Monday, December 23, 2013

Massage Recipes
I was talking to a client yesterday about teaching and training other therapists. She is a nurse who has trained countless other nurses in several settings. She was telling me that I have a very knowledgeable, confident, knowing touch which is hard to translate when teaching others the same techniques. She equated it to recipes. She has a saying, as a Southern Grandmother, "You can give away a recipe, but you can't give away the flavor."

That was an interesting and very true analogy. The reason I use so many metaphors when I educate my colleagues and my clients, is to give more depth to exactly how, where, and why I use the specific techniques that I do. I love Alton Brown, the Food Network star of Good Eats, Feasting on Asphalt, and currently Cut-throat Kitchen. He doesn't just perform recipes on the screen, he gives some science, some personal experience, and some creative alternatives to conventional methods. He has some standard rules like "Organization will set you free" and "Don't buy a Uni-tasker." I have some massage rules like "Slower is better" and "Stretch it before you Poke it." If I can become a true educator, like Chef Brown, I feel that I can convey the techniques with enough depth to "Give away the flavor." 

How Much Water Should I Drink After a Massage?

I worked on a client the other day who frequents our clinic, but who I have only seen a couple of times over the past couple of years. He is a particularly inquisitive client and likes to get each different therapist's unique perspective on his situation, by asking thoughtful questions throughout the massage. I like his questions, because I feel that he takes advantage of my hands and my brain, which keeps me more mentally engaged in his needs in that session.
When leaving this last time, he asked me, "How much water should I drink after a massage?" I have several stock answers, because it's a common question, but my most common answer is "The most important thing is to stay well hydrated all the time. One half your body weight in ounces- for example, if you weigh 100 pounds, drink 50 ounces of water daily, to maintain normal hydration. Then, drink a bit more, like you've had a good workout, to minimize soreness from the massage."

Hydration is very subjective, however. My inquisitive client got me thinking. Staying hydrated all the time is the key. It's just like sleeping habits. If I only sleep 4-5 hours a night with ambient noise and light, most nights, then sleeping 12 hours on the weekend days isn't going to help much. I get clients who come in with a gallon jug of water and start chugging as soon as they stand up from the table. If they are primarily drinking diet soda and coffee most days, and only have a little bit of water daily, that gallon after the massage is an extreme change. The body doesn't handle extreme changes well. The body prefers consistent, well balanced habits. The gallon chugger probably isn't going to hurt himself, if he is already well hydrated from consistent intake of clean water as a daily practice.So, like getting a good night's sleep regularly, staying hydrated consistently will keep the body functioning optimally before, during, and after the massage.

Check out this nifty Water Intake Calculator with several unit conversions.

Sunday, December 15, 2013

Fascia-ism vs. Fascism

I try not to be a massage fascist. A therapist can't force a muscle or tissue to do something it doesn't want to do. That's why I like "Fascia-ism." Myofascial release allows the body to respond the way it wants to, at its own pace, while the therapist gives guidance and direction as to what a positive course of action would be for the body.

Some therapists get caught up in working out the knots, by any means necessary. Gouging elbows into sensitive, over stretched, over worked, already achy muscles is not comfortable for the client and sometimes produces muscular rebellion- burning, spasm, bruising, tightening, or soreness. I prefer the passive aggressive approach of MFR, because if the body doesn't want to do it my way, I can adjust my technique and approach from a different angle or change some other variable, like adding more heat or creating movement in a tissue by stretching.

Clients seem to respond well to a balanced approach combining direct, assertive neuromuscular techniques and passive aggressive, more forgiving techniques like myofascial release and thermal therapy. It is both physical and mental- nobody likes to be forced into something they don't want to do. Mentally they have to know that the more aggressive techniques are meant to benefit them before they can accept them physically. That is where clear communication from the therapist is vital. Education of the client grows more and more important as the bodywork is more and more intense.

Finding the perfect balance of your exercise routine is the key to perfect health

Neuro-Muscular Massage and Kenny G's World Record

In my senior year of high school, I was REALLY into band. I was the drum major of the marching band. I was a flute player in the top concert band and a bari sax player in the top jazz band. I also had a teacher aide period in the band room where I could conduct the freshman concert band class and finally, I took music theory one term. Needless to say, I became very close to my band director, the late Marvin Bates. He was a huge believer in the concept that music has to sound good, or nobody wants to hear it. There are plenty of musicians with loads of technical skill and knowledge of music theory, but that does not mean that they will sell very many records.

Kenny G, for example, can do some amazing things with a soprano saxophone, but I don't want to hear any of them. He holds the Guinness Book of World Records record for holding the longest continuous note, by using circular breathing. His record is 45 minutes and 47 seconds- truly amazing, and truly irritating to listen to.

Neuromuscular massage can be like Kenny G.

I prefer, generally speaking, to use Myofascial release techniques first and more regularly than NMT, because it's "Warm and golden like an oven that's wide open" as the band Cake describes in Commissioning a Symphony in C. Good music is inviting, warm, gentle and enveloping. Good massage should have similar qualities. If it doesn't feel good, nobody wants to feel it. Neuromuscular is technical, direct, and reliable to produce helpful results to clients, but it doesn't always feel good. I like to sandwich it in between stretching, fascia techniques, thermal therapy, and reflexology, to add a more cozy dimension.

There is this adorable commercial I keep seeing lately where a penguin has its foot "Smoooshed" in a cupcake. Myofascial is more Smooooshy than Neuro-muscular, which is pokey. I want to start at Smooooshy and work from there. Again, Neuromuscular is a valuable tool in the massage toolbox, just not the most useful by itself, to keep clients feeling good while receiving therapeutic, problem solving bodywork. A best-selling therapist will be one who knows the theory of neuromuscular therapy and can apply it in a pleasing way.

Neuro-Muscular Massage and GeoCaching

The first time I went Geocaching was with my wife and her brother in Boston, Mass. Having only been to the city once before, I was tied to my GPS and route maps for the "T" - the local train.  When going on a scavenger hunt, a map will only get you so far. Once you get to the site, or GPS coordinates, you have to think smaller, more direct, less general. For example, we went to a sidewalk in the middle of a hill. It overlooked a fenced in basketball court at the bottom and a back door of an old brick building at the top. There were several big rocks piled on top of each other on the hill that we could climb on. There was a park bench. There was a small stone wall to one side. There was a tree and some flower beds on the other side. The GPS got us there, but then we had to start looking for things that were out of place. We had to pick up rocks and feel under the bench seat. We had to check window sills and bird baths to find what we were looking for.

I treat massage therapy in much the same way. My initial interview with a client is a general road map. They may say, I have pain in my hip and down my leg. That gets me in the right neighborhood. Followed up with some quick assessment, like leg length or range of motion testing, I can get to the right street. I follow that with hands on MyoFascial work like fascia fists or general drags to further assess movement, adhesion, and postural patterns. That gets me to the right property on the right street in the right neighborhood. Then finally, I get to Neuromuscular Therapy. I have to poke around until I find the trigger points on exactly the right muscle. Every step is important and I can't skip straight to NMT or I would spend way too much time with too small of a tool for the job. I would also wear out my fingers by doing trigger point work through muscles which haven't been warmed up, stretched, or softened in some other way.

Neuromuscular therapy is one tool of many that should be used cohesively to provide lasting results with massage therapy.