Tuesday, October 4, 2016

Tight Lesbians Massaged at the Beach

Let's see if that title breathes some new life into this blog I've been neglecting. Well, it's a catchier title than "Tom's 13th Anniversary of Licensure" at least. While this post does contain Mature content, it's only because the lesbian woman in this completely non-sexual story was in her 60's at the time. 

It is, in fact, my 13th anniversary as a licensed massage therapist in the state of Florida this month, which is October. As I was reflecting on my career path the other day, and the interesting twists and detours that it has taken, I remembered a story from the very beginning. My very first job as an LMT was working for Disney's Vero Beach Resort, which is not in Orlando. It's outside Vero Beach in Orchid Island and serves as a time-share property for Vacation Club members. Since it was a pre-existing resort built by some kind of tycoon in the early 1900's as a beach getaway, it had a flavor all its own. Not a typical Disney building or atmosphere. Their spa, which is a term I use lightly, was literally a cleared out maintenance storage room, right next to the giant pool pump enclosure. That was in 2003. Since then, the spa has been completely built, decorated, and staffed up to Disney's impeccable standards. Back then, however, it was just 1 room with 1 cramped massage table and a little boom box for CD's.

My massage school, Space Coast Health Institute had a contract to keep one licensed therapist on duty during all the working hours. I was cleared to start work as soon as I received my printed official license in the mail. I literally checked the mail every day after I passed the state boards, and called them the day it arrived to put me on the schedule for the following day. 

You may or may not know that Disney is quite a progressive company, in HR terms. They were one of the first big name corporations to award health and life insurance benefits to same sex spouses- way before it was legal to have a same sex spouse. These progressive policies drew many gay Cast Members (what Disney calls their employees) as well as gay guests to show support by voting with their dollars. As to be expected, the gay population of Orlando grew quickly which is why there are several gay pride events in and around Disney. Which brings us to massaging a foursome of lesbians on the beach.

In October of 2003, there was apparently a gay golfing event in the Vero Beach area, and several of the players were members at the resort. One lady in a foursome of friends was having a lot of pain after the round of golf that morning and signed up last minute for a massage. She was not expecting me, a male therapist, to be the one doing the massage, but her pain persuaded her to give me a try. I was warned in school that there would be biases against males, so I wasn't too shaken. 

Totally random picture of women golfers.

So I get her in the treatment room (maintenance closet), and the first thing she tells me is that I have to yell at her face so that she can hear me. Literally, YELL IN HER FACE, or she can't understand me, because she had major ear surgery to remove several tumors off of her auditory canal and nerves. She had huge hearing aids in both ears. As a massage therapist, it's kind of expected that we are meant to be soft spoken and that we generally tread lightly in our mannerisms- that's part of the job that I've never had to think about- I'm a quiet, introverted, non-assuming kind of person all the time, so YELLING IN HER FACE to convey any kind of information was really odd for me. 

Second, she explains that her neck and shoulders are really tight. She wishes I could just pull her whole head up and away from her shoulders (what I now know is called Cervical Traction), but "Don't do that, because it will hurt like crazy," she said emphatically. Ok, so now I know what I can't do...

Third and last direction from the YELL IN HER FACE intake interview, she explains that she gets really bad headaches constantly, all over her scalp, because after the ear surgery, the Doctor "Sewed my ears back on too tight."

Yep, you read that right, her EARS WERE SEWN ON TOO TIGHT! My first week as a massage therapist- no other professionals to consult with, yelling at an older lady in pain, in a closet that smelled like chlorine fumes. They definitely never told us what to do in this case, in massage school. All the client told me was that I couldn't really touch anything or it would hurt, but please massage me because this stuff hurts. Huh?

I fall into my training and YELL my scripted directions to her- explaining how to undress and get on the table in between the sheets etc. I leave her there to get comfortable and frantically try to figure out what I'm going to do. I re-enter the room in a few minutes and find her still fully clothed in khaki dockers, a flannel long sleeved shirt, and a member's only jacket. She might have taken her shoes off, I don't remember. All the skin I have access to is the off limits neck and ears that I'm supposed to be massaging without massaging it. She's facing down now, so communication is even harder, because she can't see my expression or lips if I say anything, so I don't. 

Thankfully, I had spent many weeks participating in public events doing massage outdoors on fully clothed clients, to get my required practical hours, so I had some techniques to get started on this hour of complicated therapy. While my hands started moving, so did my heart and mind- praying as fast as I could. I have no idea what I did for that hour, but when the time was up, she stood up from the table and was genuinely relieved. She said she felt great and was really thankful that she could get the appointment. 

That's the day I realized that it didn't matter how much or how little training you have, if you don't have your heart and soul in it, your work will not bear fruit.  I'm still grateful that God put that particular lady in my path so early on in my career- before I could get cocky with my pile of certificates. To this day it's kind of a mantra for me, "My ears are sewn on too tight," when I have a difficult client who needs my compassion, in addition to my years of nerdy technical know-how. It helps me think beyond my own needs, and to focus on what's really important. 

Friday, July 11, 2014

Stretching and Massage Class from Bodyworker Seminars

This week I took a live, hands-on continuing education class from Heath and Nicole Reed at Bodyworker Seminars. It was paid for by Massage Envy, for which I am grateful, and they even provided lunch. Because I took two days of classes from Bodyworker Seminars last year, I knew to expect a well thought out, well presented burst of therapeutic knowledge, based on the decades of combined experience and education from the teachers. The one thing I feel did not exactly meet my expectations, which is not necessarily a bad thing, was that the class spent much less time on stretching than I expected. We did hear a lecture about stretching and learned a few stretching techniques to apply to our clients, but we learned several more lotioned elbow techniques than stretches. I guess the "And Massage" portion was bigger than the "Stretching" part of the class title. After my decade of stretching clients daily, I was pleased to hear their fresh look at incorporating movement and stretching based on Thai massage, Yoga, and several other perspectives. From this class, I have several ways to refresh my daily practice, which is really the point of taking continuing education, right?

Some key things I learned:

Nicole Reed lead a warm up where we stretched ourselves, grounded ourselves, and tried to heighten our awareness of what it felt like to be inside our own bodies. During this time, she said,  "A small adjustment can create a big change." We were doing a straight leg stretch with one leg resting on the massage table while standing on the other leg. We held that hamstring stretch for several breaths and then she directed us to evert our foot on the stretching leg. This was a change of millimeters which created a dramatic change in the feel of the intent of the stretch. Likewise, she also told us to dorsi-flex the foot during another stretch to protect the knee. I can't wait to try that with clients who have sketchy knees and see how much of a difference it makes to their comfort level. 

Another eye opening concept was how much science is changing and adapting in stretching theories. There is a lot of new research and practice coming out in the last decade. It is an exciting time to be a myo-fascial therapist. For example, stretching actually strengthens soft tissue structures, it does not just relax them. When you stretch, the muscles have limited length, but fascia has far more adaptability. Most of a stretch actually addresses the fascia. The collagen, which is one part of the fascia, aligns to the line of force or tension and more collagen is built into the structure when regular, consistent stretching occurs in the same tissues.  

When we are injured, the body throws down a disorganized patch of fascia to temporarily protect and immobilize the area. After the injury is healed, stretching therapies can re-organize that patch into a stronger, more appropriate, more mobile design. Speaking of injury, there are 10 times more sensory neurons in fascia than muscle, which means 10 times more pain sensation comes from the fascia. Making a stretch feel nice to the client relies much more on fascial manipulation to create balance, than muscular focus. This is also why myo-fascial release is key to resolving chronic pain.

Heath and Nicole spent a long time explaining why sedentary lifestyles create immobility and long term musculoskeletal dysfunction. Aging is highly controllable by movement and expanding mental boundaries of what you believe your body is capable of. You have to practice not being fearful of breaking yourself with stretching. On the aging topic, they say you must "Prevent trouble before it arises." You should plan ahead for your old age physically just like you do financially. Genetics are not permanent because attitude, nutrition, movement and environment can change your gene expression. David Wolfe has been talking about "Epigenetics" lately too, which is the same concept. 

Another way of looking at the aging process is that your entire body, at the atomic level will be replaced in about 2 years time. We will have NONE of the atoms in our body 2 years from now, that we have today. If we get our atoms from breath, environment and food, we can see relatively quick results if we make positive choices today. (I'm kind of extrapolating from what Heath said about 2 years and new atoms, not directly quoting.)

The last thing I want to mention that I really loved about the class the other day was a quote they shared from Dr. Ida Rolf, "Movement is the physical acceptance of change." That's certainly something to meditate on!

Monday, July 7, 2014

Eat Move Sleep Book Review

I just read through an accessible, informative wellness book called Eat Move Sleep: How Small Choices Lead to Big Changes. The author, Tom Rath has a rare genetic condition that makes him incredibly susceptible to cancer. He has compiled a book full of his lifestyle choices that have helped him to beat the cancer progression clock. I like this book because most of the tips are easy to implement and have a sound scientific basis. 

If I could change one thing about the book, I would organize it a bit differently. Each chapter has one piece of each topic- Eating, Moving, and Sleeping. Sometimes they are related, other times, not so much. Each chapter is bite sized and useful, so it's not a big deal, but I was a little distracted by the organization. 

Here are some quotes from the book which give you an idea of the kinds of topics he covers. All of these claims are backed up with evidence and/or personal experience. 

"Sitting for many hours encourages fat cells to congregate near your rear."

"A mere 20 minutes of moderate activity could significantly improve your mood for the next 12 hours."

"When your body's motions are not aligned and balanced. Using one side of your body far more than the other, for example, can create uneven wear and serious back problems over time."

"One spinal surgeon put it, be careful to avoid bending, lifting, and twisting in particular. During these three motions, your spine is the most vulnerable to injury."

"Exposure to light in the hours before you go to sleep suppresses melatonin levels. Lower melatonin levels make it hard to fall asleep, decrease sleep quality, and could even increase the risk of high blood pressure and diabetes. "

"Getting more protein from fruits, vegetables, nuts, and fish will also increase your intake of omega-3's, which are deficient in most people's diets today."

"I keep pictures of my wife and kids directly above my desk and treadmill. This reminds me that my staying active matters as much for the people I care about as it does for myself."

"Use plates with a diameter closer to the length of your hand than to the length of your foot."

"The impact of plate color alone is quite dramatic. They found a clear contrast between food and plate keeps people from overeating."

"Sleep is a treasure, and it should be valued as one. Yet for many of us, sleep is the first thing we cast aside."

"If you structure your activity to end on a high note, you are more likely to do it again."

"Exercise creates an immediate benefit for your memory."

"Higher levels of physical activity are consistently related to greater brain volume."

"Vigorous workouts in the hours right before bed are likely to improve sleep significantly."

"People who were on teams with more social influence increased their odds of losing weight by 20 percent."

"Pick one food you eat even though you know you shouldn't. Give it a nickname that will make you think twice about eating it."

"People who eat breakfast are smarter and skinnier."

"Eating breakfast foods with a low glycemic index prevents spikes in blood sugar later in the day, which could make for better choices in the afternoon and evening."

"Data show that people who spend more than four hours a day watching video are more than twice as likely to have a major cardiac event that kills them..."

"Researchers found that for every extra hour of total commuting time per day, you would need a corresponding 40 percent increase in your salary to make the added car time worthwhile."

"People with severe sleep apnea had a 65 percent higher risk of developing cancer."

"During a 3 week disruption [of sleep patterns], the participants' glucose control went haywire...could easily set the stage for development of diabetes and obesity..."

This book contains a great deal of wisdom and I highly recommend it. I found personally that it gave me some fresh ideas and perspectives for tweaking the way I eat, move and sleep. Because I am such a nerd about these health fundamentals, I frequently re-evaluate how to optimize them for myself, and this book both reminded me of shortcomings and encouraged me to overcome them. 

Dr. Hyman Mind Body Green Interview

Here is an INTERVIEW with Functional Medicine Doctor Mark Hyman. In it he talks about food, nutrition, how to optimize your health by balance between food and movement, and some exciting changes in the healthcare system. 

Some key quotes:

"You cannot exercise your way out of a bad diet." Meaning that to compensate for poor dietary choices, you have to spend an impossible amount of time exercising. He uses the example of having to run a marathon everyday if you eat a Supersize McDonald's meal everyday. 

"The microbiome...and gene expression changes with every single bite you put in your body." It does not take weeks or months to give yourself positive wellness progress. He goes on to speak about quality of food being the key to the long term plan. 

"Sugar is a recreational drug." I compared sugar to over the counter pain relievers in a prior post and here he compares sugar to tequila. You would never pour a shot of tequila in your morning coffee, have a tequila filled candy bar in the mid afternoon and follow dinner every night with a bowl of tequila with chocolate sauce. The point is that sugar is way too prevalent and our bodies are functioning like we are walking around drunk all the time. 

"The higher fat vegan diet people lost more weight... and had better metabolic profiles..." We can't be afraid of fat, but the quality of fat is what has been throwing off our understanding of how it works in the body. Plant based fats, like nuts and seeds, avocados, and coconuts are extremely helpful to boosting health. Conversely, canola oil, which we generally buy when it is already rancid, is horrible for your health. 

What does the good doctor eat? "I eat mostly plant foods." His example goes from 75-90% veggie. He says his favorite fat is actually lamb fat. He indulges with dark chocolate covered almonds.

Dr. Hyman also mentions the Glycemic Index and how powerful it is to controlling hunger and hormonal reactions. 


The last big point of interest for me in this interview was how Dr. Hyman helped develop the Daniel Plan with Dr. Daniel Amen the "Brain Doctor." He asks what would we serve to Jesus Christ is he came to dinner. Would we serve God-made food or Man-made food? Good question. 

Tuesday, June 24, 2014

Stress Relief through Bicycling

 Cypress Point Park Trail from tampagov.net
As I have stated before, I am not a cyclist. I am not competitive and I don't wear funny colored tight pants. I am, however, an avid bicyclist who rides a beach cruiser wearing cargo shorts and whatever shoes I can keep wearing when I get off the bike and walk around in public. I use my bike for stress relief and to promote peace of mind, which I feel is the opposite of competition. Today, for example, I rode 7.5 miles in about 45 minutes on flat trails to and around Cypress Point Park in Tampa, FL. 

Tripadvisor.com's View of the Trail
My head has been buzzing with new stresses. Primarily, Mrs. Tom Heals is expecting our first baby and secondarily, I had a job interview last week for a massage therapy teaching position at a school which is within biking distance for me. 
 Yesterday I received an amazing two hour massage from Stephanie Kojima, LMT. She is a co-worker who I greatly respect - dare I say, the best therapist I've ever met? She patiently listened to me ramble and rant and gave some supportive advice. She reminded me that I can only control a very limited number of things in my life and that's all I can do- live in the present, be grateful, and make good decisions with those few things. One of the few things I can control is what I put into my body. After dropping the wifey off at work this morning, I stopped at my local produce stand and picked up a golden mango, a papaya, some bananas and a watermelon.

A quick tangent...

Dan "The Life Regenerator" McDonald gives a lot of good info in this video about seeds. He says they have infinite, exponential energetic potential. That lead me to meditate on "Having the faith of a mustard seed" and the consequent exponential faith that can easily move mountains. Dan also has stated several times that you must eat fruit with seeds, guys, so that you will have seeds in you. In other words, if you eat fruit that can't reproduce, you can't either. Papaya and Watermelon are PACKED with seeds and I'm having a baby...just sayin'.  

Ok, back on track...

After my fruity breakfast, I took a ride out to the park and feasted on some salty oxygen coming from the bay- one of my favorite, Zen inducing experiences. One of my overall bicycling goals for the year was to ride 1000 miles. Another is to ride over the Courtney Campbell bridge and back in one trip. Both are very attainable and are more to encourage me to go out and find my happy, Zen place, than to reach any specific physiological health standard. 

My little piece of Zen, this morning

I can also control my breathing and sunlight exposure, which go hand in hand when beach cruising on a sunny summer morning. While I'm not super sporty about my biking, I do use a few sport-like tools. One new piece of gear to me is a Mission cooling towel. You get it wet, wring it out, pull it in a snappy motion a few times and it chills down about 10 degrees cooler than air temperature. I love it because it fits under my helmet, covers my ears, keeps my noggin cool, keeps sweat out of my eyes, and keeps my earbuds securely in place. 

One of my best friends refers to Sunblock on me as "Freckle Repellent." Since I'm such a pale, freckly Floridian, I have always struggled with sun exposure. Since reading the Vitamin D Cure by James Dowd, I realize that Vitamin D can epigenetically turn off cancerous processes in the body. Obviously, sunburn is bad for me, but so are the chemicals in sunblock. I am learning to get the right amount of sun and the right amount of alkalization in my bloodstream to keep cancer away without harsh chemicals smeared on  my skin. Cloth barriers also help somewhat. I prefer cowboy style, lightweight, long sleeve shirts for my bike rides. Again, I like to feel like I can walk into a store without looking like the King of Spandexia.  I also ride at night when I feel too medium rare.

My goals here are similar to my mileage and route goals- I want more Vitamin D, more fresh air, and more Zen. I don't know how to quantify that exactly.


Monday, June 23, 2014

Innovative Massage Therapy

I had a longtime client ask me tonight about how I approach the body. He was curious to know if most of the techniques I do were specifically taught to me, or if I made up stuff as I go, to accommodate each client. It was a two hour massage, so we had plenty of time to talk. It took about 45 minutes for me to answer the question, because we are both music nerds who came up with several musical analogies to discuss the concept.

Guitar players, for example, are usually memorable when they do something innovative. Jimi Hendrix played with his teeth. Jimmy Page played with a violin bow. Slash bends strings all over the fret board. BB King uses his smooth trademark vibrato to sell every single lick.

These innovative guitar players have far surpassed typical routines and formulas to truly become artists. To reach this level in the massage therapy field, a therapist must be creative and brave enough to push some limits. Like music, which nobody will pay for if it doesn't sound good, massage can't push so far outside of the norm that people are scared or uncomfortable trying it. Back to BB King, his style is probably more accessible to more customers than Jimmy Page's bow solo here. 

You have to push boundaries but not too far. There are rules to follow in music that act as the framework for creativity, to make pleasing melodies instead of just making noise. The same is true for massage rules- fascia responds well to heat, grinding an elbow into shallow muscle attachments is painful, pay attention to and work with the client's breathing pattern, go slow to relax and fast to invigorate muscles...the list could go on. 

Not to disparage John Denver, who is a very talented guy, but his guitar playing is the opposite of innovative. He strums with one hand and holds steady chords with the other. Compared to Eddie Van Halen, John Denver is barely doing anything with his guitar. 

So what's the difference between my massage and a more conventional massage routine? First, I try to see the body as the 3 dimensional structure that it is. Eddie Van Halen clearly uses every inch of his guitar and comes at it from every possible direction. He also uses a diverse set of skills, string tapping, for example, that allows him to get something done more efficiently than the average player can. I find that every CEU I take and every massage I receive gives me more unique tools in my technique toolbox. I need to mix and match everything I've learned from neuro-muscular, myo-fascial, shiatsu, stretching, sports massage, craniosacral, orthopedic rehab, and anything else I can get my hands on, to fine tune the perfect treatment for the specific client in front of me.  

The answer to the question then, is that I have to draw from many techniques I have been taught first, and then, thanks to more than a decade of hands on experience, apply creativity to the basic techniques, to get the most possible therapeutic value out of them. 

Just to drive this analogy into the ground, here is a clip from the movie August Rush, in which a musical prodigy plays a guitar in a completely unique way. 

Sunday, April 13, 2014

Defining Deep Tissue Massage

I've been defining massage modalities lately for our new front desk staff to better match the client to an appropriately trained therapist. If you call up the clinic and ask to schedule a massage, one of the first questions will be, "Do you want Relaxation or Deep Tissue?" Another way to ask the same thing would be, "Do you have a problem that needs to be fixed?" Once we find out that you are in problem-solving mode, a bunch of other questions should follow, but usually don't. What results is two lists of indistinguishable, interchangeable therapists- those who do "Deep Tissue" and those who don't. 

To make things clearer for everyone, I like to explain it by sub-dividing "Deep Tissue" into 3 categories: Aggressive, Conservative, and Moderate. 

Aggressive Deep Tissue Massage would be for mostly healthy people who are large, bulky, dense, muscular, and/or have a high pain tolerance. Aggressive pressure is appropriate because they don't have contra-indications or injuries. Of course, female clients get this too, but my examples are primarily superhero types- those who feel no pain. Even a "Relaxing" massage on these dudes would be a LOT of work. These folks can be recognized by the frequent use of phrases like, "You can go deeper" and "You can't hurt me."

Conservative Deep Tissue Massage is the opposite. It takes plenty of know how, but does not require brute strength. I call it "Profound Tissue Massage," patent pending,  because it deeply affects the tissues, but it's not necessarily deep pressure that gets the job done. Conservative massage would be in cases of injury or when there's a complicated combination of issues going on. BB King is a great example here because he had repetitive stress from guitar playing (several hours a day for 70+ years), was diabetic, in his 90's, and his posture for playing the guitar put everything out of balance. It takes a knowledgeable, intuitive, thoughtful therapist with advanced training, to help solve those combined issues. Patients like him might have contra-indications for massage in some areas and be fine to receive massage in others. 

Lastly, I have Moderate Deep Tissue Massage. As you can guess, that's everyone in between Aggressive and Conservative. It takes some strength and some know-how. Most massage clients coming in monthly or more on their Wellness Plan would fit into this category. They have problems to solve, but they are typical issues that don't require as much muscle power or brain power from the therapist.  These are your folks who slept wrong and have a kink in the neck or they took a long car trip and have shoulder tension and low back pain. Hopefully, we can give them significant relief in one or two sessions and can also provide them with some relaxation at the same time. 

After distinguishing which level of "Deep Tissue Massage" is needed, the challenge is to find the LMT with appropriate training and experience. Nobody really cares what fancy name brand techniques I do- they just know that I get the results they need. That's the important part.