September 23, 2013

Bright Lights, Big Spin

A new massage client had a history of vertigo and migraines. After about $20,000 worth of tests, she had been diagnosed with post-viral balance disorder and sent to a balance clinic. Her therapy was consistent: Flashing lights, juggling balls and teeter-totter devices.

She kept mentioning how the migraines and vertigo got much worse during each session.

By the time she came in, her vertigo approximated the deck of a rolling ship. The migraines were overwhelming and she had not slept for more than three hours a night. When she did sleep, it was on a mound of pillows to keep the vertigo down.

“I’m getting worse!”

Hey, I offered, the important thing is that all the scary things had been checked and ruled out (there’s a big scary list that goes with vertigo and migraines, stuff such as brain tumors and multiple sclerosis,) info I did not share.

I went right for her history. Any car accidents? Yes, a big one 8 years ago with lots of whiplash and torsion. No soft tissue therapy. The fractures took priority.

Ok. Let’s give this a try.

I put the lower half of the massage table down two notches, and she was able to get on the table supine. I went after the anterior trapezial “nausea points” and the headaches points in the ligamentum nuchae. Her vertigo retreated, as did the migraines. Encouraged, I also massaged the masseter and infra-hyoids.

“I think we may be on to something,” I said.

September 19, 2013

Picture This

Massage therapists undergoing postural correction or structural integration often take pictures to show themselves their “befores” and “afters.”

I have been tempted to try this with clients, but on the occasions it has seemed right, the clients seemed apprehensive.

“You want to take my picture?” Sounding pretty doubtful, especially early in the therapeutic relationship, about having a photo done.

With so much online media, I thought this question would get easier to fly. Not quite.

With a recent client who had severe gait, lumbar and foot distortions, but seemed totally unaware of them other than the pain they caused, I suggested she have her husband take a cell phone video (on her cell phone) of her walking. Just so she could see why we were working on some areas and to make the tai chi walking exercises seem more worthwhile.

Trying a video at home was more comfortable for her; although she disliked seeing herself try to walk so much she erased it right away.

Tough stuff, I told her, but helpful in seeing how much the altered gait and injuries were affecting her energy.

When we are done, I told her, I bet you will like your walking pictures much better.

September 13, 2013

Core Strength and Armor

When we speak of “core strength” do we all mean the same thing? I recently experienced a very different version with a client.

Core strength is a current buzzword, with therapists and trainers giving tips on how to develop core, keep core, activate core, etc. as a panacea for injuries and prevention.

I recently read Erik Dalton’s most recent explanation of different cores and massage, with “medium core” as splinting in the quadratus lumborem and obliques to shore up lack of spinal muscular core.

I’ve also been in those martial arts classes when they instruct students to make their surface areas “hard” (external core!) to deflect the blows of others.

My experience with a client recently was a bit different “core” in terms of protecting oneself from assault. This client has been dealing with a very difficult time in life. Her mother has to be in a nursing home because she can no longer keep track of her meals and medications, along with dementia and a terminal illness.

The family first tried to care for her themselves, and then brought in elder helpers, but those solutions did not work.

Now mother is in a home, she has been scheming day and night to find a way to get out, including engineering her escape through a naïve relative.

The bottom line here is that mother has always gotten her way, no matter what, and the penalties for not going along are very, very high. While the positive side of that energy is that mother always got things done, the icky side is that a lot of mean things come out of her mouth when she does not get her way, and the abuse escalates until she wins.

This client prepared herself, rehearsing in the mirror and coming up with answers to her mom’s presumed objections ahead of time.

The next time Mom started to protest her living situation, she was ready.

“I really am trying my best to make sure you are well-cared for, and when you say mean things it stabs me right in the heart,” she told her.

Did it help? “I feel a lot better that I was finally able to say something,” my client said.

The affected muscles?

I massaged her masseter and other jaw muscles, rubbed her tummy to restore diaphragm breathing and also worked with the thoracic spine to release the erectors and neural supply to the diaphragm.

She felt better to the core. But was it core? Or a girding of the loins?

September 4, 2013

Save Your Hands

Hands are the best tools in a massage therapist’s toolbox and the most likely to be injured.

It happens to even the most careful therapists: a burn from a hot pan, a scratch that gets oily, a bit of tendonitis that turns into a raging case of nerve inflammation.

Plan A for most therapists is don’t do stuff that can hurt your hands. Hopefully we learned these things in school:

No unsupported thumb work, glide with the whole hand, wrist straight when using pressure. Push with the entire body from the feet, not the shoulders, neck or back. Avoid radial and ulnar deviation during effleurages.

Prudence in off-hours helps, too. No ATV riding, no mountain-biking, no rock-climbing, wear gloves while gardening, etc.

Plan B for many therapists is a few forced weeks off, with the resulting flat wallet. Few of us have disability benefits or the inclination to sit idle.

So there is a need for therapists to tap some resources from our wiser colleagues. Books are helpful, such as “Save Your Hands!” by Lauriann Greene et al.

Most conventions have one if not two classes in ergonomics for therapists, yoga for therapists, Tai Chi for therapists, etc.

I have enjoyed Val Guin’s classes and her DVD “Forearm Dance” that demonstrates the principles of working with a Tai Chi stance and avoiding use of the hands as much as possible.

One good self-audit for your work is to video yourself while performing basic massage moves. You will see when you lose form or go off track.

The resources are there for us to use before injury. Hopefully we can practice prevention and recovery as much as we preach it to clients….