About Lisa Philomena

Iliotibial Band Syndrome (ITBS)

IT Band Syndrome

The Iliotibial (IT) band is a thick band of fascia that runs along the lateral or outside of the knee, extending from the outside of the pelvis, over the hip and inserting just below the knee. Its major role is to stabilize the knee by moving from behind the thighbone (femur) to the front of thighbone during activities such as walking or running. IT band syndrome (ITBS) is an overuse injury of tissues of the outer thigh and the knee. It occurs when the distal portion of the IT band rubs against the lateral thigh bone and is one of the leading causes of lateral knee pain in runners, but can actually occur to anyone with overused IT bands. Runners are at the greatest risk and without proper care, the pain can become so severe, it can put runners out for months!

The most typical and notable symptom of IT band syndrome is pain on the outside of the knee. Because the pain can become so severe, many mistake the pain for a lateral meniscus tear. A difference between ITBS and a knee injury is that a knee injury will usually swell, so if you don’t have any swelling, and you’re consistently experiencing this pain, about five to seven minutes into a sport, like running, you likely have ITBS. Another way to differentiate a lateral meniscus tear from IT band syndrome is that you’ll experience a clicking sensation with a tear.

Risk factors include overtraining, improper footwear, muscle imbalances including weak hip muscles, leg-length discrepancy or high or low arches of the foot. Inadequate warm-up or cool-down or a lack of proper mobility are also contributing factors.


• Tightness of the affected muscles

• Gradual onset of burning or pain at the lateral part of the knee during activity

• Radiation of pain to the outside of the thigh

• Aggravation of pain during repetitive activities (e.g. running or cycling)

• Swelling of area where the band moves over the thigh bone

How to treat ITBS:

• RICE (Rest, Ice, Compression & Elevation)

• Anti-inflammatories for pain management during the acute phase.

—> Four Wellness uses in sessions and sells CBD clinic Level 5 Pro-Sport

CBD Clinic decreases inflammation and pain while increasing range of motion (ROM) and flexibility <—

• Myofascial relief through deep tissue work including medical massage techniques.

• Exercises that focus on identifying and treating the underlying causes of the IT band syndrome such as muscle imbalances or tightness in certain areas.

• Stretching specific to the IT Band


It is important to include an exercise and stretching protocol that focuses on regaining strength and flexibility. Soft tissue work, including massage therapy, can be helpful to restore muscular imbalances in the area. As for all exercise protocols it is important to conduct the exercises on a regular basis for a minimum of 6 weeks. For runners or other endurance athletes they could be included in a dynamic warm-up or cool-down phase.

How Four Wellness can help you?

Step 1: Book a Medical Massage Lower Extremity Session. Your session will include specific techniques that will quickly release, not only the IT Band, but all the major lower extremity muscle players. Your session will include some or all of the following: CBD Clinic Level 5, Deep Tissue, Rock Blade Therapy, Stretching, and Muscle Stimulation to reactivate muscles that have gone on strike 🙂

Step 2: Schedule a 4 view postural assessment and receive a detailed report sent via a PDF file with customized strengthening and stretching exercises. With this service, you will receive online support, intermediate and advanced program and a 1 month post postural assessment to see your hard work and results.


Lisa Philomena

Owner of Four Wellness, llc


Healthy Shoulder = Happy Client

Shoulder pain, instability, and inflexibility is the number one client complaint. Whether it’s acute, subacute, or chronic, Four Wellness is competent and skilled in assisting you with your shoulder issue.

The rotator cuff consists of four muscles: supraspinatus, infraspinatus, teres minor, and the subscapularis. Together, they encompass and stabilize the glenohumeral joint allowing internal and external rotation, abduction (moving away from midline), forward flexion, as well as allowing the shoulder to circle.

How to test your rotator cuff muscles: Take your right hand and slide it behind and up towards your left shoulder blade. Take your left hand behind your hand and slide it down between your shoulder blades. (Reverse for contralateral shoulder) Are you feeling any restrictions, pain, weakness?

Book a medical massage with Four Wellness and begin your journey in decreasing your shoulder pain, and increase your quality of life. I will use medical massage techniques incorporated with deep tissue massage in conjunction with Rock Blade, cupping, and heat therapy, as well as level 5 CBD Clinic ointment to loosen, lengthen, and stretch hypertonic rotator cuff muscles and stretched antagonist muscles as well as break through adhesions and scar tissue. From the first session, you will experience less pain and more mobility and flexibility.

The best defense in keeping your shoulder healthy is strengthening and stretching the rotator cuff muscles, and will be a part of your homework, as we work together in regaining your mobility and flexibility. I have a BS in Exercise Science. What this means for my clients is, my scope of practice exceeds most massage therapists and I am in my scope of practice in assigning exercise programs. I will also show you quick fixes you can incorporate into your daily routine, making your muscles, instantly stronger.

Want to learn more? Just ask…..

Peace, Love, Healthy Shoulder…

Lisa Philomena

Owner of Four Wellness


Got Cranky Nerves?

If you are not receiving long term relief from deep tissue massage, stretching, or other therapies stemming from a specific chronic issue, Four Wellness will test for nerve entrapment in two ways; 2 point discrimination assists in mapping out varying levels of sensitivities and through manual restriction/asymmetry screening.

In as little as 90 seconds to 5 mins of strain treatment to fibroblasts aka “dosing”, Rock Blade Therapy, Myofacial Release, will decrease and can reverse phosphorylation of the protein (peptides) the mediates the apoptosis (death) of the cells.

Fun Fact: There are 72 kilometers or 45 miles of peripheral nerve in a human body. Every cubic centimeter of skin organ has a nerve or portion thereof, supplying it, embedded into it. ~ Diane Jacobs

Motor sign and symptoms of nerve entrapment:

• Cramps

• Fasciculations (twitching)

• Muscle Loss

• Muscle weakness

• Impaired balance/coordination


Sensory signs and symptoms of nerve entrapment:

• Numbness

• Reduced Position Sense

• Tingling, Burning pain


Autonomic nerve entrapment:

• Skin, Hair, Nail changes

• Skin Allodynia (pain)

• Bladder control

• Blood pressure/Heart Rate change

• Sweat abnormalities

There are two types of nerve entrapments that cause a host of issues. The most commonly known nerve entrapment is through tunnels; for example, carpal tunnel. Tunnel entrapments narrow osteofibrous/fibromuscular tunnels and is basically a cranky nerve that has become compressive or tensional danger to the neurons inside (Lundborg 1988)

The lesser known, “grommet holes” are cutaneous nerves housed in skin ligaments narrowing aponeurotic ring skin ligament. We have grommet holes throughout our entire body. Cutaneous nerves rise up out of the depths of the body, surface through dense body wall into the skin organ, and run parallel to it, behind or within it. Sore spots on the surface of the body coincide to a large extent with the “grommet holes” or exit points for these nerves that emerge from beneath and into the skin organ. (Diane Jacobs)

Damage to or disease affecting nerve entrapment may impair sensation, movement, gland or organ function or other aspects of health, depending on the type of nerve affected.


• Systemic Diseases (diabetes)

• Vitamin Deficiency

• Medications (chemotherapy)

• Trauma + Ischemia

• Radiation Therapy

• Excessive alcohol consumption

• Immune system disease

• Genetic

• Idiopathic (unknown)

Want to learn more? Just ask!

Rock Blade Therapy can be used in several ways incorporated into your next massage session or as a stand alone therapy service.

Peace, Love, Rock Blade Therapy

Lisa Philomena

Certified Rock Blade & Rock Blade Advanced