Un-Couplings

Providing massages for married couples has always been a pleasure. I enjoy seeing the same people for massages and hearing from them how they are doing with life’s stresses – the kids, the business, the in-laws, whatever.

            

It’s always made business sense as well. I will do two instead of one massage at a house call, or in the office, and often couples like to have longer massages. I may head home from a couples massage having done three to four hours of massage in a single call.

            

Married folks often send referrals my way, so in general, it has always been a pleasant experience.

            

Mostly.

           

Here’s the bottom line:

When a couple is getting a divorce, which gets the massage therapist?

I had not realized I was part of the settlement issues as one of my couples wound round the full circle of life and gunned it to Splits Ville. I have seen these folks since 1996, almost my entire career. To say I have felt uncomfortable about this whole d-i-v-o-r-c-e thing is an understatement.

First, I had to deal with some bad news for my ego. Massaging together does not prevent divorce. It might even help people see more clearly that they need to make new life arrangements 

Second, I had to deal with the table talk. Listening, but not getting involved. Listening, but not taking sides. Listening, and trying to be sympathetic without asking any questions. Listening to very oddly un-alike versions of the same incidents and conversations. Do shrinks go through this?

Some of this process felt like being accidentally stuck in a coat-closet while a couple have a furious and hushed argument right outside the door. I cringed, I twisted, and I tried not to hear any of the intimate details

Happily, most couples I see for massage are not going to be breaking up very soon. They seem not only content, but bonded in a way that works for them as the years pass.

Oh, and she got me in the settlement. His nibs was embarking on a new path that apparently does not involve massage. Whew!

Vacation Massage Finders

Everybody else is going on vacation this weekend, so I took my vacation last week. This was a trip to the mountains, a friend’s cabin and a week spent looking at birdies and not doing massages.

          

But part of the fun of a vacation is trying to find a good massage, far off from home, without knowing much about the locals. I looked in the local tourist magazine, which listed a couple of day spas and a mobile service. I looked in the local phone book, this time a few more names and more private practice therapists.

           

Vacation massage for me is part fun-hunt/part market research. I want to see if I can find a good massage, in what venue, etc. Last vacation I had used the tourist magazine and lucked into a small place with a good therapist, although I felt bad for her as she was working in a tiny room that required leaning over the table.

Vacation before that, I had gone to the front desk of a hotel spa and asked for their best therapist. I got the newbie working in the worst room – and her touch was so good and her body mechanics so bad I ended up breaking the “fourth wall” and told her I do massage. We traded how-to tips on massage and had a great time.

            

This time I wasn’t feeling the vibe from the print ads. I looked on Yelp. These guys list reviews from customers, and they have tried to make the system harder to post fake reviews, so there is some expectation that you may get a more honest opinion about a service or place.

            

This time Yelp told me where not to go. Pretty much everything in this mountain community got horrible reviews: pricey, low-quality, inept. Except for one place, with half-decent comments, so there I went.

            

Well, it was a salon. I tend to avoid salon massage, having had a long trail of so-so massages at salons. But I reminded myself that I had a part-time job at a salon when a massage student. Everyone starts somewhere. Plus, in some communities, salons are the best option for massage.

            

I called and talked to the owner, and told her I wanted a firm, therapeutic massage from a knowledgeable therapist. Might as well cut to the chase.

            

I did enjoy a great massage - from a therapist who is just starting out. She definitely knew how to find and treat knots, and at some point in the massage I drifted off into zone-out land. I promised her a good yelp.

           

What did I learn? As a stranger in a strange place, the “electronic shingle” helped me more than asking around or trying to judge a place by the size of their print ad. Something to think about.

Supporting Pregnancy with Massage Therapy

Find Touch would like to present a guest writer, Carole Osborne. Carole is a renowned author and leader in the world of massage therapy. She has pioneered the reintroduction of therapeutic massage and bodywork to healthcare for the childbearing year. 

Supporting Pregnancy with Massage Therapy

Nurturing touch during pregnancy, labor, and the postpartum period is not a new concept. Cultural and anthropological studies reveal that massage and movement during the childbearing experience was and continues to be a prominent part of many cultures’ healthcare.1 Studies indicate that most of the more peaceful cultures use touch prominently during pregnancy and early childhood.2 Midwives, who for centuries have provided maternity care, have highly developed hands-on skills.

Current research on the benefits of touch is providing a contemporary basis for its reintroduction in many technological societies, including the United States. Scientists have found that rats restricted from cutaneous self-stimulation had poorly developed placentas and 50% less mammary gland development. Their litters were often ill, stillborn, or died shortly after birth due to poor mothering skills.3 Pregnant women massaged twice weekly for 5 weeks experienced less anxiety, leg and back pain. They reported better sleep and improved moods, and their labors had fewer complications, including less premature births.4  Studies show that when women received nurturing touch during later pregnancy they touch their babies more frequently and lovingly.5  During labor the presence of a doula, a woman providing physical and emotional support, including extensive touching and massage, reduces the length of labor and number of complications, interventions, medications, and Cesareans.6

Why Prenatal Massage Therapy?

Profound local and systemic changes in a woman's physiology occur as a result of conception and the process of labor. Changes during pregnancy span the psychological, physiological, spiritual, and social realms. Massage therapy may help a woman approach her due date with less anxiety, as well as less physical discomfort.⁷

A typical session performed by a therapist specializing in pre- and perinatal massage therapy can address pregnancy’s various physical challenges: postural changes, pain in the lower back, pelvis, or hips, and edema. Touch during pregnancy may facilitate gestation by supporting cardiac function, placental and mammary development, and increasing cellular respiration.⁸ It also may reduce depression and stress by contributing to sympathetic nervous system sedation. 9 Deep tissue, trigger point, and both active and passive movements alleviate stress on weight-bearing joints and myofascial structures, especially the sacroiliac and lumbosacral joints, lumbar spine, hips, and pelvic musculature.10 Structural balancing and postural reeducation reduce neck and back pain caused by improper posture and strain to the uterine ligaments. Prenatal massage therapy also may facilitate ease of labor by preparing the muscles for release and support during childbirth.¹¹

Beyond these physical effects, an effective prenatal massage therapy session provides emotional support. In the safe care of a focused, nurturing therapist, many women unburden their worries, fears, and other anxieties about childbearing. Bodywork may help the mother-to-be develop the sensory awareness necessary to birth more comfortably and actively. Laboring women whose partners learned and provided basic massage strokes to their backs and legs had shorter, less complicated labors. 87% of these massaged women were more satisfied with their partners’ support during labor.12  Imagine the benefits generated by the skilled hands of a trained touch specialist!

The Postpartum Period

Beginning with the baby’s birth, a new mother must cope with more changes. She is typically only 10 to 12 pounds lighter, yet she is still maintaining her body with an anterior weight load posture. Additional musculoskeletal stresses occur during the many hours of feeding, carrying and other newborn care. The massage practitioner may facilitate proprioceptive reprogramming to gently return the body to its pre-pregnancy state, to alleviate pain, and to bring about a renewed sense of body and self.¹³

Postpartum sessions often focus on relaxation, physiological recovery and pain relief. Longer- term care may normalize pelvic position and re-pattern overall body use. Postpartum massage sessions may restore functional muscle use in the lumbar spine area¹⁴, as well as strengthen and increase tonus in the abdominal musculature stretched and separated by pregnancy. Additionally, the overtaxed, hypotoned iliopsoas muscle functions can be improved. Upper back muscles which now support larger breasts and the carried infant’s weight need attention to reduce strain, and to help maintain flexibility despite the physical stresses of infant feeding and care.

For post-Cesarean mothers, specific therapeutic techniques also can reduce scar tissue formation and facilitate the healing of the incision and related soft tissue areas, as well as support the somato-emotional integration of her childbearing experience.¹⁵

Qualified Pre- & Perinatal Massage Therapists

While approximately three quarters of pregnancies proceed normally and are uncomplicated by medical conditions¹⁶, it is still advisable for massage therapists to be knowledgeable about pre- and perinatal physiology, high risk factors, and complications of pregnancy. Even without problems developing, physiological changes necessitate modifications to or elimination of various techniques and methodologies, depending on the individual and the trimester of pregnancy. When medical conditions develop, additional adaptations and consultation with physicians and/or midwives prior to sessions is prudent. Additional specific specialized training in prenatal and perinatal massage therapy helps to qualify massage therapists to safely and effectively meet women’s many and complex needs.

Somatic practitioners will find reliable, detailed, research- based protocols and contraindications in the second edition of Pre- and Perinatal Massage Therapy, and in other media and training programs created by this author. For those seeking comprehensive hands-on training and certification as a maternity massage specialist, practitioners should consider enrolling in the upcoming 32-hour technique certification workshop.

This book and these training programs have developed from over 37 years as a somatic practitioner and educator and 30 years of specialization in maternity and infant massage. Students benefit from a continually expanding body of knowledge, research, clinical experience, and consultations with other perinatal health care providers.

The highly qualified instructors of Pre- and Perinatal Massage Therapy offer a safe and comprehensive approach to pregnancy, labor, and postpartum massage therapy. They also encourage an empathetic, non-judgmental attitude in supporting women's 'pregnant feelings’. These certification workshops include over 80 techniques specifically adapted for pre- and perinatal needs, and the practical marketing strategies, ethics, and skills to elicit collaboration with other perinatal specialists and to build a successful pre- and perinatal massage therapy practice.

These courses are approved by the National Certification Board for Therapeutic Massage and Bodywork (32 continuing education credits). Each workshops and staff is also approved by the Florida Board of Massage (and other local state boards as required) and the California Board of Registered Nursing; meet current American Massage Therapy Association continuing education standards; can be used for Associated Bodywork and Massage Professionals membership; and can be used for continuing education credit with Doulas of North America.

Skilled, nurturing touch is good for moms and their babies, and for the family of humanity. As complementary healthcare research expands, more data validate improved outcomes from maternity massage therapy. With over 4 million American women pregnant annually, this is a viable and satisfying niche market for therapeutic massage and bodywork practitioners to pursue.

Author:

Carole Osborne has been a somatic practitioner since 1974, specializing in maternity care since 1980. In addition to private practice, she has worked in osteopathic, psychological, and women’s medical settings. She is author of Deep Tissue Sculpting, Pre- and Perinatal Massage Therapy, 2^nd edition and is a widely sought-after continuing education provider. In 2008, the AMTA Council of Schools presented Carole with the National Teacher of the Year Award, a high point of her 37 years as a somatic arts and sciences educator. She is also a contributor to Teaching Massage and many massage therapy publications.

To order a book or to learn more about workshops, contact the local sponsor for Portland, East West College at 503-233-6500 or www.eastwestcollegecom , or for Seattle, Simkin Center for Allied Birth Vocations 425-602-3361 or www.bastyr.edu/continunged.

Call Carole at Body Therapy Associates - (800) 586-8322 or (858) 277-8827.

Website: www.bodytherapyassociates.com.

Facebook page: Carole Osborne’s Prenatal and Deep Tissue Massage Training

###

[photos available upon request.]

References:

1    Goldsmith, J. Childbirth Wisdom. New York: Congdon and Weed, 1984.

2    Prescott, J.  Prevention or Therapy and the Politics of Trust: Inspiring a New Human Agenda. Psychotherapy and Politics International 2005;3:194-221. DOI:10,1002/ppi.6. http:..www.violence.de/Prescott/politics-trust.pdf. Accessed 2/6/2009.

3    Rosenblatt, J.S. and D.S. Lehrman. Maternal behavior of the laboratory rat. Maternal Behavior in Mammals, Wiley, New York, 1963, p. 14.  

4       Field, T., M. Hernandez-Reif, S. Hart, et al. Pregnant women benefit from massage therapy. J. Psychosomatic Obstetrics and Gynecology, 20(1), March, 1999, 31-38.

5       Rubin, R. Maternal Touch. Nurs Outlook, 11/1963,  828-31

6       Klaus, K, Kennell, J., Klaus, P. The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth. New York: DeCapo Press, 2002.

7        Field T. Diego MA, Hernandez-Reid M, et al. Massage therapy effects on depressed pregnant women. J Psychos Obstet Gynecol 2004;25:115-122.

8       Roth LL, Rosenblatt JS. Mammary glands of pregnant rats: development stimulated by licking. Science 1996; 264:1403-1404.

9       Field, 2004.

10   Pryde M. Effectiveness of massage therapy for subacute low-back pain. A randomized controlled trial. Can Med Assoc J 2000;162(13):1815-1820.

11    Bodner-Adler B, Bodner K, Mayerhofer, K. Perineal massage during pregnancy in primiparous women. Int J Gynecol Obstet 2002.

12   Chang M, Wang S, Chen C. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J Adv Nurs, 2002 Apr; 38 (1):68-73.

13   Pirie A and Herman H. How to Raise Children Without Breaking Your Back. Second edition. W. Somerville, MA: Ibis Publications, 2003.

14   Quebec Task Force on Spinal Disorders. Scientific approach to the assessment and management of activity-related spinal disorders.  Spine, 12:Supplement 1, 1987.

15   Andrade C-K and Clifford P. Outcome-Based Massage: From Evidence to Practice. Second Edition. Baltimore: Lippincott, Williams and Wilkins, 2008.

16   Ricci S. Essentials of Maternity, Newborn and Women’s Health Nursing. 2^nd Ed. Baltimore: Lippincott Williams & Wilkins, 2009.

Spinal Massage

When I first learned massage, touching the spine was a no-go. We were learning Swedish and body mechanics, using long sweeping effleurages with neural glide returns. Those bumps in the center of the back were a no-hand zone.

As we filled in the air spaces between our ears with practice and more practice, the “danger” zones were opened up. Miracle of miracles, we could actually touch the spine, rub it, knead it, run up and down its lamina grooves looking for knots and twisted vertebra. Not only would that not kill people, it made them much better faster.

I have here and there taken a good spine class, such as Erik Dalton’s Myoskeletal Alignment, and my respect and fascination for the spinal massage has grown. There is a tapping massage for the spine, a lymphatic spinal massage, a Thai yogic spinal massage, etc.

Admittedly, I have a secret. When I was clunking around in my overshoes as a newbie therapist, I could not shake the idea that the spine had a lot to do with energy and fatigue. My first few massages for fibromyalgia and chronic fatigue syndrome clients, I felt the need to pump up my spine skills. A good bit of what seemed stuck in these people seemed to go on at the spine.

But I had a sectional knowledge of the spine. Segments, dermatomes, myotomes, etc, but not a full-length spinal massage that I felt integrated all of the areas and balanced them. Thus my secret.

Looking for a full-length spinal massage I could use for total integration, I found a little book about massage for serious systemic diseases – based on hypnotic readings by Edgar Cayce. Yes, the fellow who would sleep and read people’s illnesses, recommend treatments and predict the future.

Cayce had a lot to say about massage for serious disease. He did so many intuitive readings over several decades that the techniques were collected in a book, “Edgar Cayce’s Massage Hydrotherapy & Healing Oils.”

The massages described therein tend to be small, gentle circles either side of the spine in directions to increase or decrease energy to different organs and zones. One is a massage from the brain to spine to the plexuses, a massage I find very helpful for chronic pain. Another draws with circle massage from the plexuses up the spine.

The styles of massage are food for thought, and quite handy when I feel a spinal massage is in order. Another way to see and heal the body.

Authored by Sue Peterson

Boot Camp

Super workouts like boot camp or “insane” sessions are all the rage, and I must say they have been great for the massage therapy business. Not so great for some people taking the workouts, of course, but great for the schedule book.

           

I have seen more rotator problems in the past few weeks, as people’s dedicated workouts have borne fruit. The big problems: rotator cuffs and lateral rotators. These are the little muscles who are supposed to be helping with aim and alignment and have unfortunately become the front line muscles in the insane workouts.

These little Napoleon’s  like to do it all – and my personal theory is that for people who are bound and determined to do these camp sessions, they are the first muscles to go over the falls in a barrel, so to speak. Mangling metaphors!

One nice lady had lost 15 pounds and found her thumb and forefinger tingling and numb. On both hands. Her workout included dead lifts, not something a 50-something should do without an ambulance nearby.

I’ve never been one to automatically think it is C6, as my friend therapists like to tell me, so I went hunting for the muscles. Right in the middle of the sideline massage, there they were. Both tereses and the infraspinatus felt like granite. The lazy lats were clear. After a good bit of gentle massage that included the serrate, her tingles had cleared out.

My other client example is a fellow who came in looking like he had never missed lifting a heavy barbell, kind of like some of us folks never miss a meal. Until he came in my theory that the boot camps were only frying us couch potatoes. Oh heck no.

These scalenes were down and out in Orange County. Oh my. They eventually relaxed and started to feel like muscles again. Thank heaven for trigger point massage. His big beef, though, was a definite sciatic-like pain in the glutes. Not true sciatic (has anyone ever seen one?) but referral from the over-powered quadratus lumborums.

So are all these workouts bad for people? I don’t think they are bad for everyone, just the unprepared. Folks always want to go for a challenge. To make up with intensity what they have lacked in habit. Just like all of us, I suppose, they expect any bad stuff to peel off in one massage, too.

Plus, I don’t see everyone who has been to booty camp, just the wounded. For some people, the ever-faithful rotators will try to do all the work the lats and glutes should be doing.

Instead of boot camp, perhaps it should be called the Massage Therapists Full Employment Camp.

Crickets and Desert Breezes

I have been blessed with a nice quiet office for massage therapy. My building has lots of mature trees in the yard, pleasant birdies and a very quiet accountant on the other side of my treatment room wall.

           

It has made me forget the days when people chattered right outside my room, clanged the pool gate or held aerobics classes next door.

            

Yup, I got spoiled.

So I have a new neighbor, a very nice and very smart chiropractor. He works fairly quietly, but in my office building, like many small office settings, the entire building shares a drop ceiling with ambient space above. Noise-conducting ambient space.

            

His office contractor put up some sound board on the window sill between out two rooms, and added some heft to the ceiling tiles. Yet there is still some pretty audible chatter that seems to float down from the ceiling now and then.

            

And there’s my eclectic schedule of interesting people. Joy of joys, last week one of my clients made a breakthrough with her neck pain. Her breakthrough involved yelling at the person who hit her car and progressed to telling off her father.

           

I hoped the chiropractor was not in his office. In the middle of the day. In the middle of the week. Uh-huh.

            

Well, this is the age of research. About 10 years ago was the last time I dealt with ambient noise problems in the massage room. We used a little fountain that provided enough trickle noise to mask little annoying noises. For very sensitive clients, I added a little sound machine that had birdsongs, crickets or ocean waves.

We were thinking of moving from our poolside room into the hotel. Then I was looking at ways to reduce the sound of giant washing machines coming through the floor from the hotel’s laundry. These machines would start slow, and build up a good whine like jet engines.

            

The hotel’s manager suggested I look at some sound solutions. I found some folks who were selling a drywall embedded with a liquid membrane to stop sound. They also had an acoustic caulk, outlet putty and fabric covers for the ceilings. For about the price of the space shuttle. One way.

            

We stayed in our poolside building, where the noise amounted to racquets hitting tennis balls, the occasional splash and crickets or trickling water.

            

Sound science has changed. Now companies need people to focus and concentrate on their work in a quiet environment. No more noisy cubicles that allow the boss an easy way to watch the drones. I found several companies providing fabric-covered walls, wall sculptures, special tiles and more. One even has acoustical paint! A lot of these solutions required construction, so I nixed them off the list.

Then I found a sub-specialty called “speech privacy.” This, it turns out, is exactly what I needed. A lot of medical care these days is provided in small exam rooms in big clinics. People can hear people through the walls, and even though they may not be able to hear everything, ambient voices can keep people from telling the doctor what is going on. Add to that HIPAA, the patient privacy act, requires people not be exposed to situations where they might be overheard.

On the advice of one of these sound companies, I’m investing in a $50 “white” noise machine. No more crickets.