Category Archives: Pain Management

Who is on Your Team?

05 Thursday Nov 2015

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teamTo accomplish anything in life, we must have support. Nothing really happens in a vacuum; we need people who are willing to “pour into us.” In other words, people who are on our team. Whether we are raising children, advancing in a career, learning a new skill, or (more likely) a combination of these and other things, we need to know someone has our back. We, no only, need people cheerleading from the sidelines, but also on the field with us. And let’s be honest, not everyone in your life is on your team. How can we tell teammates from opponents or those merely watching from the sidelines? To start they are encouragers, they tell the truth with compassion, they help in any way they can, and mostly they believe in YOU!

I think most of us have a good sense of the “team” among our friends, family, and even work; however, one often overlooked area is healthcare. When it comes to our health, we frequently find demanding coaches or even (dare I say) dictators, directing choices without much consent from the patient. It seems there is a lot of, “I am the expert and you are not, so do what I say and stop asking questions.” mentality going around in all fields of medicine and healing arts. In fact, a 2009 article in The Atlantic called “Power to the Patient” complains of the age-old-mantra: doctor knows best. But if a healthcare practitioner or doctor doesn’t treat you like a team member, a stake-holder and important to the shaping of your own care, then they may not be on your team. The thing you must understand is that they work for you. You are the boss, and you can fire them.

So, who is on your team, and how many people do you need? That question needs to be answered individually, but I’d like to give some personal guidelines. First, healthcare team members should be willing to answer questions and help you thoroughly understand what is happening. Second, team members will not make you feel stupid for asking questions. Third, team members should also be cheerleaders, encouraging their patients to take hold of their own health. And finally, they should provide whatever tools they have to equip their patients for self-care.

As to how many people or professionals should be on your team: that is personal. I would encourage searching out professionals from various backgrounds, which will give a wider view of health. I would also encourage surrounding yourself with as many people as you can who will support your desire for a healthy lifestyle.
In summary, it is very important for all of us to find and surround ourselves with a great “team.” And remember, we are each others’ teammates too!

To Your Health

[1] Clayton M. Christensen and Jason Hwang. “Power to the Patients” The Atlantic 2009

What the heck is a Rotator Cuff?

24 Thursday Sep 2015

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Today I’ll take a detour from the series of posts about types of massage to talk about something I think many people wonder about: that foggy mystery of the rotator cuff! Often mispronounced as “rotor cup” or “rotary cup,” the rotator cuff remains a vague image in the minds of many. So, let us take a few minutes to demystify this! You will find that the more you understand this vital area of your upper body, the more power you will have to recover from injury or, more importantly, to prevent injury in the first place.

In my experience with clients, I find most people think the rotator cuff is a covering of some sort for the shoulder. While this is true in a way, it’s not usually as they imagine. The rotator cuff is actually a group of four muscles that are involved in (wait for it) rotating the shoulder… and it has an elevating part to it as well. These four muscles are as follows: the Supraspinatus, the Infraspinatus, the Teres minor, and Subscapularis. These relatively small muscles attach at the head of the humorous (top of the arm at the shoulder) creating, if you will, a “cuff.” The muscle bodies themselves attach wholly onto the scapula (shoulder blade). Take a look at the picture below.

rotator cuff

 

 

Let’s quickly look into the movements in which these individual muscles assist. The Supraspinatus assists with abduction of the arm at the shoulder; in other words, it helps raise the arm out to the side of the body. This is generally the most injured muscle because it passes under the arch formed by the scapula shoulder blade) and the clavicle (collar bone). When it does this, it can rub and create irritation or tears. Next we will look at the infraspinatus and the Teres minor. These two muscles help in lateral rotation(rolling the arm out) of the arm at the shoulder. Finally, we have the Subscapularis. It is a broad flat muscle that is a powerful internal rotator. On many people, this muscle becomes shortened, limiting the ability of full lateral rotation and eventually causing injury.

Now that you know a little more about the rotator cuff you might wonder why this is so important. Well, I believe that knowledge is power! Moreover, depending on which actual muscle you may have injured, it will change what should be done for rehabilitation. Knowing this information could be beneficial for those who work at a job with repetitive shoulder movements. You can start to understand which rotator cuff muscles are being over-used and get some exercises to re-balance these muscles and prevent a possibly debilitating injury.

I hope this helps clear some of the fog away from the rotator cuff!

To Your Health

Deep Tissue Massage: a quick guide

11 Friday Sep 2015

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The practice of true Deep Tissue Massage requires great skill, which, according to Tom Myers, is “…elusive and not-easily grasped.” I can attest to that. Many practitioners I have come across advertising deep tissue work are simply not skilled in this particular art. There are many reasons for this, (none of which will be addressed in this post—sorry!). What I will focus on today, however, is what deep tissue massage really means, how it should feel, and what the desired results should be.

What is Deep Tissue Massage? I am going to rely heavily on the seminal book by Art Riggs called “Deep Tissue Massage.” Seems appropriate, doesn’t it? This book remains foundational in my growth as a manual therapist. According to Riggs,Deep Tissue Massage is not a “hard” massage. That is, it doesn’t take a great amount of strength and should never involve “digging” into the tissues. To be blunt, that is abuse not massage. I cannot express this enough, IT SHOULD NOT BE PAINFUL. If you feel you need to tap out, then it may be time to end the massage. If a person tells me that they do not like deep tissue work, I assume it is because they were “beat up” by a massage therapist who meant well, but didn’t understand the practice. And here is another surprise: Deep Tissue Massage should not involve work solely on the deep tissues. That would be overwhelming to the client and to their system.

Now, let us sink into the reality of Deep Tissue Massage. Simply put, Deep Tissue Massage is exactly that: Accessing and affecting the deep tissues of the body. This is done very slowly working WITH the body to “sink” as deeply as the clients body will allow us. It is also achieved by using the bones to access the deep tissues. The practitioner may also stretch the fascia to change the deep structures. This should cause not strain on the recipient or the therapist. The goal of this is to alter the structure of the body and release muscle restrictions.

Deep Tissue Massage should be designed to achieve certain and specific therapeutic goals. These could include pain relief, improving posture, increasing flexibility, and creating more freedom of movement. Deep Tissue Massage is not a “relaxation massage,” meaning that relaxation is not its primary goal. However, in the hands of a skilled practitioner, it can be very relaxing and nurturing indeed.

Always remember, when you are going to receive a massage, no matter the type, interview the therapist. This is your body they are working with. Like all professions, some therapists need a bit more training. If you care about your health, find a good therapist (or several with differing expertise) and hang on to them!

To Your Health.

What’s With Physical Pain?

09 Sunday Aug 2015

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Joseph H. Watts, LMT

Why do our bodies hurt—sometimes, seemingly, for no reason? There are systemic conditions with such symptoms, like Fibromyalgia, but today I’d like to talk about something else: those sharp pains that seemed to come from nowhere, or the slow building pain that can creep up on the joints. The pain that plagues most Americans costs us billions in lost work and destroys our chances to do the fun things we have always done. What can we do?

To begin, we need to talk about communication, particularly interpersonal communication. (Trust me, this will all come together.) Communication is extremely important for survival. Beyond that, it is important for conducting business and fo effectively connecting with our families, friends, and neighbors. We all know the emotional pain of miscommunications, or worse, non-communication. Business fail when the communication fail. Families are split when they cannot effectively communicate, and many of us know the pain that occurs when communication is cut off completely. Often if one person in a relationship stops communicating, the other person will eventually start to plea or yell to open those lines back up. Do you see where this is going?

Our minds and our bodies are intertwined; they are one, yet they are separate. The only way to keep both working together happily is if they are communicating. So understand this, your body is always talking to you. It is always telling you if something is not right. Something is a little off here, or something is a little tight there. Yet, we often ignore it. Actually, we are usually so distracted and busy we just don’t hear it. So the reason we have pain is because we haven’t been participating in this conversation. Pain is our body yelling at us that something is very wrong.

So back to that first question:what do we do about it? As an orthopedic massage therapist, I confront this everyday. I work hard to educate people about our wonderful bodies, and I have noticed that as people receive bodywork more regularly, they start to feel and indeed to “hear” their bodies again. People will begin to notice the small cues, and they can make corrections early on and avoid unnecessary pain. Adding something like yoga and mindfulness meditation to life also enhances our ability to listen to our bodies and rebuild that relationship. So the next time you feel that twinge in your back, realize that it might be time to quiet your mind and listen to your body.

To Your Health!

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Low Back Pain: Might be your…butt?

10 Friday Jul 2015

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Joseph H. Watts LMT

Low back pain is the scourge of the developed world, especially in the United States. It accounts for billions of dollars in lost work hours, millions in healthcare costs, and quite frankly (if you have ever had low back pain), it just plain sucks! There is a constant barrage of products shamelessly promoted to help you with this problem. For a price, they will give you the next supposed “cure all.” However, low back pain still exists in our culture at an ever increasing rate. What gives? I wish I could give you the quick and easy cure, but if I could, I’d be writing this from a far away beach somewhere… and I am not. Take heart: the answer *is* simple, but putting these things in practice is rarely as easy as the quick fix television salesmen would have you believe!

So…..what is this all about? Good question! I am glad you asked. Our low back pain is generally caused by a weakness of our core muscles, which are the transverse abdominals, the multifidi of the spine, the pelvic floor muscles, and the diaphragm. Alas, I am sorry to report thatthe elusive “six pack” is not part of your core. (Wait for another post for that explanation!) If you want to strengthen these you can ask a personal trainer, Pilates Instructor, or Yoga Instructor for help; even the internet will give some suggestions. But remember, simpler is better. However, if they tell you to focus on crunches then they do not know what your core is. It’s not about your stomach—it’s about a crucial and over-looked missing link: Your butt!! The Gluteus Maximus to be precise.

All day long, many of us sit. We sit at work, sit in our cars, sit in front of the TV or computer at home, sit, sit, sit, sit, sit. When we are in the seated position we keep our Glut Max in a constant stretch, while at the same time shortening our hip flexors. This creates chronically shortened, tight hip flexors, and the brain then neurologically shuts of the Glut Max.   Now, when we walk, these Glut Max muscles, which should be powerful hip extenders, don’t fire. So the Hamstrings fire, then the low back takes up the slack. This is not the job of the low back. Now the low back muscles are working overtime. That alone is enough to make them hurt, but add the shortening of the hip flexors and a forward tilt to the pelvis and you add in potential compression and pinching of the spinal discs, as well as irritation of the nerve trunks coming from the spine. This is a pain soup in the making.

Very few programs even have Glut Max on the radar to relieve back pain. So, if you have back pain, exercising the Glut Max might be a great idea. This is where the work of an experienced orthopedic massage therapist can help. Someone trained in muscle spindle activation can help re-awaken the Gluts max. And of course, you will always want to consult your doctor to make sure there is no serious spinal condition before you do any new forms of exercise.

So, remember, get off your butt. It might be the pain in your back!

To Your Healthlogo