An Ode to You and the New Year

I wish I could say I wrote this but I didn't. It was written by another wonderful massage therapist who works in Arlington, Amanda Long. It says it all so well.

Thanks for being part of my world in 2013. I hope I can continue to bring massage to yours in 2014.

A New Year's Ode

What would I be without you?

A woman with table, tater tot thumbs and nothing to do?

Who would I text "I'm running a bit late"
Who would make me think daily, "Damn, this gig is great."

Who would give my elbows a place to land
Who would keep me from an office oh, so bland?

I need not ponder these inquiries,
For you've dutifully filled out your client histories.

Magic, you say, that's what I do
But you're the prize, really it's YOU

So thanks for the shoulders up to your ears
Thanks for tight hammies and keeping me out of arrears

Thanks for sharing your vino
and letting me actualize my dream-OH,

Holidays make the gratitude flow, wouldn't you know it
But, luckily, thanks to you, I'm not a paid poet!

Preferred Technique for Fibromyalgia?

A research study comparing Swedish massage and myofascial release for persons with fibromyalgia.

The Study Question: Does a manual therapy that addresses fascia offer more benefit than one that focuses on muscle relaxation for reducing symptoms of fibromyalgia?

Participants:  12 female participants with self-reported widespread muscle pain for at least 3 consecutive months, with tenderness in at least 11 out of 18 specific soft tissue tender points. Their average age was 34.5 and each had lived with fibromyalgia for an average of 2.6 years.

The Study Plan: Weekly 90-minute sessions of either Swedish massage or myofascial release for 4 consecutive weeks (total of 6 hours of treatment per participant). Delivered by 3 licensed massage therapists who had used Swedish massage with clients with fibromyalgia and had advanced training in myofascial release. Work was performed on the same regions (neck, back, legs, arms) on all participants.

Results: Both groups showed improvements in symptoms. There was no significant difference between the two groups. However, a secondary analysis showed the 5 of the 8 participants in the myofascial release group reported clinically significant improvement while only one of the four participants in the Swedish massage group reported comparable improvement. Overall, the results appeared to suggest that myofascial release was more effective than Swedish massage.

My Take-Away: We should try both techniques if you are living with fibromyalgia and determine what works best for you (including a combination of both techniques). The more experience you have of bodywork, the better your intuition for what will work best improves. Fibromyalgia is different for each person and different each day for any given person. We need to determine at each session what your goals are and choose accordingly.

From the AMTA Massage Therapy Journal, Winter 2013. Study originally reported in the Journal of Bodywork and Movement Therapies (Jul 2013).

How (not) to change things

Talking to another small business owner last night. Talking about what it takes to make change.

No good change is fueled by hate. Changes fueled by hate rarely endure. Not in your body, your relationships, your community, or your world. This is what I've observed over time, especially when it comes to your body (of course).

If you are changing your living habits because you hate your body as it is, it's going to be tough to maintain the change. Hate fuels hot but it doesn't fuel well or over the long haul. It's too corrosive.

Hate isn't native to us. Babies are rarely born hating. It has to be installed at some point. After-market add-ons are never as strong as original factory equipment.

Think about the changes you've tried to make, especially for your body -- diets, stretching regimens, workout plans -- that you've undertaken out of hatred/anger about your body. Did it endure? Did it feel good? Would you want to live that way your entire life? (Fear as a motivator functions a lot like hate.)

Now, think about the changes you've tried to make when you were motivated by love -- for a person, a community, and (yes) your body. Do these changes still bring a smile to your face? Which ones still feel good? Which ones are still active in your life?

One of the things I've learned about being in a long-term relationship is this: it's like someone whipping out a mirror so you can see yourself at your most unattractive. Not because that person is mean and likes to make you feel bad (if it is, get out!!). In my case it's because my love for that person made me acutely aware of my nasty habits and ways because I saw how they affected someone I cared deeply for. I saw the results of my less-than-attractive ways play out in the life of someone I would never want to hurt.

That has spurred more change than anything else ever has. Loving my body and wanting to be kind and gentle with it has spurred more consistent change than any catchy phrase or guilt trip from Weight Watchers / Jenny Craig / The Biggest Loser / late night infomercials ever has.

What I have observed over the years is this paradox -- if you want to change something about yourself, you have to love what you currently have. How can both of these things be true at the same time (which is a good working definition of paradox)? Love the belly fat, the painful low back, the aching neck, the crazy feet. Love your body. Love it enough to want to be kind to it like you'd be kind to your very closest friend.

Yes, I may be crazy. You would not be the first person to suggest that.  :)  It is, however, worth a moment of consideration.

Love might actually be the answer.

Today is the memorial service for Nelson Mandela. He talked about how he chose to give up the hate he felt for his imprisonment and his jailors. Compare the changes fueled by apartheid vs. the changes fueled by Mandela's decision to move towards love and away from hate. Which one do you think is more profound, more important, more likely to endure?

Love might actually be the answer.

Simple ways to change your health (no deprivation required)

There are simple things you can do to improve your body's general health and wellbeing. The two I would probably start any list with are:

Sleep

Movement

Sleep
How would your days change, how would you feel if you got a reasonable amount of sleep most (or even every) nights? Not just enough to get through the next day (and you'll "catch up" on the weekend) (which, by the way, doesn't actually work). Enough to feel genuinely rested.

Do you even know how much sleep that is? Next time you're on vacation or have a few days with no schedule, leave the alarm clock off (or, if that's too hard, set it for 12 hours). Notice, over the course of a few days, how many hours you sleep when left alone. For me, it's 8-9 hours. For some people it's 7, for others 10.

What would happen if you made a full night's sleep your #1 health priority? How would you have to change your life to make that happen? Would you have to quit stuffing activities into the wee hours of the dawn? Would you have to record your favorite late-night show and watch it when you get home the next day? Would you have to eat dinner earlier or later?

A few years ago I decided to try just that -- make getting a full night's sleep my #1 priority for the week. The first few days were a bit ragged; like most everyone else I have long-established habits that keep me from getting enough sleep. But by the end of the week, I was managing 7-9 hours every night.

What a difference. Can you imagine facing your day fully re-charged? Virtually everything else becomes easier.

Movement
There are things the body is well-designed for and things the body isn't well-designed for. The body is built to move. Conversely, it really stinks at holding a static position for an extended period of time. Driving. Computer work. Watching TV. Even reading a book.

When you're not moving, muscles get over-tired, blood flow from the feet and lower legs gets sluggish, joints get stiff, ligaments tighten up, tendons get tense, your digestive track has to work harder...sounds exhausting, doesn't it?

Now, by "movement" I don't mean "exercise". Not running, jumping, lifting, riding, sweating, grunting, etc. I mean movement. Standing up. Sitting down. Walking over there. Coming back here. Picking that up. Moving that other thing. Looking around. Finding something under your desk.

Doing the laundry. Cooking dinner. Making the bed. Cleaning out the car. Bathing the dog. Shooing the cat off the couch. (Bathing the cat would probably actually count as "exercise".) Putting the groceries away. Walking down the driveway to get the mail. Playing peek-a-boo with the baby. Changing a light bulb. Brushing your teeth. Taking a shower.

You get the picture.

There is a place for exercise but what too many of us are lacking even more than exercise is a day full of simple movement. What we tend to have instead is hours on our butt.

Think that's not you? I bet your phone / iPod / tablet / watch / etc. has a timer. Pick a day next week. Whenever your butt meets a sitting surface (couch, chair, car, bus, train, etc.), start the timer. When you stand up, pause the timer. Next time you sit down, start the timer again. Stand up? Pause the timer.

How much time do you think you'll find yourself on your butt? Just typing up today's session notes, writing this blog entry, and talking to my husband on the phone (he's in NY on business) has been 1:45 hours. There was 30 minutes of TV before that. That's more than 2 hours that didn't even start till 9:30 pm!


So pick one -- sleep or movement -- and make next week an experiment. How will you be different and feel different from either (or both!) of these very simple healthy habits?

I wonder what that pain means?

We sometimes talk of the "mind-body connection" like it's a fascinating theory. It's not. It's truth. The entire body is one unit so there never was a separation of the mind from the body.

Your emotions happen physically, not ephemerally. They start in your brain, in a specific place, in response to some stimuli. The brain then kicks off a cascade of instructions to the rest of the body --  organs, glands, muscles, nerves, etc. Your emotions get expressed through and sometimes stored in your body, in your tissues.

This article has a great picture of where emotions can get stored. It also has some very good advice for ways to understand and work with that.

Sometimes our muscular pain is just overworked muscles. Sometimes it's more. If you suspect you've got some old emotions stuck in your tissue, let's talk about that the next time we see each other. You don't have to tell me anything about the specific emotions that you don't want to but we can include some focused work in your session if you'd like to see what it can do for you.

Be well, enjoy the weekend (and a special blessing to any of you who work retail!), and I look forward to seeing you again.

Count Your Body Parts

Take a moment and count how many body parts you have. Go ahead, I'll wait.

[insert Jeopardy music here]

What number did you come up with? 5? 10? 100? The answer is.....

1

Seriously, 1.

We divide the body into parts to make it easier to study. In truth, however, the body is only one part. A single unit. 1.

The toe and the earlobe are one.
The left hip and the third rib are one.
The bladder and the hypothalamus are one.
The hamstring and the belly button are one.

The body functions as a single entity. All parts -- all parts -- are interconnected. Yes, what happened to your neck in that car accident in 1987 can be the reason your feet hurt all the time in 2013.

You entire body is suspended in a web of fascia and the fascia is continuous throughout the body. Fascia is an amazing thing to study, explore, and understand. Fascia also allows my work to have significant effect, sometimes, with very little effort. If I can engage the fascia, I can eventually move everything in your body.

And, yes, I do think that's pretty damned cool.

How much control do we have over body fat?

From The First 20 Minutes: Exercise Better, Train Smarter, Live Longer by Gretchen Reynolds.

Meanwhile, despite the popular notion that slow exercise burns more fat than longer, harder bouts, it doesn't.

Did people burn more fat calories in the hours after they'd exercise? The answer was an unequivocal no.

Why exercise doesn't inevitably make people skinny is one of the more intriguing and vexing issues in physiology. Yet study after study finds that, with some rare exceptions, it does not..."In general, exercise by itself is pretty useless for weight loss," says Eric Ravussin, Ph.D., a professor at the Pennington Biomedical Research Center and an expert on the topic.

The idea that you can walk your way to fitness, it's just not proving to be true.

In physiological terms, the results are "consistent with the paradigm that mechanisms to maintain body fat are more effective in women," Dr. Braun and his colleagues wrote. In practical terms, they're scientific proof that life is unfair. Female bodies, inspired almost certainly "by a biological need to maintain energy stores for reproduction," Dr. Braun says, fight hard to hold on to every molecule of fat. Exercise for many women (and some men) inexorably increases the desire to eat.

Several years ago, researchers discovered that people who carry certain variations of a gene known as the fat-mass and obesity-associated, or FTO, gene have an enormously increased risk of becoming obese over their lifetimes. Close to a third of Americans of European descent may harbor this gene.

Other scientists have found that physical fitness, whether or not it's accompanied by personal fatness, leads to a longer, more robust life.

New truths about exercise and food

From The First 20 Minutes: Exercise Better, Train Smarter, Live Longer by Gretchen Reynolds.

If you're hungry, you need to eat. Food happens to be very good for that...That practical wisdom will not, of course, prevent the continued rise of gimcrack dietary fads.

Antioxidant supplements "prevent the induction of molecular regulators of insulin sensitivity and endogenous antioxidant defense by physical exercise," the German scientists concluded. Or, more bluntly, the vitamins undercut the exercise's benefits.

"The human body, [Li Li Ji, Ph.D., a professor of exercise physiology and nutritional science at the University of Wisconsin] says, is quite a smart machine.

Ask Yourself: Am I an Athlete? Be honest. If you're not working out more hour a day or at an achingly strenuous intensity, then, really, you're not.

If you're thirsty, drink. If you're not, you are probably sufficiently hydrated.

In general, in fact, exercise seems to be one of the few reliable means of avoiding stacking on pounds. If it doesn't aid much in weight loss, it is helpful in weight control.

Making Your Knees Feel Better

Do you have osteoarthritis of the knee? You can make a big difference in how you feel with self-massage.

A study in Canada showed that 20 minutes of massaging your quadriceps (front of the thigh) and around the knee can bring pain relief (though it won't increase range of motion).

The study used a specific procedure to massage the knee. I don't know the protocol but I can  show you ways to massage your quads and work around your knee. We'll both see how that works for you.

You can read the details here.

Goofiest (and good) explanation of massage I've seen lately

Just watch. And smile.

https://www.youtube.com/watch?v=hPzHjb0W9yE

Show Me Yer Scars!

Life is full of boo-boos, woopsies, and oh-sh*ts and they often leave a little memento behind in the form of a scar, large or small. So if you're older than, say, 5 you've probably got scars.

I love working with scars. I learned some basic techniques 2 years ago in a short course. I took the longer course this past weekend and now I'm even more excited to work with scars! If you've got 'em, let's take a look at them next time you're in.

Don't tell me they're too small, too old, never bothered you, etc. Every scar -- every scar -- affects the tissue around it in 3 dimensions. Scars are living tissue and are, therefore, always open to change. It's stunning (seriously, boggles the mind) how far and insidious the effects of scars can be.

This is a brief sampling of the volunteers and their scars I got to work with this weekend:

* a woman with a contracture in her palm (functions like a scar); she felt the work all the way up to her elbow

* a woman with a 20-year-old hysterectomy scar that was tightening up her low back (abdominal scars often exacerbate or cause low-back pain)

* a man with a 60-year-old (yes, 60) heart surgery scar that was affecting how much he could turn his head

* a woman with torso scars that hamper her ability to sing her full range

* a man with a scar on his Achilles tendon; he got more range of motion in that foot than he's had in his entire life

Take a moment to do a mental catalog of all your scars. How many do you have?

I did that this weekend, of course, but only just remembered this evening that I have a 48-year-old scar on my wrist! I'm curious if it is part of the reason I am decidedly less adroit with that hand.

It's worth seeing what can be done and exploring what might be happening in your body because of scars.

Got The Sequester Blues?

I can't make the government open up again but I can help you deal with the aggravation.

 

Not only can I provide massage therapy to soothe your nerves and quiet your mind, Pay What You Can is an established and enduring part of my practice. If you've got the time, I've got the table.

 

Go to Schedulicity and book yourself an appointment. It's a smart thing to do with some unexpected free time. 

Want to learn to massage your friends or family?

Every now and then a client will ask me how they could learn to do massage on a friend or family member. My alma mater, Potomac Massage Training Institute, teaches a few courses specifically for the general public. I interned with one of these classes when I was student. I can comfortably recommend these classes for anyone.

TOUCH of MASSAGE (10 am-5pm for individuals)
Learn to share the gift of Touch on September 8!

COUPLES MASSAGE (1 to 4pm)

Bring your Sweetie on September 8!

HEART of TOUCH (6 evening classes)

A more in-depth taste of PMTI's training methods, begins Wednesdays starting October 9th!

Also, Save a Life with...
CPR and First Aid Training
September 15th and November 10th

How Much Water For Exercise?

From: The First 20 Minutes: Surprising Science Reveals How We Can Exercise Better, Train Smarter, Live Longer by Gretchen Reynolds

"So how much and what should you drink if you regularly exercise? 'That's what we'd all like to know,' Dr. Coyle says....

"The most widely accepted DIY method of deciding if you're drinking properly is 'to weigh yourself before and after a workout or race,' Dr. Coyle says.

"So weigh yourself before your next hour-long run, bike ride, or other exercise session, preferably without your shoes or shirt on. Drink as you normally do. Weigh yourself again at its conclusion. 'If you're not losing more than two pounds of body weight in the course of an hour due to sweating,' Dr. Coyle says, 'you're fine. Don't change anything. If you are losing more than two pounds in the course of an hour, you may need to drink more.' And if, as happens rarely, you actually gain weight, cut back dramatically on how much drink in subsequent sessions. Weight gain during exercise is the primary symptom of hyponatremia (which, perhaps thankfully, is very uncommon in exercise lasting less than three or four hours and conducted at a slow pace)."

Note:

Dr. Edward Coyle  Ph.D., is an exercise physiologist at the University of Texas at Austin who's studied this topic for decades and served for many years as a consultant to cyclist Lance Armstrong

Water, Water Everywhere

"...about 55 to 60 percent of the human body is composed of water. Lean muscle tissue is nearly three-quarters water, and even solid-seeming bone contains more than 20 percent liquid. The stuff is essential for movement...Without water stores, the body can't produce the energy needed to propel it to a drinking fountain...

"'Plenty of people still believe that eight-glasses-a-day nonsense,' Dr. Noakes says, although a comprehensive 2005 report from the Institute of Medicine, based on years of study and scientific review, concluded that there was no credible evidence for the widespread belief that we need to drink eight glasses of water a day, especially since a large portion of a person's daily fluid needs can be met through food. Meat and vegetables contain water. So does milk. Even coffee counts toward your hydration intake, since, although it is a diuretic (meaning it promotes urination), you retain more of a latte's fluids than you lose. Drinking an additional eight full cups of water and other fluids 'is likely to be more than most people need,' Dr. Coyle says, 'even if they are quite active.'"

The First 20 Minutes: Surprising Science Reveals How We Can Exercise Better, Train Smarter, Live Longer by Gretchen Reynolds

I had heard that the "8 glasses a day" was de-bunked but now I've got the data to back it up.

Note:

Dr. Timothy Noakes, Ph.D. is a professor of exercise and sports science at the University of Cape Town in South Africa and a seminal if divisive figure in hydration science

Dr. Edward Coyle  Ph.D., is an exercise physiologist at the University of Texas at Austin who's studied the topic for decades and served for many years as a consultant to cyclist Lance Armstrong

I'm back!

I am back from a lovely vacation in California. Beautiful weather, good food, dear friends, massages.....

I will be gone one more week in September -- 23rd - 27th -- for a professional conference. Otherwise, I'm mostly here and open till Christmas.

My schedule is full this week but next week has some nice openings if you've missed me.

A Little Massage for the Massage Therapist

I leave on Saturday for 2 weeks in the San Francisco Bay area. I just booked a massage for myself and my husband for Sunday afternoon at a place highly recommended by a fellow MT.

I'm really looking forward to seeing what makes this place so well-respected by my friend. I enjoy checking out other massage practices to experience how the approach the work and to see how they run their business. There's always something new to learn.

Plus, I get a massage!  :)

A Little Rest for the Weary

Do you know the difference between rest and sleep?

I talked to someone last week who is working a full-on schedule during the week and spending every weekend travelling back and forth to visit a significant other who lives out of state. This person has absolutely no free time, no time for anything but work + relationship. No time to put feet up and watch bad TV, to read a book, to stare blankly out the window.

Despite getting enough sleep, this person is exhausted and ready to drop. What this person is missing is rest.

Rest is different from sleep. Rest happens when you are awake. It's the moments (hopefully more than just a few) when you don't have to think. You can let your mind idle. You can let go of forward movement, of meeting deadlines and crossing things off a to-do list.

Just as your body needs sleep, your mind needs rest. Your body does a lot of repair and integration while you sleep. Your mind is free to wander, discover, connect, and integrate when you rest.

Want to tap into your imagination? Your mind needs to rest.
Want to discern the solution to a problem? Your mind needs rest.
Want to feel refreshed? Your mind needs rest.
Want to be able to listen to your heart and soul? Your mind needs rest.

Without rest, your mind -- like your body without sleep -- begins to work less and less effectively. It begins to wear down, slow down, grind down. It's a car with dirty oil and not enough fuel.

How do you get rest? Here are some ways that work for me.

Meditation and prayer
A quiet worship service
Singing
Watching easy TV (I'm especially fond of Diners, Drive-ins, and Dives and The Big Bang Theory)
Going for a walk, run, swim, paddle
Read fiction
Experiencing comedy or humor
Laughing, especially with friends
A good meal eaten slowly, especially if I prepared it

Think about the last few days. How much rest was there in your life? What brings rest to your mind?

The August Doldrums

August is traditionally a slow time in DC -- people on vacation, Congress out of town, that sort of thing. It's traditionally a slow time for me too.

Which is good news for you! If your schedule has been hectic and/or your body has been hurting, I've got a lot of open spaces on my schedule in the next 10 days (and then I go on vacation). Get yourself booked in before the chaos of September returns.

"Like a chef berating his customers for being hungry."

A fellow PMTI grad -- Raju Mantina -- was profiled in the Washington Post MisFits column in the health section this week. Raj is a highly skilled and well-respected massage therapist. The columnist mentioned that Raj told him his hamstrings were "terrible" and strongly encouraged the columnist to stretch more and stretch properly.

This has led to a conversation among a few massage therapists about how we talk to our clients about their bodies. A few of us are beating the drum for banning negative language. As Amanda Long, a fellow MT, says:

"I stopped going to sooooo many therapists who made me feel guilty about my tight this or that or my inability to take a full breath. Uh, that's why I'm here. Its like a chef berating his customers for being hungry."

When you're using negative language around any relationship -- body, peoples, organizations -- you're going to get a negative relationship. What's the value of having a negative relationship with your own body? You can't walk away from it when it pisses you off. It can't come back with a stinging rebuke when you talk trash about it.

Perhaps you believe in "negative reinforcement" -- make someone/something feel bad enough and it will change its ways out of shame. I've never seen that work in a long-term effective way, especially when it's directed to your own body, your own self. Short-term, maybe. Long-term, never.

You are completely utterly profoundly stuck with your body. Every <bleeping> inch of it. And it's stuck with you and here's the good news: it's doing everything within it powers to work well and be optimally functional. Everything.

Sometimes your body, or a given body part, doesn't have access to all the resources it needs. The flu, appendicitis, diabetes, high cholesterol, etc. can all affect what your body has to work with. And it's still doing the best job it can.

If your body were a friend or a lover and you knew that your friend or lover's best was short of perfect, would you berate them, talk bad about them, put them down? You wouldn't if you wanted an enduring mutually-supportive relationship!

You have no more intimate relationship than the one with your body. At least treat it with the same respect you would a good friend because it's the best friend you've got. It's how I'm going to treat it.

Texas-bound

Just booked my flights to/from Texas! I'll be making a presentation on business plans at a national massage therapy conference. Super excited!

I also managed to book things so the trip will also include (1) a visit with a friend in central Louisiana and (2) a few days in Hot Springs AR. If you gotta go, make the most of the trip. That's my mantra!

Anyone got favorite places to go/see/do in Ft. Worth?

So I will be closed September 20 - 29.    :)

More Evening Hours!!

Good news: Starting in September I will be offering evening hours on Capitol Hill on Wednesdays from 6 pm - 9 pm. So you will be able to schedule an evening appointment on Tuesday, Wednesday, or Thursday.

The trade-off is that I will no longer be available on Mondays at Tenley Sport & Health.

Remember, this all starts in September.

Got Achy Knees?

I came across this on a massage therapist Facebook page. If you've got achy knees from osteoarthritis (not any other kind), this is helpful information.

Posted by Harriet Hall on June 11, 2013

Osteoarthritis is the “wear and tear” kind of arthritis that many of us develop as we get older. Cartilage becomes less resilient with age, collagen can degenerate, and inflammation and new bone outgrowths (osteophytes) can occur. This leads to pain, crepitus (Rice Krispie type crackling noises with movement), swelling and fluid accumulation in the joints (effusion), and can severely limit activity for some patients.

Since knee osteoarthritis is such a ubiquitous annoyance, home remedies and CAM offerings abound. Previously we have covered a number of CAM options on this blog, including glucosamine, acupuncture, and several others. The American Academy of Orthopaedic Surgeons (AAOS) has just issued a 1200 page report evaluating the evidence for various treatments for knee osteoarthritis short of total knee replacement surgery. A 13 page summary is available online. They have done the heavy lifting for us, reviewing all the available scientific studies for evidence of effectiveness. Here’s what the science says: (I’ve highlighted the ones where the evidence is strong.)

Exercise – strong evidence for effectiveness
Weight loss – moderate evidence for
Acupuncture – strong evidence against
Physical agents (TENS, ultrasound, etc.) – inconclusive
Manual therapy (chiropractic, massage) – inconclusive
Valgus-directing force brace – inconclusive
Lateral wedge insoles – moderate evidence against
Glucosamine and chondroitin – strong evidence against
NSAIDs – strong evidence for
Acetaminophen, opioids, pain patches – inconclusive (this is particularly interesting since acetaminophen is the standard first-choice drug)
Intraarticular corticosteroid injections – inconclusive
Hyaluronic acid injections – strong evidence against (and if injections are ineffective, those oral diet supplements certainly don’t have a chance)
Growth factor injections and/or platelet-rich plasma – inconclusive
Needle lavage – moderate evidence against
Arthroscopy with lavage and debridement – strong evidence against
Partial meniscectomy in osteoarthritis patients with torn meniscus – inconclusive
Valgus-producing proximal tibial osteotomy – limited evidence
Free-floating interpositional device – no evidence; consensus against

This is Kelly again....I've re-organized the list, below, grouping things by the study's findings about them.

Exercise – strong evidence for effectiveness
NSAIDs – strong evidence for

Weight loss – moderate evidence for

Physical agents (TENS, ultrasound, etc.) – inconclusive
Manual therapy (chiropractic, massage) – inconclusive
Valgus-directing force brace – inconclusive
Acetaminophen, opioids, pain patches – inconclusive
Intraarticular corticosteroid injections – inconclusive
Growth factor injections and/or platelet-rich plasma – inconclusive
Partial meniscectomy in osteoarthritis patients with torn meniscus – inconclusive

Lateral wedge insoles – moderate evidence against
Hyaluronic acid injections – strong evidence against
Needle lavage – moderate evidence against
Acupuncture – strong evidence against
Glucosamine and chondroitin – strong evidence against
Arthroscopy with lavage and debridement – strong evidence against

Valgus-producing proximal tibial osteotomy – limited evidence
Free-floating interpositional device – no evidence; consensus against

What I found most interesting was that weight loss only had moderate evidence of effectiveness. Doesn't mean it's a bad idea but it's not as effective as exercise (movement) and NSAIDs (such as aspirin, ibuprofen, naproxen, etc.).

And, yes, I noticed that massage therapy was "inconclusive". That, frankly, matches my experience too. I can bring some small temporary relief but I haven't been able to do any better than that with osteoarthritis.

Get Your Body Ready for the Fourth

Have you got some time off for Independence Day? Do you need to get your body ready for your 4th of July weekend? Let's do something about that with massage therapy. Your options next week are:

 

CAPITOL HILL

 

Tuesday, July 2: noon - 4 pm

Wednesday, July 3:  6 pm - 9 pm (change in schedule because of the holiday)

 

To schedule a massage on Capitol Hill, go to Schedulicity and schedule yourself, OR email me or text/phone me (202-744-1878).

 

TENLEY

 

Monday, July 1:  2 pm - 8 pm

Wednesday, July 3: noon - 4 pm

 

To schedule a massage at Tenley Sport & Health, call the gym directly (202-862-3000).

 

Be well, enjoy the holiday, don't forget your sunblock (!), and I look forward to working with you again.

Massage at your desk

Just finished a great lunch-time presentation on doing self-massage at your desk over at GAO. Lot of fun, lot of "oooohs!" from the participants.

Would you like a similar offering at your place of work? Let's talk!

Different Hours for the 4th of July week

Since next Thursday is a holiday, I'm opening up evening hours on Wednesday, July 3. You can get a massage between 6 pm and 9 pm at my Capitol Hill location.

Easiest way to schedule? Go to Schedulicity and schedule yourself! Quicker and easier than playing phone tag with me.  :)

A Fibromylagia Break-Through

It looks like researchers may have finally figured out what causes fibromyalgia, which means it could be treated at the source. Given how many people I know with this condition, this could be some of the best medical news I've heard in a while.

What I See, What I Don't

LOVE this blog entry.

 

There are a lot of people who land on my table who believe that all their body problems would be eased if just lost some weight. Some times it would help. Sometimes it would make very little difference.

Here's the thing that matters so much to me in my practice: you are beautiful and perfect just the way you are. Your body is doing the very best it can and is always moving towards health. It is working, for heavens sake, because you are still breathing and can still move.

Can I help you hurt a little less, move a little more smoothly, breathe a little easier? Sure and it makes me happy. But, trust me, I don't look at you and think "fat". I *may* look at you and think "shoulders look tight" or "looks uncomfortable" or "wonder what I can do to make his/her day better" or "what challenge will this new person bring me". But I'm never thinking "fat".

Get your massage on next week

It's a beautiful day, my schedule is getting full, and I think you would love a massage (I'm not wrong, am I?). Here are your options next week.

 

Tuesday, June 25:  5 pm, 6 pm (Capitol Hill)

 

Yes, that's all I've got!

 

To schedule a massage, you have heaps of options:

 

1.  Go online and schedule yourself.

 

2.  Email me.

 

3.  Call / text me (202-744-1878)

 

Go get yourself a dose of sunshine and I look forward to working with you again.

Insights into a pain syndrome

The Washington Post Health section had an article this Tuesday about myofascial pain syndrome. It's a good piece. I don't do the dry-needling mentioned in the article but I am certified in myofascial release, which can provide another treatment option.

It's also got some good illustrations explaining knots / trigger points in muscles. I recommend giving it a read.

How much does your head weigh on the computer?

I know how very very difficult it is to sit up straight at a computer (she says, pulling her head back and sitting up straight). This graphic (via Erik Dalton and the Back 2 Health FB page) should provide some encouragement.

I'm thinking of printing it out and taping it to the wall behind my monitor.

Belly rubs

Last month I ended up back in the hospital for 5 days. It turns out that the scar tissue from my surgery in December has wrapped itself around my small intestine. The small intestine can't move the way it needs to (I didn't realize it needed to move that much!) and I ended up with an intestinal blockage.

Very very painful. Would have sworn it was appendicitis if I still had an appendix!

The docs got me past the worst of it and said my body would, somehow, clear all this up on its own. I'm thinking "on it's own, my body got things gummed up, how is it going to straighten itself out on its own?".

So, I called Mike Duggan, the instructor for the myofascial release class I took last year. He's doing fascial release work on my abdominal viscera -- not just the small intestine but the large intestine and all the organs in my abdomen (scars occur in the fascia). He's working to get that fascia un-stuck and free-moving again.

It's very gentle patient work but it's, slowly, starting to have an effect. I think it will take 4-8 sessions to really get things unstuck and moving well again. I suspect my abdominal fascia has been a bit "sticky" for a very long time.

I love that I know someone who can help me with this. I love that I've taken this training so I understood what was happening and how I could help things along. I love that I also know how to do this for you as well.

Fascia is cool stuff. Scars are fascinating. I'm happy that I took the certification series last you so I can help you and myself!

How to make your calendar more attractive next week

How much better would next week look if you could already see a massage therapy appointment on your calendar? You can, you know....

Capitol Hill
---------------

Tuesday, June 4: noon - 5 pm
Thursday, June 6: noon - 4 pm, 8 pm

Tenley Sport & Health
----------------------------

Monday, June 3: 2 pm - 8 pm
Wednesday, June 5: noon - 4 pm

To schedule a massage on Capitol Hill, email me or call/text me (202-744-1878).

To schedule a massage at Tenley Sport & Health, call the gym directly (202-362-8000)

Your Body as Barometer

While I was living in Brisbane, I got connected with a local healing arts center called The Lightworkers Cottage. Wonderful place. I still get their e-newsletter. The most recent had this, which really talked to me. Listening to our bodies really does tell us volumes about how we're doing as a total entity.

Often our own bodies are talking to us and we ignore the messages they are trying to communicate to us. Tiredness, anger, insomnia, loss of interest, fear and sadness should be important warning signs that you are not managing your life well! We need to pay closer attention to what happens to us in the course of a day. Messages, signs and symbols can come to us through our pets, a close friend, a book or music that comes into our life at just the right time. Guidance is all around us. By being more alert to our dreams, our intuition, and coincidences, we can live fuller and richer lives. Once we start connecting to the language of our bodies, being open to the external signs and symbols around us, we will connect more powerfully to the possibilities around us.

Have Chair, Will Travel

Do you have a fundraising event where it would be cool to have seated massage as well? I may be able to help!

One of my 2013 initiatives to promote my practice (that sounds quite official, doesn't it?) is to help organizations raise money by offering seated massage at their events. Participants pay me. I turn over all the proceeds to the organization.

I've done it a few times this year and it turns out to be one of the more enjoyable marketing tools I've tried! I'm particularly interested in organizations / events that are within about 4 miles of my Capitol Hill office. (Tonight I was in Jessup MD, which is 30 miles from my office but, hey, I met some great people!)

If you've got an event where seated massage would be another fundraising tool, talk to me.

Degenerative Joint Disease

If you've got Degenerative Joint Disease, give the following a read. I originally read it on Anatomy & Physiology on Facebook.


Musculoskeletal Wednesday by Michel van Exsel, MSc:

Degenerative joint disease (DJD) of the knee can result in pain and constraints during daily live. When DJD is associated with varus or valgus malalingment osteotomy could result in a relief of symptoms. Osteotomy results in a shift of the weight-bearing axis away from the degenerative compartment. Varus deformity is corrected with high tibial osteotomy (lateral closing wedge or medial opening wedge). Valgus deformity, less common, is corrected with most often a distal femoral osteotomy.

Osteotomy is indicated for physiologically young patient with painful unicompartmental DJD. Before surgery is planned, any meniscal, ligamentous pathology and referred pain from the hip should be ruled out. The intention of performing an osteotomy is not be a lifelong solution of the DJD but is performed to postpone a total knee arthroplasty (TKA). Patients are often able to delay a TKA for more than 10 years. During those 10 years high impact activities could be performed.

From: Gardiner et al., Sports Med Arthrosc (21) 2013 38-46. All rights reserved to Lippincott Williams & Wilkins.

Whatch doing Thursday?

I've given myself some goals for each month to help me make a business decision this summer. In line with that, I'd love to have two more massage appointments tomorrow (May 30). If you've been thinking about it, go ahead and sign up for one of these appointments on Thursday:

1:30 pm
6 pm
7 pm

202-744-1878
massage@bowershours.com

You shouldn't have to decide

I was chatting with someone today about massage and got a question I get fairly often: what "kind" of massage do I do?

The people who ask this are are usually people who get massages in spas or spa-like settings which post different prices for the different modalities/styles of massage. I understand why spas do that but I think it's really unfair to you, the client.

Biggest problem with it? You can't make an informed decision unless you've done a lot of research about the modalities a massage therapist has access to. The descriptions in the spas I've been to aren't a lot of help. Even within the massage community, we don't all agree on what the "deep" in "deep tissue" means.

I operate on a simple principle: you tell me what you need out of your session, I'll use everything I've got to make that happen. I use all the things I've learned over time, all the modalities I've studied, all the things I've picked up on my own and I'll combine them the best way I know how.

You're not buying a product from me. You're buying an experience and an outcome. I don't tell my doctor how to relieve the pain in my abdomen. I tell him what the problem is and I trust him to use whatever techniques he thinks best. Even if I have some idea of what might help, the odds are he's more up-to-date on the latest treatment techniques than I am.

There's nothing wrong with asking for a specific modality when you want a specific experience. Love hot stone massage? Ask for it! Heard good things about raindrop therapy? Ask for it!

Don't be intimidated, though, if you don't know exactly what it will take to achieve your massage goals. That's my job and I'm happy to do it.

Last Massage Before Summer?

Memorial Day weekend is just one week away. Do you need a massage before the unofficial start to summer? Here are your options May 20 - 24:

 

Capitol Hill

---------------

 

Tuesday, May 21: 2 pm - 9 pm

Thursday, May 23: 1 pm - 4 pm; 8 pm

 

To schedule a massage on Capitol Hill, email me or call/text me (202-744-1878).

 

Tenley Sport & Health

---------------------------

 

Monday, May 20:  2 pm - 8 pm

Wednesday, May 22: noon - 4 pm

 

To schedule a massage here, contact the gym directly: 202-362-8000.

 

 

Be well, enjoy the sunshine, hope your roses are blooming too, and I look forward to working with you again.

Elephant Massage?

This is a very nice write-up about massage. Even if you don't read the whole post, make sure you slide down to the end for the elephant massage (and I'm not saying anything else about that, you have to go look for yourself).

Some news you probably already knew

The latest AMTA Research Roundup shows that massage therapy is a powerful tool for pain relief. But you already knew that, didn't you?

Memorial Day weekend

Are you making your Memorial Day plans? (It's only 10 days away you know.) I will be OPEN Memorial Day! I am seeing clients from 10 am - 4 pm at Tenley Sport & Health.

So now your Memorial Day plans can include the gift of relief, relaxation, and harmony with your body. Not a bad way to start the summer.

Need a massage soooooooon?

Here's what's available for you this week.

Capitol Hill

Tuesday, May 14:  3 pm - 9 pm
Thursday, May 16:  noon - 4 pm

Email me (massage@bowershours.com) or call / text me (202-744-1878).

Tenleytown

Monday, May 13:  2 pm - 6 pm
Wednesday, May 15:  noon - 4 pm

To schedule a massage at Tenley Sport & Health, call the gym directly.  202-362-8000.