More about me, some Q & A

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Sometimes there is confusion about whether I’m a naturopath. Not here! In Florida, I’m licensed as a massage therapist, because that’s what I need in order to work with soft tissue mobilization techniques.

My education started in Germany in 1994 at a college for natural health. I’m licensed as a naturopathic physician there, and have been specializing in treating the neuro-musculoskeletal system.
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How to recover smartly from muscle injuries

2189924965_d6d4d780d1_mSo you hurt yourself. Maybe it happened working out, maybe you were just trying to carry something heavy in an awkward way. Maybe you lunged to get that ball. But you pretty much know you hurt yourself, even if later you think “ah, it’s going to be fine, I’ll be ok, it’s just a strained muscle.”

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Did I just sleep wrong? I have a crick in my neck!

Neck-PainI think I have slept wrong, they tell me.

That’s what I hear almost daily. It’s usually persistent neck pain and stiffness, often with limited range of motion–so it’s hard to turn your head when you’re driving, you notice that you’re shifting in the seat.

If it came on suddenly, you woke up with it, maybe you did actually sleep “wrong”.

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The 7-point-plan for chronic pain and tension:

So, you’re hurting?
And it’s been a long time?

Then you’re like a lot of my clients.

Acute muscular pain is relatively easy to treat, and often goes away by itself anyway.
When a new client tells me that her neck/shoulder area has been painful for a couple of weeks, and nothing seems to help, I’m thinking “oh, this is going to be great!”. In 90% of these cases, it takes one treatment, and things are fine.
There really aren’t a lot of things that give me more pleasure than that new client checking out with the receptionist, exclaiming over and over “This is amazing. I can’t believe it. Look, I can move my head!”

Chronic pain is different.
It’s not easy to treat at all! It’s persistent, nagging, evasive, and it’s hard to predict what treatment will help. I started comparing it to predicting the weather–there are just too many different factors playing into it.
Chronic pain is now seen as a disease itself, not just a symptom, and it’s more a disease of the nervous system than the muscle or connective tissue.

So how do we treat the nervous system?

We need to get moving, develop a better attitude, get out of stress, but we also need good feelings in the areas that hurt–that’s why massage therapy can be very helpful. It gives the nerves something else to report than just pain, and feeling loose afterwards is sending signals to the brain that “this area is functioning well” which in the long run can re-educate the brain.

Here’s a video to explain these concepts. Of course it’s not as easy as that.

It’s hard to develop a positive attitude if you’re hurting so much that you can’t sleep, can’t think, and can hardly get through the day.

So here are the seven interventions, tested and approved by my chronic pain clients: Continue reading

Why is Massage Therapy So Expensive?

(update 9/9/13: Reactions I’m getting on Facebook and in the comments here suggest that I haven’t been clear.
The image is making fun of my past self and other idealistic therapists who aren’t good with money. I do not suggest people should charge $25! I had hoped my post would explain why I think that in some areas where the cost of living is high, and office space is at a premium, even $100 would not suffice to cover the cost and a living wage.
Of course the price of a service depends on value for the customer, so I tried to explain this post is not about top-notch manual therapy, it’s about an “average” relaxation massage.
And last… I do value massage therapy highly, and I know of the benefits. I will not edit the post itself, since that would make a lot of the comments look strange, but I think I should have been MUCH clearer.
Please accept my apologies.)                       Continue reading

Structural Interventions for Instant Results

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In the past four years, I’ve developed, tested and improved my own type of bodywork for quick fixes. It’s based on techniques I learned in Germany 1995-98 when I was studying naturopathic medicine and bodywork, but is also influenced by my current work as a Certified Rolfer™–or, to be more specific, SIFIR is what I do when I don’t do Rolfing®.
I’m not always going for the holistic re-education of the whole body that Rolfing Structural Integration is intended for. Quite often I see clients who are well-integrated and just have a singular problem that needs attention, often related to injury, or just “a crick in the neck”.
Other times there is a problem with pain or limited range of motion that is standing in the way of better integration and needs to be addressed before a holistic approach can be used.

In those cases symptom-oriented bodywork is called for, and that’s what I’ve been doing for the last 15 years. Now I’ve put my quick fixes into a system.

Since my clients often comment on “instant gratification”, I call it SIFIR–Structural Interventions for Instant Results.

This is not about selling “new” techniques. If you have a lot of experience with myofascial work, especially structural bodywork, the techniques themselves are similar.

What’s “new” is that I aim at high efficiency for fast pain relief. A lot of my sessions are just 20 minutes long, and the results are great.
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Do Massage Therapists Expect Tips?

Etiquette around gratuity is puzzling for foreigners like me. But it’s also a problem for Americans! We often don’t know whether a service provider is an employee or an independent contractor, whether they get paid well or the bare minimum, and some people seem to get offended when a tip is offered.

I’ve heard of massage therapy experts who refuse tips with the argument “Do you tip your doctor?”

Then I also hear some who feel insulted because they didn’t get a tip. Continue reading

Hyper-Lordosis and Lower Back Pain

from stronglifts.com

from stronglifts.com

A lot of my clients with low back problems have some form of hyperlordosis. Lordosis is the normal, slight curve in the low back, so hyper-lordosis means there is too much curvature.

Look at the image here (borrowed from stronglifts.com, who have some good thoughts on the topic).

But before I get any deeper into exploring the topic, a few words of warning: I’m saying a lot of people have hyperlordosis, and a lot of people have low back pain. I’m NOT saying that hyperlordosis automatically leads to low back pain. In my opinion, a fixed position of the lumbars and insufficient movement might cause problems in the lumbar spine, and these could cause pain. Low back pain is difficult to understand because there are so many different factors that contribute to the problem–the biggest factor is your brain.

If people have told you that your pelvis is tilted the wrong way, or one of your legs is a quarter inch too long, please read: “Your Back is Not Out and Your Leg Length is Fine”.  If you suffer from low back pain, buy this Ebook: “Save Yourself From Low Back Pain!”

(No, Paul Ingraham doesn’t pay me for promoting his work. I promote it because more people need to read it.)

Here’s what I know about hyperlordosis: Excessive curvature in the low back is often caused by short hipflexor muscles. They attach on the front of your lumbar (low back) spine and the front of the pelvis, and go to the front of the thigh. Sitting causes them to get shorter, since our bodies adapt to what we are doing. Short hipflexors, especially the psoas, pull on the front of the spine, causing it to bend too much (as explained in a short video). Add pressure from heavy lifting, or just the regular pounding of high-impact workouts, and the discs can start bulging out or even herniating. Continue reading

Treatment Guidelines for Massage Therapists #3: The Confidence Cure

image by Spielbrick Films

Now, this is the strangest of my guidelines so far–and the one that causes me the most internal struggle. I don’t want to be the cocky therapist I spoke of in part 1 of this series. But somebody who wants to get better might lose their confidence if I only talk about “trial and error” and admit freely that I don’t know what’s going on. So I’m navigating a gray area.

I say “I don’t know” but follow with a plausible theory, and explain that I will use it as the basis of my tryout treatment. But I also speak of similar cases that were easily resolved by my treatments.

Studies show that pain responds to expectations. Whether you say “You’ll have to live with this, if there is a herniation, you’ll always be in pain” or “That’s just a problem of a few tense spots, they’re harmless, but cause nasty pain that will pass in a couple of weeks” chances are you’re right.

I’ve gotten this very important piece of information from Paul Ingraham’s tutorial on low back pain. It’s a must read for massage therapists, so go buy it now!

The problem with pain is that it’s a construct of the brain, not something that happens in the tissue. We like to think that what’s going on with muscles and fascia and nerves is in direct relationship to the pain, but that’s not true.

Since it would be WAY out of our scope of practice to treat the brain, we can treat the tissue, get more mobility, more range of motion, less tension into the sore spots–but we should also keep in mind that our clients need to feel confident.

I find it easiest to be truthful and reassuring by using examples and statistics. First we need to educate ourselves, then we can empower our clients. Paul Ingraham’s website has been helping me a lot, and I keep sharing his information with my clients.

So is “the confidence cure” nothing but placebo? Ingraham has an answer here, too (and it’s “no”). Pain gets worse with stress, and the probability of the pain passing is higher when we expect it to pass. So giving correct, well-researched information is no placebo, it’s a cure in itself.

What’s your favorite source of recent information? Do you have a blog that you often recommend to clients? A news outlet? How important is research in your practice? Please comment!