Gina, the taller person, in summer of 2015
How much exercise do you "actually" need to get in shape?
Twenty minutes three times per week? Half-hour per day?
And how much is too much?
Do you need to sweat it out for an hour or more every day?
Let’s go over the (sometimes) mysterious amount of exercise that is ideal. Ideal for your health and wellness. Ideal for getting into shape. Starting with the minimum.
WHAT’S THE MINIMUM AMOUNT OF EXERCISE?
Of course, you’re going to have to start from where you are right now. If you’re not already exercising regularly, there is no need to go overboard. In fact, trying too much too soon may derail your motivation, and become a reason you just throw in the towel. Don’t be the person who goes “all-out” once then hurts too much to continue. If you start easier you won’t need as much recovery time and can get back to a workout again sooner.
So, let’s say you’re not that active (yet). What if I were to recommend “ten to twenty minutes every other day at a level you think you can do?” How does that sound as a starting point?
Pretty do-able, I’d say!
If you’re not training for a competition, you can absolutely get into great shape starting with this plan. It’s got to get longer, I’m not gonna lie. But that time is going to pass anyway, so when the next season comes around wouldn’t you want to be proud of your improved strength and fitness?
Yes, I thought so!
HOW TO DESIGN YOUR EXERCISE PLAN
Now, there isn’t one answer for everyone. The main rule is to begin with where you are. Take note of your fitness level and your goals and increase and improve slowly. There really is no quick fix (at least no quick fix that will give you lasting long-term results).
Always consider what is reasonably sustainable for you, based on:
But don’t stop there!
As you create a sustainable exercise habit, it will start getting easier. So, don’t forget to make it a bit more challenging as you go. Every week do something to push yourself a bit farther than you were before. If you’re strength training, do another repetition or grab the next heavier weight. If you’re doing cardio, go a bit longer, further, and/or faster.
A great motivational tool is to log your workouts. A simple notepad or workbook (or app) will do! Just enter your reps, sets, and/or times each time you workout. This will not only help you to keep motivated to continue, but it will also help you see where you can squeeze in that extra challenge as you progress. I like the Strava app because it syncs with my running watch, but there are many others.
Laying workout clothes out the night before can also help you prepare for a morning workout. Shoes, socks, sports bra, shorts (my running shorts have a built in liner) and t-shirt. Wake up, get dressed, drink water and go. I tend not to stretch until mu muscles have warmed up a little.
After several weeks you can stop and evaluate. Keep going the way you are, ramp it up, or change it completely. Eventually, you will find yourself getting stronger, and more fit!
DON’T FORGET YOUR NUTRITION
While exercise is very, very good for your health, wellness and longevity, it’s not the only thing to consider. What you eat is going to have at least as much impact on your shape.
Some of my favorite super-simple tips that give you the biggest “bang for your buck” are:
You don’t need to exercise like crazy to get into shape. I promise! But you do need to do the following:
Gina in fall of 2019
You want to eat healthier, but you’re super-busy.
You eat out several times a week because that’s what you "have" to do. That’s what works for you and your family (when it comes to time and convenience). But you probably realize it’s not working great when it comes to your health and fitness goals. You want better health. You want to eat better. You don’t want the extra calories, fast food and junk food as much anymore. And you DO want to save time and money. I get it! If you know my story, you will know that I have totally been there...
So, as a health coach, I am here to help you.
I have a simple strategy that I’m more than happy to share with you. It will help you to plan and prepare healthy meals for the week.
Now, you don’t need to completely abandon your regular meals out. You can use my strategy to help you eat out just one or two fewer times per week. It’s up to you.
As with any lifestyle change, start gradually so you can build consistency.
The key here is to make it easy, doable and rewarding enough to do again and again.
Let me walk you through my simple meal prep system, and how this can work for you.
PLAN MEALS FOR THE WEEK
I prefer to do this on the weekend. I’ll flip through my recipes and choose a bunch to make that week. I’ll even pick which days to have which meals if I’m feeling overly ambitious, but that’s not necessary if you’re new to this. I’ll bookmark the pages and write my chosen recipes down in a notebook or even a sheet of paper to put on my fridge. I like to have at least one crock pot meal each week because they’re so easy, and dinner is ready and waiting when you get home.
Then I create my grocery list. I take a quick look in my fridge, freezer and pantry, and list the recipe ingredients that I need to buy.
Pro Tip: If you’re not sure you have enough of an ingredient already, consider buying a “backup” one just in case. I’ve had times where the tomato sauce or chicken broth I planned to use was a bit short of what I actually needed. Having to run out in the middle of meal prep can be very frustrating.
Another thing to consider is doubling the recipe(s), so you can prep and cook once, but have twice the meal at the end. The extras can be taken for lunch, or frozen to pull out the night before a busy day, so you just need to heat it up when you’re ready.
Pro Tip: If you’re doubling a recipe, don’t forget to double the amount you buy from the grocery store.
Once you have your handy-dandy grocery list ready, hop on over to the store and pick up your essentials. If you don’t have enough food storage containers for your meals, now’s the time to pick up some of those too.
Pro Tip: If you’re not a fan of washing and chopping produce, then consider buying them already pre-washed and pre-chopped, or even frozen. You can make your meal prep even easier if you don’t mind spending a couple of extra dollars.
PREPARE MEALS FOR THE WEEK
Since you’ve already chosen your recipes and have your groceries, let’s get started on prepping some of the ingredients.
I like to book off 2-3 hours one afternoon for this. Get your recipes ready, clear off your counter, and play some music or your fave podcast (if you’re so inclined).
At this point, depending on time, I’ll either prep the ingredients, or pre-cook the entire recipe. Sometimes just washing and chopping produce and putting it in containers is a huge time-saver for weeknights. Or, you can go through and make a whole meal, and divide it up into portions and refrigerate or freeze. It’s really up to you, because the more you do now, the less you’ll have to do when you’re hungry.
AWESOME MEAL PREP TIP
There is one meal that is easiest to plan and prepare in advance. It’s one that’s also often the most difficult to eat at home if you’re busy. That’s breakfast.
Planning some overnight oatmeal is a great start to any day. Simply place ½ cup rolled oats, ½ cup your choice of milk, 1 tbsp chia or flax seeds into a container (or make 5 for the whole week). Then place the lid on, shake them up and put them in your fridge. In the morning you can quickly heat them up or even eat them cold (the oats will have absorbed the milk). Top with some fruit, nuts or high protein plain yogurt and Enjoy!
With a little planning, you’ll be able to eat healthier while you save money and calories.
This may take some getting used to, so if I can be of help, please reach out and let me know.
How hormones affect your energy and weight
Are willpower and self-control the only solution to low energy and high weight?
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.
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:
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.
The multifidi can be found running along the right and left sides of the spine. From the neck to the sacrum, each multifidus section spans three vertebral segments and helps to stabilize the spine, helping it work more efficiently and slows down degneration of the joints so often caused by the dreaded weak core, hip flexion and gravity. It might help you to think of it like a wobbly tent that becomes more stable when the lines are tightened. Because of the arrangement of the muscle on both sides of the spine, when both sides contract the multifidi help with spinal extension and fine-tuning of movements.
During hunting season, I observe my dog’s movement patterns. She’s a natural athlete. When she points I watch her nose, spine and tail in perfect alignment as her multifidi and spinal muscles contract. Her strong core allows balance as her front leg is raised. And she can get into position immediately, without a second thought, with excellent balance, over all kinds of terrain, for hours. Amazing!
Of course, it wasn’t just the dog’s multifidi that were contracted, but her other spinal muscles, and glutes too. I noticed that the dog was lengthened through the hip flexors –very important to have length here to avoid too much swaying of the low back. Anatomically, there was a lot going on. It got me thinking that perhaps muscles are only named and defined to ease our ability to describe sensation or one specific action. The thing is, I can’t think of any real-life action in which only one muscle moves. It makes more sense to think in terms of a kinetic chain-- the hip bone is connected to the back bone, the back bone is connected to the neck bone…
If you have performed any bodyweight exercises you may have done an exercise called bird-dog, in which you performed a movement similar to the pointer. Bird-dog can be a great exercise to strengthen the multifidi and other muscles that run along the spine, but there is more to it. Our muscles are connected to each other and organs by fascia, a strong, fibrous connective tissue. Our muscles and fascia work together to provide smooth movement along a kinetic chain. In a position like bird-dog, the lats on the arm-up side must be able to stretch, which requires the arm rotating muscles of the shoulder to have an acceptable range-of-motion. The (usually weak in everyone) glutes must be strong enough to extend the hip. Activation of the glutes can happen almost immediately, however, when the hip flexors are stretched.
Bird Dog is a great exercise to use when you need to strengthen your back and glute muscles.. It is easy to do in your house on a towel on the floor. Use the picture below and think of your back and glutes holding you up. Proper exercise and good massage can go a long way to help improve your back pain and help your muscles function better to reduce degeneration. Additionally, your own bird dog might recover faster and have greater muscular endurance if you spend a little time treating his or her muscles to massage.
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."
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
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
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.
Photo courtesy of ABMP
It was a cool and rainy day last spring. A woman sat in my office describing her neck pain that had been occurring almost daily for months. Her doctor told her it was probably from a pinched nerve in her back, and some arthritis to boot. She asked if she could continue receiving massage therapy and her doctor agreed that it might be helpful. Besides, the October edition of Consumer Reports listed massage therapy as one helpful treatment for osteoarthritis.
She pointed to a spot on the side of her neck, where her neck meets the top of her shoulders and said that sometimes she feels the pain up the side of her neck, into her jaw, and occasionally a headache that she can feel in her eye.
I placed my flattened fingers over the spot that my client had indicated she felt the pain. Upper trapezius, platysma, scalenes… I would address all three, but figured that most of the pain was coming from the upper traps. There are myofascial trigger points in the upper traps that refer pain to the head and eyes and sometimes into the jaw but one has to be conscientious when treating them since the area may already be exquisitely painful.
The traps’ action on the neck is lateral flexion, side bending, and her son had been telling me about how she naps—sitting upright in her easy chair, with her chin nearly on her chest, sometimes with her right ear toward her right shoulder. I have known administrative professionals with a similar kind of pain from holding a phone in a similar way. So, I decided to treat the upper trapezius first.
Paying careful attention to the “V” of the shoulder, the area in between the clavicle and the top of the shoulder blade, the muscle was treated. When I heard “Oooh that’s it,” I hung out on that spot until she said the pain was going away. Then I dug in a little more, but she quickly said that pain was subsiding, too. We repeated the releases one more time.
The upper traps also attach on the head at the superior nuchal line of the occipital bone at the back of the skull. After bringing fresh blood, oxygen and nutrients to the part of the upper traps at the V, the attachment on the occiput was treated. Having the head cradled and fascia manually rubbed and stretched is an experience that most people like. A lot. I found that to be true once again.
The traps are a big muscle, and when I was satisfied that I had left no stone unturned with her upper traps, I sifted through some of the muscles on the front of her neck that could be contributing. We did a myofascial release on the platysma, creating a little space between the chin and the shoulders. I scooted her sternocleidomastoid muscle (the scm) over a little bit to treat the scalenes all the way down to the connection on the first and second ribs. When we finished she sat up, moved her head all around, and said “THAT feels really good.”
If you suspect that your neck pain is from spending a lot of time with your ear toward your shoulder, you might enjoy some myofascial pinning and stretching, too. Try bending your ear toward your shoulder and using your firmly planted palm to pin the muscles alongside the neck. Then slowly unbend your neck and enjoy the stretch of the fascia under your palm. Feels great!
Gina McCafferty is a licensed massage therapist, and heath coach who works with women in their peri and menopausal years who have 30 or more pounds to lose.