Pain sucks. As a massage therapist, I would know. Almost everyone who comes to see me does so because they're in pain!
Most of the time, my clients have such a powerful response to massage therapy they don't need additional therapies. However, that isn't always the case. I always look for clues that indicate I need to refer a client to another practitioner, such as a physical therapist.
Physical therapy and massage therapy are both powerful methods for treating pain. By focusing on correcting the underlying muscular imbalances that have caused it in the first place. When used together, they can help clients achieve faster and better results.
There are several reasons why massage therapy is effective for anyone who is already receiving physical therapy.
Here are the top 7:
Providing pain relief, often times after the first session
Increasing range of motion so that the body can move better
Decreasing local inflammation by working above and below the area
Lessening the pain clients may be feeling during or after physical therapy exercises
Decreasing the pain clients may feel post-surgery
Bringing faster results than just physical therapy alone
Motivating clients to stick to their physical therapy treatment plan
That's the short version of why massage therapy and physical therapy are a powerful combination. If you're interested in a more detailed explanation, read below!
1) Massage therapy helps by treating short and overused muscles.
The goal of many physical therapy exercises is to help strengthen any weak muscles that are causing pain symptoms. The goal is that by strengthening weak muscles, the body will move & feel healthier. But that's only half the picture.
When it comes to muscles, imbalance happens when one muscle is weak and long while another muscle is overused and short. In order to correct this, BOTH of these problems need to be addressed. This means following the exercises provided by a physical therapist teaching clients how to engage and strengthen muscles that are weak. It also means using massage therapy to address the muscles that are chronically overused.
The right massage therapist will focus on releasing these tight muscles as well as lengthening them when they've gotten short. This can help effectively decrease pain while also improving range of motion and helping the nervous system learn how to move better!
2) Massage therapy will help with physical therapy.
Studies show that one major obstacle to physical therapy treatment is that many will stop coming in if the exercises are painful to do, or if their pain doesn't decrease right away. (Source: Read this article) Basically, if the work is too hard and painful, people are a lot less likely to do it. Massage therapy can decrease pain often with immediate results, which will help provide motivation to stick to the physical therapist's treatment plan.
3) Massage therapy can help post-surgery.
Sometimes people will experience new aches and pains after their recovery from a surgery, even while doing physical therapy. This can happen due to a change in the body alignment and how the body moves after the procedure. If clients are already doing regular physical therapy and still experiencing pain post-surgery, I suggest asking a doctor if it’s medically safe to try massage therapy.
For more detailed information on how massage therapy can help post-surgery, please check out this in-depth article: Click Here!
In summary, we see that combining physical therapy and massage therapy help clients move better and feel better by working on correcting any muscular imbalances that can be causing or contributing to pain.
Want to read more about how we work at Bodyworks DW?
Okay, so your "text neck" probably won’t actually kill you (unless you are texting and driving). However, it’s becoming increasingly likely that at some point in the next 5-10 years of tech use, you’ll develop a repetitive stress disorder.
The phrase carpal tunnel syndrome (wrist pain) has been part of the collective conscious for several decades. It's so common as a disrupter of productivity that it has spawned an entire industry of ergonomics solutions. These range from special keyboards to Star Trek styled full desk/monitor set ups. All keep you at your desk longer making trades, typing contracts, writing legal memos.
And then the 2000’s came along. Most of us jumped all in with smartphones and laptops and tablets.
Suddenly we could be productive all the time.
Standing on the subway platform?
Let me check my email.
Taking the train in from CT?
Let me just go over those sales reports.
Date just went to the bathroom?
Let me text my assistant to make sure I’m set up for tomorrow’s board meeting.
Unfortunately, there are costs to constant device use that might change your mind about your phone and tablet.
Looking down at our phone, tablet, or laptop, pulls our head forward and down. This imbalances all the muscles holding up your head (ahem... text neck). These imbalances can cause any and all of the following:
Like many things that aren’t healthy for us, these costs are not going to suddenly show up tomorrow. They build up over time. In ways that make it hard to track what the changes are doing to your body. However, there is hope for us all!
What can I do about this?
I’m not some Luddite preaching that we should all return to farming. I happen to be a business owner with 20+ employees and have tech in so many screen sizes it’s getting ridiculous. I deal with text neck too.
I’ve got a smartwatch, smartphone, an iPad for home and one for work, an airbook laptop, an iMac at my desk. Not to mention the 15 other devices I have at the office for the staff to be "productive" on. I’m just as tempted as you to go on my phone on the subway and read articles on Facebook or Twitter to pass the time. So I decided to try something out...
I had to get really clear on what my time is worth to me and what my long term health is worth to me. And I had to spend some extra cash to duplicate certain items at work and at home so that I wouldn’t have to cart them back and forth.
Is it worth it? For me this experiment has been a fascinating eye opener. It’s also reduced my daily stress levels by about 20-30%.
I have less issues with headaches at day end, my back feels better, and my overall mood has noticeably improved.
I’ve got new rules for my text neck, I count em:
#1: I am not allowed to look at my phone during my commute except to choose music.
#2: I am only allowed to work while at the office, or while at my desk at my home office. The couch is only for relaxing and the bed is only for sleeping (and well, you know…).
#3: If I need something both at work and at home, I duplicate that item rather than carry it back and forth. The value in stress reduction and ease of movement on my body is a long-term savings in health and self-care costs down the road.
#4: If I do have to look at a device, I hold it up to horizon level and keep my head up.
#5: When my arm gets tired of holding up the device to eye level rather than looking down, it’s time to take a break and put it away.
You may think I’m crazy for buying a second iPad to keep one at work and one at the office. Really the only reason for me to do that is that it has become my primary note taking device for my life coaching sessions. Sure, I could take notes on paper, but then I’d have to create a filing system for them. The iPad keeps all my notes for each client on the cloud.
Of course, you’ll have to do your own analysis of the following:
- what you can and can’t do without
- how much is your time is worth
- which work can be left until tomorrow or
- what work can be put on hold for the 45 minutes to 2 hours you spend on your commute
You’ll probably come up with different ways to reduce your load and stress than I have. (For instance, maybe it’s spending the extra cash on a monthly gym locker. You can leave your workout gear there most of the time.) Prioritize those ideas and see for yourself how helpful it can be.
Are you willing to give lightening your load and keeping your head up a try? Yes? Your text neck will thank you.
First off, what is this strange sounding condition?
It’s most common among pregnant or postpartum women. About two thirds of pregnant women have it. So why have you never heard of it? People don’t talk about.
Diastasis Recti is a condition where the rectus abdominis splits down the middle causing a vertical gap in the abdominal muscles. It can cause lower back pain, constipation, and urine leaking. It can even make it harder to breathe and to move normally.
How to treat it if you have it:
Massage therapy for Diastasis Recti can be very helpful to rebuild proper abdominal tone as long as you’re also working with a physical therapist who specializes in this issue. An experienced massage therapist can open stuck tissues that are pulling the abdominal muscles outward. These stuck tissues are generally from previous injuries that have left scar tissue behind. In addition to this kind of bodywork, you’ll need physical therapy exercises to knit the torn muscles back together.
Why “ab” exercises don’t work for you now…
It’s counter-intuitive, but doing “ab” exercises such as sit ups, or pilates, can often make the problem worse. Without proper firing of the correct support muscles, these exercises often pull outwards on the linea alba (centerline where the gap develops). This can either increase the separation, or keep it from knitting back together.
A combination of massage and physical therapy can speed up the healing process considerably. In most cases it will open up the stuck tissues that would keep physical therapy exercises from working. The synergy between the two modalities is worth way more than the sum of the parts.
Because massage therapy is an “opening” practice. Our training is in releasing tissues that are either tight (ie over-firing) or stuck (ie glued with scar tissue). We also work to retrain the nervous system to allow muscles that are over-firing to relax and settle into a balanced tone.
Physical Therapy is a “closing” practice. It’s based in strengthening and tightening muscles that are weak (ie under-firing). The repetition of certain exercises draw blood flow to areas that need it, allowing the body to heal and reconstruct itself.
Ready to put in the work?
Diastasis Recti is not a one-time fix situation. It takes a coordinated effort, diligent homework, and focused effort for 8-12 weeks. It is next to impossible to self-heal without a minimum of a few guided sessions. Most clients will need the following:
4-7 sessions with a professional massage therapist
3-5 sessions with a physical therapist who specializes in working with Diastasis Recti
15 minutes a day of homework exercises
If you’d like to know if massage therapy for diastasis recti can help you, don’t hesitate to call us and arrange a phone consultation with David Weintraub. Or book an initial session online!
Bulging discs seem to come out of nowhere, but in reality there are usually other root causes. For instance, an older ankle or knee injury can create an imbalance in the body leading to pain. Compensation from older injuries puts asymmetrical pressure on the low back. Eventually this can cause one or more lumbar discs to bulge. If the bulge presses on nerve pathways, extreme pain can result.
At Bodyworks DW, we evaluate how the rest of the body and posture is affecting your low back pain. Then we will make a plan for a series of session that will unwind any seemingly unrelated issues. As the whole body opens up, pressure on the low back is relieved, allowing the disc to return to it's normal shape. With less and less pressure on the nerves, pain slowly but surely goes away.
How Traditional Approaches Fail
Surgery tries to correct this by shaving down the bulging disc or fusing two vertebrae together. However, the root cause is still affecting the body. The surgery can eliminate symptoms for a short period. Then the bulge pops out in another disc making the problem even worse later on.
Medications mask symptoms, which can feel good and sometimes help you move through the issue. However, the root cause it usually not addressed. Pain will likely come back to plague you in the future. Opioids are especially worrisome as they are highly addictive. This can lead to reliance on them to even function. In an increasing number of cases the addiction spirals out of control.
How Massage Therapy works differently
With massage therapy for low back pain, we work to discover why the disc is bulging in the first place. Meaning you'll get a more holistic approach. The pathway might be slower, but you'll know that your pain is being reduced in a healthy way. And you'll gain the tools to keep it from coming back in the future.
In addition to massage therapy I want to point out some research from the American College of Physicians advising doctors and patients try “non-drug therapies” such as exercise, acupuncture, tai chi, yoga, and even chiropractics, and avoid prescription drugs or surgical options wherever possible. (If the non-drug therapies fail, they recommended nonsteroidal anti-inflammatory drugs as a first-line therapy, or tramadol or duloxetine only as a second-line therapy.)Centers for Disease Control and Prevention also came out with new guidelines urging health care providers to turn to non-drug options and non-opioid painkillers before considering opioids.
Research is mounting that active therapies (exercise programs, yoga, tai chi) can really help people work through back pain, and alternative approaches (massage, spinal manipulation) can be effective, too.
Are you suffering from low back pain? There are many advantages to working with our team of trained medical massage therapists.
Book online or call today to see if massage therapy for low back pain can help you!
Have you considered massage therapy for neck pain?
Neck pain is a common complaint.
We tend to keep our head in a “head forward” position. This pulls the muscles in the back of your neck into a constant stretch. And makes them work extra hard to fight the weight of your head. Muscles hate being stretched and working hard, so they yell at you. Loudly 🙂
We’ve developed truly effective massage therapy for neck pain that provides long term relief at Bodyworks DW.
Does this sound like you?
a) Sitting at a desk staring at your screen, b) looking down at your phone much of the day, c) reading your iPads in bed to unwind and destress after a long day at work
So, my massage therapist should work where the pain is the whole time, right?
It may feel good to have your therapist spend the session massaging mostly where you feel pain. However, the next day you will feel like you were hit with a bag of hammers. And it won’t do anything to relieve the pain in the long term. Massage therapy for neck pain has to address what’s causing your head to move forward in the first place. And it’s not anywhere near your neck!
The following three areas need to be released move your head into a more balanced position. This allows the muscles in the back of your neck and upper back to relax and stop yelling at you.
3) Is your current massage therapist only working on the back of your neck? Yes, we know that’s where it hurts. However, he or she is not going to make a long term impact. The back of your neck is over stretched. The front side needs to be released in order to give the back some slack.
2) The position of your ribcage in relation to your pelvis is vitally important to relieving neck pain. With a head forward position, the ribcage tilts backwards to compensate. The muscles in the mid back will work extra hard. If I only release the front neck muscles and not the mid back muscles, your neck will feel a lot better, but you’ll be stuck looking up at the ceiling.
1) Your tight hip flexors (from sitting all day) are why the ribcage moves backward and the head moves forward. And if we open up the angle of your neck and your ribcage, but not the hip angle, you’ll be left stooping over!
Effective massage therapy for neck pain addresses all of the forces pulling on your head
Addressing your neck pain effectively requires releasing each of these folds in the same session. You will feel immediate relief at the end of the first session. And you won’t feel sore or beat up the next day.
However, one session won’t “fix” the problem. The first session is a great start to open up the surface musculature. And the first session allows for deeper work in later sessions. Your relief will last a lot longer.
To have a long term impact, we will follow up the first session with 3-5 custom designed sessions. These session will work on more detailed areas in cumulative layers. Each session allows us to go deeper into the stuck front neck muscles and bring your head into better balance. With your head balanced on top of your spine all of the muscles work less. Less work = less pain!
The 2016 NYC Marathon is less than 4 weeks away...
Is this your first NYC Marathon? Taking on the training and then running a marathon is a big deal. Congrats!
Hopefully, at this point, you are feeling close to ready. However, it's normal to freak out a bit and get worried that you haven't run that many longer runs, and that none of them are a full marathon. Having worked on 100's of runners over the years, we can tell you to trust the process and stick to the training schedule.
Here are a few extra tips to make your first (or seventh...) marathon a great experience instead of a slog.
What to do in the next few weeks to prepare for NYC Marathon recovery
If you are feeling comfortable with the length of runs on you training schedule, great! Keep up what you are doing 🙂
If you are experiencing any consistent pains on your runs, book a massage therapy session and/or physical therapy session to relieve the pain. Mild to medium pain at this point in your training will add up to a real injury on race day. And make your marathon an excruciating experience. It will also mean a lot more work after the marathon to rehabilitate. Often these pains can be dealt with in a few sessions now with a good therapist. Suffering through pain until after the run is playing with fire.
Some common pain types for runners:
heel pain and/or foot pain
hip pain and/or groin pain
neck pain and shoulder pain
What to do to AFTER for NYC Marathon recovery
Book a post race recovery massage and have it scheduled 2-7 days after the marathon. Your body will be super sore and depleted. If can often take a full 2 weeks to recover and feel normal. A light to medium pressure full body sports massage will help you recover in half the time (or less!). You've put all of these hours into training, run 26.2 miles, raised money, etc. Why not treat yourself to a lot less pain and suffering after the marathon?
If this is your very first marathon, we suggest booking a marathon recovery massage about 3-5 days after. It will take several days for your body to process enough of the lactic acid to where a massage will have you feeling better. If you've run a marathon before, some seasoned runners book a marathon recovery massage for the evening of the race! Others book the next day or the day after that.
For self-care, drink more water than normal for several days, and eat more protein. You'll need the protein to rebuild torn up muscle tissue. If you get hungry, listen to that and eat something. Take contrast showers....hot, then cold, then hot, then cold.
Your system will be working overtime trying to heal hundreds of small micro-tears, and trying to flush out way more waste than it's used to dealing with. Trying to live "business as usual" is a asking for grief. Sleep lots. Stretch lots. Don't run for 2-3 weeks! (For realz).
Massage Therapy for an Ankle Sprain: what to do from the moment you get injured…
Massage therapy for an ankle sprain wasn’t my intended topic this week. Then I took a bad fall in a parkour class trying to jump a 12 foot gap. I’ve now got about 6-8 weeks of healing, before exercising again in any weight bearing or high impact capacity. Based on my own professional assessment, anyway.
It’s also timely and useful for those of you currently training for the NYC Marathon or the Ironman Triathlon to know a bit more about treating ankle sprains.
I know that there is a lot of info out there about what to do and what not to do. And much of this info is confusing and conflicting. So I’m going to walk you through what to do based on the most recent science. Using my own injury as an example.
First things first: how bad is it?! (is anything broken)
Before you attempt to do anything at all, you need to figure out if you have a broken bone or an ankle sprain. The very very very last thing you want to do with a bone break is try to move it. So you need to assess visually before assessing whether you can move it.
Questions to answer:
assuming you are in excruciating pain, is the ankle hanging off at an extreme angle? (If so do NOT attempt to move it)
do you see bone sticking out? (Again do NOT try to move it)
If it does seem like a bone break, you need an ambulance. Call 911 if you are alone, have bystanders do it if there are people around. Do not skimp here and try and get to the hospital by taking a cab. It needs to be looked at by qualified professionals and splinted/immobilized before you are moved. If you try to load yourself in a car, even with help, you are going to smack it around with every bump. This will shred the soft tissue around it even more. More shredded soft tissue = even longer recovery. Not worth it.
Okay, it doesn’t seem broken…now what? (no, not the RICE method)
First, gently test to see whether you can move the ankle at all. Small circles in both directions, flex and point, wiggle the toes. Even just a slight ability to move is a good sign that nothing is completely torn through. If you can make tiny circles, flex and point, and move your toes, then it’s likely an ankle sprain. Of course it’s still possible that you have hairline fractures in one or more of the bones or partially torn ligaments. So don’t jump to conclusions.
In the old days, athletic coaches would tell you to walk off an ankle sprain at this stage. Unfortunately, this has the immediate danger of ripping apart the soft tissue even more. And potentially tearing a muscle, tendon, or ligament all the way through. Trust me, anything torn all the way through is going to take a LONG time to recover. So you definitely want to avoid the possibility of making things worse.
In 1978, Dr. Gabe Mirkin developed the RICE method (rest, ice, compression, elevation). Since the, RICE has been king in sports medicine. The RICE method counteracted the “walk it off” method and prevented further injury to the soft tissue. However, as we are now learning, it also slows down the healing process. And potentially freezes clotted tissue to the ligaments. In the last few years, science has had a nearly 180 degree turn on RICE (in fact, Dr. Mirkin himself has refuted RICE on his own website). Several studies now show that Ice delays healing, as does anything that reduces inflammation.
Second step…flush the tissue with small light movements to a tolerable level of dull pain, but not sharp acute pain.
In the case of my ankle sprain this meant:
lie on my back and raise the ankle up to elevate it
make small tiny circles back and forth with the ankle to a tolerable level of dull pain
also point and flex the ankle and the toes to a tolerable level of pain
use your hands to assist if needed
flush for a few minutes, rest,
then lightly (and I do mean lightly) stroke the injury area with your fingertips, moving towards the heart
repeat several rounds of flushing and resting
check in with your pain levels and your body for 15-20 minutes
If the circles get slightly easier to make and/or larger, and your body starts relaxing a bit more, move on to next phase. If the area does not start to move a little better and calm down a bit, go to a sports doctor to get xrays, there may be smaller hairline fractures or a torn through ligament or tendon.
The point of the flushing phase is three fold: moving fresh blood with nutrients and proteins to rebuild into the area, break down ripped up tissue and old blood, move the broken down wastes out of the area.
The third step…very gently attempt to put weight on the area
In my case with an ankle sprain, it’s best to try to come to hands and knees first, then either with assistance or by grabbing on to something, pull yourself up on the good ankle. Then, while holding on to something or with assistance, try to gently put weight on the bad ankle.
Assess the pain this causes (and it definitely will cause pain)….is it intense but diffuse, or sharply acute on one spot?
With intense but diffuse pain, you can attempt to slowly put weight on it and take a step while holding onto a wall or another person
With sharply acute pain, take weight back off of it and try flushing it for a few rounds while standing on the good leg, then try to put weight on it again
if putting any weight on it again causes sharp acute pain, such that you can’t take a step at all, get to a doctor or hospital. You’ll want to get xrays and an MRI to see if there are any hairline fractures and/or torn tendons or ligaments. We recommend a few great NYC physical therapists on our collegues page due to their high level of experience and their philosophy of doing full 60 minute sessions with each patient.
However, if you can hobble on it with tolerable pain, call a car and get yourself home, trying to keep the injured ankle elevated on the back seat. If you don’t have a friend with you, call someone and have them meet you at home. You are going to need some help and support.
The fourth step…recovery
Once you are home, elevate the ankle, and make sure that you drink water and eat some food, preferably fruit. This will immediately raise your glucose levels and help keep you from going into shock. Have a blanket handy in case you get cold and start shivering. Absolutely try to get help from a friend, partner or family member to purchase a few needed items. Get a cane and a slip on ankle bandage that provides support and compression. Also an arnica based lotion to apply to help move the bruising through. My personal fav is Topricin:
Why a cane and not a crutch? A crutch will be much easier to move around on at first. However, it will create havoc on your shoulder. In addition, it will be too easy to get moving fast on it, which is a recipe for taking a quick wrong step and re-injuring the ankle. A cane is somewhat humbling, but you can’t really move any faster on it than your bad ankle will let you, which is a good thing.
Recovery is all about getting blood to and from the ankle. Move it or lose it is the name of the game. Keep flushing it several times daily with rounds of circles and movement to a tolerable degree of discomfort. Too much and you’ll probably just want to vomit. None, and the ankle will heal frozen in place and you’ll just have to rip the tissue back open again to get it moving. Slow and steady wins the healing race.
Wear the compression brace whenever you plan to try walking on it. For now you’ll need the stability and it will keep the blood pressure from feeling too awful. However, don’t wear it 24/7. Take it off and elevate it at home when you can (and should) rest.
A simple brace that slips on like a sock is best. You can still move a bit in it and do recovery exercises and it fits better in shoes which are also going to give support. Here is a great brace:
Recover Faster with less chance of Future Injury
While it is possible to heal this type of injury on your own, you’ll get far better and quicker results working with experienced wellness professionals. Work with an acupuncturist during the initial stages, and a massage therapist and physical therapist as it starts to heal and take weight better.
DO NOT attempt to exercise on it until you can walk comfortably, without pain or discomfort, without wearing the brace. (At least not without direct guidance from a physical therapist.)
Now that I am walking mostly without a limp, and able to take stairs up and down reasonably well, my next move will be getting advanced massage therapy sessions from my staff in order to keep the injury from adversely affecting my knee and hip on the right leg. Often the biggest impediment to healing an injury all the way through is locked up compensating musculature in the rest of the body. In the beginning, this compensation was necessary to keep you from further injuring the ankle. Now, it’s just in your way. A physical therapist colleague introduced me to using a wobble board for ankle sprain recovery and it’s a life changer. Highly recommended!
Last but not least…for NYC Marathon Runners
Our tendency is to want to dive right back into our exercise routine once we feel like we have little to no pain. This is just asking for re-injury. Take 4-6 weeks to slowly but surely add back in exercise. Act like you’ve never worked out before. Start small and steady. My first “rehab” exercise was walking to a cafe down the block with my wife for brunch after being stuck at home for 4 days. If you used to run 6 miles a run 5 times a week, start with a walk to the subway. Then walk a quarter mile a few days later. Then walk a half mile in week 2. Maybe by week 3 you try running around the block once. Maybe.
If at any point you step weird and it feels hurt again (and trust me this will happen), take it easy, continue daily flushing. It’s all part of the process of rebuilding a solid working structurally sound ankle.
If you bite off more than you can chew at this stage, you may step wrong, roll the ankle again, this time worse, tearing through already weak ligaments. Do you like the thought of having to take 8-12 MONTHS to recover?! Don’t push too hard!