On bird wings

Spring is in full force.  All the trees now wearing their new leaves. As I worked in my garden, I found myself watching a pair of mockingbirds in courtship.  How their wings fluttered a certain way as they moved from tree to tree in some sort of dance.  I had not realized what a vast array of songs they could sing.  It was like listening to an old AM radio station. A throw back to when music was not played by any specific genre. Such an unexpected delight.

My corona anniversary date came and went without much ado or time for reflection.  What I did notice was that this past year has required an insane amount of flexibility.  Some days and months going from 100 mph to a complete stop and then back to 100 mph.  It has felt like whiplash to me.  My inbox became overflowed with appointment requests from folks who now feel safe after they have gotten their vaccines. I can honestly say, “I did not see this coming.”

So, as I revisited each client’s chart, I found it had been almost one year to the date since our last session. What a homecoming March turned out to be. A welcome back of so many to the bodywork table. It has also made me realize how different each of our pandemic fatigue looks like. How we all grieve for different things that we have lost over this past year.  How there are just so many days when it is hard to find any traction to get things done and some days you just have to root yourself down.

Here is a poem I return to in times when I just need to stop for a moment and take notice. It has truly helped me thru things I have not been able to process this year.  It is my hope it will offer something similar for you.

Birdwings
Your grief for what you’ve lost lifts a mirror
up to where you’re bravely working.
Expecting the worst, you look, and instead,
here’s the joyful face you’ve been longing to see.
Your hand opens and closes, and opens and closes.
If it were always a fist or always stretched open
you would be paralyzed.
Your deepest presence
is in every small contraction and expansion,
the two as beautifully balanced and coordinated
as bird wings.
–Rumi

As always, in gratitude to you for taking a moment to check in with me.

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Nuts and Bolts of Fascia and Movement

Passion I’ve been doing bodywork for 23 years now.  It sounds like a long time, but it always feels like there is so much more to learn.   Just as I peel away the layers on soft tissue issues, I feel closer to the awe that is the human body.  To me, it is like getting a fireworks show every time I think about its amazing power and resilience.

Currently, the two things that inspire me most are fascia and movement.  And though both have been around since I started my journey, there is a thrilling amount of new information and study coming from each of these fields.  My mentors are everything to me.  I wouldn’t be where I am today without them.  So in order to further explore my ideas about the resolution of hip pain, I think it is important to look at the sources I have found to be of benefit.

Fascia        Despite the fact that fascia was first described over 100 years ago by, the founder of osteopathic medicine, Andrew Taylor Still, MD, the first international fascial conference was held only five years ago in 2007.  With the advances in research methods and technology, most of what Dr. Still hypothesized about fascia, is now being proven.

What is fascia?    Fascia is a very densely woven covering that interpenetrates our organs, muscles, bones, nerves, and blood vessels. Of great significance, it is actually one continuous structural support that exists from head to toe without interruption.  So truly an ankle sprain that doesn’t completely heal, can lead to headaches in your future if the fascia gets tight enough.  Medicine prefers to look at the body in its parts, not in its connectedness.  This is why as a bodyworker; fascia explains a lot of the clients that have fallen through the cracks in our healthcare system.

It took me until 2010 to have my own break out moment about the power of fascia.  It was during a yoga workshop that I was introduced to the work of Tom Myers, the man behind Anatomy Trains.  Leslie Kaminoff, of the Breathing Project, showed us a video dissection of the ‘deep front line’.  And yes, just like in the movie Jerry Maguire, Tom Myers work had me at “hello.”  It just tied together a lot of those loose ends.

Movement  Let’s move on to the new concepts in movement.   Every time I turn around there is a new functional movement guru.   Currently I am drawn to the work by Gray Cook and Kelly Starrett.  My thought on why functional movement is sticking now vs. previously is because we are using these tools with our professional sport teams and getting results.  They are showing that by doing a functional screening on these well paid athletes that they can predict their probability of injury. It’s funny how managers seem to prefer to pay for athletes that can stay in the game at their top performance vs. on the sideline.

Fascia and Movement relating to hip pain     When I do an assessment on my clients with hip pain, I usually find a combination of both fascial and movement dysfunctions. The key for me is to address them in the proper order.  If you don’t have the movement due to fascial tightness, I work to get rid of the restrictions before retraining their movement.  If I find an unstable joint, I get it supported with tape or bracing and start strengthening at whatever level they can manage without pain.  Even if I find fascial restrictions around this instability, I must be careful as taking any more stability away from an area may hinder my client more.

Hip pain Alignment check     Here I find that the pelvis, sacrum and low back may be impacting the hip.  Now I have to decide if the change is due to a one time trauma that has altered the position, or that a constant postural tension with fascial restrictions has led us to where we are today.  Or the truly challenging and most common is a combination of both.

Hip pain Movement Patterns     The second biggest finding I have with hip pain is muscular imbalances in the hip, abdominal and pelvic floor muscles.   My job is to figure out if the tissue is short and fascially restricted, or overactive and just on all the time and needs to be relieved of its overactive duties, or truly just weak.

“Maybe we are all cabinets of wonders.” ~ Brian Selznick

 That’s it in a nutshell.  I sense more details on hip rehab next time.

 

Hip Pain is Currently Hip!

Hip Pain- Part 1

I’m not sure if I would go so far as to say that hip pain is the new black, but over the past decade its popularity has been on the rise due to innovative arthroscopic surgeries.  These techniques are similar to those used for years to help knee and shoulder problems.  The major exception is that the hip is a much deeper joint, and by nature built for stability.   It has taken a little bit longer to figure out how to do a less invasive procedure which includes an exterior camera and weighted traction.  The huge plus is that many things that weren’t treated by the open procedure surgeries are now able to be corrected.

Why would a bodyworker be so excited about the advancement of hip surgery?  It is quite simple -research must support the things we do in medicine.  Twenty years ago, as a new physical therapist, the only hip problems referred for rehabilitation were bursitis, and post-operative care following hip fracture and hip replacement.  Today we have a much better understanding of what is happening if you have hip pain. This improved system of differentiation, offers more treatment options and the ability to screen those that may be at higher risk for more severe hip problems later in life.

Let’s consider hip anatomy

Here’s what you want in terms of having a good hip.  Nice congruent and well aligned surfaces between the thigh bone (femur) and the pelvis (acetabulum), and normal cartilage spacing between these two bones that make up your hip socket.

What if you don’t have these things?  Here is where the biggest questions live.  Are you more prone to develop hip arthritis?  Will performing arthroscopic surgery to help improve the contour and alignment of your hip joint today, prevent a hip replacement later on in your life?  Since this is all pretty new, the jury is still out on the final answer, but I believe things are looking pretty hopeful for the future of our hips.

So you have hip pain what do you do?

I recommend getting a consult with an orthopedist that specializes in arthroscopic hip procedures.  You will have to do your homework as this training is still relatively new.  For instance, in Austin, at the time of this blog, we have only two physicians with this expertise.  They will rule out if you have a true joint problem, a muscular problem, or a combination of both.  Once you know this, the options are pretty well laid out, and include medication, corticosteroid injection, soft tissue mobilization, rehabilitation and/or surgery.

Rehab Perspective- A good assessment is imperative!

An individual program should be designed to support your hip alignment and correct movement dysfunction.  Common findings are functional pelvis asymmetry, decrease in hip range of motion and muscular flexibility, and neuromuscular imbalances which include both weak and overactive muscles in the hip, abdomen and pelvic floor.  It is important to pick someone skilled in these areas of assessment to assist you in figuring out a corrective program you.

         

Your biggest job is to figure out and stop the irritating factor(s).   A good rule of thumb is any pain brought on during or after an activity or exercise should be discontinued or modified for the time being.  With this effort and putting a knowledgeable team in place, you should have the best opportunity to return to doing all the things you liked to do before your hip started to hurt.

“The obstacle is the path.”- Zen proverb

Hip pain: Part II will examine hip injuries and treatment in more detail.

 

 

Do You Choose to Be Happy?

 

So November has come to a close. I find this month brings both gratitude and the harvest season to mind. And believe it or not, both of these have to do with the art of healing.

According to Dr. John Demartini, your health and well being tomorrow are a result of what you do, think and believe today. He uses the golden rule to remind us that we reap what we sow. In other words, you get out exactly what you put in. Therefore, your thoughts and actions are the seeds you plant and the harvest that you grow will reflect that. So when you respect and care for your body; your body produces energy and health in return.

Dr. Demartini also says, “That being grateful is the essence of healing.” In my bodywork practice, I find this to be one of the hardest things for people to overcome with illness, pain or injury. Somehow our sense of frustration, anger, fear, and/or resentment of our current state of health often overrides our more positive perceptions. It’s hard to hold strongly to the belief that you will heal, no matter what. In my experience, those that believe they will heal do and those that harbor thoughts that something is truly wrong beyond their control seem to linger in this place.

If you feel stuck; I recommend that you check in with yourself to see if you are holding on to any of these emotions or if you blame someone else for what you are going through. It is perfectly normal to have these feelings; the goal here is to balance them out with positive thoughts. I find it helpful to write a gratitude list. When you feel challenged by how you feel about your progress with a current injury or health issue, you can pull from your list to change your outlook. Like the affirmation above, you truly can choose to be happy, as well as healthy.

“One of the most immediate ways to change your health is to change your thoughts and words.” ~ John F. Demartini, author of ‘Count Your Blessings’

Today is All about Balance

So the fall equinox came to town this morning at 4:04am (CDT). That means that autumn is officially here. Those that know me know how excited I get by a decrease in the Texas heat, and this summer has been one beyond any stretch of my imagination. Austin has now had 85 days over 100 degrees, and the last measurable rainfall in my yard was in May. It has created a whole new way for me to look at hot and dry. It has also created a whole bunch of imbalances in nature, as well as in peoples’ bodies.

I like that today represents the balance of light and dark; some yang with your yin, some good with your evil. The closer you live to the equator, the closer you will be to 12 hours of day and 12 hours of night. One of the biggest myths about this day is that it is possible to balance an egg on its end due to the position of the earth’s axis in relation to the sun. Of course I tried it. Did it work at your house?

So my bodywork aficionados, what in the world does this have to do with you? Well this is the perfect time to set an intention toward balance. Balance is defined as a state of equilibrium. I like thinking about it in the concept of equanimity. How can we bring about a state of calmness or steadiness? This can be looked at broadly, as in our life, work or relationships, or more specifically as in our body, breath or movements.

The bodyworker in me is always trying to find a way to bring harmony to the body. And what I know is that it starts and finishes with you, the client. My job is to get your nervous system to quiet down long enough for you to listen. We may not perfectly understand what our body is trying to tell us, but it will definitely give some insight on areas that need attention. Even on a day closer to pure black and white, your body may still speak in shades of gray. When you are calm, all you have to do is listen to the whispers.

“If your mind isn’t clouded by unnecessary things, this is the best season of your life.” ~ Wu-men

Take Your Massage Off the Table

In massage school, every one of my instructors constantly reminded us to remember to receive bodywork after graduation. I would laugh inside at how silly this sounded, like I could forget to get a massage, how is that even possible. And then massage becomes your profession, and like everything you are supposed to do, it too can get put on the back burner.

So when the opportunity presents itself, I grab that slot on the table. It becomes a treasured time and space. Most importantly it is an hour that I give myself. The key of course is to make it last! Here are some thoughts about ways you can take that massage back to everyday life.

1. Now is all there is: I feel an important part of bodywork is bringing yourself back into the present moment. Let go of focusing on how you should feel or how you used to feel, but instead explore this place where you are right now. This moment is the only one we have, remember to use it wisely.

2. Relax and trust: ‘I’ve found that perhaps the deepest source of suffering is the feeling of being flawed, the belief that “something is wrong with me.”’~ Tara Brach. The massage table should be a safe haven for you to let your guard down. Go ahead and notice the areas you hold onto in your body, but don’t beat yourself up for your imperfections. Just notice the sensations and thoughts that arise and breathe. Remember that you already have everything you need to heal.

3. Make space for the positive: The unlearning of old patterns is what creates freedom in our lives as well as our bodies. While you have this wonderful time available, pay attention to your thoughts. See if you can change them to a positive or just let them go as your tissues are being released. These mental changes are a huge contribution to your own healing process. Anytime you find you are really beating yourself up, remember to come back to the positive.

4. Breathe when things get challenging: Have you ever noticed that you hold your breath when you are stressed? When your breath is compromised, you will create tension and pain. Just by not breathing you instill a big challenge on the body’s ability to heal itself. Now is a beautiful time to really focus on your breath! First, notice your exhale. If you remember to breathe out fully, the inhale will take care of itself. Pay attention to how often you hold your breathe in a given day.

5. Smile! And flaunt those face cradle creases! It will remind someone else that it is time to get on the table.

So You Have an Injury, Who Do You Call?

Choose your injury care team wisely

If you have an injury or a pain that isn’t going away, one of your most important decisions is choosing your ‘healthcare’ team. It is actually critical in your healing to pick people you trust and feel comfortable with. So before you choose, think carefully about what that means to you. Is it their treatment approach? Your out of pocket expense? Do you have something in common? Is it a recommendation from a trusted source?

Making that call

People don’t call me because they feel good, so I always do a phone interview. First, I want to make sure that bodywork is appropriate at this stage of your healing. Sometimes I feel you could be better served by a good medical work up first. But ultimately, I want you to be heard. It’s good to have a safe outlet to tell your story and share the natural feelings of frustration, fear, and anxiety that accompany an injury.

Remember that an injury is a very challenging experience!

Sports psychologists tell us that hurting from an injury may not be purely physical; it can leave you mentally depleted. One of my clients’ biggest concerns is when will they be well again. Unfortunately, I know no one out there who has a crystal ball to foretell your particular journey of recovery.

Specializing in harmony for your body

I feel strongly that I am part of my clients’ healthcare team. My main goal is to improve their quality of life. I want to help take the swelling out of their tissues, the pain out of their scars, and put balance back into their bodies, so they can do whatever means the most to them without pain. Finish an ironman, do a handstand, whatever they wish, it’s their life!

What can you expect from a session with me?

Each person and their injuries are unique, so in my practice everyone gets a session designed to meet their specific needs. What could that look like for you? Say you have knee pain, I will first look to pinpoint where the problem is coming from. I often find that knee pain can come from the hip or the foot, so it wouldn’t make sense to focus solely on your knee unless the symptoms were from there. Next I pull from over my 20+ years experience in manual therapy, and offer my best solution.

You are a part of the team, too!

I think being a well informed team member is one of the biggest assets of your own healing. I have seen it help fuel a positive approach to healing vs. an unknowing self-sabotage. Your recovery is really all about your choices. Is that knee really ready to run a marathon when it still hurts to run a 5K? So gather a good team and stay focused on your recovery plan. If you veer off, your team will get you back on track.

“It is better to take many small steps in the right direction than to make a great leap forward only to stumble backward.” – Old Chinese proverb

What You Say Matters

freefoto.com Camellia: symbol of gratitude

 

Just the other day, an old friend gave me a very insightful compliment. It turned out to be more valuable than I could have anticipated, as with one single phone call, my carefree Saturday went from playful and free to concerned and helpless. I found myself drawing from his earlier words, as they helped me to remember that ultimately I am patient and I am strong.

Being miles away from the situation, there was nothing I could personally do to assist except to be present when the phone rang again. As hard as it is for me to feel helpless, I know that if I was a witness to pain or anguish in someone that I love, I would want someone to talk to. So I pulled strength from my friend’s earlier comment, and just sat patiently with the fact that things were out of my hands. What I could control was being there when I was needed. I could push my own fears aside and be completely present for someone else.

So in gratitude for my friend’s kind words, I want to remind us all that our words matter. I think it is important to use them wisely and with care, as they can be more powerful than you know. So if you’re thinking about giving someone a compliment, like Nike says “Just Do It!” I found truth in the saying that a sincere compliment boosts one’s morale. You never know, what you say may change someone elses’ day too!

“I can live for two months on a good compliment.” ~Mark Twain

‘Did You Ever Wonder Why No One Ever Tries Softer?’ ~ Lily Tomlin

Colin Firth/Geoffrey Rush- photo by Weinstein Company

 

I’m always behind the curve when it comes to seeing the latest movie, so yes I did miss The King’s Speech while it was in the theater. Due to the wonderful buzz among everyone I know who saw it, I was quick to watch it on DVD. And it did not disappoint. You may be wondering why this is relevant to my bodywork practice, or then again you may be right there with me. The story line ran such a strong parallel with my own belief system that besides being glued to the amazing cinematography, I felt like I was watching my own professional story unfold.

In case you haven’t seen the film yet, here is a quick glance without giving all the good parts away. This British historical drama is about the Duke of York soon to be King George the VI. To help the Duke overcome his stammer his wife seeks out Lionel Logue, an Australian speech therapist, known for his unique yet effective methodology. Logue believes there are emotional triggers that underlie the onset of most speech impediments. Initially the Duke will not discuss personal matters and only wants to work on the mechanical problem at hand. Logue agrees, and they work together on muscle relaxation and breathe control, but Logue continues to probe into the psychological roots of his stammer. The King eventually tells about the difficulties of his childhood at the time his stammer appeared: his strict father; repression of his left-handedness; painful knee splints; a nanny who mistreated him and “It took my parents three years to notice.”

I absolutely love the structural part of the human body and continue to find relevance in the study of anatomy, and other coursework to help me make sense of this amazing system. But I know that behind every pain and injury there is an emotional story as well. So when clients’ report pain or numbness somewhere, and they can remember the exact moment it came on, I find myself drawn as much to what was happening in their life that day, as the idea that the pain resulted from ‘I was just putting on my shoes.’ Besides the actual mechanical pain process, I like to look at what they may be holding on to….An inability to forgive someone, bitterness about how the pain has changed their life, anger about something someone said or did. The list can go on but I, like Logue, have come to believe that wellness comes from healing both the mechanical and the emotional. We may find that on some days trying softer may get us further ahead than trying harder.

Is Your Story Keeping you from Your Best Health?

Is your ‘story’ keeping you from your best health?

Recently I received a call from a potential client who didn’t even offer me his name. He opened the conversation with who had referred him to me, and that he preferred to get in ASAP because of his pain. Since it seemed very important to him, I proceeded by inquiring about the nature of his pain. His response was that he has persistent pain in his shoulders, which he feels comes from a guarding pattern he can’t seem to change following a cervical spine fusion surgery.

Since his issue seemed really straight forward and I didn’t have space to fit him in that day, I recommended some other bodywork practices that may have immediate availability. But now the real story came out. “Would they know what to do with a fusion?” he asked. I find I am taken a little aback, as rarely do I get a referral for someone still on restrictions without getting a phone call from their practitioner or doctor. To clarify my questions, he stated that his surgery was over a year ago and he has been given the all clear by his surgeon to resume all his normal activities.

Here is the catch, and ultimately what may be creating an underlying holding pattern in the muscles of his shoulders. On his last visit, the doctor explained that on one view of his x-rays the bone looked as if it hadn’t completely filled in, but even with this information he was released from all his previous restrictions. So despite the wonderful hall pass he received, he leaves the doctors office in conflict. As he has heard that he is not whole, in fact still quite broken and fragile, with the fusion not being completely perfect. He also heard the words he is free to get back to his life as before. But now, he just may write his story that he is getting back to his life, but despite giving a year of his life to surgery, rehab and recovery, he still isn’t well.

He needs to believe that it is okay to not have a perfect x-ray at the one-year mark, and that the doctor feels very good with the outcome of his surgery even with these findings. And most importantly, it is okay to move on with your healing by editing this part of your story to mean that imperfect doesn’t mean broken. I hope he realizes this sooner rather than later, and gets back to being himself, and not his injury. I will know this is true if he calls again, and begins by giving me his name.

“Not everything that can be counted counts, And not everything that counts can be counted.” ~ Einstein