Massage, Physical Therapy and Being Your Own Advocate

There is a reason why I choose to work in a sports rehabilitation setting. It is because I firmly believe in coupling multiple disciplines to control pain cycles. Often, clients are in the middle of physical therapy and they receive a massage for the first time from me and they are so impressed by how much better they feel that they discontinue physical therapy and opt for a few sessions of massage. They think they've found the solution.

No, no, NO!

What a waste.

Although a massage session can make a profound impact on the body, discontinuing physical therapy can unravel the process in a matter of days or weeks. There is no single solution. Finding the source and attacking it with one modality is an old paradigm. I studied an unnecessary amount of English literature/linguistics coupled with cultural attitudes in college and the way we problem solve and handle conflict stems from a polarizing approach in our language and communication. It's either "this" or "that," "us" or "them," "start" and "finish." Being able to compartmentalize and organize our thoughts and judgments reduces our anxieties and gives us a sense of completion. Good luck doing that with the human body which is one of the most complex pieces of engineering.

I will resist floating into the ethers on this post. I may have already lost you on some points. Back to physical therapy. Eight weeks of physical therapy is a drop in the bucket in your decades of habits run by a brain that is more powerful than the sum of all the computer processes in the world. I have enough experience with clients who complete the process from start to finish (ha! what finish line?) to confidently say they become the true masters of their bodies. Physical therapy isn't always about building muscle or stretching. It's about RE-EDUCATING muscles. Muscles are like people in a workplace: some are the work horses, some are lazy, some are angry, others are depressed or overly enthusiastic. I believe physical therapy helps distribute responsibility more evenly. I love analogies. Here's another one. Muscles are like petulant children. You cannot possibly control them by yourself. You need super nanny, a drill sergeant, psychologist and a master of diplomacy to whip them into productive members of society. Embarking upon treating your own musculoskeletal pain means going to school for many years and having an advanced level of self-awareness before you even begin to understand what you are doing. So yes, this is why massage therapy--one of the most passive and easy ways to address pain-- is often not the main solution. If there was a quick fix then everyone would know about it and I'd be rich.

Some things learned in physical therapy must be done long term. We are never finished maintaining the body any more than we're finished brushing our teeth. If there was an embarrassing social consequence to not doing PT you better believe most everyone would do it.


Being Your Own Advocate

First and foremost, you are your own advocate. If you sense something is not working SPEAK UP. We are taught that doctors and authority figures in health and wellness have all the answers and then we act passive aggressive (or aggressive) when we think it's not working. Only you know how you feel. No apologies necessary when challenging authority. (S)He who asks receives.

Questions to Ask a PT or Chiropractor:

• Is it normal to feel like I'm not making progress week to week?
• Should I be doing my physical therapy at home? What should I purchase to do this at home (theraband, foam rollers, balance ball)?
• Do I continue doing my own exercises and stretches after I'm discharged? Which ones?
• What activities should I avoid during and after physical therapy?
• Should I ice or heat an area? Which areas and for how long? (heat should NOT be applied to inflammation)
• Is there any other cause for my pain which wouldn't be musculoskeletal at the source? Should I consult a specialist to have it checked out?
• Do you have any online resources that show me how to do these exercises in case I forget?
• Do you have any affiliated partners like nutritionists, massage therapists, personal trainers who work with complex medical cases, etc that you think I'll benefit from?
• Should I be taking any supplements that might help me?

Keep a Journal

Keep a daily journal. What you ate, what you did, pain on a scale of 1-10, your stress levels & triggers, how much water you consumed, notation/revelations about postures, flare-ups like heartburn/sinus pain/allergies, etc. Be honest. When you go to PT you will at least have a coherent train of thought and a journal as reference. We cannot watch what you do outside of PT. There are things YOU will have to correct yourself or bring up at your next visit. If you are checked out of the process then it probably won't work or at best will stunt progress. Please note that a more anxious mind can go a bit overboard drawing conclusions that have very little correlation with their own issues. Patterns are good to bring up to a health care provider. If they brush you off then go to someone who will listen.


Best of luck! I believe in you regardless of age, medical issues and other challenges. You are the result of millions of years of evolution and you are the best of the best. And if you don't believe in evolution then you come from a long line of badass warriors and ancestors who survived things luckily we'll never see. Be proud and rock on.