Body Mechanics Orthopedic Massage

Body Mechanics Orthopedic Massage
Manual experts for your body. Life is too short for limits.

Friday, September 27, 2013

It is running season, how about a little foot pain??

It's every runner's nightmare:  waking up one morning and feeling a stabbing pain on the bottom of the foot near the heel. Plantar fasciitis affects around 2 million Americans a year, and it's not just limited to runners. Anyone who is bearing extra weight on their feet, who has body-structure problems, is over-training, is pregnant, or has compounding injuries could be at risk. 
If you search the internet you will find loads of boots  and strange supportive gear that help you deal with plantar fasciitis after it appears. Doctors might prescribe pain killers, anti-inflammatories or cortisone injections to help you deal with the pain.  All these things are geared strictly to managing the problem. They are a mere band aid in for something that many people find literally debilitating.  
The plantar fascia is located on the bottom of the foot. It stretches from the heel to the ball of the foot, supporting the muscular arch above as well as interlocking bones. Technically, plantar fasciitis is billed as an inflammatory condition, however it's not that the body is randomly creating inflammation---rather, the inflammation is being created at the heel in order to try and repair the micro tearing that is occurring there, In truth, the problem is actually over-stress or tearing of the delicate foot fascia. and the inflammation is just a symptom. 

So here is the skinny. Understanding this problem for your body is key. The tissue on the bottom of the foot is very delicate when you compare it to the things it's being asked to do. The plantar fascia is not an isolated tissue, it is one small part of a long chain of tissue that runs from the top of the back of your body, down to the tip of your toes.  Picture this tissue as something like how, when you tie a rope around a box, it helps stabilize the box wrapping the whole way around If for some reason the rope were to get shorter, things would become uncomfortable for the box....there would be less and less space until finally the tension would be so great that most likely the rope would begin to fray at one of the corners (just like your heel) in order to create more length. That is exactly what is happening to your foot. The rope is tearing at its weakest point. When you have injuries that thicken the tissue and make it less contractile, or add extra stress to the "rope",  it is at risk for damage. 

By the same token, slackening the 'rope' can take pressure off the weaker tissues. Adding length to your
visual of the 'rope'
hamstrings and calves takes pressure off the bottom of the foot. Treating plantar fascia issues is a two-fold process. You must examine what caused the flair in the first place. Is it too much tension? A structural defect? Training?  Extra weight? Or is it another muscle pulling it tight?  The second step is to create less pressure on that plantar fascia by lengthening the tissue on the posterior chain, which will decrease the inflammatory reaction from the micro tearing. Professionals in sports medicine, physical therapy, massage and orthopedics can help you with the various parts of this painful problem to get you back on track, but I have also seen a good number of people help themselves
 once they truly understand the problem. A good foam roller and a trigger point ball are always a good investment for preventative care if you know you are prone to this malady. Once this is done and the cycle is broken, it is essential you give it time to heal...after all time heals all wounds.  If you are experiencing problems that are diagnosed or that do not resolve, it is very important to visit your primary care physician. 
For more info visit
or see our sports massage program in NYC
By Beret Kirkeby

Monday, September 23, 2013

What is Orthopedic Massage?

What is orthopedic Massage exactly? Well, to be honest, that is a hard question. I have heard it described multiple ways, such as it is a combination of medical and sports massage, or a way of treating soft tissue injury which is its own style. 

Truthfully, the answer is an issue I also struggle with because my training is different from anyone trained in NY who is doing ortho work, and at first I did not realize that my training was any different because, in Ontario, where I went to school, everyone works the same way. I  was aware that I had gone to school nearly twice as long as the  New York program , but I never thought that what I  was being taught was entirely different that what was being taught here.

Lake Ontario- Toronto, Ontario
I suppose I should go back a bit and explain that in Ontario massage is covered by the National Health System.  Canadian massage therapists operate in a very different capacity than in New York. Massage is not seen as a luxury but as affordable basic health care for physical problems that do not require a prescription.  Canadian therapists might work in conjunction with a doctor or physical therapist, or entirely alone. The entire attitude towards the profession is different.

Here is what I learned about the difference:  In the first year of school in Canada we learn the basic concepts of Swedish massage, which is essentially the same as the training here in New York. It is the second year in Canada--where we only treat dysfunction,  go through an internships plus the continuing education-- is where things take a turn. The second year of massage in Canada is solely ortho. The therapists learn every single thing that could possibly go wrong physically (within reason, ie we are not studying super-rare subsets of infections and disease)  in each part of the body, including those things that we are NOT able or licensed to treat, and you are drilled on it...over and over. We are run through literally thousands of scenarios, good, bad and ugly, and graded on them. The drills are run like real live client interactions where we assess, interview, decide to treat or refer out to higher care, and then provide home care.  When the school thinks we have done enough ground work we are sent to practice on real assessments for real conditions. It is essentially our residency.  I was sent to a Parkinson's clinic, and an AIDs hospice for 3 month stints. By that time, organizing a treatment for someone with a physical problem is not really a challenge, however, reading about someone who is dealing with the possibility of death or disease is entirely different than caring for someone who is dealing with it. This part of the program gives us essential real life clinical experience, and it‘s pretty tough. Incidentally, they also make us intern in an office as a lesson in how not to ruin a business. 

From what I have understood from therapists here, they touch on ortho. The class might visit a Parkinson clinic here, and they might learn the techniques from a book just as we did, but they don't have the time to work in those environments.  In essence, the program here is a tasting platter and the Canadian is a full 6 course dinner. There is nothing wrong with the program here, it is just different. It is designed to give a great relaxation massage and show the therapists IF they wanted to learn more that there is more out there. Many, of course, have learned more, and are working in hospitals, teaching throughout NY and generally doing great work. Many therapists never move beyond working in a spa however. But why the difference? Why educate all therapists to work in a way only a handful do in NYC?

Massage Therapy in Canada is covered by the NHS, and since the insurance  is paying, they are invested in the product. The massage therapy program in Ontario fills the gap between physical therapy and your doctor. We handle the manual therapy components that often pt's are uninterested in, pain management, and the physical components of stress-related problems,  while keeping the doctors’ offices clear of minor bumps, sprains and strains. My days were filled with never ending streams of very normal problems ranging from headaches, surgery recovery, car accidents, over training, back pain and fibromyalgia. The end result is less people in the doctor’s office, less prescriptions for pain relief, and more problems caught before they become serious. 

You might pose the question of litigation. Here in NY we worry about litigation a lot. Therapists here are trained to explain that their care is not a substitute for medical care, which is really confusing as we are listed as medical professionals. You might think that, because we more frequently work with injured in Canada that the risk would be higher, however it is the opposite. Canadian therapists are far more likely to stay out of trouble by being able to accurately identify problems before they start. We have the extra training to understand when a problem is too big for us, and our training prepares us to work in emotionally difficult scenarios. 

So what is Orthopedic Massage? For me it’s being a trained professional, knowing what I can provide, and understanding my limits so I can make available the best care possible to the people seeking me out. Good care comes from understanding and pulling in the right resources, not from being the only stop in health care. Orthopedic treatment means I can pull from lots of sources and work in conjunction with trainers, and other health care providers to get the best.

For more information on Orthopedic massage in NYC please visit our website a

Thursday, September 12, 2013

What's touch got to do with it?

Many years ago I visited a doctor in Canada who was an expert in TMJ (Tempromandibular Joint-this sort of doctor works with the dysfunction of the joint). He was sort of an old school doctor, the kind with a desk littered with papers and a big laugh, so that you felt as if  you were walking into his home rather than his office. While questioning me, he found out I was a massage therapist.
Excited, he quickly posed this question to me,  "Do you think if we did the exact same touch, detail by detail, but replaced the touch with that of a robot, you would get the same results? Furthermore if you replaced me with a robot, would you get the same doctor-ing?"  At the time, I was very young and a bit  intimidated by him, despite his warmth. I thought perhaps I was being tricked by someone with a higher level degree than mine, and that his point was that it was information that mattered, not the person delivering it.  But I was wrong.  As it turns out, he himself was doing research on human touch, and why it is so important and ultimately healing. 
One of the body's most important biological features is its division between the sympathetic and parasympathetic nervous systems, or in lay terms the 'fight or flight' and 'rest and digest' systems. When the body is in the fight or flight mode, it is sending the signal to you that all is not ok and that you should protect yourself. Your heart rate will go up, your posture will change to that of one preparing to flee, sounds and perceptions might increase, and your pain tolerance might go down, prompting you to move quickly. In essence you are on high alert for anything remotely threatening. Unfortunately, this is the constant state many of us live in, in cities like New York. We are forced to defend ourselves with headphones, sunglasses and external disconnects just to shut out the stream. 
When we are touched, we have to take down those barriers. The simple act of allowing another person that close to you can override the stress response by mimicking intimacy, even in a clinical setting. It is a built-in part of our biology to expose soft things like the neck, the belly, and the vital organs only to those we trust and deem safe. This is an unavoidable part of the intimate human experience. By mimicking this behavior, you unconsciously send a signal to the brain that all is well. That reduces your heart rate, reduces your perception of pain, and changes your posture substantially - and all of these things are connected to blood flow and hormone secretion which drive our lives.  
Whether your therapist is skilled at effecting lasting change for injuries, or is a beginner who gives a basic Swedish massage, so long as it is done calmly, in a safe comfortable manner, you have the opportunity to change your health for the better that day. The Mayo clinic lists stress as the number one killer of adults.  It decreases health, and often leads people to cope by taking on other killers, like smoking and excessive drinking. Perhaps today more than at any other time, where we live in a world of technological isolation, the biological response of community and touch is even more relevant.  Your " luxury" of having a massage takes on a whole new meaning if you begin to look at it in terms of a way to override the biological response to stress and eventual disease. My personal and professional opinion is that we all must take a little ownership of our lives, and decide honestly if we are doing enough to reduce our stress. Bike, swim, run, climb, laugh... massage ...touch...but do something. For more info see our Massage program in NYC or email at 

Wednesday, September 4, 2013

Pregnancy and Posture

Today we are going to briefly look at the musculature changes that take place during a normal pregnancy and how they affect the body. A normal pregnancy is full of postural changes, and sometimes those changes are completely normal.  The end result for the person experiencing them can be confusing and uncomfortable.  Even if you have gone through it before, second and third pregnancies can be completely different, but progress much faster.   Since there is so much change occurring on a regular basis, it is important that you check in with your doctor continually.  This ensures safety for both you and for the baby. 
As the course of your pregnancy progresses, many women experience low back pain, headaches, shoulder pain, foot pain, swollen ankles and hands, and even occasionally seemingly random thoracic pains.  Many of the postural changes occurring, and the discomfort associated with them, have to do with the body accommodating the growing baby.
The uterus is nestled deep inside the female pelvis. As the baby grows, it pulls the pelvis forward and down.  Alternately, as the pelvis rotates forward, the tail bone lifts, causing the low back to curve more than it would normally.  You can approximate this change on yourself if you stand and look in the mirror, tucking and un-tucking your tail bone. Because of the increased curve in the low back, which shortens the muscles, many women often complain of low back pain.
As the pregnancy progresses and more relaxin (a pregnancy hormone) is released, the cartilaginous joints and ligaments soften in order to prepare for birth. In many cases the body feels unstable and responds by tightening up the muscles in the pelvis in order to give more support. It can often be seen most easily in the glut and piriformis muscles (butt muscles) as they shorten and rotate the legs outward. This combined with the belly pulling down and forward gives pregnant women that distinctive “duck walk”. Those shortened muscles can also be the source of pain. The nerve that feeds the leg, the sciatic nerve, runs just under or through the piriformis muscle.  Frequently during pregnancy, women report the symptoms of sciatica, which are due to the piriformis muscle tightening over this nerve.
Most of us we think of the changes that happen in the body during pregnancy as in and around the pelvis area, but actually the upper back is affected just as much. All of our spines are essentially an S shaped curve that balances itself. Whatever the low back does, the thoracic or mid back area has to reflect in order to keep balance. This is often combined with the growing weight of the chest pulling the shoulders into a rounded position. All this results in an increased curve in the upper back.  For some women this will not be a problem, but depending on their original posture, their pain tolerance and a number of other factors, for some women this leads to headaches and upper back pain.
Just as the top of the body is effected, so is the bottom. Many women experience foot pain during pregnancy. Carrying extra weight and retaining water can be very hard on the feet. As the pregnancy progresses, the ligaments supporting the bottom of the feet can be stretched and over taxed;  adding to that the swollen feet that come from carrying 50% more blood can make for a difficult time. It’s a perfect reason to put your feet up, relax and rest a while.

The important thing to remember is that under a doctor's care all of this is normal, and that the symptoms of muscular pain are treatable through stretching, exercise, massage therapy and other alternative care.
If you would like more information on massage therapy in New York, pregnancy or prenatal massage you can see Body Mechanics Orthopedic Massage's prenatal treatment page  or come see us in Midtown New York. 
For more information on prenatal massage in NYC check out our websites