Get Your Body Back!!!

I always thought that personal trainers were for trophy wives. Which would not be me.

Plus, I hate gyms. I see no reason to subject myself to an environment full of clanking torture devices, fluorescent lights, TV screens, hideous music, sweaty odors and the sound of grunting. Not when the free, beautiful outdoors–for running, hiking, biking and dancing–is right there. The only reason I can think of to join a gym would be 1) unlimited pool access and 2) unlimited sauna access. No pool, no sauna, no deal.

Then my posterior tibial tendon gave out, and I was in trouble. Running was Right Out. Biking was fine, until it snowed. Even my favorite yoga classes were off limits–too much strain on the tendons.

Out of curiosity born of desperation, I tried a personal training session with Kate, of Bodywise Wellness. She has a private, quiet, stress-free training studio in the Northern Liberties, just a few blocks from Practical Bodywork.

Kate tailored a workout specifically to my concerns, my injury and my fitness level, which was fun, challenging and burned 647 calories, according to my Cardio Trainer.

The next day, I felt the kind of sore that feels AWESOME.

I started going regularly. She gave me a completely different workout every time. After three weeks, I was trotting up stairs, instead of dragging myself along by yanking on the banister. I dusted off my dance aerobic routines. I started getting more done, having more fun, and challenging my four-year-old to race me up the stairs.

After a workout with Kate, I feel that endorphin glow you get after skiing Tahoe all afternoon, minus the price of the lift ticket. That’s something I thought my ankle injury had taken away forever.

So I am sold. So sold, in fact, that I want to buy YOU a session with Kate.

Yep, you heard me right. Kate’s training is the bee’s knees, and the perfect complement to the kind of bodywork you get from me.

Because if you’re working through an injury, struggling with chronic pain, or just aching from too much stress, you come to me. You get yourself a structural myofascial package, because that’s the series that transforms your alignment, your energy level and your outlook, all at a sweet discount per session.

And from December 16 of this year through January 6 of 2014, when you buy a structural myofascial series for yourself or for someone else, I’m throwing in a gift certificate for a one-on-one session with Kate. That’s how awesome I think she is.

So if you’ve been thinking of making some personal transformations in the new year, this is the deal for you.

It’s also transferable. You can get bodywork for yourself, and give a training session as a gift, or vice versa. You can forward this article to your loved ones with the subject heading, “hint, hint.” You can give the gift of massage, and grab your training session as a reward for being so generous. You choose.

Happy holidays! Let’s thrive together!

So How The Hell Do We Do That???

As some of my wise friends point out, changing the face of healthcare is a quixotic proposition. It’s all very well to saythat your doctor should be prescribing more massage than painkillers, that insurance should cover it, and that everyone should be insured.

But as we all know, our broken healthcare system makes far more money by selling drugs and high-intervention treatments to sick people than by investing in low-intervention therapies that keep them well. Too many people have their livelihoods bound up in the status quo. It’s not just difficult to get a man to understand something, when his salary depends upon his not understanding it; it may well be impossibleUpton Sinclair was an optimist.

So where do we start?

This is funny. Ha. Ha.First of all, like the global economy, our healthcare system is grossly overbalanced. Premiums are rising faster than our ability to pay for insurance, high rates of unemployment mean that more and more people are getting pushed out of employer-funded healthcare, and an aging population is using up more and more healthcare resources. Those who still have jobs and insurance are able to remain in denial, but the system as it stands is unsustainable.

buckyfuller

Second, our society is changing in some fundamental ways. Communication is infinitely easier, faster and more varied than at any time in history. There are a lot of smart, underemployed people with time on their hands, and highly sophisticated communications devices in those hands.

As the healthcare system slowly collapses under its own weight, there’s a lot more motive and opportunity for alternative practitioners to set up shop, and for desperate and disillusioned clients to try them. Due to the lack of a cohesive, non-exploitive alternative system (Massage Envy: even the name is bad karma), alternative healthcare practitioners have to be entrepreneurs, if they want to earn a decent living. And good entrepreneurs know that you live or die by the number and quality of your relationships.

Because of these factors, there’s a lot more scope for new healthcare paradigms gaining influence and visibility through lateral connections, like network marketing, rather than the top-down corporate capitalism model, which requires huge investments up front.

Therefore, Bucky Fuller’s ‘better model’ is building itself as we speak. As people lose their insurance, or see their premiums rise, they’re forced to take responsibility for their own health. As network marketing reaches more and more people, they will be savvier about how they choose a practitioner, and what healing modalities work for them.

At the same time, Big Healthcare is trying to save costs by cutting payments to practitioners. Mainstream healthcare practitioners will have less and less incentive to hitch their wagons to a system which is giving them less and less, and more incentive to look around for another model.

And there it will be. People like Atul Gawande are out there backing up their common sense advice with research and documentation. Practitioners who collaborate, develop skills and market effectively will have a wider range of influence over cultural thinking about healthcare. And people getting screwed by an insane system will have both the motive and means (through relentless communcation) for demanding change.

Any questions?

The Smoking Gun

widely-reported study finally traces the mechanism by which massage therapy reduces pain and promotes healing:

They found that massage reduced the production of compounds called cytokines, which play a critical role in inflammation. Massage also stimulated mitochondria, the tiny powerhouses inside cells that convert glucose into the energy essential for cell function and repair. “The bottom line is that there appears to be a suppression of pathways in inflammation and an increase in mitochondrial biogenesis,” helping the muscle adapt to the demands of increased exercise, said the senior author, Dr. Mark A. Tarnopolsky.

When you reflect on the fact that non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen not only retard healing, but have been linked to severe gastrointestinal disorders, renal problems, heart attack, stroke, erectile dysfuntion, and other side effects including death, your cost-benefit analysis may be altered. It may be cheaper in the short term to pop a pill for pain relief, but getting regular massage could save a bundle on long-term health care.

After the Fall

Recently a new client, Susie M., booked a four-session package sight unseen. “When I read about your ankle, I knew you were the one for me,” she said.

Susie sprained, and possibly broke, her right ankle four years ago. There was some confusion as to whether there was a bone chip floating around in there or not; what was certain was that she hadn’t been able to work out since. The ankle was chronically swollen and painful even after four years of treatment, including physical therapy and six months of myofascial release. Doctors had given her steroid injections to ease the swelling, but these did nothing but cause burn marks at the injection site.

As soon as I started work, I noticed that the anatomy train leading from her swollen ankle, up the right peroneal compartment, threading through her hip, and crossing the body to her left shoulder was bunched, knotted and compressed. There were so many adhesions in her right peroneals that I suspected the swelling was almost entirely a result of impaired circulation. Muscles and fascia don’t operate independently of the circulatory system; if they are compressed, they’re compressing everything around them.

After her first session, Susie declared, “I think you released more in one session than happened in six months of myofascial release.” She reported sharp pains in her left leg, hip and groin during the next few days, but on her next visit the swelling in the right ankle was 80% gone. She kept coming regularly as things unwound, and every week there was a different issue to confront, but ankle pain was not one of them. After four years, she was able to go back to the gym.

This re-confirms a long-held observation – that if one part of your body is injured, the trauma doesn’t just stay in one place. The body quickly redistributes strain to deal with it, but once the original injury heals, your body is still out of balance. This imbalance can then create a whole host of other problems unless it is addressed.

(“Confusion,” oil on linen, 36″x 48″, 2008 by Stephanie Lee Jackson, www.stephart.com

The Body Remembers

I am so thankful for the treatment that I received!!! I walked in the office a horrific mess, and Stephanie showed her concern and learned what the issue was that I was having and in four short weeks, my body responded to the gentle, yet firm work that she was putting into it.  My recovery was felt within the first visit, and continuously improved with each visit.

—Camille A., on Yelp.com

thornsivy

More than a year ago, Camille was struck by a car while she was crossing the street on foot. Most of the impact was sustained by her left hip. She underwent a plethora of treatments at the time, and reduced her pain to almost nil. Then one afternoon she ‘turned her head the wrong way,’ and it all started up, worse than before.

When Camille first came to me, she was stooped at nearly a 60 degree angle. She couldn’t lie prone with her back straight; she couldn’t lie on her back at all. She was in continuous pain in all positions. and I was concerned that she had problems outside of the scope of my ability to treat.

But she’d been to chiropractors, MDs and physical therapists, and the most recent chiropractor recommended massage. So I worked on her in the most non-invasive manner possible, adjusting positions to compensate for her pain. The entire left side of her body was in an extreme state of spasm, particularly her left piriformis and adductor muscles.

After her first session with me, she felt some relief, and decided to book a Crisis Intervention package. I didn’t find evidence of active trauma, such as inflammation, a slipped disc or scar tissue, so I simply encouraged her spasming muscles to calm down.

And ultimately, this seemed to be all that was required. By the end of her treatment, she was moving normally, the spasming had ceased, and she was nearly pain-free.

As I told Camille (and as I wrote to her lawyer, at her request), my belief is that she was suffering from post-traumatic stress. Memory of trauma is actually stored in our cells until it can be safely released; sometimes the smallest twitch is all that is required to re-activate the signal.

What does this mean, for clients and for therapists? Well, the good news is that it’s not permanent. Over time, and with patient engagement, the tissues will literally ‘release’ both the memories and the pain.

But at the same time, it’s important to remember that not all pain can be resolved by actively ‘fixing’ a problem. Some treatments, such as drugs and surgery, can make it worse. All too often, people take a hammer to a problem that merely needs a bit of unwinding.

When Stress Is The Problem

How many holistic healing practitioners have you encountered who piously urge you to ‘eliminate stress’? You’re not ‘living the life’ unless you’re ‘free from stress’!

Just makes you want to smack ‘em.

Because stress happens. If your life is entirely free from stress, you’re either a sociopath or you’re dead. You can eat healthy, exercise, meditate, get counseling, get a better job, live a ‘soul-centered life,’ and you are still no more immune to death, disease, anxiety, uncertainty, and sudden traumatic upheavals than anyone else. A huge problem with New Age evangelists is that they try to use their beliefs, habits and mantras as talismans against evil–if I just chant ‘Love is Everywhere’ often enough, everyone will love me and nobody will ever die!

Recently, dear friends, I left my day job to run my business full-time. In the space of two and a half months I came down with two colds, an ear infection, and lower back spasms that lasted two weeks. Luckily, I do not believe that ‘psychosomatic’ means ‘it’s all in your head, so just Think Good Thoughts!’ I have a realistic understanding of the mind-body connection, which dictates that emotional stress can lead to a less-effective immune system and a hyperactive nervous system, and there’s not always an easy way around it. So I followed my own advice, put my daughter in the stroller and walked for miles and miles. In a little while, the colds, ear infection and spasms cleared up, and I continued evangelizing. ;-)

So I prefer to talk about ‘stress management techniques’ rather than ‘living a stress-free life.’ That way, when you smash into one of life’s brick walls, you say to yourself, “Ah! A brick wall! Let me mix myself an iced tea while consulting a map,” instead of, “OMG! This wasn’t supposed to happen! I must be a Bad Person! Commence self-flagellation, or flagellation of others!”

I could go off on many Prescriptions for Life, since I’ve been signing up for a whole lot of holistic mailing lists lately, but in order to restrict myself to my purported area of expertise, I will confine myself to a few Tips for Stress-Induced Lower Back Pain.

  • When it’s in the acute stages, try to sleep on your back with a bolster under your knees, and a rolled-up towel behind your neck. This keeps your spine in a neutral position, and allows the spasming muscles to get over their freakout with a minimum of interference.
  • Hydrate. Drink a ton of ice water, lemon water, iced tea and diluted fruit juice. You can intersperse this with strong liquor (great muscle relaxant!) as long as you adhere to the ‘rinse cycle’ principle; one virgin cranberry seltzer for every alcoholic drink you consume.
  • Take it one day at a time. Walk as much as you can. Sit on a yoga ball and bounce; this loosens your hip flexors, which are key in stabilizing your lower back.
  • Get a massage! It won’t fix the pain right away, but it will address the spasming muscles, and send your brain into a theta-wave state which will reduce your stress reactions in the longer term.
  • Go to a yoga class, once the pain is less acute. Yoga will balance your body all over, releasing restrictions far from the area of pain which may be contributing to it.
  • Tylenol won’t kill you if you take a couple. Just don’t make a long-term habit of it.

Massaging the Violin

Science has finally come around to studying massage, sort of:

Massages Ease Low Back Pain – NYTimes.com.

…Each of the massage groups received 10 weeks of treatment, and at the end of that period, all three groups had some improvement, as measured by their answers to 23 questions about performing routine activities without help — for example, climbing stairs without using a handrail or getting out of an easy chair by themselves. They were also asked to rate the degree of their back pain symptoms on a 10-point scale.

Those who received massage scored significantly better on both symptom and function tests, and they spent less time in bed, used less medicine and were more satisfied with their current level of back pain.

As much as this supports my bias, I have a quibble with studies which look at ‘massage’ as a generic unit, as though it were the functional equivalent of taking a pill. All massages are not created equal, just as every body is unique. There’s as much difference between a rub-down by rote and a master massage as there is between a C-major scale and an encore by Itzak Perlman.

Recently I got a Swedish massage at a local spa, courtesy of Groupon. It was a screamingly frustrating experience. The therapist applied some standard moves to the surface of my skin, regardless of whether the muscles underneath were tense, knotted, spasming, or comparatively relaxed. Areas which needed little attention got far too much of it (why spend 10 minutes frictioning the iliac crest? Because it’s there?) whereas the problem spots felt all the worse for having been teased. The aggregate effect was to bring all my imbalances into sharp relief, and leave me feeling desperate for another massage.

This may be an effective marketing tactic, but it sells massage therapy terribly short. A good massage therapist will be able to feel those knots, adhesions and spasms, and perform any number of targeted actions to release them. As I havewritten at length, the area where a client hurts may not be the actual source of the problem; lower back pain can often be traced to restrictions in the legs, hips, chest and even the feet. Although it’s difficult to figure out where these restrictions might be from an initial assessment, it’s pretty obvious once you get your hands on them.

The article goes on to state, “It is unclear how massage eases back pain, but the researchers suggest it may stimulate tissue locally or cause a more generalized central nervous system response.” Hello? How much more vague can you get?Obviously massage is ‘stimulating tissue locally’ and causing a ‘generalized central nervous system response’ (it’s frequently called ‘sleep,’) but if the researchers can’t pinpoint anything more specific than that, there’s a communication breakdown somewhere. Either they’re not asking the massage therapists any questions, or the therapists themselves aren’t clear about what they’re doing.

What Kind of Massage Should I Get?

The spa menu! Was there ever a thing so enticing, and simultaneously bewildering? ‘Bamboo Raindrop Swedish Scalp Treatment’! ‘Ayurvedic Aromatherapy Deep Tissue Scrub’! ‘Lavender Acupressure Intensive for Neck Pain’! ‘Meditative Earth Massage with Reflexology’? How in the world do you decide which one you need?

The dirty secret is, 90% of all this is marketing. Spas throw together these scrumptious-sounding confections so that they can charge you more money. That’s not to say the massage won’t be worth it; you just can’t tell by the packaging.

Your best bet is to shop around for a therapist who suits you. The technique is only as good as the therapist; anyone who is mechanically applying a particular treatment is not going to perform any miracles. And miracles are what you’re after!

With this in mind, here is your handy guide to deciphering the most common terms on spa menus.

Swedish Massage: This is basic. You take off your clothes, and the therapist rubs you with cream or oil in long, swooshing strokes. It’s nice. If the therapist is following the letter of the law, however, it won’t be much better than nice; if you’ve got a lot of knots, as most of us do, it can be screamingly frustrating. Your therapist will glide right over those festering areas, giving them no more and no less attention than the top of your hip bone. And few people ever get trigger points at their iliac crest.

Deep Tissue: Swedish, only tougher. Your therapist will go after those knots, possibly using elbows; your body will get a workout. However, the joy and relief you get from this is highly dependent upon the skill of your therapist. Some poor souls are imbued with lasting terror of deep tissue, after a ham-fisted masseuse left bruises that stayed for a week. A sensitive therapist will only go as deep as your body allows. If you flinch, tense up or cry out, and the therapist doesn’t immediately back off, don’t go back.

Shiatsu: Shiatsu is an Eastern modality that is traditionally performed on the floor, fully clothed. It involves the mobilization of joints, stretches, and pressure with cupped hands, thumbs and elbows, in specific patterns calledmeridians. Many people swear by it, particularly for back pain. Most Western therapists, however, don’t do straight Shiatsu, partly because it’s hard on their backs, partly because there’s little market for it. An experienced and well-trained practitioner will integrate some Shiatsu moves into a Swedish sequence, insuring that those meridians stay balanced.

Aromatherapy: A serious aromatherapist will interview you closely about your moods, health concerns, stress levels and daily habits before putting together a specific combination of natural essential oils to boost and tone your immune system, emotional condition and spiritual state. If you are getting ‘aromatherapy’ at a spa, this will not happen. It just means that your massage comes with scented oil instead of unscented. Ask to sample the oils before your massage, and ask if they’re natural or synthetic; synthetic oils have no therapeutic properties whatsoever.

Now we come to the more esoteric modalities of massage; the ones that you may reach for if you’re suffering from chronic pain, illness, or undiagnosed disorder that baffles your physician. Some of them may be effective; others may do nothing. Most of them won’t hurt you.

Neuromuscular Massage: This modality focuses on the elimination of trigger points, those areas of acute sensitivity that may radiate down a limb, or up into your skull, causing restriction of movement and chronic pain. A good massage therapist will be able to detect and treat these trigger points during a Swedish/Deep Tissue session, and eliminate them as part of the day’s work.

Since many massage therapists are just going through the motions, however, your chances of getting a thorough trigger-point tune-up are vastly increased if you go to one who explicitly states that they are neuromuscular-capable. At the very least they should be able to tell the difference between a trigger point and a tendon.

Reflexology: This is another Eastern modality that maps the body onto the soles of the feet, and intensively works your feet in order to stimulate healing responses elsewhere. It can be a particularly relaxing treatment if you are too sensitive in other parts of your body to tolerate direct massage.

Craniosacral Therapy: If you’re suffering from chronic neck pain due to whiplash, PTSD, or severe malaise of the nervous system, you might want to give this a try. It is extraordinarily subtle; the therapist places hands on your neck and skull and senses the pulses of your central nervous system, allowing the system to gently balance itself with minimal assistance. The theory is that bones in the skull are mobile, not fused, and the treatment brings these bones into proper alignment.

This theory, however, is controversial. Whatever is objectively happening during a craniosacral session, many clients find it deeply relaxing.

Reiki: This lightest-of-light energy modality is as controversial as it is popular. If you go to a practitioner who integrates Reiki with a more traditional massage session, you can soak in any potential benefits of Reiki while still getting your sore muscles kneaded.

Thai Massage: This is like passive yoga; massage connoisseurs say there’s nothing like it. You lie on a floor mat, and the practitioner bends, stretches and rocks your body in a way which give you a workout without the sweat. Look for an uptick in Thai popularity presently!

The Mechanics of Miracles

After twelve years of practice, I’m finally getting around to reading Anatomy Trains, by Tom Myers. It’s blowing my mind–not so much because it’s giving me new information, but because it’s describing why my way of doing bodywork has the results it does.

For example, it’s a common thing for a client to come in complaining of neck pain, and wonder why I spend so much time working on their feet. Actually, they don’t wonder; they say things like, “wow, I can feel that all the way up to the top of my head.” They go away thinking I did magic.

But I’m not a magician; neither do I have an encyclopedic knowledge of anatomy (though I’m working to remedy that.) My hands know how to seek the areas of strain in your body, and I don’t assume I know where all of them are. If you have a pain in your hip, I’ll work your hip, but I’ll also work every area that connects to your hip in any direction, which means your whole body.

Because the human body is not built like a brick warehouse. It’s not a pile of units that stack linearly on top of one other from the ground up, dependent upon gravity to keep them stable. It’s more like a knot of Tinker Toys held together by rubber bands; it’s flexible, resilient, and held together by all-over tension. This kind of structure is called tensegrity.

villella-234x300

Edward Villella: not a brick warehouse.

What this means in practice is that when one area of your body comes under strain, the whole structure adjusts to distribute that strain. This means that you are capable of absorbing considerably more shock per square inch than a brick warehouse. It also means that your whole body is only as strong as its weakest link. If you’re putting inordinate strain on your right arm over a long period of time, it’s quite possible for this to manifest as chronic failure of your left ankle. (It happened to me.)

One of the phrases in the book that I loved was, “The victim screams, not the thug.” Just because you’re hurting in one place doesn’t mean that spot is the source of the problem. Particularly if you’ve been in pain for more than a day or two, and particularly if the pain isn’t resulting from an obvious, sudden injury, it’s much more likely to be a result of compensatory strain.

Recently I had a client–a dancer–declare, “when I cough, I get an agonizing pain in my piriformis.” I worked her piriformis, of course, but didn’t find any significant adhesions, certainly nothing that would cause ‘agonizing pain.’ So in addition to my regular sequence of back, hips, legs, feet, arms and neck, I worked her rib cage. She said, “that’s interesting, nobody has done this before. Feels amazing.”

While she was dressing, I heard experimental coughing sounds coming from the treatment room. She emerged to report, “I can cough without crippling myself!” Further experiments will continue.

Why Practical?

So why did I decide to name my massage therapy practice ‘Practical Bodywork’?

For entirely pragmatic reasons, of course.

On the West Coast, where I got my training, everybody names their businesses things like ‘Soul Harmony,’ and gets away with it. On the East Coast, this is openly mocked. I wanted a name that I could pronounce in front of a loan officer without cringing.

More importantly, I wanted to emphasize my conviction that taking excellent care of yourself on all levels–physical, mental, emotional and spiritual–IS practical.

What is impractical, in my view, is waiting to address your health until you have an incapacitating problem, then going to a doctor. This doctor may spend 8-15 minutes examining you, then order expensive diagnostic tests, which your health insurance (if you have it) may or may not pay for. Then a treatment is prescribed which may or may not alleviate your symptoms.

What you usually don’t get, unless you have a truly extraordinary doctor, is: a place where you can talk about everything that bothers you, no matter how long it takes or how seemingly trivial; a treatment environment that relaxes you, instead of sending your nervous system into ‘fight or flight’ mode; uncritical acceptance; and most of all, a treatment that feels incredible and nurtures you on multiple levels.

I am not suggesting that massage therapy is a substitute for medicine. Habitual self-care simply reduces the need for medicine.

This may seem obvious, except that on so many levels, ‘self-care’ is perceived as either self-torture (low-fat diets, punishing exercise, teetotalling) or self-indulgence (spa treatments every week.) My practice is founded on the notion that self-care is just that–listening to what your body needs, and providing it.

Much hoopla has been spouted by the media in recent years, touting the ‘holistic’ approach. In many places it has come to be seen as a synonym for ‘flaky.’ When I am working on a client, however, it is self-evident that she must be treated as a whole. I can’t work on her musculoskeletal system without affecting her nervous system, her immune system, her circulatory system and her myofascial system. Treating these systems has a profound effect on her emotions, her thoughts and her energy level.

People are infinitely greater than the sum of their parts. I do my best to address and honor that.