Recently, one of my clients shouted in French, “Pas si fort” after her neighbor repeatedly slammed his front door during our massage session. The sound was magnified by the thinness of her walls and affected her ability to fully relax. Translated to English it means “Not so strong.” The reality of living in a building with multiple apartments is the constant noise. While the sound levels vary, most people consider it a form of white noise. I am not one of those people. I don’t want to hear the next door neighbor screaming Farsi curses and the people upstairs throwing up in their bathroom at 1 a.m. every night like clockwork. It’s an odd thing to know the intimate details of people’s patterns and routines without ever having a conversation with them. I feel voyeuristic; almost stalker-like. But these observations are hardly forgettable. I can’t help but listen.
I am one of a percentage of the population who has a heightened sensitivity to sound, also known as hyperacusis. It is characterized by a collapsed tolerance to environmental sounds of a certain volume that can happen gradually over time or suddenly when in crisis. Mine began about 2 years ago after being terrorized by constant partying and threats in my own home from the son of my then landlord. I barely slept and my nervous system was on high alert at all times. Consequently, the sound of sirens, loud music, screaming and beeping became almost intolerable when previously I had never been bothered by such things. Gone are the days of restful sleep through anything. I hear EVERYTHING now.
Beyond a crisis, hyperacusis can be caused by hearing loss, where the tiny hairs in the inner ear have been damaged and become sensitive to certain frequencies played at louder levels. This is known as recruitment. Also, hypersensitivity to certain frequencies at louder levels can occur in conditions like Autism, which exist from birth. Phonophobia and misophonia can occur with hyperacusis. The former is a fear of the sound that one is intolerant to in the environment it is occurring in both real time and when anticipating its next occurrence. The latter has been associated with an adverse response to soft sounds like that of eating, chewing and lip movements. Interestingly, misophonia has been listed with specific diagnostic criteria in the diagnostic “bible” of psychological clinicians known as the DSM-5, but it’s not considered a discrete psychological disorder. Its origins are thought to be more neurological and need to be studied further. And speaking of the brain…
From an evolutionary standpoint, being able to pick up on sounds that others ignore lets me respond to potential danger much sooner and thus, will ensure my survival. DNA testing exists now that has isolated the gene that makes one more likely to have heightened sensitivity to sound. So it’s both environmental and biological – go epigenetics!! Nevertheless, those of us with sound sensitivity have to find a way to deal with the loud world that surrounds us. Aside from moving out of my apartment building and city limits, there are some therapeutic options. The main one is a combination of cognitive therapy and desensitization through retraining. Its goal is to get you to think about the sound with less of an emotional response and expose your ear to intolerable sounds in order to neutralize them. This weakens the neuronal activity associated with the fight-or-flight response these noises often produce. Other forms of treatment are cognitive behavioral therapy (CBT) alone, psycho-therapeutic hypnotherapy and occupational therapy. CBT allows the person to gain control of that automatic emotional response produced by the sound and desensitizes them to it. Hypnotherapy, through a reputable practitioner who is often a psychologist as well or recommended by one, uses the power of suggestion to overcome the emotions (usually the fear/rage response) to the sound. Lastly, occupational therapists deal with the sensitivity as a sensory processing disorder; therefore, they introduce each offensive sound at varying degrees of intensity along with other sounds in order to help the brain accommodate and then dismiss them. Guess I won’t have to move after all 🙂
Iliopsoas is a term used for the combo platter of muscles that is Iliacus and Psoas Major. These muscles call the posterior abdominal wall home, where they attach the lumbar spine and pelvis to the hip. This trajectory makes iliopsoas not only an important postural muscle (you need it for standing and walking) but also a strong flexor of the hip joint. Sprinting and running with high knees (i.e. hips and knees are flexed above a 90 degree angle) really recruits this muscle complex along with the usual suspects of Quads, TFL and Sartorius. Also, a wonderful calisthenic exercise known as the Mountain Climber is good for strengthening this muscle for the same reason that it flexes the hip beyond 90 degrees. We need our iliopsoas to be strong in order to keep that back straight and supported through all our daily activities outside of just exercise. Too much sitting shortens and weakens this muscle complex, causing an exaggerated curve in the lower back known as lordosis, which in turn tightens the muscles of the lumbar spine causing pain and instability. Another cause of weakness is inefficient recruitment, like say, if you were a long distance runner. Iliopsoas just goes along for the ride when your knees and hips stay below 90 degrees because you are running at a slower, more methodical pace. Even though you are maintaining a good level of fitness, overtime iliopsoas will weaken because it is not really being strengthened. Add old age to the equation, which naturally reduces muscle strength and viability, and you have all the factors that directly affect this muscular unit. Well, almost. What else is located in the deep recesses of your belly? Your guts.
Aside from your abs, the iliopsoas (specifically psoas major) keeps that lower abdomen flat, preventing the intestines from pushing forward as it creates a kind of long shelf for them to rest in. In times of elevated stress and emotional issues, your psoas major tightens and is less efficient at keeping your guts at bay. Primordially tied into our “fight or flight” nervous system, the psoas is our true “gut” muscle, stabilizing and destabilizing at the will of our environment. Digestion and other non-essential activities cease when we are on high alert leading to a buildup of toxins, inflammation and other muscular disturbances. And speaking of said disturbances, also located in the lower right corner of your abdomen in the region of iliopsoas is a valve known as the ileocaecal valve (IVC). It is where digested food passes from the small intestine into the large intestine, so that water and vitamin absorption can occur and toxins can be eliminated. This valve is designed to open for the above function and then close to prevent back-up. Any number of factors including stress, diet, parasites and irritation of the nerves that power the valve can cause it to stay in either a closed or open position. This leads to a buildup of toxins where they do not belong. The body responds with fluid retention and a host of symptoms such as joint and muscular aches/pains, circulatory problems, pinched nerves or even whole body arthritis. How does this affect iliopsoas? One of the most common symptoms is low back pain that comes on suddenly and with no explained cause. Picture yourself sitting one minute, then getting a sharp, stabbing pain in your lower back upon getting up. This low back pain is due to the close relationship iliacus has with the valve. Any dysfunction refers to this muscle, which in turn destabilizes the lumbar spine and affects the surrounding musculature in the back and hip. Chiropractors, Massage Therapists who specialize in Applied Kinesiology and Naturopaths can all address this issue effectively through a variety of changes to one’s diet, exercise and with soft tissue manipulation to name a few techniques. Do not underestimate the importance of this muscle complex. Its betrayal by either pathological and/or other causes can have severe repercussions in the whole body. Keep your guts and back in perfect alignment and they will take care of you.
One out of every three clients I encountered this past month was in the midst of a break up. Although February is nationally recognized as a time to celebrate love, thanks in part to the mass market holiday that Valentine’s has become, it seems that more and more people choose to end their relationships during this time. Break ups apply to all kinds of human connections like friendships, romantic partners, marriages or family members and illicit the same range of emotions one would encounter within the grieving process. Rather than swimming in the vortex of loss alone, these clients sought out massage as comfort. How is it that heartbreak “hurts” so much? The physical reaction to emotional loss can be explained through medical science.
When emotional stress is experienced, especially loss, our brains signal the release of stress hormones from the adrenal glands and certain proteins that constrict blood flow causing part of the heart to become temporarily enlarged and incapable of pumping well. The rest of the heart has to compensate by contracting more forcefully. The pain felt in one’s chest resembles that of a heart attack; however without the permanent damage associated with it. The heart is described as being temporarily stunned or rendered “helpless” which is an interesting choice of words given the sufferer’s mental state. This condition is known medically as stress cardiomyopathy (formerly takotsubo cardiomyopathy) but many doctors refer to it as Broken Heart Syndrome.
Pain is the brain’s primal way of responding to trouble. That trouble can be caused by stimuli both inside and outside of the physical body. Sensory receptors known as nociceptors register these stimuli and in milliseconds return the signal of pain. When we are in a state of emotional distress, the brain’s blood supply is altered, sending more blood to the area responsible for regulating physical pain. This excess flow has been found in people with depression making them more peaked to pain. The emotions felt during a break up enact this physiological response, registering an ache or hollow feeling often felt within the organs of our core; not just in the heart. The state of pain also kicks in the sympathetic nervous system to respond, known as our state of “fight or flight.” The hormones and proteins released inhibit appetite which can lead to anorexic behavior, keep us over alert which translates into insomnia or disrupted sleeping patterns, constricts blood vessels causing headaches, stops digestive juices from being released causing tummy troubles and for some, their overabundance can lead to panic attacks and adrenal fatigue.
One of the main things massage can do is kick into gear the parasympathetic (i.e. “rest and digest”) response. This is why it is so effective in stress management. Massage counters a lot of the physiological affects of a broken heart by switching off the sympathetic release of hormones and proteins related to emotional stress. In addition, it counters any muscular and postural imbalances that could develop from protective patterns of movement or the general feeling of wanting to cocoon into oneself. It also prevents the isolation and loneliness that creeps in after the shock, denial, guilt, anger and bargaining stages of the grieving process pass because it allows for touch from another that is warm, therapeutic and outside of any emotional attachment or expectation. It is a safe place to let go of emotions and come back into the body. Some of us put names on slips of paper in the freezer, bury all the things ever given as gifts, move out of the apartment whose walls are saturated with the memory of YOU and THEM, cut or dye hair in all kinds of ways to deal with a break up. But giving yourself the love you once had for another person, which in the case of my clients was in the form of therapeutic massage, will have the most beneficial overall effect for all parties involved. Acceptance is a whole lot easier when you don’t have to HURT as much.