You know those little aches and pain you’ve been living with? The ones that prevent you from living your fullest life? The it’s-because-I’m-fourty (or 50 or 25, whatever)-now aches? The I-sit-at-a-desk (stand, squat, whatever)-all-day aches?

I’m on my soapbox to caution you not to be too hasty to blame your age, or the chair you command each day, or concrete floor you stand on for hours, or the neighbor’s goat (just in case you were looking for a scape goat).

Instead, get stronger. Learn how to lift weights to improve your muscular strength. Learn how to use your own body weight to strengthen your “core”. It’s outside my scope of practice to teach you these skills, so I highly recommend using a personal trainer.

It’s also against my best interest to advise this. Clients who have taken this advise don’t come to me for massage very often anymore. They come occassionally for relaxation and if they sustain an injury. But those little, nagging, “chronic” aches and pains? Gone!

It doesn’t seem like it would take a tremendous amount of strength to sit at a desk all day and mouse away. But it does. It doesn’t seem like maintaining excellent health at 30, 40, 50, 60 (and so on), would require tremendous strength. But it does.

Get stronger. Live longer.

Back to school & back to structure. It’s time to harvest the last of the garden, get in shape with fall sports, and plan for a winter vacation somewhere tropical.

What does all this have to do with massage? Plenty!

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• Returning to school means reading for hours and lugging around a ton of books. Massage is great for tense shoulders.
• Harvesting means the dirty work of of weeding and mulching. Massage can untweek the back, knees, and neck.
• Fall sports like soccer & marathon training mean lots of running. Massage is great for the athlete and the weekend warrior.
• Planning that tropical vacation may give you a headache. Be sure to get a massage before leaving so you can enjoy the sun and umbrella drinks without pain!

The knee is the largest joint in the body, working like a hinge to offer flexion and extension of the leg. The joint is found where the femur (thigh bone) meets the tibia (shin bone) and is strapped together with strong ligaments that help prevent side to side movement and rotation when the knee is straight.

The joint is protected by a capsule filled with synovial fluid for lubrication and menisci (cartilage) to cushion between the bones. Covering the joint is the patella (knee cap), a disc shaped bone embedded in the quadriceps muscle group which allows the muscles better leverage for powerful leg extension.

Most sudden, acute injuries to the knee involve the ligaments that support the joint. One common injury is a tear in the ACL (anterior cruciate ligament), which happens when the foot is firmly planted, but the body continues to pivot. The knee twists and: Pop! Surgery is often recommended and successful. Other injuries may require “only” immobilization.

Therapeutic massage can not directly treat injuries to the bones  of the knee joint. However, it is a very effective part of rehabilitation to help restore flexibility, reduce pain, and prevent the effects of chronic pain, described below.

Chronic knee pain is pretty common. People who are overweight often struggle with knee pain due to the extra weight bearing on the joint. Overusing the thigh muscles, especially from athletics, can allow trigger points to develop which refer pain into the knee area. Muscles that have been underused (i.e. immobilization after an injury or surgery or lots of sitting ) can also develop trigger points – especially in the quadriceps – that refer pain to the knee.

Skilled massage can be used to discover and release the trigger points, reducing pain and increasing function. With a little instruction, clients can continue to self-treat trigger points to manage or eliminate pain. When your joints are less stiff, it is much easier to maintain a fitness routine, which can improve your quality of life.

So, from where does low back pain arise? Certainly it can have its origins in the low back, an area generally defined by the lumbar vertebrae and the sacrum. Low back pain can stem also from the hamstrings, especially in people with limited flexibility. The hamstrings are attached the ischial tuberosities (“sit bones”) which are indirectly part of the low back. Pain can also be referred to the low back from the anterior (front) hip muscles and even the abdominal muscles. For example, the psoas (pronounced “so-as”) muscle is attached to the anterior of the lumbar spine and if it is chronically tight or holds trigger points, can pull the vertebrae forward, causing discomfort or pain. Weak abdominal muscles can put one at risk for low back pain.

The causes of the tight muscles or trigger points that eventually cause pain are numerous. Injury from a car accident, a slip on the ice or an overzealous workout can cause pain. Loss of flexibility from too little exercise or movement can affect the low back. Back surgery can leave you with relief of one problem, but can also cause new pain. Back pain can also have its foundation in a skeletal problem or may be a symptom of a disease. Remember to include your physician in the dialogue about your pain treatment and be sure your massage therapist is aware of diagnostic testing you have had and their results.

Patients and their supporters dealing with pain are invited to attend the community portion of the conference on Sunday April 5th. Here access to the application if you want to register to attend.

My friend and colleague, Jim Dwyer, an attorney at Heiling Dwyer & Associates, is a great source for personal injury information. One of the things he likes to educate people about is revealing to your health care team any information about current and old similar injuries. That old back problem from college soccer, the car accident in ‘98, and the foot pain you were experiencing two months before the accident are all important to document.

“Honesty and candor are critical to a full recovery and a successful claim.”

A group of about 20 eager students, all with arthritis, attended the hour long presentation. We had a cross section of the general arthritis population represented in this small gathering. They asked great questions and a few were brave enough to allow me to demonstrate some techniques.

The Adult Center facility has a very helpful staff and everyone made me feel welcome and appreciated. Thanks LOAG for the chance to speak with you all.

In order advocate for the patient as best I can, I bill the auto insurance company and communicate with the patient’s attorney and physicians. Here’s a tip (#286) from my experience:

Beware the IME. Your auto insurance company may request (require) you to have an “independent” medical exam (IME). Although perfectly legal and often standard practice, such a request is a red flag that demands your attention. If you do not already have a good personal injury attorney working for you, it’s time to get one. If you do have a PI attorney, alert him/her to the IME request so you can be guided properly through it. People on your medical team who are advocating for you will also want to know of this development.

If you have any questions about being treated with massage for recent MVA injuries, feel free to call me at 503.516.2108. Or visit this page within my website.