Palpating the slippery subscap

 

Subscap can be a tricky muscle to palpate and is an essential skill to have in treating shoulders. Watch the video and learn a fool-proof way of finding it!

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Thinking about raising your rates? Use this sweet strategy

Recently, I was speaking with one of my coaching clients about raising her rates, and she was worried about running her clients off, driving them away.

I think everybody, including me, can identify with those worries.

If you're thinking about raising your rates, use a strategy I learned years ago from Sharon Desjarlais. It's called a Gratitude Sandwich.

Here's five steps that will get the job done to raise your rates without losing your clients or your integrity.

Step 1: Be intentional and decide on the exact date. Get it on your calendar. That way you won’t forget or be tempted to let it slide.

Step 2: Measure the value of your work accurately. Most therapists make a big mistake: They believe their value is in the time they spend with a client.

But your worth is never about the time. It's about the transformation. It's about the outcomes your clients get and how those results change their lives. Take about ten minutes and write down all the benefits that your clients get from...

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Chronic Pain and the Brain

As bodyworkers we all treat people in pain and most of the time successfully. But what if your client has had pain for more than 3-6 months and is not responding to your or any other treatments?

It’s possible that it’s neuroplastic pain (also known as neural circuit pain, central sensitization, TMS (tension myoneural syndrome)

Neuroplastic pain results from the brain misinterpreting safe messages from the body as if they were dangerous. In other words, neuroplastic pain is a false alarm. Though the pain can be addressed through various practices, this does not imply that the pain is imaginary. The pain is REAL!

“The relationship between pain and the state of the tissues becomes weaker as pain persists”  Dr. Lorimer Moseley

In other words the longer the pain persists the higher the chance it’s being caused by the brain and nervous system. Without the brain there is no pain.

Neuroplastic pain is caused by a brain/nervous system which has gotten stuck...

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It’s not a strength issue is it?

My client, Nancy came in the other day and was concerned about her left arm and left hand. She'd been doing bicep curls with her trainer sitting at a machine, using  a 15 pound bar and she experienced pain and lack of strength in her left arm/hand.

She has a history of an ulnar nerve injury in that arm and experiences flare ups now and then.

Her personality type is one that pushes herself hard, a high achiever and sets very high standards for herself.

I just completed my Movement Specialist Certification and there were some really handy tools in there including a  Movement Threat Screen Assessment.

I asked Nancy to visualize doing the exercise the same way she had just done it with her trainer and asked her if that caused her any worry, fear, or pain.  She reported that it did and was amazed that a visualization could produce the same experience.

But as we all know, the brain really doesn't know the difference between past, present, or future. It's always in the now.

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The upstream and downstream of bodywork

A new client came in recently, we’ll call her Glenda. She complained of pain in her lower right rib area from a car accident about 5 years ago. “It feels as if it pops out of place” she said.

 As I explored and palpated the area and verified where she felt the pain she anxiously asked, “Is there inflammation there?”

Instead of answering her directly I said “Your body is really protective of this area.”

It was beautiful to see and feel her response. She took a deep breath and said, “Yeah, that makes sense.” Here whole being relaxed and her exquisite parasympathetic system came on board.

These are the moments I treasure – I call them hallelujah moments.

Using the phrase “Your body is really protective of this area.” is a tip I got from the marvelous pain researcher Lorimer Moseley. Lorimer was a recent guest on the Thinking Practitioner podcast.

Lorimer is one of the most well respected pain researchers in...

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The Power of Reassurance

Recently I heard an interesting story from a PT (let’s call him Tom). In the clinic Tom worked in there was one PT (let’s call her Amy)  who always got the best outcomes. Tom was really curious about this since they had equal skill sets and training. Tom asked to sit in on one of Amy’s sessions. Tom observed that Amy constantly reassured her patients with statements like: “You go this!” “You are improving every day!” “The body is resilient and knows how to heal” Amy also did a through intake which included addressing the the psycho-social factors such as social support, loneliness, marriage status, social disruption, bereavement, work environment, social status, and social integration.

That was a light bulb moment for Tom and since then he's incorporated his "lessons from Amy" and seen his outcomes improve.

 Pain (both chronic and acute) often causes the amygdala to go on high alert, arousing sympathetic...

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Easy vagus nerve exercise to calm the nervous system and lower tension in the neck and shoulders

 

This is one of my favorite exercises to help calm the nervous system by directly affecting the vagus nerve and lower tension in the neck and shoulders  and increase neck mobility.

 

You can easily do this with your clients in the supine position and teach it to them as a self-care technique.

 Feel free to share this video with your clients!

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Abducted By Aliens?!

bodywork May 12, 2023

“They come at night, mostly” my client Kim quipped, quoting the famous line from Aliens (one of my top ten movies).

She’s referring to the pains down the side of her left leg that regularly wakes her up at night.

This vicious pain pattern is ubiquitous. Gyms are full of people foam rolling their lateral thigh/ IT bands.
 
Trigger point referral patterns to the lateral thigh come from quite a few muscles – the main culprits are gluteus medius, minimus and tensor fascae latae.  Mmm – all abductors of the hip. There’s a clue here!

These muscles fall into the phasic category and tend to be weak/inhibited. Bursitis and tendonitis of the muscles that attach to the greater trochanter is rampant. (Quadratus lumborum refers right into the greater trochanter often mimicking GT bursitis.)

 

Here’s a paradigm I’ve used in eliminating and/or reducing that pernicious “aBducted by...

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Suboccipital Muscles And The Eyes

body work May 12, 2023

 

The suboccipitals are immensely fascinating. While they move the head and neck, their critical importance lies in the fact that they serve as a sensory system, gauging where the head is in space and coordinating balanced movement throughout the rest of the body.

These muscles are intimately connected to eye movements, and together they support the vestibular system in forming our righting reflex. They contain an unusually large number of muscle spindles which tell the brain the exact position of the head and neck relative to gravity.  (The suboccipitals have 36 spindles per gram of muscle tissue whereas, for example, the gluteus maximus has less than 1 spindle per gram of tissue). 

Try this on a client: soften the outer muscle layers so that you have contact with the suboccipitals.  With your clients eyes closed, ask them to move their eyeballs from side to side without moving their head or neck. You should be able to feel that movement in the...

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Trochanter Bursitis – Or Is It?

body work May 12, 2023

A diagnoses of trochanter bursitis is popular these days. But is it bursitis or trigger points? And, what is causing it? What are the perpetuating factors?

To simply calm down the bursa (treat the symptom) is helpful but if the underlying causes are not addressed for the issue, it will be a lengthy course of treatment at best, and at worst, a repeating problem that can effect gait and therefore impart imbalanced forces on the entire lower extremity. A cascade of orthopedic and musculoskeletal issues can then lead to a chronic pain syndrome. A cortisone shot is good for calming it down but that’s not the whole enchilada.

Usually the easiest way to check if it’s bursitis is to gently (and I mean no more than a nickel’s worth of pressure) press on the greater trochanter (GT). If that gentle pressure eleicits pain then it’s probably bursitis.

If not, search for trigger points in G-minimus, G-Medius, TFL, piriformis or any of the other...

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