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You Can Get Better: Therapeutic Massage: Next Step to Recovery by Brandon Ellis, LMT
An Immobile Neck Don walked into my office a little skeptical. He was on vacation in Portland for two weeks visiting his daughter. His daughter had told him about the type of massage that I do and she thought I might be able to help him with a chronic condition that has plagued him for years.
As he walked in I could see that he was a strong man, over 70 years old, and still in great shape except for one minor issue—he couldn’t turn his head to the left.
His daughter had told me that Don had been through the ringer when it came to therapists. He had been to physical therapists, medical doctors, massage therapists, and chiropractors for years and with very little results. I could tell that Don was getting a massage simply to please his daughter and yet, as I shook his hand, I could see a glimmer of hope sparkle in his eyes.
“How long haven’t you been able to turn your head to the left?”
“It’s been seven years.”
I gestured for him to take a seat in the chair next to my office window. “Well, tell me what happened?”
He sat in the chair and leaned forward, “I was rear ended seven years ago by a cement truck.” He leaned back against the chair and sighed. He undoubtedly had told this story countless times. “My seat broke from its hinges and I smashed against my steering column. I haven’t been able to move my neck this way ever since,” he said as he attempted to rotate his neck to the left, but abruptly stopped. A grimace of pain appeared on his face.
“Give me four visits,” I said. “And we’ll probably get full range of motion back in your neck.”
He didn’t have much of a reaction to what I said. He just looked at me and nodded with a smile.
I asked him to stand up and turn around. I palpated his upper back and neck to show him which muscles help aid in the rotation of the neck, “These are most likely the muscles I will be massaging.”
I touched his left levator scapula, which is a muscle in layman terms that originates on the upper four vertebrae of your neck and inserts on the inside, upper border of the scapula. It was inflamed and tender to the touch. “This may be the main culprit.” I started to examine his posture. His right shoulder was much higher than his left. This made sense as his right shoulder had been overcompensating in an attempt to balance out the immobility in the left side of his neck. His right shoulder was swollen and obviously inflamed because of this condition.
I touched his right trapezius muscle, “Is that tender?”
“Yes, very.”
I looked down at the ground to gather my thoughts on exactly how I was going to work on him. He had never received the kind of massage that I was about to give him, so an education was a necessary first step.
I looked up at him, “This isn’t going to be a regular massage. You’ll have to work with me. When I tell you to move a certain way, you’ll have to move that way. When I tell you to contract a muscle, you’re going to have to contract a muscle.”
He nodded his head and I continued, “A therapeutic massage isn’t intended to be a feel good massage. It’s geared to help you get better and eliminate most, if not all of your pain. If you have too much discomfort during the massage, then please speak up and I’ll ease my pressure or change the technique.”
I looked straight into his eyes, “You’re going to have to trust me on this and trust that what I’m doing is going to help you.”
I worked on him for a little over an hour, but what occurred after the massage surprised him. For the first time in seven years he had rotation to the left side of his neck. It was only 25% rotation, but it was 25% more rotation than he thought he would ever have again.
He turned his head slowly to the left once more and said, “It doesn’t hurt as much as it did before.” He had a large smile on his face. The little hope he had when he came in transformed into a major breakthrough. He seemed to realize that a full recovery was possible.
Before he walked out the door he shook my hand and thanked me. I told him to ice his neck for 20 minutes a couple of times a day as it would keep down any soreness and inflammation that was created by the massage. “The soreness will likely be gone in 24 to 48 hours.”
I asked him to return for another massage in two to three days. If we didn’t attend to the muscles we had just worked on in a timely manner, his neck would soon stiffen up and he’d be back to square one.
With the second visit to my office I asked how he was doing. He had less pain as he turned his head to the left and I could see he still had 25% rotation.
He lay back on the table and we began the massage. I did the same techniques I performed on him during the first massage and this time, obtained better results. At the end of the session I asked him to turn his head to the left. The look on his face was serious as he reached 50% more rotation and less pain.
I asked him to come back in three days. “Please continue to ice and do some of the stretching techniques that I showed you.” He shook my hand and again smiled his grateful smile.
Three days later he was punctual and ready to go. I worked a little differently this time. I had learned what techniques his muscles responded best to during his first two massages. Because of this, the massage lasted less than an hour.
After the session ended I asked him to move his head to the left. He turned his head and his eyes got really wide when he progressed farther than 50% and kept going until he reached full range of motion.
He touched the left side of his neck with his hand, “The pain is almost gone.” He looked at me and attempted to keep a surprised look off of his face as he continued to turn his head to the left again, “I haven’t done that in years. I never thought I would be able to do that again.” He shook his head in disbelief as he sat up on the table. “That’s amazing.”
I told him to come to my office one more time. I thought it was essential to continue to retrain his muscles to remember the healthy state they were in before the accident. The option of Don coming in for a few more sessions wasn’t available since he wasn’t a resident of the Portland area.
On the fourth and last visit his wife came along. She walked into the office and immediately gave me a hug. “I have to tell you that every time Don speaks about the results of the massage he starts to tear up. Thank you so much.”
“Yes, no problem,” I walked over to my desk and picked up a piece of paper. “I wanted to give this to you guys.” I gave the piece of paper to her and she looked at it curiously.
I said, “I did a little research in your area for practitioners that do the same type of work that I do. Those are their names and numbers. If Don starts to tighten up again, make sure that he calls one of them.”
She nodded, “Yes, gladly.”
Although it’s been a year since I have seen Don, I have been in direct contact with his daughter. She gives me constant updates on the status of his neck. He continues to have full range of motion with very little pain and has yet to contact any of the names on the piece of paper that I had given to his wife.
Sciatica Kallie was in a car accident over a year before she came in to see me. Her medical doctor had diagnosed her with having sciatica, a painful condition resulting from irritation of the sciatic nerve such as an inflamed muscle or a herniated disc pressing directly against the sciatic nerve. The pain from this condition is usually felt from the low back to behind the thigh then radiates to the knee and/or foot.
I had seen sciatica in many of my clients before. It can be a debilitating condition which can cripple a person for a week or longer. Fortunately for Kallie, she wasn’t in a debilitated state.
After the car accident, Kallie’s sciatica pain slowly grew worse. She found it hard to do the simple things such as sitting in her car on the way to work or playing with her two year old son. She tossed and turned at night in her bed which made sleep nearly impossible. She started to walk with a limp.
A half a year later and fed up with this condition, she considered the advice of her medical doctor where surgery was the next viable option. It was then that her chiropractor recommended her to me.
“Give it six visits and we’ll see if you get any better,” I said.
I informed her, just as I had done with Don, that this wasn’t going to be a regular massage. I explained what to expect and what not to expect with the techniques that I use. She looked at me like she already had her mind made up about the surgery.
During the first visit I worked on the very core muscles that can clinch tightly on the sciatic nerve. It was very painful for her. Those muscles had become so tight that it felt like I was palpating a drum. There was no doubt that surgery would have been the only option chosen by her doctor, but maybe, just maybe, I could help change that option. The idea was pushed quickly out of my mind when I saw the expression on her face as I massaged her. She was lying on her back as I worked on her iliacus, a muscle that resides in the fossa of the illium (hip), deep in the abdomen. I had seen this expression before and I started to sweat as I saw the “what in the hell are you doing?” expression on her face. That expression usually led to a one time only visit. And if that was the case, then she wouldn’t get better. The only way out of that type of dilemma would be if she received an almost immediate 50% decrease in her sciatica pain. By the end of the massage I knew she hadn’t reached a 50% decrease.
“How do you feel?” I asked.
“A little better,” she said. I could tell she wasn’t thrilled with the slight result. I explained the benefits of icing the sacral iliac joint and the piriformis muscle. She shook her head no and told me that she didn’t have time to ice, saying, “I come home from work and fix dinner. After dinner I play with my child and by the time I’m done putting my child to bed, I’m ready for bed myself.”
I nodded. I knew that no matter what I said, she wasn’t convinced enough to spend ten minutes on the couch to sit on a bag of ice. At that moment, when I thought she wouldn’t be coming back, she said, “I’ll see you next week.”
“Great,” I said. “I’ll see you then.”
She came in the following week and I asked her how she was doing. She looked miserable.
“I’m in bad shape. I couldn’t get any sleep last night and I’m burning right here,” she stated as she pointed to her right upper buttock. “But for two days after the last massage I was pain free.”
I smiled and said, “Good, now what’s going to happen is you’ll start to experience more pain free days as the sessions continue.”
“Well”, she commented, “whatever it is you’re doing, keep doing it. It’s not fun, but it’s working.”
As the sessions went on I could tell that it was going to take longer than six weeks for her to heal. She wouldn’t ice which can really help in the healing process, but she did agree to the stretching and strengthening techniques that I had shown her.
By about the tenth to eleventh week she was nearly pain free. In between each appointment she gradually improved to the point that her limp disappeared. She would report fewer and fewer days spent in pain between each session. Finally, she reported an entire week without pain.
“Just a little tinge of burning right here,” she pointed to her lower left buttock. “But I wouldn’t call it burning, necessarily. I don’t even think about it anymore. I used to have to concentrate to go to sleep and somehow try to forget the pain. I don’t have to do that anymore. I just go to sleep.”
By that time the talk of surgery had stopped and I hadn’t heard one word about the advice of her medical doctor for a month. She would even skip a week of massages here and there.
Kallie still comes in every now and again with the “whatever works” attitude, but without the pain she once had. She doesn’t limp to the massage room anymore and doesn’t arrive with a worn out look in her eyes. She can now sleep, drive in comfort, and most importantly, she can now play with her son.
A Year and a Half Prior I came out of massage school with the belief, like most people, that chiropractors, osteopaths, and naturopaths offered the best healing options. Receiving a massage was just a way to feel nice, less stressed, and well oiled. Because of that belief, I wasn’t very good at massage. I wasn’t trained to deal with the world of acute and chronic injuries that plagued many of the clients I was massaging. I simply did not know what to do. It was a guessing game for me when I started my practice, and I must have disappointed many clients. It was rare for anyone to come back for a second or third massage and I felt like I wasn’t helping anyone.
That’s when I came upon a man who had been doing massage for about 17 years. He was trained in a style called Onsen Therapy. It’s a technique that focuses on the root of the problem instead of the symptoms.
When I met this man he was massaging more than forty people a week while achieving excellent results. They were results that I didn’t think were possible with massage. I knew that I had to learn as much as I could from this guy—and fast. He wasn’t a teacher in a school so I couldn’t learn from him in that fashion. He didn’t have time to trade massages with me and he wasn’t taking on any apprentices. The only way I could learn his technique was to receive massage directly from him, so I called him up on the telephone. I set up appointments for two times a week for several months.
I had my own health issues, so at my first session, I could hardly move my knee without pain and on a few occasions my knee had locked up. For this issue, he didn’t focus on my knee. In fact, he never touched my knee. I stood next to his massage table as he examined my pelvis. He put his thumbs just above my sacrum and said, “Okay, bend forward and…stop.” He then mumbled something under his breath and added, “Bend forward and…stop.” He took his thumbs off of my pelvis and scratched his chin, saying, “Yep, that’s what I thought. It’s your SI Joint, but we’ll get to your psoas first.”
I hopped up on the table and lay on my back. He put his fingers on the right side of my abdomen and pushed down on my psoas muscle. I could feel a small amount of pain radiating from my psoas down to my knee. He spent about five minutes releasing that muscle.
“Do you still feel any pain radiating to your knee?” he asked.
I shook my head, “No, not anymore.”
Then he said, “Alright, turn over.”
I turned over and he worked on my right SI joint, which is located next to the lateral border of the sacrum. He spent about ten minutes on it, then said stand up and walk around the room.
As I did so, he asked, “How does your knee feel?”
I stood in awe as I asked, “How did you do that?” The pain was almost gone. My knee felt light and free.
He replied, “I’ll teach you. Just watch what I do and ask me as many questions as you’d like.”
During the next session, he took away the headaches that I had had for months. In only four or five sessions, he took away the lower back pain that I had had for years. He balanced me out to the point where I didn’t remember ever feeling so good.
In each session, he’d walk over to the muscular/skeletal chart that hung on the wall to show me which techniques he had just used and would explain how it affected my body.
It took me awhile to be able to use these techniques on my clients, but once I did I was seeing results that I had never seen before. I was as inexperienced and as nervous as ever, but I was seeing client after client getting better and their responses were, “Whatever you’re doing—keep doing it!”
With the tutelage of my mentor, the help of my best friend (who acts as my guinea pig), and my clients who are all my tutors, I see results that are quick, long lasting, and real.
Why do I tell you this? I’m not here to pitch to anyone that I am the best therapist or that my style of therapy is the best around. I still have a lot to learn. In fact, there are therapists in many different modalities that can do what I have described above.
The reason I write this is to give you, the reader, an optimistic hope. Even though you have a chronic condition and are in a lot of pain, there is always a strong possibility that you can drastically improve through therapeutic massage. I see it all the time. You can improve to the point where the thought of “overwhelming pain” or “improving your bad condition” doesn’t enter your mind anymore. Yes, you might have a little ache and pain here and there, but nothing near to what you were experiencing before. You can get to the place in your life where the only thing that crosses your mind is how balanced your body feels, how healthy you are becoming, and how the movements of your body have been radically enhanced.
You can be the next Kallie or the next Don. Or, better yet, you can be the next you.
Brandon Ellis is a Licensed Massage Therapist in Portland, Oregon - OBMT #12645. To contact Brandon, email him at [email protected].