That’s Rolfed Up

Realigning your internal framework a la Rolf!

During the mid-point of my massage education, one of my professors described a technique known as Structural Integration. Falling under the alternative medicine umbrella, structural integration aims to put the body back into proper alignment by manipulating connective tissue (i.e. fascia) to release areas of restriction based on how the client has been moving and holding their body in space. This manipulation is done to affect the deepest level of the musculo-skeletal system (we are talking right down to the nerves) which might feel quite intense in the moment, but over time can reduce pain caused by improper movement patterns. In tandem with the work, the client is re-educated in how to move properly in order to maintain the results of the treatment.

One of the most popular modalities of structural integration is Rolfing. I was familiarized with this when a close friend, who suffered traumatic injuries from an accident, received this bodywork along with her physical therapy. She went from being unable to walk all the way to full on modern dancing within a year. I recall her saying it hurt – A LOT. Intrigued, I did some research to see what it entailed. Created by biochemist Dr. Ida P. Rolf, who recognized that the body’s systems were all interconnected through a seamless network of connective tissues, it was originally meant for the chronically disabled to help improve their mobility. However, she soon learned that her method of postural release also applied to people with chronic pain, stress and/or who put intense physical demand on their bodies. Hmm…sounds like somebody familiar, e?

Like any effective form of bodywork, Rolfing is a holistic approach, taking into consideration the individual and what their needs might be to adjust the treatment accordingly. Adjustment is key also in the depth of manipulation of their connective tissues as well as the mobilization of their joints. Some of us, although mentally psyched for it, find that our bodies will fight back. As a therapist, you have to know how to knock on the door in order to be invited into a particular area of the body. The client needs to feel safe, comfortable and trusting of your touch, especially when the work will be painful. The end goal is free and fluid movement. Usually this will be done in 10 sessions; however some people feel very dramatic changes to their posture and movement right after their first session. (See the diagram I posted in the header for an idea of what happens)

Now that the benefits and technique have been laid out for you, there is the task of finding and working with the right Rolfer. A therapist cannot claim they Rolf unless they have been Certified by The Rolf Institute of Structural Integration, the only organization worldwide that educates and certifies Rolfers. You can search for and check a therapist’s credentials via the Institute’s website Verification link. Certification aside, a therapist’s approach can and will vary. It is important to find a practitioner that communicates effectively and listens to your feedback in a constructive manner. Another friend of mine received the technique and found that her therapist would not ask her questions or address her comments regarding the work. She left the experience feeling she was treated like a body, not a whole person. That is never a good thing in any form of bodywork and usually does not produce results. If you are open to being Rolfed, take the time to research your practitioner and/or get referrals from those who have been privy to this treatment. Dramatic change is priceless.

For more information on the latest in Rolf techniques and research:

http://www.rolfresearchfoundation.org

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Massage for a Broken Heart

This too shall pass…

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.

Brain and pain rhyme for a reason, kids.

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.

Trigger Points – the baggage our muscles hide!

Is this your back?

If the above image gives you the impression that a group of assassins  are ready to fire on you, stay with that feeling.  No one is immune. They hide in your muscles and sinews waiting for something or someone to activate them. Some gather in groups while others migrate to new territory, but more often than not they refer their pain elsewhere to trick you. They are trigger points.

A trigger point is defined as a hyper irritable spot within a taut band of skeletal muscle that elicits pain locally when compressed, but can also refer it elsewhere or be accompanied by muscle spasm. When touched, these spots can feel like hard nodules ( i.e. the “knots” we so often refer to in our backs and other body parts). It was Dr. Janet Travel, physician to the late president John F. Kennedy, that first came up with the term when she noticed that these points of pain tended to happen in predictable patterns that could be mapped out on the body. Her maps can be found in the 2 Volume book she wrote with David G. Simons, “Myofascial Pain and Dysfunction: The Trigger Point Manual.”

How do you know if you have one or more of these bad boys lurking in your tissues? There are a few characteristic symptoms which include sensitivity to pressure in a muscle, stiffness accompanied sometimes with a pulling sensation emanating from a particular point in the muscle, pain that refers from the point compressed to another area of the body and pain that has a dull, aching or burning quality to it.  Other symptoms sometimes experienced are various autonomic phenomena like dizziness, sweating and fever as well as headaches, numbness, loss of range of motion and dysfunction of the muscle involved. While the cause of trigger points remains a much disputed medical topic, it is safe to say that they most commonly occur when muscles are chronically overloaded, as in the case with occupational and exercise overuse, injury and poor posture. Also, chilling of a muscle (i.e. catching a draft or having an air-conditioner blow on you) and the position in which you sleep can also create these points. Sometimes these points are even triggered by emotional and stress related events.

Any qualified massage therapist (ME!) possesses the skills needed to deactivate these points and treat the surrounding tissues. In my opinion, your first course of action should be massage therapy. Thereafter, if the points do not resolve within a few treatment sessions, you should be referred to a chiropractor, osteopath or physical therapist, all of whom employ more aggressive treatment measures. The protocol used to address trigger points via massage is a combination of sustained compression of the point followed by cross fiber friction and deep strokes in the direction of the muscle fibers to clear out metabolic wastes and encourage the flow of blood into the affected area. I am a huge fan of a myofascial technique known as skin rolling. It literally involves me picking up your skin and rolling it along different angles between my fingers, almost like cookie dough. This is an important diagnostic tool for me to find these stuck points, especially if a client is unsure of the location of their discomfort. The sustained compression of these points temporarily stops the pain signal coming from the brain and the flow of blood to the area, so that when it is released, blood literally floods the point and washes wastes away. The first compression is always the worst because the pain level will be greatest then. It is super important to breathe through the 8-10 second count, as the point is held. On a scale of 1 to 10, the pain/discomfort should be around an 8. With each subsequent sustained compression (about 4 in total) the pain level will dissipate while the force of compression stays about the same. During these compressions, many clients will break into a sweat or become hyperemic (flushed) in the area of the trigger point. Sometimes there are twitches in the muscle or surrounding tissues near the point being worked on. Even stranger, the point can move while I am compressing and I literally have to chase it through its migratory path until I shut it down. Once the compressions are finished, the point is rubbed vigorously in a cross fiber pattern between 1 to 5 minutes and then all the fibers of the muscle get treated to a nice and slow, deep rub down. I like to then apply a bit of heat in the form of a heated dry towel (no more than 10-15 mins on) or a topical irritant like Tiger Balm.

Best case scenario, trigger points will get resolved in one intense session, but more often than not, multiple sessions are needed to deactivate years of evil. It’s extremely important to assess what is going on or has happened in your life, both physically and emotionally that, although your brain might have dismissed, your muscles and tissues beg you to notice. This awareness will help you focus your attention back onto yourself and deal with the baggage at hand because trust me, your muscles have better, more productive things to do than carry the weight of the world in their nooks and crannies.

Additional reference available at:

http://en.wikipedia.org/wiki/Trigger_point

NOTE **Read personal trainer, running coach and kayak instructor, Jeanne Andrus’s post about her experience with Trigger Points. I think it to be a helpful read:

Trigger Points