάνεια.
2. Τοποθέτησε το πόδι που θες να διατείνεις πίσω σου.
3. Οι πτέρνες ακουμπούν καλά στο έδαφος.
4. Μετακίνησε το βάρος σου μπροστά, προς τα δάχτυλα, μέχρι να αισθανθείς μια ήπια διάταση στην περιοχή της γάμπας του αντίθετου ποδιου.
5. Κράτα 20¨και επανάλαβε το ίδιο στο αντίθετο πόδι.
Άσκηση στο χώρο μας.
1. Τοποθέτησε και τις δυο σου γάμπες πάνω στο Foam Roller.
2.Τα χέρια σου στηρίζουν και σηκώνουν το σώμα σου.
3. Ρόλαρε πάνω στο Foam Roller σε όλο το μήκος της γάμπας.
2417 hours ago
#linkinbio In this video we'll show you how to use the KneeMD Device for knee rehabilitation. Physical therapy can help to reduce the pain, swelling and stiffness caused by knee osteoarthritis. Our knee MD program focuses on improving the strength and function of the knee with physical therapy, in combination with our unloader braces. Reminder that this month, 2.5% of all gross sales for IPS OAide300 Knee Braces will be donated to K9 Partners in observance of Veteran's Day.
How does our Brain Perceive Pain in our Body? by ⠀ @thecornerstonepilates ⠀⠀⠀⠀⠀
Pain comes in many forms. Pain is very individual. How we perceive the severity of our pain or even how we treat the pain depends on how our brain processes the pain.⠀
Research shows that there is so much more involved with pain and it can be very complex as it relates to our entire body system.⠀
Types of Pain:⠀
• Acute Pain is caused by an injury to the body. It warns of potential damage that require the brain to take an action and can develop slowly or quickly lasting minutes or months. The pain goes away when the injury heals.⠀
• Chronic pain continues long after the trauma is over. It does not warn the body to respond and usually lasts longer than 6 months. It is more difficult to resolve because it may be as a result of trauma physically and also has an affect emotionally.⠀
⠀ #pain#chronicpain#acutepain#brain#burlingtonpilates#pilates#pilatestudio#pelvicfloor#pelvicfloorexercises#pelvichealth#Burlington#BurlOn ⠀⠀⠀⠀⠀⠀⠀⠀
608 hours ago
I am passionate about complementary health. My aim is to offer you a safe, compassionate and relaxed space to aid and support you to a healthier and more resilient version of yourself. -
There are 4 types of pain.
⚠️Nociceptive (normal protective pain, tissue damage as a result of trauma or threat of tissue damage)
⚠️Inflammatory (occurs as a result of trauma and is an essential part of the healing process) ⚠️Neuropathic (nerve pain)
⚠️Nociplastic (absence of clear cause of mechanism such as with conditions like Fibro myalgia or IBS)
Different treatment approaches are required to treat different types of pain.
Characteristics of pain can be mechanical which is a response to a specific stimuli or non-mechanical where the pain doesn't necessarily follow a pattern or have one particular cause or driver.
This is helpful following an acute injury to act as a protection to an area of tissue that has been damaged. That level of sensitisation should reduce as the tissue improves.
Sometimes the system does not behave in this way and a high level of sensitisation will continue despite the threat to the tissue no longer being there. The reason for this can be different for each individual - so a successful recovery is more likely if the rehab and management of the pain is personally meaningful to that individual.
Perceived level of threat, stress, reduced sleep and illness are big factors in winding up the pain system and keeping it on high alert. These could be reasons why your nervous system has not wound down as you'd expect it to after a reasonable period of time has passed since your injury, or why daily functional tasks can begin to cause pain (such as gradual onset work-related pain).
Physiotherapists are experts at diagnosis of musculoskeletal conditions and at guiding clients through the pain management pathway. We have a deep understanding of anatomy, injury mechanisms and neural pathways. This allows us to work with clients to provide both short term relief as well as finding long term solutions to pain.
Intravenous (IV) therapy is an advanced form of pain treatment that provides pain medication to into the body via an IV drip inserted into the patient's arm. Provided in our office, this highly effective treatment option allows patients to have a custom mix of medications that perfectly addresses their symptoms and needs. The IV therapy usually takes 30 minutes to an hour to complete per session, and the relief is felt immediately. Schedule an IV for pain relief today!
Chronic pain does not have to be permanent. Dr. Badday offers a wide variety of treatments for pain relief and is dedicated to helping his patients to manage and relieve their pain to live full and active lives. Schedule a pain management consultation today!
29113 November, 2019
About to start practicing a new sport? Physical therapy is the key to prevent injuries. MIO tracks ROM over time to better analyze body movement. Try MIO now and see REAL results 🏌️♂️🏃♀️🏃♂️🤸♀️
4 proste ćwiczenia uruchamiające odcinek lędźwiowy kręgosłupa.
Polecam do wykonywania, zwłaszcza kiedy: * wstajesz rano z uczuciem sztywności i czujesz, że musisz się rozruszać, by móc zacząć normalnie funkcjonować,
* siedzisz godzinami za biurkiem i już w połowie pracy masz problem ze znalezieniem komfortowej pozycji,
* przeciążyłaś/eś się na treningu i łupie w krzyżu.
Do wykonywania codziennie - pełny zakres ruchu, bez bólu, dużo powtórzeń [pierwsze dwa nawet w setkach]. Co ważne, do wykonywania również w stanie ostrym. Jeśli w tym stanie jest choćby minimalny zakres ruchu, w którym nie czujesz bólu – pracuj w tym zakresie, zamiast kłaść się do łóżka. Ruch przyspieszy odprowadzenie stanu zapalnego i spowoduje znaczne przekrwienie, co wpłynie na szybszą regenerację i – co za tym idzie – szybsze pozbycie się bólu.
Now that we are back into the winter wonderland season there are a few key things to keep in mind when it comes to shoveling snow.
Before starting to shovel do a quick warm up, take walk down your street to warm up your body.
When starting to shovel use a smaller shovel if you have to lift the snow out of the way especially if it is heavy or wet slushy snow. Use a large scoop type shovel for pushing the snow safely.
Another big thing to keep in mind is limit twisting your body to “throw the snow” as that is a large contributing factor to back injuries.
When lifting the snow try and lift with your leg muscles instead of your back muscles as your leg muscles are much larger and stronger muscles.
To avoid those pesky slip and falls in the winter when shoveling put down some sand or salt first! And as much as it is a pain in the you know what shovel sooner rather then later!
Dr. Badday offers stem cell injections for pain relief from his offices in Irvine & Los Angeles, CA, to help his patients get back to feeling and functioning their best as quickly and safely as possible. Schedule a pain management consultation today!
24112 November, 2019
𝙒𝙃𝙊 𝙒𝘼𝙉𝙏𝙎 2 𝙁𝙍𝙀𝙀 𝙏𝙄𝘾𝙆𝙀𝙏𝙎
To live professional boxing this Saturday in Conroe? 🥊
Δύσκαμπτοι Ώμοι - Κινητοποίηση Ώμων.
Δύσκαμπτος ώμος σημαίνει περιορισμός κινήσεων και αποφυγή δραστηριοτήτων!
Άσκηση στο σπίτι.
1)Ξεκίνα σε θέση push-up.
2)Πίεσε το έδαφος με τα χέρια σου.
3)Πίεσε το έδαφος με τα πόδια, οδηγώντας τα ισχία ψηλά.
4)Κατεύθυνε το στήθος προς το έδαφος για μεγαλύτερη έκταση στο άνω μέρος του σώματος.
Επανάλαβε 10 φορές.
Some people absolutely hate medication. Any type of pill, even supplements. They just can’t stand it. Advil, Tylenol you name it,they just hate it. They will suffer before they reach for it.
This message is for you folks. Friends, it’s 2019. There is no need to suffer! There is no need to push through pain.
This oil Ortho Ease is formulated for just that. Pain. It’s just a big bunch of plants and other natural things working together to give your body relief from pain.
So, if you are that person but you are tired of dealing with pain this could be the answer for you.
As a massage therapist I deal with people every single day who are dealing with loads of pain and I myself know what it is to have pain and I have to say, this stuff really works. Hand to heart, it does 🙂
See my bio for link.
Surgery can be painful, expensive, overwhelming and it can be very inconvenient. PT is an effective strategy that avoids surgery and relieve pain completely. MIO tracks ROM over time and helps clinicians keep patients motivated. Try MIO now and see REAL results. To learn more click on the link in the bio 🏌️♂️🏃♀️🏃♂️🤸♀️
At Pacific Pain and Regenerative Medicine, with offices in Irvine, California, and Los Angeles, Dr. Hassan Badday offers IV therapy as an innovative treatment for chronic pain. This in-office procedure uses an intravenous (IV) drip to provide patients with a customized blend of pain relievers that are delivered directly into their bloodstream. We provide this simple and effective treatment in an outpatient setting, so patients won’t need to stay overnight in a hospital. Check out our blog (See link in bio) for more details or to schedule an appointment.
Here's another frequent point I use on my headache patients in the clinic.
This one works particularly well for headaches around inner eye region (closer to the nose) and along the eyebrow.
Also works great for nasal congestion due to muscle tension in the face.
To perform and locate:
1️⃣ Palpate along the inner portion of the eyebrow and feel for a hollow crease that is sensitive to palpation (touch).
2️⃣ Press and massage until either tenderness of point subsides or headache/congestion is no longer present.
Be sure to follow this page for more self-care tips you can do at home.
📸: A Manual of Acupuncture
Booking options in bio
Joseph Hoots LAc, MSTOM
☎️: 347-833-2275 (SMS OK)
📍: Astoria, NY 11102
Call or text to book at my other locations in
Bethpage (Long Island) and the Financial District
✳ Providing 5⭐ quality in-home acupuncture and bodywork services for the greater NYC area ✳
11110 November, 2019
Acute pain is short-term pain that last no longer than three months and tends to be associated with damage, or possible damage, to your body. For example, if you pull your lower back it is likely you will feel pain associated with the spasm and inflammation. This is acute pain. Usually it will settle as your body heals because the affected part no longer needs protecting. Healing is usually less than three months, even for quite severe injuries.
It may seem strange, but pain can be a good thing. When you first injure yourself, acute pain can help you change what you are doing so you avoid further damage. Without acute pain, a person might keep lifting heavy boxes when the lower back is in spasm potentially leading to further injury.
When we injure ourselves, our nerves carry a lot of information to the brain to make it take notice. In our body there are millions of nerves and they constantly interact with each other. It’s not a one-way street - signals travel up and down constantly.
Your brain - the biggest bunch of nerve cells in the body is really important when it comes to understanding pain. It may surprise you to learn that all pain, no matter where or how it is felt, is produced by the brain. When you injure yourself, it is the nerves’ job is to say to your brain ‘danger – something is happening to your back.’ It is then your brain (and not your back) that interprets this and says to you ‘hey, this hurts!’ In this time your brain also weighs up many aspects of your immediate environment as well as other life factors such as what you do for a job, your personal or cultural beliefs, whether you’ve injured your back in the past or what you are planning to do in the future! Only after sorting through all of this, will it tell you whether your back hurts or not. It does this incredibly quickly and well before we are aware of any pain. .
7010 November, 2019
Welcome to the team Dr Angel!
Dr Angel is a health professional with many years dedicated to finding ways to alleviate pain. He started as a Medical Doctor (MD) and Anaesthetist in Latin America, dedicating many years to clinical practice and as a scientific advisor for the pharmaceutical industry. He learned that analgesic medication has many limitations and side effects, which leads to the failure of many treatments that focus on symptoms and not in the root cause.
Twenty-five years later and in a new geography, he decided to explore a different approach to help people in pain through manual therapy. He enjoys helping clients resolve pain and imbalance issues through various massage techniques. His clinical approach to bodywork is an advantage to any client, especially with his extensive medical background and knowledge in anatomy and physiology.
Angel is a Remedial Massage Therapist trained in:
• Myofascial Release
• Trigger Point Therapy
• Dry Needling
• Lymphatic Drainage
• Deep Tissue
• Swedish Massage
• Sports Massage
Multimodal analgesics are great at reducing opioid requirement postoperatively. The most commonly used are: acetaminophen + NSAID +/- gabapentinoid. I’m interested in moving away from gabapentinoids due to its sedating profile. This meta-analysis presents an interesting alternative: duloxetine (an SNRI). The benefits (decreased pain scores, opioid consumption, and PONV) without seemingly any downsides seem too good to be true. There are potential interactions with vasoactive medications (eg. ephedrine) and procedural medications that may increases the risk of serotonin syndrome (eg. methylene blue). What multimodal analgesics do you give perioperatively?
Do you have experience giving duloxetine perioperatively?
Life is totally like a box of chocolates, you never know what your going to get... joint pain, stomach cramps, mouth ulcers, acne, fatigue, constipation, diarrhoea, fistula, depression.
One thing I do know.. much like a box of chocolates... I ALWAYS get through them ALL!!!!! You are always stronger than you think 💪🏼💪🏼 as you fight through whatever challenges this Illness throws at you, remember you are not alone 💜💜
Chronic pain can be a disabling condition which can make it difficult for people to enjoy fully active lives. Dr. Badday is committed to getting you out of pain so you can live life to the fullest. Schedule a pain management consultation to start living pain free.
Help for Headaches 》Try this quick and easy headache hack to help relieve headaches.
Remember, occasional headaches are not uncommon, but if you are experiencing headaches or migraines on a daily basis, let's get you scheduled for an evaluation with Dr. Nash to determine the underlying cause.
Happy Friday!! We have an announcement!!!! Throughout the month of November, buy 10 IPS OAide 300 Knee Braces and get 1 FREE Knee MD Device! The Knee MD device wholesales for $450 and can replace or supplement in-office PT services.
This month, 2.5% of all gross sales for IPS OAide 300 Knee Braces and all Juventix Regenerative Medical Products will be donated to K9 Partners for Patriots in observance of Veteran's Day. Please read below to learn more about this worthy cause.
K9 Partners for Patriots is a Florida local non-profit organization providing service dog training free of charge to qualifying veterans and active duty service members struggling with Post-Traumatic Stress Disorder (PTSD), Traumatic Brain Injury (TBI), and/or Military Sexual Trauma (MST). K9 Partners for Patriots is especially unique as the majority of service dogs trained are shelter rescues. To learn more about this fantastic organization, or to donate/volunteer, please visit their website at www.k9partnersforpatriots.com or call (352) 397-5306.
What better way than to give the gift of massage? It tells others you wish them the nicest things that life can bring and that you're sending them the gift of health, rest, and relaxation. We offer an easy and convenient way to purchase and send (or print) gift certificates online. Come take a look and let us take the stress out of your gift giving! Select the button below to go the Gift Certificates page of our website. From there, choose a Service or Dollar Amount gift certificate, select a style, and add a personalized message to the lucky recipient! Recieve $25 towards any service when you buy $100 in gift certificates! Thank you for your continued support! Happy Holidays! http://www.perfectpressuremassages.com