It was a dark and stormy night. I had just finished writing my notes for the day when I heard a knock on the door. I went to open it and I saw a man standing there, squeezing his neck at the base of his skull.

 “Are you the Anatomy Nerd?” he asked, wincing a little. 

“Yes, and you are…?”

 “The Headache King,” he replied.

I nodded, dimmed the lights and led him to a comfortable chair in my office.

“Do you get headaches very often?” I asked.

​“Yes. I’ve been in a few car accidents over the years, fallen off horses, fallen skiing, and now I sit at a desk all the time.” He grimaced. “The pain starts in the back of my head and wraps all the way around to the front. It’s worse if I get a draft on my neck. My wife gets them too, but they’re much better since she stopped using anything labeled diet or light.” 

I had him show me exactly where he feels the headaches and asked him to perform some basic range-of-motion moves such as moving his head in an ear-to-shoulder way and a few neck rolls to help me understand his headaches more.

Determined to de-throne the “headache king” part of all this, I started to massage the suboccipital muscles. I decided to start on the one called Rectus Capitis Posterior Minor, because that’s usually a biggie for people with headaches when… “Thaaat’s the spot!” he exclaimed. Like most people when their massage therapist gets THE spot, he acknowledged that I was in a very good place to work.

The sub-occipitals are a group of muscles that allow you to turn your head and look up. Turning the head we’ll call rotation, and looking up we’ll call extension. If these muscles are locked long or short you may have difficulty rotating your head as well as flexing or extending. If he is sitting at a desk all day, his head probably comes forward, and his suboccipitals have to work to tilt his head back and keep his eyes level with the horizon so he’s not looking down. It’s just the way our nervous system and by default our muscles respond to the conditioning.

As I worked, I thought more about how our brains control our muscle length and realized that if his head was forward of his center of gravity, his sub-occipitals would go back to what they were used to until we changed something further along the kinetic chain and even made a plan for him to change up his ergonomics a little. The Sternocleidomastoid, the SCM for short, came to mind. If you are familiar with this muscle then you know that its main action, when both the right and left contract, will bring the back of the ears (mastoid) toward the breastbone (sternum). Try that on yourself. Try to bring your mastoid process, the bump behind your ear, toward your sternum. Now, keep your eyes level with the horizon. Because of neurological laws, your body will adapt to that position in a very short time. Did the back of your head move toward your spine? Even though for most of us that movement was an exaggeration, that action does cause your occipitals to contract and they’ll do it  Every. Single. Time.

 If your head is forward, your suboccipitals may stay contracted, possibly becoming swollen, restricting bloodflow, increasing trigger points and causing painful headaches.

After applying some techniques to the suboccipitals, he begged me to wrench on his SCMs. “He’s a jester now,“ I thought happily. I soon wrapped up, saying goodbye to the soft-tissue I had been working and showing him a couple of key moves to do at home to help relieve the pain and and bring fresh oxygen and nutrients to the muscle tissue.

Before he left, he made another appointment, bought his wife a gift certificate for Mother’s Day, and left-- doing neck rolls, stretching and whistling a happy tune as he walked back out into the dark and stormy night. 

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Gina, the taller person, in summer of 2015

Gina in fall of 2019

How hormones affect your energy and weight
Are willpower and self-control the only solution to low energy and high weight?

Maybe not.

It might actually be your (powerful) hormones.

And we’re not just talking about sex hormones here; we’re talking about the hormones that directly affect your blood sugar, metabolism, and appetite. Things that actually control your energy and weight. Let’s go over a few of the critical links between your hormones, and how they affect your energy and weight. The links may be stronger than you think.

WHAT ARE HORMONES
Having healthy, happy hormones is all around the “health waves” these days.  
And for good reason! Your hormones are part of the master control system of your entire body. Hormones are compounds made by one part of the body that are used to communicate with another part. For example, insulin is made in the pancreas. When your blood sugar gets too high, insulin is released into the bloodstream. Then, it goes to your muscles and other cells to tell them to absorb that sugar out of the blood (and if there is still too much blood sugar, it signals to store it as fat).

Your hormones control not only your blood sugar, but also your metabolism and appetite (plus a host of other things). And you probably already know that having healthy blood sugar, metabolism and appetite is a foundation for your optimal energy and weight.

So, how can your hormones get out of whack, zap your energy and pile up the pounds?

COMMON HORMONAL IMBALANCES
In optimal health, your hormones would work great, and you’d have ample energy and be a good healthy weight. But often there are problems with this whole setup.

• One common issue is that there may be too much or too little hormone released to have the desired effect. This is known as hypo- or hyper- “hormone” (i.e. hypo- or hyperthyroidism).
  
• Another common issue is that, even if the right amount of hormone is released, the cells they communicate with can start ignoring them. This is known as hormone “resistance” (i.e. insulin resistance).
• Long-term stress also releases Cortisol, the stress hormone, which over time can lead to increased belly fat in addition to a host of other health issues
  

As you can imagine, if your hormones have such critical jobs such as controlling blood sugar, metabolism and appetite, they can definitely cause issues with your energy and weight.

HORMONES AND ENERGY
Your metabolism is key for controlling your energy. Metabolism itself is basically how much energy (calories) you burn, and the chemical processes that take place. One of the main players of this is...you guessed it! Your thyroid hormones.

Your thyroid releases hormones that affect the metabolism of all the cells in your body. If it’s too low and your metabolism goes down (hypothyroid), you may feel cold, hungry and tired. If it’s too high and your metabolism is too fast (hyperthyroid), you may feel hot, jittery and lose weight.

What you actually want is an ideal metabolism, ideal energy use, ideal temperature, and an ideal weight. Your thyroid hormones are the master controller here.

HORMONES AND WEIGHT
Your weight may be controlled by hormones more than you think! Insulin controls your blood sugar, and whether that sugar is going to be stored as fat or not. And when your blood sugar is too low, you may start craving sugar and carbs.

You also have hormones that control your appetite! How hungry and how full you feel are controlled by the hormones ghrelin & leptin. Ghrelin is known as the "hunger hormone" and it drives us to seek food and eat it. It is released in higher amounts when we are short on sleep for even one night! When those two hormones get out of whack, you may find yourself wanting to eat because your body thinks you’re hungry and not satisfied...even if that’s not true.

And craving food (especially sugary ones) and not feeling full are going to be huge drives for you to eat more. Even if your body doesn’t truly need it, the hormonal signals tell you that you do.

And don’t forget about the stress hormone cortisol. When it’s too high for too long, it tells your body to store fat. And not just any fat - belly fat!

SUMMARY AND WHAT YOU CAN DO

Your body is very complex and uses hormones to control a huge number of functions. They control your blood sugar, metabolism, and appetite, amongst others. And these directly affect how much energy you feel, how much you weigh, and even where your body fat is stored.
Here are a few “hormone stabilizing” tips that might help you with your energy and weight:

• Get regular exercise to use up excess blood sugar before your insulin has your body store it as fat
• Try stress-relieving activities like deep breathing, massage, meditation or even coloring to reduce your (belly-fat inducing) cortisol
• Support your thyroid with iodine-containing sea vegetables, fish, legumes, or even an egg
• Balance your blood sugar with extra fiber from our ripe local fruit, avocados, or flax seeds if they suit you
• Reduce blood sugar spikes by replacing your juice or soda with fruit-infused water
• If you need some support with your energy levels and/or weight, schedule a strategy session with me to see if I can help. This is one of the topics that we cover in my 12 week coaching program.

REFERENCES

http://www.precisionnutrition.com/fast-weight-loss-changes-hunger-hormones

http://www.precisionnutrition.com/all-about-thyroid

https://authoritynutrition.com/9-fixes-for-weight-hormones/

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Take a Load Off: Leverage Your Pain Relief with Self Care

Leverage. It's a word we hear often enough, but what does it mean to you? We often think of leverage as having the upper hand in a situation-- having an advantage.Working smarter, not harder. Today, let’s explore how our bodies use leverage to allow us smooth, strong movement as we do, you know,  #allthethings.

First, let’s make sure we are all on the same page with what leverage is. Tortora and Grabowski, 2003, describe leverage as an advantage when a smaller effort can move a heavier load.
 A LEVER can be a bone. 
The FULCRUM would be the joint (elbow, knee, shoulder…)
And EFFORT would be your muscle contraction, ​

The joint hinges when your muscle contracts and brings the bones closer together (for example when you bend your arm at the elbow, your biceps contract, closing the angle between your upper and lower arm). A LOAD, or resistance, opposes the movement. In your body, movement occurs at the joint when the effort is greater than the load. Stay with me here...

There are three different types of levers and they are categorized by the positions of the fulcrum (F), the effort (E) and the load (L). We'll call them first-class levers, second-class levers, and you guessed it, third-class levers. 

Here is our first scenario: You are sitting at your desk, attending another zoom webinar or something, and you notice that your head or neck hurts. In this case, the weight of your head is the load (L), is in front of the fulcrum (F) which is your atlanto-occipital joint. The effort (E) or force, comes from the muscles that tether the back of your head to your spine. They are working very hard to keep your head up-- eyes level with the horizon-- but you keep looking down at your screen. This is how many "knots" occur. This EFL arrangement is a great example of a first-class lever. As an aside, a pair of scissors works the same way. Your thumb and fingers contribute the Effort, the Fulcrum is the hinge and the Load is the paper.  Over time, the muscles in the front of the neck can also “reset” to think that that the forward neck position is normal. If you have ever felt tension in the front of your neck and stiffness  when you tip your head back, this could be why. To learn how to reduce this pain and tension yourself, schedule a muscle pain consultation online via the appointment button on my website.

The second-class lever is the strongest. Imagine this...Our days are getting longer and hopefully warmer and we are thinking about the garden. We have to move heavy loads in the wheelbarrow. In this example, the Fulcrum is the wheel, Load is all the dirt or weeds we have to move and Effort is applied to the handles. Because the load is close to the fulcrum, the wheelbarrow allows us to work smarter-- we use less effort to lift such a heavy load. It is the strongest because E is further from the pivot. Many anatomists believe that we don't have any second-class levers in the body, but others contend that the action of the calves attaching to and lifting the heel produces a similar wheelbarrow effect. 

The third-class and most common kind of lever is when the effort is situated between the fulcrum and the load. FEL. Here's the vignette: Picture yourself at the gym doing bicep curls. The weight is in your hand (load), and your biceps brachii muscle (effort) contracts which bends your arm at the elbow (fulcrum).  This set-up isn't as strong as a second-class lever because in this situation the effort is closer to the fulcrum. 

Often our levers are unable to function the way they should due to "knotted" muscles. Take a load off. Improve your leverage. Work smarter, not harder.  A combination of knowledgeable massage therapy combined with the right kind of exercise for your situation can help your joints move more smoothly and efficiently through an optimal range of motion. 

I’ve been practicing therapeutic massage for pain relief and improved range-of-motion for 15 years. Visit my website and click on the make an appointment link if you'd like a $25 consultation to help with leverage your pain with self-care. Even during this pandemic, I am here for you. I can easily talk you through some massage techniques and quite possibly some exercises that will help you have less pain and better mobility.

Most of the literature suggests that 80% of people will suffer from at least one episode of back pain sometime in their life. No matter what the underlying reason is that causes the pain, one of the muscles that is often involved is the multifidus or plural, multifidi. ​

Sometimes. Only sometimes I have a client who comes in and says "Gina, I don't understand. I was sore (or wiped out) the day after my massage."

First, being a little sore is NORMAL after a massage, especially if its been a while since you have had one. The soreness is kind of like the soreness after a quality workout and usually says au revoir in 24-48 hours. The WIPED OUT feeling is something different. Its usually due to dehydration.

"But GINA, I drink a big container of water every day."
Doesn't matter.

How often have you gotten up from the massage table and had to (ahem) pee? We just finished an hour or longer of making your blood vessels bigger which transports more blood, oxygen and nutrients (faster!) to your body systems-- we have increased your circulation. I've always been taught that sodium and potassium help your muscles contract and relax the way they should. Knots and cramping often happen when they aren't doing a good job of that? Is it because partly of dehydration?

So when we work out a knot in a muscle, we are bringing fresh "food and drink" to the muscle. The food and drink has to come from somewhere in the body. Makes sense to replace it, eh? Water. If you don't have enough you will feel it in terms of feeling drained, maybe even a little feverish, sore, and fatigued. That's why your massage therapist always says to drink extra water after a massage. Forget everything you have ever heard about "toxins". Please. It's so last century.

You cells and body systems will also benefit from the electrolytes in a hydration drink. Not fake sugars mind you, but real honest to goodness drinks made from real ingredients, and mostly water. Remember Sodium, Potassium, Calcium and Magnesium-- They are required for muscles to work, for muscles to relax and contract properly. Forget the fake food and fake news and give me something authentic, dammit. Here is one of the hydration recipes form our weekly newsletter. 

​Weekly Hello Hydration Recipe 
Keeping hydrated is an important part of staying healthy. Water promotes cardiovascular health, keeps your body cool, helps muscles and joints work better and keeps skin supple. Here is this week’s hydration recipe:
​
Cantaloupe, Honey, and Mint Water
Ingredients:
½ c water
½ c honey
4 c (about 2 lbs) cantaloupe cut into 1 inch pieces
¼ c fresh lime juice (about 2 limes)
2 Tbsp fresh mint leaves
¼ tsp salt
sparkling water or club soda
mint sprigs for garnish
Instructions:

• Combine the honey and water in a small saucepan and heat over medium low heat until water and honey are combined and just beginning to boil, about 2-4 minutes. Remove from heat and cool slightly.
• Combine honey syrup, cantaloupe, lime juice, mint leaves, and salt in a blender and puree until smooth.
• Using a fine meshed sieve or a piece of cheesecloth, strain the cantaloupe mixture into another container. Discard solids. You should end up with about 2 cups of liquid.
• In each glass, pour ½ c of the cantaloupe juice over ice. Fill the rest of the glass with sparkling water or club soda and stir to mix. Alternately, you can mix equal parts cantaloupe juice and sparkling water in a pitcher with ice and pour into glasses as needed. Garnish with a mint sprig and enjoy!

Reeling in relief
What a gorgeous weekend we had for fishing opener. Sunny days and temps in the 70s had people flocking to our great lake, its tributaries and inland waters. Someone had given us a very large fishing pole (huge, really) and right away we were inundated with stories about dislocated shoulders, arms that tightened up and wouldn't straighten out, and hand cramps. It was like being at camp, sitting around the fire and learning the legends.
I wasn't sure I believed the tales about the shoulder getting thrown out of joint from casting, but I know all about hand cramps. I remembered last year when I insisted on using an older, heavier fishing pole that probably would have been great to put a worm and bobber on and let it sit. But I had to cast, and strong and conditioned as my hands may be (think occupational bonus) they cramped.
So what was going on? Let's take a look at a few ideas, including first, the anatomy of the lower arm.  
Let's say there are two kinds of muscles in the hand: Long muscles and short.  
Long muscles first: The long muscles run from the forearm to the fingers, crossing all the joints in -between. The muscles that cross the joints so we can bend our fingers in order to grip the fishing pole or pull weeds are called flexors. They are located more on the palm side of the hand and forearm. When your arms are at your sides and you turn your arm in such a way that your palms face forward, you are in a position known as "anatomically correct".  We always refer to the palm of the hand as the front. The muscles that straighten the fingers, as in letting go of the fishing pole, are the extensors. They are located on the back of the hand and forearm.  
The short muscles of the hand attach on the hand, finger or wrist bones. In other words, they do not attach upstream on the radius or ulna, they stay in the fingers, hand, or wrist. These are the ones that help us squeeze our fingers together or spread them apart, they help us use our opposable thumbs, and help us flex and extend our fingers at the joints within the hand. In case you were wondering, they are the lumbricals, interossei and hypothenar eminence. The thumb also has short muscles.  
Holding that weight for so many hours may have made the short muscles of my hand contract to the point of fatigue. It was, as they say, a bummer. I didn't want to get skunked.
So what did I do? I massaged my hands, rehydrated and stretched. Electrolytes like sodium and potassium help muscles relax and contract the way they are supposed to so I picked up a sports drink that boasted being electrolyte-laden. I took a break from my repeated casting and reeling to drink up and rub my hands between the bones and around the joints. It felt pretty good. Then I stretched my fingers, especially at the joint where the fingers meet the hand. Then, I waited. Waited to see if rehydrating and massaging my hands would help. It seemed to, or maybe just taking a little break was all I needed.
Fortunately, there wasn't a repeat of the hand cramps this year, nor any shoulder dislocation. It really was all blue skies, and we even caught some fish.

Photo courtesy of ABMP

It was race day, a cool mid-October morning and I was in the Bretting Community Center providing post-event massage. The Whistle Stop Marathon runners were starting to come in at their various paces. At one point a sweaty guy came over and flopped face down on my massage table. “Please…” he pleaded. “Please work on my hamstrings.”
The hamstrings are comprised of three individual muscles. In your mind’s eye, visualize the back of the thigh. Now see three lines running from just below the knee up to the sitting bone of the pelvis. Those are your hammys. The “true” hamstrings cross two joints: the knee and the pelvis at the thigh. When the hamstrings contract, they cause the knee to bend and the hip to straighten (extend). Muscular balance between your hamstrings, glutes, and hip flexors is necessary to prevent rotation of the pelvis that contributes to back pain and degeneration. When you bend at the waist and reach for your toes, you are stretching your hamstrings. Most of us haven’t learned many truly great hip flexor stretches.
When you are running or walking the hamstrings have a lot of responsibility. Not only do they contract to bring your heel toward your backside, but on the way back they have to stay contracted. Where before (in the leg cycle of running) their duty was simply to bring the foot toward the rear, now their purpose is to control hip flexion and leg extension against gravity as the leg returns. The hamstrings act to decelerate knee extension. I could understand why this guy sought some hamstring relief. 
I used to attend a weekly “speed play” sprint workout for runners, and I could always feel my hamstrings afterward. I could feel them so much that the next day was always a swim day instead of running or biking, just to get some extra recovery time. The hammys help stabilize the knee then assist the glutes (with about 30% of the torque) in hip extension to propel the runner forward. Then their function changes to control hip flexion and knee extension before setting up the cycle all over again. These muscles have to be strong and well-conditioned to endure this sort of dynamic repetitive motion against gravity. Increases in speed or mileage without adequate conditioning have been known to set the hamstrings up for injury.
I asked the fellow on my table some questions so I could determine the appropriateness of massage for him then had him sign the consent-to-treat form. I noticed he was shivering or shaking so I wrapped his goodie-bag space blanket around his back and shoulders then put another blanket over that. I did a little rocking and compression to relax his nervous system then started to work on his hamstrings. I could see his breathing becoming smooth as I worked. His shivering had stopped. 
When his 15 minutes were up, he sat up looking refreshed. He said he felt great and told me he was scheduled for a full-length post-event massage the next day back in his hometown. He said he likes to get massage on his recovery days every other week. I commended him for taking such good care of his body, then pointed him toward the water and electrolytes.
I wiped my table down and called over the next person on the list. Having done this before, I had a good idea what to expect.
“It’s my hamstrings.” she said, walking over to the massage table. “They feel pretty tight right now.” 
I told her that she had come to the right place and set to work.

​Steering clear of pain
It was a dark and stormy night, one of those nights when the wind threatened to lift the roof off the house and send us spinning into Oz. I heard the phone ringing and went to answer, knowing that these storms often blow in the most interesting conversations.
“Is this the anatomy nerd?” asked the voice on the end of the line.
“Yes,” I replied, hoping this was a call about muscles, bones and posture. “What’s going on?”
“Well,” said he, “I drive a lot for work and I think its wreaking havoc with my body. Every time I go for a long drive I get a pain in my low back or sometimes my cheek. Sometimes it feels like it travels up my back and locks into a painful spot under my shoulder blade. I want to understand why.”
“Well,” said I, “Tell me what you think happens to your body while we’re driving.”
This is what he said. “My car is an automatic transmission, not a stick, so when I drive my right leg is outstretched and my left leg is bent. In other words, my left leg’s hamstrings are passively contracted while my right leg quads are passively contracted. That probably puts an uneven torque on my pelvis.
Moving up my spine, that torqued pelvis probably makes my shoulder height different. With my arms outstretched to reach the steering wheel, one scapula probably rotates more than the other, putting a strain on the scapular muscles giving me a pain right under the shoulder blade. That’s what I visualize is happening when I drive.”
“So what you’re saying,” I began to reiterate, “is that when you drive, one leg is outstretch and one is bent so the muscles adapt respectively. Maybe that position, over time, puts torque on your pelvis, which causes the muscles up the spine to contract more on one side than the other. When your arms are reached around the steering wheel, maybe one scapula rotates upward or downward more than the other side and you think that perhaps that contributes to the pain under your shoulder blade. Did I understand your theory correctly?”
“Yes, precisely.” He said. “I’ve been using my foam roller to roll on and also stretch out after work. I try to take stretching breaks to get myself into a different position than I’m in all day. I noticed that the bird dog pose both strengthens and stretches the muscles that are weak from driving, so I do that too. Do you have any other ideas?”
I thought for a moment. It sounded to me like he had a good handle on things. I suggested maybe meeting with a physical therapist or a personal trainer to learn some corrective exercises. I also told him that some kinds of therapeutic massage could help realign his muscular-skeletal system especially when used in combination with core exercises. Another suggestion was to consider the purchase of a trigger point bar, like the Theracane variety they sell at health food stores or some doctor’s offices.
We were just about to disconnect when the wild winds whipped once again, completing the task for us. I often look back on this call and hope that more people take proactive steps such as hydration and exercise to prevent certain kinds of musculoskeletal pain.