Don’t be a PRUDE. The pelvic floor is important and we need to talk about it.

 

I didn’t know I had fractured my spine as a freshman in high-school until I was 43 years old and my hip ‘blew out’.  What does my hip pain have to do with a spinal injury?  I am a bodyworker whose job it is to discover dysfunctional patterns in my client’s bodies and help them bring balance before it causes a chronic problem, however, I couldn’t see it in myself until irreversible damage was done.  My story may be unique to my body but the treatment I discovered through the process will help many others.

 

As a student athlete on the track team my events were high-jump, shot-put and discus.  Every day after school the team practiced, many times until almost dark.  I remember practicing late one day, very tired, but I was jumping very well that day, I got up to 4’10” which is just a foot shorter than I am now.  Excited and wanting to jump higher, I raised the bar slightly and tried again, this time knocking the bar off the stand and onto the mat.  Just as I fell to the mat, all my body weight landed on the bar on my right lower back.  I was immediately in sharp, shooting pain, a lot of pain.  However, I could ‘walk it off’ and limp home.

 

That night it hurt badly, but my parents decided to make me comfortable by adjusting my bed so I could sleep sitting upright and I rested that night.  The next day, month, and years, I functioned, even though there was a near-constant ache in my back.  I was never diagnosed by a doctor for the symptom, and I carried on with my life.  Searching for relief of back pain naturally was the journey that led me to a 21-year long career in health and wellness (which is a story for another time).  Bottom line is, 30 years after hurting my back, my hip blew out without warning.

 

The day my hip got my attention I was teaching a class and during the course of the day my hip started hurting, and it hurt worse and worse as the day wore on, and it didn’t stop hurting with every step until I had laparoscopic debridement surgery almost a year later.  It was discovered that I had worn down the cartilage protecting the bone and frayed the labrum in my right hip.  Every step I took was bone-on-bone which was the cause of the intense pain.

 

While rehabilitating from surgery, I had time alone to focus on myself and put all the pieces together.  There was extra bone on the lumbar vertebrae on the right side, where I landed on the high jump bar and fractured it.  As bones heal from breaks, they create extra bone and make that site stronger than their adjacent areas.  Because of the fracture it appeared from x-rays that I had a natural fusion in the facet joints of L4, L5, and S1 on the right side only.  I have always been an active and athletic person.  As I moved around, exercised, and continued to grow a little more, my body compensated in a dysfunctional and unsustainable way.  The lumbar spine went into an anterior rotation to the right and I developed scoliosis, a c-curve to the right where the left side was left in a constant eccentric load.  The left SI joint stopped mobilizing because it was already pulled too tight, and had the job of stabilizing the load of my upper body on my hips.

 

Putting it simply, my hips shifted to the right, and because of the extra body weight on that side, the femur displaced laterally (to the side) 30 degrees out of the joint.  This was just enough to rub the joint the wrong way.  Over time, I had damaged the joint.  Now that I finally knew the cause, I could help my body fix the root of the problem.  I didn’t just want to heal my hip, I wanted to change my pattern, so that it’s sustainably functional… for the rest of my life.  Of course, I had to do all of this without my osteopathic surgeon helping because he is limited by liability and the insurance companies to only treat the symptom.  Since the symptom was my hip, I had to rehab my spinal injury on my own.

After surgery, I couldn’t put more than 50% of my weight on that right side, and I had to use crutches to get around.  After a while, I went down to one crutch, on my left side.  After walking for a month with most of my body weight on my left side, although I was sore, however, I observed strength developing for the first time in my left lumbars.  I started working with them daily and discovered I could hold the weight of my hips off my right hip by using my left lower back muscles and working to mobilize the left SI joint.  The discovery took on a whole new meaning when I dug deeper into the pelvis for muscular support.  This is where the pelvic floor took on a new importance to me personally and professionally.  This isn’t just a ‘me’ problem because I have a unique circumstance.  This information is for the masses!

 

My discovery was that if I could activate my pubococcygeal muscles (PC) enough, my pubic bone and coccyx lined up and my hips shifted back to center balance.  Wow, that’s hard.  I could only hold it for a few second at a time at first, but quickly realized the benefit of discovering this link and then became inspired to start intensive training to correct the pattern.  I am rehabbing my spinal injury, and my hip at the same time and building the foundational strength and endurance to hold that new pattern while I function in life.  Having a career which requires physical strength and stamina for hours at a time, I’ll have to be even stronger so I can have proper body mechanics while giving treatments.

 

Now, we have all been taught about Kegal exercises to strengthen the PC muscles, right? Remember, mother or grandma saying to practice training them by stopping the flow of urine mid-flow?  They can get weak from many reasons, including childbirth, and weak PC muscles can lead to bladder incontinence.  Of course, we can squeeze hard enough to not pee ourselves, but can we do it hard enough to become a functional foundation for our hip alignment?  That’s tough to do, especially without something to squeeze against, some kind of resistance.

 

Sorry guys, but this next part is just for the ladies.  Key-word… weighted Kegel balls, eggs, rods, any kind of small weighted device safe to insert into the vagina and hold it there.  That’s right, hold it there while you walk around, cook, drive, and work.  You can find them and order from Amazon.

 

For the guys, imagine pulling your testicles up into your pelvis creating a dome shape inside your core, and hold it.  These are your PC muscles.

 

Did I really think my journey would lead me to become an advocate for the pelvic floor muscles?  NOT until it became a matter of functioning well or not functioning at all.  Training them is hard work, and at first you won’t be able to do it for long without noticing pain somewhere else in the body that is weak and trying to catch up.  Do it like you would working-out at a gym.  Train them until you get sore, then rest…   and repeat.  Strength and endurance will come with time, and the whole body will benefit from a strong foundational core from which to move functionally and will readjust accordingly from that strong core working out other issues in the thoracic spine, neck, shoulders, even down to the legs and feet.

 

Check in with your body right now.  Are you using your PC muscles?  Or are they just ‘splayed out’ being ‘couch-potatoes’?  If you squeeze them, how does that affect your hips or spinal alignment?  Even activating them while being seated as you are reading this you can see a benefit, right?  Now imagine being strong enough to hold them subconsciously and benefitting from correct postural alignment in the whole body as a result.

 

I think there are a lot of others out there that need this information.  Whether or not you have an imbalance in your hips, training to have strong PC muscles comes with a lot of positive side effects, some of which you will have to experience for yourself, but not limited to not peeing yourself when you sneeze.

 

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Massage Hack #3 Imbalance in the ribs part 1

As a massage therapist, there is nothing more frustrating than working on a person’s body and not being able to make a difference in the tissue.

  • Maybe it’s because the joint isn’t as neutral as it could be, making the soft tissue have to stabilize instead of mobilize.
  • Maybe something on the opposite side of the body or joint is pulling making a tug of war situation limiting mobilization of a joint.
  • Maybe the person is holding on to an emotional pattern which won’t allow a shift in soft tissue or causing chronic lymphatic congestion.

There could be dozens of reasons why a person’s body isn’t responding to treatment.  Over thousands of clinical hours and two decades studying human movement and bodywork, I have developed certain protocols in dealing with acute and chronic musculoskeletal dysfunctions in the body.

In this series, I will provide you with quick, concise, and accurate information on how I have successfully treated certain conditions in the body over and over.  I am making this intellectual information available free of charge because I believe in inclusivity instead of exclusivity, and I want the most number of people on this earth to be able to be helped with this knowledge.

Disclaimer: It is YOUR responsibility to adapt this information to the training you have received and are qualified to do, and work within your scope of practice and laws in your area.

Problem: In prone position, one side of the ribs is higher than the other.

 

Question?: Is it an issue isolated to the ribs? (If yes, read on) Is it a rotated spine issue? (If yes, see Massage Hack #4)

 

Assessment: For a rib-only issue would be to see if the spine is in neutral through the thoracics. If yes, then the ribs could be being pulled laterally caused by a restriction in the subscapularis, serratus anterior/latissimus dorsi area, OR at the (anterior) sternocostal joints, pulling the ribs that appear higher into a more lateral/anterior position in relationship to the lower side.

 

Wait, you ask… why do the ribs appear higher if they are being pulled laterally or anteriorly? Because the rib heads (where the rib meets the spine at the facet joint are most likely eccentrically loaded (stabilizing) therefore the rib heads are not set in the joint neutrally, and appear to be posteriorly ‘higher’ in comparison to the other side.

 

Treatment: If you have an Ortho-Bionomy release for the ribs, this would be the place to start.

 

If you are a direct tissue therapist, start the client side-lying with arm over head, soften the lateral rib cage and all the muscles that attach from the long head origin of the triceps brachii on the scapula to the rotator cuff muscles, to the latissimus dorsi and serratus anterior. Look at the intercostals as well. Then ask the client to turn supine and assess the chest muscles, subclavius, and intercostals where the costal cartilage meets the sternum.

 

ReCheck: Ask the client to lie prone again and assess the rib height to see if it has been corrected. If it has not been corrected, read Massage Hack #4 which talks about rotation of the spine as a cause of rib cage imbalance.

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Massage Hack #2

Sub-occipital Relief by way of Anterior neck

 

As a massage therapist, there is nothing more frustrating than working on a person’s body and not being able to make a difference in the tissue.

  • Maybe it’s because the joint isn’t as neutral as it could be, making the soft tissue have to stabilize instead of mobilize.
  • Maybe something on the opposite side of the body or joint is pulling making a tug of war situation limiting mobilization of a joint.
  • Maybe the person is holding on to an emotional pattern which won’t allow a shift in soft tissue or causing chronic lymphatic congestion.

There could be dozens of reasons why a person’s body isn’t responding to treatment.  Over thousands of clinical hours and two decades studying human movement and bodywork, I have developed certain protocols in dealing with acute and chronic musculoskeletal dysfunctions in the body.

In this series, I will provide you with quick, concise, and accurate information on how I have successfully treated certain conditions in the body over and over.  I am making this intellectual information available free of charge because I believe in inclusivity instead of exclusivity, and I want the most number of people on this earth to be able to be helped with this knowledge.

Disclaimer: It is YOUR responsibility to adapt this information to the training you have received and are qualified to do, and work within your scope of practice and laws in your area.

Problem: overly tight sub-occipital muscles at the posterior upper neck, where the neck and cranium meet. These set of muscles can at times seem impossible to loosen up, no matter how you try to mobilize them. Many times these muscles and surrounding fascia are ischemic, and very dense, even up on the occipital ridge of the cranium.

Treatment: soften/mobilize the longus capitis and longus colli muscles located on the anterior neck. What? You say? That’s an endangerment zone. Yes, it can be a tricky place to work, which is why receiving proper training is essential. There are non-invasive ways to soften those muscles indirectly (Ortho-Bionomy) as to minimize risk of dissecting a major blood vessel. There are also safe direct methods to mobilize those muscles with proper training and advanced palpation skills, you can learn how to navigate behind the sternocleidomastoid, up and over anterior transverse process attachments, weave underneath the blood vessels and slide onto the longus muscles without making direct contact with the carotid arteries and jugular veins. With expert palpation skills, you will know if you are on a blood vessel because you will feel a pulse. Constant communication with your client is also essential here as when you are on the correct structure, it will give the client a sensation of having a tension headache. The feeling of headache will go away once you remove the pressure, but it’s the sign you’re on the right muscle. The amount of pressure you would use would not be enough to dissect a blood vessel if you were on one, because you would not add any extra pressure beyond the weight of your own thumb or chosen finger for this work and there is no stripping. Even the direct work is very gentle and deliberate.

Re-Check: In my experience, mobilizing the longus muscles has a profound and immediate effect on the posterior upper neck (sub-occipital group). Usually both myself and the client is amazed on how loose and mobile it feels after doing this protocol

 

For more information on Ortho-Bionomy classes near you, visit http://www.ortho-bionomy.org

For more information on career training or CE classes in Indiana, visit http://www.carmelschoolofmassage.com

 

Massage Hack #1

Massage Hack #1 Lower Leg Congestion and the Mobility of the Fibular Head

 

 

As a massage therapist, there is nothing more frustrating than working on a person’s body and not being able to make a difference in the tissue.

  • Maybe it’s because the joint isn’t as neutral as it could be, making the soft tissue have to stabilize instead of mobilize.
  • Maybe something on the opposite side of the body or joint is pulling making a tug of war situation limiting mobilization of a joint.
  • Maybe the person is holding on to an emotional pattern which won’t allow a shift in soft tissue or causing chronic lymphatic congestion.

There could be dozens of reasons why a person’s body isn’t responding to treatment.  Over thousands of clinical hours and two decades studying human movement and bodywork, I have developed certain protocols in dealing with acute and chronic musculoskeletal dysfunctions in the body.

In this series, I will provide you with quick, concise, and accurate information on how I have successfully treated certain conditions in the body over and over.  I am making this intellectual information available free of charge because I believe in inclusivity instead of exclusivity, and I want the most number of people on this earth to be able to be helped with this knowledge.

Disclaimer: It is YOUR responsibility to adapt this information to the training you have received and are qualified to do, and work within your scope of practice and laws in your area.

Problem: Massaging lateral half of lower leg prone or supine, distal to proximal, perhaps a deep stripping effleurage, and when you get to the upper 2/3 of the leg, just below the knee a few inches you run into a wall of congestion that can’t get out of the way. Perhaps it’s a ball of stagnant lymph, or it’s short, dehydrated, immobilized fascia, or it’s that the fibular head can’t get out of the way…Or all three and more… It’s painful to the client if you just bulldoze your way through so what do we do?

 

Treatment: Mobilize the fibular head by whatever scope of training you have had and available techniques in your ‘toolbox’. My training is in Ortho-Bionomy (O-B), positional release of joints, and neuromuscular re-education. So my first technique is the least invasive O-B/positional release to help the fibular head’s reflexes to self-correct, move into neutral, and start to mobilize in both directions equally and easily in relationship to the tibia.

 

Re-Check: Go back to the original massage technique and check to see if the congestion now has a place to go, the fibula will get out of the way and there will be a clear channel for lymphatic drainage to occur as well as allowing the fascia to stretch into more space. Now there should be less intensity for the client when you repeat the original massage strokes and a shift in tissue can occur.

For massage/career training and CE’s in Indiana visit http://www.carmelschoolofmassage.com

For Ortho-Bionomy training near you , visit http://www.ortho-bionomy.org

 

“Hey I told you the pain was on the OTHER side”

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Have you ever been working on a client who complains of pain in one area of their body but the knot/restriction is actually on the opposite side of the body or joint?

 

Have you ever wondered why this is? Or how to explain it to clients when you want to work on the opposite side of the body that they are experiencing pain?

 

My favorite answer is an educational response. I say, “The area you are experiencing pain is the symptomatic area. The cause of the problem may actually be in the antagonistic or opposite side of the body or joint.”

 

Basically what is going on is that the restricted myofascial area is much stronger than the symptomatic side and often pulls the non-restricted side into an eccentric contraction (a loaded muscle under a stretch). This causes pain in the elongated and loaded muscle because it is constantly having to work to pull the body/joint back into a neutral alignment (and it’s losing the game of tug of war).

 

As a therapist we have a conundrum. “If I don’t work on the area that is in pain, they won’t feel like I listened to what they needed/wanted. However, if I make the elongated side even longer, I may be making their musculoskeletal alignment even worse.” This is the thought process going through our heads.

 

The following example is a way I have found to work WITH (not ON) the client to achieve both success and education for the client.

 

What I will say is that I have a theory that I would like to test and I need their help by giving accurate feedback about how their body feels. I will say that I suspect that there is a restriction on the opposite side of the body or joint that may be pulling the body or joint out of alignment thus causing pain. Then I ask if it would be ok to palpate and observe the tissue.

 

After assessing the tissue, if the data supports the hypothesis, then I will point out the observations to the client by asking if they feel the restriction and the difference from side to side.

 

If they do feel the differences, GREAT. If they don’t then this now becomes a lesson in self-awareness for the client as you describe the quality of the tissue from side to side and ask them to observe it with you through palpation and movement.

 

Then ask if it’s ok if you work on the restriction and see if it helps relieve the pain on the painful side. Once you release the tissue, go ahead and ask them to check the painful area and tell you what they feel. You may want to then bring both sides into as much balance and suppleness as you can, but setting them up for success by certainly addressing the adhesion being the cause of the dysfunction.

 

You have just educated your client about how the body is constantly trying to move toward neutral to keep us functioning at our greatest capacity. You taught them the the source of pain is often NOT where you feel the pain in the body (when you’re talking about musculoskeletal dysfunction). AND you taught them that the pain can become relieved INDIRECTLY when you work on the restricted side thus bringing the body back to a neutral state.

 

Now try this with your clients, and have fun discovering how incredibly connected our bodies are.

 

As always, use discretion using deep tissue techniques as they may not be appropriate for people with special health conditions.

Why I’m Grateful For My Sinus Infection

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You’re probably wondering what the heck did she just say? It sounds like the start of an essay for grade-school such as, “Why I Love My Dog.” Yes, I said I’m grateful for my sinus infection and I’ll explain why.

In general I’m a very healthy and active person. I hardly ever get sick, and when I do, it only lasts a short while… Until THIS time.

It usually starts as a viral bug, and 9/10 times I fight it off within 5-7 days. Occasionally (maybe once every 2-3 years) it will be followed up with a secondary bacterial infection, which would need prescription help.

This time… it was viral for 5 days, I would feel better for a day or two, then viral symptoms again for 5 days. Then I felt better for a day or two. Then it came BACK for a third relapse. It’s actually been going on for the ENTIRE month of August.

I’ve been doing all of the suggested things by my General Practitioner, holistic health professionals, well-meaning friends, family, and body-workers. Nothing has helped.

In the past, when I’ve had physical pain or injuries , I’ve used that as an opportunity to learn how to treat those injuries in other people. It made me a more empathetic and knowledgeable therapist. I teach my students to look at their own pain in that way and use it to their advantage.

So, what do I do when I’ve tried everything that’s supposed to work and nothing does? I look at my life, like I would an injured body, and ask, “What is working?” “What is not working?” “WHAT IS OUT OF BALANCE?”

The awareness that the illness has brought to my consciousness about the imbalances and blessings in my life IS THE reason for my gratitude. Here are the lessons I learned:

I realized that work life and personal life was not in balance. The illness forced me to take time off from work, and allowed me the time to actually look at my calendar and create more time off, make REGULAR appointments for massage, chiropractic, physical therapy.

I became aware of the fact that when life gets too busy, I sacrifice MY exercise, MY self care, MY diet…. Which lead me to the question, “Why am I not valuable to MYSELF?” So then I was reminded that I needed to have as much love for myself as much as I love my family, my massage clients, my friends. I started taking my supplements again, made time to stretch, self-massage, and sleep more.

Another BIG lesson…..I needed to let go of some control and let other people take responsibility for things…THEN, I realized how many AMAZING people are in my life who are more than willing and capable to step in and do JUST that!

I’m INCREDIBLY GRATEFUL for my husband, mother, father, brother and in-laws for taking impeccable care of my children on a regular basis, AND for stepping in extra while I was feeling too fatigued on some days to make sure they had proper exercise, meals, and entertainment.

I never have to worry about their safety or well-being because I KNOW they are loved and cared for by all of my extended family.

Another biggie… I think work-balance has been the most profound lesson in all of this. I realized that I had my nose to the grindstone for over three years now pouring intense energy into mastery of my craft, and growing the massage school. I had my hands in every aspect of the business, and this time away has taught me that my staff, students, and peers are capable of handling anything and everything I need them to do, and they do it with a SMILE on their face! I now know beyond a shadow of a doubt that they are all angels walking on this earth.

I learned it IS OK to give up some control. I realized I did a really good job surrounding myself with excellent staff members! They TRULY CAN do anything and everything with supreme professionalism

My students…WOW. When I had to cancel my treatments of regular clients who are in constant pain, instead of them not getting any help, my AMAZING apprentices gladly stepped in to help. My clients got to receive top notch treatments, and I got to rest. That is a sign of TRUE professionalism, and I couldn’t be more proud of them.

Would I have learned these lessons without getting sick? Perhaps, over a longer period of time… But this is where the miracle happens… I got to learn all of this in ONE month’s time!

 

Thank you for the lessons, Universe, I am forever grateful! Now… let the healing begin!

 

 

 

Joint balance + Soft Tissue Release = Marriage Made in Heaven

OB Logo

WARNING: The Following post contains some totally geeky bodywork stuff and jumping right in…

 

Chiropractors know that releasing soft tissue in conjunction with correcting joint mis-alignments allows the body to stay in alignment longer than without soft tissue release.

 

Massage therapists know that the muscles won’t loosen up if they are supporting a joint mis-alignment, and so mindful bodyworkers know that it is a marriage made in heaven to receive both joint balance and muscle balance at the same time, or as close to the same time as possible.

 

Unless you have a chiropractor who works inside your massage practice and schedule your treatments back to back, you probably won’t be able to gain the same amount of benefit that you would if your chiropractor is also a trained massage therapist, or vice versa. For many people, this combination of treatments is not feasible.

 

However, as MT’s we DO have tools available to us through continuing education. Through CE’s I have found the perfect way of helping set up the conditions for the body’s joints to move more toward neutral, by applying Ortho-Bionomy® techniques. Then, as a trained massage therapist, I can then reassess the tissue and soften any restricted tissue that might pull the joint back out of alignment.

 

What’s Ortho-Bionomy? GREAT question! It can be described in many different ways. It was founded by a British Osteopath, Arthur Lincoln Pauls, and is based off of Osteopathy. Osteopathy is a branch of medicine that believes the body will heal itself given the right conditions. Ortho-Bionomy® (O-B) is a system/modality of bodywork that sets up the conditions for the body to self-correct. Yes, I said SELF CORRECT.

 

The way my brain understands it is that O-B works on the level of the nervous system and the fascial (connective tissue) communication network. Parts of the system of this exquisite bodywork involves gentle positioning of the body, and engaging the tissues either energetically, or physically through traction or compression. It takes many hours of training to become proficient at applying the principles and techniques, but well worth the effort!

 

If you only know me through reading my blogs, you might think all my clients are black and blue when they leave my office, but that’s not usually the case. In fact because I use O-B techniques in my treatments, my clients experience MUCH LESS soreness than with just deep tissue techniques. They tell me all the time, “I thought I would be WAY more sore than I was.”

 

Learning to use the O-B principles has also changed the way I apply deep tissue techniques. Gone are the days of plowing through restrictions as a more ‘green’ deep tissue therapist. I now honor what the body is trying to support with that restriction, try to understand why it’s there, and figure out a way to relieve the CAUSE of the restriction (instead of just relieving the symptom). This is done through observing joint alignment, reading the body’s posture, asking questions about lifestyle, injuries, applying O-B, etc. Then as a last resort, going into the restriction if absolutely necessary to relieve the pain caused by restricted tissue.

 

In addition, because of Ortho-Bionomy training, when I apply the deep tissue techniques, it is done with more finesse. I go slower. I put my mind into the tissue and visualize it opening up and letting me in.   I move with the body more, and less against it. Work with nature, not against it. O-B has given me a vehicle with which to work WITH the natural rhythms and cycles of the body in order to help create a state for healing to occur.

 

Allowing joints to move toward neutral alignment through Ortho-Bionomy® techniques and combining that with adhesion release as needed has allowed my clients to stay pain free longer and has created a niche market for my practice.

 

For more information on Ortho-Bionomy® please visit www.ortho-bionomy.org

 

If you want to take classes in Indianapolis, contact the Carmel School of Massage & Healing Arts and visit our website at www.carmelschoolofmassage.com for our Ortho-Bionomy Class schedule.