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Movement is Life

This spring, my wife and I had the great fortune to visit the homestead of my ancestors in Norway. It was an amazing experience to stand inside the little home that my grandmother was born in, then left at age 15 (by herself) to come to the USA. My cousins took Janet and I on two walks, both memorable in their difficulty. One was a stroll after dinner- a three mile hike through mountain trails. The other, a 7.5 mile hike that was a steep ascent, unlike anything I have ever experienced. On the way up, I was going to mention to my cousin that even though I can do 100 mile bike rides, this was a severe challenge. Speaking first, he told me that his father did this hike at age 85! (I didn't say anything more about my tired legs.)

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Activity levels in Norway seem incredibly high and built into the culture. As a result, Norway is rated the healthiest country in the world. Yes, diet plays a role, but I think activity is the major player in their good health. In this newsletter, I'd like to explore massage therapy and movement from a couple different perspectives. 

Massage Therapy: Making Comfortable Movement Possible

It is well known that for many conditions, controlled and graded movement is far better than total rest. When I first started practicing, bed rest was a common prescription for back pain. No informed health provider makes that recommendation now. The research data supports the idea that the more you move, the better. 

It is however, hard to move when you hurt. If your therapist at BodyWork Associates can alleviate your discomfort to the point where movement is possible, very good results are likely. This is perhaps one of the greatest benefits of our targeted Precision Neuromuscular Therapy. 

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As someone deeply involved in the research, I have seen many studies that show that massage therapy is more effective when combined with other approaches as well- often those approaches are pain management and/or movement related. 

Active Recovery

We at BodyWork Associates are big proponents of the active recovery approach. If one of the UI athletes is injured, almost never is complete rest assigned by the trainers. These kids are back on the playing field in record time and it is not because they are playing hurt. Their activities are scaled back, but never completely ceased. Why?

One necessary component of healing is blood flow. Muscle contraction is natures way of increasing blood flow to an area. If your low back hurts and you spend days resting in bed, your blood flow to the low back is severely compromised. A simple activity like walking can jump start your recovery. 

Try This Experiment

Place your hands on your back and start walking. Do you feel your back muscles contracting? They engage (at low levels) with every step you take. Step forward with your left foot and feel the muscles on the right side of your back contract. Putting weight on the right foot engages the left side of the back. Walking then is a great way to increase blood flow to the muscles of the spine. 

Even more interesting is research into the pressure on the discs of your lower back. Intra-disc pressure goes down with increased walking speed. Conversely, the slower you walk, the greater the disc pressure in your lumbar spine. Pick up the speed and you will feel better. 

Massage vs Ultrasound

On a side note, one very interesting recent research study showed that deep massage increased blood flow to the muscles and and increased tissue temperature greater than that produced by ultrasound! 

During Your Session

It is highly likely that during your session, your BWA therapist will incorporate some stretches and movements. This concept is vital to success in the work. Treating a muscle alone isn't enough- it has to be shown that greater comfortable range is now possible. If not, the nervous system still constrains movement based on old information. It acts as though there is still a problem. 

In fact, research shows that if you have a problem and you compensate, the compensatory movements stay even when the problem disappears. Our specific approach, Precision Neuromuscular Therapy, is like a software update for your nervous system. 
 

After Your Session

We strongly encourage our clients to move after a session, especially if you have come in with something specific. When we interact with your muscles, it is highly likely that they are more pliable and you are more body-aware than before your session. Without strain, choose an activity that also is exploratory. If you are a golfer, go to the driving range and practice your short game. Take that ballroom dance lesson, that Tai Chi or yoga class. Join your spouse for a walk in the woods or around the neighborhood. You will feel better for having done so. 

Sitting Too Long Can Kill You

There has been an abundance of evidence that our propensity to sit for long periods is devastating to our health. Since the average person is now sitting for 9-10 hours a day, our life has changed drastically from my grandparents who farmed the land. In a new study published this week in the Annals of Medicine, greater time sitting leads to a lesser life span. Read a nice summary of the research here.  

Movement is Life! 

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Muscles Are Like People; Sort of...

A few days ago, one of my clients wondered why I didn't just "go after" a very tender and aggravated area of her leg. In her mind, if the problem is so focal, why not zero in and get it over with. 

Working Indirectly - (Using the Back Door)

In a way, muscles are like people. If someone is really angry with you, everything you do is another possible irritation (or worse). A gentle attempt at an apology can backfire, no matter how noble your intentions. When the threshold of tolerance has been crossed, every stimulus is a threat. 

In such cases, the best strategy is often an indirect approach. The situation must be diffused before any real intervention can happen. With muscles, one example of an indirect (or back door strategy) is treating other muscles that have the same function or nerve supply to reduce the activity and irritation at the primary site of pain. 

My client was astonished at how much better the original site of pain was after working related areas. To be honest, I am sure she thought that I was a bit lost when I moved away from the site of pain since none of the other muscles I addressed were where she felt her original symptoms.  But, returning to the original site that was previously so painful, the intensity had diminished by more than 50%. At that point, we were able to gently and thoroughly treat the epicenter of her pain without it being overwhelming. 

The Direct Approach  (The Front Door)

There are many other times, if not most, when it is absolutely essential to address sensitive areas with exact precision. In research at the National Institute for Health, the areas of injury we look for in a muscle are often about the size of a grain of rice. Feeling something that small is no easy task. We seek and need your feedback. The turn of a wrist or a slight change in the angle of pressure can be the difference between success and failure. If you feel that we are close, but not quite "on it", don't be afraid to tell us. 

Which is Appropriate: Direct or Indirect?

 The key is how your nervous system responds. If the focal area feels like a "good pain", then a direct approach is preferable. If you feel the need to recoil as we press on the site of discomfort, an indirect approach is probably a better choice.  This is part of the art and science of massage therapy. We appreciate your clear and honest feedback to navigate help us be as effective and efficient as possible.

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Helping Knee Pain

 In our staff educational training seminars this month, the focus has been on helping knee and foot pain issues. While our work with neck, shoulder, and lower back discomfort is well known, issues of the lower extremity get much less attention but are no less crucial. 

     The premise of the work is the same as for many of the other conditions we address: Muscular problems can often mimic or display the same symptoms as much more serious issues. Pain on the inside of the knee could easily be assumed to be an injury to the internal ligaments of the knee. As in every other part of the body, the brain will always protect deeper structures with muscular protection; muscles with take the brunt of the trauma first, protecting deeper and more sensitive structures. As a result, the muscles are often a source of pain when the ligaments are uninjured.

 

     What about arthritic changes in the knee? Can targeted massage be helpful even in cases like that? To answer this question, researchers at the University of Miami Medical School did a study on 24 people with arthritic knee pain. The results?

  • Knee pain reduced and range of motion increased
  • Treating the quadricep and hamstring muscles were essential to achieving good outcomes.
  • Survey scores revealed that participants receiving massage had less pain, greater activity, and less sleep disturbances. 

 

     Countless people with knee issues have benefited from our targeted Precision Neuromuscular Massage. Realistically, you may want to budget for about three half hour sessions with a focus on the knee. The odds are very good that our Precision Neuromuscular Therapy can help. In addition to our therapy, strengthening and stretching the quads and hamstrings are essential.

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Dealing in Crisis Mode- Welcome to the Lily Pond

“What happens to people who never have this kind of work done?”

I have been asked this question more often than I could ever count. Two concepts are embedded in this question. First, I want to address "this" kind of work. For many years, BWA was in a position of defining what massage therapy was to Champaign-Urbana. As massage has become more popular, many other massage practitioners have appeared on the scene. Many clients have also received massages on a cruise or a vacation. Often these sessions are pleasant, but our clients tell us that general massage is not at all in the same league as what we do at BWA. This is because our work is rooted in Precision Neuromuscular Therapy (PNMT), work that is very targeted and focused and grounded in results. Massage in a spa setting is great, but has a completely different purpose than PNMT.

The second part of the question refers to allowing "nature" to take its course. What does happen when aches and pains are left untreated? Aches and pain become internalized as ‘normal’ by the nervous system. Over time, the problem area slowly gets worse, largely unnoticed by the host. At some point, crisis happens and drastic measures are needed. These measures are often expensive and somewhat dangerous, but often the only resort left. Practitioners of these drastic measures exclaim that only their methods are effective against such maladies, which is true if the process is allowed to escalate to such a degree. This does not address the possibility that the whole mess could have been averted by proactive measures. How does this happen? Why is it so common?

The real problem here is chronology. As the ancient Chinese philosopher said, “He who solves a problem before it surfaces, who calls that clever?” Why is there such a tendency to wait until crisis happens? While I have talked about this issue for years in my classes, mentioned it to countless clients and colleagues, I did not really get it until a few weeks ago listening to someone describe a scenario with a lily pond. Strangely, I marvel at how what we think we know suddenly reaches a new understanding, understanding that is visceral as well as cognitive.

In the lily pond story, imagine a five-acre pond with a lily or two in one corner. Of course, lilies are pretty and decorative and a couple in your pond is OK. The problem is they grow prolifically. (In this instance, the lilies double every day and fill the pond in one month.) Where there was one, there are now two, two then four, four then eight. The owner of the pond is still unmoved; eight lily pads in the pond is hardly a big deal. Since the owner of the pond hardly pays attention, the lily pads go unnoticed. Only when the pond is seemingly suddenly overtaken by lily pads and the owner realizes there is a problem, does the owner call for a service to eliminate the lily pads. The problem is, at day 29 with the pond half full with lily pads, the lily pads are one day away from taking over the pond completely. If the pond service is delayed at all, it will be too late. If they arrive immediately, the actions taken are severe and expensive. The owner is resentful that the service was so expensive and they killed other vegetation and fish in the process. He/she would probably not recommend them to anyone else because it was too expensive and they were a bit careless. Is this fair?

When we wait until day twenty-nine, not much good happens. Actions taken are drastic and painful. The problem is that all the motivation for intervention is at day twenty-nine, not at day ten. Perhaps we must do a better job of teaching our clients to address the underlying causes before they become big problems. You can bet that the pond owner doesn’t need to be reminded to keep the lily pad population under control. We learn to change our furnace filters, get our teeth cleaned, and change the oil in our cars every 3000 miles or so. The time to address the soft-tissue problems with massage therapy at BWA is before there is a painful crisis. Massage Therapy is certainly not as effective during a crisis as more drastic measures. Does this mean that manual therapy is not as effective as other strategies? Clearly that is not what should be surmised. Real wisdom is not how to deal with crisis. Real wisdom is avoiding crisis. If we did this the cost (in both dollars and suffering) would be reduced substantially. 

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Time Heals All (or maybe not)

While I was in between clients the other day, a woman came into the office looking at our Temper-Pedic cervical pillows. Hearing more about her needs, it was clear that she was looking at a new pillow because her neck hurt. Inquiring how long her neck had been hurting, she informed me that it had hurt for almost three months. A few days after a low-impact car accident, her neck began to hurt. When I asked her about what she had done in response, she replied that time heals all and her neck would surely improve eventually. How much time is reasonable? Two months? Five months? After a certain point this strategy doesn’t seem very logical.

Life tends to constantly remind us that ignoring a problem seldom makes it go away. Clearly however, there are physical issues that do dissipate with a little time. What is a reasonable criterion to know the difference?

One possibility is trajectory. If you have a muscular issue, it is not uncommon for it to last for two to three days. After day four, is the pain getting less or staying about the same? Is this discomfort affecting daily life? If each day the condition continues to improve, it is likely to disappear on its own. This can be a bit tricky to perceive as your nervous system can habituate to the pain, that is why noticing if the discomfort affects your daily life is sometimes more accurate than just measuring the intensity of pain. If the discomfort isn’t improving significantly each day, consider getting some targeted Precision Neuromuscular Therapy to change the course of events. The goal of our massage therapy is to speed up the process, helping you to recover as quickly as possible.

What does recover mean exactly? This is a fair question, given some recent research data. As you are aware, when your body is in pain, you use yourself differently. Muscles alter their function and often go into protective tightness. What makes sense is that when the pain is no longer there, the muscles return to regularly scheduled programming. This is a nice idea, but not born out in the research data. Muscles seem to continue their altered function even when this is no longer needed. This can lead to a different set of problems down the road.

Having our targeted approach to massage therapy is like pressing reset (or the refresh button) on an electrical system. It causes the system to reassess the state of affairs based on current, rather than historical data. That can be a powerful tool to redirect the system back to more optimal functioning. 

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PREVENTING AND TREATING MUSCULAR SORENESS

 

The aftermath of muscular exertion is often a few days of aching pain called Delayed Onset Muscle Soreness or DOMS.  While soreness after a significant exertion is somewhat of a given, there are things you can do to lessen the effect. 

The most important factor in preventing and treating DOMS is increasing circulation to the area. (People used to think this was due to lactic acid build-up, a misconception that has lasted for decades). Here are two strategies you can use at home. 

1. The best way to increase circulation is muscular contraction. If possible, move using a gentle form of exercise. If you are sore from a very long bike ride, go for a nice walk the next morning. Your muscles may initially complain, but will relent if you keep the activity at a low level. 

2. Use contrast therapy. Apply moist heat for two minutes and then cold for thirty seconds. Alternate four to five times. The temperature differential is what helps and this is far more efficient than long stretches of cold or heat. 

Massage Therapy

Research has shown that short sessions are better at dealing with DOMS than longer sessions. This is the strategy we use with U of I athletes. If you know that you are going to do something strenuous, schedule a half hour session the next day. 

Also, on occasion, deeper massage work can create post-massage soreness. The best way to prevent this from occurring is to move after a session, rather than rest. If you had deep work on your calf and thigh, go for a short walk afterward. It really helps prevent post-massage soreness. 

I just applied this myself, as I did a 100 mile bike ride a week ago. The next day, I had one of my staff do a short massage therapy session and I made sure to go for two walks with my wife. After the second day, the soreness was not noticeable. 

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That Which is Overlooked

When we have discomfort, the over-riding impulse is to identify exactly what hurts. Actually, the "what" question is much easier that the "why" question. Here are two examples of when the actual cause isn't what we feel at the time.
 

TMJ issues and Neck Pain
 

Imagine that you have multiple tender areas in the muscles of the neck. What you might guess is that you have neck tension, but nothing seems to help. Although you may not put them together, my staff might ask you about any tension in the muscles of the jaw you might not have noticed. Why? Problems in the muscles of the jaw often increase the tension level of the muscles of the neck, which then presents as neck discomfort.

 In one research study, subjects with advanced arthritis of the jaw were given an injection to anesthetize the joint. Where one would expect the relief to occur is in the area immediately surrounding the joint. In fact, where the greatest relief occurred is in the muscles of the neck!
 

Thoracic Restriction and Low Back Pain

Pain in the low back is far more common than pain in the thoracic spine (mid-back). There is however, a good deal of evidence that restriction in the thoracic spine can lead to pain in the low back. Here's why.

The low back is built for stability, not mobility. Rotation of the whole low back is less than ten degrees! The thoracic spine is ideally suited to rotate to more than fifty degrees. If your thoracic rotation is restricted and you are trying to create rotation, such as to swing a golf club or tennis racket, you will try to accomplish that action by rotating your low back instead. This will result in low back pain, but all the treatment of the back will ultimately fail.

What the mid-back cannot do, the low back tries to accomplish. This is not going to go well!

Strangely, symptoms are not always felt in the problem source such as the low back or jaw, only in the area that overworks to compensate. The staff at BWA is very mindful of these relationships and wants to address not only the symptom, but the possible cause.

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Massage and Knee Pain

We have see quite a few clients lately who have presented with pain in the knee that has been attributed to arthritic changes. Our results have been quite good, and the research supports this.  

 

There's been more than one study suggesting massage therapy helps relieve the pain associated with osteoarthritis of the knee. More recently, the results have again been affirmed by research supported by the National Center for Complementary and Alternative Medicine. This 2012 study comprised 125 adult participants diagnosed with osteoarthritis of the knee.

 

At eight weeks, there was significant improvement (measured by an arthritis index score called WOMAC) in the 60-minute massage groups compared to usual care and the massage group reported less pain. The lead researcher stated, "The three highest doses of massage improved relative to baseline in WOMAC pain at 16 and 24 weeks, in stiffness at 24 weeks, and functionality at 16 and 24 weeks." The results seemed to last.

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Why Don't You Have a Large Menu of Services?

It’s a Simple Menu

I was on the phone the other day with a company that wanted to help promote BodyWork Associates online. One of their big features was that as we change service menus, it would automatically be updated on their site. As politely as possible, I declined. This company was very used to dealing with spa centers, where there is often an extensive list of services available, often each with a long description. Change two or three aspects to the protocol and Voilà, you have a whole new menu item to market.

From a business perspective, I get it. From a personal perspective, I haven’t the least bit of interest. At BodyWork Associates, our menu revolves around you. At the beginning of your session, one of my staff will sit down with you to inquire what your goals are for the session. Even if you have been in previously, your goals for that particular day might be completely different. Plus; you have the right to change your mind! It is very common for a client to state that they want a general session, only to discover as one of my staff examines his/her neck and shoulder area, that the session would be better spent dealing with only that. The opposite also happens where fifteen minutes of concentrated work creates a resolution that is then followed by forty five minutes of general work. You get to choose.

In a way, a menu is- “I have an answer and I hope it matches your question.” For us, our desire is to match your needs with what we do, not the other way around. It isn’t flashy, but I think it is one of the reasons we’ve been here since 1982. Thank you for supporting us in that endeavor.  

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Looking Back, Looking Forward

This April, I celebrated my 38th anniversary of practicing massage therapy, a milestone that I never expected to accomplish. Looking back over this period, it is very clear that my career, and the nature of the work itself, has changed dramatically over the years. Part of the reason I am thinking about my career is that one of my clients asked me this question- Knowing what I know now, would I still have chosen this path? In the past, the answer was a quick “yes”. This time, I thought about his inquiry for a few moments before answering in the affirmative. His question caused me to both look backward to the past and also reassess what is important now with regard to the mission and the function of my chosen path. It is only natural and appropriate that time and experience has reshaped the fabric of my work. The result of such a long career is evolving clarity about the mission of this work, where it fits in the larger picture, and why that is important.

Looking back on those very early years, I was completely enamored with the novelty of massage therapy; it felt as though I was a pioneer down a new and important path. Years later, as I discovered neuromuscular therapy, it felt like a new chapter in my massage career had unfolded. The work required far more anatomical and technical skill than general massage and I was inspired by the challenge and the possibility of massage as a corrective and truly therapeutic modality.

During that time, it is also with a bit of embarrassment that I recall my overzealous assessment of the value of massage therapy in the treatment of musculoskeletal pain. There is an effect in psychology called the Dunning-Krueger Effect; the people who know the least are the most confident. That was certainly true for me during this time; I was unaware of that which I did not know.

As I dove ever deeper into the science of the work in the mid 1990’s, I became more and more deeply aware of the endless mysteries associated with this (and any field) of knowledge. The more I learned, the less sure I was about that which I had never previously questioned.

At the same time, a different kind of confidence began to emerge. Every client I saw became a learning experience. Research endeavors that had unexpected outcomes took me down previously unknown routes of exploration. Instead of being devastated and demoralized by research failures, I was rediscovering the same wonder for massage therapy that I had in the very beginning of my career. That sense of wonder continues to the present moment.

As many of you know, I don’t typically see people for general massage therapy for relaxation these days. Not because massage for relaxation isn’t valuable in its own right, but because I can best serve others by using my skills to solve very difficult problems. This is the interesting part with regard to my practice; as my skills have elevated, the complexity of the conditions I see has also increased. Each day is filled with deep challenges and complicated cases that push the limits of my ability.

Part of the reason that I share this background with you is that even though my career and type of massage I do has changed tremendously over the years, the mission, far clearer today, is still the same as it was in 1977. Hands-on therapy such as massage can play a vital role in health care. Far too many people suffer from musculoskeletal pain thinking that nothing can be done to help them or that the pain they experience is somehow “normal”. The development of Precision Neuromuscular Therapy (PNMT), the work that I teach, is based on effectiveness and efficiency.

As I travel and speak at conferences across the country, I have heard many presentations from researchers, health care providers, and educators from our top health care institutions and places like the National Institutes for Health. The picture they paint isn’t pretty; the data on the effectiveness and efficiency of standard approaches isn’t just underwhelming- it is a high cost that all of us are paying. This trend is not sustainable; we just cannot afford to waste money on approaches that don’t yield real benefits. As technology increases, the costs have gone up substantially. If the outcomes increased in proportion to the cost, then this increase may be justified. In fact however, our outcomes aren’t better at all. Only the cost has increased. In 2011, we Americans spent 13 Billion dollars on spinal fusions alone. The annual cost of back pain is estimated to be in the neighborhood of 90 Billion dollars! Is there a way that massage therapy, specifically Precision Neuromuscular Therapy, can fill gaps in the system and save both individuals and our health care system valuable resources?

This questions consumes my thoughts these days and demands that we clarify exactly what we are best at, especially targeting conditions that are not well served by traditional approaches. My goal for BWA is to keep better outcome data to help us know exactly that; did what we do work and how we can tweak it to be even more effective.  A condition like TMJ (jaw pain) is a prime example of how we can be effective and efficient and save both the individual and the health care system substantial amounts of money and aggravation. Typically, with just three sessions, our success rate with pain in the jaw is very high. The total cost of these three sessions is a tiny fraction of what other more invasive approaches can cost. The science is also clear- more invasive approaches to TMJ pain are very expensive and do not produce favorable outcomes. My goal is to have a whole set of areas with which we are clear that we can help. On the flip side, it will also be clear that there are some conditions in which we have little to offer, therefore should refer to other disciplines who are more effective. We should know what we are good at, and what we are not. 

More than ever, I believe that there is a place for our specific form of massage therapy called Precision Neuromuscular Therapy. While we have lots to do in the future, our track record with many common muscular ailments is one of effectiveness and minimal cost. Our commitment as an office is to continue to improve and refine our approaches to maximize results. You, our clients, deserve nothing less. 

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That Which is Overlooked

When we have discomfort, the over-riding impulse is to identify exactly what hurts. Actually, the "what" question is much easier that the "why" question. Here are two examples of when the actual cause isn't what we feel at the time.

TMJ issues and Neck Pain
 

Imagine that you have multiple tender areas in the muscles of the neck. What you might guess is that you have neck tension, but nothing seems to help. Although you may not put them together, my staff might ask you about any tension in the muscles of the jaw you might not have noticed. Why? Problems in the muscles of the jaw often increase the tension level of the muscles of the neck, which then presents as neck discomfort.

 In one research study, subjects with advanced arthritis of the jaw were given an injection to anesthetize the joint. Where one would expect the relief to occur is in the area immediately surrounding the joint. In fact, where the greatest relief occurred is in the muscles of the neck!

Thoracic Restriction and Low Back Pain

Pain in the low back is far more common than pain in the thoracic spine (mid-back). There is however, a good deal of evidence that restriction in the thoracic spine can lead to pain in the low back. Here's why.

The low back is built for stability, not mobility. Rotation of the whole low back is less than ten degrees! The thoracic spine is ideally suited to rotate to more than fifty degrees. If your thoracic rotation is restricted and you are trying to create rotation, such as to swing a golf club or tennis racket, you will try to accomplish that action by rotating your low back instead. This will result in low back pain, but all the treatment of the back will ultimately fail.

What the mid-back cannot do, the low back tries to accomplish. This is not going to go well!

Strangely, symptoms are not always felt in the problem source such as the low back or jaw, only in the area that overworks to compensate. The staff at BWA is very mindful of these relationships and wants to address not only the symptom, but the possible cause. 

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It Must Be Arthritis. . .

It is a comment that I hear quite often; "At my age, my pain is probably due to arthritis."

While this is possible, it is by no means a given. Arthritis may be the source of most of your pain or perhaps the soft tissue surrounding the joint may be largely the culprit. 

I recorded this six minute video to explain- I hope you find it useful

Doug Nelson

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I Exercised Once. . .

The other day, I had a client ask me a perplexing question. He had referred a friend to BWA, who saw Eric for a one hour session. The person had been having sciatic pain down the leg for three months and no one had been able to help him previously. In a last ditch attempt, he decided to try coming to see us after speaking with my client. After the session with Eric, the client was now free from pain for seven days, the first pain relief he had for three months. After a week of no pain, the deep ache down the leg slowly returned. My client was asking if there was someone else his friend should see or another treatment available. 

What I find very sad about this question is the idea that you can have pain for months and yet expect one session to "fix" it. Oh if it were only true. So much in life is about building momentum, more process than event. 

Thank about statements like:

  • I tried exercising once and didn't lose any weight. . .
  • I took a lesson on the violin and still couldn't play Bach. . .
  • I ate healthy once and didn't feel any better. . .

We at BWA are very sensitive to possible time and monetary issues with regard to appointments. We don't ask you to come for a long series of sessions or make you sign a yearly contract. At the same time, it is important to understand that if you are coming in for a specific problem, a series of three to four sessions is probably in order. In that way, whatever gains we make will not be lost over time. Plus, it can take a session or two to localize the real problem, which isn't always apparent in the beginning.

When and how often should you return? The ideal is that if you experience a lessening of symptoms after your session, you should return before the symptoms resume in earnest or re-escalate.  In our former example, the person should have come back after about five days. The third session should probably have been about 7-10 days after the second session. In all probability, that should have solved the issue. All things considered, especially compared to the cost of other interventions in terms of time and money, our Precision Neuromuscular Therapy is very efficient. As with so many things it isn't just what, but how often and for how long. Working together, we can make progress and problem solve through the many variables on the way to better muscular health. 

Best,

Doug Nelson

President, BodyWork Associates

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Stress: Two Simple Strategies

We have two different parts of our nervous systems, one that lights up when we are under threat "fight or flight" and one that is often labeled "rest and digest".  

  1. Being under stress and in "alarm" mode changes our breathing.To switch from alarm mode to rest and digest, try this simple exercise.  Place your hands on your lower ribs.   As you breath in, feel your lower ribs expanding outwards, against your hands. This movement of the ribs is a cue for the nervous system to switch from alarm to rest.  The neurobiology is complicated, but the science is clear. (This is different than "belly" breathing, which does not have this effect on the nervous system. 
  2. During the "alarm" phase, massive amounts of glucose are released into the bloodstream and are targeted for the lower extremities. (There is some really good data about chronic stress and adult onset diabetes as a result). It makes sense that when you are under increased stress, do your best to vigorously exercise your legs. Bike, run, walk briskly, whatever. You will feel the difference afterwards.

 

 When stress increases, the effect is as physical as it is mental. The good news is that we can use physical strategies to combat the effects of stress as well.  

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The Land In Between

A fundamental issue that every business must address is this: Who do we serve? And why?

For all of us here at BWA, we are clearer than ever about those two questions and I would like to share some thoughts with you.

Fundamentally, we straddle two very different worlds. We clearly are not a spa and we are also not physical therapists. We serve the land in between those two, which happens also to be where the greatest need is.

While we aren't a spa, the work that we do is inherently relaxing and renewing. Few things give my therapy staff greater pleasure than to see the smiles of our clients after a session. We have the sense that we have contributed to his/her day, allowing them to resume their schedule with a little more ease and grace.

On the therapy side, most people who come to see us initially have some sort of muscular discomfort that has made their life more difficult. Often, these muscular problems weren't severe enough to address with their doctor, just an annoyance that made everyday life that much harder. Moreover, many of them ascribed the pain to aging or considered these problems "normal" until they saw us for Precision Neuromuscular Therapy.

This is our place in the community, our niche and our mission. So many people hurt and don't know that our special form of massage therapy can truly help. We are massage therapists, but we emphasize the therapy part of the equation.

To have the skill to accomplish real results in muscular discomfort requires a far deeper understanding of anatomy and much greater clinical skills than general massage. For all of us at BWA, this isn't a hobby or a part time job, it is our mission and our place in the world. Thank you for being part of it and part of our family.

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Stress: Dispelling Misconceptions By Doug Nelson

Somewhere along the way, the meaning of the word stress went astray. Today, stress is usually considered a negative, and most active people view stress reduction as impractical at best.  To better understand stress, we must first look at its history.

 

Stress research began in the 1950's with a growing understanding of how it affects the body. Early pioneers in the field were people like Walter Cannon and Hans Selye. The concept of stress was new at the time, so Selye borrowed the term from mechanical engineering in an attempt to define the physiological response he was identifying. Ultimately, stress research became a new field of human health, but the foundations of his research are often misunderstood, as is the effect of stress on the system.

 

What is stress?

 

Selye defined stress as simply the cost of adaptation. When the human nervous system senses change, a response is needed and adaptation is required. The collective cost of all adaptations is called stress. Selye made no mention of whether the stimulus (which can be emotional, mental or physical) was by nature good or bad; any change requires response and adaptation. Therefore, stress is simply responding to life, and life is stressful. Lack of stress is called rigor mortis. Not much of a choice!

 

Many people become “turned off” when someone talks about the evils of stress. Others believe if you simply breathe deeply, life will be better. But, breathing deeply isn’t enough. So, how do we reduce stress? Close the business? Sell the house?  Get rid of the pets? Not much of a choice...

 

With today’s hectic pace of life, it is imperative for us to understand and deal with stress appropriately. Here are a few points to consider:

 

  • Stress is cumulative. The initial effect of stress is to stimulate the system, much the way a performer is energized by adrenaline before a performance. If that adrenaline rush lasts too long or is too intense, performance suffers. The cost of constant adaptation is cumulative; unrelenting stress will damage the system over time.  
  • Bodies are battlegrounds. Have you ever come home after a tough day and said, “Wow, it’s a war out there”? The battleground of this "war" is your own body. Each skirmish, each victory or defeat, leaves a few casualties on the battlefield. Eventually, the “wounded” are strewn everywhere. Self-care approaches, such as physical exercise or playful activities clear the field (body) and are enormously helpful in reducing the harmful effects of stress.
  • Stress can be managed. To attempt to eliminate stress completely is misguided. Every active person must learn to intelligently address the cumulative residual effects of stress and find reasonable methods to manage it.  What works for one person may not work for another, but understanding and committing to a method that works for you can help improve performance, productivity and overall health. 

 

Let’s face it: For a boat to push forward in the water, waves must be created. Boats that do not move in an effort to avoid stress may as well be called docks. Those of us with a mission in life don’t want to sit, we want to sail! Sailing can be stressful. Managing stress shouldn't be.

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