Petra what? An in "depth" look at modalities

A Therapist greets their new client, and they exchange information about what kind of massage the client wants to get that day. The client says "deep tissue". Hold up...what is does someone mean when they say deep tissue? Do they even know what they are asking for? Deep tissue is exactly what it says it is; a series of massage techniques that access the deep muscle tissue. There are no therapist's elbows exiting out of the front of your body, or pain that makes you hold your breath or makes you consider punching your therapist. No seriously, it shouldn't ever feel like that. After warming up the tissue, by increasing circulation and kneading the tissue you are introducing yourself to it. Saying hello, you can let me in. Otherwise you meet up with spasms, muscle rejection and running the risk of hurting a person. Once you have established yourself, you can then begin sinking deeper into the belly of a muscle as a client breaths you in. You can strip them, deactivate trigger points, you can stretch their fascia and break down adhesions. There is a process that takes place, and it does so on multiple layers of muscle tissue. Then comes an elbow, forearm, edge of a hand, thumbs, fingers or a palm. A nice solid and slow drag is applied and *wa la*, you have just witnessed a little deep tissue going on.

Myofascial work is work done on, in, around and involving the fascia in the human body. What is fascia you ask? It is the connective flexible tissue that sits between your muscles and skin, bone and muscle and runs through the muscles, and it is found EVERYWHERE in the body. It also surrounds blood vessels, and nerves. Have you ever cleaned a chicken? You know that very thin layer of what seems like skin that is between the skin and muscle? That is chicken fascia. Fascia can bundle around scar tissue, hypersensitive points in the body, dysfunctional postured muscles...binding those things and creating dysfunction in the tissue itself. Because it also surrounds nerves and is considered the endless web of the body, when fascia in one area is dysfunctional, it creates a ripple effect in the rest of the body. This results in pain, fascial bundling and dysfunction.


The work itself is almost always done without using oil. It involves using a strong drag on the skin. You may drag the tissue oppositely (if that's a word), using two hands in close proximity to each other, or you may drag it to wherever you want it. You drag it until it stops dragging and then you hang out. Once your hand begings moving again, it means that fascia is releasing. You can also use forearms, or elbows. Heat also helps to warm the fascia, which results in the tissue sort of liquefying. After it cools back down it will reform into its original composition. Myofascial work is simply amazing.
Just a quick story about a very neat moment I had with a client. We will call him Joe. Joe was a retired police officer who was in his mid 60's. He woke up that day with awful back spasms that were hurting him so bad he admitted to crying. He came to see me begging for me to do something and not wanting to turn him away, I agreed to work on him as long as he was comfortable during the session. After getting him into a comfortable position, I started out with some deep diaphragmatic breathing and heat. Initially he was so uncomfortable that more than the resting weight of my hand on him was too much. As I began his MFR treatment, he spasmed a few times. I was persistant and kept working, gently, and intentfully on his back. I worked very slowly and gently on this man and as we worked together over the next hour, amazing things happened. First he breathing changed, then his reported pain level began dropping. His spasms subsided, and I was able to get in a little light massage. 6o minutes later, he stood up cautiously, but a new man. He had no drugs, no expensive Dr's bill, and as I later found out, no reoccurrence of this pain or those terrible spasms. He was in complete awe and appreciation, and I was feeling relief for him and thankful he trusted me to help him. I believe in the power of massage, and yet I think I was a little stunned at what had just happened. I always start a massage out with MFR.

"Trigger Point Therapy was pioneered and developed in this country by Dr. Janet Travell, President John F. Kennedy's personal physician during his years of persistent back pain. Today it is commonly referred to as Neuromuscular Therapy. This is another favorite of mine.

A trigger point is a hyperirritable tender spot in an abused muscle that refers pain ("triggers" pain) to other muscles. This is why the pain in your head may be coming from a neck muscle and the pain in your neck from a shoulder muscle and the pain in your low back from a hip muscle.
If the trigger points are not treated, they can be the culprits in lingering pain even after an injury has healed, and the reason why the headache, neck ache, and backache keep returning year after year. Some of the causes of trigger point activity in your muscles are stress, excessive chilling, injury, overuse, strain, as well as chemical, drugs, alcohol, and environmental pollutants. Active trigger points keep the muscles tight, restricting blood flow and compressing nerves perpetuating a vicious pain-spasm cycle in the muscles. The effect of decreased flexibility limits movement encouraging postural patterns which may sustain the cycle for years. Trigger Point Release Therapy is a valuable component of preventive as well as rehabilitative care. Some of the neuromuscular therapy techniques, also referred to as neuromuscular re-education, are:
Joint and spinal manipulation (by Doctors)
Spray and stretch (by Physical Therapists)
Frictioning across the muscle fibers and ends of muscles
Shaking, stroking, and stretching of muscles and fascia
Joint movements, isometric exercises and stretching
Direct pinpoint pressure on the trigger point
Release of associated skin, tendon, and ligament trigger points
Myofascial Release
Fascial Smoothing"

References: Myofascial Pain and dysfunction, The Trigger Point Manual, Volume 1-2.

Now that you have a better idea of what these terms mean now, isn't it time to schedule that massage?

Creative ways to tip

So what do you do when it gets to be that time when the massage has ended and it's time to pay for your (hopefully awesome) massage? After you have your jewelery back on, you've fixed your "do" and it comes to that sometimes ackward moment of tipping; what's YOUR next move? Perhaps you weren't able to stop at the ATM, or maybe you just aren't really sure how much you should tip. Do you tip every time, or only once and awhile? Do you even "need" to tip?

Thus has come the question I have heard a million times. "So how does this tipping thing work?" It's a very subjective thing, but the most ackward part for the therapist is being put in the position to tell someone what they ought to pay you as an extra thank you. Although tips are not required, they are appreciated. As with any tip, this decision, of course, is based on the quality of service received. I was never really sure what to say without feeling like I might be lowballing the experience, nor did I want to seem like I was taking advantage of anyone either. Then one day, after I was finished with my client and we said our good byes, I walked back in the treatment room and found a beautiful potted plant she had left for me. AH HA! This was the perfect idea!! I was absolutely thrilled. I knew she appreciated me and all the hard work I had been putting into our sessions together. The plant still sits in my home and every time I look at it; I remember my client and the smile her generosity put on my face.

The conversation has come up between myself and other therapists and we have all come to the conclusion that we love non conventional tips as much as we love recieving money. Here are some of the tips associates and or I have gotten and would be delighted to recieve in the future.

A bottle of wine
Massage goodies- oils, new equipment, reflexology nubbies, a blanket
A gift card to a favorite cafe or restaurant
Books
A potted plant
A donation to a favorite charity
Coffee beans
Candles
Artwork
Music
Movie tickets
A weekend getaway for two (MY FAVORITE GIFT EVER!)
Here's some irony, a gift certificate for massage :)
A gift certificate for a manicure/pedicure
Fresh organic veggies or fruit
If you offer a service, a complimentary service
Scarves
Fancy makeup
etc etc etc...

Whether its big or small, expensive or inexpensive, it is always appreciated. So the next time you have had a great massage and you want to keep that $ tucked in your wallet, use your creativity!

Hot stone massage? Yes please!

We've all seen the iconic picture with some lucky person laying on a massage table, hot stone arranges perfectly on his or her back.

While it's gives you a totally false pretense on what to actually expect during a hot stone session, you still feel relaxed just looking at it don't you? Heat is wonderful. So what really happens during a hot stone massage and what does it really look like? Hot stone massage started about 5,000 years ago in India, as an Ayurvedic practice; spreading to other cultures and regions. Each culture recognizing heat's powerful ability to relieve pain, tension, emotional stress, and other infirmities. Truly, it is an ancient practice for modern day stress.
During my hot stone class this summer led by John Stickel (who is an AMAZING teacher and therapist) we spent time balancing tiny warm stones in between toes, learning the flip -n- flow of a proper hot stone session and spent several blissful hours practicing this on eachother. The rocks aren't your average stones, they are basalt river rocks which are very smooth and dense. You will also find they are the perfect heaviness which feels really great when they have cooled enough to sit on your skin. They hold a tremendous amount of heat and are perfect for the job. The next key ingredient in a hot stone massage is hot oil. Yes, I said hot oil, and lots of it. The principle is to get as much oil on the client as possible to provide a nice glide for the hot stones to quickly slide over. The heat from the stones emanates a bright burst at first, and then mellows down to a nice warm radiant feeling. Your tissue literally melts under the heat (ok not literally) But one thing is for sure. It is amazingly relaxing, and you are guarenteed to drool. It's like getting into a hot tub and letting the heat suck the stress out of you. The therapist will work in a purposeful pattern suited to your needs and might even spend some time positioning stones in a particular area that needs some extra attention.
What I have found when praciticing hot stone treatment is how quickly relaxation is achieved, and how hard it can be to rouse a client after a session. I am flattered when someone falls alseep, as it assures me I have done my job well. It is also extraordinarily useful in warming the tissue for direct treatment work that may take several sessions of manual therapy (using only the hands) to achieve the same depth. What a nice way to encorporate something new in massage and a great way to be pampered.