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.

 

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