Massage Update

September 2009

Volume 8, Number 9

In This Issue

Special Announcements

Educational Tidbit – The Knee Part 1

My Annual Essay

Ted & Alice

Off The Table

Quotes for the Month

Monthly Links

Important Office Info

If you’re a new client, click above for some important information on how I run my schedule and the offices.

Open Saturday Spots

Click above to see when there are time slots available on upcoming Saturdays. This information is updated daily.

Link of the Month

Click above for a link to the website of the Vanilla Bean Café in Pomfret, CT. It’s a fun place to visit.

Comments or Questions

Click above if you’d like to send me a comment on this newsletter or if you’d like to submit a question for the Question of the Month feature.

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Contact Us

healinghands@snet.net

(203) 253-5576

Special Announcements

Sorry about the spelling error last month... tendons are not “mush”.  I also meant to change the Link of the Month, but I forgot it in my haste to meet my sending deadline.  Here are some very important items this month:

First:  My other office in Old Saybrook will be open again on Sunday Sept. 20th.  I work up there just one Sunday each month, so if you know of anyone the other side of New Haven who might be able to use my services, please forward this newsletter on to them.  I don’t have my September date set in stone just yet.

Second: Even though it’s September, Saturdays are still crazy. As I’ve mentioned before, I can only see 5 people each day. I have 3 clients that have taken weekly spots on Saturdays, leaving just 2 spots open. That’s why my Saturdays are booked so far in advance. I do post any open Saturday times on the home page of my website.  Just click on the link in the left column.  I update it weekly or whenever there is a change, so don’t hesitate to give it a frequent look as people do sometimes need to cancel their appointment.

Lastly: The Monday Morning Mailing List is a weekly email informing you of any spots that are still available as of early Monday morning.  I still send it out, though there hasn’t been much to offer lately. If you’d like to get that email, I need your permission.  Just click on the Comments or Questions link and let me know you’d like to be added to that mailing. I offer a no spam promise. You can always call me and ask to be placed on my standby list.  I ask that clients who do cancel give me 24 hrs notice, so if you’re on the list, you might just get a call.

Educational Tidbit – The Knee Part 2

Last month I began discussing knee problems by giving you a short anatomy lesson and describing the most frequent treatment for knee pain.  This month I want to get more specific about various causes of knee pain and whether or not I can help you. You may want to refer back to that article since I’ll be using some specific terms this time. Last month I mentioned the most common source of pain that I see – patellofemoral syndrome – which is a tracking problem of the patella along the femur, typically from an overdeveloped vastus lateralis muscle compared to the vastus medialis.  This is often found in runners and cyclists. Massage can help loosen up that outer quadriceps muscle while a physical therapist or personal trainer can help you develop the inner quad muscle. You use the quad muscles all the time, especially when you stand up from a seated position. This syndrome can also happen with women who have wider hips as their Q-angle will be wider than normal. To keep this simple, I won’t define that here. Another cause of pain is Iliotibial Band Syndrome. The IT Band is a tendon running from the gluteus maximus and TFL down to the knee. There are bursa sacs at both the lateral femoral epicondyle & the greater trochanter of the femur to reduce friction. But if the band is hypertonic, the bursa sac may swell or become inflamed.  Massage and stretching can help loosen up the IT Band and reduce the pressure on the bursa sac.  Rest & Ice will help reduce the swelling and inflammation. This is another problem I see in athletes. Strains (muscles & tendons) and Sprains (ligaments) are common due to injuries. These are diagnosed by a physician. Like burns, they are graded by the level of severity: 1 is mild, 2 is moderate & 3 is severe. Specific massage can help you with grade 1 because massage will increase the circulation to the area, helping the healing process. Because of my additional training, I can also help you with grade 2 issues.  But grade 3 is best left to an orthopedic physician because surgery may be needed to reattach a torn tendon or ligament.  Then you’ll also be seeing a physical therapist for rehabilitation. Osteoarthritis is another cause of knee pain. It comes in a few different forms. It could be an erosion of the hyaline cartilage that protects the ends of the bones, causing a narrowing of the joint space and leaving the bones to rub on each other. Osteoarthritis can also produce small bone spurs, some like grains of sand under the patella that can cause pain.  While massage can help loosen up the muscles so the bones aren’t so tight, massage cannot fix this issue. The erosion of the cartilage may require injections of a synthetic cartilage or replacement of the joint. Bone spurs may be dealt with via arthroscopic surgery. It’s best to discuss this with an orthopedic surgeon. Rheumatoid arthritis is a chronic autoimmune condition that causes joint degeneration. Both the bones and the cartilage erode and there is a great deal of inflammation. A person typically deals with periods of flare-ups and remission.  Massage can only be performed during the subacute phase (no inflammation) to help maintain joint function, otherwise you’ll need to discuss this with a Rheumatologist. Tendonitis is simply inflammation of a tendon, usually caused by overuse, an injury or a rheumatic condition.  Depending on the cause, massage can help, along with R.I.C.E., which I explained last month. Meniscus tears are another painful proposition. The meniscii are fibrocartilagenous pads that act as cushions for the knee, but can become damaged and slip slightly out of position. Sudden locking of the knee joint is a classic sign of a meniscus tear.  While massage feels great, it won’t fix the problem.  See an orthopedic surgeon to tell if arthroscopic surgery is needed. A chronically tight Tensor Fascia Latae (TFL) muscle can also cause knee pain by creating a “functionally short leg” and scoliosis as a compensation by depressing the pelvis on the “short” side. Massage can certainly help with this issue as it is a result of muscle tightness. Trigger Points are predictable areas within individual muscles where microtrauma has caused the area to be extremely tight.  Muscles of the posterior compartment of the leg, quadriceps, hamstrings and adductor groups can all develop trigger points that refer pain to the knee. A specially trained massage therapist (yes, me), physiatrist, physical therapist, or chiropractor can all help you with trigger points.  Other conditions that can cause knee pain that I’ll mention but not describe here are stress fractures, fibular nerve compression, piriformis syndrome, sacroiliac joint dysfunction, baker cysts and gout. I can help you with piriformis syndrome and SI joint dysfunction, but not much with the others.  The knee is a very complex structure.  The more you can tell me about your pain, the more I’ll be able to help you or refer you to someone who can help.

My Annual Essay

The kids are back to school, so what did you do this summer???

Mostly I worked.  When I did get some time off last week, I was first notified that I’d been summoned for Federal Jury Duty in Bridgeport. I was luckily able to defer it to later this year; otherwise I’d have been extremely upset. Mostly I needed time off to recover from working so much.  Most of my joints have been aching, so I’m either overworked or I have Lyme’s Disease... We began our vacation with a trip to Tanglewood up in Lenox, MA.  James Taylor was accompanied by the Boston Pops with John Williams as the guest conductor. It was a glorious day to be sitting on the lawn, covered head to toe in clothing and SPF85. We also spent a day in the “Quiet Corner” (Northeastern) of Connecticut, returning to Ted’s birthplace of Pomfret. We were happily surprised by a couple of great gallery & fine crafts stores and a nice place to eat called the Vanilla Bean Café.  I’ve linked to their site on the Link of the Month in the left column. We tell Ted we “rescued” him from a life on a farm... We tried spending a day checking out the arts scene in Norwich, but that was a total bust. If we were looking for drugs, we could have easily scored.  Norwich is still a city to avoid. So we headed down to Mystic and had lunch along the Mystic River at S&P Oyster Company. We’ll go back there for dinner some day. Carol & I also took our kayaks up the Lieutenant River in Old Lyme and had a very peaceful excursion. We also visited the Open House at the Katharine Hepburn Cultural Arts Center (The Kate) in Old Saybrook. Carol was one of the original Board of Trustee members but had to step down last summer when her paying job began to get crazy.  They’ve done a spectacular job renovating this historic building. Mostly we took time to unwind and have dinner with some great friends, like Marlene, Judy, Len & Beebe. You may remember that Judy miraculously survived after having her neck destroyed by a drunk driver in January. She had to have additional surgery on her neck last Friday which was successful. Our prayers are with her during this latest phase of her recovery. 

Here’s a photo I shot with a tiny waterproof “kayak camera”. The fixed focus is set much too close for my liking, so much of the photo is out of focus and I can’t fix it. I have to keep the photo this small in order to keep this newsletter down to just 3 pages, should you decide to print it out to line your bird cage.

Ted & Alice

Off The Table

The often troubled running back of the Miami Dolphins, Ricky Williams, is training to become a massage therapist. I’m hoping he’s a success at it. Did you know that Jimmy Buffett has a minority interest in the team?

It’s been awhile since I bought a new car.  Though I’m getting better gas mileage, my fuel tank is much smaller, so my total range is about the same.  I still have to fill up once a week.  But at least I can use regular grade...   

Quotes for the Month

Here are a couple of my favorite quotes for this month:

“There is no pleasure in having nothing to do. The fun is in having lots to do and not doing it.” -- Mary Little

“Since the general civilization of mankind, I believe there are more instances of the abridgment of the freedom of the people, by gradual and silent encroachments of those in power, than by violent and sudden usurpations.” -- James Madison