Don’t Chase the Pain

A very common critique of my work is that I take the time to listen to clients make them feel like their voices are being listen to more than just being heard. The thoughts of my clients that they convey is considered very seriously during the pre-chat at the start of every session. I believe one of the reasons I hear this so often is that therapists are often times not trained as well as they should be in the area of providing context to their work. By this I mean when someone asked for focus and area because it causes him pain or just comfort it is the responsibility of the therapist to help the client understand what they see while they are working the tissue and how that may change the game plan for that days session. When a client doesn't receive that type of communication it will oftentimes lead to a very decide is fine client because of your feel they are not being listened to. Today's blog post really goes to the heart of this phenomenon of massage therapist and bodyworkers trying to do their jobs but not understanding how important they are to the person they're serving and what you can do with your service providers to show them that's what you're looking for.

So what do I mean by the title of this particular posting? As a professional soft tissue therapist we are trained not to chase pain now when we are in school but as a career is involved and we learn more about our industry and we start to choose to interact with the most senior members of our industry. This simple few words can greatly define your career as a bodyworker and thus reflect your beliefs as your clients will see them. It's not only about how you project yourself as a therapist but also the perception that your clients get for the work they receive and one of the greatest things that I have learned is that there must be a balance between communication and understanding. 

At our most basic level of training massage therapists are taught that unless we are addressed by a client during a service we are not to speak unless it is necessary to get information from the client regarding what's currently happening and that should be as concise as possible. The other thing we are taught is that we are not to speak unless we are spoken to first if the client wishes to have a more lengthy conversation during their service. What we should be taught in addition to that is that we must clearly convey that we have listened to our client not only verbally but the type of work we performed should reflect that. That could be as simple as immediately addressing an issue about a shoulder when the client came in with that as her number one priority. I simply initially palpating the area we demonstrate that we now only understood them but that we are taking direct action as a result of it. Many of you I'm sure I'm reading this saying this sounds like customer service 101 and yes you would be correct but in a massage environment for some reason this fact is been someone ignored by many of the massage schools and is not fully grasped until years after graduation.

In many cases the sources of pain are not in the areas in which we feel the pain presented itself from this is simply the mechanics of the human body. That is why I believe in discussing topics with clients very carefully before any service begins and to make very clear communication during a service as well as doing the required paperwork after the service to have a clear record of what did take place. On average it will take me approximately 15 minutes after her client has left my office to complete all of the necessary paperwork in order to then clear the room and prepare it for the next client which means I often give myself 30 minutes between services just to make sure that the last client is well taken care of in all respects and that the next client will get that same service when they come in.


When a client comes in complaining of pain in their neck for example I will oftentimes ask several follow-up questions which helps we need to form an idea of what could be a possible cause or a possible aggravating factor. By starting with the simple research before hand it gives me the opportunity to let the client tell me really what they don't want to be feeling when they leave. In the case of a sore neck there could be several contributing factors several causes and several different points elsewhere in the body that could present themselves as that pain but are not actually coming from the neck. When someone gets on the table complain of neck pain as their primary concern the first thing I will do is make sure that I've done a proper diagnostic palpation. Diagnostic palpation is simply a term used to describe the process of interpreting the information my senses like my sense of touch will get from the tissue and start to form a mental picture of the anatomy that will help me better understand how to mix proceed with the problem. This is a technique that takes years to develop and tested because there are miscommunications that can occur during a pre-chat session in which case I need to then tell the client what I think I am saying and give them some possible more concise or accurate words to describe the pain that's been going on so that we have a mutual understanding before any further treatment is conducted.

When it comes to the case of a neck that we are discussing in the scenario I will often times have people face up because the weight of the neck and head often times act as a pressure barrier which will prevent me from going into deeply causing the least amount of discomfort. There will be particular patterns in the muscle tissue that will start pointing me towards causes that I can look at. But before I work on the neck I will always work on the back and shoulders simply because most of the time the neck and shoulders are being stretched from the the front of the body. If you let off the tension in the shoulders first will oftentimes allow the neck to relax and become much more pliable. Creating this pliability in advance of actual direct contact makes the experience much more comfortable and it takes significantly less time complete the network that will result in a long lasting effect. What makes my work different from so many others is that I will tell someone before they get on the table but general game plan which would mean that I would let them know that they would start in the face down position to allow me to look at the shoulders first in plain terms I would say why the same as I have explained it here. This is by far these most simplify explanation of what I try and do every day for my customers to let them know that they are now only being heard about listen to.

If you find yourself in a situation where you feel you're not being listened to here are my recommendations for how to bring your provider and you're closer together when I comes to communication. 

First and foremost I think it is absolutely vital that a practitioner make every effort to be an open book to their clients in terms of being able to speak openly and to encourage that openness when it comes to initiating communication before, during, and after a session. Unless a practitioner conveys this repeatedly by not only their body language but by simply stating very clearly that if they should want for anything only need do is ask. The second thing you can do is to make sure that you convey that you plan on communicating during the session should you want anything and that goes for whether the practitioner has made that environment for you or not. I would also encourage every single client to remember the name of the practitioner who is working on them at the time so that if there is a concern you can address them directly this sounds like a fairly simple thing but it actually helps the practitioner because it allows them the opportunity to know that they are being directly addressed. So often you'll find individuals will simply start talking and you don’t quite always know whether it is a general comment or whether it's been directly asked to you so coming from my side of the table I always prefer that people tell me they want to communicate with me by using my name. The third and final thing I would say is that if a practitioner does not necessarily confirm what they want to do before they do it in light of the information you have given and what they have on in your body if they go into an area that you don't quite understand why I would strongly suggest that you ask! If you have pain on the right shoulder and the practitioner is only there for a few minutes but seems to spend a significant portion of time on the upper shoulder working it much harder in my opinion the best advice I can give is to simply ask "I know I told you that I wanted work done on my right side but I'm having a hard time understanding why you would want to spend so much time over on the left, why would that be?

This is actually a very good reminder for the therapist working with you at the time. In my humble opinion I believe the greatest away the client can get the best service I've ever had this by simply communicating and making sure they are understood. If therapist does not have the confidence or the training to do that to your satisfaction I believe in most circumstances the therapist will have the technical skills to meet your requests, they just simply need to be reminded that communicating and educating the client is their responsibility and then you welcome it.

A parting note I do not want to leave anyone with the impression that bodyworkers need to be taught customer service when really customer service should have been done when they were in massage school. I don't consider it an excuse I do consider the idea an explanation and why so many clients sometimes. But I will say after years of being a professional practice full-time that there are things I reflect upon often but I wish I had done better sooner this would be one of those areas I am glad however that I have surrounded myself with wonderful mentors and colleagues. And I wish to convey the simple message to all my current clients and those who are reading this around the world. The truly great customer service is a refined art that takes time to develop and with such an Internet service I believe it is vital that trust be built based on communication driven in the long term by could results.

With that I wish every client and therapist out there the very best sessions they will ever have. I hope in some small way this has helped.

Stretch that Neck

Are you slumped over a desk quite often or are you seeing children doing nothing but starring down at their electronic devices? Most likely work and wondering what is all that going to do to the health of their body in the long term or to your own body when you get home for the evening and your neck upper back and lower back are sore. On increasing basis I am seeing more and more people come in with these two problems that have a similar yet simple solution. And I will say that it's not about telling people how to live their lives it is more about working with the situation as it currently stands. So let's talk for a moment about what this really is and what is not.


The modern world is very much a lean forward society. What this has created over the last few hundred years has been an epidemic of people who feel pain in the upper neck and back also including the shoulder blades themselves. This is the result of leaning forward and bending the head downward towards the chest more often than not raining the head upwards towards the sky. As a result of many people make the mistake of the game or muscles especially in their neck and shoulders are just tight or as I often hear it "I carry all my tension in my neck and shoulders”.


The truth is that in almost all cases that a client brings to me of tightness or pain in the neck and shoulders it is that the muscles located in and around the neck and shoulders are being stretched like a trampoline instead of overworked. Think of it this way: if you were to take a plastic bag and place it into a firm grip in one hand and then place the other end of the bag into perhaps a Workmans device and start pulling it eventually what you would find is the areas are most stretch near the anchoring points not where you are pulling the bag with your hands. This analogy works very well because it mimics almost exactly what the human body is doing internally.


When we lean forward so often and use our hands and arms to perform task directly in front of us the muscles in the front of the neck and tectorial muscles in the front of the chest stir to shrink because the body gets the message that they do not need to go to their full range of motion because that's not what we are demanding of them. As a result the body starts to reduce the muscle mass and length of each muscle in the front of the body. Most often they can be felt in the scalene muscles of the neck and as well in the pectoral muscles. As a result of the shrinking mass the muscles on the shoulders in the back of the neck are pulled forward and stretched like a piece of canvas leading people to believe that the muscles are tight as in they are knotted up. This might sound like semantics but to someone who is trying to figure out how to help someone that can be somewhat deceiving which means that diagnostic palpation is always required to verify what someone is saying compared to what their body is saying.


So when the opening paragraph I discussed that there would be a simple thing you can do to help deal with this problem and here it is: we must simply learn to stretch the muscles in the front of the body back out more often which would tell the body that it can indeed function within the full range of motion. This is achieved through subtle reminders and exercises completed by a client between appointments. The reason that I often give people homework in this regard has to do with the idea that if someone is willing to do some of the work at home it makes the time they spend with me more valuable because then I can tackle the bigger issues in that area that require my special skills. It also allows me enough time to investigate other areas of the body that may be of interest to the client.

The most simple stretch I can provide people is to simply lay on the edge of the bed and place their head on the edge of the bed in such a location as to line up directly with the point of the skull meeting the spinal column. Go back approximately the length of your index finger and keep your head perpendicular to the sailing you're looking at in front of you. If you wish to enhance the stretch put out your arms straight out to your side. Move your head slowly over a period of approximately two months all the way off the side of the mattress. Is important to remember that in this particular stretch want to make sure that your only holding that straits position for 30 or so seconds it does no one any good to overstretch the area so quickly. Over the period of approximately 30 to 60 days the particle get the message that those muscles need to lengthen that are short in the front of the body and neck. This will then intern slowly release pressure from the neck and shoulders. 


For some individuals they may still have their full range of motion and the stress and tension they feel in there tissue is simply a psychological stress reaction manifested in the physical tissue. This is far more rare than people anticipate and should be treated as such that means during a bodywork session it is often a good idea to have some time to simply relax. I do offer many of my clients the ability to do a meditation massage service which is a guided meditation done during the massage to allow those physical stress reactions to stop for a duration of time during the service which will make my job much easier and make people feel much more comfortable. These manifested physical stress reactions are major problem in the sense that if people make the assumption that it is all a physical problem then they never address the psychological one that is causing it. A sure sign that this is a psychological causes in my opinion is simply asking yourself how are you sleep at night. If people in general have a problem sleeping at night and there is not a physical problem involved then it's typically a psychological problem of their brain slowing down and allowing them to sleep.


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Massage Therapist Takes on Car Accidents

For those who are unlucky enough to have motor vehicle accidents is a very disorienting and confusing event and if you have serious injuries it can really take a toll on your dignity as well. But I thought it might be interesting for people to know a little bit of how as a massage therapist I see motor vehicle accidents. Most people have motor vehicle accidents come to me looking for help and pain relief but I believe it's also important to understand what I see in the human body as a result of these accidents.

When you look at the physics of a car accident it has been studied very very well and there are multiple sources that can give you reliable information as to how the human body reacts to high and low speed car crashes from multiple directions in varying degrees of severity. In general when people are hit from almost any direction physics tells us that the torso of the body being the heaviest and the one with the greatest range of motion will move forward and extreme pace and that the arms and legs including the head will move violently this is one reason why we have safety belts in order to prevent the inertia from exceeding our ability to stay in the vehicle. As a result of this basic physics lesson we find out that the muscles and bones that give us the ability to hold our lambs and her hands on the word bodies will receive the most violent action from the crash. When I first see people one of the things that will notice his reaction of the muscles in the neck from the damage to the spinal column into the nurse in that area. The body will attempt to compensate for the inertia of the force generated in the crash this music muscles and tissues will rapidly titan and that the bone structure will alter as a result not only of this tightening but out of the kickback you get from the vehicle in other words the “backboard effect”. The spinal column can be greatly affected by an accident this can cause balls to move far out of alignment and can cause a massive inflammation response usually people feel this has a severe soreness headache nausea among other symptoms. I will usually get my hands on people within 48 hours of the actual occurrence which means I will still see some form of this reaction. 

Depending on the type of vehicle and the type of crash you may also have damage from the original inertia an impact in the arms and legs most recently were also saying facial injuries from people who are texting and driving eating and driving apply make up and driving force of the airbag throwing objects in for the air back into the persons face in some cases this is not something to be treated with massage or something I can call secondary injuries. Also medical professionals within the first 24 hours will administer some kind of drug to control pain as well as to control inflammation and muscle tightness in some cases I believe this is absolutely necessary and others I believe that simply reducing inflammation by getting the person into a stable state and then applying ice packs and other remedies may be show just as much affectiveness.

And high-speed crashes or severe whiplash case is there a Y also be severe neurological effects to the brain which means serious disorientation nausea vomiting and localized swelling around certain place of the skull that are typically not treated by conventional medical practices. These neurological effects can last for months after the crash which is one of the reasons why neurological scans and meetings with specialist can be very helpful in reducing the severity of early symptoms and reducing the appearance of prolonged chronic symptoms of months after the event.