Boost Your Mobility and Performance with Massage Therapy

Many think of massage therapy as a tool for relaxation and stress management, and that’s absolutely the case. Today, though, I’d like to discuss the benefits of massage as part of an overall personal training package. The combination of fitness, conditioning, stretching and rest with professional manual therapy has enormous benefits for mobility and performance.

What is mobility?

Mobility is the ability to move or be moved freely and easily. Mobility is critical to the quality of a person’s life in the sense that it not only allows for continuous movements of joints and tissues through their normal, healthy range but it also determine’s one’s ability to engage in activities of one’s choice. Studies show that a loss of mobility is correlated with depression, particularly in older adults.

How is mobility lost?

Typically, we lose mobility either through a traumatic injury causing impairment to a joint or soft tissue, or by the accumulation of changes that result from not challenging our musculoskeletal system in a normal, healthy ranges. This is the corollary of the “move it or lose it axiom”.

A good example of the latter can be seen in those with latissimus dorsi (“lat”) restrictions. We possess the traces of a primate body which was adapted for hanging and swinging from trees, through quadrupedal bodies that moved with a semi-erect posture, pulling along with the arms. Modern humans for the most part spend most of their times with their arms below shoulder height. We build our homes so we don’t need to reach up, and seldom in normal life to we hang or pull ourselves upwards or forwards (swimmers and gymnasts notwithstanding). As a result, there is a lack of challenge to the shoulder extension musculature and the result is a “caving in” of the upper body, with a loss of range of motion in overhead shoulder flexion and a loss of strength in shoulder extension (think of swinging the arms overhead in a yoga sun salutation or doing pull-ups).

What are the effects of lost mobility?

Loss in ranges of motion affect the resting position of joints. This leads to postural dysfunction which can contribute in varying degrees to musculoskeletal pain syndromes. Restrictions in mobility also encourage individuals to use “trick movements” in order to circumvent restrictions, but these trick movements can create further strains and dysfunction. Take for example, the case of the shortened overhead reach. An individual may bend sideways in order to increase their reach without challenging their shoulder. In the long term, that might lead to problems in the low back.

This brings us to performance. Whether you are an athlete or a mover (martial artist, dancer, yoga practitioner, gym goer, etc.), your body achieves its best performance when it can move without restriction or pain through the most efficient planes of movement in the natural patterns. Pain and restriction contribute significantly to loss of strength and the ability to apply strength to the movement of weight (either the body’s own weight or an external weight). I have witnessed a client increase their ability to perform a pectoral butterfly press by 20 pounds after five minutes of trigger point therapy. Simply, that person’s nervous system would not allow full strength to be applied with the degree of pain and limitation in the muscle.

How does massage therapy help?

At the least, massage therapy is associated with pain reduction, the remediation of tension and an increase in circulation to soft tissue. However, there are a number of very effective specialized techniques massage therapists can apply to increase mobility.

Stretching, particular with the use of Proprioceptive Neuromuscular Faciliation (PNF) is effective in changing the length of muscle tissue. Shortened muscle prevents joints from going through their full range of motion and the ability of a muscle to contract is moderated amount of overlap between the microscopic filaments in the muscle fibers. A skilled therapist can help balance the length of muscle so that joint movement is not inhibited and so that maximum strength, power and endurance are achieved.

Joint mobilization is a technique which dates back to the time of the ancient Greeks and is used to increase the small, internal movements of joints within their capsules. Without these internal movements, the larger external joint movements are hindered with a subsequent loss of mobility. Chiropractors work intensively with what are called high-grade (large movement), high-velocity (quick movement) mobilizations, but massage therapists are trained to work with smaller, more gradual movements that are nonetheless very effective in increasing functional range of motion.

Myofascial release is a somewhat generic term that refers to the treatment of contractile tissue (muscle) within the matrix of the stretchy, fibrous connective tissue which binds the parts of the body together. Fascia in particular is the term for the connective tissue which surrounds and permeates the muscle, bone and membranes of our musculoskelatal system, including that which wraps the layers of the skin to our frames. Various traumas and injuries as well as metabolic processes can bind parts of the fascial matrix so that instead of stretching and moving with freedom, the fascia and all the tissue to which is is bound become more resistant to movement. A clear example of this type of binding (sometimes referred to as “adhesion”) is frozen shoulder (adhesive capsulitis), wherin the fascial matrix of the shoulder joint shrinks and tightens around the bone, massively restricting shoulder range of motion. A skilled massage therapist can apply numerous techniques to fascia to encourage the breakdown of improperly adhered fascia while encouraging the body to repair itself in a more functional pattern.

Remedial exercise is an important component of a treatment plan for contemporary massage therapists. Therapists commonly offer exercises to complement the hands-on work and boost the effectiveness of the treatment. Resistance and isometric exercise are used to strengthen weaker muscles, while self-stretching is recommended to lengthen shortened muscles. Self-massage can be taught for clients to maintain their mobility gains while range of motion exercises can be given to make sure impaired joints are progressively moved into a more natural, healthy range.

The scope of practice of massage therapists in Ontario includes the assessment and treatment of soft tissue to  “develop, maintain, rehabilitate or augment physical function.” The potential for augmentation of function, including that of mobility and performance is tremendous and for this reason massage therapy and other manual treatment should be considered an important part of a training program, whether for an athletes or for anyone interested in better, more comfortable and more graceful movement.

New Hope for the Case of Massage Therapy and Post-Workout Muscle Pain

It has long been assumed that massage helps reduce muscle soreness after a hard workout – the kind that literally feels like muscles have been “shredded”. Thee has, however, been a lot of healthy kepticism about the contribution of massage to relieving DOMS (delayed onset muscle soreness).

While DOMS is not well understood, and the lactic acid theory has long been disproven, the leading theory is that muscle soreness is caused by mictotrauma, possibly with some small inflammatory role, and that an exacerbating factor is the loss of peripheral blood flow and impairment of endothelial function that occurs up to 72 hours after an intensive workout, especially if eccentric training is performed.

A newer and very interesting study associates massage with a decrease in the loss of peripheral blood flow after a workout, as well as mediation of the loss of endothelial function that normally occurs. The endothelium is the inner lining of blood vessels, and it plays an important role in the regulation of blood flow as well as systemic inflammation, a component of atherosclerosis and peripheral artery disease.

The study group was broken into three. One had massage without the workout, one had the workout and no massage and the third received both. The workout in question was an eccentric leg press, causing significant muscle tissue stress in the quads.

The two groups that receives massage experienced a reduced loss in peripheral blood flow lasting up to 72 hours, while the group that had no massage and did the exercise actually had decreased peripheral blood flow which recovered only 72 hours post-exercise.

Further, the no-massage group reported the strongest symptoms of pain and soreness. It had been speculated in previous research that increased circulation could be a factor in massages mediated muscle soreness reduction but a strong relationship with post-workout blood flow had yet to be established.

As with all research, there is still room for improvement. The mechanisms involved are not well understood. The results, while significant are still in the order of 10% or less improvement, which may or may not produce noticeable results. This is consistent with the amount of benefit cited in other publications on DOMS and massage.

On the other hand, for athletes that are consistently training at high intensity and living with chronic muscle soreness (and from my experience, there are a lot of these recently), the effect of massage on peripheral blood flow might be really important, and improvement of endothelial function may lessen the accumulation systemic inflammation (a risk factor for arterial disease) and lead to maintenance or improvement of athletic performance. For those athletes, even a modest 3% reduction of DOMS symptoms might be considerable indeed.

Remember, exertional muscle soreness has been shown not to be related to lactic acid, which metabolizes quickly after it is produced. The leading theory relates to micro-trauma of muscle and associated tissues.

 

REFERENCES

Massage therapy restores peripheral vascular function after exertion. Franklin NC, Ali MM, Robinson AT, Norkeviciute E, Phillips SA. Arch Phys Med Rehabil. 2014 Jun

Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis. Torres R, Ribeiro F, Alberto Duarte J, Cabri JM. Phys Ther Sport. 2012 May

Effects of massage on delayed-onset muscle soreness, swelling, and recovery of muscle function. Zainuddin Z, Newton M, Sacco P, Nosaka K. J Athl Train. 2005 Jul-Sep

[Effects of massage on delayed-onset muscle soreness]. Bakowski P, Musielak B, Sip P, Biegański G. Chir Narzadow Ruchu Ortop Pol. 2008 Jul-Aug

The effects of athletic massage on delayed onset muscle soreness, creatine kinase, and neutrophil count: a preliminary report. Smith LL, Keating MN, Holbert D, Spratt DJ, McCammon MR, Smith SS, Israel RG. J Orthop Sports Phys Ther. 1994 Feb

The effects of massage on delayed onset muscle soreness. Hilbert JE, Sforzo GA, Swensen T. Br J Sports Med. 2003 Feb

Genetic research shows why exercise builds resistance to depression

We have long known that vigorous physical exercise builds physical and emotional resilience but not much has been known about why. On an emotional level, overcoming obstacles builds self-esteem and “mental toughness” but genetic changes also occur at the cellular level when our bodies build muscle.

A recent piece of research from the UK has shown how a particular gene which is activated by vigorous exercise helps to degrade a substance called kynurenine, produced in the liver as a metabolite, which is known to cross the blood-brain barrier and is associated with depression, cognitive loss and tics. Kynurenine is also implicated in some degenerative conditions such as Alzheimer’s.

The gene in question, PGC-1α1, doesn’t add bulk to muscle (hypertrophy) but is involved in many of the effects related to endurance training – increased oxygen burning efficiency, changing muscle type to greater endurance capacity (oxidative), and inhibiting atrophy of muscle tissue, including loss of muscle mass with age (sarcopenia).

This research underlines the importance of vigorous endurance and resistance exercise in fighting depression as well as cognitive decline and stress. It also speaks to recent thinking on the importance of exercise in aging and that older adults can and should be doing vigorous exercise within a safe range for their health status and physical condition (often, trainers and physios have had a tendency to underperscribe exercise for older adults).

Of course always check with your health care provider before starting a new training, work smart and enjoy your new genes!

Massage and Blood Pressure

I just read about this study which shows that medication for moderate high blood pressure (140-149/90-99) may be less effective than previously thought and also highlights the importance of lifestyle change to mitigate the risks and severity of hypertension. I have had high normal to moderately high blood pressure at times of my life (exam time definitely knocked me into the latter for a while) which I control by regular exercise and tracking my calories to keep my weight down (even a small decrease in extra fat can make a difference).

I wanted to make sure as many people as possible understood the importance of controlling high blood pressure as well as the good evidence supporting massage therapy in doing it.

What is Blood Pressure?

As a gross oversimplification, let’s consider a garden hose. As you know, in order to water the lawn, you have to crank the knob on the tap until there is enough force to push water into the hose and out the tap – in circulatory terms, that amount of force is the Cardiac Output, and the amount of pressure exerted on the tubing of the hose is Blood Pressure. The longer the hose is, the more force you need to move the water, and the greater the pressure. The narrower the hose is, the more force you need (to get the same output) and the greater the pressure. Our circulatory system is similar, but far more complex because we have over 50,000 miles of hose with many different branches and thicknesses from 5 micrometers to up to an inch in diameter.

Although the pressure in different arteries changes from place to place based on distance from the heart and diameter, our “Blood Pressure” is usually measured in the upper arm in two numbers where the first is the pressure during a heart beat (contraction or systole) and the second is the pressure when the heart is relaxed (diastole). 120/80 is the magic number which is considered ideal blood pressure and in best case scenarios, if you measured you BP several times throughout a day on both arms, keeping in mind that pressure changes a lot over the course of the day with activity, it would average out somewhere around there.

What is High Blood Pressure (hypertension) and why does it happen?

Between 120/80 and 140/90 is a zone considered “high normal” or “prehypertension”. If the average pressure is in this range, it may or may not affect health (depending if there are other conditions involved), but it might show that you are heading for higher pressures. Anything above 140/90 is considered high blood pressure (this applies to either number so 130/95 or 145/80 for example also count). The higher the numbers, the greater association with health risk including heart disease, kidney disease, retinal disease, and stroke among others).

So what causes this? There are many ways hypertension can occur. Let’s take our hose example. If something causes the arteries to narrow and harden (which happens with age and with the formation of arterial plaque), then the water (blood) pressure must increase. A similar effect happens in the case of obesity, where the extra tissue (fat) not only lengthens the hose (since there is simply more tissue that needs blood flow, the body has to increase the amount and length of the small vessels to meet that need), but the hose is narrowed due to the extra weight and compression of mass around it. The hose narrows and then more pressure is required to keep the water moving. Interestingly, muscle tension and swelling can have a parallel effect, the hardened muscle tissue or fluid compressing the tubing.

There’s one more factor to add to the analogy. Suppose that instead of having a nozzle at the end of the hose, we loop it back into the tap. Now the water pump’s job is to keep the water moving around in a loop. The amount of power involved also depends on how much water there is in the hose that needs to be pushed along. In the circulatory system, the quantity of fluid is the Blood Volume (BV).

As you can see by sprinkling salt on a slice of cucumber, sodium has a way of extracting and retaining salt from surrounding tissues and so the more sodium which is circulating in the blood, the more water will be retained and the greater the BV will be, increasing blood pressure. This is why those with high BP are put on a low sodium diet and why a principle means of medicating hypertension is the use of diuretics to make the individuals “pee out” the extra water, similar to poking a hole in our hose loop to let some water leak out, reducing pressure.

Why is hypertension harmful?

There are many ways high blood pressure may harm our bodies. First, it can overwhelm the smallest vessels (as small as 5 micrometers with walls one cell thick), and create chronic damage and inflammation. This harms the parts of us that have the most of these vessels such as the kidneys which are a matrix of tiny tubes that filter our blood. Our kidneys also regulate our blood pressure and when they are damaged, there can be a dangerous blood pressure cascade. Our livers, lungs and retinas also have a lot of small vessels that can be damaged by too much pressure.

Increased blood pressure can also create turbulence in the arteries, which frictions the inner wall. This leads to inflammation and cellular damage which are known to lead to the formation of plaques (fat deposits on the artery wall to protect the damaged cells), which unfortunately also narrow the vessels (increase blood pressure even more), and harden them (more pressure). If the plaques form in areas that obstruct blood flow to the heart or brain, a heart attack (myocardial infarction) or stroke (cerebrovascular accident) can occur.

Another concern is damage to the heart muscle itself. The more pressure that builds up in our hose-loop, the harder the pump has to work and as any mechanic or plumber knows, a pump that has to work beyond its design specs will inevitably wear down and fail. In the case of the heart, the muscle may actually weaken and enlarge over time, becoming a less effective pump. As it becomes less effective, it has to beat faster to make up for lost power. Over time the heart muscle gradually becomes less and less effective and fails – congestive heart failure.

How might massage help?

While massage can’t directly affect some risk factors – age, weight, genetics, diet, there are signs that massage can and does help moderate blood pressure. Why is this? Most of the effects from massage have to do with decreasing muscle tension (discussed above), and working with vasomotor tone – a million dollar word that refers to the muscle tone of artery walls, which is regulated by the nervous system. You will notice that in a state of anxiety (as in “white coat” syndrome, where blood pressure is much higher in a doctor’s office because of anxiety about medical situations), blood pressure increases.

This is because our nervous system responds to stress and fear by shunting blood away from our core and into the muscles in our limbs as a way to prepare to run or fight for our lives. This shunting is provided by changes in the muscle tone in the arteries. Sadly, since most of our modern anxieties can’t be resolved with running and fighting, we tend to retain states of moderate anxiety an as a result, inappropriate shunting occurs, resulting again in higher blood pressure. Massage helps to relax the muscle and decrease nervous system firing so that shunting system is relaxed (aka, you relax).

Massage helps to reduce unnecessary muscle tension, another result of ongoing low grade stress and anxiety. When the muscle are less hard, there is less pressure on the arteries, and a reduction in blood pressure. Another possible action of massage pertains to the movement of fluid. When muscle tissue is contracted, blood flow increases to that area and sometimes that extra fluid is slower in returning, creating a pocket of increased pressure. This can be accentuated by ongoing tension and long periods of inactivity (movement helps our bodies return fluid to the heart). Massage techniques can specifically or generally help move that stagnant fluid.

Is the effect temporary or long-term?

On of the criticisms regarding massage and blood pressure is that the effect of reduced pressure is short-term and while measured as a positive effect right after treatment, there is no long-term reduction in blood pressure. There is a distinct lack of longitudinal evidence regarding long-term effects of blood pressure but in some cases benefits of up to 72 hours have been clearly observed.

Secondary benefits of massage therapy – a gold mine

Most research and clinical evidence around massage and blood pressure centers on relaxation, Swedish massage being the active ingredient. However, this overlooks some very important secondary effects.

Since cardiovascular and resistance exercise in specific, and movement in general are considered important ways to moderate blood pressure, then massage therapy which has as a goal to improve pain-reduced or pain-free movement must be useful in helping those who can’t or won’t start moving and exercising. These kinds of effects can be had by reducing myofascial dysfunction, improving joint range of motion and decreasing pain and fatigue from tense, short or overworked muscle.

Furthermore, there is an association with massage therapy and positive regard for the body, a desirable effect which can encourage individuals to become proactive in their lifestyles, and to make more positive lifestyle choices around diet and exercise, all of which factor into better health outcomes. Even if there is only a minimal change in blood pressure, these lifestyle changes may mitigate some of the negative effects of blood pressure, or may work well in conjunction with medication or other medical interventions.

Something to consider

Although massage may not be immediately effective in changing your blood pressure, if you are prehypertensive or (like 40% of Americans) moderately hypertensive, you may wish to talk to your doctor about the benefits of massage therapy and how it can fit into your health care plan. A qualified massage therapist can offer not just relaxation and improved muscle tone, but may be a valuable ally in your fitness and weight loss goals.

It should noted that much of the research around massage and hypertension is based on shorter session, but very consistent (15 minutes, three times a week). Your mileage may vary but for optimal effects, try massage consistently for at least a month or two to be sure of its effects.

And if massage doesn’t help, maybe dark chocolate will!

Resources and citations

A preliminary examination of the effect of massage on state body image. Dunigan BJ, King TK, Morse BJ.

The effect of massage therapy on blood pressure of women with pre-hypertension. Moeini M, Givi M, Ghasempour Z, Sadeghi M.

Durability of effect of massage therapy on blood pressure. Givi M.

Effects of Swedish massage therapy on blood pressure, heart rate, and inflammatory markers in hypertensive women. Supa’at I, Zakaria Z, Maskon O, Aminuddin A, Nordin NA.

Effects of Swedish massage on blood pressure. Aourell M, Skoog M, Carleson J.

Qualitative study of women’s experience after therapeutic massage. Garakyaraghi M, Givi M, Moeini M, Eshghinezhad A.

Blood pressure responses to lifestyle physical activity among young, hypertension-prone African-American women. Staffileno BA, Minnick A, Coke LA, Hollenberg SM.

Hypertension/High Blood Pressure Health Center on WebMD

Strength Fitness and Body Weight Status on Markers of Cardiometabolic Health. Roberts CK, Lee MM, Katiraie M, Krell SL, Angadi SS, Chronley MK, Oh CS, Ribas V, Harris RA, Hevener AL, Croymans DM.

Positive research on self-massage: Acute effects of self-myofascial release using a foam roller on arterial function. Okamoto T, Masuhara M, Ikuta K.

Effect of changing levels of physical activity on blood-pressure and haemodynamics in essential hypertension L Nelson, MD Esler, GL Jennings, PI Korner

Electromyography Sheds Light on Quad Development

So called patellofemoral pain syndrome is a condition that shows up a lot in the clinic. It results in pain around the kneecap especially in loaded positions such as stair climbing and squatting, or after long periods of exertion. The condition, although still poorly researched, is usually attributed to wear and tear in cahoots with dysfunctional development of the quads, which due to varying fibre direction and obliquity guide the patella laterally and medially through its range of motion. We often talk about the “VMO”, the teardrop shaped medial belly of muscle that pulls medially on the knee. Frequently, the medial muscle is weaker than the lateral and the kneecap is pulled outwards while gliding on the femur, causing compression and erosion of the patella’s cartilage (chondormalacia patella)

The problem is, since the quads act synergistically, its hard to know just how to target the medial ones in training for balance. There are a number of prescribed exercises (wall squats et. al.) However I have never been satisfied that these actually do what they are supposed to.

A recent study released by the journal of strength and conditioning research used electromyography to measure the contrac recent tion of the quad muscles during extension (the lifting part of a squat) under a number of conditions such as different hip rotations and during different phases of the movement.

Several findings are important to VMO training. For one thing, there was negligible difference to muscle contraction based on toe direction for the lateral quads, which contradicts some common advice about hip rotation to train the VMO.

As well, the measurements indicated that the greatest force in both lateral and medial quads occurred between the middle and end of the range of movement – when the legs were closest to straight. In particular, the medial quads were most active near full knee extension towards the end of 8 repetitions.

The researchers also measured shear force during exercise and found that it was greatest near the the end of extension, leading to the recommendation to avoid straightening the legs under load during acute injury recovery.

In practical application, we can conclude that differential development of the VMO is more challenging than believed and that the best results will be found towards the end range of knee extension, making deep squatting less applicable for VMO development. The medial quads seem to fatigue faster than the lateral, so fewer repetitions with a greater load may be more effective.

When I give exercise for VMO, I always emphasize the importance of proprioceptive feedback by first squatting without a load and with the hands pressing the VMO to make sure it is active during movement. It would be interesting to see some research about the role of feedback during leg extension on patellofemoral syndrome rehabilitation.

Here’s a great article breaking down the information in the study from Breaking Muscle. Here’s a good article in Sports Injury Bulletin about patellofemoral pain and VMO.

The Beauty of Aging with Mobility

I just read this article from Gold Medal Bodies, an excellent training site, and was inspired to write a little about how amazing it is to explore movement as a lifelong passion.

At 43 (I realize it isn’t so old), I can say without reservation that despite a pretty heavy knee injury, many tendinoses and bouts of weight gain and loss, I am fitter, stronger and better able to move than I have ever been. I don’t credit this to any particular system of training, or any magical wellness approach but rather to a simple thing: as I have gotten older, I am far more capable of patience, insight and the ability to see long term gains with a moderate, consistent approach.

I’ve learned that extremes seldom result in good long-term outcomes, but rather in injuries, inconsistent practice and crises of self-worth and avoidance. I have learned to have fun with movement, playing with the environment and being methodical. Every day I move every part of my body through their normal limits and then patiently explore a little beyond that. I put on good music and I move with enthusiasm.

I sincerely believe that we should enjoy exercise to make it worth doing. Thankfully, there’s a million ways to move and get the heart pumping. Find something that looks and feels cool for you and believe that you can do it. You don’t have to be a professional, lift your bodyweight or run a marathon. Move every day in a way that makes you feel alive and the listen closely to what your body tells you so that you can learn from experience.

With awareness, patience, joy and insight no matter what kind of movement moves you, you will absolutely feel better and be healthier. The last component is humility, because there are limits to anyone’s abilities. Some days are harder than others and sometimes you do need to just let go your ego and rest. Injuries are to be respected as learning tools, but don’t let them define you too much. They too can be overcome with practice and time.

I look forward to decades more of learning, growing and moving and I hope you enjoy it as much as I have.

Amazing X-Rays of Joint Kinematics

In my last post I spoke about the “internal movements” of joints and how significant they are to mobility. These movements, often referred to as “accessory movements” are collectively referred to as arthrokinematics, which is quite simply means “joint movement”.

It can be quite tricky to visualize the internal movements of joints unless you spend quite a lot of time with a skeleton model or cadavers, but a new project by Cameron Drake and Orthopedic specialist Dr. Noah Weiss has produced some beautiful animations of X-rays allowing us to clearly see these movements.

Notice, for example, how the head of the humerus (the round ball at the top of the arm bone), rolls downwards as the arm moves away from the body in an example of “inferior glide”. Also makes clear how the head of the humerus jams into the acromion (the large projection at the top of the shoulder blade) at the end of the movement.

Shoulder joint
Shoulder joint – notice the rolling of the head of the humerus

On the knee, you can clearly see the movement of the patella (kneecap) as it glides up and down on the tubercles of the femur (leg bone). When this movement is inhibited by muscle imbalance, it creates uneven wear and tear on the articular cartilage, resulting in joint pain, weakness and creaking sensations (often known as patellofemoral pain syndrome).

Knee Joint
Knee joint – see how the patella glides!

On the ankle joint you can really see how the talus (the part of the foot which articulates with the leg bones) rolls forward and backwards as the foot flexes and points.

When muscle and other soft tissue prevent the talus from rolling backwards, it can limit the ability for the foot to dorsiflex (flex the top of the foot towards the knee), which in turn impedes movements like squatting and lunging and creates a feeling of compression in the front of the ankle joint in those positions.

Joint mobilization is a great technique for improving joint kinematics and increase range of motion, mobility and comfort. A trained massage therapist has a great toolbox of joint mobilization, stretching and range of motion techniques to address these issues.

Make sure you go and visit Drake’s blog to see the rest of the fantastic images! Here’s a link to Dr. Weiss’s webpage on the project.

 

 

 

New This Fall: Thai Massage Intensive Certificate

After taking some time to revamp the Thai massage training program, I have established a new course: the Thai Massage Intensive. This program takes the already well-established material from the Thai 1 level course and merges some of the most important information from Thai 2. The end result is a program that gives students a complete foundation for a strong Thai massage practice.

To improve the learning experience, the class will be limited to 6 students, increasing the amount of contact time with each student and the depth of feedback. I am also adding a full third weekend to make for a 30 hour program (15 CEU’s).

The course takes place weekend afternoons between noon and 5 with a 30 minute break.  The first session for fall 2014 beings September 20 and continues Sept 21, 26, 27 as well as Oct. 4 and 5 at Myosense Wellness at Slater and Bank.

This is a unique opportunity to attend an in-depth Thai massage foundation training which has never been offered in Ottawa before. For registration details, use the contact form on this website or email info@ottawathai.com.

Location: Myosense Wellness, 208 Slater at Bank
Date: Sep 20-21, 27-28 and Oct. 4-5
Time: Noon-5pm each day (30 hours total)
Cost: $500,  $175 deposit and balance due by Sept. 6

A recent study shows relief of the symptoms of scleroderma with the application of Thai Massage

A 2013 study in co-operation with Khon Kaen university, Thailand has demonstrate effectiveness of Traditional Thai Massage on patients with systemic scleroderma, one variation of a pathology that can cause severe contracture of the body’s connective tissues, particularly in the hands and forearms. The condition can vary from mild to severe and deforming and is often difficult to treat because it is considered an auto-immune reaction somewhat similar to rheumatoid arthritis.

In the study, patients were given two weeks of daily home treatments (in this case, relatives administered the Thai Massage protocols), In a separate aspect of the study, cotton wrap gloves were also used post-treatment to increase circulation. After two weeks, participants were tested for mobility and hand function and a 50% reduction in disability was recorded. Although the study group was small (28 participants), and the duration short, the results are nonetheless statistically significant (p<0.5).

This study is significant in the sense that it not only shows Thai massage as a promising modality for the treatment of scleroderma, but it also underlines the value of Thai massage in mobilizing connective tissue adhesions (scleroderma largely being a condition of excess fibrosis and inter-meshing of superficial fascia), which could have implications for numerous other conditions including IT band contracture, carpal tunnel syndrome and postural dysfunction.

Citation in the Pubmed database. For the full text of the publication, click here.

 

8 Ways Thai Massage is Unique… and Beautiful

Over the last ten years as a Thai Massage practitioner in Ottawa and Montreal, I’ve gotten a lot interesting reactions when I try to explain what I do. The first question I get is usually “how is it different that traditional massage?”. I try to resist the urge to talk about how Swedish massage is a relatively new massage system, drawn from Chinese Tui Na Massage, a much older tradition. That usually just gets blank stares and makes me seem pretentious. I decided to make a list to share with clients and others. Makes for great elevator talk.

Here are 8 ways which I think show the difference between Thai Massage and Swedish (or other table) Massage. There’s thousands of marvelous practitioners in both fields and they all practice differently so don’t take this as the be all and end all list definition of Thai Massage. Also, I have great respect for both systems so this isn’t a “grudge match” article to prove which is best (in fact, recent research shows that Thai Massage and Swedish Massage may be pretty similar in their effectiveness).

There first four are the more obvious things you’ll notice receiving Thai for the first time. The last four are the subtle ones: things that you might miss even after your hundred-and-eigth Thai Massage.

1. Get close to the ground.

IMG_20140323_104726972_HDREven though it can be modified for the table, Thai Massage is traditionally practiced on a thin mat down on ground. This allows more room for the receiver to sprawl out and for some of the larger movements to be done (think hip stretches and spinal twists) without needing to turn over or shift position. It also let’s the giver get in close so they can use their body weight to mechanical advantage. This is what accounts for the deep pressure that is possible with Thai massage. In some cases, the practitioner can even get up on their feet and walk on the receiver’s back (don’t worry, this is optional and I always check in to make sure clients are okay with deeper pressure). It also provides the leverage that allow smaller practitioners to pull off seemingly impossible moves on much larger people.

2. Keep your clothes on.

2012-06-17 17.06.08Not everyone is comfortable disrobing for a stranger, which is why some prefer Thai Massage’s tradition of working over the clothes. While some Thai practitioners do use oils, and have the receiver wear a sarong or other loose garment, most have their clients dressed in loosed, comfy clothing that allows them to stretch and move easily. Please bring something appropriate: once or twice I have had clients arrive with short skirts or skinny jeans and have had to make an impromptu diaper with a sheet.

Since no oil is being used, most of the techniques apply compression with the palm, fingers, thumbs, elbows or even knees (always being sensitive to comfort). This might seem less relaxing than Swedish style stroking or effleurage, but the effects are actually be similarly sedating and the pumping action is beneficial for circulation.It’s much easier to move through different stretches and positions without having to constantly play with sheets, so the receiver can focus on relaxing.

3. Yoga without the yoga.

DSCF3111Often Thai Massage is called “Lazy Person’s Yoga.” I avoid the term myself because I don’t like to think of my clients as lazy. After all, they made the time to come to the appointment and they worked to pay for it. It does bring up a good point, thoug. The greater part of a Thai Massage consists of the receiver being moved through different positions and stretches, many of which are very similar to yoga postures. That’s why I often think of Thai Massage as applied yoga therapy. Some even refer to it as “Thai Yoga Massage.”

The receiver is urged to relax and not use any muscle at all, Yet they get the benefit of performing the poses, such as increased flexibility and relaxation. Many find that when they don’t need to apply strength to stand or keep balanced, they can ease into the stretches with less discomfort. If the practitioner is skilled, the receiver will get the sequence of movements that best suits their needs at that moment, on that day without feeling unnecessary pain or awkwardness.

4. It only LOOKS like contortionism.

This is one of the ones I usually DON'T show!!
This is one of the ones I usually DON’T show!!

I’m always careful of what images I show people because there’s a tendency for some to get scared away by what look like somethings between a chiropractic adjustment and “Cirque du Soleil”. It is true that the stretching of Thai Massage can be deep, and usually involves several joints at a time. However, receiver most often doesn’t feel nearly as contorted as they might expect and a skilled practitioner knows how to prepare a body for progressively deeper and deeper stretching as well as how to listen to the body’s limits and respect them.

5. It’s all in the rhythm

While most forms of manual therapy involve rhythmical movement, Thai Massage makes it into an art form. Rarely does a good Thai Massage ever stop flowing and pulsing to a subtle tempo, with a rate and speed that is most appropriate to the receiver.

Thai Massage is often referred to as a therapeutic dance, but it’s also very similar to rocking a baby, since the receiver is completely relaxed and passive. This rhythmic movement calms the nervous system and invites the receiver to enter an almost trance-like state, where they might feel they are floating between sleep and waking. In this state, the receiver is best prepared to change negative patterns in their body and mind, and they are most receptive to the subtler “energy work” of Thai Massage.

6. Metta and Smṛti.

BuddhaChrist_huggingThai Massage has been preserved within the tradition of Theravada Buddhism in Thailand for centuries. Some, myself included, believe that it came to Thailand with missionary monks travelling from India and other parts of Asia. Doctor Jivaka, known as the patron saint of Thai Massage, was reputed to be the physician of Gautama Buddha himself some 2500 years ago.

As a result, Buddhist philosophy is present in the heart of Thai Massage. Practitioners are expected to work from a place of mindfulness (in Pali, “smṛti”) (full awareness of the present moment) and “Metta”, which is a Buddhist term meaning “unconditional loving-kindness”. One is expected to treat each client with the same caring, non-judging demeanor with which one would embrace a distressed child. For many, just to receive this type of caring attention is quite healing on its own.

7. Introducing “Sip Sen”

sen line_wryAs is the case in many Asian healing systems, Thai Massage proposes that vitality comes from subtle life force that courses through our bodies. Any disturbance in the movement of that energy translates into congestion in our bodies, and eventually poor health.

What many don’t realize, though, is that the Thai “energy lines” are based on a different system than the Chinese meridian system, or that of the Ayurvedic “nadis” (though there are some very close links with the nadis). In Thai Massage, the lines are called the “Sip Sen”, simply translated as “Ten Lines”. Some correspond with meridians from other systems, while others are quite different. The “Sen” tend to follow anatomical pathways and have a remarkable congruence with myofascial meridians as discussed by Tom Myers and other leading anatomists and physical therapists. Working on the Sen is a bit like clearing a rain gutter of dead leaves, clearing the way for water to flow and protecting the roof. If you ask your Thai Massage practitioner: “How are my sen today?” they may be impressed.

8. The whole is worth more than the sum of its parts.

leonardoMost often, Thai Massage practitioners will treat the whole body in each every session. This can be confusing for someone coming in with a particular complaint. On the other hand, if you consider the principle that disease and discomfort are caused by blockages in the “Sip Sen” (see number 7), then it’s easier to understood the whole body as a unified entity with all the parts working together in sometimes surprising ways. It would be considered undesirable to make adjustments in one area without making sure that those adjustments don’t unbalance other parts of the body.

It’s like tuning a guitar. Tightening one string may cause other strings to change tension and go out of tune. Each time a guitar is tuned, all the strings must be carefully tuned to create harmony. The practitioner will spend extra time on those areas that are most affected, but may take the time to work on other areas too. Often people are surprised how much pain and tension is present in areas they hadn’t even thought of. For many, especially those who have been through medical procedures that compartmentalize their bodies, it can be empowering to be treated as a whole person rather than a collection of (seemingly) broken parts.

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