Nov 7, 2011

On the Surface

Used by permission, ABMP.com
As a massage therapist, I am proud to provide wellness services and promote health in my community. Part of how I do this is by the choice of products I use, or rather, do not use. Many people associate massage with having oil, lotion or cream slathered up and down their backs. This can feel wonderful and serves to help promote relaxation, release endorphins and spur the body's self-healing capabilities.

The kind of massage I typically practice, what I refer to as bodywork, does not employ the use of lubricants, or at least, seldomly so. Using myofascial, deep tissue and craniosacral techniques, the intent is to change the relationship of the tissues within the body for better balance and a healthier dynamic. This kind of change is impossible to accomplish when lotion or oil is used; my hands merely slide over the surface remaining in the superficial layers.

When I do use lubricant, I make every effort to ensure it is safe for the client, and for me as well. I strongly encourage all massage therapists to research and consider the kinds of lubricants they use, again for the safety of their clients, but also for their own occupational safety. After all, those that do use lubricant have direct contact with it for hours at a time, day after day after day.

A great place to research the safety of your lubricant ingredients is the Cosmetic Database, located on the Skin Deep page of the think tank and advocacy group Environmental Working Group (EWG). There one can search many thousands of personal care products and find out about the safety of the chemicals used in a given product. Each product is given a rating between 0 and 10, 10 being the most hazardous. If a specific product you're interested in is not listed, you can search by the individual ingredients listed on the packaging.
Used by permission, ABMP.com

It is important to note that personal care products are not regulated the same way our grocery items or drugs are. In fact, there is very little regulation of the products we put on our skin, hair, lips, teeth, nails, eyelashes, underarms, etc every day. It is also important to note that our skin is in fact permeable, thus what we put on our skin can wind up in our bodies and affect our system (that's how nicotine or birth control patches work).

I like the Cosmetic Database for its robustness and usability, and for the effort EWG puts into explaining its methodology in researching and reporting and for its disclosure of what is known (or not known) about these chemicals. Information available on a given chemical is a large factor in how it scores on the database.

It is my professional obligation to ensure the safety and quality of care for my clients (as required to hold a license in the State of Oregon) . Part of this is taking the time to research and know the products I use.


Thanks for reading!


Sep 26, 2011

Bodywork or Massage?

A few weeks back, I was sitting with a dear friend of mine in one of our favorite haunts in NE Portland. Following a late afternoon romp in Laurelhurst Park, avoiding duck poop as we tossed a nerf ball back and forth, we were enjoying a brew and a plate of nachos. Perhaps we were discussing possible ideas for a logo for her new business, or our endeavor to train for and run a 1/2 marathon, when out of the blue Lauren, my friend, said, "I think I'm starting to know what you mean when you say 'bodywork'."

Ah, yes bodywork. After going to school for 'massage therapy' and becoming a 'licensed massage therapist', my friends and family don't quite follow when I describe what I do as bodywork, not massage.

The term bodywork can be understood in two ways: it is an umbrella term, encompassing all forms of manual therapy, including massage. It is also the term I use to distinguish and differentiate myself from the word massage. A contradiction this would seem? Allow me to elaborate.
 
In broad terms, bodywork is an umbrella term for all kinds of manual therapies. Manual therapy is the use of skillful touch to deliver treatment, describes Deane Juhan, in Job's Body: A Handbook for Bodywork. Thus, as different as these practices are from one another, Swedish (relaxation) massage, Shiatsu, Feldenkrais, Rolfing & Structural Integration, Visceral Manipulation, Trager, Craniosacral and Aston Technique can all be labeled under the umbrella term of bodywork (and these are just a few of the many hundreds of manual therapies and modalities that may fall under bodywork). I even consider private instruction in Pilates and Yoga as forms of therapeutic bodywork.

And yet, bodywork is also a very specific term, more specific and very different from what massage, unfortunately, has come to imply.

Going back to Juhan's description of bodywork, he writes that it conveys the 'idea of the body being touched in a deliberate fashion for specific results,' meaning there is a process of intention for both the the client and the therapist. The client is not passive, like a slab of meat on table, the therapist is not impassive, like a lump of stone. A session of bodywork is the meeting point between the needs of the client and the methods and the discretion of the therapist. 

Bodywork is a practice that one builds upon over time. Meanwhile, massage is what is innate to our human selves and we use it on ourselves or to comfort others when we hurt physically, emotionally, spiritually. A person benefits enormously when they receive respectful, safe touch from any other human being. But bodywork is not innate to us, it is a combination of knowledge, skill and study that are developed over time and practice. Bodywork is about intention.

An example of what I mean is that a person may come in with a knee that becomes painful during running. I could massage the area around the knee, the quads, the IT band, the hamstrings and perhaps the sensory input will assuage the pain for a while and relieve muscle spasm. But the knee will more than likely continue to cause pain when that person runs again.   

In contrast, with bodywork I assess the factors that may be causing the knee pain, often which are not at the knee, but come from the hip and/or the foot, and use methods to recreate balance there. When the foot and the hip are in balance, the knee will naturally and quite happily come into balance. And is more likely to stay in balance, as the factors causing it to be imbalanced have been addressed.



Thanks for reading!

Sep 3, 2011

Adding Assetts: Advanced Hip and Pelvis

Last week I learned some new powerful and refined techniques for assessing and treating troublesome hips. Advanced Rolfing instructor and head of the certification program Advanced Myofascial Techniques, Til Luchau, demonstrated techniques to release tension in the soft tissue around the hips, as well as releasing the joints within the hip and pelvis.

Along with adding a couple dozen techniques to my repertoire, I also learned how to quickly assess and find restrictions in the hips and pelvis, allowing for more focused work where it is needed most. Even in the short time since implementing this new know-how into my work, I've enjoyed seeing my clients walk out of sessions feeling better and moving more freely.

The hip bone, also called the innominate, meaning 'nameless' in Latin, is actually 3 bones that fuse embryologically: the iliam, ischium and pubis. The two innominates join at the pubic symphsysis joint in the front and the sacrum in the back.
Some brief Anatomy:

The hip/pelvis system is marvelous and complex. It is where our upper body meets our lower body and its unique wide, bowl shape allows for our distinctly human upright nature. The hip socket is shallow and dish-shaped, allowing the femur that articulates with it great flexibility to move freely in many directions. Freedom of motion is important and a key aspect of the hips, but also has an inverse relationship to stability. Therefore strength in the soft tissues, the ligaments, tendons, muscles and enveloping fascia, is required to create stability in this vital structure, which must negotiate the functions of mobility for our legs to carry us where we want to go while also giving support to our heavy upper body. Altogether, about 20 muscles work in a harmonized symphony to create or prevent movement in our hips as we move and stabilize ourselves throughout the day, according to J. Earls and T. Myers in Fascial Release for Structural Balance (2010).

Where the hips are in space, whether we are standing, sitting or in motion, also determines the alignment of the spine and upper body. The base of the spine, the sacrum, articulates with the two hip bones creating the sacroiliac joint (SI joint). The sacrum is also the platform for the first lumbar vertebra (L5). If the hips are tilted to one side, often due to tightness around the hip socket, then the sacrum is also tilted and the spine must compensate for it by curving and counter-curving. The pelvis also tilts front to back. A little tilt is good, and creates relaxed curvature of the spine. But too much (sway back) or not enough will put tension on the body as it tries to maintain an upright posture. It's good to keep your hips relaxed, mobile and balanced, because their condition affects your whole body!



Techniques and Applications:

While at this Hip/Pelvis workshop, one of my favorite techniques I learned is actually a ligamentous release (ligaments are the dense connective tissue the link bone to bone). The sacrotuberous ligament attaches the bottom half of the sacrum, which is the fused base of the spine, to the back and bottom of the hip bone. This ligament anchors the sacrum. Working to release this ligament can help relieve tension further up in the low back, along with tension in the musculature of the hips, such as the gluteus maximus.

This technique, along with the others I learned last week, are helpful in balancing and mobilizing the hips, including in treating sciatic pain, which is a common condition, causing pain, usually on one side, starting in the glutes and down the back or side of the leg, and sometimes into the low back area.



Thanks for reading!






Aug 25, 2011

Square Power

The Square swipes debit and credit cards.
I am really excited to be able to now accept debit and credit cards (Visa, Mastercard, AmEx, Discover) at PDX Massage Therapy! I've been using "Square" for a couple months now, having learned about it from a client. The card reader, which attaches directly into my droid phone, is small and works via a simple, free app. I've been happy with the utter simplicity: all I need is my phone, the Square device and with a swipe of the payers card, I can accept their payment in less than 30 seconds. I spent so much time researching Paypal, Google Checkout and other companies offering credit card processing, and was dismayed by what an unwieldy process it is. But for my simple transactions, I've finally found a simple device and service. I can recommend square to any other massage therapist, or small business owner who needs to process simple payments in person. Here's a recent review from PC Magazine.




Thanks for reading!


May 10, 2011

Deep Pressure vs Deep Tissue

In my own words, deep tissue is not deep pressure. This is the great misconception. 'Deep' is actually an anatomical term that simply means 'under' (from Gray's Anatomy, accessed here). Deep Tissue refers to the muscles and connective tissue (fascia) that are not easily accessed using traditional Swedish techniques. Nor can these deeper tissue be reached by simply applying more pressure.
Pump up the Volume:

Put another way, if you turn up the volume on the radio, does that mean the quality of sound coming from the speakers is improved? Just because a therapist can 'turn up the volume' by pushing harder, doesn't mean you're getting a higher quality treatment, it just means you're more likely to come away from the massage feeling bruised.

Deep Tissue requires 'advanced training and a thorough understanding of anatomy and physiology,' as described at massagetherapy.com. It also requires patience and attentiveness to the overlying tissues so that they are not injured.

I studied deep tissue with Jonathon Primack in an 11-week course at East West College of Healing Arts. He includes on his website a very good description of what deep tissue is really about. I learned an incredible amount from Jonathon, but it was just scratching the surface. I continue to study and develop both my technical skills in palpation and technique, as well as reading and learning as much as I can to deliver quality bodywork.


Thanks for reading!


All content authored by Kate Barkume, Licensed Massage Therapist, Portland, Oregon

Apr 28, 2011

The tension in your body - Icosahedron


6 dowels + 12 tacks +
24 rubberbands = 1 icosahedron


I'm so excited to share my tensegrity model! With just six dowels, 24 rubberbands and 12 thumb tacks, I was able to assemble this icosahedron (20-sided shape of equilateral triangles) in about 5 minutes. No glue or nails are used to hold this sturdy structure together. The equal tension of the rubberbands around the ends of the dowels (held in place by the tacks) keeps it all together, even if I press down on it or stretch the individual components apart.

I built the model using instructions provided in the 2nd edition of Anatomy Trains: Myofascial Meridians for Manual and Movement Therapis, by Tom Myers (Myers, 2009). Throughout the manual, Myers employs photographs of Thomas Flemons's beautiful and complex biotensegrity models, available at www.intensiondesigns.com. This one is much, much simpler, but still lots of fun to play with, and useful as a tool to illustrate how our bodies work and relate to stress (that is, mechanical stresses).

Keeps its shape, even if you squish it!
Tensegrity is the words 'tension' and 'integrity' smooshed into one. The basic idea is that (structural) integrity is maintained through tension. The term tensegrity was coined by designer, engineer and futurist, R. Buckminster Fuller (of soccer ball-esque buckyball fame) and was used to describe the profound sculptures of Kenneth Snelson (Oregon-born, no less).

Other common instances of tensegrity are tents, spiderwebs and suspension bridges. But what's cool about this tensegrity model is its independence from external support - it holds itself together, despite external forces (like if I were to throw it as hard as I can against the ground), through its intrinsic balance of tension and compression forces. And it does so with the absolute minimum of materials. This means the structure is optimally efficient to handle stress, because it distributes stress equally across the whole system. Put another way, "tensegrity structures are mechanically stable not because of the strength of individual members but because of the way the entire structure distributes and balances mechanical forces." (Ingber, Donald E, "The Architecture of Life", Scientific American Magazine, Jan. 1998)

The cat inspects the 20-sided contraption
So as a massage therapist, what can I say about the relationship of the body to mechanics, architecture and the distribution of forces in an icosahedron? Put another way, if a client comes to me, describing pain in her left hip, why might I begin a series of treatments working on her feet, or perhaps her right hip, and not work directly on the area of pain?

Going back to the icosahedron model, if you push one of the dowels, or pinch a rubberband, you can can see the whole structure respond. If you continue tweaking it more and more, this increased strain is nonetheless distributed around the whole figure. Finally, when there is so much stress that it breaks, likely as not, the breaking point won't be where you were stressing it the most, but will be at the weakest point of the structure, perhaps far away from where you were tweaking it. The idea is, the same thing happens in the body. To relieve pain in the hip, we have to look at and treat the body as a integrated whole. If we do not find and relieve the imbalanced lines of tension around the hip, then dysfunction causing pain in the hip will not be resolved.




Thanks for reading!


All content authored by Kate Barkume, Licensed Massage Therapist, Portland, Oregon