Good Hands Are Good News for Headaches

Massage is the best therapy for tension headaches and migraines, and more people should be hitting our tables instead of reaching for drugs or other remedies, says Boris Prilutsky, a massage instructor and researcher in Los Angeles.

This article is the third in a series of articles about headaches and therapies. The first article is here.

Stress is a main cause of tension headaches. In addition, most people spend hours working on computers -- in static postures that accumulate muscle tension in the upper thorax and cervicals.

“In most cases we are addressing tensions in the neck , upper back, and TMJ muscles, so we are not just treating the symptoms of headaches but the cause,” says Prilutsky, a massage therapist and researcher with 38 years. He is an NCTMB continuing education provider.

A client presenting for treatment of headaches needs to be assessed carefully, Prilutsky said. Watch out for potential symptoms of other illnesses such as fever, or a sudden intense onset with no prior history of headaches. Those people need a doctor’s evaluation for infections or other serious conditions before trying massage.

But most clients will present with well-documented and already diagnosed headaches, he says. He advises not to be too concerned about the type of headaches and focus rather on the precipitating factors, such as constant muscular higher resting tones or pathological muscular tensions at neck, upper back and TMJ regions. Sternocleidomastoid headaches, trapezial headaches, irritation of the vertebral artery, etc. can be tracked back to our ever-growing population of people who spend too much time staring at screens, clicking or typing. A history of whiplashes, contact sports, or constant stress increases the intensity and frequency of these headaches, he says.

Boris says massage reduces the upper body tension immediately reducing headache intensity or “completely eliminating headaches.”

“To sustain these results clients need about 12 to 15 treatments. Also it is important to note that people diagnosed with migraines often actually have tension headaches,” Prilutsky said.

With true classic migraines, massage can alleviate most symptoms by balancing the sympathetic and parasympathetic systems, which leads to a normalization of blood vessel dilation believed to create migraine pain.

For some fabulous techniques to ban headaches, check out Prilutsky’s videos. YouTube ranks his as the most-watched self-massage videos. Techniques include acupressure, lymphatic, Russian sports massage and Swedish styles in the treatment of headaches. For a sample of his videos for massage therapists, try: http://medicalmassage-ceu.com/CLASS/

Little Women and Gentle Men

When it comes to face-down offers on the table, I thought women therapists would have the best stories. Oooh my, I was mistaken.

Well, OK, the female therapist who told me she was propositioned by the rabbi was a good one. It was during one of those long holiday weeks and there was a religious group staying at the hotel where she worked. Rabbis are pretty busy blessing food and saying prayers and other things, and then they get a break after everybody checks out. The rabbi came in for a massage and asked her what the difference was between massaging one area versus another…i.e. down there versus the shoulders…..then he tried the old “who would know?” God knows, she answered. I must say her story, for lack of another word, left me in titters.

The diaper change got me too. This lady who looked like about 70 dropped off her husband, who was 90-something, and said “Keep him here as long as you want. I need a nap.”

When the therapist came into the room to start the massage she noticed he was wearing a diaper. Halfway through what she thought would be a 90-minute to two-hour massage, the gentleman asked for some help achieving Nirvana. She told him you can’t always get what you want, but sometimes you get what you need. Tee-hee.

Heck, perhaps not so dramatic, yet it happens to pretty much every therapist. Someone hints, asks, propositions or demands items not on the menu. So I bravely asked some of my male therapist friends for their proposition stories. I figure they must have a few good ones.

One fellow who worked at a gym had a massage room in the male locker room, alleviating the need for modesty from the clients. A client asked him what he did for fun, in a way that begged the answer.

“I drill,” he replied, and he did just that for an hour.

I was shocked. “You drilled him?”

“Yes. I pushed on every trigger point in his body at plus-ten pressure. Guy didn’t even breathe.”

“Oh. I thought you meant something else,” I said.

A male therapist who worked at a spa said he had a female client asking him to come to her house. He was too afraid to say yes, knowing he could get fired. After about her fifth visit he figured she could not be a pro shopper, and he said yes.

“When I went to her house, she opened the door and laughed when she saw I had my table,” he said. “I thought she actually wanted a massage!”

It is different for men, I guess.

Body Dysmorphia: Spa for a Cure

I'm not sure what the number one killer of women is--in terms of physical diseases--this week. But I certainly know one of the top emotional diseases that kills women slowly over their whole lives and goes largely unchecked: Body Dysmorphic Disorder. And most women have it, to some degree. What is Body Dysmorphic Disorder? Very simply, it means that you think there is something wrong--often terribly, personally, unforgivably wrong--about part or all of your physical body. And every failed attempt to make your body into something it is not or do something it simply does not want to do tends to make you feel that--unlike the woman on the front of Glamour or Vogue or even Shape magazine--you are a freak of nature. And it just keeps going downhill from there.

As a massage therapist, I see evidence of this disorder ALL THE TIME. Or rather, I hear it in the nasty things women say about themselves. I once heard a comedian say something to the effect of, "If someone else said to you the things you say about yourself, you would have no choice but to try to take his life." It's funny, but it rings rather true, yes? And although many women know consciously that most physical self-slander is unfounded and ridiculous, they still really want to to look like one of those girls in an ad for body butter.

So what to do about this nasty problem? We probably won't be able to boycott the people who set up ads for Victoria's Secret or write those silly Cosmo quizzes. So instead, I'd recommend the occasional visit to your local women's spa, which is not only incredibly enjoyable and good for your health, but reminds you what real women look like.

Seriously. I don't go to stare, but unless your blind, cross-eyed, or looking at the ceiling, you're going to notice some of your surroundings. And your surroundings are utterly, unashamedly naked. Women of all colors, ages, shapes, and sizes . . . and I do mean all. It sounds cliche, but you can never really believe the stories about magazines and air-brushing until you see a full range of naked women, none of whom are going to appear in any ads without a make-up, lighting, clothing, and camera crew. Even if one of them might approach the kind of "beauty" touted in most advertising, she would still be wearing a shapeless cloth "hat," and trust me, no one looks hot in cheap cotton headwear.

When I was a pre-teen, my parents gave me a "sex book" called The Changing You. On the front, there is a little girl looking into a mirror and seeing herself all grown up as the Homecoming Queen. Now, I was very relieved, since I was terrified of becoming an overly-tall version of Little Orphan Annie. Wow! I was going to be the Homecoming Queen! Thank God! But I didn't, of course. And though I was lovely, I could never see it, because I didn't match those pictures. I wish I'D had a spa in my life; I might have been more sane. But I have it now; when it comes to having a healthy emotional life, it's never too late . . .

Have an Ice Day

Recent events have highlighted for me the importance of being iced.

Honeysnookums was scheduled to have minor surgery for thumb trigger finger. I, of course, was designated driver, waiter, jar-opener and recovery coach.

Part of Honeysnookums surgical preparation involved getting a prescription for a well-known heavy-duty pain reliever with narcotic effects the first letter of which is V.

When I saw the bottle on our kitchen counter, I swooped in, uninvited, to talk about how much faster and better one feels when pain medication is avoided. Ice, I said with empirical authority, is the best pain reliever for muscle-skeletal issues. It has none of the colon-dessicating, dehydrating, hallucinogenic effects of narcotic pain relievers.

It works directly on the area of pain production, inflammation, and not once has anyone had to spend 30 days away from home to break the habit of icing every night. Ice works so well, that generations of ballplayers, people who can easily afford to blow mounds of money on things to feel better, prefer ice to any other pain solution.

“Whatever,” Honeysnookums said. “I just don’t want to take drugs because they make me loopy.”

Good enough.

On the arranged day we showed up at the surgery center at 4:30 a.m., a time I never before had conscious experience of, and after prep talked to the doctor. As he ran down the pre-op list, he asked Honeysnookums if the pain reliever prescription had been filled.

“Yes, but I don’t plan to use it. I am going to ice and take an ibuprofen instead.” Honeysnookums announced.

Stunned, the surgeon paused. Finally he stammered: “Of course, ice is best.”

I think at that point I had made a discovery. Perhaps, like those of us in the massage field, this surgeon knows that ice is best. Perhaps, like massage folks, he knows people will promise to ice and then don’t.

Well, not having the other options, I have made it a point to make sure people know how to ice. I discuss how gel packs work best with a towel between the skin and pack. And I explain how ice boomerangs if left on for more than 20 minutes. Oh, and those follow-up calls. If I can get someone to ice, I know they will get better. I’ve even taken out the ice cups and demonstrated how it works and why.

Well, happy to report, Honeysnookums is a week post surgery and hasn’t had much pain and is healing better and faster than expected.

Which is why I say: Have an Ice Day

Gender of-Fenders and Service with a Smile

I don’t like to think about sex in the context of massage, but I am somewhat ticked at what I see as some pretty serious whining going on amongst male therapists responding to Lynna Dunn's recent article about “discrimination” against male therapists.

Gentlemen, please put yourselves in the place of the person at the front desk, booking massages for multiple rooms and dealing with whatever comes their way in the form of client complaints. Any front office/schedule person, after five minutes in the massage business, will learn to ask that question. Why? Because a lot of male and female clients do not want a male therapist.

Is that right? No.

Is that fair? No.

Now get over it.

I sympathize, I empathize. I rage against human nature and its folly. Why is there such discrimination allowed in this enlightened age. But that won’t change hearts and minds. People are as people do. And most don’t ask for male therapists.

Massage is, after all, a service industry. We serve the clients. If the clients don’t want such an intimate service from a male, we can’t stand there and argue. Service means their problems, unfortunately, are our problems. Our problems get to stay our problems and should not be shared with the clients.

Sometimes this problem is sexual, sometimes it is about past experience and abuse, sometimes it’s about not having a perfect body.

On the occasions when I have asked clients about their preferences, I’ve gotten some pretty strange stories in reply. They may tell me about a creepy massage they had where the therapist seemed to be checking them out. One client told me that a male therapist had slapped her copious cellulite hip and recommended a local surgeon saying “Most clients who have this problem have it removed.”

On the bright side, I’ve had clients tell me they always ask for a male because they don’t want a namby-pamby application of oil from someone with weak wrists. One such lady told me she went to the spa only because she had a gift certificate. Otherwise she had a nice man come to the house and massage her “everywhere” for only $50 – for two hours.

Gentlemen, I feel your pain. I also know that in every other job I have ever had in my life, males have the advantage in pay, promotions and perks. So butch up!

Barefoot and Footsore

As a kid, summer meant running around outside barefoot, and being barefoot was freedom itself. We'd even brave hopping around on the hot asphalt next to the ice cream truck for five minutes if it meant hours of cool grass between our toes to follow after. Once my father told us we could get ringworm running around barefoot so much, and that spoiled it for a while. Since he didn't explain what ringworm was, we naturally pictured really agressive earthworms with ravening fangs, ready to burrow up through the bottoms of our feet. In the end, the call of the cool grass won out, so we just told him we'd decided to run around barefoot really fast.

However, it's been a while since I've found being barefoot particularly attractive. In the past few years especially, issues with hip dysplasia, etc. have made it much nicer for me to walk around in supportive shoes, often with orthotics. And I've spent a lot of money on shoes to do massage in, while skimping on other needed household items, since my work is my passion, and I want this body to last.

Ironic then, that I should recently find myself working as an independent contractor in a space where no one wears shoes. It's a comfortable, spa-type environment with a shoe rack by the door and a basket of slippers to encourage clients and employees to relax, feel and home, and probably not wear out the carpet. Which would be great if I didn't find working barefoot painful. And the whole issue is doubly ironic since I've worked at places before where therapists wanted to work barefoot and weren't allowed to do so--now I've landed rather in the opposite camp (which I didn't know existed).

I'm not exactly sure how to handle this problem at the moment. I've tried working barefoot, but it feels odd and my back hurts. I've tried taking off my shoes at the door, carrying them to my workspace, and putting them on during massage. But frequently I forget I'm wearing them and trot out to wash my hands in my Danskos. Has anyone ever heard of orthotic socks? This is one of those relatively little things that could end up driving me and my low back batty.

Five Things I Wish Job Applicants Wouldn’t Do

This is my edition of the B&M (B--- & Moan) Club and it comes after interviewing therapists for employee jobs providing massage, and reading a recent findtouch blog about how not-fun it is to be interviewed for massage positions at chiropractic offices.

True, I have sometimes felt disrespected during interviews when I was looking for work in massage, and it did not bode well for future business relationships. But I have been on the hiring end of the process. Not as a chiropractor, of course, but a hard-working therapist and spa owner. I figured I had a lot to offer, empowering therapists to do their best in a creative environment, and I assumed, eek, that most potential employees would be interested.

1. If you arrive late, wearing dryer lint on the back of your jeans, I have to assume you have trouble getting to work on time and dressing in appropriate attire. If your neighbor drives you because your car is broken, and your child is with you because the sitter is sick, you do get points for perseverance. They do not outweigh the 500 red flags.
2. If you have not been convicted of a felony lately, be proud of that. But know that if you tell me you weren't guilty and were forced to take a plea, and the unreasonable state parole office forces you to tell potential employers, I will think you have trouble taking responsibility for your actions.
3. Lots of people in the business know where it is tough to work, so I don’t need a laundry list of your current employer’s dishonesty and lack of ethics. Do I need to add that it makes me wonder about your honesty and ethics?
4. No matter how much you were adored at massage school, you still have to do a good massage with all clients. I’m not interested in dating you, or socializing with your buddies on the pro volleyball circuit.
5. References should be to people you have worked for, who know your working habits and practices. Your clients should love you, and their testimonials are not references. P.S. Borrowing money from a client to buy a massage table is not a great way to show initiative.

Big sigh. I feel so much better now.

I know not everyone may agree with this list, but please, if you identify with it, makes some changes. It could spark your career.