Whiplash

Healing a Pain in the Neck
Hope Bentley
Getting rear-ended in traffic. Face-planting at the bottom of a ski slope. Tumbling over the handlebars on your bike. Whiplash comes in many forms and can become a long-term problem if not treated correctly. Fortunately, massage and bodywork can address the ache and discomfort that come with whiplash and prevent chronic pain down the road.


Understanding Whiplash

The term "whiplash" came into use in 1928. Doctors will sometimes use "hyperextension injury," to describe it, but "whiplash" is a more visceral account of what has happened to the victim's neck. The neck itself has made a whip-like motion bending first towards and then away from the point of impact. As the head moves rapidly in one direction, the muscles in the neck receive the message to contract. The momentum of the head can cause strain or sprain to the muscles and ligaments in the neck as the head reaches the end of its movement.

Car accidents are the most common causes of whiplash. The American Academy of Orthopedic Surgeons reported that about 20 percent of people who have been in rear-end collisions later report whiplash symptoms. Whether front to back or side to side, whiplash can affect muscles all the way into the victim's back and arms. The most serious form of whiplash compresses nerves in the neck and cause multiple sprains of the ligaments.

The good news is, serious hyperextension injuries are in the minority, as whiplash usually comes in the less serious version of the injury. "Fortunately, about 95 percent of the time whiplash tends to be more superficial damage, like slight muscle strains and tears," says Ben Benjamin, Ph.D., a massage therapist who holds a doctorate in education and sports medicine. But whether the pain is minor soreness or serious discomfort, massage can provide relief and prevent chronic problems in the long run.


Whiplash Symptoms

The symptoms of whiplash include neck pain and stiffness, headaches, pain in the shoulder or between the shoulder blades (sometimes called "coat hanger pain"), low back pain, and pain or numbness in the arms or extremities.

Often people who suffer whiplash do not feel the effects until two or three days after the injury-causing incident. Benjamin explains that this delayed onset is because it takes time for scar tissue to manifest in the sprained or strained muscles and ligaments. And because scar tissue is more adhesive than regular tissue, people experience it as stiffness in the injured areas.

Whiplash affects primarily the neck, but victims shouldn't ignore the rest of the body. This injury can pull the long muscles on either side of the spine, which reach all the way to the tailbone and can cause discomfort along the way. Discomfort or stiffness in the chest and arms can also be due to whiplash. And headaches may be the result of slowed circulation to the head caused by the swelling in the injury.


Massage Can Help
Any massage that causes a general relaxation of the client's muscles can help relieve muscular pain in common types of whiplash injuries. In addition, massage increases the amount of oxygen that reaches the healing tissues and opens those tissues so they can receive oxygen and nutrients, thus speeding the healing process.

In addition to relaxation massage, specific bodywork methods ease acute whiplash discomfort and help prevent chronic fallout. For example, myofascial approaches restore fluidity to the fascia--normally a slippery tissue that surrounds all the moving parts inside the body--allowing freer movement of muscles and ligaments. Friction-based massage helps break up scar tissue and relieve stiffness. Trigger point therapy works by releasing tension held in tight knots of muscle. And any type of bodywork that stimulates circulation helps ease and prevent headaches.

Finally, the incident that caused the whiplash in the first place, (a car wreck, for instance) can be traumatic. Massage helps relax a client's psyche as well as their muscles, helping her or him work through the emotional issues induced by the accident.

Because the neck is such a delicate part of the body, it is important to proceed with caution. Benjamin advises waiting a few days after the accident to seek treatment. This allows the initial scar tissue to knit, which is an important part of the healing process. The initial treatment should be extremely gentle, and if there is a chance of a fracture, a concussion, any disc problem or other serious injury, the client should make sure to see a physician first.


Let the Healing Begin
It used to be that physicians would immobilize whiplash injuries with a cervical collar, but now health care professionals advise a more temperate course for their patients.

"I recommend gentle neck movement within your range of motion while lying on a pillow," says Benjamin. Movement may help prolong the benefits of the massage by continuing to circulate blood, oxygen, and nutrients through the healing tissue. "Heat or cold, whichever feels better, can also help," says Benjamin. "Soaking in a hot bath can also be beneficial." Limiting physical activity for a few days and getting plenty of rest in the wake of a whiplash injury is also a good idea.

Whiplash is traumatic and should be addressed soon after the injury to avoid any chronic problems. If you or someone you love is suffering from the repercussions of whiplash, consider a bodywork session to ease the discomfort. Massage can help lessen muscle pain, induce relaxation, and ease the trauma often associated with whiplash. You'll be back to your old self in no time.

Expecting Moms Embrace Massage

Pregnancy MassagePregnancy Massage Contributes to Nine Healthy Months
Hope Bentley
During pregnancy physical and emotional changes cascade throughout the body. Nausea, fatigue, swelling, heartburn, headache, and emotional turbulence are just some of the symptoms that come with the territory. Fortunately, massage can help ease these issues, so that the mom-to-be can focus on what's most important: her baby.

The First Trimester

"In the first trimester I see a lot of cases of nerves," says Megan O'Connor, a New York-based certified prenatal massage therapist. "Massage can give reassurance." This is largely because newly pregnant women may experience a range of emotions--elation, anxiety, contentment, and even fear--made more poignant by the hormonal changes that accompany pregnancy. Fortunately, massage therapy can help ground an expecting mother and ease the emotional roller coaster that comes with pregnancy.

But is massage safe in the first trimester? According to Susanrachel Condon, founder of Niara Healing Arts Massage Therapy and Perinatal Support Systems, "It is absolutely safe and can be very beneficial for an expecting mother."

Having said that, there are some precautions to take when considering prenatal massage. If it is a high-risk pregnancy or there's a history of complications--diabetes, high blood pressure, miscarriages, placenta previa, preeclampsia, or any other medical condition--a midwife or doctor should be consulted before scheduling a massage. In addition, it is very important for pregnant clients to speak openly with their massage therapist about any concerns or issues.

On the other hand, bodywork techniques like shiatsu access the meridians used in acupuncture, including trigger points that can relieve nausea. According to O'Connor, a good therapist will also teach a mother-to-be how to activate the trigger points herself, as most nausea treatments are more effective when applied at least three times a day. Techniques such as this can be a great relief to a woman navigating the early days of pregnancy.


The Second Trimester
A woman in her second trimester may begin to have trouble with circulation, sometimes because the baby's weight begins to pinch the major veins in the mother's legs. Poor circulation can cause swelling of the extremities, headaches, and exacerbated carpal tunnel syndrome. Massage will increase circulation and help create space in the body to relieve the pressure from the baby's weight. Condon explains that weight gain and joint laxity can cause women to feel off balance and clumsy. Massage can relax the muscles around the joints and ground and balance a pregnant woman.


The Third Trimester

As the baby grows heavy in the final trimester of pregnancy, major changes are likely to occur in the musculoskeletal system, and massage can become even more essential.

"A lot of women feel discomfort in their lower backs because the womb is moored to the sacrum, which is that triangle of area at the base of the spine," O'Connor says. "The weight of the womb pulls on that mooring and can be very uncomfortable."

Women may also experience discomfort in their abdomen. As the baby grows, the mother's muscles are stretched, her organs are compacted, and her lungs are compressed. Massage can minimize or prevent abdominal muscle tear, a complication that happens with some women. A practitioner can also help reposition the baby to alleviate discomfort and ease breathing.

And when labor finally begins, massage can help facilitate the birth, perhaps especially appealing for women considering natural childbirth.


On the Table
But how exactly does a pregnant woman--complete with enormous tummy and tender chest--receive a massage? Many prenatal massages are given with the pregnant woman on her side, semi-reclined, briefly on her back, or on a specially designed pregnancy massage table, and often with a network of pillows for support.

Condon explains that prenatal massage is not simply a regular massage except in a different position. A qualified prenatal massage therapist will know the changing physiognomy of a pregnant woman and will tailor the massage to the needs of the client.


Postpartum Massage
Now that baby is here, mom needs a massage more than ever. Says O'Connor, "I think postpartum massage is extremely underrated."

After baby arrives, bodywork can help a new mother ease back into her body again, relax sore muscles, address any abdominal muscle strains or tears that occurred during pregnancy, and cope with the life changes and lack of sleep that come with a new baby. In addition, the uterus will sometimes linger low in the abdomen instead of returning to its proper place. A Maya abdominal massage therapist can help restore the uterus to its proper position.

Nursing moms may feel reluctant to book a massage due to leaking breasts, but O'Connor says not to worry. "Women shouldn't be concerned about massage while they're nursing, even if they feel like an uncapped fire hydrant!" she says. Practitioners will accommodate nursing women, with proper draping and towels.

Pregnancy is an important time that needs to be honored, and prenatal massage plays an important role. As the body goes through miraculous changes, bodywork facilitates pregnancy and helps the expectant mother stay comfortable, connected, and healthy.

Fibromyalgia Demystified

Bodywork as a Key Therapy
Cathy Ulrich
Jane had just been diagnosed with fibromyalgia. She was happy to have a name for the mysterious, traveling pain she had felt for some time, but she was still worried about how to deal with it. She'd done research on the Internet, but the information left her more confused. "There are so many causes and ways to treat it," she said. "I don't know what to do." A friend of Jane's recommended massage as part of her treatment plan. "She said it helped her," Jane said, "so I'm willing to try."

For fibromyalgia sufferers, muscle pain, tightness, and general body discomfort can all too often become a way of life. But what is fibromyalgia, and what can be done to help?


What is Fibromyalgia?
Fibromyalgia, which literally means "connective tissue muscle pain," causes severe tenderness in multiple points throughout the body as well as persistent fatigue, morning stiffness, and non-refreshing sleep. Fibromyalgia is found in about 2 percent of the adult population, and women are five to seven times more likely to have it than men.

Theories about the cause of fibromyalgia include thyroid imbalance, sleep disorders, genetic predisposition, allergies, trauma--especially whiplash injuries--and possibly even viruses. Many who have fibromyalgia syndrome have other conditions as well, including depression, irritable bowel syndrome, chemical sensitivities, intolerance to exercise, restless legs syndrome, extreme sensitivity to cold, and seasonal affective disorder.


Factors At Play
Jay Goldstein, MD, a leading researcher and clinician, identified three common factors in people who are susceptible to fibromyalgia. It's helpful to consider these factors when planning a treatment approach:

1. Biochemical factors, such as hormonal disturbances, allergies, frequent colds and viruses, and nutritional deficiencies.
2. Biomechanical factors, such as congenital deformities (one leg longer than the other or scoliosis, curvature of the spine) or functional conditions (poor posture, overuse syndromes, or poor breathing patterns).
3. Psychosocial factors, like depression, anxiety, or difficulty coping with stress.


Bodywork Can Help
Fibromyalgia is best treated using a multidisciplinary approach, and bodywork can be a key part of healing, recovery, and management. Depending on your specific needs, any or all of the following methods may be helpful.

Swedish Massage
Because stress is such a strong component of fibromyalgia, regular massages for relaxation and stress reduction can be beneficial to your program. Swedish massage is the foundation of training for most massage therapists. Its primary goals are to gently relieve muscle tension, improve circulation, and restore the balance between mind and body.

Rolfing
This whole-body approach is designed to restore postural alignment and ease. Rolfing--and other related forms of bodywork under the umbrella of structural integration--helps to free soft tissue tightness and remove the structural imbalances that create stresses and strains on the body, restoring biomechanical function. Whiplash and other types of neck injuries are commonly seen in fibromyalgia cases. Rolfing aligns the body so the head and neck can rest more easily.

Lymphatic Massage
The lymph system is the body's primary way of eliminating waste at the cellular level. When the lymph system is backed up, tissues can get bogged down and become irritated, inflamed, and swollen. Biochemical disturbances are a key factor in fibromyalgia, so restoring the mechanical function of the lymph system can be important. Lymphatic massage is a specific form of therapy designed to improve circulation, remove waste, and reduce swelling in the tissues. It's often a good way to start a bodywork session.

Neuromuscular Therapy
Trigger points--pivotal body points that hold and release pressure--become small areas of extreme tenderness and tightness for fibromyalgia patients. Neuromuscular therapy is a specific form of bodywork designed to free these trigger points along with the fiber in the surrounding tissues. Neuromuscular therapy encompasses many different techniques, but the system is designed to relieve the tightness in the deep soft tissues and to eliminate trigger points.


Considerations
Sensitivity to touch varies greatly for fibromyalgia patients. Some people prefer very deep work, while others are sensitive to the lightest pressure. It's important that you establish good communications with your massage therapist so you can explain what feels comfortable to you and what doesn't.

When you're in an acute flare-up, limit your bodywork to more gentle techniques. When you're feeling better, deeper work intended to eliminate trigger points or work on posture may be more appropriate. Partner with your therapist to find the best approach.

You may be sore after a session. A moderate level of soreness can be expected, but should only last about forty-eight hours as your body adapts to the changes. If it lasts longer or is more severe, bodywork may be too aggressive or the session may be too long. Start out slowly, learn what works best for you, and let your therapist increase the time or intensity as you progress.

Fibromyalgia is a soft tissue condition, and bodyworkers are experts at working with soft tissues. By including massage in your care, you can expect to manage and improve your fibromyalgia.

The Benefits of Lymphatic Massage

Fuel Wellness with a Healthy Lymph System
Cathy Ulrich

Six months after hip replacement surgery, Larry was learning to walk again and life was returning to normal. But one thing still puzzled him. When he stood for any length of time, his left ankle would swell, and when the inflammation was at its worst, his right ankle would also swell.

"I can understand why my left leg is swollen," he says. "But why would my right leg swell? I didn't have surgery there. And why am I getting swelling six months after the surgery? Shouldn't it be better by now?" The answer is that although Larry's surgery had occurred on the opposite side, the right leg would swell when the inflammation became too much for the left side to handle.

Fortunately, lymphatic massage can help address Larry's problems. This special type of bodywork, while very gentle and seemingly superficial, helps to restore function to the lymph system and balance the body.


The Lymph System
Most people are familiar with the body's vessel system that carries blood to and from the tissues, but few understand there is another equally vital system of vessels that removes cell wastes, proteins, excess fluid, viruses, and bacteria. The lymph system picks up fluids and waste products from the spaces between the cells and then filters and cleans them.

Like the roots of a tree, the lymph system starts as tiny vessels--only a single-cell wide--that eventually branch into larger and larger tubes that carry these fluids back to the blood stream. This network of delicate vessels and lymph nodes is the primary structure of the immune system. The lymph nodes act as check points along the pathways of the vessels. They filter the fluid (called lymph) and serve as the home for lymphocytes--little Pac Man-like cells that attack and destroy foreign bacteria and viruses and even abnormal cells, like cancer cells.

When the lymph system works well, we feel healthy and have a strong defense against illness. When it's sluggish or blocked--say after surgery or an injury--we can have swelling, feel tired, and be more susceptible to colds and infections.


Lymphatic Massage
A customized form of bodywork, lymphatic massage may help the lymph system do its job better. By understanding the anatomy and function of this delicate system, your massage therapist can assist your body in clearing sluggish tissues of waste and swelling.

Though lymph vessels are found throughout the body, most of them--about 70 percent--are located just below the skin. These fragile vessels work to pick up fluids between the cell spaces when gentle pressure is applied to them from increased fluid build-up, muscle contractions, or the pressure of a therapist's hands. By using very light pressures in a rhythmic, circular motion, a massage therapist can stimulate the lymph system to work more efficiently and help it move the lymph fluids back to the heart.

Furthermore, by freeing vessel pathways, lymphatic massage can help retrain the lymph system to work better for more long-term health benefits.

Massage therapists versed in lymphatic drainage therapy, an advanced form of lymphatic massage, can identify the rhythm, direction, and quality of the lymphatic flow and remap drainage pathways.


Who Should Get It?
Lymph massage can benefit just about everyone. If you're feeling tired and low on energy, or if you've been sick and feeling like your body is fighting to get back on track, lymph massage would likely serve you well.

In addition, athletes, surgical patients, fibromyaliga and chronic fatigue sufferers, as well as those wanting a fresh look may want to consider lymphatic massage. Here's why.

After a sports injury or surgery, lymph vessels can become overwhelmed with the demand placed on them. When tissues are swollen, deep tissue techniques may actually cause damage to the lymph vessels and surrounding structures. Lymphatic massage is often the treatment of choice, because it helps the body remove proteins and waste products from the affected area and reduce the swelling. This helps reduce pressure on cells and allows them to reproduce faster to heal the body.

Surgical procedures involving lymph node removal--such as breast cancer surgery--can cause limbs to swell. Severe limb swelling needs the attention of a medical team, but in milder cases, lymphatic massage alone may be enough to prevent or even treat the swelling. It's important that your doctor be involved in your care. Let your doctor know you'd like to see a massage therapist and make sure you have medical approval.

Lymph massage can also be part of a care program for fibromyalgia or chronic fatigue syndrome. Because it's so gentle, it is well tolerated by these patients, who are often experiencing sore trigger points throughout the body. And by encouraging lymph flow and removing waste products, this gentle form of bodywork can help restore immune function and improve vitality.

Estheticians are trained in a very specific form of lymphatic massage. When you get a facial, your esthetician will gently massage your face to help improve lymph flow. When lymph is moving freely in the face, you'll have clearer, healthier skin without a buildup of toxins and fluids.

So, if you're feeling a bit sluggish, experiencing mild to moderate swelling, recovering from a sports injury, or interested in optimizing your lymph system for stronger immunity, ask your massage therapist about lymphatic massage. It can have a powerful impact on your body's ability to heal.

Massage Calms ADHD Kids

Helping Children Find Focus
Cathy Ulrich
Imagine lying on a massage table. As your massage therapist sets to work, you feel your body relax. Your muscles soften, your nervous system calms. Now, imagine how you feel when the massage is over--relaxed, alert, calm, and content.

Anyone who has gotten a massage understands the many benefits that it offers. Massage is usually reserved for adults--or sometimes infants--but what about massage for kids and adolescents? If massage helps calm the body and improve alertness, how might it help kids with attention-deficit/hyperactivity disorder (ADHD)? Can children and teenagers who can't sit still benefit from massage?

Understanding ADHD
Attention-deficit/hyperactivity disorder, or ADHD, is rapidly rising as the most common psychiatric diagnostic label for children. Anywhere from 3-7 percent of all school-age children and adolescents may have it, and it is one of the primary causes of behavioral problems in general pediatric settings. Nine boys are diagnosed with ADHD for every girl, but the rate of diagnosis for girls has been rising as well, and girls who are diagnosed have the same level of impairment as boys.

Kids with ADHD show difficulty holding attention and display impulsive behaviors and overactivity levels beyond what might be expected for their age group. They typically show poorer academic performance, have difficulty in social settings, and can't adapt as well emotionally as kids without ADHD. Studies show that a diagnosis of ADHD puts kids at higher risk for delinquent behaviors and substance abuse. Other diagnoses such as learning disabilities, mood disorders, and anxiety disorders are often seen in the same children.

Medical Treatments
Now a household name, the drug Ritalin is the most common medication prescribed for children diagnosed with ADHD. In fact, it's the most common drug prescribed for any childhood disorder. It's been estimated that more than five million school-age children take Ritalin annually.

Known to stimulate areas of the brain associated with attention, arousal, and inhibition, Ritalin seems to help improve ADHD symptoms in about 75 percent of cases, but its effects last only as long as it's taken, and it does produce side-effects. Nervousness, headaches, sleeplessness, and rapid heart rate are sometimes seen with its use, and overdose can produce severe effects such as agitation, hallucinations, high blood pressure, seizures, heart arrhythmias, and psychosis. In addition, studies are only now being conducted on long-term effects.

Ritalin, as well as other psychostimulant drugs, can be effective in improving attention span and modifying behaviors associated with ADHD, but kids need to be monitored carefully for side effects and appropriate dosage.

Massage for ADHD
Two recent studies conducted by the Touch Research Institute at the University of Miami reported that regular massage therapy can be an effective treatment for kids with ADHD. One study found adolescent boys who received ten 15-minute daily massages were observed by their teachers to be more focused in their schoolwork, and they fidgeted less. In addition, the children rated themselves as happier than those who participated in a relaxation therapy program.

Another study involved kids aged 7-18, 20 percent of whom were girls. Each subject received a 20-minute massage twice a week. They showed immediate improvement in their moods and longer-term behavioral improvement in the classroom. They also reported feeling happier and their teachers found them to be more attentive.

In adult studies, massage has been shown to reduce levels of the stress hormone cortisol, helping to mitigate the active fight-or-flight response. Massage also helps improve math computation performance and raises alertness levels, as measured on electroencephalograms (EEGs). Finally, massage decreases depression and increases mental focus. The same effects are seen in children and teenagers with ADHD.

The Details
Incorporating professional massage into your child's routine may help him to develop an age-appropriate ability to focus, a calmer disposition, and even increased confidence. Studies report that two 20-minute massages a week are enough to show significant improvement in ADHD children. Because these kids have trouble staying still for prolonged periods, they better tolerate shorter, more frequent massages.

For massage on children with ADHD, a practitioner generally uses simple, moderate-pressure strokes to the child's head/neck, arms, torso, legs, and back. Dividing time between these areas--say four minutes each--will address the full body and is enough to get the desired effect. Most kids do fine fully clothed.

A comfortable bed, chair, or table in a quiet room is best. For parents seeking skilled bodywork for their kids, chair massage is a great choice, done with the child fully clothed and for about 20-30 minutes at a time.

In addition, supplementing with home massages between professional sessions can also be useful. Talk to your massage therapist about private massage lessons for you. She can teach you simple, effective techniques to use on your child when frequent visits to the massage therapist may not be practical.

By adding massage to your child's routine, you're giving him much needed physical contact and helping to calm his nervous system, which will pay dividends in his ability to do school work, interact with peers and teachers, and be happier in general. And if you're massaging your child yourself, you'll create the opportunity for a stronger emotional bond between the two of you.

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