Category Archives: Rambling

Overcoming the Inertia of the Body

I’d like you to try a quick thought experiment: Imagine doing one intense workout in the course of a month. You charge yourself up, you break through your mental block, and you finally go to that fitness bootcamp you’ve been dreading. You lay it all on the line, and you kick butt. What effects will this have on your health?

Over the short term, there will be huge effects. Protein synthesis and catabolism will both be through the roof. You might burn in excess of a thousand calories, prompting significant lipolysis. You’ll spend a couple of hours bathed in adrenaline, and then you’ll get some feel-good chemicals in the aftermath.

Over the long term, what is the effect of a single intense workout over the course of a month? Probably… nothing at all. A single workout isn’t capable of moving the needle on your scale, let alone prompting lasting physical changes in your body, or biochemical changes in your brain. Why? Because of negative feedback. Because of the inertia of homeostasis. When your body notices big changes in your blood, it releases hormones to counteract that. When your sympathetic nervous system is in an unusual state of overdrive, it will tip the balance in the other direction until you can relax and digest. ... continue reading.

Massage Tutorial Video: Talking to Clients On the Table

New video! This week we’re talking about talking. More specifically, what can you do to maximize your time with a client on the table? Especially in a time-crunch environment, finding little nooks and crannies to fit client education into can be invaluable.

I find this especially useful when I’m dealing with areas of heightened sensitivity. If a client comes in with a painful sacroiliac area and sciatica symptoms, for instance, I try to talk them through the treatment as I deliver it. I want them to know what I’m trying to achieve with my slow steamrolling, and I ask them to let me know their experience. Does it feel like we’re in a relevant area? Do you feel this referring pain anywhere else? As I gather information, I can also deliver some, telling them about their posterior pelvis and where relevant muscles attach. When you live with chronic pain, learning more about it can be a relief in itself! ... continue reading.

Massage Video: Working with Shoulder Pain After Surgery

Here’s a new video about how I work with postsurgical shoulder pain. I talk about my strategy, and I demonstrate specific techniques for working gently from a myofascial perspective:

I’d like to highlight something that’s changed for me in my practice: While I do explore the client’s range of motion, I do my best to avoid those painful end-points. Over the course of my career, I’ve found that mobilization can work just as well (or better!) when it’s done painlessly. If done patiently and with good communication, it can be a way of demonstrating to the client that safe movement is possible. I’ve frequently had clients stand up with a greater comfortable range of motion despite the fact that I didn’t try to increase that ROM on the table!

I’ve also started erring on the side of less specific work during that first session, especially in areas that are prone to guarding or spasm. That specific stripping and trigger point work can still be incorporated in future sessions, but by working broadly at first, I can help the client gradually get used to movement and contact without provoking spasm or next-day tightness.

Let me know what you think! Is there anything that you’d add or do differently? Did I finally drone on for too long during a video? 🙂

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Is Your Massage Practice Sending the Wrong Message?

Here’s an important article about a negative experience that a client had while on the table: https://danceswithfat.wordpress.com/2016/03/20/dealing-with-a-fat-shaming-massage-therapist/

In a previous rant, I said that massage therapists causing pain—and making their clients think it was necessary—was one of the only massage-related phenomena that truly made me angry. Well, this counts as causing pain. If someone comes to me with a unique human body, anything that I say or do to stigmatize that person for their shape, or size, or sounds, or smell, is causing harm. They’ll leave that experience thinking, “I was wrong for putting myself in that vulnerable position.” In other words, they trusted us with their body, and we breached that trust.

Maybe you would never think of commenting directly on someone’s weight, which is great! With that as a given, I’d like to direct your attention to something that we’ve learned from psychological and medical studies: The power of words, and the power of symbols in general. How we speak, and even the signs and pictures in our offices, can communicate a powerful message of brokenness or wholeness to our clients.

Consider the client with back pain who walks into a doctor’s office and sees one of those “3 kinds of spinal dysfunction” infographic posters that doctors like to decorate their offices with. Cheery. As they’re sitting there waiting for their doctor to arrive, that vulnerable human is seeing a herniated nucleus pulposus pressing on a nerve, and an osteoporotic lumbar vertebra crumbling to dust. That doctor could be as reassuring and encouraging as Mr. Rogers, but the damage has been done. Is there any chance they’ll leave that environment thinking, “this is something that my body can handle”?

In the same way, think about what happens when we talk about a client’s “bad back.” Maybe they said it first and we’re just picking up on the language, but it’s not something that we have to buy into. We can choose not to pick the client apart, or to pathologize a relatively normal ache or pain. Instead, we can talk about that person’s back in the context of their return to pain-free living. We can discuss the pain without bad-mouthing the part.

We can apply that same “language of wholeness” to all aspects of our professional presentation. Most, if not all, of our clients are self-conscious about part of their body. How many of your clients have apologized to you about leg hair, or their “back fat,” or cellulite? These are all perfectly normal features for a body to have, but they feel ashamed. There are some things that we can do verbally in that situation to help them feel accepted (I’d love to hear some of your reassuring responses in the comments!), as well as through kind, accepting contact.

But, what about the other symbols in our professional environment? Think about what it communicates when a client is perusing our menu of services and sees “Lypossage: Recontour your cellulite through non-invasive massage” or “Face-lift massage: Look years younger with just 5 treatments.” What about facial treatments that offer to make fine lines disappear, and tighten up sagging skin? Or, like the massage therapist in the article, you’re advertising shakes that can supposedly help clients lose weight?

Does my body need -contouring--

“You deserve to be pain free. You also might have saggy skin, and have you considered how unsightly your cellulite is? And isn’t it about time to lose that spare tire around your midsection?”

These are things that we’d never say out loud, but we can sure as heck say them with the products and services that we offer. We can accidentally imply them when we comment on clients’ physical appearance, even if it’s just to praise them for losing weight. Maybe that’s not something they consider praiseworthy. Maybe we could stick to wholeness and kindness, and leave all the picking apart and judgment to insensitive Facebook posts and YouTube ads.

I don’t mean to make any massage therapists feel put on the spot by this post. I know that we’re all well-meaning. I know that some of you offer those “slimming/contouring” services because you find them valuable, and they help your business. Still, I want you to consider the symbology of your words and your professional environment. We can create safe spaces where human bodies can just be human bodies. Humans have hair, and zits, and subcutaneous fat. I’ve got super flat feet and a sunken chest, and I’d love for a massage therapist to help me accept them, rather than trying to change them (and, by extension, me).

Let me know what you think about this. How do you communicate acceptance of your clients in their myriad shapes and sizes? Has a massage therapist ever made you feel ashamed of your body or mind, whether accidentally or on purpose? I’d like to hear your story.

Dealing With Your Massage-Related Injuries

You may have heard me make the claim that I’m injury-free. “I’ve been using my weird body mechanics and low tables for a decade, and I don’t have any pain to show for it.” How could that be possible? How can a massage therapist avoid all injury?

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It… may have been an exaggeration. What I mean to say is that, while I’m CONSTANTLY injuring myself in new and interesting ways, I don’t have any chronic pain to show for it. It’s a matter of giving each new ache or pain the reverence they deserve, actually treating the injuries instead of ignoring them, and adapting to allow those parts to recover.

Let’s look at the last two months. I got a twinge in my thumb while doing some weird little swirling flourish thing during petrissage (I have no memory of commanding my hands to do this), and I started having pain in my wrist after allowing it to extend to an extreme angle during a high-pressure move.

What did I do? Well, I certainly didn’t keep doing the same stuff. I immediate instituted a thumb vacation for my right hand, choosing to use fists, fingertips, forearms, and thumbless petrissage for a couple of weeks (see my thumb self-care video for more).

No biggie, it’s happened before. The wrist thing was fun and new, so I had to figure out new adaptations just for that. It turned out that any pressure on the palmar surface of my hand that allowed my carpal region to sink was going to produce some pain, so: More soft fist and elbow use, even if it meant using each hand in an asymmetrical way. One hand would be palm-down, the other would be fist-shaped, and everything was groovy. My clients didn’t notice, and I’m sure it felt good.

In fact, I always find these injury adaptations interesting. They force me to try new angles, and new combinations of tools. I always take some new technology away from the “rest” period, making this process an integral part of the evolution of my technique.

By the way, in the same time period, I also injured my back in the gym and acquired some new knee and ankle pain while out running. My workout routine, fraught with injury, is actually where I learned the whole adapt-until-it’s-better dance. I switched up my exercises at the gym, increased my warm-up time before my runs, and redoubled my nightly stretching.

I also actually cared for my injuries. I iced my knee, and I wrapped my hand and ankle for the first few days of each respective injury. I took a day off when I needed it, but I also made the recovery period as active as I could: I kept working, and I kept exercising, just with the alterations needed to keep from aggravating my sensitized nervous system.

Make no mistake: As a massage therapist, you are an athlete. While we can put a lot of safeguards in place (warming up, stretching, using sensible body mechanics), injury and recovery are just part of using your body in extraordinary ways. Definitely listen to your body, and don’t invite pain by ignoring warning signs or being careless. At the same time, try to lose the fear that you have about being injured, and be prepared. You’re going to get aches and pains, so how are you going to deal with them?

Of course, If your aches are piling up faster than you can deal with them, it may be time to lessen your work load, or consider different ways of working. Your table height might be wrong, or you might be relying on petrissage too much. You might not be resting enough between clients, or forgetting to eat. If you’re overworking out of pressure from your boss or your clients, it’s time to look out for yourself. Ain’t nobody else going to.

As a final note, also recognize when an injury goes past your ability to deal with it. If it’s more than just a “twinge,” If it’s not getting better, or if it keeps flaring up despite your best efforts to adapt, it’s time to see a doctor.

What do you think? Am I the only one constantly dealing with aches, pains, and twinges? Have you found ways of working that have reduced your frequency of injury? Let’s talk about it in the comments!