Saturday, May 22, 2010

What Is Referred Pain?

Have you been experiencing muscular pain that just doesn't seem to go away? Have you tried getting massage, but it just doesn't seem to help? And have you asked yourself what else you can do to make the pain go away?

It may be that you're experiencing a phenomenon known as "referred pain." Because of the way we humans are built, it is not uncommon for this kind of thing to happen.

Referred pain happens when you have a trigger point--a hyper-irritable, tight area of muscle that's deprived of oxygen and nutrients--that causes pain sensations to run along the nerve away from the trigger point. Sometimes this pain can be experienced quite far away in areas you wouldn't think are related. But our bodies are designed in such a way that our nerves run along, around, over, under and sometimes right through the middle of our muscles. It's possible for tight muscles to impinge, or squeeze, certain nerves and cause not only pain, but numbness, tingling, even weakness or difficulty controlling the muscle. Some trigger points can even cause symptoms like nausea and dizziness.

This is why many people that are diagnosed with what the doctor refers to as Carpel Tunnel Syndrome, but surgery or other allopathic treatments haven't been effective and it may, in fact, be the brachial nerve being impinged by the scalene muscles in the neck that are causing Carpel Tunnel-like symptoms in the arm and hand. It's why you may be experiencing what you think is sciatica (nerve compression due to a bulging vertebral disk) with pain radiating down your leg, when it may actually be nerve compression due to a tight piriformis muscle.

Low back pain can be caused by many things including poor posture, arthritis, spinal disease such as a ruptured or bulging disk, or it may be a muscular problem due to postural distortions like scoliosis or work habits, such as sitting at a desk all day. But just because you're experiencing low back pain doesn't mean the muscles you think are causing the problem are actually the real cause. It may be referred pain due to other muscles. For example, many people who feel pain in the low back automatically--and understandably--think it's being caused by weak or tight quadratus lumborum (a.k.a. "the QLs") muscles, the muscles that attach to your lumbar spine, 12th rib and posterior iliac crest. But the iliopsoas muscle--which attaches on the anterior side of your spine and runs down to your femur--is a known culprit for causing low back pain. So if you've been trying to fix it with massage, but the massage therapist is only working on your QLs, perhaps it's time to suggest they work on your psoas*. (*Note: Working on the psoas involves the massage therapist going deep through your abdomen. It may feel quite uncomfortable, such as bad menstrual cramps, especially if your psoas has never been worked before.)

If you're experiencing pain that you have not been able to get rid of, talk to your doctor and call me. Perhaps working together, your doctor and I can figure out the real cause of your chronic pain and help you eliminate it. Visit my Web site at for my contact information.

Thursday, May 20, 2010

What to Expect During Your Massage Session

I'm sure that those of you who have never experienced a table massage have many concerns about what to expect during a massage session. Many times, preconceived notions cause the unexperienced to avoid getting massage, even if they need it badly. So, to put your minds at ease, I'd like to address those concerns.

Will I have to be naked during my massage?
How much clothing you remove is completely up to you. Any reputable massage therapist will use professional draping with the sheet--meaning that only the area being massaged will be exposed. For your safety and security, absolutely NO private parts or genitals should be exposed at any time.

It is easiest for the massage therapist if you undress down to only your underpants. The reason for this is so that if massage oils or creams are used, it won't get all over your clothes. I personally prefer to use the elastic of the client's underpants to tuck the sheet in to help ensure that you are properly covered. However, if you are more comfortable with leaving more clothing on, I can still work through the clothing, though, to protect your clothing, no massage oils can be used.

The most important thing is that you feel comfortable during your session.

Should I Tip My Massage Therapist?
Again, that is completely up to you. In general, tips are appreciated, but certainly not required. If you do decide to tip, you may tip however much you feel comfortable. It is generally understood that some people are uncomfortable tipping or are financially unable to tip, so if you don't tip, your massage therapist shouldn't take it as an unspoken commentary on his or her work.

What Kind of Massage Can I Expect?
When you call to make an appointment, ask questions about what kind of massage is offered. It's also a good idea to ask if the massage therapist you are scheduled with is nationally certified. Some states also require massage therapists to be licensed--Michigan currently has a licensing law, but has not yet implemented the process to hand out those licenses.

Many other styles of massage exist, including Thai massage, Reflexology, Lomi Lomi, Hot Stone Therapy, Craniosacral massage, Shiatsu, and several others. If you are interested in a particular style of massage, please ask if it's available.

I offer therapeutic massage including Swedish (or relaxation) massage as well as deep tissue massage, chair massage and some sports massage. I don't perform any of the other styles. I do not perform sensual massage.

Tips for a Successful Massage Session
1. ARRIVE ON TIME! If your appointment is scheduled for 1:30, please try to arrive about 5-10 minutes before so that you have time to disrobe and get onto the table. You may also need a few minutes to fill out a health history form and to talk to the therapist so that s/he can determine what problems you're having and formulate a plan on how best to help you.

2. COMMUNICATE WITH YOUR THERAPIST. Giving accurate information about your health is important to the therapist--s/he must know if you have a condition that might contraindicate a massage. In order for your massage therapist to be effective, it's very important to tell your therapist if they are using too much or not enough pressure. And if, for any reason you feel the need to stop the massage or if the therapist is doing anything that you dislike, please say so. Don't feel you need to keep quiet about anything.

3. ASK QUESTIONS. If there's anything you want to know, don't be afraid to ask questions. Ask why you've been experiencing that back pain or why you've been getting headaches. Ask what you can do to help reduce your pain. Ask what you can expect during the massage. Ask about what your therapist specializes in and how they can help you. Whatever you may be curious about, ask questions.

If you'd like more information or would like to schedule an appointment with me, please visit my Web site at

Tuesday, May 18, 2010

What IS Deep Tissue Massage Therapy?

Deep tissue massage therapy is often mistaken by many people for any kind of massage that is performed with hard pressure. Deep tissue massage can utilize hard pressure, but it doesn't have to. With any good massage therapist for any type of manual massage, the amount of pressure should be dictated by the client. Some clients can take harder pressure than others. But harder pressure can also be utilized during a relaxation massage--it just depends on what the client wants.

Relaxation (or Swedish) massage and deep tissue massage are two completely different styles. When we massage therapists refer to "deep tissue," we're talking about affecting the deeper layers of muscle and fascia. True deep tissue massage includes two styles: Myofascial therapy and Neuromuscular massage therapy.

Myofascial therapy loosens the bonds between the fascia and the muscles to increase range of motion, decrease tissue adhesions and loosen scar tissues that may have formed. It also increases the oxygen and nutrient supply to muscular and fascial tissues to improve muscular health.

Neuromuscular therapy employs trigger point therapy. It works with deeper layers of muscle to deactivate points of pain which refer pain around or away from the knots. These points of pain are known as trigger points. Trigger points can cause pain because they are areas in the muscle tissue that are tight and lack proper blood supply. Referred pain happens because the tightness in the muscle sends signals along the nerve path. Nerves travel along, around or next to muscles, which is why you can feel pain in areas that are distant to the tight area. The muscle may also compress the nerves and cause pain, numbness, tingling and/or other sensations other regions of the body along the path of the nerves.

Deep tissue massage therapy is intended to work out these knots and increase circulation, giving more oxygen and nutrients via more blood to the area, thereby decreasing pain and possibly compression of the nerves.

Be aware that deep tissue massage therapy can sometimes be somewhat uncomfortable and somewhat intense. However, it is not intended to cause pain--as in when you react by saying "Ouch!" If it hurts too much that your body seizes up and you jump, then the massage therapist should back off. If it's uncomfortable but bearable, try taking slow and very deep breaths--this will usually help you through it until the massage therapist moves on to a different area. If it's too uncomfortable to bear, don't be afraid to speak up! Communication between you and your massage therapist is extremely important. If you don't say anything, how can they know they're hurting you?

It should also be mentioned that with deep tissue massage therapy, you may sometimes feel bruised. This is normal! Because it's deep tissue work, some of the blood vessels and capillaries in the skin may be ruptured. It's ok to have a few bruises, especially if you really need the work done. Also, some people bruise more easily than others, especially if they are taking blood thinners. But again, if you experience too much pain that you can't breathe through it, you should tell your therapist to use less pressure.

A good massage therapist who performs deep tissue massage therapy should have sufficient training in both Myofascial massage as well as Neuromuscular massage therapies. If you're not sure whether your massage therapist is trained in deep tissue massage therapy, ask them.

I am a nationally-certified massage therapist who specializes in performing deep tissue massage therapy in Ann Arbor, MI. To find out more about me, please visit my Web site at