Some notes about pain theory: owies

How do we understand pain? For me it is a little different each day, but today I want to go back to my oldest understanding that I'm aware of. I know about Owie Theory from my mom. I've heard her use it recently to talk about her arthritis in her hands or the bruises she gets sailing, but when I was a kid, I was the owie haver. Owie is a noun, it's whatever it is that occupies painful spaces. It can be chased out with love or by using a bandaid as a physical manifestation of love. Man, those Johnson + Johnson ad execs get the job done! The more I learn about pain in the nervous system, the more I go back to the owie. Today I was receiving some work from a colleague and she was focusing on the pain I still get in my hips 2.5 years after a bad injury. As she found the deep places to work I had this feeling of owies swarming. They were like a nest of little ants or something. As my attention was drawn by her work, I thought of an ant farm. A super-deluxe one I never saw in person. An owie farm all through my hips and low back. They were made of my fear that I would never feel any other way. She changed the angle she was working through and I felt the owies start to walk out. An owie exodus. They marched off my screen. They pushed wheelbarrows and had their gold sewn into the linings of their little coats to avoid theft on the road. As my muscles relaxed, as my joints aligned themselves better with a sigh,  I could feel my body become less hospitable to owies. After she was done, I got up and marched around. I stretched and did funny looking movements that felt really good. I will surely have many more owies in my life but maybe not this weekend.

Self-care moment #1: heat on your neck

I'm using heat on my neck right now while I write this, because my acupuncturist recommends it when you have cold/flu symptoms and I've found that it does help me feel more human, whether it helps me get better or not. Feeling better when you're still sick is great, so I don't care either way.  

 Me using my heat pack on a work break. It's so good, people.

Me using my heat pack on a work break. It's so good, people.

But I'm a massage therapist, so I'm not going to tell you about excess wind and cold/flu stuff, because that's not my training even a little bit, but what I can tell you is that heat on your neck is really great for preventing neck and shoulder tension from getting worse. It won't dig through old tension and move it along the way massage can, but it's really great at preventing the new fresh tension from setting up home. This is my #1 self-care recommendation for clients who are getting ongoing massage for specific muscle tension, because it means that I'm not working through the same surface-level tension each time, we can progress to the deeper stuff in fewer sessions. But there's no reason to not try it before you come in, or preventatively, to keep your neck/shoulder tension down to a duller roar.

Heat feels cozy and can help interrupt some kinds of stressful moments. It also provides a pleasant sensation and so can give your nervous system some relief if you have chronic pain. 

The best tool to use is the one that fits easily into your life, and for me that's the microwave it's-full-of-rice kind. I bought the one I use at the office at good old Cambridge Naturals and I sewed the one I use at home, but you can also make your own by taking an old clean sock, filling it with dry rice and tying the open end shut. Add the contents of a couple of your favorite herbal tea bags and you can call it aromatherapy. You put it in the microwave to heat it up, mine takes about 2.5-3 minutes.

You shouldn't use heat if:

  • you have numbness
  • or an existing burn (including sunburn!)
  • have serious circulatory problems
  • or an active infection
  • If you try using it and it feels bad for any reason, just skip it, your body is smarter than advice from a stranger on the internet.

Chronic Pain and Isolation: Some things I want to say.

Pain cycles and healing processes can be super isolating. There's the practical part where logistics take over -- when I fell and bruised my tailbone a few years back, I couldn't really go out to meet my friend because I had a finite amount of activity I could handle in a day and things like "walk up to my second floor apartment" or "this place is a 7 minute walk from the nearest T station" or "transfer to the Red Line" weren't on the table if I also wanted to have groceries and clean clothes. People in disability and chronic illness communities talk about spoons as the unit of energy required to do various things through the day, and temporarily I was down to necessities-only spoon numbers.

This temporarily was longer than I wanted. It seemed reasonable (though frustrating) to miss the rest of cross-country ski season, but it made me want to scream going to the pool that summer and feeling how few laps I could do. The pool check-in guy would say things like "done already?" or "did you have time to get in the pool?". The pool was full of women more than twice my age swimming for 5 times longer than me. That summer, a formerly acquaintance-level friend became a best friend because she would spend 45 minutes in transit to get to my house and take me for a walk, slowly trudging 0.4 miles uphill with me for cuban fruit smoothies and maybe on a good day we'd take a victory lap 0.2 miles to the bookstore. For a full year, I worked my job at half volume, calculated my spoons precisely each day, went to PT twice a week and did tedious exercises twice a day. It felt like this routine was my new life, that I was now a person who did funny sideways leg lifts and that I was the only person who wasn't out going on fun bike rides or taking circus classes or whatever, and that this would always be true.

I was wrong and my information was terrible. During this period of extreme self-pity, one of my long-term friends was unable to visit me because she was recovering from an injury of her own, stuck in her own isolated bubble in a hard-to-T-to part of town. My physical therapist's office was full of people of all ages rehabbing their own problems and at work I was hearing about peoples' pain and limitations all day, and had been for a career longer than a decade. People tell their massage therapists way more about their limitations and pain than they tell their friends or co-workers and it's a shame because I have amazingly smart and resourceful clients who develop really awesome strategies for healing and working within their limitations. I have a number of clients who all work for the same large company in Kendall Square, and a group of them all had identical hand pain and didn't know it. They furtively fold stretch breaks into refill-their-water or bathroom breaks so that nobody perceives them to be weak or broken, and I sit in my office hearing them all, wishing they could share their strategies or have a stretch-and-share circle.

"I think it's conservative to assume that 20% of people you see on an average day are actively managing some health problems and you just don't know it," I found myself saying to a client a few weeks back and I've been thinking about it since then. Does this sound right to you? It sounds low to me, but I wanted to be a little conservative. Even if it is wrong, which I don't think it is, is anything harmed by behaving as though it is true? Recently there was a flutter on my Facebook wall with equal numbers of my friends scoffing at pre-peeled plastic-encased oranges as a ridiculous convenience food that was destroying the earth and friends saying "this is an accessibility thing, stop judging", and I thought of all my clients who have hand pain bad enough that they can't open moderately-heavy doors and develop creative strategies to get through, perfecting their casual loiter to just follow someone through when another person opens the door. What would it take to live in a world where we regularly easily offered to help each other, where we could find out how to help the people we interact with or care about without it being a big deal?

What should you look for in a massage therapist?

These are notes I made a while ago and never moved to my new website. They're still the standard that I use when I get a massage.

A good massage therapist:

  • is excited about their work
  • talks to you with respect and compassion
  • encourages you to trust your own body
  • works with, not in opposition to, your body
  • treats each client uniquely
  • varies technique and pressure as needed
  • maintains a high level of safety, hygiene, and professionalism
  • keeps a clean and welcoming office space
  • respects your limits and preferences
  • is reliable and punctual

There is no massage therapist who is right for everyone. Find a massage therapist who makes you feel comfortable, respected, and relaxed!

Self-care techniques that might work on the tension you have right now: Headaches!

Pain and tension can come from a lot of different causes. Sometimes there are serious problems, and sometimes excess tension is just excess tension. Here are some self-care things you can try. I make no guarantees about any of these working for you, and as in all self-care, take care of yourself. None of these should hurt, and if they make anything worse, they're not the right thing for you. These are things I would personally do for mild-to-moderate tension in my own body that aren't too hard to explain in writing over the internet.

A lot of headaches have tension as a contributing factor, especially tension in the neck.

  • Try the mad scientist thing: Gently but firmly grab your hair by a handful on either side of your head and gently pull it in a direction that feels good. Mad scientists do this because they know that their skull is covered by muscles and fascia that can hold tension and that melting/stretching that tension away can help them think clearer and relax. Make sure that your breathing is relaxed when you do this. It should feel good, and you should have hair like Rod Stewart when you are done.
  • Using a heat pack can be really helpful. For headaches, the best places to put it include around the back of your neck or on your jaw.
  • Maybe you don't have hair to do the mad scientist thing with, in which case you can do the thing Bugs Bunny does to Elmer Fudd in "The Rabbit of Seville" at the beginning of this clip, right before the mid-century fruit salad thing happens. For added bonus relaxation, soak a big washcloth or small hand towel in warm or hot water and ring it out and then put it on your head and massage your scalp and forehead through it. Work down into your jaw muscles if that feels good too! 

The speech I gave where I revealed my secret massage agenda

Thanks for coming out tonight! I appreciate your patience with my public speaking, as somebody who spends her workday in a quiet room with one person at a time, I'm a little out of my normal state here. I'm excited to introduce my work and I'm even more excited to answer any questions after I'm done.

 

I've been doing massage professionally for 13 years, and I've been a birth doula for 10. Most of the clients I see are experiencing something new or alarming in their health. You wake up and your neck doesn't turn as much as it should, or you have a difficult month and develop a headache that doesn't go away, or some tingling in your hands. Maybe you are pregnant and somewhere in your 5th month, you and your low back are no longer on speaking terms. Massage is super-helpful with all of these problems.

 

Massage can be stressful. It can be healing when you have pain, anxiety, tension, but it usually involves going to a stranger, who may or may not be able to help you, who you may or may not feel comfortable with, and then you get undressed and they touch you. A good massage can feel like a miracle, and a bad one can feel like paying $90 to feel uncomfortable for an hour. 

 

My first massage was both helpful and super-stressful. I thought I was being considerate and groovy and urban in some way by acting like I knew what was happening and not needing anything from the massage therapist, but actually I was just cold and awkward and anxious. After my massage, some of my muscles had relaxed enough that I felt like a bad-ass athlete biking through town later that night. Moving felt easier, and my mind was clearer, but it wasn't one of those healing-miracle hours. 

 

Some clients come in very familiar with massage, knowing what they want and talking to me about it in specific knowledgeable terms, but what I really like to do is give people a great first massage, teaching them what they can expect from me and how massage should feel and what it can do. I love telling people that massage shouldn't hurt, and that I have a lot of different techniques that I can use to accomplish basically the same thing, so if my technique feels annoying or irrelevant, just let me know you'd like me to switch it up. I love sharing my terrible crayon-drawn pictures of draped for massage on my website, so clients know how they'll be covered during their massage.

 

All of us massage therapists are required to do continuing education, so by the time someone is a few years out of school, we all have a lot of different techniques that we can use. Some people get really into one type of massage or energy work, but I've chosen to mix it up so that I can work with a wider variety of clients with different needs. It's important to me to be fully trained to work with my clients through pregnancy and postpartum, or to be able to do orthopedic work with clients who only feel comfortable fully dressed. 

 

Some clients have a lot of anxiety about getting massage because of their size or gender or some other aspect of themselves that they worry I'll judge them for. A lot of men think their feet are ugly, but in 14 years of doing massage with a very diverse client base, I have never seen ugly on a table in any person, except for the one time early in my career a client tried to bully me. Some clients are afraid of breaking my table or being too big for it, and I love that it is engineered to hold 1000 lbs. 

 

Every day I go to work I have my regular agenda and my secret agenda. 

 

MY NOT-SECRET AGENDA

To use massage technique that is evidence-based and kind to help people with their pain that is caused by chronic tension or postural imbalance and give them information and support that is appropriate to their lives at any life stage or state of health where massage can benefit them.

 

MY SECRET AGENDA

To help my clients whose bodies have not been safe or comfortable places find their way home, in a slow, safe way that they are 100% in control of. To help my clients practice experiencing touch that feels good and learn language skills for communicating about touch. I do this in the context of evidence-based, orthopedically-educated massage that respects the mystery and miraculousness of healing. I truly believe this is world-changing.

Problems I Can Probably Help You With (A short list based on questions I get a lot)

  •  I woke up and I can't turn my head. I think maybe I slept funny?
  • I'm pregnant and my back is getting really uncomfortable.
  • My hands are starting to hurt/tingle/feel tired at the end of a day. I'm worried I'm getting Carpal Tunnel.
  • I just started CrossFit/Yoga/Rock Climbing/Glass-Blowing/something else strenuous and I hurt all over.
  • I shoveled over 100 inches of snow out of my driveway and my back or neck or arms really hurt now!
  • My jaw clicks/pops/feels stuck. I can't eat chewy bagels.
  • This point behind my right eye starts hurting just about every day.
  • I think the tension I'm carrying in my shoulders makes my migraines worse.
  • I'm having a lot of stress and it's all landing in my shoulders.
  • My knees hurt when I run.

The Birth Partner Toolkit w/Julia Blencowe! Now you can register!

Do you want to learn to be even more excellent to your pregnant partner? Come and learn:

  • Some basic but awesome massage techniques for common pregnancy woes and for active labor
  • Comfort measures for labor (use them at the hospital or at home!)
  • Positions for labor and birth
  • Self-care for partners

I'm excited to be teaching this class with Julia Blencowe, a birth and postpartum doula in the community who has been providing emotional support to families around their healthcare choices since 2010. She became a doula in 2014 and focusses on helping families stay emotionally and physically healthy during labor, birth and the entire perinatal period.

 

Where: Cambridge Health Associates, 335 Broadway in Cambridge, MA

When: August 15th 10:00am-12:30

How much: $85 per couple

REGISTRATION IS CLOSED FOR THIS CLASS