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Dedicated to Pam Thayer

by Jill Kristin Berkana 12-18-22

Massage Therapy and Integrative Healthcare: An Overdue Embrace

11 Saturday Mar 2017

Posted by Jill Berkana in Tidbits from the Massage Mamma

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“Medicine is like the Tai Ji. There are two theories of thought. But truly one does not exist without the existence of the other. They are intertwined as people try to make them a dichotomy.”       ~Brent Jackson

The intent of this blog post is to address and plead with the small and shrinking group of holistic health care practitioners, specifically massage therapists, who have a tendency to say negative things about western or traditional medicine to their clients, step out of scope with diagnoses and prescribing, and they do this all day long. I know this group well because 20 years ago, I was a full-fledged member.

This morning as I stand in my kitchen making breakfast, breathing and hungry, I’m reflecting on how many times traditional/western medicine has saved my life and the lives of my loved ones. My father, grandmother and brother have all suffered from serious bouts with Diverticulitis. My brother endured a temporary colostomy bag while his large intestine healed, and my dad had surgery to remove two thirds of his large intestine after years of suffering with chronic pain and acute flair ups of the disease. I recall his discomfort from time to time as a child, and watched him peel the sesame seeds off the top of his hamburger buns.

I’ve been a holistic health care professional for 27 years and counting, and a nutrition/natural medicine passionista for over 30, therefore, when I first started to have intestinal pain 22 years ago I decided to take matters into my own hands. This was also convenient because I did not have health insurance at the time. I did my research in naturopathic journals, read books on cleansing and fasting, talked with the experts at the health food stores and started a disciplined practice.  I have since done annual fasts coupled with intestinal cleansing for a week every year since I was 30. I have not had any significant problems, until now. This year the disease caught me. Seeing as I had done a short fast and cleanse 3 days prior to my attack it is possible that the cleanse itself is what exasperated and/or revealed my condition. I will never know. I will also never know if my lifestyle choices kept the disease at bay until now. What I do know now is I have it, I am fragile, and my life has been saved once again by western/traditional medicine.

While I was in the hospital I really wanted a massage. I was having horrible headaches due to the IV drugs saving my large intestine from rupturing, but no, sadly, there was no massage. While I was suffering an incredible wave of nausea with a completely empty stomach due to doctor prescribed bowel rest the nurse DID swirl her warm hand on my back which felt wonderful and comforting. She put lavender aromatherapy in the room, and cold washcloths on my forehead. They did allow my husband to come in and spoon me for an afternoon nap. This all was VERY powerful medicine, however, there was no massage therapist there to give me a much-needed neck and head massage. Why is that?

Some hospitals are finally providing massage therapy which is paid for by patient insurance and prescribed by the physician! With all my heart I thank the AMTA, the Massage Therapy Foundation, pioneers such as Ruth Werner, Xerlan Deery, Susan Salvo, Carole Osborne, Brent Jackson and too many others to mention for the progress massage therapy has made in the hospitals. Still, massage therapy is not fully integrated. Why is that?

Here is one prominent obstacle. There are still too many massage therapists practicing some form a shamanism, (for lack of a better word) making false claims about healing, telling clients to eat toxic essential oils, encouraging clients to forego doctor’s orders, diagnosing, and demonstrating to the greater medical community our profession’s inability to stay within its scope of practice and collaborate with consistent integrity and ethics. Sad.

Sadder still is most of the massage therapists doing this have positive intent and really think they are helping their clients! This is what they were taught in school by their beloved mentors, and now… some 20 -30 years later… they are telling the same very old story. Some of these folks are teachers and continuing to propagate the mythology and lack of professional boundaries.

Massage Therapists in every single inch of the United States should be required to take a certain amount of continuing education to renew their license including at the very least professional ethics and research competancy. Additionally, the Continuing Education providers absolutely should comply at a higher level so we know the people who are getting massage therapists up to speed, are up to speed. Last I heard, continuing education is only required for licensure renewal in 35-37 states.

If you are a massage therapist and you are not taking continuing education courses I hope this article will inspire you to pursue it for yourself and for your clients.  If you don’t like my message, please just take a moment to reflect on how many times traditional/westernized medicine has saved your life or the lives of your loved ones. Alternative Medicine is OUT  and Integrative Health Care is IN! It should not be us OR them but us AND them!

By no means am I saying that western/traditional medicine is perfect. Obvious to all of us paying attention, pharmaceuticals are completely out of control, along with health care costs. If massage therapy can get it together and collaborate with a high level of professional integrity we can position to replace at least some of the pills and surgery.

You should powerfully advocate for yourself and your body whenever you are submitting to healthcare of ANY kind. For example, the doctor wanted to give me one more bag of antibiotics and I told him, “too much medicine, not enough nutrition” and so, he put me on soft food before I took the next bag.

My journey with Traditional/Western Medicine:

  • In 1977 I had pneumonia and was saved by medical intervention
  • In 1988 my son was born via emergency C-Section after a 40-hour labor at home with midwives. The medical intervention saved both of our lives.
  • In 1995 I was in a horrific car accident and medicine did not keep me alive but kept me out of unbearable pain.
  • Medical Intervention repaired both my right big toe which I crushed under 300 pounds of wood in Costa Rica, and my thumb which was damaged in two car accidents. I am walking/running and doing powerful massage today.
  • 2017 – Doctors and medicine kept my large intestine from exploding.

Let’s face it, if you crush your leg, do you really want a shaman to chant over it and apply some tree sap? If you are a massage therapist, please do get up to speed and keep up. It’s not hard to do! Our profession is investing considerably in research and many new valid discoveries have been made! This is terrific news!

And if you have not yet got the memos:

  1. Massage Therapy is fine for healthy moms-to-be in the first trimester.
  2. Massage Therapy does NOT remove toxins.
  3. A new muscle has been discovered. See if you can find it.
  4. The parasympathetic nervous system may not govern the Sacral Plexus.
  5. Massage Therapy does NOT spread cancer.
  6. There is MORE! FIND IT!

Back in the day I would read a rune to each and every client at the end of their massage. I calculated their astrological charts to better understand how I could help them. I had crystals in my massage room and I still do because they are pretty. Today I believe in magic. I like to do ceremonies under the full moon, and I’m known by family and friends (not clients) for my special “white witch flu brew” around cold and flu season. I cut my teeth on the mystical, and I also know it’s high time massage therapy really honor the boundaries of our profession so we can work with and support the healing of those who need it the most.

Here is some powerful work all massage therapists should read:

Tracy Walton’s “5 Myths and Truths about Massage Therapy”

The Impact of Massage Therapy on Function and Pain

Here are easy ways to stay connected to what is new:

The Massage Therapy Foundation

The American Massage Therapy Association

Research Perch

“Let me look at your shoes” a super easy MT hack for basic gait and postural assessment.

25 Sunday May 2014

Posted by Jill Berkana in Tidbits from the Massage Mamma

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7357582_f520As massage therapists part of our job is to help our clients become aware of, take responsibility for, and change behaviors that interfere with their ability to have a healthy relationship to their bodies. Many of our clients come to us because they have musculoskeletal pain, and often that pain is a result of unhealthy movement and postural patterns.

Unhealthy movement and postural patterns are a result of LIFE, specifically trauma and conditioning.

Trauma: We are born through trauma, and for the entirety of our lives we experience different forms of emotional, mental, and physical trauma. Every type of trauma can lead to physical compensation patterns.

Other Stuff: Trauma is not the only thing that can lead to postural or movement dysfunction. We also have cultural modeling, and overuse due to occupation or lifestyle to point to.

Whether it is overuse from lifestyle, occupation, cultural modeling or trauma the result is that everyone on the planet has some type of postural and movement dysfunction which can ultimately lead to pain in the musculoskeletal system. I like to call this job security.

When a client presents with a complaint of musculoskeletal pain we can sooth and support by providing the basic massage therapy manipulation we massage therapists provide in a session, but there is oh so much more we can do to support our clients in changing behavior that leads to pain from movement and postural dysfunction.

Truly, if we do not empower our clients with some form of awareness and self-care to move them into a healthier relationship with their own body and life, we are missing a huge opportunity to serve them. We are here to help long-term, not just apply lotion, rub, collect fee and reschedule.

We can interview, assess gait, do ergonomic assessments, assess posture, etc. and that’s all wonderful. The intent of this article is to share a very simple assessment hack that can provide a ton of feedback and support the fascinating and unfolding story of what is going on with your client, and how we can help them.

Look at their shoes!

  • Ask your client if you can look at their shoes. If yes…
  • Pick them up and look at the soles.
  • Compare one sole to the other. Is one more worn out than the other? What does THIS tell you?
  • Are the soles worn evenly, or is there some type of deviation?
  • Look closer…
  1. Are the shoes worn on the inside edge bilaterally or not?
  2. Are the shoes worn on the outside edge bilaterally or not?
  3. Are the shoes worn under the big toe bilaterally or not?
  4. Are the shoes worn at the inside of the heel bilaterally or not?
  5. Are the shoes worn at the outside of the heel, bilaterally or not?
  6. Are the shoes worn down in the middle of the arch, bilaterally or not?
  7. Are the shoes worn down evenly on the entire shoe, bilaterally or not?

Here is where things get interesting and your curiosity and that of your client’s should be stirred.

What I have found to be consistent imbalances over the span of my practice:

  • If one sole is worn out more than the other we have a pretty big indicator of favoritism of sides here. At this point I would ask my client, are you right or left side dominant. Counter-intuitively, often the side that is not dominant is the one that is carrying the weight. Being a mom I know that I did the heavy lifting with my left side (kid on hip) while my right dominant side had to manage details (putting the key in the front door). I will then explore with them if they have ever injured the side that the sole is not worn on. Sometimes, information comes up that is very helpful in determining a treatment plan.
  • Are the shoes worn on the outside edge bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as lateral muscular aspects of the lower body in a state of hyper-tonicity with ischemia, and weak medial muscles including the adductors. This is a good time to explore the knee stabilizers and maybe check the tracking of the knee.
  • Are the shoes worn on the inside edge bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as medial muscular aspects of the lower body in a state of hyper-tonicity with ischemia including the adductors, and weak lateral muscles including the abductors. This is a good time to explore the knee stabilizers and maybe check the tracking of the knee.
  • Are the shoes worn under the big toe bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as medial and anterior muscular aspects of at least the lower body in a state of hyper-tonicity with ischemia including the quadriceps, and weak posterior muscles including the hamstrings. This is a good time to explore the hip flexors, abs, check for forward head posture, TMJ and especially the illiopsoas for issues.
  • Are the shoes worn at the inside of the heel bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as medial and posterior muscular aspects of at least the lower body in a state of hyper-tonicity with ischemia including the soleus, gastrocs, hyperextention and medial rotation of the knee, short internal hip rotators, and tight hamstrings.
  • Are the shoes worn at the outside of the heel, bilaterally or not? Whether they are bilateral or not, the side or sides that have this indicator will often show up as lateral and anterior muscular aspects of at least the lower body in a state of hyper-tonicity with ischemia including the peroneals, and lateral rotation of the knee, short external hip rotators, specifically piriformis may be an issue.
  • Are the shoes worn out on the entire sole bilaterally? This indicator will often show up as the need to get new shoes! 🙂

You can always attempt to replicate where they are favoring the weight on their feet to give you clues of where holding might be. In the end it seems whatever point that is being favored on the foot sends a line of tension through the body with corresponding tightness, and weakness in the antagonistic muscle groups.

An amazing instructor of mine once told me that whatever is going on in the feet will always send repercussions throughout the entire body. Having recently experienced my own foot surgery which resulted in false sciatica pain syndrome due to my protective and compensatory gait, I really get it. I can’t stress how interested you should be as an Massage Therapist in your client’s shoes…and the older the shoes the better!

Finally, you can help encourage your client to become more aware of their movement patterns and work towards balance in their body through stretching, strengthening, and receiving consistent awesome bodywork and massage therapy from YOU! As always, a mindful, and compassionate approach will support the highest level of success for you and your client.

Jill Kristin Berkana

Jill Kristin Berkana Founder/Director Berkana Institute of Massage Therapy and Bodywork Passionista

 

 

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