I found myself in a room full of highly achieved manual and movement therapists from a wide array of disciplines who needed to practice their manual muscle testing. I had some muscles in need of testing. Can’t do it myself, so, why not?
I took one for the team [wink].
I Had It All Wrong
The case of my Naughty Neck was not even close to what I expected it to be.
Most days in clinic, I find people have a lot of overwork happening in the muscles in the back of their neck.
These guys (neck extensors for the kinesiologically literate) like to work overtime, usually because of a history of car accidents/whiplash, and lots of hours logged sitting with slumpy posture over a computer keyboard, handheld device, or steering wheel.
I believe manual therapy is one of the most underutilized therapeutic interventions in our current healthcare paradigm.
Musculoskeletal stress and injury is the leading cause of sickness related workplace absenteeism, and the most diagnosed condition during doctor’s office visits.
In a study of global disease in December 2012, it was found that musculoskeletal disease is the second leading cause of disability and has the fourth greatest impact on global health and longevity.
The population at large is really missing out on something very effective and useful.
Wikipedia defines Manual Therapy as, “Manual therapy, or manipulative therapy, is a physical treatment primarily used by massage therapists, physiotherapists, occupational therapists, chiropractors, osteopaths, and osteopathic physicians to treat musculoskeletal pain and disability; it most commonly includes kneading and manipulation of muscles, joint mobilization and joint manipulation.”
For the sake of Scope of Practice issues, I will only comment on the value of manual therapy from the perspective of a massage therapist, to which I humbly profess my professional allegiance, in context with my own education and experience.
In other words, as a massage therapist with oodles of training, my scope of practice does differ than say, a fresh graduate.
I claim Doctors of Sports Medicine, Osteopathic Physicians, Physical Therapists, Biomechanists and Chiropractors amongst my teachers.
This gives me a little more insight and perspective into the issues with your tissues, and provides me with a more comprehensive approach to assessing and addressing your aches, pains, and injury complaints.
No, I will not crack your back for you.
Yes, I can manipulate and mobilize soft tissues to free up movement and provide for greater, more effective movement economy.
I also shamelessly do a victory dance when research studies assert the efficacy of what I provide my clients.
Another nod to the efficacy of massage therapy comes from the Canadian Medical Association Journal (CMAJ). In this study, participants were randomly assigned to one of four groups, 1) comprehensive manual therapy, which included soft tissue manipulation, remedial exercise and posture reeducation, 2) manual therapy only, 3) remedial exercise with posture reeducation only, and 4) placebo treatment of sham laser therapy.
Of the four groups, the comprehensive massage group showed statistically significant improvements in improved function, less intense pain, and a decrease in the quality of pain.
Furthermore, at the 1-month follow-up, the comprehensive massage group reported no pain in 63% of it’s subjects versus 27% of the soft-tissue manipulation group, 14% of the remedial exercises and 0% improvement of the sham laser therapy users.
If you need more information to justify calling a well-trained massage therapist for your aches and pains, and so I can do some more victory dancing, you can find more support for massage therapyhere and here.
A good Google Scholar query will also provide numerous studies supporting acupuncture and spinal manipulation, either chiropractic or osteopathic (yes, they can be different), and movement based physical therapy programs.
Different strokes for different folks, and all that.
Like I said, I claim allegiance to my profession and I do see greater need for all of us manual therapists to work together instead of back-biting and ego-driven in-fighting.
Yeah, there’s a lot of school yard shenanigans amongst us manual cowboys and cowgirls.
I think it does the most disservice to you, dear reader who-has-aches-and-pains-and-would-just-like-some-relief.
No wonder the medical community-at-large roll their eyes and shake their heads at us sometimes.
I shake my head at us too.
And no wonder, despite ample evidence supporting it’s effectiveness, why manual therapy is so often disregarded as a viable and useful option in your recovery program.
At the end of the day, you shake your head at us as well.
This makes me mad as Hell, and I can’t just keep quiet about it anymore.
What’s got my feathers ruffled, you ask?
I’m sick and tired of hearing people tell terrible stories about how they went for massage therapy and the therapist beat the shit out of them.
Here’s someone who took time out of their busy life and spent good money in the hopes of feeling better in their own body, but what actually happened is another sad case of misinformation on the part of the client and the professional.
What we got is someone looking for pain relief, and got a heaping dose of hurt shoved on them.
So, who’s at fault?
As a 17 year veteran, I think I have a leg to stand on when it comes to my opinion on this topic.
I’ve logged in hundreds of thousands of hours laying my hands on human bodies, as well as collecting stories from the people whom entrust their body’s well-being (quite literally) into my hands.
And if there is one myth, misrepresentation, and piece of misinformation still circulating in the massage and bodywork profession it’s this:
MYTH: for massage therapy to be effective, it has to be painful.
Hate to break it to you, but this is as false as it gets!
The human body doesn’t respond favorably to aggressive, noxious stimuli.
In fact, the part of your brain hardwired for survival reads painful stimuli as a threat and a stressor.
A cascade of chemical and hormonal responses begins. In 8th grade science class, it’s called the Fight-or-Flight response.
Eat, or be eaten!
And guess what….we don’t heal in that state. Like, 0%.
Riddle me this
Know what the difference is between a knife fight and surgery? One is socially acceptable.
The brain reads it the same way. Stress.
That’s why big time drugs are used during surgery; to paralyze your body and turn pain receptors and memory centers off in your brain.
Why do you think you need a breathing tube during surgery? Because your body shuts off enough that you can’t do it yourself anymore.
So, you wanting to be painfully ironed out during your very poorly executed deep tissue massage actually has diminishing returns.
Deep is a geographical term. It has nothing to do with how hard a massage therapist presses into your tissues.
It’s our job as professionally trained massage therapists to collect the information you present, ask the right questions to get the bigger picture, and then use our glorious and wonderfully trained brains to figure it out.
You know you got a great massage session when the therapist has taken the time to get to know you, takes a closer look at your individual situation, zeros in on the exact causes, and gives you some recommendations to play around with on your own time.
You feel relief, not like you were beaten with a baseball bat.
You shouldn’t have to recover because of your massage session. The massage is supposed to be a part of your recovery.
How about you?
Have you ever experienced a terrible massage? (I have! I could tell you stories)
Have found an incredibly gifted massage therapist? What is it about them that keeps you coming back for continued care?
Share your stories below in the comments; I would love to hear what your experiences are!
That’s a lot of time sitting on your duff at your desk.
No wonder I hear a lot of complaints about sore necks, shoulders, and upper backs.
In last week’s blog post I laid the foundation for understanding and identifying Upper-crossed patterns in the body.
To review, UCS is observed with a collapse through the chest and ribcage, an increased C-shaped curvature though the upper back and neck, with the upper arm bones rotated inward.
Discomfort is classically felt in the upper back, between the shoulder blades, the neck, and the shoulder joints. It’s also not uncommon to feel pain and tingling down the arm, into the hands, as well as experience frequent headaches.
UCS is commonly seen in people who spend a lot of time sitting in front of the computer.
I also mentioned the one thing you shouldn’t do.
When I chat with my clients about what they do with their upper back pain, most people show me they try to manage their discomfort by further rounding their upper back or stretching their arms across their body. This increases the amount of slump through the upper back and collapse through the chest.
I won’t discount the fact that it does feel good in the moment. I am of the opinion that this is the go-to not because it’s therapeutically corrective, but because you just spent a few hours pretending to be a statue in your cubicle and a little movement through the spine feels extra nice. It’s not the right stretch, but movement rules the road, so get it in however and whenever you can!
Without further ado, I’d like to launch into some workplace solutions for your upper back and neck pain. The workplace ideas are different than the home solutions, seeing as crawling under your desk to stretch may be frowned upon in certain corporate environments.
Sit Less. Move More.
We are designed to move. Your body is home to 360 joints and 640 skeletal muscles.When it comes to your body, the old adage rings true, “use it or lose it”.
Think about it: you park you’re ass in your desk chair, and with the exception of lunch, a few pee breaks, and a trip or two to the copier, you’re pretty much stuck in a stagnant posture for the majority of your 9.4 hour workday.
It’s like when you were a kid and would make funny faces at other kids and grandma would threaten you that if you kept making lewd faces you would freeze like that. Grandma was kind of right in a way. When you park-and-hold your body, it actually adapts to what you ask it to do.
Solution: ask it to do something else. Warning: doing something different will feel strange and maybe slightly uncomfortable at first. Your body is freaking out because it’s been out to lunch. It’s normal. It passes.
What does this look like in your workday?
Your smartphone is for more than checking Facebook. Use apps to help remind you to unlock your joints and do something different. It’s recommended that you get up for a few minutes of moving every half hour. When you get rolling on your work, it’s easy to forget. Set a timer to remind yourself to get up regularly. iOS friendly apps like Stand Up: The Work Break Timer can be helpful.
There are many different apps across different operating platforms to check out too. There are even ones to remind you to switch your focus farther away than your computer screen; yep, there are also muscles in your eye! Set that timer and get off your duff. Take a stair break and a stare break.
Adopt a Dynamic Workstation
It’s been said sitting is the new smoking and increases your risk for obesity, many diseases, and aches and pains. It even robs you of your productivity potential. If you are a disciplined exerciser, when you break down the ratio of exercise to the rest of the day, even avid gym rats are actually quite sedentary. Movement doesn’t require a change of clothing and shoes, nor does it mean you have to sweat your face off. Movement needs a reframe. Moving more doesn’t imply you exercise more. A very popular workplace solution is implementing the regular use of a dynamic workstation. A dynamic workstation allows you to perform your work sitting or standing throughout the day and is easily adjustable to allow for changes in your posture. There are many ways to adopt more dynamic movement into the office, from expensive hydraulic desks to IKEA hacks. There are even cardboard box methods that are inexpensive and portable. The possibilities abound; find the one that works best for your particular work environment. I typically switch from sitting at my desk to standing at the kitchen counter, or even popping a squat on the floor to do some computer work.
Do the Right Stretches
It’s easy to fall into the trap of not stretching. Stretching also doesn’t mean you need to go to yoga class. Remember our Movement Reframe; quality movement doesn’t require a change of clothing, nor does it take an hour out of your day. Stretching is merely a strategic method of inviting movement into your tight spots. When it comes to UCS, it’s really easy to “stretch” the area that is fired up and aching. That area, between the shoulder blades in this posture, is already elongated. Stretching further elongates the area and does nothing to calm down the feistiness.
The area that really needs the attention is up front in the chest and abdomen.
Following are a few strategic movements you can easily perform while at your desk:
Reach for Heaven
You’ve been collapsed forward for hours; get your arms up in the air. This helps open your chest and abdomen, loosen your shoulders, aides in circulation and fluid balance, and gently activates the muscles in your back.
Hands Behind Your Head + Look Up
Lace your hands behind your head and gently squeeze your
shoulder blades together and down your back as you open your elbows to the side. Don’t pull your head forward. You should feel a stretch in your chest. Next, bring your elbows back together and slowly extend through back through your spine so your elbows point to the ceiling. This stretches your front line as well as brings some mobility to the spine, which has been stuck in a C-shape for awhile.
There’s the Door
Use the doorframe of your office or your cubicle to help you move, release tension, and restore your posture. Place your hands, shoulder height, on each side of the frame. Keeping your abs strong, gently move forward through the opening by squeezing your shoulder blades together and down your back. You can also put your hand on the doorframe, should height, and slowly rotate away from your hand. Both movements stretch your front, and activate the muscles on the back of your body.
Do these movements throughout the day to loosen up, release tension, and restore your posture. Your body will thank you and movement helps your mind operate at its greatest potential.
Opening your chest and bringing strength back into your back muscles will help you sit up straighter, breathe easier, and feel more relaxed all day long.
It’s incredibly easy to be strategic with your body while at work. Start today and be amazed at the improvement you feel in your body.
Stay tuned for next week’s third installment: What you can do at home or the gym when you have the ability to get on the floor, use some bands or weights, and have more time to dive deeper into your body to restore your posture and efficient function.
Need more help? Feel free to contact me with questions, or schedule an assessment for yourself to receive individualized instruction and care for your aching, stressed out body.
You’ve been sitting at your desk plugging away at your to-do list like a boss. Minutes turn to hours.
All of a sudden you feel like you are being stabbed in the back by a white-hot poker of torture. You shift your shoulders around, but it seems like you just can’t get away from the burning pain in your upper back and behind your shoulder blades.
The discomfort is distracting and it wears you out. You keep eye-balling the clock for the coveted clock-out time so you can go home and sit on the couch and rest your aching shoulders.
Is it time to go yet? Is it Friday yet? What the F can I do for my aching body?
Shoulder blade pain is a common issue I see coming through the door in my Gurnee massage therapy office.
So common a pain it keeps me in business. I jest. But not really.
The shoulder blade, known as the scapula by us in the biz, is the “winged” shape bone sitting on your back and moves (or should move) when you move your arms and shoulders.
The scapula moves gloriously with a wide range of whole body and arm movements, and gets sore and sticky when we stick them in one place and forget about them.
In our current culture, where a paycheck is earned by hours sitting at a computer or behind the wheel of a moving vehicle, we are doing a serious disservice to scapular biomechanics, and as a result lead to tight, achy, burning pain in the shoulder blades.
Many people, exhausted and sore from sitting all day, turn to even more sitting on the couch as a way to recover and recuperate their aching upper back.
This is a crap idea.
Here’s what’s going on with your body: you are exhibiting Upper-crossed Syndrome.
Upper-crossed syndrome (UCS), as defined by Dr. Vladimir Janda, a Czech neurologist and physiatrist, is a postural pattern that highlights where muscular imbalance in the upper body and neck are found.
These observable patterns are used to aid those of us in physical medicine in our endeavors toward helping you recover from your aches and pains.
UCS is often found in people who spend a majority of their time sitting at a desk or behind a wheel, usually with little to no regard for efficient posture.
Weakness is often found between the shoulder blades and mid back, where tightness is exhibited in the upper back, neck, and chest muscles.
Your body is losing the war against gravity.
As days turn into decades, your muscles continue to freak out, hurt, and eventually your hardware changes, leading to shoulder and neck injuries and joint changes, like the dreaded arthritis, rotator cuff injuries, and disk disease.
Take a walk around your office and observe your colleagues’ posture:
Slumpy shoulders. Arms rotated in as they use the keyboard and mouse. Collapsed through the belly. Head shifted forward, ahead of the shoulder joints. Chin jutted up to keep their eyes on the monitor screen.
Nailed it, didn’t I?
I understand your achy back, neck and shoulders. I know what to do to help you with it, and which things you can play around with at home or the office to get that pain to ease up.
In the following posts I will highlight the easy things you can do while sitting at your desk to help you get through the day, as well as the slightly more involved things you can do at home or the gym to help yourself out.
In the meantime, here is my parting advice:
Quit rounding your shoulders, a la giving yourself a hug or stretching your arm across your body, as a means to alleviate the ache.
It’s backwards. The real solution will feel counterintuitive to you, but it works. Guaranteed.
Stay tuned next week for easy, and non-weird, things you can do while at work to help ease your aching back.
If you’d like some insights on what to do before then, feel free to contact me for some one-on-one instruction.
Feeling pain, being hurt, or having an injury is a drag. Pain zaps your energy and steals you away from the more enjoyable parts of your life. Instead of participating in sports, fitness, leisure, or social activities, you make apologies about how you just can’t join in right now.
You can’t walk because you sprained your ankle. You can’t lift your kids or grandkids up because your back hurts. You have to stay home instead of going out for martinis with your girlfriends because you have a serious headache. The only thing for you to do is to sit on the couch or go to bed early.
If you ask me, that’s no life at all! We are gloriously made to move and to feel incredible enjoyment from the extremely wide variety of movement that is available to us. Moving shouldn’t be a cumbersome and difficult chore. If it is, we need to improve ourselves so movement is effortless and enjoyable.
The Bad News
Left unchecked, your pain or discomfort can evolve from a simple strain pattern into a massive issue.
Often times a simple remedy could be applied to a minor ache, resolving the issue easily and quickly.
Much of the time these minor aches are left to their own devices longer than necessary and quickly turn into compensation patterns. Fast forward, this turns into decompensated movements that can further erode your anatomical hardware. In short, what was a small, easily remedied ache can morph into something un-fixable by non-invasive means.
The Good News
Together, we can restore you back to your former glory and get you back into action. Here’s the plan:
Step 1: Properly identify your areas of weakness, imbalance, and dysfunction
Strain patterns are predictable to well-trained eyes. An imbalanced body doesn’t function properly. You will lift objects incorrectly and walk weirdly; anything to avoid pain and still get the job done. The body is resilient in this capacity, but when the brain recruits other parts to pick up the slack for an injured area more injury is possible.
Step 2: Restore balance and function
Utilizing manual therapy and correctives can greatly enhance the natural healing process. Properly applied bodywork can help restore range of motion, muscle tone, and movement patterning. The goal is to create space, comfort and ease while your body rights itself.
Step 3: Retrain dysfunctional movement patterns and restore strength
The work isn’t finished at the end of the bodywork session. The final component is to look at the behavior and movement patterns which led to your aches and pains. Using proper stretching, strengthening, and lifestyle approaches can significantly improve you ability to move and function.
You don’t need to suffer when your body isn’t working or feeling well. Making the choice to work with a well trained manual therapists and movement specialist can be enjoyable and effective. You may even feel stronger, more graceful, and better at life than before you were injured. Don’t quit your life because of your aches and pains. Take action today and begin the process to identify and correct your imbalances. Turn your weaknesses into strengths and enjoy the enjoyable parts of your life.
If you “deal with” aches and pains, or have said, “getting older sucks”, than you may benefit from a postural and movement evaluation. Feel free to contact me with any questions you may have, or to schedule an evaluation to see how your aches are related to your daily patterns and habits.
Don’t sit on the sidelines of your life. Take action! Schedule your eval today.