Pain - Practical Bodywork

The Biochemistry of Rage

CW: sexual assault

When I was in my early twenties, a friend of mine started having neurological problems. Intermittent, acute idiopathic pain, fatigue, and intermittent paralysis. Doctors could not find a cause. Some accused them of making it up to get attention.

At the same time, this friend started having flashbacks. Memories, long buried, of repeated sexual abuse by a relative, at a very young age.

They spoke up about the abuse. After some battles, they were even believed. The abuser was prevented from abusing others.

Over time, the neurological problems got worse. Many diagnoses were proffered and rescinded. They spent more and more time in a wheelchair.

The experiences of this friend, and of many others, inspired me to study alternative healing, particularly the relief of chronic pain. Over the years I heard countless variations on this story. Childhood abuse, adult disease and disability.

So when, in 2012, the results of the Adverse Childhood Experiences Study were made public, it validated a suspicion of mine. As the study indicated, childhood trauma can disrupt the structural development of the neural network, and the biochemistry of endocrine systems. This can have far-ranging health consequences in adulthood, correlating with everything from heart disease, obesity, diabetes, cancer, and emphysema, to behavioral and mental health issues like alcoholism and depression.

Trauma disrupts the nervous system.

If you have been living under a rock for the past few weeks, you might have been able to avoid the avalanche of people telling their sexual assault stories, in the wake of allegations against Harvey Weinstein. After a few days of it, I got off social media.

Because the guys complaining about people expressing their feelings were a little much.

As if feelings aren’t reality.

Feelings, as I understand from decades of professional experience, are data. Feelings are biochemistry. Feelings are a language more truthful, rational and compelling than any amount of intellectual rationalization.

And when I hear the feelings of millions of traumatized people dismissed as so much whining, I get kind of enraged.

It’s that kind of language that keeps abusers comfortable. It’s that kind of talk which keeps victims quiet. And it’s an ontological lie, told in order to maintain a status quo which is monstrously destructive.

Because every human being will experience trauma. It’s built into the system. What causes unnecessary trauma is trying to ignore and suppress the body’s natural response to it. Emotions are tunnels, which we have to traverse in order to build resilience.

I spend my days coaxing people’s bodies to release unprocessed trauma.

And I don’t have much patience with those who try to shut them up.

Satirical Aerobics

For years I have had a dream.

It strikes me that most exercise videos are excessively earnest. Perky! Sincere! Cheerleader-esque!

There seemed to be few, if any, home workout routines for people with a healthy sense of irony, and a taste for the absurd. My people.

For too long I lacked the time, the equipment, and the chutzpah to make an ass of myself, without losing 30 lbs and an ankle brace or two.

But now–thanks to the unremitting skill and attention of Terry McHugh of NovaCare Physical Therapy, and Dawn of MotherHeart Studio–my chronic knee and ankle injuries are so well-healed that I can skip, sauté and bourreé to the satisfaction of all my kitchen appliances, and the total expense of dignity.

Because nothing hurts.

EXCEPT MY BROKEN, BROKEN HEART.

On The Bleeding Edge of Science

Twenty years ago, a friend of mine stopped being able to walk.

It happened intermittently. She’d be fine for a few weeks or months, then collapse. She had intense pelvic pain that doctors couldn’t find a reason for. Some thought she was faking it and sent her to the psych ward, or gave her a catheter without anesthetic “to teach her a lesson.”

No doctor, as far as I know, asked her if she had a history of childhood abuse.

Then came the CDC’s Adverse Childhood Experience study (ACE), a study of 17,000 adults which correlated long-term health outcomes with childhood trauma. It suggested that certain experiences are risk factors for leading causes of illness and death–as well as poor quality of life, including idiopathic pain. Chronic, high-intensity stress in childhood, it seems, can re-engineer your nervous system, and not for the better.

In my bodywork practice, my biggest source of fascination and frustration is “mystery pain,” often accompanied by “mystery fatigue.” I can get a little obsessed. In trying to solve the problem of why a client is in pain, exhausted, dizzy, depressed, anxious, can’t walk properly, or gets “pins and needles” for no apparent reason, I’ve researched not only musculoskeletal problems, such as injuries, arthritis, disc disease, spinal stenosis and spondylitis, but also adrenal fatigue, chronic Lyme, and any nervous system illness we have a name for, including every type of sclerosis that they thought my friend had, and then ruled out.

And I keep going back to the ACE study. All the TED talks and spin-off studies and New Health Initiatives focus on prevention, which is splendid. But what about people whose nervous systems are already kerflucked? Is there any way to help them?

Answer: I don’t know.

We know the nervous system is plastic; it can be rewired, to a certain extent. We know that PTSD is treatable. Could we develop a protocol in cases of idiopathic pain and fatigue syndrome, otherwise known as Nobody Knows Why I’m Kerflucked?

Because the danger in addressing an undiagnosable problem in a holistic way, is that you may be attacking it at the wrong level. You can’t heal a broken leg by changing your mindset. Too many holistic practitioners make claims that aren’t backed up by research. As a colleague noted when she said, “I don’t know any other massage therapists quite like you.”

So I keep asking questions. I keep reading research. And I keep up my attempts to hack into your nervous system, and tell it there’s no cause for alarm.

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!

The Problems That Can’t Be Solved

My brother-in-law, Leif Weaver, passed away on November 14, after an eighteen-month battle with aggressive mantle-cell lymphoma. I loved him a whole lot.

His memorial was filled with friends and family who were just as broken-hearted, many of whom had flown cross-country on a few hours’ notice to say goodbye. We spent the evening swapping hilarious Leif stories, hugging one another and openly weeping. Love was everywhere.

During the course of his illness, I and others close to him experienced a host of sympathetic, stress-induced symptoms. Back spasms, sciatic pain, the onset of MS. Medical treatment could only take us so far. The body and mind have their own methods and timeline for processing trauma, physical and emotional.

In my bodywork practice, I call myself a creative problem-solver. The truth is, a lot of problems can’t be solved. While going through Leif’s illness and passing, I’ve shared the pain of many of my clients who are dealing with similar situations. When someone you love is seriously ill, your mind has to do something with the inevitable feelings of fear and helplessness; often this manifests as intractable pain. As both patient and therapist, sometimes all I can do is acknowledge the pain, treat it with the skills at my disposal, and wait for it to pass.

It always does.

How To Make Your Body Disappear

Some fun new research has discovered that turning your gym into an oversized, self-propelled boom box can boost your workout performance:

…the results showed that most of the volunteers had generated significantly greater muscular force while working at the musically equipped machines than the unmodified ones. They also had used less oxygen to generate that force and reported that their exertions had felt less strenuous. Their movements were also more smooth in general, resulting in a steadier flow of music.

Directional Flow, artwork by Exper Giovanni Rubaltelli Abstract Design — ‘Directional Flow,’ Exper Giovanni Rubaltelli
Abstract Design

Earlier research has already demonstrated that music both inspires workouts and calms the nervous system, improving overall performance. Along with endorphins, it’s a natural pain reliever (as I can attest, having shredded my posterior tibial tendon by running with the assistance of Coldplay.)

But still, most of us treat things like music as incidental–nice to have, when we think about it, but not necessary or integral to our lives.

Music, however, can be a gateway to the state of consciousness known as ‘flow’; when we are so engaged in an activity that our sense of time and identity seems suspended. As Mihaly Csikszentmihalyi describes, in ‘Flow: The Secret to Happiness,’ our brains can only process about 110 bits of information per second. When our brains are immersed in a creative activity, there is not enough bandwidth left over for maintaining a sense of individual identity, and all that goes with it–hunger, fatigue, worry, and pain.

I don’t know how many of you experience this, but during my 20+ years as an artist, I routinely use music as a way to jump-start a state of flow. It’s like hopping on a train. The music seems to obviate doubt and paralysis by providing a clear pattern for moving and thinking. My brain is both attending and translating the sounds into a series of creative decisions which leave no room for extraneous sensations. It’s only when the album ends that I notice I’m hungry and have to pee.

How does this happen for you? Do you ever drop your body while you’re working? What about during a massage?

Touchy Topic Tuesday: Blame Is Of The Devil

Half of the harm that is done in this world is due to people who want to feel important. They don’t mean to do harm but the harm does not interest them. -T.S. Eliot, poet (1888-1965)

A new book, ‘Scarcity,’ details groundbreaking research on what poverty does to the mind:

Worrying about money when it is tight captures our brains. It reduces our cognitive capacity — especially our abstract intelligence, which we use for problem-solving. It also reduces our executive control, which governs planning, impulses and willpower. The bad decisions of the poor, say the authors, are not a product of bad character or low native intelligence. They are a product of poverty itself. Your natural capability doesn’t decrease when you experience scarcity. But less of that capacity is available for use. If you put a middle-class person into a situation of scarcity, she will behave like a poor person.

The vampiric effects of scarcity extend to both time and money; people who are chronically short of time tend to spend it putting out one fire after another, rather than following a long-range plan; people who are dieting spend an inordinate amount of mental energy thinking about food. Chronic pain can have a similar effect, creating a scarcity of energy and mental attention which impoverishes your world.

But that would be the predictable thing to discuss. What I really want to talk about are the corrosive effects of blame.

Assuming that the poor make bad decisions because they’re lazy or stupid makes us feel comfortably superior; it reinforces our ‘just-world’ viewpoint, a bias in thinking and perception that assumes the world is just, and that bad things don’t happen to good people. It creates a distance between ourselves and the things we fear, and gives us the illusion of control over our circumstances.

It’s also incredibly cruel.

This habit of blame often shows itself in how we treat cancer patients, the obese, the mentally ill and people with HIV. In addition to dealing with the disease itself, patients are saddled with the burden of answering judgmental questions like, “Did you smoke? What are your eating habits?”

Not surprisingly, these sorts of lines of questioning can exacerbate the emotional roller coaster of cancer treatment. A recent study found that at least one-third of men with colon cancer experienced some degree of stigma or self-blame related to their malignancy. That group appeared to be more vulnerable to depression as well, the researchers found.

Even if we’re not going around blaming other people for their problems, we often do it to ourselves. Self-blame and self-punishment can be used as a kind of talisman against abuse from others, as well as an attempt to motivate change: “see, look here, I’m beating myself up so that you don’t have to.”

But self-abuse alienates us from ourselves and from others, just when we need kindness and support. It can even give instructions to the subconscious mind which are diametrically opposed to what we want and need. “I’m a lazy, worthless, greedy slob. Might as well die now.”

I’m not even going to ask if you’ve done this, because you’re human. I will ask you to consider, however, that there is a vast difference between blame and responsibility. Blame is of the devil. Responsibility is the opposite.

(This last link will take you to Pretty Lady’s radical ranting upon the subject. Click at your own risk.)

Touchy Topic Tuesday: I Am Embarrassed To Tell You This, But…

…I’m wearing an ankle brace.

Turns out my crippled ankle wasn’t psychosomatic after all. According to my fabulous new podiatrist, I have posterior tibial tendon dysfunction, caused by the extra bone in my flat, flat foot torquing my gait and stretching the tendon until it is practically shredded. He says if I don’t wear this brace, I’m a candidate for surgical reconstruction of my entire ankle joint when the tendon gives way completely.

It took me awhile to assimilate this information.

Because it’s a lot easier to be the big, strong person who helps OTHER people with their frustrating pain and mobility problems. It is terrifying to admit that I don’t have all the answers, that I can’t fix everything, that most mornings I have a hard time negotiating my way downstairs, because my ankle won’t flex properly. It is hard to ask for help.

On the other hand, it’s great to be running up and down stairs again. A little support in the right place makes all the difference.

And knowing what I know about alignment, I am kicking myself for not recognizing the obvious. I was so focused on how the rest of my body was affecting my ankle, I failed to consider the possibility that the ankle was, in fact, the source of the problem. It’s a wonder my knee and hip and back aren’t completely wrecked; for this, I have yoga and foam rolling to thank.

The moment that mortified me the most was when my podiatrist said EXACTLY THE SAME THING to me that I say to my own clients. “You need to take care of this now, so you’ll be massaging people for longer.” Ouch. I can spend my life telling people that self-care is not a luxury, but am I walking my talk?

It seems to me that the people who give the most to others are often the least willing to give to themselves. Are you one of them? Think about how many people are depending on you, at your job, in your family, in your relationships. If something happened to you–like, say, you stopped being able to climb stairs, or walk more than 30 feet, or started getting regular migraines, or collapsed under intolerable strain–how would this affect them? How does it affect them when you’re exhausted, anxious and in pain? Are you more likely to become impatient, angry or detached?

And if a child of yours were forced to endure the same level of pain, stress and fatigue you put yourself through on a daily basis, would this be okay with you?

Well, then.

Touchy Topic Tuesday: How To Hobble Your Ankle Without Falling Down

Update on the crippled ankle: last weekend I used a foam roller on the spot where my hamstrings attach to my ischial tuberosity–the butt bone–and my ankle joint cracked. It’s been getting gradually better ever since. The first thing I do every day is foam-roller that same spot, because it seizes up overnight.

So, how does that work?

anatomytrains-the-spiral-line-thomas-myers — The Spiral Line. Note stirrup under ankle and butt bone attachments.

This diagram shows the Spiral Line, the specific fascial continuity that I believe has been hobbling my ankle. As you can see, the Spiral Line crisscrosses the body, swinging down the side of the leg, looping under the ankle like a stirrup, and running up the back of the leg where it attaches to the butt bone. Bingo!

A fascial train, (or anatomy train, as Thomas Myers calls them) is a distinct, dissectable pathway where all the fascial fibers run continuously in the same direction, whether they are involved with muscle, tendon, ligament or bone. One of the singular things about fascia is that it does not stretch; it enables movement by continually reconfiguring its fibers. Thus, when your fascia becomes restricted in one place or another, it will tug on everything else connected to it. Ergo, a crippled ankle with no visible ankle-related trauma.

The fact that fascia does not stretch is possibly why, even with a regular yoga practice, my ankle got increasingly worse over time. Stretching your muscles will not necessarily affect restrictions in your fascia. I was able to figure out where to use the foam roller, however, by noting the fact that Triangle Pose with my right leg in front was both satisfying and excruciating.

But how, you may ask, did my Spiral Line get so messed up in the first place?

In a word, stress. Nobody has yet determined exactly how or why your fascia gets gummed up when there is a lot of cortisol running through your nervous system, but so it does. This happens regardless of what your conscious mind is doing. It is so much a product of the obscure obsessions of the subconscious, that stress-related fascial restrictions are worse after a good night’s sleep. At least, mine are.

As you may imagine, this is an incredibly frustrating feedback loop. You rest, you do your yoga, and the pain only gets worse.

Fortunately, there are foam rollers, Rolfers, and bodyworkers who specialize in structural myofascial work. 🙂 Once you get to the root of your problem (in both a physiological and psychological sense, which may take some time), you can start working to break that feedback loop.

This is why the clients of mine who get the best results are the ones who come most regularly. We are re-educating both their fascia and their nervous system. Many clients report that they start to relax as soon as they approach my front door. Which, for me, is a wonderful thing to hear.

Touchy Topic Tuesday: Is ‘Tapping’ For Real?

Full disclosure: I just did this. Three times. I felt like a real fool.

But I’ve had an inflamed ankle for way too long now, especially considering that my job is to relieve problems like chronically inflamed ankles. I know what’s causing it. I got into this line of work partly because of first-hand experience with intractable pain. I’ve done all the things I advise my clients to do: yoga, bodywork, proper shoes, cutting back (WAY back) on workouts, arnica, even the evil NSAID in a pinch. And I’m still hobbling around like Quasimodo.

Quasimodo — Me, dragging my carcass through the parking lot.

So I tried a few rounds of tapping. Spoiler: It did not magically heal my inflamed tendon. It did, however, go a small way toward relieving the chronic tension in my right leg which I believe to be the original cause of the inflammation. I’ll keep you posted.

The ‘science’ behind tapping, such as it is, has been mostly dismissed or ignored by the mainstream medical establishment. Interestingly, the skeptics dismiss it out of hand on the basis that ‘the existence of a human energy field cannot be proven by science.’ But the EFT sites that I perused didn’t directly mention ‘chi’ or ‘human energy field.’ Instead, they present tapping as a way to gently rewire the nervous system.

This makes a certain amount of sense to me, as a bodyworker. The major cause of chronic tension in the musculoskeletal system is stress, i.e. arousal of the hypothalmic-pituitary-adrenal axis. When your mind is fearful, it stimulates your brain to release hormones which promote a fight-or-flight response. This, in turn, charges up your muscles, stiffens your fascia, and turns off your immune system. You’re prepared to run, but you’re not handling routine maintenance, much less repairing damaged tendons.

The thing is, most of your neurological activity is not under your conscious control. The vast majority of time we are operating on autopilot, even when we think we’re alert and present and calm. In my case, there seems to have been a macro running in my brain on a repeat loop, telling my right leg to get ready to run. (The left one had this problem for about six years, seven years ago.) And no amount of me telling my leg to chill the heck out has had any effect. If any magic trick can get into my brain and turn off that switch, I’m all for it.

Additionally, I’m beginning to suspect that there is a special and little-understood relationship between fascia and the nervous system. There is still no clinical consensus on what causes fascia to become restricted, with one camp theorizing that it sticks to itself because of physical trauma and repetitive stress, and the other pointing to the nervous system as a controlling agent in fascial viscosity. This may not seem important to you, but I would genuinely like to know whether I’m helping my clients because I’m manually un-sticking their fascia, or because I’m encouraging their nervous system to relax. It makes a difference to what kind of continuing education workshops I attend.

At the very least, tapping seems to activate the placebo effect, which is the best I can do right now, all other bases having been covered.

Have any of you tried it? What were your results? What’s your opinion?