Very broadly speaking, I provide 4 categories/levels of care; General Wellness Care, Acute Care, Corrective/Restorative Care, and Maintenance Care.
Each person is unique and requires a unique approach. And even as such, each individual may have different needs at each new session. Thus, I start each encounter with “What Can I Do For You Today”? I want to know what has brought you in today. If it is an ongoing issue, I want to know what has worked and what has not worked with everything you have done and tried, with your last treatment session (here or elsewhere). If it is a new issue we will explore what may have led up to, and contributed to, your current complaints. Each of the levels of care, General Wellness Care, Acute Care, Corrective/Restorative Care, and Maintenance Care, may be approached independently, but more likely, together, to create the most ideal support for your current goals. Lets take a look at each category.
General Wellness Care
“An ounce of prevention is worth a pound of cure” as the old adage goes. It is certainly true. General wellness care is something you make a priority because it makes sense. Instead of waiting until a problem arises general wellness care helps reduce the potential for problems to occur. In terms of your massage therapy session the goal would be to increase flexibility and circulation, which should reduce hypertonicity (tightness) of the muscles, break up adhesions (stuck tissue), which will increase range of motion in the joints and limbs. All these things go a long way to helping prevent future problems. When your muscles are able to relax to their normal resting length/tension you are less likely to become injured when lifting or performing other activities of daily living. When your circulation is optimal you will have healthier tissue, less discomfort, better energy, improved repair and renewal of your tissues, improved sleep (which is vital for repair and regeneration), improved mood and alertness.
Acute Care
When a injury occurs massage therapy can help the body heal quickly and as fully as possible. Any injury to the body puts into play many courses of action from inflammation to activate a immune response, neurological to inhibit use of the area (forced rest for recovery), and compensative mechanisms (eg; other muscle groups taking up the slack). Therapeutic massage provides help by helping the lymph system deal with dead and damaged tissue removal, removal of infection and immune complexes, lactic acid. Therapeutic massage helps overburdened muscles that are compensating for the inured area. Therapeutic/ neuromuscular massage identifies and releases trigger points (hypertensive areas) in the injured and compensative muscles/tendons/fascia. Trigger points may last indefinitely if not correctly treated causing less than optimal muscle function, referred pain, faulty joint alignments/tensions/function. Therapeutic massage can help maintain range of motion of the joint/limb while healing. (a good example of this is with a shoulder injury that can take months to heal. If shoulder range of motion is not maintained it may be lost). Therapeutic massage helps bring in fresh blood and oxygen along with nutrients to help the area repair and heal. Massage can also help reduce the pain and discomfort, not only for the area of injury, but for the whole body. Any injury presents a stress, both emotionally, and internally/physically. Massage is very helpful for reducing this stress and goes a long way to helping the healing process.
Corrective/Restorative Care
After the acute phase the body can either be healed or enter a state of chronic dysfunction. Chronic dysfunction means there is always some remaining issue resulting from the injury. It may be a constant or intermittent achy feeling, maybe range of motion is not as good as it used to me. It may mean you are more prone to re-injury of the area than before the initial injury. Chronic dysfunction of a inadequately healed injury can, and often does, result in a compensation pattern that itself becomes a chronic pain or weakness. An example of this is a knee injury that changes the way you walk for an extended period of time. Over time the compensatory muscle patterns that set in change the way you walk and the position of the hips and low back which can cause sciatic type of pain or even chronic neck pain. The other knee may start having problems, or the ankles. Muscle imbalances that affect the positioning of the joint may lead to arthritic type of complaint in that area or create trigger points that begin to set up other compensation patterns.
Therapeutic massage along with corrective exercise training can help correct chronic dysfunction. When I am working on the body I am looking at it in terms of balance. What is the length/tension relationship of all the muscles controlling the joints, limbs, torso? What is tight and what is lose? Are there trigger points involved? Are there scar tissue restrictions? Where is the pain and how is the person compensating? What activities of daily living are contributing to these patterns? Various massage techniques are employed. Trigger point therapy, scar tissue/adhesion release, circulation, mobility via active and passive range of motion exercises and muscle energy techniques. By reducing the hypertonic muscles, releasing scar tissue, etc, corrective exercises to strengthen the weakened areas can be more effective. There is a rule in physiology that essentially states the opposing muscle groups to a hypertonic muscle group will be weak and stretched, or vise versa . What this means is, if your core and abdominal muscles (stomach) are weak and inactive from lack of exercise/poor lifestyle choices/C-section birthing/or any other reason, the back muscles will be tight and overpowering. So to try and do abdominal strengthening (core exercises, sit ups, etc) will not do much for the abdominals, and will most likely cause back pain, unless the over tight back muscles are first release/relaxed. Often times I see with chronic low back pain the muscle imbalance I have described, weak core and tight back. When the person bends over to lift something the abdominals are not able to stabilize the hips and a low back spasm occurs to try and stabilize the area. When massage and corrective exercise are properly combined it can be very effective in helping to correct a chronic injury or pain pattern.
Maintenance Care
Maintenance care is similar to wellness care except with more emphasis on maintaining specific areas that had previously been involved in injury or chronic patterns. In my experience I have seen areas of injury that have healed are often more prone to injury/reinjure than those that have not been injured previously. This brings us back to the first principle I mentioned about a ounce of prevention. This is where your investment in yourself pays off.
Putting it all together.
So when you come in for your next session I always ask what is going on. Maybe this week has been the week from hell and your nerves are fried, you haven’t been breathing optimally, and you simply need to chill out, breathe, release the tension and stress. In this case we’ll put on some chill out music, keep talking to a minimum, and do a full body Swedish Massage to whisk the stress away. In this case deep tissue work would only add additional stress to the body.
Or maybe we need to focus specifically on the neck tension that’s been causing a headache all week along with tight shoulders and back. It may be the hip pain or low back pain that’s had you all week. We can either focus the entire session on all the surrounding areas to work out that issue, or we can incorporate a bit of both, relaxation with focused deep tissue therapy. It is all totally up to you and what your goals are. I will always listen and discuss your options to give you the very best session for your specific needs. To continue your progress in between sessions I can recommend stretching and strength exercises to help you. Individual strength training sessions are available as well to help you with your home program.
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