Archive for the ‘Massage’ Category

How do I relieve butt pain after running?

Friday, March 2nd, 2012

yoga-squat.pngFrom Runner’s world:

Piriformis syndrome is a frustrating condition that’s literally a pain in the butt for runners. This throbbing ache originates in the buttocks and often radiates down the legs and/or to the spine. The culprit is an overtaxed piriformis muscle (from running on uneven ground or having tight hamstrings, for example) that spasms and aggravates the sciatic nerve. This routine will help keep your piriformis strong and flexible. Do the exercises three times each week, after a run.

Bonus Postrun Relief
After a long run or intense workout, end your stretching session by placing a thermalball under your right sit bone. Put all of your weight on the ball and slowly rotate your hips to release the piriformis. Do this for several seconds, and then switch sides.

side-plank-leg-lift-art.jpg 

CLAM SHELL
Lie on your right side with your knees bent. Rest your head on your hand or on your arm. Contract your abs and slowly open and close the top leg 20 times. Rest and repeat; switch sides.

PIGEON FORWARD FOLD
Begin on your hands and knees. Bring the heel of your right foot in front of your left hip. Relax into this position and hold while taking 10 to 20 deep breaths. Repeat on the opposite side.

SIDE PLANK WITH LEG LIFT
Start in a plank position. Rotate your body so that you’re balancing on your right hand. Slowly, with control, lift and lower your top leg five to 10 times. Rest and switch sides.

STANDING FIGURE 4
Stand on your left leg. Rest your right foot on your left knee and do a single-leg squat. With your hands on your hips, hold this position for a few seconds. Return to start and repeat 10 times on each leg.

Chronic Low Back Pain Patients (CLBP) display altered brain…

Wednesday, February 29th, 2012

Display Altered Brain Connectivity in the Default Mode Network—An Arterial Spin Labeling (ASL) MRI Study 

pain biomarkers:

Some people say “pain is all in the mind.” Perhaps it actually is, according to a poster on an imaging biomarker presented at the 2012 AAPM (American Academy of Pain Medicine) Annual Meeting. The researchers, from Harvard Medical School and the Martinos Center for Biomedical Imaging, looked at the brains of people with chronic low back pain and discogenic pain along with those of healthy people using arterial spin labeling, a form of MRI that measures blood flow to particular brain regions. Comparing the images showed changes in connectivity between regions of the brain. While this is early work in a small group, the imaging technique may have potential as an objective biomarker for chronic pain. Pain biomarkers are elusive, but could be useful in diagnosis and tracking pain in clinical trials, as well as in helping patients and physicians differentiate chronic pain from psychological symptoms.

poster290.jpgPain in the brain

Anger Management

Monday, February 27th, 2012

How to deal effectively and productively with angry complaints

Never underestimate the power of the angry customer.  The more a complaint is repeated, the longer its legs grow.  A small issue can morph into a big deal.  It can trigger a rant that ends with a referral source never calling you again. You could end up on with a social network free for all, one that won’t improve your business or reputation.

Move quickly to resolve issues.  The longer a customer remains angry the more frequently he/she will tell others about what happened.  As you wait to solve the problem, they continue to have no information to share about the how the problem is being solved.

Show empathy.  Often this is the most difficult strategy.  When a complaint comes at a bad or busy time, it is difficult to show you care.  There’s and old saying, “Never let them see you sweat.” Well, never let a customer sense you don’t care that they are upset and explain to them the actions you are taking to resolve the problem.

Send a follow-up note to those who complain.  Let the customer, referral source or patient know that you appreciate them taking the time to discuss a problem.  Let them know the relationship is valuable, and thank them for giving you the opportunity to not only fix the problem and keep their business, but to ensure the same problem doesn’t happen again.

Linking Fibromyalgia to Depression and Anxiety

Monday, February 27th, 2012

Living with fibromyalgia pain can contribute to depression and anxiety. But some experts believe there are other related conditions that could be contributing to your blues.

By Nancy Christie

Medically reviewed by Ed Zimney, MD

Chronic, widespread muscular pain and tenderness, sleep problems and fatigue, morning stiffness and headaches, concentration and digestive irregularities: All of these symptoms can make daily functioning very difficult for those with fibromyalgia. But equally challenging are the depression and anxiety that often accompany the disorder.

Over a lifetime, as many as 62 percent of fibromyalgia patients may experience symptoms of major depressive disorder, and 56 percent may experience some type of anxiety disorder. According to Jacob Teitelbaum, M.D., medical director of The Fibromyalgia & Fatigue Centers, anxiety in people with fibromyalgia often manifests itself as rapid shallow breathing (hyperventilation), while depression may be expressed as a decrease in normal interests.

While it is not unexpected to have an emotional or psychological response to a chronic illness, there may be other physiological reasons that explain why anxiety and depression occur in fibromyalgia patients consistently enough that they are listed as symptoms of the condition. “Biochemically, depression is very different in [people with] fibromyalgia than otherwise,” says Dr. Teitelbaum. “In fibromyalgia, it is often associated with an underactive adrenal function [a low cortisol level], whereas depression [in a non-fibromyalgia population] is associated with a high cortisol level.”

Fibromyalgia: Physical Factors That Can Affect Emotional Health

According to some doctors who routinely treat fibromyalgia, there are a number of factors that appear to increase the likelihood of developing anxiety and/or depression if you have this condition.

Hypothyroidism. Antiaging medicine specialist Pamela W. Smith, MD, MPH, director of The Center For Healthy Living and Longevity in Michigan, says, “Ninety-five percent of people with fibro have low thyroid function (hypothyroidism) and 100 percent of them have low adrenal function — and both conditions can cause depression and anxiety.” The thyroid gland produces hormones that help regulate metabolism. Fortunately, hypothyroidism (when the level of certain thyroid hormones produced is below normal) is easy to diagnose. A complete blood test for thyroid levels, including TSH (thyroid stimulating hormone) and other thyroid hormones, can identify if a problem exists, says Dr. Smith. Once treated with appropriate medication, thyroid function should return to normal, and depression or anxiety should ease as well.

Low cortisol levels. Cortisol is a hormone produced by the adrenal glands in response to stress. When the adrenals produce an insufficient supply of cortisol, however, it can result in what’s sometimes called “adrenal fatigue;” symptoms include muscle aches and pains, extreme fatigue, anxiety, and elevated levels of cholesterol, blood sugar, and blood pressure. According to Dr. Smith, adrenal fatigue can occur when the body is under stress for extended periods of time. “When you are first stressed, cortisol elevates,” she explains. “But if you stay stressed for a long time, the body can’t keep up by making extra cortisol, so it makes just enough to keep you alive.”

Dr. Smith says that low cortisol levels related to stress often do not show up on standard blood tests, and she believes they are best measured by saliva testing. “Many physicians only measure cortisol levels as related to Addison’s disease or Cushing’s disease. They do not look at what happens when the body makes only enough cortisol to stay alive but not to function well (adrenal fatigue),” she explains.

Cortisol levels can be normalized by reducing stress, says Dr. Smith. Techniques Dr. Smith recommends include “prayer, meditation, tai chi, yoga, breathing techniques and massage, [although] herbal therapies, adrenal extracts, and medications may all be necessary to bring cortisol levels back to normal.” she says, adding, “it may take one to two years to fully normalize the body’s stress system.” As cortisol levels are restored, fibromyalgia-related anxiety and depression generally lessen, she notes.

Poor mitochondrial functioning. Mitochondria are the energy-producing parts of the cell that assist in vital body processes like metabolism. When their function is impaired, they can also play a role in the development of depression and anxiety in people with fibromyalgia, says Dr. Smith. She reports that in her patients, supplements such as coenzyme Q10 (CoQ10), the amino acid-like compound L-carnitine, NADH (nicotinamide adenine dinucleotide, which is related to niacin, a B vitamin), D-ribose, and the antioxidant alpha-lipoic acid all help to refuel mitochondria. And in some patients, taking these supplements has been helpful in reducing symptoms of depression and anxiety related to fibromyalgia.

Vitamin D deficiency. Fibromyalgia has been linked to low levels of vitamin D, which has also been found to occur more frequently in patients with anxiety and depression. Vitamin D deficiency can be offset by supplementation and eating foods enriched with this nutrient, such as fortified orange juice or margarine.

Poor sleep. Insufficient restorative sleep can lead to or aggravate existing anxiety and depression in people with fibromyalgia, and they do not go into the stage of sleep known as REM sleep, says Dr. Smith. This problem may be further compounded by taking antidepressant medication, which can suppress REM sleep in certain people. Other causes of non-restorative sleep in patients with fibromyalgia can include muscular aches and pains and, according to one study, decreased levels of the hormone melatonin.

“There really are metabolic reasons why people with fibromyalgia have the symptoms that they have,” says Dr. Smith. She recommends that people with fibromyalgia undergo testing to determine if an underlying deficiency or a related health condition could be complicating their situation and bringing depression and anxiety to the surface.

Is 8 hours of sleep normal?

Wednesday, February 22nd, 2012

In 2001, historian Roger Ekirch of Virginia Tech published a seminal paper, drawn from 16 years of research, revealing a wealth of historical evidence that humans used to sleep in two distinct chunks.

His book At Day’s Close: Night in Times Past, published four years later, unearths more than 500 references to a segmented sleeping pattern – in diaries, court records, medical books and literature, from Homer’s Odyssey to an anthropological account of modern tribes in Nigeria.

When segmented sleep was the norm

  • “He knew this, even in the horror with which he started from his first sleep, and threw up the window to dispel it by the presence of some object, beyond the room, which had not been, as it were, the witness of his dream.” Charles Dickens, Barnaby Rudge (1840)
  • “Don Quixote followed nature, and being satisfied with his first sleep, did not solicit more. As for Sancho, he never wanted a second, for the first lasted him from night to morning.” Miguel Cervantes, Don Quixote (1615)
  • “And at the wakening of your first sleepe You shall have a hott drinke made, And at the wakening of your next sleepe Your sorrowes will have a slake.” Early English ballad, Old Robin of Portingale
  • The Tiv tribe in Nigeria employ the terms “first sleep” and “second sleep” to refer to specific periods of the night

Source: Roger Ekirch

We often worry about lying awake in the middle of the night – but it could be good for you. A growing body of evidence from both science and history suggests that the eight-hour sleep may be unnatural.

Have you been burned by HOT STONES? Ask for thermalball therapy instead!

Wednesday, February 22nd, 2012

The following are some common reasons clients have been burned by HOT STONES that massage therapists need to be aware of:

THE CLIENT WASN’T EMPOWERED. Massage therapists need to make sure their hot stone clients actively participate in the session and know they not only can—but absolutely should—let them know if the stones are too hot or they’re uncomfortable. Also, massage therapists can check in with clients, asking the client specifically about the temperature of the stones and if adjustments need to be made.

LACK OF INFORMATION. The importance of a thorough intake form cannot be overstated when talking about working with hot stones, as a variety of conditions are contraindicated. Sometimes, however, clients might not list specific conditions on the form, perhaps not realizing the potential for adverse reactions. Perhaps talk with your clients directly about some of the conditions that are contraindicated as you discuss the treatment plan with them before starting the session.

STONES HEATED IMPROPERLY. Heating stones in any device other than a unit specifically designed for this task is never appropriate. Crockpots, slow cookers, microwave ovens, ovens, heating pads and hot plates, to name a few, aren’t acceptable devices for heating stones—ever. Also, burns can happen when the water is too hot, so be sure you have a thermometer you can calibrate to properly monitor the temperature of the water you’re using to heat your stones.

NOT ENOUGH MATERIAL BETWEEN STONES. When using hot stones, massage therapists need to be sure there is some type of material between the stone and the client’s skin. Burns can result if you leave stones that are too hot sitting on the client’s skin. Although this situation may seem obvious, massage therapists need to continually monitor the temperature of their stones, particularly when they’ll be sitting on your client’s skin instead of being used during a massage.

When placing stones, you must remember to use a sheet, towel or clothing between the client’s bare skin & the hot stone.

When placing thermalballs, just put the ball on the skin!

Thermalballs have been engineered to reduce most of the risks associated with hot stones and were specifically designed to offer the finest thermal therapy device available.

Using Thermalballs cold

Hot stone massage and thermalball therapy are popular techniques, but your clients might really benefit from using a combination of heated and cooled thermalball massage therapy. Contast temperature therapy is extremely powerful healing technique.  Cold thermalballs can be particularly effective for chronic and acute conditions, such as injuries and inflammation as well as providing a numbing sensation to sensitive nerves. It is a potent pain killer, better than an ice pack when you need to apply specific pressure as well.

Similar to when heating your stones, however, you need to make sure you chill your thermalballs properly. You can place your thermalballs in the freezer or in a bucket of ice.

As with heated thermalballs, you should use a calibrated thermometer to ensure the stones are the right temperature—ranging from room temperature to 25 F.

Cooled thermalballs help remove heat from the body and allow the client to relax the affected area.

Massage therapists might consider using chilled thermalballs for trigger point work, as well as cross-fiber friction.

Using both heated and cooled thermalballs during a massage can be very effective in reducing inflammation and congestion in isolated areas. Between the applications of heated and cooled thermalballs in an isolated area, however, you need to be sure you warm your hands before placing hot objects on your client, as they may still be cold from working with chilled thermalballs. Without warming your hands first, accurately gauging the temperature may be difficult.

After alternating between hot and cold thermalbals in an isolated area, it’s best to end with a cold application to allow the body to continue to reduce any inflammation and congested blood and or lymph in the area, resulting in less pain and stiffness for your clients. This final application of cold thermalballs in an isolated area will be a “heating response” and will support the body to internally heat itself. The results will be long lasting for your client—sometimes for hours after the session has ended.

When to use heated Thermalball massage

There are myriad circumstances where hot thermalball massage makes sense. If you have a client who has a sprain, strain or acute bursitis, for example, thermalball massage can help alleviate the pain associated with these conditions. Someone dealing with a sports injury, like tennis elbow, knee pain, carpal tunnel etc… might also benefit. Common ailments, such as headache and bruises, can also be helped.  Using both hands on a large (Mega) thermalball will allow you to apply temperature and pressure to larger areas such as the back.

Again, having a good understanding of a client’s health and the basics of hydrotherapy, however, are absolutely necessary when designing a thermal therapy treatment plan. If a client has a condition that might benefit from hot thermalball massage therapy but is suffering from an ailment that contraindicates heated thermalball massage, err on the side of caution when developing a treatment plan. In this case, protocol dictates “less time, less temperature.”

Contraindications & Considerations

As with all techniques and modalities, hot and cold thermal therapy isn’t going to appeal to every client. And, as is also the case with most every massage therapy modality, there are clients who shouldn’t receive hot thermalball treatments.

FOLLOWING ARE SOME CONDITIONS WHERE HOT STONE THERAPY WOULD BE CONTRAINDICATED:

This list is not exhaustive, and massage therapists need to take a client’s full health history as presented during the intake into account before performing hot and cold stone massage.

  • DIABETES

  • CANCER

  • AUTOIMMUNE DYSFUNCTIONS

  • EPILEPSY

  • NEUROPATHY

  • HEART DISEASE

  • SKIN CONDITIONS

  • RECENT SURGERIES

  • PREGNANCY – although many client love to use the larger thermalball cold for the back aches.

Thermalball therapy or hot stones? Why?

Wednesday, February 22nd, 2012

Heated or Cooled Thermalball therapy

Whether helping relax, heal from an injury or decrease pain, thermalball therapy works. Massage works because you’re committed to continually learning and honing your skill in the modalities you practice. Taking continuing education, studying with therapists who have been in practice or who are especially adept at particular modalities, all combine to make you a better massage therapist.

And when dealing with your clients, knowledge is power—especially when using modalities that have the potential to harm. Following, you’ll learn more about how to safely practice with hot thermalballs.  These are the same practices that you would follow with hot stones, but thermalballs are much safer.  The insulated encasement keeps the heat (or cold) “in” and not at the surface of the ball.  The interior is much hotter or colder than the “skin” of the ball.  You know how much the thermalballs have improved your technique (even if only to reduce your hand pain due to acupressure and trigger point therapy as well as long strokes gliding over bony prominences.

(the technique)

As with all massage therapy treatments, many factors will guide you when determining how to incorporate hot thermalball techniques into a client’s session—if at all. For example, a thermalball session with a client who has multiple health problems will be necessarily different than a session where the client has no health concerns.

When using hot stones, too, you want to make sure that you don’t overdo it the first time you use the technique with your clients.

The thermalball modality, like most massage techniques, is meant to build over a period of weeks, and your clients should always leave the session feeling revived, energized, relaxed and supported. If a client feels sick or in pain—or the temperatures overworked their internal systems—they may rethink returning. Remember, your goal as their massage therapist is to help them realize the gentle benefits of receiving ongoing thermalball massages.

Thermalball therapy can be used with several massage modalities, including Swedish massage, as well as placed on the client’s body. When placing thermalballs, however, you DO NOT have to remember to use a sheet or towel or clothing between the client’s bare skin and the heated ball!  You must remember to use a sheet, towel or clothing between the client’s bare skin and a hot stone!!! During thermalball placement, the heat takes 1 to 4 minutes—depending on the size of the thermalball —to fully penetrate before your client can accurately discern if the stones are too hot. (This average time varies, too, according to the internal temperature of thermalball, as well as the health of the client, and size and placement of balls.)

(the musts)

KNOW YOUR CLIENT. Especially with hot stone massage, ensuring your clients fill out a detailed intake form is necessary. Massage therapists need a full understanding of the client’s health to determine what temperature would be appropriate. Be sure you know if your client is suffering from any injuries, dealing with chronic tension, taking any medication or plan to have any other treatments (For example, if a client is receiving multiple treatments throughout the day at a spa, one heated treatment in a six-hour timeframe is an acceptable guideline to follow.)

Keep in mind that the client’s health not only dictates the temperature of the thermalballs, but also how long heated (or chilled) thermalballs can be offered to a client’s body.

PROPER HYDRATION. Hydration is vital when doing a heated thermalball massage, both internally and to the client’s skin. Without proper hydration, burns may not occur as they often do with hot stones, but checking if the client’s skin appears dry, applying some form of moisturizer, such as massage oil or lotion, is a must.

Keeping the client’s internal system hydrated is just as important, however. Have clients drink water prior to, during and after their thermalball session. Think about it like this: Adding temperature to Swedish massage, for example, demands the body respond not only to the modality, but also to the increase of blood flow encouraged by the temperatures. Again, proper hydration is a must.

HEAT THERMALBALLS PROPERLY. First, the fastest way to heat thermalballs is by microwaving them in a Kewler Krock with the balls submerged in water.  Direct Microwaves, hot plates, slow cookers and ovens—to name only a few—are never appropriate places to heat thermalballs.

Also, the only safe way to heat thermalballs is in water, as you can accurately control the heat of the water, making sure the thermalballs don’t get too hot. You should invest in a calibrated thermometer, however, to test the temperature of the water instead of relying solely on the thermostat of the heating unit. Any heating unit you purchase should have a temperature control so you can adjust the temperature of the water as needed. Generally, water between 110–130 F will get your thermalballs to the proper temperature. If you haven’t purchased a Kewler Krock, a large microwaveable bowl filled with water, so that the thermalballs are completely submerged.  You need to make sure the entire ball is covered.  The reason for this is that if the non-toxic proprietary thermal fluid boils, the steam can reach high enough temperature to deform the encasement.  If this happens, retire the thermalball to cold use only.

JUST RIGHT. How will you know if your thermalballs are a safe temperature for your clients? A good indication is if you can hold the balls comfortably in your hands. Squeeze or hold the stone in your hand for a count of five seconds: If the balls are too hot for you to hold then they are too hot for the client.

You also need to consider how the thermalball will be used during the session to gauge the proper temperature. For example, using thermalballs during a massage is different than placing a heated thermalballs on the spine, and you need to take this difference into consideration when heating your thermalballs. Massaging with heated thermalballs, for example, will improve the heat transfer, sometimes rapidly.

Conversely, thermalballs resting on a client’s body might hold their temperature for a longer period of time.

UNDERSTAND THE BODY’S REACTION. Applications of heated thermalballs (or chilled – icyball) produces a series of internal responses. Working with temperatures acts as a derivative—decreasing blood and lymph in one area by increasing blood and lymph in another.

Prolonged application of heated thermalballs to a reflex area causes dilation of the blood vessels of related organs. In other words, the use of heated stones on isolated areas pulls blood from the reflex organs to the tissue in those regions, resulting in warm, flushed skin. Often, this result opens the door for therapists to work even deeper on trigger points or really tight muscles.

The amount of time you use heated thermalballs on a client’s body is determined by how strong your client’s body is at the time of the massage therapy session. The stronger the constitution of your client, the more time you can introduce heat to the body; the weaker your client’s body, the less time you’re going to want to offer heated thermalballs. Remember above all else, however, that if you are in doubt about how a client can handle hot thermalball therapy, you should always error on the side of caution and limit the time you use heated thermalballs.  If the client has been exposed to and enjoys hot stone massages, then they will be absolutely energized by a thorough thermalball or icyball massage.

Why Clients Get Burned with HOT Stones

When done properly, there is no reason for a client to get burned during a hot stone session. That’s not to say, however, that burns never happen. Many times, if not in all cases, a burn could have been prevented.  The best way to prevent burns is to use thermalball products instead or in addition to hot stone therapy.  The single most quoted reason for switching to thermalball only therapy is the reduced risk of “burns” from hot stones and the balls ability to glide over bony prominences as well as the bonus therapy they provide to your own hands!