Kelly Hochheimer, LMT

Massage Articles

Choose an article below:

Back Pain and Massage: How Bodywork Can Help

Implications of Bodywork: Human Touch has Powerful Results

Breath Into Your Massage: Mindful Breathing Enhances Bodywork

Whiplash: Healing a Pain in the Neck



Back Pain and Massage:

How Bodywork Can Help

 Karrie Osborn

 Whether it's a pulled muscle from yoga class or an afternoon basketball game, or a long-term pain caused by injury, most of us will come to know the beast that is called back pain. In fact, when it comes to low-back pain specifically, researchers say that 70-85 percent of the population will experience it at some point in their lives. 

Causes of Pain
Experts say the cause of back pain can be the result of several factors. High on the list is stress. When our body is stressed, we literally begin to pull inward: the shoulders roll forward and move up to the ears, the neck disappears, and the back tightens in the new posture. "It's an armoring effect," says Angie Parris-Raney, a Denver-based massage therapist who specializes in deep-tissue massage and sports therapy. "That protective mode, with the muscles in flex, can even result in visceral problems," she says, where the pain also affects internal organs.

In addition to stress, poor posture, bad ergonomics, lack of exercise, arthritis, osteoporosis, a sedentary lifestyle, overexertion, pregnancy, kidney stones, fibromyalgia, excess weight, and more can contribute to pain.

Geoffrey Bishop, owner of Stay Tuned Therapeutics in Flagstaff, Arizona, says mechanics is the main cause of back pain that he sees in his practice. "It's mechanics, including repetitive use and ignorance about preventative postures, and neglect by employers and employees to provide rest and recovery." The past also plays a part, he says. "Old injuries and traumatic events, left untreated and unresolved, seem to dictate where stress lands in the back as well."

Massage Offers Hope
Those who suffer with back pain know there are no easy answers for chasing the pain away. Physical therapy has proven effective for some sufferers, as has chiropractic and acupuncture, but massage therapy is also making a name for itself when it comes to providing relief. In fact, research has shown that massage can be a great friend to the back-pain sufferer.

"Massage therapists have long treated low-back pain safely and effectively," says Les Sweeney, president of Associated Bodywork and Massage Professionals. "They have done so less expensively and less invasively than is possible with other treatments."

In fact, a study by the Group Health Research Institute in Seattle found that massage was more effective at treating low-back pain than medication. Patients who received massage once a week for 10 weeks were more likely to report that their back pain had improved, and improvements were still present six months after the study. Other research from the University of Miami School of Medicine and the Touch Research Institute showed that massage can decrease stress and long-term pain, improve sleep and range of motion, and help lower the incidence of depression and anxiety that often accompanies back pain.

For Parris-Raney's clients, the length of pain relief provided by massage therapy varies depending on the condition they are experiencing. Getting on a regular massage schedule, however, has really helped her clients manage the back pain, she says. When they go past their normally scheduled appointment, "their bodies know it's time to get a massage again." Whether it's just helping clients get through the day, or reminding the stressed-out office worker to breathe, Parris-Raney says massage can play an important part in back pain relief.

Whitney Lowe, owner of Oregon's Orthopedic Massage Education and Research Institute, says the benefits of massage for back pain depend on the primary cause of the pain. "If it is predominantly muscular pain, then massage has a great deal to offer in reducing pain associated with chronic muscle tightness, spasms, myofascial trigger points, or those types of problems. If it's something caused by a joint alignment problem or compression on a nerve, for example, then the role of massage might be somewhat different, such as helping to address the biomechanical dysfunctions, but not really being able to get pressure off the nerve itself."

Massage Works
When it comes to back pain, there are a lot of options out there. Ultimately, massage, and its myriad benefits, might be a viable answer. For back pain sufferers, Parris-Raney says massage can work wonders. "Massage can help relax the body, relax the psyche, and improve a client's range of motion and circulation to the affected tissues," she says. Not only can massage help directly with the pain, but it can also make life a little easier, too. "Massage lets you tap into the parasympathetic system," she says, "and tap into all the good hormones that help you sleep better and help you handle stressors along the way." All of that helps in building a healthier back and a happier you.

From stress relief to skin rejuvenation, the benefits of massage are extensive. When it comes to managing back pain, however, there are some specific benefits touch therapy can offer:

--Improved circulation. With increased circulation comes faster recovery time for sore, overworked muscle tissues.
--Increased release of endorphins. The prevalence of these natural painkillers is boosted every time you have a massage. This can only help in managing pain.
--Improved movement. Range of motion and flexibility both get a boost with       massage.
--Increased relaxation. When you relax, your muscles relax, thereby calming the pain.



The Implications of Bodywork

Human Touch Has Powerful Results
Cathy Ulrich
Whether in giving or receiving, touch is as essential to human survival as is food. Infants deprived of touch, even when they are getting adequate nutrition, will fail to thrive. Elders isolated by loss of partners and friends become depressed not only because of the absence of social interaction, but also because of the simple loss of physical contact.

We calm our pets by stroking them, we greet each other with a hug or a handshake, and we soothe our children by holding them. No other form of connection is as powerful and universal as touch. Taking a look at how this sensation is connected to the brain provides insight into the significance of bodywork.

Skin and the Brain
The adult human lives inside an envelope of about 18 square feet of skin. Every inch houses thousands of nerve endings and various kinds of sensory receptors, all working to tell the brain about its surroundings. The cold of an ice cube, the softness of a cat's fur, a warm breeze, the caress of a loved one--all of these feelings are possible because of our skin. Our skin tells us about our environment and ourselves. When we touch something with our fingers, we're not only sensing the object, we're also feeling our own skin, our own boundaries.

In the first few days of an embryo's life, the cells that eventually become a fully formed baby divide into three layers. The brain and skin come from the same layer, and they develop together, not only before birth, but well into the first year of life. When a baby is held, cuddled, and breast-fed, she's getting crucial stimulation to build neural connections between her skin and her brain that will ultimately last her entire lifetime.

Study after study has shown that touch is not only important for development, but is crucial to survival. James H.M. Knox of Johns Hopkins Hospital reported in 1915 that babies left in orphanages and given proper nutrition died at a rate of about 90 percent. Other studies of the same era confirmed these findings and showed that those babies who did survive were often mentally handicapped and stunted in their growth. These valuable studies helped institutions understand the importance of touch. When staff was added to provide enough time for each child to be held, handled, and touched, mortality rates dropped dramatically.

Massage for Children
Those early statistical studies showed how vital touch is to developing infants. Researchers are also finding that giving massage to premature infants can improve their growth and overall health. A study conducted by the Touch Research Institute (TRI) at the University of Miami found that when stable premature babies were given five, one-minute massages a day, they gained 47 percent more weight than their counterparts who didn't get massage.

A 2001 study conducted by TRI showed that when mothers gave their infants a 15-minute massage before bedtime, these sleep-challenged kids went to sleep more quickly and were more alert during daytime hours.

Conversely, clinical research and sociological studies link touch deprivation with aggression. A 2002 study reported that adolescents with a history of aggressive behavior showed less aggression and were less anxious after receiving a 20-minute massage twice a week for five weeks.

Massage also reduces the symptoms of Attention Deficit Hyperactivity Disorder so kids can concentrate better, and it's even been found that the right kind of touch can help kids with autism relate better to teachers and family members.

Massage for Adults
Ongoing research by the Touch Research Institute continues to prove that massage is an important therapy for many conditions. After a massage, levels of the stress hormone cortisol drop in saliva tests, examinations show an improvement in alertness and relaxation, depression scores decrease, and mental focus improves.

The exponential growth of the bodywork field is a testament to the value of safe, therapeutic touch. Of course bodywork can play an essential role in the healing of specific chronic or acute orthopedic conditions, but it also serves as a powerful aide in improving the quality of life for adults.

Stan, a former client, was going through a nasty divorce. He had friends to support him emotionally, but it seemed that the thing he missed most was the nurturing touch of his partner. He credits weekly massage appointments, along with seeing a counselor, to his emotional recovery. Massage can be a healthy way to get that much-needed human contact.

Massage for Elders
People confined to nursing homes rarely get more than daily hygienic care in terms of touch. Yet elders need touch as much as infants, studies show that when they receive regular massage, the elderly have less depression and anxiety, experience better physical coordination, and show a decrease of stress hormone in their saliva.

Geriatric massage is a growing field requiring specialized training, and many massage therapists offer it in their practices. Some nursing homes now provide massage to their residents. Elders appear to respond as well to bodywork as, if not better than, their younger counterparts.

Contact for All Ages
Before babies learn about their hands and feet, they need the touch of loved ones and caregivers. We retain that need our entire lives. Remember to savor touch the next time you're lying on a massage table. Your therapist is not only working out tight muscles, she's contacting your entire nervous system, calming you through pathways that were put in place before you were born.



Breathe Into Your Massage
Mindful Breathing Enhances Bodywork Benefits

Cathy Ulrich

Mindful breathing brings an individual back into their body, facilitating presence and relaxation. During her massage, Elaine was having trouble relaxing, continually talking about all of the stressors in her life. I took a deep breath and asked her to do the same. Suddenly, her body relaxed and I finally felt her respond to the work I was doing. So, what shifted with that simple suggestion?

In The Moment
Elaine was thinking about the stresses in her life instead of where she was at the moment. She was in a safe space, receiving gentle, supportive bodywork. And yet she couldn't relax. By simply asking her to be mindful of her breath, she immediately felt her body and became present with me in that space. Many meditation traditions use the breath to quiet the mind. With mindful breathing, we're suddenly thrust into an awareness of our inner spaces and a feeling that we actually do live in a body.

Reduce Pain
One of the first things expectant mothers learn in natural childbirth classes is breathing techniques to help control labor pain. By consciously breathing during contractions, they learn to shift the feeling of pain to just sensation. Elaine came to see me because she had chronic pain in her foot, knee, and hip. Often chronic pain sets up as a vicious cycle of muscle tightness, impaired blood flow, and more pain, even in areas distant from the original problem. When I asked Elaine to send her breath to the foot, she changed her feeling of pain to simply sensation and this opened a door that allowed me to change the holding pattern in her tissue. Of course she couldn't physically breathe into her foot, but the imagery of sending warm, healing breath into her foot from the inside while I worked on it from the outside changed her relationship to the pain. Try this simple technique yourself. As you tune into your breath, notice your body. Is there discomfort or pain? Being actively aware of your breath during a massage enhances the benefits of your session. Breathe in, and think of filling your lungs with healing oxygen. Now breathe out, and imagine sending this warm, healing oxygen directly to the place that hurts. Continue gently breathing into the area for a few minutes. What does it feel like now?

Relieve Stress
When I worked with Elaine, I noticed that the more she talked about her stressful life, the shallower her breath became. She was breathing high in her chest in short, rapid breaths. Her mind had transported her back to her stressful life, even though she was in a place where she was supported and encouraged to take a break from that stress, putting her body into a fight-or-flight response. One clear manifestation of this is rapid, shallow breathing. While stress can produce this breathing pattern, the good news is that we can consciously change the breathing pattern and reduce the stress. It works both ways. As I asked Elaine to slow her breathing and take deeper breaths, the tension in her face softened. Her body relaxed on the table as if she were sinking into the padding. Her feet became warmer, a sure sign that her circulation had changed and that her nervous system had switched from fight or flight to the calming mode of rest and digest. Try this for yourself. The next time you're feeling stressed, stop for a moment and notice how you're breathing. Is your breath high in your chest? Is it fast and shallow? Now, gently invite your breath to slow down. Start to pull breath into your lungs by letting your belly relax and expand as you inhale. Spend a few moments with yourself and your breath and look at the stressful situation again. Does it seem so bad now?

Your Massage
Receiving a massage does involve participation on the client's part. While the practitioner is the expert on the bodywork, the clients are the experts on their bodies. In our culture, the client/therapist relationship is often a check-your-body-at-the-door affair. But so much more can happen when the client works with the therapist. The next time you go for a massage, try these suggestions to achieve mindful breathing and enhance the benefits of your session:
- As you settle onto the table, feel the weight of your body on the table and begin to notice your breath.
- Feel your breath moving of its own accord. Where is it most noticeable? Bring into the spaces that feel less full (without effort--just invite).
- When your therapist starts working, notice the pressure and rhythm. When your practitioner lets up on the pressure, breathe in. When she/he applies pressure, breathe out.
- If your practitioner comes to a tender area, pay special attention to your breath. Work with the tenderness on the exhale, imagining that you're breathing out the pain.
- As your therapist works on different areas, imagine your breath moving there to meet her. Send your breath wherever she is working. Let her work on the outside, you work on the inside.
- Notice the changes as the massage progresses. Notice your thought patterns. Notice your comfort level. Notice your stress (and how it melts) as you send breath to the various areas of your body.
- When your session is complete and you sit up, notice how your breath feels. What do you notice about your body, the room, the light? Why not use the lifegiving force of breath to make your next massage an even more beneficial experience. Just breathe.

Whiplash: Healing a Pain in the Neck
Hope Bentley 

Getting rear-ended in traffic. Face-planting at the bottom of a ski slope. Tumbling over the handlebars on your bike. Whiplash comes in many forms and can become a long-term problem if not treated correctly. Fortunately, massage and bodywork can address the ache and discomfort that come with whiplash and prevent chronic pain down the road.

Understanding Whiplash
The term "whiplash" came into use in 1928. Doctors will sometimes use "hyper-extension injury," to describe it, but "whiplash" is a more visceral account of what has happened to the victim's neck. The neck itself has made a whip-like motion bending first toward and then away from the point of impact. As the head moves rapidly in one direction, the muscles in the neck receive the message to contract. The momentum of the head can cause strain or sprain to the muscles and ligaments in the neck as the head reaches the end of its movement.

Car accidents are the most common causes of whiplash. The American Academy of Orthopedic Surgeons reported that about 20 percent of people who have been in rear-end collisions later report whiplash symptoms. Whether front to back or side to side, whiplash can affect muscles all the way into the victim's back and arms. The most serious form of whiplash compresses nerves in the neck and cause multiple sprains of the ligaments.

The good news is, serious hyper-extension injuries are in the minority, as whiplash usually comes in the less serious version of the injury. "Fortunately, about 95 percent of the time whiplash tends to be more superficial damage, like slight muscle strains and tears," says Ben Benjamin,Ph.D., a massage therapist who holds a doctorate in education and sports medicine. But whether the pain is minor soreness or serious discomfort, massage can provide relief and prevent chronic problems in the long run.

Whiplash injuries can lead to headache as well as neck, jaw, and back pain.

Whiplash Symptoms
The symptoms of whiplash include neck pain and stiffness, headaches, pain in the shoulder or between the shoulder blades (sometimes called "coat hanger pain"), low back pain, and pain or numbness in the arms or extremities.

Often people who suffer whiplash do not feel the effects until two or three days after the injury-causing incident. Benjamin explains that this delayed onset is because it takes time for scar tissue to manifest in the sprained or strained muscles and ligaments. And because scar tissue is more adhesive
than regular tissue, people experience it as stiffness in the injured areas.

Whiplash affects primarily the neck, but victims shouldn't ignore the rest of the body. This injury can pull the long muscles on either side of the spine, which reach all the way to the tail-bone and can cause discomfort along the way. Discomfort or stiffness in the chest and arms can also be due to
whiplash. And headaches may be the result of slowed circulation to the head caused by the swelling in the injury.

Massage Can Help
Any massage that causes a general relaxation of the client's muscles can help relieve muscular pain in common types of whiplash injuries. In addition, massage increases the amount of oxygen that reaches the healing tissues and opens those tissues so they can receive oxygen and nutrients, thus speeding the healing process.

In addition to relaxation massage, specific bodywork methods ease acute whiplash discomfort and help prevent chronic fallout. For example, myofascial approaches restore fluidity to the fascia--normally a slippery tissue that surrounds all the moving parts inside the body--allowing freer movement of
muscles and ligaments. Friction-based massage helps break up scar tissue and relieve stiffness. Trigger point therapy works by releasing tension held in tight knots of muscle. And any type of bodywork that stimulates circulation helps ease and prevent headaches.

Finally, the incident that caused the whiplash in the first place, (a car wreck, for instance) can be traumatic. Massage helps relax a client's psyche as well as their muscles, helping her or him work through the emotional issues induced by the accident.

Because the neck is such a delicate part of the body, it is important to proceed with caution. Benjamin advises waiting a few days after the accident to seek treatment. This allows the initial scar tissue to knit, which is an important part of the healing process. The initial treatment should be extremely gentle, and if there is a chance of a fracture, a concussion, any disc problem or other serious injury, the client should make sure to see a physician first.

Let the Healing Begin
It used to be that physicians would immobilize whiplash injuries with a cervical collar, but now health care professionals advise a more temperate course for their patients. "I recommend gentle neck movement within your range of motion while lying on a pillow," says Benjamin. Movement may help prolong the benefits of the massage by continuing to circulate blood, oxygen, and nutrients through the healing tissue. "Heat or cold, whichever feels better, can also help," says Benjamin. "Soaking in a hot bath can also be beneficial." Limiting physical activity for a few days and getting plenty of rest in the
wake of a whiplash injury is also a good idea.

Whiplash is traumatic and should be addressed soon after the injury to avoid any chronic problems. If you or someone you love is suffering from the repercussions of whiplash, consider a bodywork session to ease the discomfort. Massage can help lessen muscle pain, induce relaxation, and ease the trauma often associated with whiplash. You'll be back to your old self in no time.

Bodywork has an arsenal of methods to treat whiplash injuries for a full recovery.