Snow and Irony

Every week at the chiropractic clinic where I work, we have a clinic-wide meeting. And at one of these recent meetings, an interesting topic came up: What kind of plan did we have for snow days? Would the LMPs be willing to come in? Which ones? Would it be worth it even if many of the clients didn't show up? And as the group discussed the issue up one side and down the other, I sat and listened and thought to myself that if irony were an alternative universe, I was right smack dab in the middle of it.

Do you have any idea of how many clients I treat for whiplash every week? How many people out there are on PIP claims because some genius out there rear-ended them while texting? Well, if you're reading this, you're probably an LMP, and thus you know these facts intimately. And as a related question, do you remember Christmas week two years ago when it snowed bucket- loads in Seattle, and the city government failed to do just about anything to clear the damn roads, and the whole area was a death-trap because ice ruts combined with snow-stupid drivers does not a fairy tale ending make? I remember it well, and shudder every time I do (I lived near and worked at Northgate Mall, an icy holiday hell).

So when I was asked my opinion on the snow days plan, I said honestly that I thought we should be really careful on tackling bad roads when our clinic actively advocated physical health. I mean, after all, I've seen what wrecks do to the body, and I don't want to intentionally put myself in harm's way unless it's for a really, really good cause. I said I trusted my car--though I'd feel safer in a truck--but I trusted other drivers not at all. Not here. Maybe in Minnesota, but not here, especially after two years ago. And I am very emphatic that I am a hard worker and a tough woman, but I would question driving 40 minutes to do two massages that could most likely wait a day or two until the weather is safer.

And yet, I don't know. Ironic it may be, but if my job was in jeopardy, would I risk my neck (or a lifetime of neck issues) for a $25 massage? Two of them? Sometimes I think we have enough irony in our work. Many of us are gifted healers, yet we ourselves do not get the help we need. Mostly self-employed or workers in small businesses we often do not have health benefits, unless we have them through a spouse or purchase a major medical policy that is virtually useless unless we are lying at death's door. We care so much for clients that we are too exhausted to do regular trades on each other. Or we care so much for clients that all we want to do is get out and get home and clear our energy instead of staying and doing trades. Those of us who work for others rarely get to sit down and eat calmly for even 15 minutes between talking about after-care and flipping rooms.

And the list goes on and on. We are healers, and yet as creative and balanced as we work to be, help others work to be, it seems that our own healing always falls last. I don't know the answer to the problem--finances, employers, and the economy dictate choices we don't always want to make--but I know it's wrong. We preach what we preach for a good reason. Isn't the practice part of the equation supposed to be a virtue? Because if it isn't, I'd really like someone out there to provide me with some of those padded bar thingys that hold serious drivers in place... and a big ole truck, preferably with a winch.

Four In-Laws, Two Parents and One Wedding

We have minutes, centimeters, inches and cups and all kinds of ways of measuring things, but we massage therapists don’t have a great way to measure tension.

How tense is someone during final exams? What about IRS audits? Or a divorce?

It seems that if we can measure everything in life we should have some sort of gold standard for tension, especially in these days when the relative value scale of stress as expressed in soft tissue has reached new heights.

I hereby propose the FILTPOW, a measurement of muscular tension that I dedicate to a lovely client who actually has four in-laws, two parents and has just survived organizing a big wedding.

The FILTPOW measures the exact angle of stoop between T3 and C6, multiplied by the number of shallow breaths per hour and divided by the number of minutes it takes to get all the old folks to go potty and into the van and off to the church on time.

It can be lowered on the wedding day by a medicinal glass of wine at 7 a.m. or a primal scream in the safety of the ladies room, but is heightened by the arrival of the groom in a wheelbarrow.

Thus a 10-hour day reading budget lines on a computer screen would be the equivalent of .23 FILTPOWs while a trip to jail to bail out a spouse should be about 1.5 FILTPOWs. Having to post the house to make bail would raise the bar to 2.2 FILTPOWs.

Using the FILTPOW scale would help us in documenting our massages, and we can, like the folks at the earthquake tracking center, use a scale that out-Richter’s Richter.

True, some measurements such as the mile are quaint reminders of when we walked a lot and felt every step. In the modern world, a mile is a minute on the freeway, but a FILTPOW is a true measure of how much a vertebrate organism can take at family gatherings.
Well, I hope FILTPOWs catch on.

I’d like FILTPOWs to go the way of Smoots, a measurement of how many times it takes a group of friends to roll a drunken MIT freshman named Dick Smoot to get across the Mass Ave. Bridge. If memory serves, the distance was about 1538 Smoots. Thus history is made.

Word about Politics.. and Massage

It is surely obvious to most therapists in the massage world for more than five minutes that two subjects are never discussed or commented on during one’s precious break – and one of them is politics.

And I admit to being one of those massage therapists who manages to say “Mmmmm” if someone comes in all wound up because life as we know it will end Nov. 2, largely because as a group we are too stupid to get the “common sense” and “plain truth” of important matters.

It is important to think and vote, but not on the massage table. I’d much rather folks epiphanies be about the connection between use of the diaphragm and reducing neck pain, for instance, than some fear-wracked prediction of Armageddon and asteroids after the school board vote.

Indeed, this has been a fun season for folks to get all worked up about things. Times are tough, money is tight and usually busy people have more time to listen to talk radio.

One of my favorite clients, a fellow who spent the last 50 years of his life building things from the chaparral up, is convinced that we are driving over a cliff in flames. His voice not much muffled by the face cradle, he announced that all Americans should be learning a certain foreign language because that’s our new overseers will require us to speak when we serve them.

I felt that table shake, a sign to me surely that his blood pressure rose. He gave me a sample of the vocabulary he often used while building suburbs and cities. I was impressed at how he cleaned up some favorite expressions to be more suitable for mixed company, although I think we can all change the consonants in our heads without much trouble.

“What in tar-nation is going on with this country? We can’t do a darn thing right so let’s add some more things the government can royally buck up? People just don’t have any common sense!”

“Mmmmm,” I said.

Yes, it worked once again. He settled down, hopefully into a waking dream about huffing bellows and steel furnaces turning into cool mountain streams and crisp autumn air.

After his massage, I handed him a glass of water and broke my rule.

“When your Dad was the age you are now, what were his political views?”

“Heck, he thought Harry Truman was the Anti-Christ!’ he said “He did!”

“Mmmmm” we both said, in unison..

How Many Repetitions Are Enough?

Clients often ask me how many times they should be doing an exercise to build strength. Often they are coming from a more-is-better place - the gym - and they are confused.

I don’t always feel comfortable answering that question, either. How many repetitions of an exercise are fine may well depend on what the point of the exercise is – strength? size? flexibility? What about function? If the muscle is a core muscle, does that change the formula as opposed to those muscles we like to see flexing in the mirror?

And what do I, as a massage therapist, really know about exercise? Do I need a course in physical exercise to answer that question? What if I say something different or conflicting from what the trainer says?

I would like to know how other massage therapists handle this question.

Of course, in the meantime, I’ll give you an idea of how I handle that question. I touch people all day, and I get a feel for muscle health in terms of its aerobic state, lymph circulation, and flexibility. Over the years I have learned to trust my hands when they tell me something. I know that granular, adhesed muscles won’t stretch or exercise very well.

After some massages and stretching, they may be ready to perform. The nervous system, truly, is in charge. If the parasympathetic system is not engaged, change is not about to take place.

If that sounds like a massage therapist’s answer to another massage therapist, it is. And it’s way too complicated for clients. I usually go simple and easy.

I tell clients like to do three slow, pain-free repetitions. Three isn’t many, but I say three because everyone ignores the slow, pain-free parts. If those reps go okay, then I’ll do something else and then do another set of three. Three reps, three sets.

That is a lot less than the standard gym advice of three sets of fifteen, done in succession. It’s so way off from what most people are told that it does get their attention.

For me the bottom line is that muscles need to be relaxed and pain-free to exercise in a healthy way. If something is too tight or hurts to move, the body will protect it by substituting another muscle or group, or the muscle will be injured. Repetitions that feel good generally are going to help. Wobbly, strained, borderline-painful repetitions are going to make problems worse.

Sometimes the biggest change I can get from people is to stop instead of pushing through a pain. Shoving through pain only works if you are in the NFL. They have a good pension plan.

Cheeky Little Ligament!

Being my alter ego as I often am, Superwoman, I hate to admit I went "Wii!" -- and Wii!-ed myself right into a lot of pain.

Yes, there are lots of warnings on the box, and yes, I am not 16 anymore. But it was so much fun hitting fake homeruns and beating the girls at bowling, I didn’t stop, warm up, hydrate or anything else.

Next morning, I had some serious fun trying to do massages.

It felt like something between a groin pull, a hamstring pull and a possibly serious symptom of visceral disease in the pudendal area. The act of sitting down hurt. Sitting hurt. Standing hurt. It hurt to touch the gas pedal. It hurt to move my foot to the brake. It hurt to lie in bed. It hurt to toddle off to the bathroom. It DEFINITELY hurt to use my feet to push during a massage!

That night I spent a few hours soaking in Epsom salts, trying to treat myself. The groin was painful, but the adductor magnus, gracilis, and the hamstrings were at my “normal” length. The piriformis wasn’t sore, nor were the glutes or low back. Psoas had my normal range. Puzzled, I slathered Epsom lotion on the medial thigh for the overnight cure: eight hours of sleep.

Next day I was no better, if not a little worse. Lately my massage trading buddy and I had been too busy for our weekly trade. Now I begged for some table time.

My trading buddy, who thought my predicament moderately hilarious, had me go prone on the table. Some palpation of the sacrum, the hammies and pretty soon he had found where the pain lived. In the inside lower cheek, just above the leg and next to the gluteal fold. He gently pressed the area, and I felt the pain flood my groin.

“Aha! The sacrous-spinal ligament!” he said. “That recreates the pain!” I said.

After about 10 minutes of trying to remember the name of the muscle also possibly involved – go-gos, Gemmullus? Obturator? – we are both kind of old hands – he called it out – quadratus femoris!

“Forcible lateral rotation of the foot!” he said. Sounded like Wii bowling to me. Somehow when putting some extra English on one of those bowling ball deliveries I’d managed to nail the right foot into forcible external rotation – and I had missed guessing at the cause by a mile. It wasn’t a groin injury at all.

Later that evening, with some relief finally setting in, I checked the internet and found some interesting citations. First, I found a paper on surgical decompression of the ligament in a woman with a long history of intractable sciatica. Lo and behold, the sciatic nerve toodles right on by that the sacrous-spinal ligament and the quadratic femoris, and might just be really annoyed by sudden torsion or injury. Another citation fingered the ligament as a cause of pudendal pain in women. Another paper blamed the sacrous-spinal ligament as culprit in people who have symptoms of disc disease, but don’t have any findings upon X-ray.

As they say in professional wrestling, school was out. With 15 years beside the massage table, I had yet another epiphany about the body, it’s complicated anatomy and my own enthusiasm for winning at any cost. Yes, I too have Gung-Ho Disease.

Lessons learned:
1. Don’t expect to be able to spot the problem when treating yourself.
2. No slacking on the weekly massage schedule.
3. Leave the Wii! world championships to people who are less competitive and more flexible.

Walk, Walk, Walk

This morning when I was helping my friend Margaret move some furniture around her house, I almost stumbled over a pair of dusty aerobics steps. “Hey,” I said, “I think Leslie has some of these things, but hers are inclined, so you don’t really have to step up, just slightly up and out.” Margaret found this extremely amusing: “Leslie this, Leslie that, Leslie says . . . you’d think you guys were really close.” “Well we are,” I said stubbornly, but laughing along with her. “She told me this morning how glad she was that I took time for myself today.” Leslie, you see, is not actually a “friend” I know to talk too; in fact, she wouldn’t know me from Eve. Leslie is Leslie Sansone, and she and I walk together three or four times a week in my living room.

I really hated exercise growing up. Exercise was not fun. It was used as punishment (go run around outside: you read too much); as humiliation (middle school P.E.: anyone for a friendly game of War?); and most importantly as prevention for, GASP!, “getting fat” (go ride your bike or you’ll grow up and get fat and no one will want to take you to dances and such). Now that I’m older, I still see how much torture and guilt exercise generates for the normal person, and it makes me sick. And it literally makes some clients sick, especially when they get struck by guilt, and—being out-of-shape—overwork themselves in the gym. So generally, I’m big on recommending swimming because it’s such good movement with so much less stress on the joints, etc. And of course, water aerobics is just mad fun. The only part I personally hate about swimming is either having to have clothes to change into, or driving home in a damp swimsuit, especially in this climate.

I also love walking, but moving to Seattle fixed that for me. To be fair, walking in Arkansas can be miserable in the in the summer, but at least you have long evenings and a cool-down at dusk where walking can be enjoyable. But no matter what the season in Seattle, rain is rain, and here it’s cold rain to the bone and all kinds of lovely gray things to look at on your promenade. Still, I realized this summer that I needed to move my body for my body’s sake, so I needed to look for something that I could do that I could both enjoy and keep up with. Leslie Sansone’s Walk Away the Pounds book caught my eye, and even though I wanted to walk-in the health benefits more than the walk-away-the-pounds benefit, I fell in love with this six-week, journal-based, down-to-earth program and the normal, positive-but-not-freaky, non-anorexic, woman-next-door-type guru who invented it.

I bought my book at our local Fred Meyer, and although I could order dvds from Leslie’s http://www.walkathome.com/, I usually get them at about a third of the cost from discount dvd websites. Frankly, I don’t think Leslie would be hurt that I purchased my dvds from another seller; as weird as it sounds, I think she really means it when she says the important thing is to do something good for yourself and “just stay in motion.” She’s client -based, and so am I, so I think I trust her more than some of these other work-out girls. Here are a few other reasons I like the Leslie Sansone Walk At Home Program so much:

1. She looks like an attractive 40-something woman. Which she is. She does not look like a plastic surgeon’s fantasy project who secretly wants to look 20 again. In other words, “regular’ people can relate to her.

2. She talks like a normal person. She has her own unpasteurized dialect, and if she’s nearly choking on the word walk (how many times can you say it while walking without needing a serious drink of water?), she never shows it.

3. She’s encouraging, but not preachy. She seems honestly more centered on health than just weight.

4. She doesn’t try to be a diet idiot: she sticks to what she knows.

5. She doesn’t try to sell you a bunch of useless crap; have good shoes, can walk.

6. Her materials are true to their levels. Beginner is beginner and advanced is advanced.

7. She isn’t lying; not only did my heart perform better in testing after her program, but we did all my measurements before and after, and I did indeed lose an average of 2.25 inches all-around.

I now can add Leslie’s Walk At Home program to my exercise recommendation list, and I feel really good about that. I know that my clients cannot hurt themselves doing it, especially since she regularly tells walkers to “slow down at any time” because “as long as you stay in motion, you’re doing something good for your body.” My only complaint would be that I prefer her solo dvds to the ones where she walks with a group of people. Why? Because she talks to them a lot instead of talking only to me, and frankly, that makes me jealous. My Leslie. Maybe I am getting a little too attached? Oh, well. Daily exercise is finally fun, and I feel I owe a debt of gratitude :-)

Seven Secrets THEY Don’t Want You to Know

My client, a teacher-in-training, was astonished when her fellow students ignored her first practice teaching class.

Her collegial group huddled over their laptops, tracking a package on UPS, reading e-mails, even one was applying to a competing college’s credential program.

Her carefully crafted first lesson was treated like a slow fly on a hot day.

She was dumbfounded, to say the least. What would happen if they had to put up with that behavior during their own first turn around the track, she asked. Could they at least pretend to be interested? How would they like to be treated like Charlie Brown’s teacher?

I sympathize, I empathize. In my own massage practice I had run into clients who don’t listen, employees who hated the least little coaching.

Ever helpful, I volunteered an idea. You know that guy who makes people pay for the chance to find out how they can power up themselves personally? They get to walk on coals and find their true destiny? Perhaps what we need is that marketing hook for all lesson plans.

Should learning be packaged like soap, electronics and political opinions? Can a shouting commercial pitchman make people pay attention? Order now and I’ll double this offer!

Well, aren’t people supposed to multi-task these days? Sure, we all do. But her cognitive learning course was basically saying that if people can’t focus and listen they can not learn.

Perhaps a good hook is what they need. Instead of cognitive learning 201, try:

“Trick Your Students into Testing Well”

“Five Principles of Successful Vice Principals”

“Teach Algebra While you Text!”

“Get a Teaching Credential Just for Showing Up!”

Taken to its logical thread – yes I do have one - how about marketing hooks for those folks on our tables?

“Never Have a Headache Again!”

“Feel 20 Years Younger without Getting a Divorce!”

“Look to the Left without Pain!”

“Discover Your Personal Power Ranger Within!”


Well, it was good for a few laughs. Perhaps it might make a good e-book.