Post Partum Massage

Out of all the people I work on, there is one job that stands out. Motherhood. Not just being a mother, but more specifically, being a new mother. Caring for a baby is the most physically demanding job. Construction workers? Delivery people? Furniture moves? None come close...... The list of contorted positions a mother has to put herself in is endless. There is no ergonomic way to breastfeed, change diapers, lift your child, and place in and out of the car. Not to mention that all this is being done with a 15 pound infant. New mothers can acquire excruciating lower back pain from all of the lifting and turning, usually at the same time. This pain comes from low back muscles like the spinalis group (along the spine), quadratus laborum, and all of the many hip muscles. More common are upper body spasms in the shoulder, neck and arms. I have had clients flare up their Thoracic Outlet Syndrome while caring for their newborn (see blog on 2/3/09 for details on TOS).

Obviously massage can help alleviate all of the pain and discomfort due to these spasming muscles. Massage can also assuage the mother's emotions. Women go thru a whole gamete of feelings post partum and having the time and space to just be with oneself can help to relax and ground her during this time.

Session Lengths

30, 60, 90 minutes. These are the typical lengths of a massage. Each 30 minute increment completely alters the type of massage one receives. 30 minutes is only enough time to work on 1 muscle group. This type of appt. is for someone that does not have the time for a full massage, but still needs work done. It's also a good alternative for those that need/want bodywork but do not want spend as much money. 60 minutes is the standard length of a massage session. There are a number of things we can do in an hour. We can do a full body and work on everything and also be able to focus on one area. I can focus on more than 1 area in the hour, however it depends on the muscle groups. 1 hour is not enough time to focus on the shoulder AND legs. There are 2 other options when receiving a 60 minute massage. 1. You can delete muscle groups to spend more time on others. For instance, if you are a desk worker and a runner, you may opt for me to not do your arms so I can apply that time on your legs. 2. We can spend the whole hour on one group. I do recommend this to some clients that need a lot of work done let's say on their upper body. If I spend the full hour on their shoulder, back, and neck, I can achieve more from deeper and more specific work. 90 minute sessions are for people that need/want a lot of deep work done on multiple muscle groups. You know that desk worker/runner I mentioned? They may not want delete any muscle groups from the session, in fact they may want deep work done on every group. 90 minutes is perfect for that. You do not have to be an athlete for 90 minutes, it is about what kind of work you want done and how detailed you want me to get at it. I have recently added a 75 minute session to the options. This is for somoene that needs a little more time than an hour but they don't want to spend the time or money on the full 90 minutes. This is an excellent way to get a little more work done without the lengthy commitment. Everyone always wants to know what I do. I get 90 minutes, always. Besides being a full time massage therapist, I work out a lot and also spend quite a number of hours on the computer doing work for my practice. I need/want deep and specific work done on all the muscle groups and I am not willing to give up any of them; 90 minutes it is.



There has developed an industry standard that has really disturbed me. There are places that do not give the full amount of time, in fact, that is their policy. Let's say you book a 60 minute massage. There are places that will refer to the session as 60 minutes, but fail to mention that the time includes your interview with the therapist as well as getting on and off the table. This can reduce the table time to 45-50 minutes!! This is not enough time to do a good job, nor is it ethical. This is done mostly in spas and chiropractor offices. I will give some spas credit, for they sometime mention in their brochures and sites that one's massage time includes what I have listed above, or they simply refer to a 60 minute massage as a 50 minute massage. At least you know what you will be getting... For the chiropractors I believe they shorten the time b/c of a different mindset. They see it as being in a doctor's office, so you are paying for 60 minutes with the therapist, not a 60 minute massage. In this circumstance, you are pretty much at the discretion of the therapist and what they seem as fit for your time. I strongly disagree with this practice. When I book a 60 minute massage, you better believe that I expect 60 minutes on the table getting work done. That is what I booked, that is what I am paying for, that should be what I get. If a place stipulates otherwise, that is fine, you are aware. But for those that just charge for the full time and cut it, that's false advertising and unethical.



In my office, if you book a 60 minute massage, you will be on my table receiving bodywork for a full 60 minutes. The time it takes for me to discuss your session and you getting on and off the table is booked into the appt. as extra time. I book a full 20 minutes extra w/ each appt. and 30 minutes for new clients. This is really how it's typically done and any deviation of this is poor service if you ask me. if you are late for your appt, depending on my schedule and how late you are, I may be able to give you the full time but chances are I won't. This will be specifically discussed before you get on the table so you are aware of what you will be receiving.



What I want you to take away from this is to be an educated consumer. If you pay for a certain service, you should receive it. If you are not sure, ask.

Have a cold? Cancel your appt. & call me in the morning.

If you have a cold, are sick, just had a vaccination, or have an infection of any kind, please cancel your appointment!!

Regular massages can have a dramatic affect on the body and it's functions. Primarily, your circulatory system is going to get a boost during the massage and after. If you have any of the above, the massage could exacerbate it. So if you walk in my office feeling kinda crappy, you may wake up the next morning feeling much worse. This is the main reason why I will not work on you. Even if you decide you are OK with this type of reaction, morally I will not do that. Two other good reasons for you to stay at home; 1. I do not want the germs spreading to me nor my clients. 2. You will most likely not be comfortable or enjoy your massage anyways.

Easy reference checklist. If any of the below apply, please cancel your massage appt.:
~ taking antibiotics
~ cannot breathe through your nose
~ cannot stop coughing
~ you have a fever or a virus reducing your body temperature below normal
~ received a vaccination the day of appt.
~ any flu-like symptoms

So for you health, please stay home and rest.

Is that Normal??

50% of clients ask me if what they are experiencing is normal. Like most of my replies, the answer is yes and No. ;)





It is always normal to feel what is going on in your body. That is why we have our nervous system; to give us warnings when something is off. Now let's focus more on muscles... With each muscular action we perform, there are a number of muscles that become engaged, so when 1 goes out it does effect many others. So you are not alone when your posterior shoulders (b/w shoulder blades etc) are tight, you will experience discomfort on your anterior shoulders (pectoralis muscles) when I work on them. People also want to know if particular pattern of muscle pain and tightness is "normal". It definitely is! Most of us have similar muscular makeup as well as similar types of jobs. Most of us these days have a job where we sit at a desk for hours and hours. it is quite "normal" for those people to experience problems with their shoulders, neck, and arms. it is common for people that have standing job to experience patterns of tightness in their low back, hips, and hamstrings. You are not alone in your discomfort and pain and the patterns they fall into. In fact, these patterns are heavily researched.





Now, here's the flip side. If you are experiencing pain or discomfort, this is your body's way of telling you that something wrong or "abnormal" is going on. Our bodies are constantly trying to remain in homeostasis or balance. They cannot function in a way they were designed to if something anywhere is out of balance. So when you start experiencing pain or discomfort in your muscles, it is your bodies way of telling you that they are tight and it is time you need to do something about it.





So in conclusion, you are like the rest of the population when you feel certain types of discomfort and pain patterns, however, this is not normal for the body.

Non Smoking Section

It's hard to believe that with all of the research, people still smoke. Then again, I still consume my ice cream sundaes on a regular basis, and my thighs definitely prove the research on trans-fat and high glucose corn syrup.

We all have our vices that we know are bad, but need to continue anyways. I would never tell you what to put in your body, nor judge you on it. That is, just as long as it does not effect me or my practice. I hold every one of you with the highest esteem. When you are in my room, you are the only I thing I care about at that time. I do my best to come up with ways to make your massage session not only therapeutic, but also a relaxing retreat.

To ensure the best experience for all, please do not smoke or drink before your session. No cocktails with lunch or dinner and please no smoking within an hour of your appointment. Smokers and drinkers (even just one recent glass of wine) exude a smell. The chemicals from the substance comes out thru the pores and fills the room. Since I am a non-smoker, I really do not want to spend the next hour in a room that smells like we sat down and shared a smoke. Nor do I want the next client to think I am a smoker or attempt to relax in a room that smells of stale alcohol or cigarettes. Plus, massing someone under the influence of alcohol or drugs is illegal.

So enjoy life and by all means, enjoy your vices; but please don't share them with me. :)

TMJ

TMJ, Temporomandubular Joint Disorder. SO many people suffer from TMJ pain and have no idea what actually causes it! The most common cause of TMJ discomfort is from grinding and clenching the teeth. This is most commonly done at night while we sleep, but can also occur throughout the day when we are stressed. One of the most popular treatments is the purchase of a mouthguard from one's dentist. This apparatus is extremely important on many levels. First of all, it protects the enamal of your teeth. With constant grinding and clenching, the tooth itself can wear aware quite fast; leading to tooth loss, nerve damage, etc. Second, the mouthguard helps to reduce the habit. Our brain gets a feeling of satisfaction from feeling the 2 layers of teeth together. This is why this behavior increases during times of stress. The mouthguard places a layer of material between the teeth so that brain cannot get that stress relief it is looking for. Over time, our brain will find another outlet. I know they are expensive, but it is worth it. I wear a mouthguard and can feel a major difference if I skip a few nights. I have tried the ones from a regular drugstore and there is no comparison. I chewed right thru it within a few days. I have had my current mouthguard for 5 years now.



So what does a massage therapist have to do with a disorder that effects the teeth? Plenty!! if you suffer from this, you know about the headaches and neck pain. off the top of my head the list of muscles TMJ effects are the temporalis, masseters, pterygoid group, sternocliedomastoid, scalenes, splenius group, occipitals, etc. The referral pain from these muscles can lead to various types of headaches, neck pain, muscle stiffness, clicking and popping of the jaw, tinnitus (ear ringing), mock sinus infections, dizziness, blurred vision, etc. Trigger point work in the superior shoulder, neck, scalp, and face can make a world of difference if you suffer from TMJ. It helps to reduce the pain and over time, eradicate it.



Some other tips to help alleviate the pain is in prevention. It helps to not chew gum, avoid chewy dough (like on thick pizzas or hoagies), nail biting, etc.



Check out this blog to learn some TMJ self massage. The video is pretty good. I recommend NOT opening and closing your mouth during the massage like the therapist says. http://vids.myspace.com/index.cfm?fuseaction=vids.individual&VideoID=7196758

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is an umbrella term for multipe disorders arising from entrapment of the brachial plexus or the subclavian artery and/or vein. The brachial plexus is the webbing of nerves that goes down into your arm affecting your neck, shoulder and arms. TOS can be identified by pain in the neck, shoulder and/or arm, muscle spasms, headaches, numbness and tingling of the fingers, weakness in the arm and hand.



The most common people to suffer from this condition are those that have obtained neck injuries in car accidents, but more often are those that sit at a non-ergonmically set up desk. Why the desk workers? Typically the average computer worker does not sit with proper posture, nor has their work station set up ergonomically. The repetitive motions and behaviors from this starting position over-work and tighten muscles that can entrap these nerves and blood vessels.



You can do a lot to prevent TOS from occuring or from getting worse. Those of you that have been to my office know the lecture well; watch your posture and stretch. One's posture is so importnant!! if you sit down and are automatically slunched over or extending your neck, you are then moving from an incoorect starting position. It is impossible for any other movement to be ergonomic after that. Also, while you are in that incoorect body position, your muscles are isometrically contracting and are going to get over-worked and subsequently tighten up and spasm. I cannot stress enough the importance of proper posture at your workstation.



I tell all of my clients to treat their job as if it were a workout. Warm up and stretch. That's it; it is that easy. If you were to play tennis for 8/9 hours straight, I would hope you would warm up your body prior, and take frequent breaks to stretch out related muscles. The same goes for your job. if you are going to sit at your desk all day, warm up before hand. This means do some shoulder rolls or close the door to your office and do some kickboxing punches. it is also quite important that you stretch constantly throughout the day. if you cannot remember, pair it with another behavior. For instance, every time you get up to use the restroom, strecth before you sit back down. You can also program your computer to remind, like it does for meetings and appts.



As a Neuromscular Massage Therapist I can go into the related muscles (scalenes, levator scapula, pec major and minor, etc) and work out the Trigger Points associated with TOS to assist relaxing and lengthening the muscle tissue. With massage, posture, stretching and sometimes physical therapy Thoracic Outlet Syndrome can be alleviated and can be eradicated. But it is hard work and you have to do your part in the healing process as well as prevention.

Why Are You Working On My Neck When My Thumb Hurts?

The term 'Trigger Point' is thrown around a lot in my office. Most clients are confused as to what exactly one is and is it the same as a knot.

Yes and No.

Yes - They both are pretty much the same physiologically. Get ready for the anatomy lesson; A sarcomere is a microscopic unit of tissue that is part of a muscle fiber that is responsible for contracting. Contraction occurs in a sarcomere when its two layers come together and interlock. Millions of sarcomeres have to contract in order for a particular muscle to move in the slightest. A trigger point and/or knot occurs when sarcomeres are chemically prevented from releasing from their interlocked state. Typically, a muscle works by its sarcomeres acting like tiny pumps, contracting and relaxing to circulate blood and nutrients, as well as getting rid of waste products. When a sarcomere holds their contraction, blood flow halts in the immediate area. The resulting oxygen starvation and accumulation of the waste products of metabolism aggravates the TP/knot and begins a painful cycle of pain and energy crisis in the cells.

This occurs from over use (repetitive motions or strenuous workout), under use (laying on the couch sick for a week), or improper use (poor posture and ergonomics).

No - A knot is merely multiple sarcomeres locked up in the muscle tissue causing acute discomfort. Trigger Points are more complex. Not only is acute discomfort possible, but also referred pain into other areas of the body, tenderness, muscle weakness, motor dysfunction, and autonomic phenomena (sweating, ticklish, ear ringing, burning, numbess, etc.)

As a neuromuscular therapist, I primarily focus on TP's and their tested patterns to facilitate you feeling better. This is why I ask so many questions and require working on multiple muscle groups in order to troubleshoot your complaint.

Run, Tight Boy, Run!

I don't know about you, but as soon as my MT leaves the room I rush to remove my clothes and make a mad dash for the table. What if they knock and I am not done yet? What if they come in and I am in the middle of the room with no clothes on? These are fears I have before and after the session. I should know better.....



For those of you that have are scared of the same, I assure you this will never happen. After our initial interview, I slowly walk to the restroom to wash my hands and sometimes to use the facilities (there are no bathroom breaks for massage therapists!). When I meander back, I quietly listen at the door. Do I hear movement? Were those footsteps over to the table. How long will they wrestle with the draping until they are comfortable? When all of these sounds have disappeared and I hear a long loud sigh, I knock and wait for your response. Then and only then will I walk into the room.



After the massage is a different story. I wait until you get off the table, get dressed, and decide to open the door yourself. I must wash my hands and arms after the massage, so when I say, "Take your time." I really mean it. Just don't take too long.... ;)

Need a New Mattress? Try This First.

I know I am part of the minority, but I am a sleeper. I can fall asleep anywhere. I get a good 8/9 hours of sleep every night, and wake up ready to take on the world. This is why those 8am Saturday appts. are always the best ones to get!

Being that I sleep long, I know that I have to make sure I am positioned appropriately, or I will have hell to pay the next day. When we medical professionals give advice on sleeping positions, it is usually to get you into the most anatomical position.

Think about it; when you stand, there is space between your legs. So when you sleep on your side, place a pillow between your knees. This will keep that space there and relieve pressure off of your low back. Again with the knees… when you lay on your back, put that pillow under your knees, just like the bolster in a massage treatment.

If you sleep on your side and tend to have shoulder issues, try “hugging” a pillow. If you notice while you lay there, your shoulders get scrunched inward. “Hugging” a pillow will pull your shoulders back and keep you from rolling them in.

Notice how I did not mention stomach sleeping. This is because it is the worst position to sleep in. It can wreak havoc on your neck and especially the lower back/hips. I know this is comfy, so if you must, try putting a pillow under your ankles. That will at least relieve some low back pressure and prevent you from pulling your leg up and knotting up your hips.

I sleep with a pillow to move around with my knees and one next to the bed for when I roll onto my side. For my neck, I use a memory foam contour pillow. I do not like to endorse any products, but I have had success from this pillow. Before you ask, I bought it at Kohl’s on sale (of course) for less than $15.

If Only I Could Afford it Everyday......

I know wonder how often they should receive a massage. It is really particular to your goals and how aggressive you want to accomplish them.

When your session is over, I will ask if you have any questions and see how you feel. Then we can discuss together the appropriate treatment plan for you. If your goal is to alleviate chronic pain, reduce discomfort/pain from an old or recent injury, then the sessions need to be much closer together. Some people come once a week for an hour, every other week for an hour, every other week for 90 minutes, or twice a week for 30 minutes each. Again, we will have to see how your body reacts to the session to decide which is best. A one hour session per month is usually used as a maintenance plan, after the “kinks” have been worked out. If you are coming for relaxation purposes, then it is only necessary when you feel the need.

I try to get a 90 minute massage every week. I see massage as a way of living well and as healthy maintenance. Just like working out and brushing my teeth regularly, I need bodywork. In reality w/ life and scheduling, it usually ends up being every other week.