A massage therapist recently asked the question, "Who was your mentor and what did you learn from them?" Immediately, a particular individual came to mind and I began to think of how I would answer that question. Then I thought of the first massage therapist I considered to be a mentor. And then the second one. Shortly after, I thought of two individuals who came into my life a couple of years ago. They challenged me in ways that changed and improved my thinking. I thought back to my science-minded father who did little experiments with me and bought an encyclopedia for me when I was five years old. The list kept growing longer. It seemed to have no end.
The SomaSimple forums are one of the best resources available for any manual therapist working with clients with chronic pain. However, massage therapists who find their way to the SomaSimple site are often overwhelmed at first by the enormity of the material, intimidated by the level of discussion, and confused about where to start. Having been through that and survived, I'd like to help make it easier for those curious massage therapists who come behind me. Why? Because I think that what SomaSimple has to offer is of enormous value and can't be found anywhere else. It is one of the best resources I've found for learning about current pain science and how to apply it in your practice.
SomaSimple is a website of forums and archived material for science-minded manual therapists. The majority of members are physical therapists (called physiotherapists outside of the U.S.). Other professions are also represented: osteopaths, chiropractors, massage therapists, yoga instructors, personal trainers, coaches. What they have in common is an interest in pain science and science relevant to manual therapists.
Massage is older than humans. Monkeys will often groom another monkey when it becomes agitated. Nit-picking among primates is not just a matter of hygiene, it's a manner of soothing and bonding. All mammals engage in some sort of stroking of one another. Tigers lick their cubs, rats lick their pups. We are biologically wired to respond to touch, to stroking. Massage has been with us since we humans became human, since before we had language. It comes naturally to us.
We take its benefit for granted. We know, from direct experience, that it feels good.
If I could make only one recommendation to individuals living with chronic pain, it would be to read the book Explain Pain by David Butler and Lorimer Moseley.
Directed at both clinicians who work with chronic pain patients and patients who live with chronic pain, Explain Pain shows how the discoveries of modern pain science can be put to practical use. Written in understandable language with a touch of lighthearted humor, Butler and Moseley take a complex subject and make it possible for the average person to understand and use. One client remarked that she thought it would be hard to read and was delighted that she did not find it difficult at all.
Graded exposure can be a useful technique for persons living with chronic pain. Graded exposure is a method of finding movement that is pain-free and building on that. The idea is to break the brain's association between a particular movement and pain.
Until now, I have not published guest articles nor have I published articles unrelated to massage therapy. However, I recently read a paper on gay men, addiction, and post traumatic stress disorder that presented an idea so important that I strongly felt it should be more widely read. As massage therapists, we encounter clients who may seek massage to relieve anxiety and depression and this information could be directly relevant to us.
The author is my long time friend Jeffrey Schneider, volunteer and outreach coordinator for the San Francisco Zen Center. Jeffrey wrote the paper as part of his training to be a drug and alcohol abuse counselor. The paper puts forth the idea that post traumatic stress disorder, caused by growing up in a world where young gay men live in constant fear, may be an unrecognized factor in drug and alcohol addiction in gay men.
When Ida Rolf began putting her hands and elbows on people’s skin and applying pressure, creating a slow, sustained stretch, she imagined that she was stretching fascial sheets. Generations of manual therapists have followed her thinking, accepting this explanation to account for the changes felt in tissue tension beneath their hands and the sensations experienced by those who receive this type of therapy.
In July of 2011, Will Stewart of 3-D Optimal Performance interviewed Dr. Timothy Noakes, a South African exercise physiologist and author of Lore of Running. Noakes recently published Waterlogged: The Serious Problem of Overhydration in Endurance Sports , a book which addresses the little known hazards of drinking too much water, especially for women in endurance sports. The primary subject of this interview is the Central Governor model proposed by Noakes to explain the role of the brain in our experience of fatigue during physical exertion.
Low back pain is one of the most common and persistent pain problems, affecting millions of people. Besides working hands-on with clients, I try to help them understand how pain works and to find ways they can continue to help themselves at home.
Cory Blickenstaff is a physical therapist in Vancouver, WA. My clients have found his videos on "edgework" and "novel movements" to be helpful and enjoyable.
"Edgework" is finding the point in a movement where it begins to transition from easy and comfortable to slightly guarded or painful. Movements should be done slowly, watching carefully for the first sign of holding the breath, muscular tension, or pain. The movement presented in the video is one possible movement. Other movements can be used as "edgework" using the same approach.
"Novel movements" are movements that are a little different from the way we normally move. As Cory says, they are movements about which the brain has not yet formed an opinion. By practicing novel movements, we can try to find movements that are not painful and break the association between movement and pain.