Your Pain May Not Be Where You Are Hurting

                True story:  I became fascinated with Massage Therapy after a car accident.  Auto insurance covers massage therapy, so I pursued it as a form of injury treatment.  I was experiencing horrible pain radiating around my left ribcage.  I received many hours of massage to the area, and always experienced great relief—for about two hours.  Finally, after several months of trying every type of Massage Therapy in existence, I was referred to a practitioner who took a moment to assess me.

                “Your pelvis is way off.”

                “My pelvis doesn’t hurt.”

Well, when my vehicle was slammed sideways, my seatbelt pulled my hips into a severe rotation, and my upper torso had been twisting the opposite way to compensate.  The therapist performed some specific techniques to level out my pelvis, and my rib pain went away completely within two treatments. 

                The longer I work on bodies, the more I know that in almost all cases, people aren’t feeling the primary pain, they are feeling the secondary pain.  More examples:  tight pecs cause horrible upper back pain, nerve impingements in the neck or chest cause carpal tunnel-type symptoms, tight hip flexors cause upper hamstring pain, imbalanced quads cause knee pain, and the list goes on and on.  Clients on my table are constantly shocked at how much a seemingly unrelated area hurts, only to get great relief to their chief complaint when the primary area is treated.

                Injury assessment and the ability to correctly identify the cause of pain takes experience, intimate anatomical knowledge, and advanced training.  Treating the cause of pain and eliminating symptoms, rather than simply “rubbing where it hurts” is precisely what defines Therapeutic Massage.  Pain relief is what I was desperately seeking as a car accident victim years ago, and providing it is my passion today as a Therapeutic Massage practitioner.

The Magic Question Answered: How Soon Should I Get My Next Massage?

As I work with first-time clients on injuries or chronic pain, and they experience relief, this question almost invariably follows:  How soon do I need to come back?

Here is what usually happens:  A client comes in, gets a therapeutic massage, feels much better, and then they wait until they start feeling symptoms again before they come back.  This way, they keep making the first step toward improvement over and over again, and never get to the second step.

This is a problem.  Therapeutic massage is extremely effective, but it is rarely a one-time fix.  And, it is cumulative in nature.  So, when to come back depends on what your therapeutic goals are.  If you are just trying to maintain status quo, then it is fine to book when symptoms creep in.  If, however, you are like most of our clients and you are trying to improve your current pain scenario, then frequency is very important.  If a client returns to the massage table before any ground is lost, and before the tissue slips back into old, learned holding patterns, then the next step can be taken, rather than the first step repeated multiple times. 

Simply put, if you want to bring about improvement, then hit it with some frequency (ideally weekly to every two weeks) until you get where you want to be.  When your therapeutic goals have been met, then the frequency can be greatly reduced to more of a maintenance schedule (something more like monthly or less depending on your stretching habits).  By “biting the bullet” and aggressively treating for a shorter period of time, you can move past the first phase of relief, enjoy cumulative improvement, reach your goals, and get the most for your massage dollar.

Sleepy Hands? Therapeutic Massage Can Help

                One of the symptoms that I treat more and more frequently today, even in children, is numb or tingling hands.  Often times this is a very basic nerve impingement that is very effectively treated by Therapeutic Massage.

                The nerve plexus, called the brachial plexus, that enervates the arm and hand passes from the spinal cord in the neck.  It then passes first under the scalene musculature of the anterior neck, and then under the pectoralis minor muscle in the chest before proceeding into the arm.  When either, or both of these areas are tight, the result is compression on the nerve.  The resulting symptoms can be numb or tingling hands, shooting pains or deep aches in the hands that can’t be reproduced by pressing on them, constantly itchy or cold hands, or a weak grip.  These symptoms are referred to as Thoracic Outlet Syndrome or Pec Minor Syndrome, depending on which muscles are affected.

                This set of symptoms has become particularly prevalent because of our long hours in front of computers.  Basically, the pec muscles become shortened when we have our arms in front of us, as in driving or keyboarding, and the shortened musculature squeezes the nerve plexus against the ribcage, causing impingement.  Forward head posture, again accentuated by computer use, causes the anterior neck musculature to act in a similar fashion.

                Therapeutic Massage can specifically target and lengthen the necessary musculature to alleviate pressure on the nerves.  Treatment for theses syndromes is usually very effective in very few treatments.  In addition, home care exercises will be assigned to maintain improvement and relief.

                More information and photos of stretches to treat Pec Minor Syndrome are available at:

http://www.restoremassagetherapy.com/stretching-guides/pec-stretches.html

Continuing Education: Myofascial Release

                My decision to change career paths and pursue massage therapy was largely influenced by a practitioner of a type of bodywork known as Myofascial Release.  At the time, I’d been struggling with lingering pain from injuries from a car accident, and his approach was completely different and very effective.  I received far more relief from two sessions with him than I had in the dozens prior to him.

                Later, after finishing Massage School and becoming Nationally Certified by the National Certification Board of Therapeutic Massage and Bodywork, I had the opportunity to spend 60 hours studying Myofascial Release myself, under the originator of the modality, John Barnes.  National Certification requires continuing education credits, so I was very excited to add this tool to my arsenal and get some credit for it.

                Myofascial Release (MFR) differs from traditional massage in that it addresses the fascia, or connective tissue, which surrounds muscle groups, individual muscles, and even each muscle cell.  The fascia has incredible tensile strength, and when trauma or injury occurs, because it runs throughout the body in a web-like fashion, it can create an effect like a snag in a sweater, where it pulls from many different directions.  The fascia is treated in a different manner as well, in that no oils or lotions are used, to better enable gripping of the tissues.  The practitioner works very slowly, sinking into deeper layers to access the fascia, then moving in slow, separating motions, seeking and then releasing the adhesions that they find.  There are more structural and more energetic applications of the same technique, depending on the intent of the therapist and the goals of the client.

                Because of the deep scarring that is accessed and released, the healing of MFR can be very profound.  Where a more surface rubbing over a muscle might not release a deep-seated scar, Myofascial Release techniques can be applied with great effect.  I have had great success using MFR in post-surgery clients to restore the range of motion lost due to scarring and immobilization for a period of time.

                Nationally Certified Massage Therapists are constantly adding to their knowledge base of treatment methods in order to stay current and certified.  In addition, they must constantly update their ethics certification.  When seeking massage therapy, always ask for a therapist who has been Nationally Certified.  These therapists are not just practicing a trade, they are practitioners who are committed to professionalism, ongoing education, and the eventual mainstreaming of Therapeutic Massage into health insurance coverage and the medical community. 

Ice Massage: Yes, Really.

After an injury, many of us know that we should treat with the acronym, RICE—Rest, Ice, Compression, and Elevation.  Many people would rather apply a hot pack than an ice pack to something that hurts.  Ice often sounds quite unappealing, particularly in the middle of a Minnesota winter.  In the case of chronic (long-term, not flared-up) injury, heat can be soothing, and helpful before stretching.  As a rule however, heat can actually bring more inflammation to the area of injury, slowing healing.  Ice is definitely preferred over heat, particularly with an acute (new) injury.  This is because ice is truly miraculous in its inflammation-reducing properties.

When ice is applied to muscle tissue, initially the blood vessels constrict.  Very quickly, though, a reaction called “reactive vasodilation” follows, in which the blood vessels actually dilate very wide, allowing for greatly increased blood flow through the tissue.  This is very important in the case of an injury.  The increased blood flow carries away the metabolic wastes and the byproducts of inflammation, and the new blood brings in oxygen and nutrients that allow the muscle tissue to heal more quickly.

To reduce inflammation, twenty minutes with an ice pack works very well, but five minutes of ice massage works even better.  Sports Therapists often integrate ice massage into an injury treatment session in cases of severe inflammation.  The therapist will literally apply pressure and massage strokes to the affected area with ice.  The combination of tissue manipulation, pressure, flushing, and reactive vasodilation produces unparalleled inflammation reduction. 

When seeking Therapeutic Massage for an injury, consider discussing the option of ice massage with your Therapist.  Ice Massage is one of the most effective tools for combating inflammation in injured muscle tissue.

Should I Buy a Massage Membership?

                There have been many changes to the massage industry in recent years, one of which is the rise of discount franchises which offer memberships.  Are these a good idea?

                There is one thing I like about memberships, and several things that I don’t like.  I do like the idea of people having a reminder to get their bodies onto a massage table at least once a month because it’s just plain good for you. 

                Now, without getting into the issues that go along with these franchises, here is my main contention with the concept of a massage membership:  It does not allow for real, honest, therapy with a flexible treatment plan.  If very basic relaxation is all that is desired, a membership is sufficient.  If therapeutic massage with pain relief or treatment is sought, then a membership is not the right program.

                Typically, memberships will not be found in massage facilities which specialize in injury treatment.  An acute lower back injury, for example, will not be well served with a once-a-month plan.  A specialized therapist will need to perform assessments, perform different types of bodywork depending on the results of these assessments, assign homecare, and more than likely, treat the injury with some frequency in the early phases.  Once the injury has healed, the client can certainly back way off on the frequency of treatment, and the therapist will give them the necessary stretches and exercises to prevent reoccurrence.

                So, maybe you don’t have an acute injury--just chronic stress--and you need a good deep tissue massage.  Again, those facilities with experienced and highly trained therapists will be able to provide the greatest degree of relief. 

And, this relief is on your schedule, whenever you need it—without locking you in.

               

Stretching—Secret Weapon of Sports Therapists

                There are many techniques which a Sports Massage Therapist can employ during a session to bring about a specific and desired result.  One of the most effective by far—the integration of stretching into the massage.  Basically, there are a few factors at play in a Therapeutic Massage.  An injury or pain syndrome has been assessed.  The targeted musculature has been palpated (assessed by touch), then treated accordingly, with the intent of improving tissue quality.  At this point, more than any other, muscles are receptive to change.

                Each muscle contains receptors which communicate with the brain to allow for movement.  These receptors can be manipulated, or re-educated, to assume a different resting position.  Taking advantage of this by integrating stretching into a massage session when the tissue is most malleable brings about the greatest and most lasting change.   The importance of this is two-fold.  On a single-muscle level, the treatment and relief will be the most thorough.  On a joint level, it will help to re-create balance by specifically lengthening muscles which were previously causing strain and dysfunction. 

               

Why Chiropractic Treatment Should Be Partnered with Therapeutic Massage

I am often asked about "my take" on chiropractic treatment. My opinion: like any profession, especially massage therapy, there are some incredible practitioners who really provide some relief, many that I wouldn't describe as "stellar", and some that are downright overly aggressive and damaging.

There are some cases that completely necessitate chiropractic treatment.  So, assuming you have a great chiro, here is my hard and fast rule:  If you are going to be receiving chiropractic care, you MUST receive massage therapy.

Why?  There is a very simple answer:  Muscles move bones (this is what allows us to move).  So, if you adjust the bones without addressing the forces that pulled them out in the first place, then these forces will simply pull them out again.  And, depending on the aggressiveness of your chiropractic treatment and the level of tension in your musculature, you may sustain a little bit of soft tissue damage in the process.

But...partner your chiropractic treatment with some therapeutic massage, and you have the perfect conditions for a stellar adjustment that will hurt less and hold better. This leads into another common question:  Which first—Chiropractic or Massage?  My answer:  Massage, for all of the above reasons.  Massage is a great primer for chiro.  I have massaged plenty of traumatized and inflamed tissue post-adjustment.  Had the order of treatments been reversed, the client would have been more comfortable for both, and the results would have been better.

As always, choosing a therapist with an intimate understanding of injury treatment and anatomy is vital to get the best results.  Correct assessment of the condition and specific targeting of the necessary musculature is the key to providing relief to any pain syndrome or injury, whether or not you opt to partner your massage therapy with chiropractic care

High School Injury Treatment—In High School

Over the last decade, working on hundreds of weekend warriors, I’ve heard a recurring statement: “That’s an old injury from high school.”

                The interesting thing is that the old injuries from high school, when left untreated, turn into big dysfunctions in adults.  Humans are built for survival—not for maximum dexterity and grace—post-injury.  Basically, a cave-man needed to have his arm not fall off following a predatory attack much more than he needed to preserve his perfect tennis serve—and this is how we are still built.  Studies have shown that many years after an injury heals, scar tissue continues to be laid down.

                The purpose of scar tissue is to form a durable bond over a tear or trauma, and its fibers are laid down in a hap-hazard formation, like darning in a sock.  Scar tissue is a given, but the degree to which it it heals in a functional manner can be greatly influenced.  Proper rehabilitation during healing can help the scar tissue fibers to be laid in a more parallel formation, creating a functional repair with strength and range of motion, rather than a dysfunctional scar which is stiff and debilitating.  Three factors affect healing and function: proper loading (rehab exercises), stretching, and Therapeutic Massage.

                The importance of treating injuries when they occur, the incredible rigor of high school athletic programs, and the responsiveness of young muscle tissue (yes, it takes a hint much quicker than older muscles do), caused me to create my high school athletic discount program.  We are seeing a huge increase in the numbers of young athletes we treat.  Therapeutic Massage is incredibly effective at treating their injuries and keeping them in the game. 

And long term, they won’t be the adults on the table with joints which have been aching since high school.