Massage Therapy--Articles and Essays

The following articles were originally written for Suite101. However, I no longer have the mental fortitude to continue writing there, so I have moved my work here. They're in no particular order, but the titles should give you a good idea what each is about. I hope you find them useful and informative.


Sports Massage--An Introduction
Massage and Arthritis Pain
Low Back Pain and the Psoas Connection
Massage Therapy for Plantar Fasciitis, or My Feet are Killing Me
Carpal Tunnel Syndrome
Oh My Aching Head!!
Massage and Sciatica
Massage after Mastectomy
Honey, Would You Rub My Back?
Honey, Rub My Back--continued
Massage and Frozen Shoulders
Massage and AIDS/HIV
Massage and Stress Management
Massage and 'Growing Pains'
Massage and the mind
Massage for your Baby
Massage for the Expectant Mother

Sports Massage--An Introduction

This is a topic that we'll be getting more into in later articles. Right now, I want to introduce sports massage in general terms and outline the importance and benefits.

Many people think that sports massage is only for professional athletes or for competition-ready amateurs. However, many weekend athletes can benefit from massage before and after their unaccustomed exertions. In fact, these intermittent athletes might benefit most of all.

Professionals who have access to regular massage know how it helps maintain their peak condition, flush metabolic wastes from muscles after a game or workout and to warm muscles before a game so they're ready to go.

What many casual athletes don't realize is that they, too, can reap the benefits. While regular massage therapy is good for stress management, pain relief and general health maintenance, sports-specific massage can help you avoid injury and to recover more quickly from the strains and physical stresses of whatever sport or activity you engage in.

While massage shouldn't take the place of pre-sport warming up, it can be a useful adjunct. It's also important to remember that you should warm up before you stretch. A little jogging in place, jumping jacks, even walking up and down a set of steps a few times to get the blood moving and the muscles warmed will help avoid injury from stretching cold muscles. Think of an elastic that's been in the freezer all night. If you take it out and subject it to sudden stretching, it may very well snap or fray. Warm it in your hand first, and you can stretch it to its fullest without damage. Your muscles are similar, so warm them up first, then stretch, then go on to the sport or activity.

"That's all very well," you say. "Where does massage fit into all this?" Well, in addition to your own warming activities, a massage therapist versed in sports massage, can use techniques that help the warming process. He or she can also stretch the muscles, get the blood flowing to the limbs that are going to be most active and generally help you prepare for whatever you're going to be doing. Remember, this works best in conjunction with your own pre-event exercises.

A key point you want to keep in mind is that you don't want a relaxing sort of treatment before you go out and play. There are massage therapists who don't realize the importance of rapid, light techniques and who are used to giving slow, deep massage. This is fine after the sport is over, when you want your muscles flushed and loosened so you aren't as sore the next day as you might otherwise be. Relaxing massage before you go out and run or play tennis or baseball will leave you feeling enervated and sleepy instead of energized and ready to go.

Something that many amateur teams do is to chip in to hire a massage therapist for the afternoon. Many of us are willing to give a good rate for our time, and we bring all the equipment we need. All the team members have to do is turn up, flop on the table and let us know if they're on their way to play, or if they've just come from their turn and need to relax. The rest is up to us.

Whether you use massage pre- and post-exertion or not, make sure you take care of yourself with proper warm-up, stretching and cooling down after. After all, the point of engaging in sports is to make yourself healthier and happier, not injured and miserable.

Happy playing, all.

Massage and Arthritis Pain

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One of the many reasons people come to me is for the relief of pain caused by arthritis. I tell them that there is nothing that I can do for the arthritis itself, nor can I make it go away. However, what I can do is to help the muscles nearby to relax and thereby reduce some of the pain.

What I cannot do is to change the arthritic joint, especially when it is affected by rheumatoid arthritis. Osteoarthritis can sometimes be helped by massage: the increased circulation to the joint helps it to heal itself a little and to make the arthritis itself back down somewhat. I use it on my own finger joints when they start to act up and get stiff. I perform some frictions and other firm techniques along the joint line and so far, it has worked remarkably well to keep my hands mobile and functioning. When you consider the attrition rate for massage therapists at the ten year mark is somewhere around 70% and I have been doing this for 10 and a half years, then you can see how effective massage can be for maintaining joint function.

Osteoarthritis is caused by general wear and tear on the joints, especially on the hyaline cartilage which coats the end of each bone and prevents bone to bone contact (if I remember my schooling correctly). When the cartilage wears down, the bones lose their buffer and begin to rub together, causing pain and inflammation as the body reacts to the new stresses. The surrounding muscles may become tight and tense to act as a splint, helping the joint to function. Splinting can be a helpful thing, but there are times when muscles become too enthusiastic and the tightness becomes stiffness and an inability to move easily. This is where massage therapy can help.

Rheumatoid arthritis affects the joint lining and can lead to destruction of the bone and joint capsule. I remember vividly examining the x-rays a client brought in of her elbow. The top part of one of the bones of her forearm had been completely eaten away by arthritis and the bone came to a jagged end about 3" (three inches or 7.5 cm) below the elbow. She came to me mostly for relaxation massage to help her body release the tension caused by this severe case of RA. RA is the worse version of arthritis, in my opinion. This is the one that can cause deformity of the joints, deviation of the fingers and toes, and severe loss of function. All a massage therapist can do for someone with RA is to provide relief for some of the pain of the surrounding area, at best. We can't undo the damage done to the joints and bones.

For OA, on the other hand, as I said above, sometimes massage can help the joint heal itself, although this is a rare situation. Massage can relax the surrounding muscles, increase circulation to the joint and local area to bring fresh oxygen and nutrients and to remove waste products from the cells. Many of my clients who suffer from arthritis find that regular massage, which might be weekly for some and monthly for others, brings relief that lasts longer than medication and is less harmful to the body, overall.

If you have arthritis and find that you're not as limber as you once were, go looking for a massage therapist and ask what they can do to help you. At worst, you'll have a nice, relaxing session; at best, you'll find your pain reduced and your body moving more freely. Good luck and good health.

For more information on arthritis, go to: All About Arthritis

Massage Therapy for Plantar Fasciitis or My Feet are Killing Me

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If youíve ever been diagnosed with Plantar Fasciitis, you know how agonizing this condition can be. Symptoms usually start with pain on the bottom of your foot when you first put weight on it after being at rest. This, then, usually progresses to pain that lasts longer and longer, and, in some cases, can eventually lead to bone spurs.

What is happening is that the fascia on the sole of your foot (the plantar surface) becomes irritated and inflamed. Fascia is a resilient membrane that surrounds each muscle fibre, each fibre bundle, each muscle and each group of muscles. The plantar fascia is somewhat thicker and tougher than that in other places, and it attaches to the bottom of the heel bone (the calcaneus).

When it becomes irritated, or stretched more than it cares to be, it pulls on its attachment point. The pain is felt at the back part of the arch of the foot, just in front of the heel. It can be a sharp pain, or burning, and itís almost always worst when you first stand on it. The reason for this is that while youíre sitting, or lying down, your body is trying to repair the microdamage done to the tissues. As soon as you put weight on it again, the arch flattens slightly, pulls on the fascia, and causes further damage. After you walk around for a bit, your foot gets more used to the stresses being put on it and the pain diminishes somewhat. However, without treatment, the cycle merely repeats over and over, until the pain is almost unbearable.

Massage Therapy can be useful in several ways. A well-trained or experienced Massage Therapist should be able to treat the symptoms, and to recommend exercises to help prevent recurrences, as well as help the condition to subside.

Treatment can be painful, as it is often necessary to work on the tenderest site at the back of the arch. The good news is that the pain doesnít usually last long, and most people report a diminishing of pain in a matter of seconds. I, myself, like to work on the entire sole of the foot, as well as the muscles in the back of the calf. Some of these muscles insert on the sole of the foot and contribute to the problem when they are tight, so itís nice to make sure theyíre as relaxed as possible.

My treatment includes mobilization techniques for the entire foot and ankle. The training I had and the scope of practice under which I practise allow me to do so. Some state and local laws do not allow Massage Therapists to do any joint mobilization of any type. However, I include this in working on the lower leg and foot, and find that making sure the bones can move freely help the muscles to unclench.

I use deep thumb kneading along the entire arch, and the rest of the sole of the foot. I often focus treatment on the attachment point of the fascia. The purpose of the massage is to increase circulation to the injured tissues. Increase in circulation brings fresh oxygen and nutrients to the muscles and fascia and helps to carry away metabolic wastes more efficiently. In turn, this helps the body to repair the damaged tissues.

Exercise which I prescribe include using a golf ball on the sole of the foot to help break up adhesions, and to help mobilize the tarsal bones. I also recommend practising grabbing things with your toes, and other exercises to use the muscles of your foot. As a further self-help measure, I show clients how to massage their own feet between sessions with me in order to speed up the healing process.

In many cases, the plantar fasciitis responds well and quickly to massage techniques. Iíve had quite a few clients report a decrease in pain, and an increase in the ability to walk without difficulty. For those whose livelihood depends on being able to be on their feet all day long, this treatment is of incredible value. Itís very gratifying when someone is able to continue work, or to return to activities he or she enjoys because I was able to help.

If you suspect that you have plantar fasciitis, call your medical professional and have an assessment. Investigate your local Massage Therapists for someone with the training or experience to help you.

Happy recovery.

Carpal Tunnel Syndrome

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All too frequently nowadays, we hear about Carpal Tunnel Syndrome. And all too frequently we all know someone who has had to resort to surgery to correct the problem. Sometimes the surgery is successful and the person is never troubled again by the numbness and pain. Unfortunately for others, the surgery is unsuccessful, and the pain recurs. In many cases, physiotherapy has proven helpful, and sometimes chiropractic medicine does the trick. In others, massage therapy is the ticket to freedom.

Massage treatment for carpal tunnel mostly involves work to the forearm muscles, especially to the flexors (the muscles that curl your fingers into fists and bend your hand towards your forearm). When these muscles are tight, feeling hard and resistant to pressure, they often close down on the nerves that supply your hand. A massage therapist skilled in this work, can loosen the muscles, increase the circulation through the area and free up the compressed nerves. Combined with exercises for you to do at home and at work, this can lead to a reduction, and in some cases a complete cessation of symptoms.

Because quite a few of the muscles involved attach at the other end to the lower part of the humerus (the bone of the upper arm), it is important to work through there, too. Working on the attachments of the muscle should stimulate a relaxation response in the belly of the muscle. I like to combine this work with a deep kneading of the muscle itself, feeling the fibres loosen and relax under my fingers. Itís very satisfying to feel a muscle go from feeling like a bronze casting of a muscle to being soft and pliable, to see the clientís reaction as the numbness starts to subside and the pain to recede.

In addition to the work described above, I use deep thumb stroking of the tendons where they cross the wrist from the hand down into the forearm, giving them a good stretch as I go. Part of my training involved learning how to mobilize the bones in the wrist and hand, and I use those techniques, too, on the theory that movement is life, and the more freely the bones and muscles can move, the happier and healthier a body is. When I feel that Iím starting to push the envelope to the point that the muscle is on the verge of being irritated, I switch to the muscles on the back of the forearm. Itís important to keep a balance, I believe, and when one group of muscles is tight and pulling, it usually causes strain on the counter group (the antagonists). Therefore, no treatment is complete without addressing the arm, the body, the person as a whole and not a small dysfunctioning part.

To maintain the free movement, I also use passive stretching of the forearms, and show the client how they can do these exercises at home to stay loose and functioning properly. I also recommend wrist supports for those who use a keyboard a great deal, and try to find other helpful suggestions for other clients in jobs with repetitive wrist motions. In this part of Nova Scotia, there are quite a few people working "in the fish," employed by the fish factories cutting and processing fish. This involves long hours of standing on a concrete floor, reaching for a fish, then using a small, sharp knife to cut it apart, remove the innards and bones, and pass it along the line. Many of these workers suffer terribly from carpal tunnel syndrome, and need to be able to work when the fish comes in. The work is seasonal and unpredictable, so quite a few of these hard-working laborers try to come in for maintenance to keep them functioning during the season.

There are some very good books out there on treating and avoiding carpal tunnel. These are all available through Amazon.com:

1 - Conquering Carpal Tunnel Syndrome: And Other Repetitive Strain Injuries - Sharon J. Butler, Jacqueline Entwistle Freeman (Illustrator); Paperback
2 - Repetitive Strain Injury : A Computer User's Guide - Emil Pascarelli, Deborah Quilter (Contributor); Paperback 3 - Carpal Tunnel Syndrome and Repetitive Stress Injuries: The Comprehensive Guide to Prevention, Treatment and Recovery - Tammy Crouch; Paperback

I hope anyone suffering from this condition will consider trying massage and other therapies. How much nicer to have relief without resorting to surgery unless it is absolutely unavoidable.

Happy recovery.

Oh My Aching Head!!

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When she first came to me three years or so ago, it was in desperation. Here she was, a young woman in her mid-thirties, about 5í 1Ē, and weighing about 108 pounds. She suffered from daily headaches. Blinding ones that left her breathless, and unable to function some days. She was taking prescription painkillers and going through a bottle of acetaminophen in two weeks, roughly about 10 pills a day. She would wake up in the night to take painkillers just to be able to sleep through until morning. The last time she went to her doctor, he had told her, ďWell, your father had headaches his whole life. You will, too. Youíll just have to get used to it.Ē

Someone else told her about massage. So, with nothing more to lose she made an appointment. She wanted a full-body, 90-minute session, and could I please help her headaches? I could certainly try.

Reading over the case history form she filled out for me, and talking with her, I learned that she worked in one of the fish factories as a fish cutter, and spent long hours standing on a concrete floor, reaching for the next fish with one hand, cutting with the other, her neck almost constantly in a bent forward position. She worked odd hours, depending on when the fishing boats brought in their catches for the factory, and some days might only work a couple of hours, or on a busy day, might work up to 10 hours or more.

All of this suggested to me that the headaches were coming from stressed muscles in her neck. The treatment consisted of the first hour on her body from neck to toes, front and back, including her arms and hands and shoulder muscles. Then the next 30 minutes was just for her neck. She lay on her back, covered by a flowered sheet (I prefer a less clinical approach...the crisp white sheets and lab coats favored by some Massage Therapists just scream "hospital" to me, and I donít relax as much as I could. To others itís reassuring and professional.)

I sat in my computer chair at her head, adjusting the height of my chair so I could reach her neck comfortably. I started with putting my hands under her neck and feeling all along the length for the tension spots, asking for verification of the places I thought should be tender. Quite a few of the tight spots turned out to be "trigger points" and referred pain into her head. Using a combination of kneading with my fingers, stretching her neck, trigger point therapy and gentle movements of her neck, getting her to breathe deeply and to relax her neck as much as possible, we were able to get rid of the headache she had come in with.

We set an appointment for the next week, and when she arrived, she was delighted to tell me that she had been headache free for three whole days. Further sessions became farther and farther apart, and now I only see her about twice a year. She now takes her prescription pain killers one or two days a month, with her monthly cycle, and is off the acetaminophen. The headaches do still come monthly, but usually only then unless she overworks her neck. However, the stretches and home care she practises keep them manageable.

Headaches are often treatable with massage or chiropractic or a combination of both. Itís certainly worth it, even if you suffer with migraines, to look into one or both of these therapies. The side effects are nil, although sometimes the trigger point therapy can leave your neck feeling tender for a day or so, but not always. And itís wonderful to be able to cut down on medication that might be having long term effects on your liver and other organs.

Happy recovery.

Massage and Sciatica

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It seems that most of us, at one time or another, have suffered the pain of "sciatica." It can range from nothing more than a mild tingling down the back of the thigh, or in the calf and foot, or it may be an agonizing pain that makes it hard to walk, move, sit, stand, or even lie down comfortably. Current medical treatment might involve prescription pain killers, physiotherapy, and even surgery.

I, myself, prefer a somewhat less invasive approach, although sometimes quite an exercise in pain endurance. Of course, not every treatment is painful, and when massage does hurt, it should be of the "OHHH, that hurts so good!!" variety of pain. Back on track...how can massage possibly alleviate sciatica, you ask, sciatica is an irritation of the sciatic nerve. What can a massage therapist do for nerve irritation?

Well, the first thing we need to do is to look at the simple mechanics of the hip and buttock area. The nerve itself is made up of several nerve roots coming from the low back and sacral area, and combining to make a nerve bundle which, up at the buttock level is about as big around as oneís thumb. This makes it an easy target for compression. I often find with my male clients who suffer from this, that the culprit is often a two-inch thick wallet tucked into a rear pocket and then sat upon. Since the sciatic nerve, as it branches out descending the leg, supplies the back of the thigh, and the entire lower leg and foot, itís small wonder that they then suffer from pain down the leg.

Now, I donít have a good drawing here, but I'll try to find one. Under the gluteus maximus muscle, there are a group of small, but vitally important muscles. These serve to stabilize and rotate the leg at the hip. The largest of these is piriformis. It runs from the sacrum on a slight angle out to the greater trochanter, that big bony bump you can feel in your thigh when you stick out your hip to the side. The sciatic nerve has to navigate between piriformis and the other muscles, and when piriformis is tight, it compresses the nerve. And presto, pain and dysfunction.

So we come to what exactly massage can do for this. I usually start with hands-on assessing of the entire low back and buttock area. I often find that low back muscles are also involved, and so treatment includes that general vicinity. Then I zero in on piriformis, starting with the edge along the sacrum. This is when people start to groan a little, and tell me, "OH! Thatís where it hurts." I just smile to myself. I have a good idea whatís coming, and usually a few minutes later, Iíll hear, "WOW!! Thatís REALLY sore!" when I start to find the trigger points in the piriformis.

Naturally, I adjust pressure and technique depending on the person under my hands. Sometimes what is most effective is gentle vibrations on the buttock and sacrum. Other times, the deep work does the trick. The fun part (for the therapist) is finding what works for each individual. Everyone is different, has different tolerance for pain or discomfort, and each body is unique. What works for a 250-pound, 30-year-old bodybuilder probably is NOT the same thing I want to use for a 110-pound, 75-year-old woman. Of course, she might be able to take more, you never can tell.

Another very valuable treatment for this type of pain is chiropractic care. I often refer clients to their favorite chiropractor for co-treatment. I work the muscles, the chiro adjusts the bones, and the client benefits from both, often obtaining relief that lasts for months and months. So, if this nasty little condition rears its ugly head, and your doctor tells you, "Itís sciatica.", donít despair. Track down a massage therapist or chiropractor near you and get to the root of the problem.

Happy recovery.

Massage after Mastectomy

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She has been a client for almost three years. At 81, she is one of the older ladies whom I treat for a variety of conditions. She is a sharp old woman, with a wry sense of humor, who comes regularly for work on her shoulders and neck to keep her free from pain, and to maintain her range of motion.

Thirty years ago she lost a breast to cancer, to a radical mastectomy that left her with just a little strip of her pectoralis major muscle (which helps to move the arm at the shoulder), and a scar. No little tidy thin line across the chest wall, but a large triangle of scar tissue, point down, with a tail that runs across the front of her shoulder well out onto her upper arm. This tail tends to restrict the movement of her arm, and this is her good arm, the other having been injured when she was newborn, and a careless neighbor hurt it trying to dress the new baby.

In the past, I've worked on the tail, trying to increase its flexibility, but two weeks ago, I asked her permission to work on the main body of the scar where it adheres to her ribs. I theorized that if I were able to loosen the adhesions so that the scar tissue would slide across the ribs instead of being anchored to them, this would enable her to move her arm a little bit more. To my delight, and hers, after two sessions of this, she is finding a small increase in her arm's range. We're both hopeful that continuing this work will maintain the gain.

So now, finally, we come to my main point, which is that any woman who has had a mastectomy, no matter how long ago, or is facing one in the near future, consider the potential benefits of massage therapy after surgery. Check with your doctor to make sure that massage is not something you should avoid, and look for a therapist trained or experienced in this type of therapy. For some women, lymphatic drainage to help reduce the swelling in the arm and shoulder area would be most beneficial. For others, gentle treatment along the scar to keep it free-moving and to minimize adhesions would be the focus of treatment.

In all cases, it seems that simple touch of the area serves a huge psychological benefit, in having someone else just accepting your new appearance, and demonstrating by example that it is not something to avoid touching. Many women have found that their partners are initially afraid to touch the chest where the breast used to be, in case they remind their loved one that she's no longer 'the woman she used to be'. And it's true...she's not. But THIS is the woman she is now, and needs all the nurturing, loving, hands-on she can get. Many massage therapists are not averse to teaching easy to learn, easy to use techniques to clients and their loved ones for use at home.

As my client mentioned above demonstrates, it's never too late to start with massage for mastectomies. I repeat, though, check with your medical doctor first, and then look for someone you feel comfortable with. Check with friends who go for massage, ask your doctor for a referral, look around. Don't be afraid to ask the therapist their training and experience. This is YOUR body, and YOUR health.

Happy and quick recovery.

Honey, Would You Rub My Back?

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This week, I'm going to tell you how to give a relaxing back massage for someone who is carrying a lot of tension in their upper back and shoulders. Another time, we'll focus on the low back and hips. Eventually, you'll be able to give a full back massage that your loved ones will be clamoring for. Make sure you get them to read this little how-to item, so you get to be on the receiving end, too.

Have your friend or loved one lie face down on the bed (I'm assuming you don't have a massage table) with no shirt on. Get a little bit of oil on your hands (cooking oil is fine and canola works well) just enough that your hands don't stick to the skin. Start at the base of the neck, and using a little pressure, run your hands down both sides of spine as far as you can reach. Right now, you just want to get the oil on the back...so spread it around the shoulder blades and upper back.

Now, go back up to the trouble area and use your thumbs (try not to use the very tips, that hurts) to put pressure on the muscles on either side of the spine, and press outwards for an inch or so. Do this for the whole area from midback to the base of the neck. If it hurts at all, it should be a "gee that hurts good" feeling. You can do one side and then the other, always applying pressure AWAY from the spine, and not directly ON the spine.

Now, to help loosen up all the muscles in that area, put your palm on one of the shoulder blades and shake it. You should get a nice loose movement going of the whole shoulder girdle and arm. Do the same for the other one.

Go back to the back muscles, and with the thumbs again, and as heavy pressure as your hands and the person's back can take, stroke from the spine all the way out to the shoulder blades. Do that on both sides (one at a time) from the bottom of the shoulder blades up to the base of the neck again.

In many people, the muscles in the back of the neck feel like guitar strings, and you'll probably find some very tender spots along the upper part of the back and across the top of the shoulders. Don't be afraid to work on them, but make sure you get feedback on whether it hurts or not. If the person says you're going too deep, or it hurts, lighten the pressure immediately.

This should start to relax some of the tight spots in the upper back. Now you can use the heels of your hands to rub circles all down the sides of the spine (neck to midback or lower). Keep checking to make sure it's not too painful ever, and trust your instincts. If you feel that working on a particular spot is right...it probably is.

Work on the upper back and shoulders like this (throwing in your own variations) for about 30 minutes, if your hands can take it, and finish up with some light strokes up the back, out across the shoulders and back a couple of times. All done, and your friend or loved one should be happy. Good, now get him or her to do it for you!

Happy back rub.

Honey, Rub My Back--continued

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It has been an age since I wrote the first part of this, and I refer you to the article archives. I talked about how to give a nice back rub for the upper back and shoulders. Now, we're moving down to the lower back.

Many of my clients come to me because of back pain of various types. The techniques I will describe below are not meant to take the place of therapeutic massage, but are good for relaxation and de-stressing.

The easiest place to do this is on the bed. Make sure the room is comfortably warm, so the person on the receiving end doesn't get a chill. Have your oil close by on the bedside table or a breakfast tray. You should have on clothing you can move easily in and the recipient should be either naked or in underwear with the waist band pulled low on the hips.

Have the other person lie face down on the bed and get comfortable. (Grammar note: To avoid using horrible grammar, I'm going to choose a male recipient. I detest using "their" when I'm talking about one person.) You can either kneel by his side, or straddle the backs of his thighs. Try to keep your weight off his legs.

Pour a little oil or lotion in one hand and rub both hands together. Then put both hands on his lower back with the heels of your hands on the space between the dimples. Your fingers should lie along the curve of his hips. Slide your hands up his back as far as you can comfortably reach without stretching. This is now your stopping point. Move your hands out along the ribs and then back down his sides to the starting point. Repeat this two or three times.

Use alternate hands and rub from the spine (remember no pressure on the spine) outwards and circle back. Move up one side of his body to your stopping point and glide back down. Repeat for the other side. Caution: light pressure over the lower ribs. This is a relaxing massage and there's no need for heavy pressing. Check from time to time with the recipient to make sure you're not hurting him and that everything feels fine.

The next step is to use your finger pads (the part where your fingerprints are--not the tips) to make small circles on either side of the spine. Start just above the dimples and work your way back up to your stopping point. Return to start with a slow glide. Put the heels of your hands on the dimples and press with one hand and then the other. Don't do it too hard; just enough to get a nice, gentle rocking motion. Let your hands slide up and out a little, circle back, go higher and circle back, all the way to the stop point. Glide back to start.

You can use your thumbs to do some of the work. Don't be afraid to experiment and always check with the person on the receiving end. Finish with light strokes up the middle of the back and out to the sides and back down. This should help relieve some tension in the lower back and just generally feel good. When you're finished, cover the person with a warm blanket and let him lie there for a few minutes to savor the comfort.

The hardest part comes next. Persuading him to return the favor.

Happy back rubbing.

Low Back Pain and the Psoas Connection

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I thought I would continue with low back pain this month before moving on to something new for December's column. One of the most common reasons for people to seek help from chiropractors and massage therapists is low back pain. It can range from the occasional mild twinge to debilitating pain that might have someone flat on their back for a couple of days, or even longer. Often, pain pills don't do enough, and although rest might alleviate the pain, it frequently returns.

There are a myriad of causes for low back pain, but today I am focusing on one in particular: the psoas (pronounced: so-az) muscle. The "low back" link on my front page leads to an excellent picture of psoas and how it connects to the lower spine and femur (the thigh bone). Its main job is to flex your hip, so if your leg is free to move, your thigh rises: think of walking up stairs. If your leg is held steady, you bend at the hips: think of doing full sit-ups.

When you sit for a long time, psoas is in a shortened position and it gets used to it. So when you go to stand up, and ask psoas to straighten out again, please, it sometimes gets quite snippy and the next thing you know, your bottom half is standing, but you're all bent over with your low back shouting nasty things at you. That would be psoas voicing its disapproval.

Usually, at this point, the only thing to do is to hobble around until the pain lessens and you are able to stand erect. That is fine for the short term, but the next time you sit at your desk or table, psoas will leap at the chance to shorten up and make life difficult. Massage and chiropractic can help, but one of the best things you can do for yourself is to do some easy stretches to keep psoas used to the idea that it's okay to lengthen.

Here's how: Stand with both feet pointing forward, about shoulder distance apart. Move one foot forward as far as you comfortably can, keeping it pointed forward. Now, and you may need to hold on to something so you don't topple over, slide your other foot backward, bending your front knee as you go lower. It's okay to lean your body forward some, but try to keep your knee from going ahead of your foot. If you are flexible, you might want to try this at the foot of your stairs. Put the front foot on the first or second step and then slide the back foot backwards.

This movement extends your hip and stretches psoas. Hold the stretch for a few seconds, bring the back leg forward, and repeat. Do this three to five times per side, and remember to do it daily. Keeping psoas moving through its entire range of motion will help maintain its flexibility and reduce its chances of catching you when you least expect it. It also won't hurt to take it to your local massage therapist to have it worked on and loosened and to have these lunge exercises demonstrated in person.

In short, keep moving, stretching and stay active to stay healthy. Keep low back pain at bay with easy self care.

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Massage and Frozen Shoulders

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No, I'm not talking about going out in the wintertime with inadequate covering.

Frozen shoulder, also known as Adhesive Capsulitis, is a condition that can creep up on you or appear without warning. I remember one client of mine from many years ago who had been putting dishes away in a cupboard over her sink when it struck and left her unable to raise her arm. In fact, many times there is no apparent reason for it at all.

In other instances it can occur after an accident such as a bad fall, or a motor vehicle accident. Arthritis may be the underlying cause for others. When the shoulder has been immobilized in a cast or a splint, the joint may 'seize up' afterwards. Pain is usually felt on the outside part of the upper arm and is dull, but sharp when you try to move the shoulder. In the early stages, it may be painful at night, especially when you are lying on the affected side.

Movement is restricted. Usually most difficult is rotating your shoulder outward. Imagine you have something in your hand you want to pass to someone beside you. Ordinarily, you would just turn your arm and hand it over. With Frozen Shoulder, this movement is extremely difficult. The two other movements most affected are the ability to lift your arm to the side and to raise it to the front. Reaching across your body, behind you or turning your arm in toward you are usually unaffected.

Traditional treatment often involves physiotherapy, also called physical therapy, and most clients whom I have seen have been told by their MD's that it might take up to eighteen months to recover. Some have had drugs prescribed for the pain, and in some instances they've had muscle relaxants.

The first steps in massage, at least in my clinic, involves having the person lie on my table face down at first while I assess the tissues around the shoulder. I feel for tension in the muscles and tendons, trigger points and anything out of the ordinary. The next thing I do is to find out just how restricted the movement is by taking the shoulder through its paces. I make sure the person is not trying to move the arm so I can feel where it is catching, and I ask for feedback as I go. I make a note of how far it moves before it starts to hurt. Treatment consists of experimenting with different techniques to loosen the tight muscles, to stretch the tendons and to help break up any adhesions that might be forming in the joint capsule. It can be quite tender to work on when it's in this condition, and I ask for constant feedback. After a time, I again put the arm through its range of motion to see if it is now going any farther than it was before.

I often use shaking as a technique to help loosen all the tissues. I get the person to relax the shoulder as much as possible and then, with one hand holding the upper arm near the elbow, and the other hand under the front of the shoulder, I move it rapidly but gently up and down, back and forth and around in circles. This is generally very effective.

What I have found useful is seeing the person with this condition twice a week for a few weeks, then once a week for perhaps two months. We do not get to full range in that time, but there is a noticeable improvement in pain free movement of the shoulder. If you should suddenly find yourself unable to respond when someone says, "Whoever wants a hundred dollars, raise your hand?", then you might want to consider visiting your nearest Massage Therapist.

Massage and AIDS/HIV

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This is a topic that came up in massage school several times, with arguments presented for and against providing touch therapy for anyone who was HIV positive, or had full-blown AIDS. One of my teachers was adamant that he had no intention of working on people with AIDS. His stand was that not enough was known, in his opinion, about the transmission, and he owed it to his family not to expose himself. I am certain that one or two of my fellow students agreed. I did not.

I thought then (in 1991) that there was sufficient evidence to show that transmission was not through casual contact, and since I had no intention of sharing body fluids with any client at any time, I had no qualms about working with people with AIDS. This belief holds true for me today.

Physically, there is not a lot massage can do for someone with AIDS/HIV, although certain reading I have done suggests that regular massage can have a positive effect on the immune system. Since the trouble with AIDS is a compromised system, anything that boosts its function is a good thing. My only concern physically is that I must be in good health, so that I am not a threat to the client.

On the emotional/psychological front, massage for people with AIDS is a marvellous thing. Too often, one of the first reactions of friends and family to a diagnosis of HIV, is a reluctance to touch the person. It is a harsh and sad reality that some people find themselves terribly isolated at a time when support is most needed. This, then, is where massage therapy can have a powerful effect.

The treatment does not have to be deep muscle therapy, or anything with a lot of pressure. The gentlest of relaxation massages - soothing, comforting, caring - can have a profound influence on the recipient's state of mind and feelings. To have an hour of someone's undivided attention, to be the focus of another person's caring touch, can be as healing to the mind and spirit as any medication for a physical ailment.

If you, or anyone you love, has been diagnosed with HIV or AIDS, by all means look around for a therapist who is comfortable and knowledgeable and caring. The benefits, physical, emotional, spiritual, will be well-worth the search.

Good health.

Massage and Stress Management

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I often read advertisements for massage and other forms of relaxation techniques that say they "get rid of stress." This particular phrasing bothers me, because what we are really doing is helping you manage the effects of stress. It is impossible for me, or any other health care provider, to remove the stressors from your life, and this claim smacks of false advertising to me.

However, although most of my practise comprises medical/therapeutic massage, rehabilitation massage, and so on, I do have the occasional opportunity to perform relaxation massage. There are those among us who refer to this as 'fluff and buff'; I use the phrase myself, but I do not mean to demean the practice of this type of massage.

In fact, there are days when a gentle relaxation, Swedish, whatever you wish to call it type of massage is just what the doctor ordered. Sometimes an hour of soft lighting, soothing music, and the undivided attention of caring hands is exactly what someone needs to restore them to a state of clear mind and healthy body.

This hour gives the body and mind a chance to let go of the physical and emotional tensions of the day. It's a chance to let the mind wander where it will, following the music or whatever paths it chooses, to explore the connection of mind and body. Many of my clients who receive regular massage, whether the relaxation or the more medical type, report to me that over time they have become more aware of their bodies and their response to stress factors.

I find this encouraging. Knowing when you are under stress, recognizing the effects in yourself, is half the battle to defeat those effects and reclaim good health for yourself.

Massage and 'Growing Pains'

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Growing pains. Those of us with children have certainly heard complaints from our kids at various times about how much their joints hurt, or their arms and legs, at different times. Many of us dismiss it as 'growing pains' and leave it at that. Some parents have given children's aspirin or acetaminophen for the pain. But what is it, really?

Well, my understanding is this: Children's bones are not completely 'bone' until they are done growing in their late teens or early twenties. The center part is bone, with cartilaginous growth plates at each end of this part, and then the end parts are also bone. The cartilage grows outward, lengthening the arm or leg or finger, and is turned to bone from the center out.

We tend to think that this growth occurs at a microscopically slow rate, but any observant parent can tell you that children DO go through growth spurts, seeming, in some cases, to spring up overnight. This is when we hear the moans and groans. Why? Well, muscles cross joints. They have to, in order to do their jobs. So, when leg bones grow a few millimeters or more, a thigh muscle, for instance, that attaches below the knee, suddenly finds itself stretched that amount without warning, and it hurts. In fact, all the soft tissues around the growing bone seem affected and tender.

This is where massage comes in. Massage to the muscles all around the affected area improves circulation, helping to nourish the new cartilage/bone and the muscles on top of it, relaxes the poor, stretched and unhappy tissues and just feels good. My children have all come to me at some point or another asking for massage for ankles and knees, especially. This is something anyone can do and only takes a few minutes of your time.

Have your child sit comfortably on the couch with the sore limb in your lap. Use a firm, but gentle touch, and rub all around the joint, moving out in larger circles to the muscles above and below. Ask your child to tell you if you're being too rough, or if it hurts worse. Move the skin around on the muscle below, take a gentle grip of the leg muscle and shake it back and forth. In fact, you can gently shake the whole leg to loosen up everything, and your child will probably find it hysterically funny. This is a nice way to strengthen your bond with your child and to show that you care.

So the next time you hear a kid complain, "Oh, my ankle hurts, my knee is sore," don't dismiss it as 'growing pains' and something the child has to live with. Get in there and rub your kid the right way!

Massage and the mind

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By now, many people are aware of the physical benefits of regular massage - the improved circulation, decrease of the effects of stress, reduction of headaches, improved range of motion of formerly stiff joints, and numerous other happy results.

What we often fail to consider is the emotional and mental benefits of massage. We know how much babies and children love the warmth that comes from physical contact, but we deny it for ourselves. Our North American society is almost phobic when it comes to touching other people, or even ourselves. Many women do not perform regular breast self-examination because of a deep-seated belief that it is somehow "dirty" to put your hands on your breasts. In reality, this contact can save your life.

Consider the number of times a day you have actual physical contact with the people you encounter. We won't count the bumping and jostling of big-city bus and subway rides. How many people do you touch, and how? Do you shake hands with a co-worker or someone coming into your office for a meeting? Does anyone pat your shoulder or your back as they pass your desk or workplace? Do you greet an old friend with a hug?

All of these examples are of appropriate, non-sexual contact, and each can add to the quality of your day. But many people go through days, weeks at a stretch without even this simple contact. Men, especially, are touch-deprived in our society. Most physical contact men experience is either sexual or violent in nature. By "violent," I'm not referring to fights or causing harm, but the force used in sports like football, or the casual punch on the shoulder, often delivered hard enough to sting, and dismissed with "Ya wuss! You hit like a girl!" We call this sort of thing "male bonding," and it's all over our high schools.

Women have the freedom to embrace their friends and even coworkers, without being accused of inappropriate sexual advances. Men endure being called anything from homosexual to a harasser, should they make an attempt to hug a friend or coworker. Somewhere, we've lost our compassion and humanity, when we gave up reaching out compassionate, caring hands to each other.

Teenagers are becoming involved in sexual activity at an increasingly young age; and most of them, boys and girls, say it's mostly to feel warm and loved. The solution? I can't say. But I would like to see massage, not as therapy, but as a healthy form of touch, taught in health classes in high school. Perhaps if our youth could learn to touch each other with respect, and compassion, the need for sexual touch would diminish. They might grow up understanding that warm and caring contact goes far beyond sex.

Tomorrow, when you get to work, pat someone on the back, shake a hand. Spread the warmth of human contact.

Happy hugging.

Massage for the Expectant Mother

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If you are pregnant or are planning to be, then I hope you will find this article helpful. For many women, the joys of pregnancy are more than balanced by the physical discomforts that go along with this time. From tenderness of the breasts to the loosening of the pelvic ligaments, from low back pain to the clenching of Braxton-Hicks contractions, a woman's body experiences a great many changes. Not all of them are fun.

Massage, whether from a therapist or from your partner or a friend, can help alleviate many of the discomforts and make your pregnancy and delivery easier. A word of caution: BE VERY CAREFUL DURING THE FIRST TRIMESTER. Avoid deep abdominal and low back massage for those first three months.

After that period, you can have your whole body done. For the first few months, you can still have light massage for your whole back. You will probably still be comfortable lying on your front, but as soon as that becomes a problem, experiment with other positions.

When I am working with a pregnant woman, I pull out all the spare pillows I can put my hands on. I get her to lie on one side, with her top leg bent at hip and knee, and I put one pillow under that knee. She also gets a pillow for her head and another to rest her arm on or to hug against her chest. When she is quite comfortable, I am then able to massage most of her back and the top hip and buttock. Then she maneuvers herself over to the other side and I repeat the treatment. This way, she gets her entire back and both hips treated. Breast massage may also be part of the session to help relieve the heavy, full feeling many women experience with pregnancy. Massage improves circulation of blood and lymph, and helps keep the breasts healthy. I also encourage all my female clients to practise regular breast self-massage. For an excellent site on the how-to and why, go to The Medicine Garden.

In addition to regular massage throughout pregnancy, massage during labor has been known to provide relief and a lessening of the pain. More and more massage therapists and hospitals are offering massage to laboring mothers. If you have the option, seize the opportunity, or take your labor partner to a class or two on labor massage. The "Loving Pregnancy with Partner Massage" has some very good instructions on how your partner can provide massage. It might make all the difference in the world to you.

Stay tuned...in two weeks I'll be discussing infant and child massage.

In the meantime, happy pregnancy.

Massage for your Baby

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We are born needing physical contact with others. For nine months, we have been embraced and cradled in the womb, surrounded by and constantly touching the protecting walls. Touch is the first sense that we develop, and it is essential to have caring, nurturing touch throughout our lives.

Right from birth, our instincts crave contact, the warmth and security of a mother's arms, or a father's protective embrace. Most people's reaction to a baby is to want to touch it, or kiss it, to stroke its soft cheek. We all feel the need for reaching out to others, and for others to reach out to us.

Babies and children can derive special benefits from massage, and other healthy and appropriate physical contact. Premature babies who receive several short massages daily do better than their counterparts who do not. They gain weight faster, develop faster, and are ready to go home sooner. Full term babies also benefit from regular massage. Babies are very active little people, as busy in their own way as any athlete. They wave their arms and kick their feet, constantly exercising and working their muscles. And, like any athlete, they benefit from a soothing massage after all their strenuous working out. A good time for massage for your baby or young child is right after bath time. For infants and toddlers, the massage doesn't have to be longer than ten minutes or so. You can dust your hands with baby powder or cornstarch so your hands don't stick to baby's tender skin, and just stroke firmly, but gently. Start with baby lying on her tummy and use your whole palm to stroke from the top of the shoulders down the back, and across the buttocks. Those little muscles work hard moving the legs, and need to be addressed. Do this several times, even continuing the stroke all the way down to the feet.

Now turn baby over to lie on his back and begin at the chest and move down across the belly several times, then move into a clockwise movement over the belly. This is following the natural movement through the large intestine, and can help to relieve gas pains associated with colic.

After the chest and abdomen are done, hold one of baby's arms in your hand, and use your fingers to knead the muscles for a few seconds, then use your free hand to stroke lightly from wrist to shoulder a couple of times. Repeat this for the other arm. Now you can do the same for the leg, although you might want to hold the leg in one hand and knead and stroke with the other. Use your thumb and finger to massage baby's feet. Watch your baby carefully for feedback. If she or he shows signs of distress, stop and go on to something else. Massage can be overstimulating to the young nervous system if carried on for too long.

Finish up with baby's face, using your fingertips to stroke from the center of the forehead out to the sides, and down around the chin. Don't forget very light strokes across the scalp, trying to avoid the "soft spots," and include the ears in this last go-round. You will enjoy it, baby will love it, and you'll have found a way to bond that can last for many years.

As your baby grows, vary your techniques. Find books on baby massage, look for workshops to attend, and continue to use massage as long as you and your child both benefit from it.

Happy babies to you all.