Bringing Balance One Adjustment At A Time

Outside of spa work and my private clientele, I also provide massage at a Wellness Center in midtown. This little den of health offers chiropractic care, massage therapy, holistic health & nutritional counseling and postural exercise. The approach is corrective and the result is a stronger, pain free and more erect version of your former self.  In order to understand fully what the corrective approach entails, one must first comprehend what chiropractic care is. Many people hear the term Chiropractor and immediately shudder. Images of having one’s head placed at odd angles for the “cracking” of bones turns the fear-o-meter up high. Worse yet, is the notion of chiropractor as being a fake doctor, sadly due to the gads of crooks that run insurance scams and give the profession its bad rep. I recall being eleven years old and walking past this man in the street with a little skeleton propped on a table advertising a Chiropractor’s office. Five years later, when my mother had a car accident and was advised to get chiropractic adjustment for her case, into that same office we went. During each visit the doctor did the same thing to her back and neck , which left my mother feeling much better than she went in. However, within a few days, the pain and stiffness would return. When she had brought this up to the chiropractor, he told her that she would need chiropractic adjustment for the rest of her life if she wanted to remain pain free. This sounded unfathomable to my mother and once her case was settled out of court, she stopped going.

What that chiropractor told my mother would only be true IF the approach was not corrective. His care consisted of giving people quick fixes for their pain, so they would keep coming back. This is no different than popping a pill. It is not dealing with the root issue(s). The body is comprised of superficial and deep layers of muscle all covered by connective tissue. When a joint is misaligned, say in the vertebrae of your back for example, then the muscles surrounding that joint try to stabilize it and protect its position, even if it causes them to function improperly. They are like the dutiful bodyguards of a volatile criminal – the more they support his activities, the more they plunge themselves toward certain destruction. I know I am making a rather “dramatic” analogy here; however, this is serious stuff. No one should be okay with being in chronic pain and having limitations in their mobility and life activities. When the joint is adjusted which is basically giving it a little help to go back into its proper position, not “cracking” as we all like to refer to it, the muscles can let go. Depending on the individual’s condition, the muscles might have a hard time settling into their new normal, which is why massage pre and post adjustment really helps to flood them with the nutrients and support they need to move in their proper way. Take a look at the videos below where both doctors explain the corrective approach and especially the client testimonials, some of which were in dire physical straits when they first came in.

and client testimonial

I’m really lucky to be able to work with this group of medical professionals and it has taught me so much about a comprehensive approach. We all work as a team, consulting one another to find the best way to bring a client/patient’s body back into balance. If you are within the NYC limits and dealing with chronic pain resulting from an injury, lifestyle or some unknown factor, definitely make it a priority to visit the office, where you will get a complimentary spinal screening, along with adjustment and report of findings to let you know what is going on underneath those layers and what your treatment options could be. Everything in its proper place, starting from the inside out.

BIBC team candid Jan 2014
Our little wellness family 🙂

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The Magic Number

What’s your magic number?

How many massages can you do in a day?

This is a popular question posited to me by many a new and regular client. You can never be fully honest for obvious reasons. You don’t want to seem tired and overworked, even if you are, because now the client is thinking they will get a shitty massage or feel guilty that they are number (insert double digit) of the day. If I am in the spa setting, I usually make a joke and say that I am “strong like bull” in a mock Eastern European accent and tell them not to worry. If I am in a clinical setting, I distract them back to the matter at hand – their condition, thus dismissing the question altogether. If they bring it up again, I then tell them these clinical massages are shorter and more focused, so don’t worry about me. Let’s focus on you!

The only thing a client should be focused on…

Truthfully, there is a magic number of massages a therapist can perform consecutively before burn out happens. Of course, this number is different for all of us. I weight train and exercise at least three times a week; therefore I am “strong like bull.” Despite this strength and stamina, I know that if I do 5.5 hours of consecutive massage, I am at my body’s limit for the day. I learned this from the rare times I had done 7 or even 8 hours of consecutive massages. The next day, I could barely make my hands into fists coupled with the ache in my forearms and shoulders. Now, for those of you who may say, “You work a 6 hour shift? That’s so part time.” Let me take a moment here and define what consecutive means in this context. These massages are occurring literally back to back. Once the one client is off the table, there are between 5 to 7 minutes to get the room changed over, grab a sip of water, then run to get the next guest without looking like you ran to get them. This is usually what happens in a spa setting, as the booking is done to maximize profitability; not to consider the physical demands made on the therapist. So, you see how 5.5 hours of continuous physical work plus the added cardio of running up and down stairs for guest pick up, drop off and supplies is enough of a full work day for me. You cannot compare it to a 9-5 p.m. desk job, which exhausts many in a different manner (i.e. from holding their bodies in poor sedentary posture and mentally focusing on a screen with few breaks).

Burnout of a different kind…

I recall working an event where another therapist boasted at the amount of clients they could take on in a day. Observing their body mechanics, I assessed that within a few years this therapist would surely burn out. Chronic Tendonitis is a common occurrence in any profession that requires repetitive movements over long periods of time. Taking breaks to stretch, hydrate and regroup mentally and physically allow this career to last beyond the statistical death knell of 3-5 years. I’m not ashamed or scared to say NO when asked to go above and beyond my limit at this 3 year mark of my professional career. After all, I want to be able to straddle both physical worlds – the demands of my fitness regimen with those of my profession. I feel blessed that I know what my magic number feels like, as it makes me a better practitioner for my current and future clients. As for the rest of my fellow LMT’s, may yours pop up sooner than later.

Models and Problems

This is my brain performing “massage”….any questions?  🙂

There is nothing better than a person who is health and wellness minded coming to me for massage. You don’t really have to convince them of the benefits or teach them about its affects on their body because they are already informed and on board. Instead, as you work with them, they learn more about their body’s movement patterns and underlying stored tensions, making release and corrective care all the more possible. After a series of sessions they will be right at home in their new state of being and come to you for follow ups whenever they feel the need for them. Sigh…if only all client situations were like this.

One client that I have been working with now for a few weeks fits the model client moniker to a tee. He comes in with stories and updates on the results of his last session and what his activities/work/lifestyle have procured for me this time around. I share him with another therapist. We both approach his motley crew of issues with different perspectives and techniques, but always end up with some kind of change/result. This weekly challenge is such a learning process for myself. Having to get creative in order to circumvent limitations and other obstacles takes me away from my usual approach to a particular muscle issue and brings back the spark of why I got into this profession in the first place. It also makes me hungry for more education, which (lucky me) New York State is going to require in just a few short months to renew my license. I do my little happy dance post session, when I can see the effects of the work; a little less rounding of the shoulders, an arm fully flexing up to one’s ear, a little pain free spring in one’s step. It’s a great feeling.

In contrast to the model client, is the problem client. They come in many forms, sometimes seeking out massage on their own or having it forced on them by a health care professional or a loved one. They almost never feel comfortable with anything you may try out to address their issue(s), that is if they can pinpoint what it/they are in the first place. They don’t communicate their feelings easily or over communicate as in “choreograph” the entire massage session. On the one hand, I welcome clients being specific about where their trouble spots are and what they prefer me to do; however, one has to be a little reasonable. After all, there is a flow involved with a good massage and jumping back and forth between body parts, over flipping from supine to prone or over working a particular region or muscle kind of kills that vibe.

A funny thing happened a few weeks ago with one such problem client. After a handful of sessions where said client answered all my intake questions with shrugs and my inquiries on our work with a down-tempo “it’s ok” I had become a little more than frustrated. I was starting to gas out completely and couldn’t count down the minutes until our session ended. No longer client centered and feeling drained, I stopped focusing and sort of mindlessly moved about the tissues and musculature I was addressing. My zombie massage was, to me, the worst massage I could ever give a person. However, in this state, my problem client finally let go. In my daze, I heard a comment on how sore the front of their thighs were. At first, I thought the voice came from the inner recesses of my head…or the television blaring in the client’s family room. When it dawned on me that the client was actually communicating with me, I snapped out of my zombie mind and asked where they felt the soreness might have stemmed from (activities, diet, etc.) In three minutes, I received more feedback than in all the weeks I had been working with this individual. My crappy massage was this person’s saving grace. I know now to start off in a general way with said individual and allow them to lead me where they need. This problem turned out to be a model – a learning experience to challenge my approach to different personality types. Sometimes the egg can be cracked without too much force or effort. Take that, brain!!

What Are You Running For?

After the runner’s high fades…ouch!

It’s marathon season in the Northeast. Thousands of people participated in the ING NYC Marathon on November 3rd . For those who may not know, the race traverses all corners of New York City’s 5 boroughs covering a distance of 26.2 miles (never forget the .2). Three years ago, I volunteered to provide post marathon massage to members of the FDNY; all of whom took part as a charity effort, competing against the NYPD‘s team. I think the firefighters made the better time that year – gotta love them!

Outside of marathon training, many New Yorkers whose favored form of exercise is running describe themselves as runners and only runners. I found this fascinating, for as much as I train in Thai kickboxing, I never call myself a kick-boxer. Other people I know who incorporate Olympic lifting into their workouts also will never call themselves Olympic Lifters. So why do people who run become so defensive about their running. When told, Oh, so you like to run? their immediate reaction is No, no…I’m a runner. I run (insert mileage/distance covered) every day, such and such times per week followed by accolades like and I’m about to do my third marathon.

After the initial defense, to which you nod and note their determination and dedication, they begin to list their assorted musculoskeletal injuries. This is where my mind really gets blown. Is it normal for a thirty four year old non-athlete to have had multiple knee and a hip replacement surgery? Answer is no; however their injuries  are worn like metals of honor. What I have also come to realize is the more they are able to run through the pain, despite their cartilage and tendons fraying to strands, the prouder they are. The only way you would know that something was off would be by observing their running gait (professional eye helps in that department) and the appearance of their knees and hips post run.

A little self massage of the Plantar Fascia…

Since many of my clients in the last two weeks have been runners, I decided to share with you all some of the more popular injuries experienced amongst this group. Blisters, weakened toe nails and callouses aside, feet suffer from the manner in which the individual runner pounds the pavement. Plantar fasciatis is an inflammatory condition that affects the connective tissue sheath that covers the sole of the foot. This inflammation leads to heel pain that radiates to the center of the foot. We test for it by pressing a thumb into the base of the great toe and extending the entire foot.  Most clients that I have had with this condition feel it more acutely in the belly of their arch into the medial/inner side of their foot. In normal walking gait, our heel strikes the ground first followed by a rolling out of the balls of our feet from left to right to push off for the next step. Running gait sends the strike further up into the middle part of the foot. In the case of plantar fasciatis, the runner is usually putting too much roll/strike into the inner arch of the foot, which leads to the inflammation they experience and related pain pattern.

Sharply related to the bottom of the foot is another condition known as Achilles Tendinopathy. The achilles tendon is a thick band of connective tissue that anchors the calf muscle’s two heads into the heel of the foot. Constant wear and tear from activity leads to degeneration and a weakening of the tendon, which makes it vulnerable to rupture. The areas that are weakened often feel tender to the touch and the tendon itself appears thicker looking. Much like with the plantar fasciatis, it is believed that an over rolling/striking into the inner arch of the foot can cause the achilles to become over strained, thus leading to the tendinopathy. The only way to heal both of these conditions is to reduce activity to allow for the collagen fibers to rebuild/repair themselves. Also, the wearing of insoles and a correction of one’s striking gait can help. However, many runners do not allow themselves this rest and repair time. At some point, it will become impossible to take even walking steps, let alone to run.

Achilles Tendinopathy in the left foot is clearly delineated by the black marker – thicker, misshapen and you bet, painful!

Moving further up the leg we have a condition that affects both the knee and hip known as Ilio-Tibial Band Friction Syndrome. Stats say that over 10% of runners will experience this condition at some point in their running life. Much like the other two overuse conditions mentioned, this one occurs from excessive training/activity. The locus of pain is on the outside of the knee over a bony prominence where the IT Band passes over each time the knee flexes and extends. It can radiate down into the shins or up into the hip, where the IT Band originates. It is super painful during activity and for some, even at rest, depending on how aggravated that huge strip of fascia is.  Stretching the glutes, especially the sides which encompass your little kickboxing muscle behind the pelvis known as the TFL, definitely helps as well as correcting, like the other two conditions, running gait and posture. But again, these conditions stem from pushing one’s limbs to their limits. In tandem with Ilio-Tibial Band Friction Syndrome, there is also “Runner’s Knee” or Chondromalacia Patellae. This condition is an inflammation of the underside of the patella or knee cap which leads to Patellofemoral Pain Syndrome.  This area is covered by smooth cartilage that normally allows the femur to glide easily when the knee is bent. However in runners, the constant friction causes the cartilage to get irritated which leads to thinning and softening, hence the moniker chondro (cartilage) and malacia (softening). Also, if one’s gait is out of alignment, the patella will not track properly and will also irritate the cartilage. A tight IT Band also relates to this condition as do the Lateral and medial quad muscles. Knees will crackle audibly with pain often felt in the front of the knee and on the condyles of the femur slightly above the knee.

If you wear all your cartilage away, surgery is the only route you will be covering.

Outside of physiotherapy, anti-inflammatory medications and icing one’s painful parts, taking the time to properly heal tissues, which should include massage to break up adhesions (i.e. knots or stuck points in tissues), clear toxins, build up the blood supply and elongate taut fibers will extend one’s running “career.” Let’s face it. If you are going to call yourself a runner and wear your battle wounds proudly, you should also invest in the care necessary to make your mileage count!!

Giagia was a Chinese Doctor…

Among all the old world wisdom my giagia (Greek for grandmother) imparted on me, I have this one distinct memory of her admonishing me for something rooted in traditional Chinese Medicine. We were in Greece, specifically in the village of my mother’s childhood home, in the mid-1990’s. I was about 15 years old and had just returned from a full day at the beach. I sat on this cement block that was in the yard to wait for a late lunch to be prepared. Suddenly, giagia stormed at me, with dish towel flailing, screaming to get off the cement. I hadn’t a clue why, but obeyed immediately. Of course, when I went to sit on a rug near the front door, more screaming and flailing ensued. I gave up and just stood. During lunch, when she was calmer, she explained that sitting on stone, whether it be cement, marble or a rock in the front yard, could make a woman lose her period and her fertility. She explained that the chill of the stone would penetrate my bum up into my girly parts and then, the rest of the body.  She proceeded to detail a story in which she and another friend had gotten “colds” in their privates and ended up losing their periods for more than a year,  all because they leaned and sat on stone. Say whaaaaaaaaaaaaaat????? I took it in politely, but it sounded like an old wives tale woven to prevent me from looking unladylike or something etiquette oriented.

I don’t think this dog has anything to worry about!
(Original URL: http://jdombstravels.com/dogs-santorini/)

Fast forward fifteen years later to the Eastern portion of my studies in Massage. Suddenly, giagia’s tale didn’t sound as far fetched. I learned that things like “wind” and “cold” can penetrate the body at key points. One of the popular ones is GV14, a point at the C7 level of your cervical vertebrae or in layman’s, the bony bump at the base of your neck where it meets your upper back. Think about when an insidious draft hits the back of your neck and all of a sudden, you can’t move or turn your head. I can’t tell you how many clients come in with a so-called “crick” thinking that they slept funny. After a few minutes of creating some “heat” in the area, the crick always dissipates. Through conversation, I learn that they slept with either a window open or a fan facing them or if it’s in summer, the AC is to blame. The GV14 point is the meeting area of all the YANG meridians in the body. YANG being defensive energy, it makes sense that this is where pathogens, fevers and excess heat are expelled. This is also the vulnerable point for exterior conditions, like say a chill to invite itself in and wreak havoc. And just so we are clear, when the Chinese speak of “wind” they mean any pernicious influence getting into the body and doing its sneaky damage. Can you hear that authoritative voice yelling at you to wear a scarf before you go outside? That strip of cloth covers GV14 ever so perfectly. Backing up those matriarchal commands is many an acupuncture text noting that the GV14 point should be kept warm and supple at all times.

I was super curious to see if she was spot on about the way cold penetrates one’s privates . The body itself is separated into three burners, each with their own ideal climate and temperature to ensure proper function. The lower burner is where you would find the reproductive and alimentary systems of the body. It is considered a swampy environment i.e. damp and warm, but this kind of environment has a tendency to fester and combine with pathogenic factors like, oh…say COLD or heat, which are generated by both internal and EXTERNAL factors. In the case of cold, the factors are almost always from external exposure; therefore, the possibility of prolonged sitting on stone conducting cold into the “drainage ditch” that is the lower burner is a very likely one. Let’s proceed. With respect to the genitalia and reproductive function, COLD mixed with dampness really taxes the Kidney YANG. The Kidneys have a special role in fertility, as I had noted in my previous posts on baby making. It houses the JING or life force of the parent. It is one part of the pre-natal Qi necessary to conceive a baby. If the mother’s JING is weak and/or her Kidneys taxed, it will be all that much more difficult to conceive and things like miscarriage or spontaneous abortion are very likely to occur. Excessive dampness in general manifests symptoms in women like vaginal discharge and painful, copious periods. Mixed with the pathogenic factor of heat and there is burning, itching and excess. Mixed with the pathogenic factor of COLD and things stagnate, congeal in the environment and make everything heavy and static. Blood stasis equals a loss of one’s period, known as amenorrhea or extremely painful periods; i.e. dysmenorrhea.

Thinking back to my giagia’s cautionary tale, you would think that she had access to some Traditional Chinese Medical text. What supposedly had happened to her and her friend after sitting and leaning on stones reads like an invasion of damp-COLD in their lower burners. Ironically enough, the manner in which she got her period to come back was by drinking Cinnamon and clove tea. A popular herbal treatment for clearing COLD is the use of cinnamon bark, which has a warming affect internally. Well, then. The fifteen year old skeptic in me has been silenced. My giagia must have been a Chinese Doctor in some former life. God rest her incredibly wise little 4′ foot 9″ soul.

Additional Sources:

http://www.yinyanghouse.com/acupuncturepoints

http://www.acupuncture.com/newsletters/m_aug07/m_dec03/main2.htm

Anger Management

Even the most balanced person in the world, when triggered, can completely lose it. Anger is a strong, uncomfortable emotional response to something or someone that has provoked you. It is how we psychologically interpret an offense, wrongdoing or denial that is often met with a desire to retaliate. It is our immediate response to stop a threatening behavior or situation that many psychologists believe has a primal function to ensure survival. However, in excess, anger can have many physical and mental consequences. Think of a pressure cooker. You can only let the steam inside build up for so long before the whole thing explodes.

One Flew Over the Cuckoo’s Nest…a pressure cooker meltdown in action.

For the last few weeks I have been functioning in a fog of anger resulting from an unfortunate series of events outside of my control. All attempts to go with the flow are challenged on a daily basis as I try to weather this Category 5 Super Cell ravaging my life. With my blood already boiling in its channels, add the 90 plus degree weather and humidity here in NYC, and I feel like I am being cooked from the inside out/outside in. Therefore, it is no surprise that my digestion, skin and sleep have all gone awry. In Chinese medicine, emotions and physical illness are closely tied. Anger causes excess heat in the body, so my feeling of being cooked is spot on. The emotion itself is tied into the Wood element, whose governing organs are the Liver and Gall Bladder per Chinese 5 Element Theory. Physiological functions aside, these organs function to drive us forward in life, set goals and get things done. Despite my best efforts though, I have been feeling like all my attempts at forward movement and reasoning are met by impenetrable brick walls that hit back. The buildup of anger causes an imbalance of excess manifesting in digestive dysfunction, headaches (especially behind the eyes, as is the case with a migraine), muscle tension and tendonitis especially in the pathways of the organs (lateral leg, flanks of the torso, shoulders and neck). These are just some defining symptoms for these organs, but as we all know, when one thing is out of whack, other areas of the body will be affected.

All the elements in Chinese 5 Element Theory have a generational and controlling/controller relationship. This means that each element and its organs have the capacity to nurture and be nurtured by other elements. They also have the ability to pull energy back from other elements and vice-versa as a sort of system of checks and balances to keep everything harmonious. In the case of Wood, the Liver and Gallbladder are nurturers of Fire (there’s the HEAT again) which is comprised of the Heart, Pericardium (the bodyguard of your Heart), Triple Energizer (your Immune system and temperature regulator) and Small Intestine (the almighty discerning organ of what should stay and what should be eliminated both in your body and in your life). So you see, if there is an imbalance in Wood, some of that excess is going to visit the child. The best way to address this would be to make the nurturer of Wood stronger, in order to suck some of the energy out. That would be the Water element, comprised of Bladder and Kidney. These meridians run from the head down the spine into the back of the legs and then up the interior legs starting from the middle of the sole of your foot all the way up to your clavicle. It’s a good amount of somatic topography to cover and has a major role in all our life functions. What do you need most if faced with adversity? A good strong back bone and inner resilience. What do you need if there is a FIRE a-brewing internally? A whole lot of WATER.

The excess of anger in Wood has the potential of over controlling the Earth element, which includes the Stomach and Spleen. Appetite and digestion would be affected, as I am seeing in myself. What is typical is a feeling of fullness which translates to a lack of appetite and a total aversion to hot food. In my case, despite the excess heat in my system, all my body craves is spice. This, I learned recently, is a huge no-no because it will only serve to feed the overheated beast. When in doubt, food should be lightly cooked and no extreme of temperatures should be entering one’s mouth. There are many “cooling” foods that aren’t necessarily cold. If anything, they are more water rich, which quells the fire and also detoxifies. Some examples are lemon, orange, watermelon, celery, Daikon (Chinese radish), kelp, tomato, chrysanthemum tea and seaweed. The Metal element consisting of Lung and Large Intestine are the controllers of Wood and are greatly affected by the buildup of heat, which rises. My normally clear complexion has seen some eruptions and with the skin being the 3rd Lung of the body, it is clear how the heat is trying to escape. Hello, inflammation! Large Intestine, the great eliminator of waste in the body, can’t do such a great job under these circumstances. Bouts of constipation and poop with undigested bits demonstrate this. Hence, why it is important to adjust your diet. And apparently, some of the biggest builders of heat in the body aside from spice are caffeine, certain vitamin B supplements, sugar, alcohol and adrenaline (stress hormone produced in times of high alert, kind of like now).

So what do I do with all this HEAT? Aside from the adjustments to my diet, I sought out some bodywork to bring my nervous system down. Two hours of point work and muscle release specific to the organs involved in my excess heat and I finally felt a still point in the madness. A day later, I was boiling again over yet another uncontrollable situation. In my mind I tried to go back to the still feeling I had when my practitioner’s hands came off of my head, but it was hard. There were moments during our work together, where he had me breathe with a deep long “oooooo” sound which tied into the release of my Large Intestine. I channeled that sound, thought of a song that I could sing under my breath as I walked the streets of NY and much later, at work between clients that would settle me down. And, it kind of worked. Sort of ironic that therapeutic touch and music, my two loves in life, were exactly what smoothed my feathers out.

ADDITIONAL SOURCES

“Between Heaven and Earth – A Guide to Chinese Medicine” by Harriet Beinfield, L.Ac. & Efrem Korngold, L.Ac. O.M.D (c) 1991 Ballantine/Wellspring

“Dragon Rises, Red Bird Flies” by Leon Hammer, M.D. revised version (c) 2010 Eastland Press

http://www.pingminghealth.com/article/581/warming-and-cooling-characteristics-of-common-foods/

Cellulite is NOT an itis…

On the left, cellulitis; On the right, cellulite – big difference!

I can’t tell you how many times, when discussing “trouble spots” with a client they refer to their cellulitis. What they mean to say is their cellulite, but the term they choose has nothing to do with the aesthetic appearance of their wobbly bits (see image above). It is understandable that for some women, the look of cellulite can feel like a serious medical condition. With summer unexpectedly here, they become acutely aware of their “imperfections” and panic; rushing to the spa for any firming, toning and detoxifying treatments available in the hopes that they can bare their flesh without fierce judgements. Cellulite doesn’t happen overnight, though. We are all born with a certain amount of fat cells that are distributed throughout our bodies according to our genetics. As we enter puberty, hormonal fluctuations affect our metabolism and shifts the distribution of the fat underneath our skin. The same thing occurs as we age and enter into menopause. In 80 to 90% of women, some level of cellulite will be visible; however the following factors greatly influence its widespread formation. Take notes:

  • Poor circulation and lymphatic drainage

The tissues in your body need to be fed and then flushed of the by products and toxins left behind after the fact. However, if you have a genetic or pathological insufficiency, the “toilet water” sits and festers, causing the breakdown of the matrix that holds the fat cells in their proper place. Since it all has to get flushed up and out, the areas most affected are the extremities. Exactly where you don’t want to see the cellulite.

  • Increased levels of stress hormones in the blood

We all know a high stress lifestyle can take a toll on our health, but it also has an affect on our fat distribution and connective tissue. Cortisol and catecholamines are stress hormones release by the adrenal glands as part of our “fight-or-flight” sympathetic nervous response. The body instinctively slows its metabolism and increases its “padding” of fat as it reacts to survive. The presence of the hormones over long periods of time can start to break down connective tissue, which as mentioned above, creates the matrix that holds the fat cells at bay. Once the matrix is damaged, the fat cells push up against the lower layers of skin, which is the puckered look that we all recognize as cellulite. The slowed metabolism also causes weight gain, which swells the size of the fat cells, making them pucker up even more.

  • Yo-yo dieting

Weight fluctuations occur as a result of physiological and hormonal changes. Step on the scale in the morning and again at night, and you could see your number rise or fall by 5-8 lbs. This is normal. Patterns of weight loss and gain over long periods of time of more than 20 lbs, damages the elasticity of the skin and connective tissue matrix. Out pops the cellulite.

  • Liposuction

Remember how we are all born with a certain number of fat cells? This procedure removes them from specific areas of the body also referred to as “re-contouring.” Once the fat cells are gone, they are gone. However, should the individual gain weight, the fat cells that are left redistribute the bulk in places the individual never had before. This is why the best candidates for liposuction are those who lead an active lifestyle and have a consistently clean diet.

And speaking of active lifestyles and clean diets, let’s segue into how one can address cellulite. Certain treatments and topical applications can produce visible results if the person remains consistent with modifications to their diet and exercise. Here are some of the one’s I can vouch for in my professional and personal practice. Still taking notes, I hope :-).

Dry brushing per day keeps the cellulite at bay…

Dry Brushing – One of my favorites is dry brushing. The practice consists of lightly brushing the surface of the skin in long upward strokes, starting at the lower limbs and moving upwards toward the heart. The brush bristles should be made of natural fibers and the brush itself easy to grip in order to properly handle it. Not only will you exfoliate the top layer of skin, but the increased blood flow to the capillary networks renews and tightens the skin’s surface. The movement towards the heart promotes proper circulation and flushing of the tissues via the lymphatic system. Done daily, it’s a great way to diminish the dimples.

Flushing and tightening

Caffeine, topically applied – As a little girl in Greece, every female relative young and old swore by their CLARINS cellulite cream and slathered in liberally in all corners and crevices of their bodies. What many creams geared toward cellulite contain is caffeine and what they do is act as a diuretic for the tissues, flushing out excess fluid and helping to tighten the surface of the skin. The cellulite puckers less; happy times on the beach. What I have seen work best is an application of caffeinated cream prior to a workout. The combination of an exercise induced sweat and that of the caffeine is like a one-two punch, firming and flushing. Also, since tissue repair happens during sleep, an application at night can be effective as well.

Courtesy of “8 Kilos to 50” Tumblr (You go girl!)

Get your sweat on and build muscle Recall how earlier we talked about people having a predisposed amount of fat cells that are distributed under the deepest level of skin in different ways dependent on genetics, hormones and age. These factors are sort of written in stone; however what you can control is how much a fat cell can swell. Therefore, the amount of lean muscle you build will reduce the size of the fat cells and help spike your metabolism, as muscle requires more calories than fat for maintenance. Reducing your overall body fat % will counter the factors you cannot control. A wonderful little exercise known as the Bulgarian Split Squat can do a whole lot to diminish the look of the dimples that many women have directly under their gluteal fold. At least, that’s what I have found within my own workouts. A tiny addendum to this bit on exercise is to make sure you are hydrating properly to flush your system out while also maintaining a balanced diet that is specific to your activity level and overall bodily needs. Consulting a registered dietician or certified nutritionist for advice is a great way to make sure you are eating right for you, cellulite or not.

It is also important to keep in mind that within that 80-90% of women who have cellulite are the fashion models, actresses and popular girls we gush(ed) over and/or envy. It’s a fact of physiological life that we can address to a certain extent, but inevitably must come to accept. Be good to your body through all its transformations and transitions and hopefully, it will be good to you.