Do’s & Don’ts of Healing Scar Tissue-Tip #2

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Scars often occur do to improper treating/handling of cuts, scraps and open wounds. Here are few tips to help avoid any unnecessary scarring and infections while caring for the wound.

DO:

images (22)Colloidal Silver- has been around for almost a hundred years since it was first used by physicians and medical experts as a form of antibiotic, capable of fighting a great number of bacteria that thrive in the human body. It was proven potent for killing such infectious organisms, safe without the unfavorable side effects associated with other types of antibiotics.

Colloidal silver is not only a powerful bacteria-fighting agent. Several studies have revealed that colloidal silver is also a great antiseptic that works to heal cuts, abrasions, and wounds. It helps the skin develop its healthiest form without destroying tissue cells. Colloidal silver has wonderful healing properties and helps damaged tissue to regenerate. Major hospital burn units use colloidal silver bandages and ointments.

How it works:
Studies have shown that colloidal silver works to treat scars and stretch marks by simply immobilizing the enzyme that the fungi, bacteria, and viruses use for them to survive. The silver interacts and blends with the blood once applied to the scars and stretch marks and then enter the cells to look for the infectious organisms that need to be destroyed. It destroys the bacteria quickly by suffocating them in less than six minutes. The suffocation takes place right after the initial contact of the silver with the organisms. If the task is successfully done, the colloidal silver is not just capable of restoring the scars and stretch marks, but it also helps to make the immune system more active and strong.

How to apply:
Apply a few drops of the solution placed directly into the affected skin. You can use a cotton bud for the application, and you can also use a band-aid for disinfection purposes.

Precautions:
It is important to note that the colloidal silver should not be overly used for an over dosage of this solution can cause certain complications. You might feel something itchy or sluggish after a few days of application, but this is simply typical for colloidal silver. You can eliminate these symptoms by taking enough amount of water.

Another problem individuals must deal with involves mixing colloidal silver with other drugs you may take on a daily basis. This could be anything from something as small as something to relieve head and body aches to more potent pharmaceuticals that help with osteoporosis and various other disorders and diseases.
colloidal silver blue skin
The most talked side effect is Colloidal argyria. This occurs when you have taken excessive amounts ofcolloidal silver and it begins to look as though it is staining the skin. If you overdo it you take the risk of turning your skin blue.

History:

images (1)Silver has been known for its medicinal and antimicrobial properties for thousands of years. Hippocrates,“Father of Medicine,” used silver for tissue repair & wound healing. The ancient civilizations of Greece and Rome used silver to control bodily infection & prevent food spoilage. The King of Persia used silver containers to carry water to prevent contamination. Throughout the ages, the ‘Metal of the Moon’ as it was known to some of the ancients has been used effectively for numerous medicinal purposes.

Prior to the 1938 colloidal silver was the principle antibiotic treatment in the United States, prescribed by thousands of medical doctors. At that time colloidal silver was considered to be very high-tech. In the last several decades, major colloidal silver technology advancements have been made enhancing safety and efficacy

Don’t:

images (2)Hydrogen peroxide has been touted as the miracle chemical of the century. Its uses include water purification, bleaching of commercial products, and use as a cleaning agent. However, when it comes to its medicinal uses, it has a long history of being abused and misused.

When you pour hydrogen peroxide onto wounded tissue, the wound immediately starts to bubble, a process imagesthat is followed by an intense pain. People used to think that this meant the antiseptic properties of hydrogen peroxide were kicking in. Scientists now know that this is actually an indication that healthy tissue is dying. This slows down the healing process and gives scars a greater chance of forming. Multiple randomized, controlled trials show that hydrogen peroxide does not prevent or treat infections in wounds.

When hydrogen peroxide is applied to the wound, it combines with a natural chemical in human tissue. This combination generates oxygen and water. The concentrated amount of oxygen that is generated can kill off any bacteria that may be contaminating the wound, but it also kills healthy tissue in the body at the same time. The type of killing that is done by the concentrated oxygen is toxic to the human body. It kills anything alive indiscriminately, whether it’s bacteria or healthy human cells. When the body is trying to repair the wound by sending in a microscopic repair crew, these cells can fall victim to the random killing by hydrogen peroxide.

To prevent wound infection, there are many more precise ways to kill the bacteria without hurting the healthy tissues in the body.

History:
Along with its role in infection prevention, hydrogen peroxide has historically been used to get rid of dead tissue in a bad open wound. This has also been proven ineffective, and the majority of medical professionals have halted this practice.
Instead of using hydrogen peroxide, most doctors use a sterile salt water to clean the wound. This salt water is often drawn into a syringe and squirted into the wound to clean out any debris trapped inside the wound.

In a pinch:

Minor accidents, abrasions and bruises will occur at the most inconvenient of times. It may be useful to know how you can help prevent infection if you don’t have a medical disinfectant like rubbing alcohol handy. Here’s a simple solution you can assemble from household ingredients if you’re in a pinch.
Ingredients:
• Bottled water
• 1 tablespoon salt
• 1 teaspoon vinegar (alternatively, fresh lemon juice)

Steps
• Add bottled water into a glass cup until it is a little more than three-quarters full, making sure that the glass was clean beforehand
• Add salt into water. Salt can be iodized. The salt used for regular cooking will be ideal. Salt is known to contain many bactericidal properties.3
• Mix well until all the salt dissolves in water.
• Add vinegar and mix well. Any kind of vinegar (processed or natural), will do the trick. Vinegar contains a mild acetic acid, which can cleanse and disinfect wounds. If vinegar is unavailable, fresh lemon juice will also suffice.
• Soak into cotton wool and apply to fresh cuts and abrasions on skin. It’s preferable to open a sealed pack of cotton wool.
• After use, dispose of this liquid. It’s not suitable for storage either at room temperature or by refrigeration. Make a fresh preparation each time this procedure needs to be repeated.

Other Natural remedies

download (3)Cayenne pepper: For internal bleeding take one tablespoon of cayenne in a cup of water to stop the bleeding. Cayenne can also be placed directly on an external cut to stop bleeding. You may completely pack the wound if you have enough pepper. Black pepper may be used instead if cayenne is not available. This remedy does not sting like you might imagine and is very important for emergencies.
Plastic Wrap Applying plastic wrap to the skin for three to seven minutes will help clotting and won’t take off the scab when it is removed.

download (2)Sugar: Sugar is an excellent disinfectant. For open wounds or skin ulcerations, sprinkle on granulated sugar to help kill bacteria and speed healing. Smear a ring of petroleum jelly around the edges of the wound to hold the sugar in place, then put a little sugar directly on the wound. Cover the wound with a bandage; change the bandage once or twice a day.

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Tea: Apply a moistened tea bag to the cut to soothe and stop the bleeding.

images (3)Tea tree oil: Derived from the leaves of the native Australian Melaleuca alternifolia tree, tea tree oil contains antiseptic compounds that make it a powerful disinfectant. Use a 10% solution (about 1½ tablespoons to a cup of warm water) to rinse and cleanse wounds.
No matter how you choose to treat an open wound. Always err on the side of caution and if it is a very deep wound or shows any signs of infection contact your doctor immediately.

The children are our future…So how about we pay attention now!

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I received a call the other day from a fellow Massage Therapist. He was
referring one of his clients, a 15 year old male athlete ( lacrosse
goalie and football linebacker) with severe pain in his right knee. The boy’s coach told his mother he needed an MRI and that he most likely tore
something. My friend did not agree and wanted to see what I
thought and if Integrated Therapeutic Stretching would help. He had tryouts in two days and they were concerned about injury.

According to the client he only felt the pain when he was crouching in goalie position. I had him do it for me. He had all of his wait on the outside of his feet which were not wide enough apart to support his weight properly.

I ran him through some quick range of motion & muscle tests as he lay on the table with no resulting pain but revealed very limited ROM throughout the boy’s lower body. As we started to stretch it was quickly discovered that his left glutes were locked up. Hip rotators on both sides were in as bad a shape. IT Band and hamstrings were at 60% ROM and his quadriceps were down to 45%. This is 15 years old folks!

It is terrifying to see the physical shape of children today. Either they are overweight and under exercised or they are over worked, participating in multiple sports where proper strength and flexibility training is nonexistent.

Sports injuries are on the rise in children and teenagers. Each year more than 3.5 million sports-related injuries requiring medical treatment occur in children under age 15. Today, as more and more children and adolescents participate in the same sport year-round, many young athletes are developing overuse injuries. In fact, overuse is responsible for about half of the sports injuries that happen to middle and high school aged students.

We worked together through each stretch, showing him how his body is supposed to move utilizing body proper form and mechanics. He was very eager to learn as was his mother. I assisted and guided him through the stretches focusing especially the ones which really opened his restrictions. Both he and his mother were surprised at how tight he was in the beginning and at speed with which he loosened up.

Now as we were working I observed a deep scar about 1inch in length on his left knee which he claimed was “no big deal” and said it was over a year old. His mother chimed in “the bad one was on his foot”. Three years prior he flayed his right foot open on a fence. There was a huge c shaped scar on the sole of his foot which upon palpation showed to have spread and attached into the arch.

I asked if he wanted to see something cool and then I proceeded to release the scar on his knee. When I asked him to bend his knee his eyes opened wide and said “That’s Sick!”. His knee flexion had increased by 20% . Next with his mother’s permission I went to work on his foot. When I was done I had him stand up. He laughed out loud and said “No Way! Thats Totally Sick! I can feel the bottom of my foot”. His mother , shocked at his reaction said ” I didn’t know you couldn’t feel your foot?!” “Neither did I” was his reply.

We followed this up with gait re-education and proper mechanics required for his respective sports positions (i.e. crouching and squatting). While he still had some minor pain he could see how adjusting his stance took the pressure off his knee. After having him go through the stretches once more I recommend to the mother that if the pain comes back or increases then she should indeed seek their doctor’s advice.

The mother was shocked at how much the scars were affecting her son. I explained to her that scars and adhesions are generally overlooked by health professionals because the extent of physiological affects they can have on the body have never really been acknowledged. The slightest restriction from falling off his bike at 4 could alter how he grows and have major repercussions from one end of his body to the other.

Four days later the duo returned, the tryouts went great and when asked about his knee he said “it still hurts every now and then but whenever I felt it start I shifted around until I felt right and the pain stopped.” I asked if had been stretching and he say before and after the games. (In the four days since I had seen him he had two lacrosse matches and two days of football tryouts). He was also very excited for more scar therapy “It was so weird but I could feel my foot moving better as I played!” His mother than asked if I had any extra time to look at her two scars that have been driving her crazy for years.

During the course of my career I’ve treated many patients whose problems could be traced back to a scar they had forgotten they even had. While not every scar presents a problem, very often they do. Doctors, along with basically everyone else, tend to ignore scar tissue from surgery and accidents especially in children.

Today children are playing more and more sports driven by the need of scholarships and future fame. It is time we start to pay attention to the adverse affects of training and playing so hard so young. We need to make sure that the fall off the bike or the cut from climbing over the fence does not lead to issues later on.

Do’s & Don’ts of Healing Scar Tissue-Tip #1.

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Whether it’s acne pock marks, or the legacy of a burn, wound or surgery, few of us like scars on our skin. And there’s no shortage of remedies that claim to make scars smaller, thinner, less noticeable and heal faster. In this series of blogs I will attempt to shed some light about natural and medical scar treatments.

Do:

download (5)Use Lavender essential oil to treat scars especially burns. Lavender is one of the best all-round essential oil, according to Shirley Price in her book “Aromatherapy for Women.” Lavender oil is gentle, inexpensive and effective. Lavender essential oil can be used to treat acne, scars and most skin conditions; it can be applied direct to the skin, in small quantities.

Lavender essential oil is a very effective antiseptic, antibacterial and antimicrobial that reduces pain, itching and promotes rapid healing. In addition, lavender reduces scarring. When lavender oil is applied to a burn from the onset, the burn may heal with no scarring at all. (For larger burns, put lavender oil onto a gauze or cloth and apply to the burn every few hours.)

How to use it?
• Apply several drops (2-4) on location several times a day
• Directly inhale, diffuse, or
• May be used as a dietary supplement

Safety Considerations With Lavender Essential Oil

Lavender essential oil can sting a little when a wound is still fresh, but once it’s scabbed over and has started healing, lavender essential oil, applied topically, can help minimize scarring while it heals.

Lavender has a relaxation property, often used to fragrance products for bedtime, like lotions and satchels for bedrooms. WebMD warns that lavender essential oil can depress the central nervous system and cause drowsiness and sleepiness (especially good when used properly to treat insomnia and induce relaxation but dangerous when used for other properties and healing in which sleepiness is not a desired effect). You shouldn’t drive or do other dangerous things until you know how lavender will work for you.

rene-maurice-gattefosse
History fact: A French scientist, René Gattefossé, was severely burned in a laboratory accident and immersed his hand in a vat of Lavender for two weeks. Gattefossé found that Lavender oil promoted tissue regeneration quickly and healed the wound with no scarring!

Don’t:

One of the most popular treatments for scarring is vitamin E.
But will vitamin E really help to improve your scar?

can_vitamin_e_h_photoVitamin E, or tocopherol, is a fat-soluble antioxidant. It’s found in capsule or liquid form at drugstores, grocery stores, health food stores, and online. The so called effective remedy consists of opening vitamin E capsules and applying the content on the scar. But this topical use of vitamin E does not result in scar healing. Vitamin E has been shown to penetrate layers of the skin and reduce the formation of free radicals which can interfere with healing. Vitamin E also influences the production of collagen, a structural protein partially responsible for the strength and elasticity of skin. Although many people apply vitamin E oil to their skin to minimize scars and it’s sometimes recommended by physicians after skin surgery, there’s very little evidence that shows it helps.

Vitamin E Research :
Current research does not support vitamin E oil to reduce scar formation.

A study on the effects of topical vitamin E on the cosmetic appearance of scars at the University of Miami that there is no benefit to the cosmetic outcome of scars by applying vitamin E after skin surgery and that the application of topical vitamin E may actually be detrimental to the cosmetic appearance of a scar. In 90% of the cases in this study, topical vitamin E either had no effect on, or actually worsened, the cosmetic appearance of scars. Of the patients studied, 33% developed a contact dermatitis to the vitamin E. Therefore it was concluded that use of topical vitamin E on surgical wounds should be discouraged.

Research by K.C. Wan and J.H. Evans at the Hong Kong Polytechnic University, published in 1999 issue of “Free Radical Biology & Medicine,” found higher amounts of free radicals in hypertrophic scars, which become thicker, redder and more elevated than regular scars. Another study by T.L. Khoo at the Hospital Universiti Sains Malaysia, published in a 2010 issue of the “Journal of Plastic, Reconstructive & Aesthetic Surgery,” concluded that tocotrienols, a vitamin E subfamily, made no significant improvement in scar parameters. Also, a study conducted by Morganroth, Wilmot and Miller in Philadelphia for a 2009 issue of the “Journal of the American Academy of Dermatology” determined that scar products containing vitamin E oil did not support usage for the reduction of postoperative scar formation.

Be on the lookout:
For specific ingredients found in commercial wound ointments and dressings.
Listed below are just a few ingredients present in store bought wound products. Most of these products produce skin irritation, sensitization, and are linked to allergies, cancer and/or immune suppression. Here they are:
• Petrolatum
• Mineral Oil
• Propylene Glycol
• Butylated Hydroxytoluene (BHT)images (19)
• Benzalkonium Chloride
• Yellow #5; FD&C Blue #1
• DMDM Hydantoin

Even many of the natural ointments contain some of these ingredients. Make sure to read the labels and please, test the area for allergic reactions before applying anything to your skin!

Mandatory Gratuities -Oxymoron

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images (18)I was settling up with a new client when she asked “And what is the recommended gratuity?” I explained that “while I appreciate the thought it was not necessary”. She was very surprised and commented that the last few places (both spa and private practice) she went to had a mandatory gratuity policy. This really drives me crazy.

The definition of mandatory is: containing or constituting a command: obligatory
The definition of a gratuity is: something given voluntarily or beyond obligation usually for some service; generally in the form of a tip.

A gratuity is just that. When a person is happy with a service that has been provided for them and wish to show their appreciation. So, would someone please explain to me how demanding a client be grateful for the service they have paid you to perform, whether or not they actually did appreciate it, acceptable? Especially to the point of requiring they give more money on top of the already established fee?

Now I am not saying one should not accept a gratuity. I believe it is a personal choice. It is up to the individual as to whether or not they wish offer a gratuity and to accept one. As I mentioned earlier I always tell my clients it is not necessary but if they insist I will accept because of what the offering means to them. I usually put the tip in a draw and then make a donation somewhere down the road with it, my way of paying it forward. But, again this is my choice there is nothing wrong if another therapist decided to keep the offering. The therapist performed a service to the best of his/her ability and were rewarded for the effort.

I know that there are a few points of view out there in regard to the Massage Profession. The first is we are a service industry and that there is no reason why we should not accept tips. The second is that we are healthcare providers, the same as doctors and physical therapists, and it is unprofessional to accept tips. We are all in service in one way or another from the doctor to therapist to contractors to the waitress at the local dinner. It is always uplifting when one is complimented or thanked for a job well done. Where the distinction falls as to who should or should not receive a gratuity it is commonly left up to proper social etiquette. What most fail to see is that if we follow proper etiquette everyone receives a tip. – hospitals are giving grants, doctors receive the fruit basket or bottle of wine at the holidays. We leave holiday bonuses for the mailman and the garbage collectors. We leave the tip on the table at the end of the meal for the waitress. How much we give, if at all, is a personal choice. While society likes to comment on the end results it is no one else’s business and it is certainly no one else right to demand that their way of doing something be adhered to.

There is also the unwarranted distinction of whether or not the therapist is working for themselves or on staff at a spa. In other words, it is required to tip the therapist at a spa because the house is taking a cut and the therapist makes less. First off the therapist chooses to work for the spa and that alone does not make them worthy of a gratuity. If the client is really pleased with the service then by all means have at it, however, the client should not be required to do so. It is a bad habit of some spas to make gratuities mandatory to make up for the low wages they pay the therapist. So in other words, the Spa is demanding the client not only pay them for the service but also share the cost of paying the salary of the therapist as well. If a spa wants quality staff then pay a decent wage.

A client once told me how she went to a spa where the staff was rude, she waited 20 minutes past her appointment time and the massage was just o.k. In spite of all of this when she paid for her treatment, she included a tip as etiquette required and she was promptly informed out loud “that is not how we do it here your tip is not enough”. She felt so embarrassed she gave them more money and fled. Granted this is not the norm but what is the incentive, for those who need one, to do a good job if they are already guaranteed a bonus no matter how they perform?

As far as not tipping a therapist in private practice because all of the money goes to them- well please, the therapist is paying their own overhead and has bills like everyone else. Either way if the client is pleased with the massage there is no reason not to express their appreciation and it is up to the therapist to choose to accept it. That’s all I am saying.

Wide Band Narrow View

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A_HAD_1p_P36Should we stretch? Does it help or does it cause harm? This is a very popular debate. One that usually ends in “Well… there is no evidence that proves it is good… but everyone does feels better afterwards.” or “It is a waste of time that can only lead to loss of strength.”

When we think about stretching we tend to think only about the muscles and static holds. These narrow views are what gives stretching a bad reputation and where all of the misunderstandings occur. We should be stretching the whole body, which is primarily made of fascia, in line with the way it was designed to move, dynamically.

For example let’s look at the knee. Usually when there is an knee issue most look to stretching the Quadriceps or Hamstrings muscles. body_worlds_knee When the IT Band comes to the knee joint it binds into a large network of connective tissue or Fascia. This fascial network comes across the front of the knee depending on the direction of force and it connects down into the shins. The IT Band fascially connects into the Peronals & Tibialis Anterior. The knee cap is embedded in fascia. When we have Knee injuries such as patella tracking, meniscus tears, ACL we often focus our view on the Hamstrings and Quadriceps addressing only half the possibilities of causation. Perhaps the fasica is inflamed. A common complaints of knee pain is a sweeping type of pain across the knee and under the knee cap. For it to be sweeping across it must be the fibrous attachments across the knee. This is not the type of pain a Quadricep or Hamstring would be causing.

So by opening up our point of view to encompass all of tissues involved, while recognizing the patterns in which it is connected and functions leads to a productive pain reducing, fascial lengthening, muscle educating and recovering stretching session.

Law of Averages

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images (17)Who’s goal is it to be average? Average looking, of average intelligence and so forth. When it comes to social acceptance and self image the last thing anyone wants is to be considered average. Except of course when it comes to our health. Being average is actually the goal. Health is often determined or judged according to averages.

Take blood pressure for example, the average range for blood pressure is 120/80 to 110/70. Mine happens to be 90/60, I work out and am in relatively in good shape. During an annual check-up, the nurse taking my blood pressure was alarmed and said that my pressure was low. I had to explain to the nurse that if she would take the time to read my chart she would see that 90/60 is in fact normal pressure for ME. download

What would have happened if I did not know what my personal norm for blood pressure was? I may have been prescribed medication to raise my pressure, which I would most likely have taken without question, because we always listen to the Doctor in the nice white coat, right?

Our health care uses averages as it’s guidelines. Now, do not get me wrong, we need guidelines but that is all they are a guide – not the ultimate answer

images (16)I have a client, 49 year old female, who is very flexible – almost hyper-mobile. During rehab for a knee replacement the PT tested her range of motion (ROM) and noted that she had 90 degrees of hip flexion and told her “wow you have healed really well” and was satisfied with her recovery. For the average person 90 degrees of ROM is considered, sadly, as acceptable and in some cases the goal. Unfortunately for my client, her normal hip flexion ROM prior to surgery was 120 degrees. Trusting that the PT knew what he was talking about she accepted the diagnosis. Meanwhile she did not feel like “she was good to go”, again quoting the PT, and was still experiencing pain and restriction. After increasing her limited ROM and eliminating her back pain she said “I had no idea my pain was related to the knee as they said I was healed. I just thought, well this is what getting old was like”. Again she is only 49 years old. Her ROM prior to surgery should have been documented somewhere. Rehab goals should not be to achieve the average. While a surgery such as a knee replacement will present new limitations it should not be assumed that she is only ever going to be average from here on out.

images (13)Let’s look at this from another perspective. What Doctor should a female go to when the symptoms of Menopause begin? The standard answer is the Gynecologist. But why? – a Gynecologist, for all intense purposes is a plumber. Menopause is not a plumbing issue it is a hormonal one- women should be turning to an Endocrinologist for assistance with the change.
A gynecologist will most likely prescribe estrogen for all of the women who come to him/her. Here is another important time when a woman needs to know what is normal for her. All women should get a full hormonal blood work up every ten years starting when they turn 20 and put the information away until the time occurs. Then she will have a complete history of her hormones. This would be a more appropriate guide for what she personally needs as a supplement, if any, at this point in life.

It is so important that we pay attention to our bodies as well as our instincts when it comes to our health care. We need to when know something is not right for us personally. We should not blindly accept recommendations for surgery, or reasons for continuing/ending treatment. We rarely follow our instincts because we are unsure and uninformed about our own body. The more connected one is with their own body, the better prepared one is to figure out which health options are best suited for us, indidivually. Knowledge is power, combine it with understanding and confidence the result is a uniquely healthier, you. And there is nothing average about that.

Alphabet Soup

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images (3) There was no better lunch when I was a kid than a salami sandwich and a big bowl of alphabet soup. I loved to dunk the sandwich and when I was finished soaking up the soup, I had all the letters to make up stuff with. There was a never ending combination of letters and tons of hysterical laughter as my siblings and I came up with sayings to match the initials. Sometimes they made sense, other times they were just funny. Either way they all came out of the same bowl, tasted the same and helped fill our tummies.

I was recently reminded of those forgotten afternoons. A friend who has been a very successful massage therapist for 25 years attended my Scar Tissue Release course last weekend. He has never joined any of the massage organizations , he rarely attends continuing education courses, preferring to read studies and magazines. However, with the new CEU requirements for New York, he decided to come hangout with me and 47 others for a few days.

The next day he came in for a session and while discussing the course material he thanked me for taking the time during the class to continually explain the multitude of acronyms that were being tossed about by the students. He was both amazed at the sheer number of them and amused that, when explaining them, I would break down the techniques to the origins from which they hailed. He said for a moment there he felt…well, really out of the loop…but then he realized it was all just different version of what he already knew and he felt much better. I just smiled and agreed that there are really no new techniques, everything stems from something else. There are only new points of views and presentations.

Right after that conversation, another massage therapist friend (a continuing education junkie) called asking had I heard of this technique or this one (insert any three letters at random) and what did I think of them. Once again, I found myself breaking down the technique with her and taking it back to the origins of the work. She also told me how arrogant a fellow student was during the class, continually challenging the instructor, not to contribute to the information being shared, but rather to simply prove her wrong. Unfortunately, this is not a very uncommon situation I am sad to say.

A few thoughts came to me after this combination of conversations.

SI, PNMT, EFT, PRT, NFT, MET, PNF, ART, ITS, FMS….ABC…123…

There is obviously a need for coming up with a descriptive name for a technique (or a disease for that matter) and who does not enjoy a good abbreviation these days. However, as professionals, we really need to get into the habit of clarifying what we say for those around us. Using acronyms without explanation alienates us from those we are trying to work with, whether they be clients/patients or fellow professionals. There are only so many combinations of letters, many get used over and over again and have many different meanings.

If you find yourself using an acronym during a conversation, which we are all want to do, take two seconds to clarify what they stand for and to make sure the person(s) you are speaking with is familiar with the therapy/technique/disease you are referring to. Spouting off a series of letters and big words does not make you seem educated and professional, more likely you will come off arrogant and full of yourself. Instead, take the time to acknowledge the possibility that not everyone is in the know and have the where with all to clearly define and explain what those snappy letters stand for. This my friends, is not only proof of your intelligence and competence but of your consideration and compassion for others.

I know better than you….

It is very popular for professionals to disparage other professions. Doctors & Physical Therapists look down on Massage Therapists. Massage Therapists complain about Physical Therapists. Massage Therapists & Physical Therapists alike criticize Doctors and so and so on. It is bad enough that the health professions are divided and not working together for the benefit of the client/patient, now it seems we are often condescending towards the various styles of practice within our own professions.

We should all be banding together to support the needs of our clients/patients by learning and understanding other therapies/techniques and what they have to offer. Whether or not you agree with another style of massage or another therapy, as a professional, you should never belittle or denigrate it to an inquiring client or colleague. As a professional, you should be capable of explaining the premise behind the therapy/technique, what it seeks to achieve and how it is administered. After stating the basics, then you can explain from your point of view, how it differs from your approach. This leaves the client/patient or colleague with the ability to make an informed decision of their own as to whether or not to pursue it further. The clients/patients needs vary depending on the individual and the moment in time of the need. There is no one end – all -be-all therapy and more often than not it takes a cocktail mixed to each person’s particular needs.

Time to change the menu…

Throughout my classes I encourage my students to contribute information on their specialties. I discuss a variety of therapies, their merits and when they can be used in conjunction and when one is more preferable then another. I encourage my students to seek out training in specialties that may call to them such as Oncology Massage or Visceral Manipulation. I recommend other courses from Instructors I respect such as Tracey Walton and Marty Ryan. I have even asked them and others to help round out my students knowledge with one page handouts sheets (i.e the top ten facts about massage & cancer) including their promotional information.

I will also ways love Alphabet soup, but lately I find myself more in the mood for Stone soup. It is not a meal one makes on their own, rather it is a community effort, all contributing their own special ingredient, combining all together to share with each other for the betterment of all. I have the pot and have tossed in the first few stones and there is a seat for all who wish to join in at the table.
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Wholistic Toolbox: The Rotator Cuff and injuries related to it

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Jenns 6 InjuriesThe shoulder is made up of three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collarbone (clavicle). The shoulder is a ball-and-socket joint: The ball, or head, of the upper arm bone fits into a shallow socket in the shoulder blade. The arm is kept in the shoulder socket by the rotator cuff. The rotator cuff is a network of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate the arm.

There is a lubricating sac called a bursa between the rotator cuff and the bone on top of the shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when the move your arm. When the rotator cuff tendons are injured or damaged, this bursa can also become inflamed and painful.

When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears occur in the supraspinatus muscle and tendon, but other parts of the rotator cuff may also be involved. In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object. The fraying is caused by too much tension or an imbalance in the muscles which needs to be corrected.

Causes of a rotator cuff injury may include falling, lifting and repetitive arm activities — especially those done overhead, such as throwing a baseball or placing items on overhead shelves. Repetitive use and/or improper body mechanics can also lead to injury. As we age and become less active we tend to lose strength and tendons begin to breakdown. Rotator Cuff Injuires are most common in people over 40 years old. There is a very good chance that a rotator cuff injury provided it is not severely torn, can heal with self-care measures or exercise therapy

Rotator cuff injury signs and symptoms may include:

Pain and tenderness in the shoulder, especially when reaching overhead, reaching behind the back, lifting, pulling or sleeping on the affected side

Shoulder weakness

Loss of shoulder range of motion

Inclination to keep the shoulder inactive

The most common symptom is pain. It may occur when reaching up to comb hair, bending the arm back to put on a jacket or carry something heavy. Lying on the affected shoulder also can be painful. If a severe injury, such as a large tear, has occurred there can be continuous pain and muscle weakness.

So our primary goal is to release scar tissue that has formed following injury, restore ranges of motion and regain stability. Torn muscles, most commonly the supraspinatus (on the top of the shoulder blade), create general instability in the shoulder joint. Once range of motion has been restored, strength will be required to fully resolve the injury and prevent the problem from becoming chronic (i.e. frozen shoulder).

The manner in which the treatment is tailored depends on which muscle is torn. Make sure to determine the exact injury and tailor the treatment accordingly. If your client is very apprehensive about stretching the shoulder, begin with strength training (i.e, manual resistance and ROM movements) to establish confidence and stability. Once initial gains in stability have been attained you will have greater success doing the stretching protocols. This is especially true for dislocations.

Make sure to pay attention to the client’s reactions both emotional and physical. Work with the client and address their issues as you go.

So how would I work with A Rotator Cuff Injury:

I would use the following Stretching protocol

Shoulder Horizontal Abduction

Shoulder Extension

Shoulder Internal Rotation

Shoulder External Rotation

Shoulder Horizontal Adduction

Shoulder Abduction

Posterior Hand Clasp

I would then proceed to opening up the cervical area with another series of stretches. Once I have the client out of pain and confident that they can in fact use their shoulder I would introduce strengthening exercises. Starting with a light manual resistance and gradually moving up to weights. I am also massaging (in between stretches – gives the client a break and brings their awareness to the changes in the soft tissue) and treating trigger points as they arise. Finally I would review the client’s body mechanics and try to correct improper use that is contributing to the problem. The client would be given a protocol do follow at home with daily shoulder stretches and a shoulder-strengthening to help prevent a recurrence. Especially important is a program of strength exercise to promote balanced strength about the shoulder.

So now you know my approach I would love to hear yours! Please share how you view and treat the Rotator Cuff.

Understanding is Relative

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The following story was circulating on Facebook:
A young couple moves into a new neighborhood. The next morning while they are eating breakfast, the young woman sees her neighbor hanging the wash outside. “That laundry is not very clean; she doesn’t know how to wash correctly. Perhaps she needs a better laundry soap.” Her husband looks on but remains silent. Every time her neighbor hangs her wash to dry the young woman makes the same comments. A month later, the woman is surprised to see a nice clean wash on the line and says to her husband: ” Look she has finally learned how to wash correctly. I wonder who taught her this?” Replies the husband, ” I got up early this morning and cleaned our windows.”

And so with life…What we see when watching others depends on the clarity of the window through which we look.

This story so hit home with me. I was brought up in a very judgmental household. I never realized how much I used to presume and judge others and situations until one day my husband (then boyfriend), thankfully, pointed it out to me (yes, I still married him!)

We often make monumental mistakes when we judge other people and their actions. We see the world through “life experience” tinted glasses. Before we move to judgment we should always take a step back and examine how and why we came to a conclusion or, at the very least, understand that we may not have a clear view (all the facts). We need to stay open to the possibility that there is information we are missing. i.e. Is the woman on line holding everyone up because she is being inconsiderate or is she having a bad day and forgot her wallet? Is that really obese person lazy and gross or is he doing battle with a disorder/disease? Until you know the whole picture and, even then, unless you are personally going through the exact same thing, you can never fully understand what it going on with another individual. Emoting good wishes instead of hurtling daggers of judgment benefits everyone. You will be amazed how pleasurable life is when you openly look for and begin to perceive a broader view of the world.

Another point in the story above which is often overlooked is that the husband let the wife continue misjudging her neighbor for a month. I can tell you that not only was I shocked by the realization that I was acting like a true member of my family (something I strive to avoid) I was also grateful to be shown the error of my ways. However, to be honest, I was also annoyed with my husband for taking so long to tell me. If you hear someone being judgmental or simply misjudging, then tell them. They may not appreciate it but then again you never know unless you try.

Understanding that we all view the world from our own perspectives is one of the most important lessons one can learn as a Healthcare Provider. While waiting for a movie to start I was channel surfacing and came across a hospital drama (could not tell you which one, sorry). A young female doctor was frustrated because she could not convince her professional model patient, suffering from a rare cancer of the jaw, to have the surgery which would save her life by removing a large piece of her mandible (Jaw bone). The model wanted to look into alternative methods before having her face permanently altered. The Doctor, presuming it was all about the model’s vanity, asked her supervisor for advice and the supervisor’s reply was “stop judging your patient”. Totally not what the she expected to hear. It forced her to take a step back and examine her own perceptions. She realized that she was in fact looking at the situation through her own personal references, a person who’s identity revolved around her intelligence not her appearance. What proceeded was a very open and honest conversation between Doctor and Patient, which I might add started with the Doctor apologizing. Taking the time to try and understand exactly where our clients are coming from should be the first step in every treatment.

“What you see and what you hear depends a great deal on where you are standing. It also depends on what sort of person you are.”
― C.S. Lewis, The Magician’s Nephew

When in Doubt Ask!

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question2-724662The movie “When Harry Met Sally” (1989) starring Billy Crystal and Meg Ryan is best remembered for the hysterical Deli Orgasm scene. Meg Ryan’s character, Sally, was showing Billy Crystal’s character, Harry, that men have no idea when women are faking it. Men just trust/assume that all is going as it should. The other unique quirk in Sally’s personality was her constant questioning of everything in her life. She could not order a meal unless she knew every detail and gave specific instructions on how she would like it prepared and served. Now most people would find this an annoying quality in their friends and family. But, truth be told, Sally’s questioning always got her exactly what she wanted or needed (at least in the daily necessities of life).

Asking questions, for some reason, is very difficult for most people. The problem is either we do not feel we have the right to question, or we are afraid to appear stupid. (By the way no question is ever stupid if you truly want to know the answer.) And some times we simply do not know what to ask. Researching and asking questions is a habit we all need to develop and become efficient at, especially when it comes to our health.

For example, when deciding to hire a personal trainer at your gym, do you take the word of the 20 something girl behind the counter “Oh he/she is the best trainer in the gym”, or do you ask specifically what his/her qualifications are? i.e.

• “How long has the trainer been training?” “How long at this facility?”
• “Is the trainer certified and if so, by what organization?”
• “What are the specific certifications held by the trainer? ”
• “What is the trainer’s style of training…Boot Camp/Army Sergeant or gentle encouragement?” in other words is it the right one for you?
• “May I speak to some of his/her clients?” (for this there is whole other set of questions)
• What questions, if any, did the trainer ask you?

You are basically planning to turn over your body to this person. Don’t you think it is worth a ten minute interview? Yet most are more concerned about the cost and trust/assume that the gym would not be employing unqualified trainers. I had a client who was the “top trainer” in a local gym and upon explaining which hamstring I was stretching I received a blank look. When I questioned the trainer ” Do know how many different hamstrings there are in your leg?” her answer was ” of course…two” (The answer, if you did not know, is actually three.)

Even scarier to me is that we almost never question Doctors, Surgeons, or Therapists (Physical/Massage etc). In my last blog I mentioned that Surgeon’s are not required to take training in or be certification to perform new procedures. I was somewhat surprised at how quickly people defended the Doctors and stated that it was OK as they are qualified professionals. Really? How do we know this? Is every surgeon or doctor out there the best at what they do? In every profession there are those at the top (most qualified) which means there is also a middle of the road (somewhat knowledgeable or skilled) and a bottom (a health risk!) . How do you know which one you have unless you ask?

Taking some time to research on line about a disease, injury, surgery and formulating questions can mean the difference between a full, speedy, successful recovery and long, lengthy, painful not so much recovery.

• “Please explain the disease, injury, surgery to me?” If the Doctor does not take the time to answer your questions in the manner in which you understand the answers, is this the Doctor for you?
• “Does the doctor specialize in this disease, injury, surgery?”
• ” How often has he/she dealt with or performed this disease, injury, surgery?”
• “What is the doctor’s success rate?”
• “Realistically how long is the recovery from the surgery?”
• “What types of medicine will I be on before /during/after and what are the short/long term side effects?”
• “Will I need physical therapy? Are there alternative therapies I can try first?”
• What questions, if any, did the doctor ask you?
(these same questions can be used for any therapist, Physical, Massage, Occupational etc)

These seem like basic questions everyone would ask but time and time again I have clients walk in the door without a clue as what were the specific effects of their illness/injury. What was done (or why for that matter) to them during a surgery. What the effects of the procedure or medication was having on them? Is the rehab being done correctly? I have a client who suffered an open fracture of the elbow. Her physical therapy was “torture”. When she questioned the Doctor about it he replied “It is supposed to be torture and she would just have to put up with it.” It turned out that the Doctor forgot tell the PT that her forearm was fused and could not perform rotation. Something the PT was trying to force her arm to do. She knew that something was wrong but did as she was told for another 5 months until she could no longer take it.

People go to the Doctor/Therapist because they are in pain and do what the authority figure tells them to do because they are told it will take the pain away. They never think to question the doctor/therapist or research alternatives (i.e. other more qualified doctors, alternative treatments) until it is too late and the damage is done.
Blindly trusting someone because they presumably know more about something then you do is dangerous. We allow electricians, mechanics, plumbers to take advantage because they have knowledge we do not. In the end we complain about being over charged and shoddy work. We can end up in dangerous situations in our homes (leaks and structural issue) and when we drive ours cars (believing the brakes work and the fuel filter is clear).

This is bad enough but what is even more terrifying to me is that we do the same with our health. We choose to trust and hope rather than taking the time to gather the information and ask questions in order to make the best decisions. This is the information age. There is no excuse for not thoroughly researching and understanding something when it comes to one’s personal health & well being and that of our families. As a Therapist I always take the time to make sure my clients understand the treatments they will receive from me and that they are armed with the proper questions and information when seeing their doctors. Fear should not be a factor when making a decision, trust should be earned not automatically given. The only way to know if someone is faking is to ask. The results are mutual satisfaction for all parties concerned.