March 29, 2012

Muscle Relaxers after Massage

 Lots of massage therapists recommend use of Epsom salt soaks after massage, and I’m one of them. Trouble is I felt bad when older clients confessed the last thing they would do is “slip” into the tub.

I did a bit of research (read the package) and it turns out that while Epsom salt soaks are great. Epsom compresses work just as well. I now recommend compresses or simply soaking feet in a pan of Epsom soak.

It was Eureka time when I saw an Epsom salt lotion at the drugstore. It seemed fairly reasonable, $10 for eight ounces. As I usually do, I experimented on myself and my own family and I was soon recommending it to clients who wanted Epsom without the soak.

In all this, I wondered, just what does Epsom salt do? I asked one of my clients, a biochemist, and got this answer. Epsom salts are magnesium sulfate, a type of salt that contains magnesium, a natural muscle relaxer and regulator, and sulfate, another chemical that reduces inflammation. Just as calcium helps muscles contract, magnesium helps muscles relax. The magnesium and sulfate are probably very important as well because both tend to be missing from processed foods.

That’s a pretty interesting pedigree, and helps explain why I love my Epsom soaks. The salts can be taken by mouth, but when you do you will find out why most people won’t go near Epsom-ed water: It has a volcanic laxative effect. As in gangway, coming though!

I’ve seen some stuff on the internet about other kinds of magnesium, such as chloride, carbonate, taurate, etc., but those tend to get into the oral supplement area, which I like to steer clear of. Epsom salts and magnesium chloride sprays are fairly inexpensive when compared to other topicals.

I would love to hear from other massage therapists’ thoughts and experiences with Epsom salt, magnesiums or other topicals.

March 20, 2012

The Original Sheets

Those pesky on-line reviews came in handy last week when I tried to order new sets of sheets. The picture on the website looked like the flannel sheets I had come to like, but the reviews told a different story.

‘I ordered these sheets because I had bought them before and liked them. But the sheets that arrived were made of a different material and don’t wash very well.’

That review kind of cooked it for me. I was more than happy to purchase great flannels at a fair price, not get third-tier stuff that cost the same as premium.

I popped off to another, more pricey site, knowing I would likely get my preferred sheets. The irony set in later, as I pondered what seems to happen a lot in the marketplace for goods – and services. Are you getting what you pay for? Yeppers peppers, that question does come up when providing massage.

Am I providing what people have paid for? Are we massage therapists providing what people have paid for? Is it premium service or just-so? What are people getting for their money?

Massaging people all day can be what you make of it, and I like to make it interesting. I’m always looking at intakes and asking people what’s the goal for today – relax, unstick something, relieve pain, whatever. It’s always fun when they say all three.

In the marketplace, people know what they want and tend to vote with their feet when they don’t get it. And in the electronic marketplace, they will let the next customer know.

A lesson learned from sheets and clients.

Authored by Susan Peterson, CAMTC, NCTMB

March 13, 2012

Take a Breather

Sometimes I get a client who “can’t fog up a mirror.” No, not dead, this client just had no visible signs of breathing.

Her presentation was odd stiffness on the right side of the spine at T-3, not pain, but not feeling right. I was thinking some sort of paraesthesia. She uses her right arm and side a lot at work, and has what a lot of us therapists would call “Type A” personality.

And as she talked, I could hear her. But shuckers, I could not detect her taking a breath. In or out. Nada.

I also noticed her chest looked very tight, with her sternum and shoulders looking relatively large and her posture too perfect. I thought about the “Charles Atlas” or “military posture” in which people have too erect a posture and hyper-inflated chests. A classic form of a person in a hurry with a lot of responsibility and a sense of loss of control. Hmmn. That is modern life, isn’t it?

Hey, whatever I observe, the massage tells the story. This lady had severe knots in the anterior serratus, traps, thoracic erectors and stabilizers. And a heck of a time breathing,

After a warm-up massage, I decided to try for a breath. Prone, with the shoulder supported by a thick towel, I rotated the arm onto the low back and applied medium pressure with my ulna to the T-3 zone next to the spine.

And I waited. How long? 15 seconds? A minute? With no overt response. It seemed as though her entire body took a pause. Then the belly expanded, her thoracic spine began to soften. With the arm rotated behind her, the SCMs, serrati and traps couldn’t provide their usual forced inspiration. We have diaphragm!

As these things often do, the story poured out. She had been working a lot and she had a bad blood test. She had several expensive scans and a biopsy, stretching over two months, before the doctors figured it out. It was an unusual auto-immune disorder, with no choice of drug except steroids.

With all that stress, her breath had gotten “tight” and simply would not calm down. When she came out of my therapy room, the “football shoulders” were gone. She looked pretty relaxed.

By Susan Peterson, CAMTC, NCTMB 

March 8, 2012

K-not k-not

K-not, K-not!
Who’s there?
Ok, it is a set-up for a silly joke, but the k-nots I see every day in my massage practice have always fascinated me.

Some seem to have layers, sizzling through separate muscles, fascias and actions, seeming to head into the center of the person. Some have hot points like the top of a stove. I swear some have emotions, usually sad or angry. (I have not seen happy emotions stuck in a knot, ever.) Cold knots give me the chills. Some knots prompt giggles or outright laughter. Some knots are “transporters” sending people back in time.

I often see repeat clients, giving me some opportunities to compare my impressions of the knots with the stories that emerge with therapeutic time.

These observations are very empirical, of course, coming from a thumbs-length investigation of knots over the years. I wonder if other massage therapists have experienced this and have a different take on these themes.

Thus I propose my k-notastic cannon.

Hot knots: I associate these with recent injury, such as inflammation in the wake of an accident or whiplash. The heat seems to emanate from the tissues which have been overstretched or locked-down.

Cold knots: These seem to represent really old injuries that have been sitting in the tissues for a long time, such as whiplashes or other traumas. Sometimes the cold knots in the hips and lumbar areas are from old back spasms or injuries that have caused the muscles to have less function or blood flow. Basically these are “frozen” muscles.

Emotion knots pop up now and then and give me an impression that comes up through my thumb or olecranon of the feeling that went with them when they were made. I’m always curious what the client is feeling, but I have always had a sense that they need to tell me what they feel without prompting. Usually I feel a negative emotion, such as frustration or anger. Here and there a giggle or laugh pops up, but these don’t seem to be actually funny, but nervous.

The “transporter” knot was one I had heard about occasionally from other therapists but never experienced personally. I have had clients pop up with spontaneous stories while I am doing trigger point therapy, but I was never sure about the “transporter” effect.

Then I took a class in which the instructor showed us a fun way to get to the posterior scalenes. I was one of the test bodies. At the moment my table partner touched that spot, I went back in time, not to the events, but to the feelings when I had been struck by a drunk driver in my brand-new car. My table partner hung in there while I turned three different shades and went through the time capsule. I felt all the anger, disgust and disappointment I felt then.

Yes, all this is pretty k-notty stuff. These are impressions, of course, not easily explainable to folks outside the field. On the occasions when I talk with other therapists about these experiences, it is something we nod about because we know of what we have felt.

March 6, 2012

Why we do what we do

There are many reasons why I decided to become a massage therapist. In many ways I’ve been a body wor
ker since I was quite young, exchanging back rubs with my younger brother, and training him to walk on my back, until he was much too big and unwieldy for it. When I first sought a more “traditional” path, University and a career in business, the stress led me to a regular schedule with professional licensed massage. Soon, I found myself dreaming of a daily life with ambient light and soft music, all as a backdrop to helping people feel better and leaving me happier than when they arrived.

Over the years since realizing that goal, I’ve had many opportunities to enjoy the Truth of that choice. At l
east weekly, and more often daily, I am privileged to have an interaction with a client who had no idea that they could feel better, who stands a little straighter and moves a little freer than an hour ago. There is joy in helping a new athlete achieve their goal to run their first marathon, or to assist a new parent in being able to lift their child without pain. Occasionally, though, there is an experience that seems to run deeper, into depths that only the clients know, and rarely share.

Muscles have memory, not only for the patters of physical activity we engage in, but also for the stressors and emotions that we quite literally *internalize*. Sometimes, when the physical tension from stress is released a client will have an equal release internally of the emotions related to it.

This had happened on occasion throughout my career, and had always been an opportunity to practice empathy and respect, preserving boundaries of professionalism and comfort, giving space for the client to have their experience without unwanted interference. Sometimes, I would be a sounding board to what was coming up, offering sympathy without judgment.

Then there was the day when I met Consuelo (not her real name), who was brought to see me by her son, to receive her first ever professional massage. Consuelo had taken a hard fall, cracked her patella, and suffered severe whiplash, but had no insurance to pay for treatment. In her mid 70s, she shuffled in, obviously in pain. She spoke very little English, but had been instructed by her son, a previous client of mine, as to what to expect. He gave me an overview of her condition, which she confirmed by pointing to areas of discomfort.

The truly amazing part came later, when she was on the warm table and started to relax. She responded tentatively at first, not sure how to react. Then, as she started to feel better, breathe more deeply, and her muscles began to unwind she began what became her mantra for the rest of the hour.

“Thank you, ma’am. Thank you, ma’am. Oh, thank you, ma’am!”

The intensity with which this statement was delivered really struck me. The pure gratitude and simple appreciation came through so clearly that it brought me the impression of someone who had done so much for others (as exemplified by her loving son waiting in the lobby) and very little to take care of herself. I started to tear up at the thought, all the while grinning to myself and replying to her in soft tones of reassurance.

When I began to work on her hands, I came to a spot where one of her fingers was twisted due to an older injury. Immediately her head popped up from the table. “First husband, in Philippines,” she said, “bad man, twist back! I left!!” This was nearly shouted.

“Sounds like you did what you had to do. Good job.” Was my reply.

Something about Consuelo’s openness, her vulnerability, and her courage really struck me. I haven’t seen her since, but for that one day she and I were Very Good Friends. After we were finished, she dressed, and we had a brief outtake discussion, we walked together out to where her son was waiting. She had impulsively hugged my waist as we walked, and did not let go. She told her son I was “magickal” and “beautiful” and I told him that it was the other way around. His mother was amazing. He had to agree.

I smiled about Consuelo for days after that, renewed in my resolve that I am in the right profession.

Written by Melissa Holm, LMP at Dreamclinic, Inc.

March 1, 2012

From Stuck to Unstuck

Massage therapists often meet people who are stuck – stuck shoulders, stuck vertebrae, stuck glutes.

And we see the pathology that stuck creates – abnormal gaits, painful bending, leaning torsos, migraines, etc. There’s nothing more satisfying for a massage therapist than to get the stuck out and restore normal function to muscles, joints and ultimately, the entire person.

I have come up with my “Stuck Hall of Fame,” a bit of nostalgia for me. I offer it as a memory jog for other therapists out there in to think of their own mondo-stuck folks and how rewarding it was to help people back into wellness.

My big Stucks:

The young mom who worked her way through college delivering the morning paper. She would start at 3 a.m. folding the papers and then drove around tossing newspapers out the window of her subcompact. Her right serratus anterior felt like half of a softball stuck to the ribcage.
The businessman who decided to play poker with a certain well-known and ruthless local developer. He won, but his middle scalenes lost. His symptoms: pain radiating from the neck and head down into the rib cage and shoulder.
This lady worked out a lot and enjoyed a wonderful Hawaiian vacation – cliff-diving for most of a day. It wasn’t the first dive that got her. Maybe the 50th? She had lost track, but her traps and levator scapula were holding onto that last dive. It was not a fun plane ride back to the mainland.
A woman who had good-sportingly gone on the company’s team-building retreat. Hey, that shoulder had not moved more than a few inches in years. Then two of her teammates grabbed her arms to help her over the wall on the obstacle course. Gung-ho! The next day, after sleeping in a tent, her subscapularis had cemented itself to her ribs.
I find it most rewarding to get these stuck spots to breathe again and rejoin the rest of the body. The power of touch and massage is wonderful. Don’t you think?