Sunday, July 26, 2009

Ergonomics

Ergonomics, as I define it, is the science of making improvements to your work space and daily tasks, to more efficiently fit your body and routine. Its goal is to prevent pain and injury. The warning signs your body is communicating to you that can occur in the hands, wrists, arms, shoulders, neck, head, hips, back, legs, or feet include:

  • numbness
  • burning or tingling
  • soreness, aching, or tenderness
  • pain - throbbing or dull
  • swelling
  • tightness or stiffness
  • weakness or cold

Most of us these days, in the US, have computers and therein lie a lot of these issues. The computer is such a great resource, but what a time stealer. We become so involved we lose complete track of time. One should get up every half hour, while at the computer, to do something else; for example, stretch, do another task, or simply stand. Vary your position and tasks often; set a timer to make sure you do. I work from home, so when not with clients, I'm on the computer reading, typing, or networking. I'll start a load of wash, which takes about half an hour, and when the buzzer goes off, I get up and put it in the dryer. Unload the dish washer, make the bed, clean something (ugh), go for a walk, do your exercises, study; break up your tasks throughout the day so you are not in a static position. Those of you at an office, move your phone away from the desk, if sitting all day is an issue, then get up to answer it. Stand up to print documents, file, or even to read your computer screen for a while if you can get the monitor up higher (stack up books underneath). For more information (by HP) on setting up your computer work area ergonomically, click here. For an excellent free download, of stretch breaks you can do at your desk, with periodic pop up reminders, click here.

This week was a busy client week and I had to finish the remodeling work started in the client bathroom as well. So, I did extra repetitive motion tasks realizing it would probably compromise my wrists. The median nerve pain told me it was time to stop. I chose to finish up knowing it would hurt for a day but that I would not abuse it further for the rest of the week, and worked as efficiently as possible in the mean time to get the work done. This included using my other hand, as often as possible, to paint the walls and seal the floors. I then was extra careful of my body mechanics while with clients that day. In between, I dry skin brushed my forearms from wrist to elbow, front and back, until the circulation was greatly increased. Afterwards I did muscle releases, massaged my forearm, and rested my hands for the evening. The way to avoid carpal tunnel pain is prevention and that means prioritizing tasks. Usually when I have a busy client day, I will not use my hands for other tasks that include pulling weeds, carrying buckets, typing, writing, food prep, playing the piano, cross stitching, knitting, or in this case, painting. Those of us who use our hands to make a living know this is not always possible, so are sensible and cautious in situations like I had this week. My wrists feel much better today, the bathroom is done, and I'm receiving a massage tomorrow; ahhhhh...

Tuesday, July 21, 2009

Communication with Your Massage Therapist

I had a couple new clients this week. Most of my clients are regulars (monthly or bi-weekly) so a new client keeps me on my toes as I want them to return too. We have to get to know each other, so good communication is essential. After the intake and evaluation she asked me to spend time on specific areas of tension. I asked what kind of pressure she preferred and to let me know if more was needed at times, or (conversely) when to back off.

Of course, the body communicates as well, with areas of sensitivity, misalignment, and tight muscles that aren't quite ready to let go. Gradual pressure to the clients level of comfort is my working process. This client had regular massage treatments in the past and knew to speak up and give feedback. Never lay quietly on the table, uncomfortable with techniques you aren't enjoying. Let the massage therapist (MT) know and they can change it up as MTs are trained in a lot of different modalities. A first session with a new MT might have this dialog: "I prefer medium pressure" to start, and then, "you can go deeper here" or "that's a little too much."

Don't think only deep techniques are required to work out those knots either; it's an individual preference. There are many light touch therapies that are just as beneficial as deep tissue in releasing the muscles. A skilled and experienced professional will mix it up to get the desired effect depending on your response.

It's normal to feel a little sore in the heavily worked areas for a day or two. Any soreness after that usually means it was too much too soon, so let the therapist know next time you see them and they'll adjust. Communicating effectively with your MT can make all the difference to whether you receive a good massage or not.

Sunday, July 19, 2009

The Future of Massage Therapy

Here's an exciting, well balanced, recent document, I came across yesterday, that suggests the direction MT research should take next; by a group of our industry proponents: Click here to read. It discusses evidence based MT effects, as well as, limitations in our research that need further attention. For example, we can say, based on our current research evidence, a well established effect of MT is its reduction in anxiety. Effects reported in other studies, such as pain reduction, are not yet as well understood and need more scientific analysis. Our profession is young, from a research point of view, and is subject to the same scrutiny every other established profession has endured. It's important to me, as a MT, we define and control our industry to the extent that some outside profession does not. To that end, we need to develop more rigorous study that can hold its own when compared to other health care professions. In any case, this article addresses all these points and more, in an easy to read, well organized and thought out manner, with the most up to date information I've seen summarizing the future in MT.

Friday, July 17, 2009

Innovations in Networking & Research Literacy

Blogging, discussion boards, Linked In, Face book, Twitter; unbelievable how we network these days. Check out this wonderfully creative YouTube Video that has put it all to music and dance in an updated version of West Side Story called Web Site Story: http://www.collegehumor.com/video:1913584

I'm also reading a book my advisor suggested, when I was whining recently about massage therapy not being accepted by the medical community, called The Diffusion of Innovation by Everett M. Rogers; great book! When Pete first suggested it I thought, how can this apply to a practice that's been around for thousands of years? Lot's of reasons, it turns out, and there's a whole discipline of study around this subject that is subdivided into at least ten different major research traditions, including public health (which is my college at the university). The reasons behind MT's slow diffusion into current mainstream health practise include social and cultural explanations. That leads back to an oft debated discussion in our industry to evidence based practise. I'm only going to go there briefly as MT's debate this quite thoroughly through our associations discussion board: http://www.massageprofessionals.com/group/EBMT. It's just time for more and better research, plain and simple.

I don't want to change the fact that we get to spend an hour or more with our clients, we touch them in healthy ways, we listen to them, and encourage healthy behaviors. I do want to be able to answer their questions, to the best of my knowledge, and explore the mechanisms behind what we see works, with illness and injury, on the table each session. I also want to be able to look it up, when I have questions, to see what other MT's have tried and found successful; their outcomes. I want to be able to trust that their research has been reviewed by my knowledgeable peers and critiqued for bias, confounders, and limitations. I want to be able to review those studies with my well trained critical eye, and make up my own mind as I filter all the information that's out there. I want the research to include MT's because we know muscles best! Yes, our work is intuitive, and that's best mixed with experience and education.

Thursday, July 16, 2009

Great Resources

Yesterday morning I connected with Laura Key of Lotus Massage and Wellness Center. She has a beautiful place off of Grant and Country Club for any one needing MT's more central; check them out: http://www.lotustucson.com/. I've had a few other MT's express interest in support of research here at the U of A, so check here for updates to my progression with initiating this endeavor. I'm also spending a great deal of time reviewing the research that has been done actively since the '80's, some as early as the '30's. Here are the sources I use in finding MT research articles, or studies, in scientific journals that have been peer reviewed:
  1. http://www.pubmed.com/
  2. http://www.massagetherapyfoundation.org/index.html
  3. http://www6.miami.edu/touch-research/research.htm
  4. crisp.cit.nih.gov/crisp/crisp_query.generate_screen
  5. http://mtabc.wordpress.com/2009/04/17/the-cochrane

If you find something that interests you and can't get access to the free text, copy and paste the title of the article in your web browser, do a search and it will usually lead you to a free copy. If anyone needs help, let me know.

Wednesday, July 15, 2009

Local MT Resources

So, I spent a good deal of yesterday following up on leads regarding a MT research collaboration between the MT schools and the U of A for my internship requirement. Mostly dead ends so far, from several well meaning interested parties. I did, however, enjoy tea with a new friend, Jan Schwartz, who's also in the MT industry and shares my belief in the need for evidence based practise. Jan's slaving away on her masters thesis this summer and hopes to be done by the end of this year. In the meantime her online business has taken off; you can check it out at: http://www.educationtrainingsolutions.com/. She also shared with me her contacts in the field and I joined a new local group, at her invitation, called Holistic Tucson Online. Thanks Jan.

Did I mention I received a massage on Monday? Thank you Donna, it was wonderful. If you are in need of a massage in the Marana Twin Peaks area, or have insurance that covers massage, Donna is an approved provider: donnabishop.massagetherapy.com. I receive at least two massages a month from different MT's, and they are so well worth it. Not only do I get to receive the benefits of relaxation, muscle work, and self-care, it's like taking a class. You get to experience another MT's techniques and are reminded of how a client feels and what they experience on the table. The benefit of self-care in receiving a massage refers to the notion you are doing something healthy towards illness and injury prevention. It also gives you a feeling of control knowing you have a tool you can rely on for maintaining optimum health. Exercise, good nutrition, and massage keeps me out of the doctors office and at my best.

Tuesday, July 14, 2009

Grinding My Wheels

It's so nice in the desert early morning. Went for my 6:30 walk and saw several assorted sizes of lizards scurrying around; they are so interesting and we don't see them when it's cooler. The quail are scooting around as well, tooting like they do. All the critters are pretty active in the cool of the morning. Now to bring my temp down. Ever try freezing grapes for a quick cool down? Also, frozen bananas cut in half with peanut butter in the middle, on a stick? I have to be creative, in my household, to get my fellows to eat enough fruit.

I've been gathering info as I call it, in preparation for my internship prep class in the fall at the U of A; preparing to prepare. I'd like to do my internship on research in massage therapy (MT). So far, I have one professor who's showing some interest and a few contacts locally in the MT industry. I have lots of ideas and hope the MT schools are interested in collaborating; much begging to do. I've spent the past several weeks reviewing the completed studies in MT research. There have been over 9000 studies since the '60's. I'd say the U of A is behind the times here. A few CAM studies going on, but no MT specific research. These three women have contributed a great deal to MT studies over the years nationwide: Tiffany Field, Janet Kahn, and Patricia Sharpe. All three are PhD's and LMT's; I'm impressed.

Monday, July 13, 2009

The Who, Why, & What For

Welcome,

I am a licensed and nationally certified massage therapist with about 20 years experience. I specialize in stress and pain management, as well as, ergonomic intervention as a way to prevent illness and injury. For the past three years I have also been working part-time on a masters in public health at the University of Arizona here in Tucson. Why, many people ask? To gain further skills in promoting massage therapy to the public and changing our health model from one of disease focus to a model of wellness; it's all about prevention folks. I'm also very interested in massage therapy research because I like to get to the root of things and understand the outcomes and mechanisms of therapeutic massage.

I thought I'd share with you what I'm learning and my thoughts about health. A natural approach, that avoids medication and surgery, should be your first call to action when your body gets out of balance. Therapeutic massage increases your awareness while working out tight muscles and reduces your stress through relaxation; a valuable tool in your arsenal of defense. Pain should be your guide in making physical choices, not your enemy. Listening to pain helps you avoid injury by pacing yourself and knowing your limitations. We can still be active and listen to our bodies; that's awareness.