Massage Therapy for your Office Injury

Massage Therapy for your Office Injury: Why they occur and how to stop them!

Meghan Krupka, LMT, talks about the demands of your job, the toll it can take on your body, and the office injury it may come with.

According to studies completed by the Occupational Safety and Health Administration and the United States Bureau of Labor Statistics, musculoskeletal disorders cost approximately $15 billion in workers’ compensation costs each year. Per data collected in 2013, musculoskeletal disorders also accounted for about 33% of all office injury and illness cases. The most common of these injuries are related to the neck, shoulders and back. In addition, sedentary time and time in front of screens has only increased over the years. 

Today, the work hard, play hard and hustle mentalities are the foremost attitudes adopted by many New Yorkers. We spend a lot of time sitting in front of computers, on phones and handling stressful situations. The pile up is causing more and more office related injuries. What can you do to help alleviate your pain? Seek out a medical massage in New York City!

Our bodies are designed to move and be dynamic!

However, modern day work and office culture emphasizes sitting for long periods of time. Prolonged sitting wreaks havoc on our spines. This creates muscle imbalances and restricts our ability to move easily. Over time poor posture can lead to an office injury and inhibit our enjoyment of daily life. 

Massage therapy, particularly medical massage, offers a holistic approach to combating office injuries and postures. It goes beyond addressing just the symptoms of your pain. Medical massage can also address emotional issues related to pain and stress such as depression, anxiety and poor sleep. These are also commonly tied to office stressors. 

First things: what exactly do we mean by posture? And “good” posture?

Posture refers to how you hold yourself upright. It is how you carry yourself both in motion, stillness, and rest. Posture is dynamic, it is not static. Even when you are still, your muscles are working in concert to keep you upright. 

Posture is also your body’s response to any resistance that tries to disrupt your balance. The most well-known resistive force is, of course, gravity 🙂 Our posture is also a collection of our physical and emotional habits in relation to others. 

Having “good” posture then means your body is able to adapt to the physical and emotional stresses imposed on it. Without causing you pain. It needs to be able to do this dynamically. “Good” posture is being able to move and change your shape to minimize stress. The “best” posture for any given situation is the most efficient. The one that needs the least muscular force and uses the least amount of energy to sustain. 

Therefore, “poor” posture would be highly habitual shapes that overuse muscles and energy to resist outside stressors. The result is an uncomfortable shape. Over time the discomfort will progress to pain or office injury. These “poor” postures frequently arise in an office environment. Let’s face it, our bodies were not designed to sit for long periods. If they were, we’d probably be shaped like a weeble wobble!  

Upper Crossed Syndrome: hunched shoulders, rounded back and forward head posture

Upper crossed syndrome is your typical upper body desk posture after a long day of staring at the screen. You are leaning in close to your computer, shoulders rolled forward, head and neck craning towards your screen and upper back is rounding. In this position, your front (anterior) muscles are in a contracted or shortened position. Your back (posterior) muscles are being overstretched. This postural habit, when prolonged, frequently results in neck, shoulder and back pain. It can even end up restricting breathing. 

Medical massage therapy in New York City is great for lengthening and encouraging the muscles that are shortened to release. Great medical massage therapists will also provide at-home corrective exercises to address the stretched muscles. These often need strengthening and activation exercises to fully address upper crossed syndrome.  These are great ways to combat your office injury.

In an office or desk setting, upper crossed syndrome can often go hand in hand with lower crossed syndrome. 

Lower Crossed Syndrome: sleepy glutes, weak abdominals, tight hip flexors and low back pain

What’s under your desk? Your legs! These also have a typical musculoskeletal pattern that they take on when sitting for long periods of time. In lower crossed syndrome, your glutes and abdominals are not being activated. And your hip flexors (front hip muscles) remain in a contracted and shortened position. As with upper crossed syndrome, there are muscles that are being shortened and muscles that are being lengthened. 

Counterintuitively, it’s the lengthened muscles that usually ache all day. However, it’s the shortened ones that will give you the most relief by being worked on. 

Our medical massage therapists in midtown and the financial district will similarly work to open up and release the contracted muscles. And also provide rehabilitative exercises to strengthen those that are lengthened.

Both upper and lower crossed syndrome usually won’t present pain symptoms until these postures are truly chronic. Thus, massage therapy treatment will likely take more than one session to correct. Full resolution will also require you to do your homework! 🙂

Carpal Tunnel Syndrome: Support your wrists!

Typing and using your mouse are repetitive motions. They require your wrist to rest on the desk (a hard surface). This puts pressure on the tendons and nerves running through your wrist.  Considering how many different tendons run through such a small area, compressing this area is taking away precious real estate! 

Inflammation, irritation, weakness and tingling sensations result when the compression becomes too constant. Carpal tunnel is specifically when the median nerve is compressed and results in tingling sensations, weakness and pain. The carpal tunnel is a particularly narrow passageway in your wrist. 

The easiest solutions to alleviate compression is to support your wrists or to change your forearm positioning to be more neutral. A neutral hand/wrist position has no bend in the wrist. A soft support underneath your wrists or bringing the keyboard down into your lap can achieve this. This can prevent an office injury!

However, when symptoms become prolonged changing your typing position often isn’t enough to help with the pain. Medical massage therapy is a very valid form of treatment to address the inflammation, pain and tingling. In a medical massage session you can expect the entire length of your arm, shoulder and neck to be worked to fully address the symptoms and root causes. 

Mental health is Affected by an Office Injury

The stress that can exist in the workplace or office may also result in mental health or emotional imbalances such as anxiety and depression. These can then lead to problems such as disrupted sleep. Massage therapy does not just affect the musculoskeletal system. In fact, it can be argued that its effects on the nervous system are even more substantial. 

Medical massage therapy has the ability to reduce negative feelings because of its influence on your autonomic nervous system. Massage helps your body and mind trigger a state known as “rest and digest.” You literally have a whole different set of nerves for this system called the parasympathetic nervous system. These don’t get used when you are stuck in stress mode.

Over time, being stuck in your sympathetic nervous system (“fight or flight”) can cause cortisol addiction. Which leads to chronic fatigue syndrome and cellular breakdown. Wondering why you are in chronic pain at 27? One reason is you need more naps 🙂 

When dealing with continual workplace stresses that may cause an office injury, regular massage therapy sessions may help to offset the effects. 

“Your best posture is your next posture”

– Morgan Freeman

Our bodies were meant to move. To be dynamic and adaptive.

Variety in movement (and therefore posture) is a good way to combat postural habits. However, sometimes you find yourself in too much pain and discomfort from an office injury to move as freely as you once did. Medical massage therapy is a solid option and place to start. 

One issue is common with many of the previously discussed syndromes. When you try to partake in an activity that demands greater flexibility and strength than you currently have available you can get further injured. For example, when your shoulders are habitually rounded forward, doing overhead activities may be difficult or painful. For some, this can also be as simple as walking to and from work. That’s a big deal to affect such a basic movement. 

Medical massage, frequent movement, and stretching all complement each other to holistically relieve you of pain caused by a common office injuries and postures. 

How we Help you with your Office Injury at Bodyworks DW

At Bodyworks DW, nearly all of our sessions will include a body reading or postural assessment. This is pretty standard regardless of what you are coming in with. We offer both pain management massage therapy and maintenance massage therapy. The number and frequency of needed massage sessions depends on your specific case and how your office injury is affecting you. If you get a Bodyworks DW medical massage in the Midtown area or the Financial District studio, you can be confident of receiving the highest quality care. Would you like to schedule a professional massage for your office injuries with one of our highly trained massage therapists? Contact Bodyworks DW today or click on the button to book online at our massage Midtown or massage Fidi studios!

Medical Massage in New York by Alexon Santos LMT staff massage therapist at Bodyworks DW Advanced Massage Therapy

Medical Massage in New York at Bodyworks DW

Alexon Santos, LMT, staff massage therapist at Bodyworks DW, writes about the benefits of medical massage at Bodyworks DW

Alexon Santos LMT - staff massage therapist at Bodyworks DW Advanced Massage Therapy

Medical massage therapy is massage offered for the purpose of a therapeutic benefit

All professional massage therapies have some therapeutic value. Medical massage is different because its ultimate goal is providing a therapeutic treatment, not just relaxation. This treatment takes different forms. Goals can vary considerably between different clients. Having a massage therapist with strong training in medical massage in New York is something you can count on. It's part of every licensed massage therapists' 1000+ hours of training during school. 

Medical massage is often recommended by another health professional. And is performed as part of a larger treatment plan. For example, your physical therapist may refer you for massage therapy. Medical massage can loosen your muscles, improve muscle tone, increase flexibility, and increase range of motion.

Qualified and licensed professionals are required for the best treatment

Licensed massage therapists use their extensive knowledge of physiology and anatomy to design sessions to be effective. Most professionally licensed massage therapists will tailor the sessions to the needs of each patient.

First you and your massage therapist will first sit down for a brief intake interview. During the intake you will get to discuss your affected areas and symptoms. In addition they will ask about your medical history. Then they will perform a general postural assessment. The first session will be structured to meet your needs and be part of a plan for future sessions. The goal is to find the fastest and least resource (time and money) consuming way to relieve your symptoms.

If you are looking for medical massage in New York, our massage therapists have more training than most other states. The average massage therapist in the United States has about 600 hours of training. In New York, massage therapists are required to have 1,000+ hours of training in order to be licensed. This includes many hours of medical massage training. Medical massage in New York can be done well by any practitioner with a New York State license.

In other states, you’ll want to research whether your massage therapist has post school training in medical massage to be sure they are qualified to work on your specific condition.

There are many issues that medical massage can be effective in treating

Injury Treatment and Prevention

Medical massage accelerates the healing process of freshly injured tissues by stimulating blood circulation to the area. This decreases swelling and helps to relieve the pain from new injuries. It also allow you to heal more quickly. This is true for Injuries caused by impact, overuse during sports or work, bad posture and body imbalances. Or simply by poor physical conditioning.

When it comes to injuries, massage therapy helps with all of the following:

  • Loosening muscles
  • Improving muscle tone
  • Increasing flexibility (range of motion)
  • Reducing adhesions
  • Preventing the formation of new scar tissue
  • Stretching old scar tissue to reduce its impact

Massage is important to accelerate the recovery process. Most common injuries can be treated in a medical massage studio. Including low back pain, neck pain, sprained ankles, sciatic symptoms, shin splints, tennis and golfer elbow, rotator cuff tears, and many others.

Pre Surgery Preparation & Post Surgery Recovery

Medical massage in the pre- and post-surgical period contributes to the success of the surgical intervention. It also shortens how much time recovery takes. Medical massage in the preoperative period helps prepare the body to better handle surgery. Massage stimulates lymphatic and blood circulation. This improves tissue oxygenation and decongests lymphatic pathways. Both outcomes will help you heal, lessen edema, and lessen pain after surgery. 

Medical massage helps in the tonicity of muscles and elimination of toxic waste to the body. Massage can also help break up any scar tissue and keep the muscles flexible so less scar tissue will develop at the surgical site. The increased range of motion and movement allows more blood to flow to the surgical site which allows for faster healing.

Treatment of Chronic Conditions

Medical massage can be very helpful in the treatment of autoimmune diseases. When combined with traditional medical treatments, medical massage can improve quality of life for patients.  Massage assists in relieving pains, lowering anxiety and depression, improving blood pressure, lessening stiffness in joints, and many other benefits.

Massage is certainly not a cure for these conditions. In fact, for most autoimmune conditions there is no traditional medical cure. Medical treatment usually consists of immunosuppressive medications that help to lower symptoms. These need to be taken regularly for maintenance. Regular massage therapy along with these medications can help you feel even better.

For any autoimmune disease, you should consult with your healthcare provider to see if massage is recommended.  Among cases of autoimmune diseases, medical massage has achieved great results in treatments of arthritis, multiple sclerosis, fibromyalgia, lupus and many others.

Prenatal Massage

Medical massage can be a good option for anyone who’s preparing to be a parent. Massage during pregnancy is a therapeutic type of bodywork focusing on the needs of the parent-to-be. It helps to prepare your body to go through the changes of gestation.

Massage during gestation, has remarkable effects. It causes the endocrine system to inhibit production of stress hormones. It also promotes the release of calming hormones. During gestation many people experience lower back pain, sciatica, sore feet, and labored breathing. In late pregnancy the uterus rests on the muscles of the pelvic floor and the lower back. Massage therapy can help release muscle tension and reducing inflammation on the nerves. It is especially helpful in lessening aches and pains during the 2nd and 3rd trimester.

Doctors used to advise not getting massage therapy during the 1st trimester. Studies have shown that this older advice was not warranted. There is a large body of science showing that massage during the 1st trimester is perfectly safe in most cases. If you are having abnormal medical conditions during the 1st trimester that are requiring bed rest, then avoid massage. Otherwise, there is no reason not to enjoy the benefits of medical massage during your entire term!

Medical Massage in Midtown and Fidi At Bodyworks DW

At Bodyworks DW, our medical massage therapists create programs of sessions that extend outside our studio. Our treatment plans include stretches and exercises for you that can help lessen the number of sessions you’ll need. And prevent pain from returning later.

Our team is highly prepared to offer diverse types of techniques that will help you in different ways. Including prevention of injury, maintenance of your wellness, and relieving more complex situations and problems.

We offer medical massage in Midtown and the Financial District in New York City. Would you like to schedule a professional medical massage with one of our highly trained massage therapists? Contact Bodyworks DW today or click on the button to book online at our medical massage midtown or medical massage fidi studios!

 

Neck Pain Massage Therapy_ Designing Effective Lasting Treatments @ Bodyworks DW with David Weintraub LMT

Neck Pain Massage Therapy: Designing Effective Lasting Treatments

David Weintraub, LMT and owner of Bodyworks DW, writes about neck pain and the positive effects of massage therapy to overcome it.

David Weintraub Licensed Massage Therapist and Owner at Bodyworks DW Advanced Massage Therapy

Why effective neck pain massage therapy shouldn't focus exclusively on your neck

Neck pain is a very common issue. Our phones and devices are constantly pulling our attention. Our head follows our eyes putting us in a "head forward" position. This pulls the muscles in the back of your neck into a constant stretch. And makes them work extra hard to fight the weight of your head. Muscles hate being stretched and working hard. So they yell at you with achy pain. Thankfully, neck pain massage in New York and can be an effective and lasting treatment...when done properly.

Does this sound like you?

a) Sitting at a desk staring at your screen for 40+ hours a week
b) Looking down at your phone multiple times a day
c) Reading your tablet in bed while propping your head up on a pillow

All of these habits tighten your anterior neck muscles (the ones in front). While simultaneously pulling on the posterior neck muscles (the ones in back).

My massage therapist should work mostly where the pain is, right?

Actually, no. That might feel good at the time. But it won't last more that a few hours to a few days if you are lucky.

The next day you may even feel worse. Like you were hit with a bag of hammers. Working only on what hurts won't do anything to relieve pain for the long term. Truly effective neck pain massage has to address what's causing your head to move forward in the first place. And the cause is usually not your neck!

For most common neck pain, the following three areas need to be released together at the same time. This will move your head into a more balanced position on top of the ribcage. When the head is balanced in gravity the muscles in the back of your neck and upper back get to relax. And stop yelling at you with achy pain.

The Three Main Areas to work on in a first session

1) Hip Flexor Muscles (any muscle that helps bring your knee towards your chest...there are more than 12!)

Your hip flexor muscles are tight from sitting all day. This pulls the top of your pelvis forward into an anterior tilt (forward tilt). Basically you can think of it as a small but significant fold forward in your hips. This forward fold pulls you entire upper body forward. If nothing else changed, you would feel stooped over.

2) The Ribcage Position

The position of your ribcage in relation to your pelvis is vitally important to relieving both back and neck pain. With an anteriorly tilted pelvis, the ribcage tilts backwards to compensate. The muscles in the mid back will work extra hard. Basically you will be doing a backbend all day long. You'll have to in order to keep the ribs balanced on top of your forward tilted pelvis. In addition to putting your head and neck in a poor position, this also puts a lot of strain on the low back.

3) The Pectoral & Anterior Neck Muscles

With the ribcage doing a backbend to balance the pelvis, your head needs to move forward to compensate. If it didn't, you'd be looking at the ceiling. As you head pulls forward it overstretches your posterior neck and upper shoulder muscles. Yes, we know that's where it hurts 🙂 However, working back there is not going to make a long term impact. The back of your neck is already over stretched. Releasing it into length even more (which is what massage does to muscles) is not going to help any. To really provide relief, the front side anterior neck muscles need to be released in order to give the back ones some slack.

If your massage therapist only releases the front neck muscles and not the mid back muscles, your neck will feel a lot better. But you'll be stuck looking up at the ceiling. And if they open up the angle of your neck and your ribcage, but not the hip angle, you'll be left stooping over! So, to really release your neck muscles in a way that sticks, we need to make sure all three areas are in better balance. This will allow your head position to float back on top of your pelvis and ribs naturally, without effort. Finally your neck muscles get to rest!

For most neck pain and upper back pain clients, we sequence all three areas in a neck pain massage session. We work on releasing hip flexor muscles, then mid back muscles, then front of neck muscles. By the time we work on those back of the neck muscles, they are already super relaxed and ready for deeper work. You'll leave feeling your neck light and moveable in ways that you had forgotten exist 🙂

What Next? That felt great and lasted weeks! But now that familiar ache is starting to come back...

The above 3 step session is a basic outline of what would happen in a first session. It's going to provide a lot more relief than a standard massage session and it's going to last a lot longer than you are used to. In order to get that relief to last long term we recommend a series of sessions to address some or all of the following (depending on the client):

  • Any old ankle injuries your have that change the angle and shape of the foot: these usually cause hip flexor tightness
  • Your adductor muscles on the inner thigh that may be stuck together due to sports injuries: these also cause hip flexor tightness
  • The position of your shoulder blades on your ribcage: these are often "rolled forward" pulling on the muscles in the back of your neck in a similar way to the front neck muscles
  • Your side body fascia: if the ribcage isn't inflating and deflating while breathing, both the shoulder and neck muscles get "stuck"
  • Your jaw muscles - tension from trips to the dentist or daily unrelieved stress tightens these causing headaches and also neck and shoulder pain

As each of these related causes for neck pain is worked on, it will become easier and easier to balance your head on top of your ribcage. Eventually, usually after 4-7 sessions of neck pain massage, pain becomes a thing of the past.

Effective neck pain massage therapy addresses all of the forces pulling on your head

We've developed truly effective neck pain massage therapy that provides long term relief at Bodyworks DW.

First, we'll address your neck pain effectively by releasing each of the three main contributing factors in the same session. You will feel immediate relief at the end of the first session. And you won't feel sore or beat up the next day.

Next, to have a long term impact, we will follow up the first session with 3-6 custom designed sessions. These sessions will work on more detailed areas in cumulative layers. Each massage allows us to go deeper into the stuck front neck muscles and bring your head into better balance. With your head balanced on top of your spine all of the muscles work less. Less work = less pain!

We offer neck pain massage in Midtown and the Financial District in New York City. Would you like to schedule a fantastic neck pain massage with one of the best massage therapists this city has to offer? Contact Bodyworks DW today or click on the button to book online at our neck pain massage midtown or neck pain massage fidi studios!

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Low Back Pain Massage Therapy Treatment by David Weintraub

Lower Back Pain Treatment with Massage Therapy in New York

David Weintraub, LMT and owner of Bodyworks DW, writes about the benefits of massage therapy for lower back pain. And how massage therapy rather than using the traditional approach of surgery or medication can produce better results at a lower cost.

David Weintraub

Why medication or surgery is only masking the root cause of your pain

Massage therapy for lower back pain is an effective alternative treatment to surgery and medications. Additionally, in most cases the results are noticeably better than either of those traditional approaches. This is according to the newest research. (Excerpt from Vox article "A comprehensive guide to the new science of treating lower back pain").

Lower back pain from bulging or herniated discs often seems to come out of nowhere. In reality there are usually other root causes. An older ankle or knee injury can create an imbalance in the body leading to lower back pain. Compensation patterns from older injuries put asymmetrical pressure on the lumbar spine. The lumbar spine is the part of your spine located in your lower back. Eventually this pressure can cause one or more lumbar discs to bulge. If the bulge presses on nerve pathways, light to extreme pain can result.

How Traditional Approaches can Fail

The most common surgical approach is called a laminectomy. This surgery tries to correct pressure on the nerves by shaving down part of the bulging discs. However, the root cause older injury is still affecting your body. The pressure is still there on the lumbar spine. A laminectomy can eliminate the pain symptoms for a short period. However, in many cases a new bulge pops out in another disc later. This usually makes the problem even worse later on.

Medications such as pain relievers and anti-inflammatories mask symptoms. This feels good and sometimes can help you move through the issue by allowing you to stretch into the stuck area again.

However, the root cause is still not being addressed. Pain will likely come back to plague you in the future. Opioids are especially worrisome as they are highly addictive. This can lead to reliance on them to even function. In an increasing number of cases the addiction spirals out of control creating a far worse issue than the pain itself.

How Low Back Pain Massage in New York works differently

With back pain massage in New York, we work to discover why the disc is bulging in the first place. Meaning you'll get a more holistic approach. And of course we'll spend some time massaging the muscles in your low back.

In addition, we'll work to identify and address any older injuries that caused the low back tightness to begin with. Once the older injured joints are moving better, your low back will have less work to do. Pressure lessens on the lumbar spine. This allows pain to decrease naturally without medications or surgery.

This pathway might be slower than popping a pill. But you'll know that your pain is being reduced in a healthy way. And you'll gain the tools to keep it from coming back in the future.

[T]here are perceptions that opioid therapy for chronic pain is less expensive than more time-intensive nonpharmacologic management approaches. [However,] many pain treatments, including acetaminophen, NSAIDs, tricyclic antidepressants, and massage therapy, are associated with lower mean and median annual costs. [As] compared with opioid therapy. (excerpt from CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016)

We offer back pain massage in Midtown and the Financial District in New York City

If you are in acute or chronic low back pain we recommend booking as soon as you can make an appointment.

Are you suffering from lower back pain? There are many advantages to working with our team of trained medical massage therapists.

At Bodyworks DW, we evaluate how the rest of your body and posture is affecting your low back pain. Together we'll make a plan for a series of back pain massage sessions. This will help to unwind any seemingly unrelated issues. As your whole body opens up, pressure on the low back is relieved. This allows the discs to return to their normal shape over time. With less and less pressure on the nerves, pain slowly but surely goes away.

If you would like to schedule a fantastic back pain massage and experience the benefits above, please contact Bodyworks DW today or click on the button to book online for back pain massage in midtown or fidi!

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NYC Marathon tips 2018

NYC Marathon Tips: How to Heal an Injury That Makes You Want to Drop Out… and Finish Strong

David Weintraub, LMT and owner of Bodyworks DW, writes about marathon tips and gives detailed session notes about a client’s marathon recovery.

David Weintraub

Here we are again about 6 weeks before the NYC marathon. Our medical massage therapy practice is getting flooded with new clients who are in pain training for the marathon. Each year we get an influx of folks worried they’ll have to drop out and desperate to get back on the road. We can’t guarantee that our NYC marathon tips will get every single one of them through the race. That being said, we have a great track record of helping runners rehabilitate quickly from an injury. And get back up to stride even this close to race day. Having learned a few things over the years, we are happy to share our best NYC marathon tips so that you can have the best day ever on November 4th!

My First Marathon Client That Almost Dropped Out

I’ve been in practice for close to 12 years now. Each year I routinely work with a several dozen NYC marathon runners in all phases of their training. However, my first, was way back in 2009, just a couple years after graduating massage school. A friend of a friend was training for his first ever marathon as a first time runner. (He was not a runner before starting training in spring).

NYC Marathon Tips 1

Start training long before you think you need to: My current advice for folks who aren’t already runners is to start training for a marathon 18 months before race day. (Most people start 6-8 months beforehand). He had started in April, just 7 months before the race. And yes, lots of people start training for their first NYC marathon in the spring of the same year and do fine. However, some folks have older injuries lurking in your history. These will tend to come out and wreak havoc on your training somewhere around September/October.

My client, let’s call him Sven (not his real name), came to me with a golf ball sized knot of seized up muscle tissue in his left calf… 4 weeks before race day. It had been getting progressively worse over the prior 3 weeks. It had gotten to the point where he could no longer run a single mile without debilitating, cramping pain.

He was obviously distraught and unsure what to do. Sven was worried about letting all the people who donated to his race down (a common concern). But he thought that he was beyond help. He had been to a physical therapist 3 times with no relief. Sven was highly skeptical that I could do anything to help him but our mutual friend assured him I was “miracle worker.” (no pressure there or anything!)

Ethically, I’m not allowed to make a guarantee that I can help clients. There are always going to be some cases that are beyond what massage therapy can relieve. Sometimes, surgery and physical therapy are a client’s best recourse. And sometimes all of the best NYC marathon tips you can find won’t matter. So I want to get that out there lest folks think that I actually go around touting myself as a miracle worker (no faith healing here, just straight up science at work). I told him this, and that I’d try my best but I thought I might be able to help.

How we got the client through race day in 3 medical massage therapy sessions:

Session One

I spent most of that first massage on the back of his legs. This included some truly intense deep tissue work directly on the bunched up calf tissue (with his permission of course). We also worked to open up his right hip which was not moving well due to an older injury. I theorized that the hip injury resulted from an even older right ankle sprain. This was confirmed by the client, so I also worked to get the right ankle moving with better alignment.

At the end of the session he said the whole area felt better than it had in weeks and he hoped that this would get him back to race form. At which point I gave him some of the best injury recovery advice I’ve ever come up with…

NYC Marathon Tips 2

Start Over Again – When recovering from an injury DO NOT try to jump back into the same level of training you were at before the injury. That is a sure fire recipe for the injury popping right back again and keeping you down. For Sven, I told him to do the following:

  • Wait two days (agonizing for a runner) before running, spend time stretching
  • Run only 1 mile as long as you aren’t in sharp pain
  • Then stop and call it a day
  • If you are in sharp pain during that 1 mile stop
  • If that went fine with no pain, rest the following day
  • On fifth day, try running only 3 miles as long as there is no sharp pain
  • Rest the following day
  • Book a follow up session for the next week on the 7th day after our first session

I can hear your teeth grinding just reading that list. “But, but, but….it’s only 4 weeks to race day and you are saying I should only put in 4 total miles this week?! What about my big 18 mile long run coming up?!?!?!?!”

Trust me, Sven wasn’t going to make it on that long run in the condition he was in. Thankfully, he did trust me and followed the NYC marathon tips to the letter. He emailed me after each of the 1 mile and 3 mile runs. Sven let me know that there was no sharp pain, just a “bit of tightness that opened up during the run and stopped bothering me by the middle.”

Session Two

Sven came in a week later for session number two. His calf still had a ball of seized tissue but it had shrunk down from golf ball sized to marble sized. We worked on it again, then focused more on quads and hip flexors including the all important psoas muscle. We also worked on opening up his ribcage, and diaphragm. In order to bring his upper carriage into a better alignment with his legs, we worked on his neck.

So many runners come in and request that I work on their legs over and over again. What they don’t realize is that their upper carriage tension in the neck and shoulders is a huge factor for why their legs are always so tight.

After session 2, I gave him the following to do:

  • Wait two days (again, totally agonizing for a runner) before running, spend time stretching
  • Then run 6 miles as long as you aren’t in sharp pain
  • Then stop and call it a day
  • If you are in pain during that run stop
  • If that went fine with no sharp pain, rest the following day
  • On fifth day after session 2, try running 12 miles as long as there is no sharp pain
  • Rest the following day
  • Book a follow up session for the next week on the 7th day after our first session

Sven followed the NYC marathon tips we gave him, emailing me to let me know that his whole running form had opened up. This was likely due to the upper carriage work. He felt not just fine but even better than before on the 6 and 12 mile runs. He wondered whether he even needed the third session. I told him to keep it just in case and that we might be able to shave some time off his run by working on his external hip rotators. He kept it.

Session Three

He came in for session 3 feeling good but a bit worried that he was getting to his long run a bit close to the race. The calf knot was almost non-existent. We spent the session working on his side body, bringing the left and right sides into better symmetry. This session is great for getting the ball and socket joints of the hips and shoulders free again which allows the rest of the body to ease up and relax. The session was on a Thursday.

I gave him the following homework:

  • Wait two days before running, spend time stretching
  • Then run the 20 mile long run as long as you aren’t in sharp pain
  • If you are in sharp pain during that run stop
  • If that went fine with no sharp pain, rest the following day
  • After that take it easy in the lead up to the race doing no more than a few short runs just to keep limber

Sven did fine on his long run and took it easy. Race day went swimmingly and he actually shaved a bit of time off his intended pace! He then followed our NYC marathon tips for race recovery and booked a post race sports massage. He came in for a post race recovery massage a couple days after the race and felt 100% normal by day four.

NYC Marathon Tips 3

Book a post race recovery massage: Some experienced runners book a recovery massage for the evening of race day. Unless you have run several marathons and are sure you’ll react well to that, we don’t recommend it. You could wake up the next day feeling like you had been run over by a tank. However, any time between the day after race and 4 days after the race will be super beneficial. Especially if you have to work at the office and sit in a chair all day. For our studio, we tend to book out the week after the NYC marathon in advance, so book early.

In support of all you runners, we are offering 10% off all sessions from October 1 through November 11th for anyone who is an official participant in the NYC Marathon. Simply bring in your entry approval when you come in for a session and we’ll happily apply the discount 🙂

What we have learned since then:

In a way, Sven was lucky that he was so sidelined. He was willing to go against all instinct and take it easy for a few weeks, even with race day approaching. Had he been in slightly better shape than he was, he might have pushed too hard after the first session. And re-triggered the injury.

Most of these repetitive stress running injuries are due to two main factors. One, an older injury that creates an asymmetrical running form. And two, the slow steady pressure that builds up in the muscles compensating for the older injury. As you start piling on the miles, there comes a tipping point when the system can’t handle what you are asking it to do. It starts complaining loudly. Then boom, you are sidelined.

Correcting the form towards a more symmetrical alignment means less work for muscles to do to get you moving forward. Which in turn means an easier run and faster times.

If all of your muscles are working towards propelling you forward you’ll go faster. If some of them are pushing you sideways or up (or even backwards) instead, you’ll lose efficiency and slow down. Other muscles will have to work harder to fight that movement. You’ll also increase the impact with each stride creating the potential for stress fractures in your feet, shins, hips, or spine.

Ideally, we would work with you when you first start training so that you already have an improved running form. Before you pile on the miles. My NYC marathon tip for Sven after he completed his first successful NYC marathon was to cross train over the winter. Then come in for a few sessions next spring to work on his form. And to go celebrate his first completed NYC marathon  in style 🙂

However, as you can see from above, coming in for medical massage work at any point before race day is likely to improve your day. If you are injured, follow our NYC marathon tips and book a session. Also coming in for a post race recovery massage can get you back to normal quickly!

Good luck to everyone running this year!

sports injuries cartoon

Sports Injuries After Age 30

David Weintraub, LMT and owner of Bodyworks DW, writes about sport injuries and how to prevent them as we age.

David Weintraub

How to readjust your routine to avoid pain

When were your first sports injuries?

If you are into sports now, odds are you started playing team sports when you were young. I remember my first soccer tryout at 9. I also remember my first sprained ankle from getting slide tackled at 11.

There were a lot more sports injuries where that came from between then and now...
Soccer, track, cross country, cycling, swimming, and later aikido (and that one ill fated parkour class during which I sprained my ankle).

Along the way I’ve sprained both ankles more than once, severely torn a hamstring muscle twice, smashed fingers and toes, and torn a rotator cuff. I've gotten a bone spur on my wrist, had shin splints, plantar fasciitis, hip pain, low back pain, and herniated a disc in my neck.

If it weren’t for all the bodywork, acupuncture, physical therapy, and chiropractic work I received since my mid 20’s I’d be taped together with duct tape just to function. And probably would have needed a few different surgeries (currently surgery free at 46).

Like most of you, I’ve got the scars to prove my sports history. Unfortunately, as I get older, all of these old sports injuries make it even more likely that I’ll re-injure myself. So I’ve learned the hard way to be more cautious and create a regular self-care routine.

How scar tissue gets formed:

Each time we sustain sports injuries (or any other injuries) our body has to make a decision. It has to decide whether it has time to heal itself with properly functioning replacement tissue or with scar tissue. The more severe the injury, the more likely the body will use scar tissue.

Why?

Building replacement tissue takes time. If you are bleeding internally (or externally) time is a big factor. Your body has to make a choice:

  1. replace the tissue with beautiful “good as new” skin or muscle and risk bleeding out, infection, death….or
  2. plug the hole with scar tissue and save itself.

We all have scar tissue in our bodies. Those of us with a sports background likely have a lot more of it. Can you list all the injuries you’ve had?!

What makes scar tissue such an issue:

Our bodies are basically a bunch of functional pieces glued together. The glue is called “fascia.” Fascia is non-living tissue that our body makes to stick stuff together. It’s made of mostly water and collagen fibers.

Scar tissue is also non-living tissue that sticks stuff together. And it’s also made of mostly water and collagen fibers.

If they are both water and collagen fibers...what’s the difference?!

In healthy fascia, the collagen fibers are woven together in a cohesive way like fabric. It has structural integrity that allows for some movement and stretching in certain directions and also limits movements in others. When healthy, it acts like an ACE bandage already built into your joints, muscles, tendons, and ligaments.

In scar tissue, the collagen fibers are thrown into place like a pile of pick up sticks. The body has to stop the bleeding from an injury quickly. It doesn’t have time to carefully arrange the collagen fibers for structure and healthy movement. If you have any noticeable skin scars you can attest to the difference. Healthy skin moves and stretches, while a scar feels hard and immobile.

Scar tissue can show up in big ways and also in little ways. Push things too hard and you end up with tiny “micro” tears in the muscle tissue. Most of these will be healed with properly functioning muscle but a few may be just too much for the body to handle without plugging it with scar tissue. Over time these micro-tears add up to restricted movement.

You can’t get rid of scar tissue.

The more scar tissue we have the stiffer and more limited our movements become.

And once scar tissue is formed it’s there for life. The idea that you can “break down scar tissue” and that the body gets rid of it is a modern wellness myth. However, a good massage therapist can help to work into the scar tissue and make it more pliable.

With bodywork and regular stretching the scar tissue can form a better alignment and act more like healthy fascia. So you can usually get most of your range of motion back.

Here’s the really important thing:
The older we get, the slower our body gets at healing, the more likely that injuries are going to be plugged with scar tissue instead of healthy tissue.

Check out this Washington Post Wellness article if you want to read more about this: Click here! 

What can I do to prevent sports injuries as I get older?

The first bit of advice I can give is that we all need to readjust our definition of “injury.” I ask hundreds of clients every year about their injuries and many will say, “oh I’ve never really gotten injured….” Which is interesting considering that they are coming to me because they are in pain.

We think of sports injuries as broken bones, torn ACL ligaments, sprained ankles that lay us out for weeks, etc. These absolutely are sports injuries, and major ones. It’s the minor ones we gloss over.

Pushed too hard at the gym yesterday and are feeling a little pinchy “tug” in you hip when you walk up the stairs? That’s an injury; it needs time to heal. But hey, you’ve got to keep to your exercise schedule or you’ll (insert self judgement here). So you go right back to the gym and do another hard workout.

At the beginning the hip is screaming at you, but it “warms up” during the workout and actually feels a bit better now.

The next day it’s yelling at you even more….. And wouldn’t you know it, but your shoulder feels a bit “off.” Yet most of us go back to the gym again anyway.

When you use your emergency systems just to get through everyday life, what’s left for an emergency?

Your body has some amazing tools to be able to function while injured. These include a handy couple of internal drugs called adrenaline (you know and love this one) and cortisol (it numbs pain).

These tools were designed by evolution to make sure that you could keep running or fighting the bear that was chasing you even if it had already injured you. They gave our species a fighting chance and likely saved your ancestors from a bad scrap or two.

Unfortunately, most of us are overusing and addicted to these life saving internal drugs. We mostly use them to bolster our ego and to avoid dealing with the emotional impact of growing older.

So here’s the unvarnished truth: the older you get, the harder it is for your body to recover, the more likely it is that you’ll injure yourself, the more important self care and good maintenance becomes. You can still go hard. However, you'll need a bit more effort on recovery and maintenance.

We aren’t going to “bounce back” like we used to. We can either accept this or break ourselves against the wall of reality. Your choice 🙂 

New Rules for Preventing Sports Injuries as we age:

  1. If you experience any sharp pain beyond regular soreness and muscle fatigue during exercise, STOP. No really, just stop. Do some cool down walking, then light stretching and/or foam rolling (as long as it doesn’t activate the sharp pain area). Then hit the showers and call it a day. Give your body at least 24 hours to heal itself, then try some light exercise again. If you can exercise pain free, great! If not, stop and give your body another 24 hours.
  2. Don’t do any exercise that involves those specific muscles while you are experiencing pain. All you are going to do is rip up even more tissue in the area. However, if it’s your hip that hurts you could do shoulder presses if it doesn’t activate your hip pain.
  3. Practice good post workout self care. This means a minimum of 10-15 minutes of cool down (walk around until your heart rate decreases) and stretching. This is super important as the fascia get heated and more fluid during exercise but the muscles get shorter due to repeated contraction. If you don’t stretch out after you work out, your fascia cools down and hardens around the contracted muscles making everything tighter.

Helpful Tips:

  1. The newest science proves that for cardiovascular health, 3-4 HIT (high intensity training) workouts of 30 minutes each with at least 48 hours in between is just as effective as 1-2 hour long runs 6 days a week. Bonus: less time needed, and more recovery time for healing!
  2. Variety is healthiest which is why you are starting to hear about major football and basketball athletes doing pilates, yoga, ballet, etc. Create a mix of different activities that you like. Or if you are a dedicated runner or cyclist, mix up the speed or distance of your exercise with short sprints, hill workouts, etc.
  3. A hot shower or bath after a workout is a great idea! For bonus points, douse yourself with cold water for 30 seconds at the end (in the shower you can try going back and forth between 2 minutes hot, 30 seconds cold a few times). The heat opens up the blood vessels allowing more blood to wash the fatigued muscles out. The cold squishes the vessels tighter, squeezing out lactic acids. Going back and forth acts like a pumping system for your muscles and speeds recovery.
  4. If sharp pain persists beyond a few days get thee to either a sports massage therapist who’s experienced with injury recovery work. A great practitioner should be able to get you back to the gym (or class or road, etc.) after a session or two. The longer you wait to have it checked out, the more likely it will need multiple sessions to relieve it. And the more likely that you’ll have injured yourself to the point where you need to take weeks to months off from training to fully recover. And nobody wants that!

If you start following the above and incorporating more self-care into your exercise routine, you’ll feel better overall and be far less likely to experience pain. You’ll also find that a less is more approach will save you time while still meeting all of your exercise goals. Good luck!

Here at Bodyworks DW Advanced Massage Therapy, all of our therapists are highly trained to handle sports injuries in their many varieties. We’ll be able to look at your form and see if an older injury is throwing your alignment off and really find the source of the current pain so that you can get back to it quickly, with more knowledge of how to prevent a relapse. We’ll also be able to assess when you have a more serious injury that may require seeing a physical therapist or orthopedic doctor.

Book Appointment

physical therapy meets massage therapy

Doing Physical Therapy? Massage Therapy Can Improve Results!

David Weintraub, LMT and owner of Bodyworks DW, writes about the benefits of supplementing your physical therapy plan with massage therapy treatment.

David Weintraub

7 Reasons why this powerful combination works

Pain sucks. As a massage therapist, I would know. Almost everyone who comes to see me does so because they're in pain!

Most of the time, my clients have such a powerful response to massage therapy they don't need additional therapies. However, that isn't always the case. I always look for clues that indicate I need to refer a client to another practitioner, such as a physical therapist. 

Physical therapy and massage therapy are both powerful methods for treating pain. By focusing on correcting the underlying muscular imbalances that have caused it in the first place. When used together, they can help clients achieve faster and better results. 

There are several reasons why massage therapy is effective for anyone who is already receiving physical therapy.

Here are the top 7:

  1. Providing pain relief, often times after the first session
  2. Increasing range of motion so that the body can move better
  3. Decreasing local inflammation by working above and below the area
  4. Lessening the pain clients may be feeling during or after physical therapy exercises
  5. Decreasing the pain clients may feel post-surgery
  6. Bringing faster results than just physical therapy alone 
  7. Motivating clients to stick to their physical therapy treatment plan

That's the short version of why massage therapy and physical therapy are a powerful combination. If you're interested in a more detailed explanation, read below! 

The Breakdown: 

1) Massage therapy helps by treating short and overused muscles. 

The goal of many physical therapy exercises is to help strengthen any weak muscles that are causing pain symptoms. The goal is that by strengthening weak muscles, the body will move & feel healthier. But that's only half the picture. 

When it comes to muscles, imbalance happens when one muscle is weak and long while another muscle is overused and short. In order to correct this, BOTH of these problems need to be addressed. This means following the exercises provided by a physical therapist teaching clients how to engage and strengthen muscles that are weak. It also means using massage therapy to address the muscles that are chronically overused.

The right massage therapist will focus on releasing these tight muscles as well as lengthening them when they've gotten short. This can help effectively decrease pain while also improving range of motion and helping the nervous system learn how to move better! 

2) Massage therapy will help with physical therapy. 

Studies show that one major obstacle to physical therapy treatment is that many will stop coming in if the exercises are painful to do, or if their pain doesn't decrease right away. (Source: Read this article) Basically, if the work is too hard and painful, people are a lot less likely to do it. Massage therapy can decrease pain often with immediate results, which will help provide motivation to stick to the physical therapist's treatment plan. 

3) Massage therapy can help post-surgery.

Sometimes people will experience new aches and pains after their recovery from a surgery, even while doing physical therapy. This can happen due to a change in the body alignment and how the body moves after the procedure. If clients are already doing regular physical therapy and still experiencing pain post-surgery, I suggest asking a doctor if it’s medically safe to try massage therapy.

For more detailed information on how massage therapy can help post-surgery, please check out this in-depth article: Click Here!

 

In summary, we see that combining physical therapy and massage therapy help clients move better and feel better by working on correcting any muscular imbalances that can be causing or contributing to pain. 

Want to read more about how we work at Bodyworks DW? 

Click to Learn More about our Massage Therapy

text neck massage therapy neck pain shoulder pain

Save your text neck

David Weintraub, LMT and owner of Bodyworks DW, writes about "text neck," what it is and ways to prevent it.

David Weintraub

The perils of “always on” technology:

Okay, so your "text neck" probably won’t actually kill you (unless you are texting and driving). However, it’s becoming increasingly likely that at some point in the next 5-10 years of tech use, you’ll develop a repetitive stress disorder.

The phrase carpal tunnel syndrome (wrist pain) has been part of the collective conscious for several decades. It's so common as a disrupter of productivity that it has spawned an entire industry of ergonomics solutions. These range from special keyboards to Star Trek styled full desk/monitor set ups. All keep you at your desk longer making trades, typing contracts, writing legal memos.

And then the 2000’s came along. Most of us jumped all in with smartphones and laptops and tablets.

Suddenly we could be productive all the time.

Standing on the subway platform?

Let me check my email.

Taking the train in from CT?

Let me just go over those sales reports.

Date just went to the bathroom?

Let me text my assistant to make sure I’m set up for tomorrow’s board meeting.

Unfortunately, there are costs to constant device use that might change your mind about your phone and tablet.

Looking down at our phone, tablet, or laptop, pulls our head forward and down. This imbalances all the muscles holding up your head (ahem... text neck). These imbalances can cause any and all of the following:

  • neck pain
  • shoulder pain
  • TMJ
  • headaches
  • low back pain
  • carpal tunnel syndrome
  • anxiety
  • low energy
  • bone loss
  • depression
  • memory loss

Sound scary? Don’t believe it?

Check out this New York Times article: Keep Your Head Up: How Smartphone Addiction Kills Manners and Moods

Like many things that aren’t healthy for us, these costs are not going to suddenly show up tomorrow. They build up over time. In ways that make it hard to track what the changes are doing to your body. However, there is hope for us all!

What can I do about this?

I’m not some Luddite preaching that we should all return to farming. I happen to be a business owner with 20+ employees and have tech in so many screen sizes it’s getting ridiculous. I deal with text neck too. 

I’ve got a smartwatch, smartphone, an iPad for home and one for work, an airbook laptop, an iMac at my desk. Not to mention the 15 other devices I have at the office for the staff to be "productive" on. I’m just as tempted as you to go on my phone on the subway and read articles on Facebook or Twitter to pass the time. So I decided to try something out...

Experiments DW

Over the past 2 weeks, I’ve been running an experiment to see just how much I can lighten up my daily commute (see the last blog post on how much we carry around with us and tips to help with that).

I’ve gotten down to just leaving home with the following:

That’s right….NO BAG.

I had to get really clear on what my time is worth to me and what my long term health is worth to me. And I had to spend some extra cash to duplicate certain items at work and at home so that I wouldn’t have to cart them back and forth.

Is it worth it? For me this experiment has been a fascinating eye opener. It’s also reduced my daily stress levels by about 20-30%.

I have less issues with headaches at day end, my back feels better, and my overall mood has noticeably improved.

I’ve got new rules for my text neck, I count em:

#1: I am not allowed to look at my phone during my commute except to choose music.

#2: I am only allowed to work while at the office, or while at my desk at my home office. The couch is only for relaxing and the bed is only for sleeping (and well, you know…).

#3: If I need something both at work and at home, I duplicate that item rather than carry it back and forth. The value in stress reduction and ease of movement on my body is a long-term savings in health and self-care costs down the road.

#4: If I do have to look at a device, I hold it up to horizon level and keep my head up.

#5: When my arm gets tired of holding up the device to eye level rather than looking down, it’s time to take a break and put it away.

You may think I’m crazy for buying a second iPad to keep one at work and one at the office. Really the only reason for me to do that is that it has become my primary note taking device for my life coaching sessions. Sure, I could take notes on paper, but then I’d have to create a filing system for them. The iPad keeps all my notes for each client on the cloud.

Of course, you’ll have to do your own analysis of the following:

- what you can and can’t do without

- how much is your time is worth

- which work can be left until tomorrow or

- what work can be put on hold for the 45 minutes to 2 hours you spend on your commute

You’ll probably come up with different ways to reduce your load and stress than I have. (For instance, maybe it’s spending the extra cash on a monthly gym locker. You can leave your workout gear there most of the time.) Prioritize those ideas and see for yourself how helpful it can be. 

Are you willing to give lightening your load and keeping your head up a try? Yes? Your text neck will thank you.

massage therapy for diastasis recti massage case study

Massage Therapy for Diastasis Recti

David Weintraub, LMT and owner of Bodyworks DW, writes about treatment options and massage therapy benefits for Diastasis Recti.

 

David Weintraub

Getting to the core of the issue

First off, what is this strange sounding condition?

It’s most common among pregnant or postpartum women. About two thirds of pregnant women have it. So why have you never heard of it?
People don’t talk about.

The facts:

Diastasis Recti is a condition where the rectus abdominis splits down the middle causing a vertical gap in the abdominal muscles. It can cause lower back pain, constipation, and urine leaking. It can even make it harder to breathe and to move normally.

How to treat it if you have it:

Massage therapy for Diastasis Recti can be very helpful to rebuild proper abdominal tone as long as you’re also working with a physical therapist who specializes in this issue. An experienced massage therapist can open stuck tissues that are pulling the abdominal muscles outward. These stuck tissues are generally from previous injuries that have left scar tissue behind. In addition to this kind of bodywork, you’ll need physical therapy exercises to knit the torn muscles back together.

 

Why “ab” exercises don’t work for you now…

 

It’s counter-intuitive, but doing “ab” exercises such as sit ups, or pilates, can often make the problem worse. Without proper firing of the correct support muscles, these exercises often pull outwards on the linea alba (centerline where the gap develops). This can either increase the separation, or keep it from knitting back together.

A combination of massage and physical therapy can speed up the healing process considerably. In most cases it will open up the stuck tissues that would keep physical therapy exercises from working. The synergy between the two modalities is worth way more than the sum of the parts.

Why?

Because massage therapy is an “opening” practice. Our training is in releasing tissues that are either tight (ie over-firing) or stuck (ie glued with scar tissue). We also work to retrain the nervous system to allow muscles that are over-firing to relax and settle into a balanced tone.

Physical Therapy is a “closing” practice. It’s based in strengthening and tightening muscles that are weak (ie under-firing). The repetition of certain exercises draw blood flow to areas that need it, allowing the body to heal and reconstruct itself.


Ready to put in the work?

Diastasis Recti is not a one-time fix situation. It takes a coordinated effort, diligent homework, and focused effort for 8-12 weeks. It is next to impossible to self-heal without a minimum of a few guided sessions. Most clients will need the following:

4-7 sessions with a professional massage therapist

3-5 sessions with a physical therapist who specializes in working with Diastasis Recti

15 minutes a day of homework exercises


If you’d like to know if massage therapy for diastasis recti can help you, don’t hesitate to call us and arrange a phone consultation with David Weintraub. Or book an initial session online!

 

NYC Marathon Recovery

NYC Marathon Recovery

David Weintraub, LMT and owner of Bodyworks DW, writes about tips, tools, and recovery for pre and post Marathon run.

David Weintraub

NYC Marathon RecoveryThe 2016 NYC Marathon is less than 4 weeks away...

Is this your first NYC Marathon? Taking on the training and then running a marathon is a big deal. Congrats!

Hopefully, at this point, you are feeling close to ready. However, it's normal to freak out a bit and get worried that you haven't run that many longer runs, and that none of them are a full marathon. Having worked on 100's of runners over the years, we can tell you to trust the process and stick to the training schedule.

Here are a few extra tips to make your first (or seventh...) marathon a great experience instead of a slog.

What to do in the next few weeks to prepare for NYC Marathon recovery

If you are feeling comfortable with the length of runs on you training schedule, great! Keep up what you are doing 🙂

If you are experiencing any consistent pains on your runs, book a massage therapy session and/or physical therapy session to relieve the pain. Mild to medium pain at this point in your training will add up to a real injury on race day. And make your marathon an excruciating experience. It will also mean a lot more work after the marathon to rehabilitate. Often these pains can be dealt with in a few sessions now with a good therapist. Suffering through pain until after the run is playing with fire.

Some common pain types for runners:

  • runner's knee
  • heel pain and/or foot pain
  • hip pain and/or groin pain
  • shin splints
  • plantar fasciitis
  • neck pain and shoulder pain

What to do to AFTER for NYC Marathon recovery

Book a post race recovery massage and have it scheduled 2-7 days after the marathon. Your body will be super sore and depleted. If can often take a full 2 weeks to recover and feel normal. A light to medium pressure full body sports massage will help you recover in half the time (or less!). You've put all of these hours into training, run 26.2 miles, raised money, etc. Why not treat yourself to a lot less pain and suffering after the marathon?

If this is your very first marathon, we suggest booking a marathon recovery massage about 3-5 days after. It will take several days for your body to process enough of the lactic acid to where a massage will have you feeling better. If you've run a marathon before, some seasoned runners book a marathon recovery massage for the evening of the race! Others book the next day or the day after that.

For self-care, drink more water than normal for several days, and eat more protein. You'll need the protein to rebuild torn up muscle tissue. If you get hungry, listen to that and eat something. Take contrast showers....hot, then cold, then hot, then cold.

Your system will be working overtime trying to heal hundreds of small micro-tears, and trying to flush out way more waste than it's used to dealing with. Trying to live "business as usual" is a asking for grief. Sleep lots. Stretch lots. Don't run for 2-3 weeks! (For realz).

massage therapy for ankle sprain

Massage Therapy for Ankle Sprains: Advice for Runners

David Weintraub, LMT and owner of Bodyworks DW, writes about his personal ankle injury, how massage therapy for ankle sprains helped, and provides helpful tools and tips on ankle injury recovery for runners.

David Weintraub

Massage Therapy for Ankle Sprains: what to do from the moment you get injured...

Massage therapy for ankle sprains wasn't my intended topic this week. Then I took a bad fall in a parkour class trying to jump a 12 foot gap. I've now got about 6-8 weeks of healing, before exercising again in any weight bearing or high impact capacity. Based on my own professional assessment, anyway.

It's also timely and useful for those of you currently training for the NYC Marathon or the Ironman Triathlon to know a bit more about treating ankle sprains.

I know that there is a lot of info out there about what to do and what not to do. And much of this info is confusing and conflicting. So I'm going to walk you through what to do based on the most recent science. And show you when to add in massage therapy for ankle sprains. Using my own injury as an example.

First things first: how bad is it?! (is anything broken)

Before you attempt to do anything at all, you need to figure out if you have a broken bone or an ankle sprain. The very very very last thing you want to do with a bone break is try to move it. So you need to assess visually before assessing whether you can move it.

Questions to answer:

  • assuming you are in excruciating pain, is the ankle hanging off at an extreme angle? (If so do NOT attempt to move it)
  • do you see bone sticking out? (Again do NOT try to move it)

If it does seem like a bone break, you need an ambulance. Call 911 if you are alone, have bystanders do it if there are people around. Do not skimp here and try and get to the hospital by taking a cab. It needs to be looked at by qualified professionals and splinted/immobilized before you are moved. If you try to load yourself in a car, even with help, you are going to smack it around with every bump. This will shred the soft tissue around it even more. More shredded soft tissue = even longer recovery. Not worth it.

Okay, it doesn't seem broken...now what? (no, not the RICE method)

First, gently test to see whether you can move the ankle at all. Small circles in both directions, flex and point, wiggle the toes. Even just a slight ability to move is a good sign that nothing is completely torn through. If you can make tiny circles, flex and point, and move your toes, then it's likely an ankle sprain. Of course it's still possible that you have hairline fractures in one or more of the bones or partially torn ligaments. So don't jump to conclusions.

In the old days, athletic coaches would tell you to walk off an ankle sprain at this stage. Unfortunately, this has the immediate danger of ripping apart the soft tissue even more. And potentially tearing a muscle, tendon, or ligament all the way through. Trust me, anything torn all the way through is going to take a LONG time to recover. So you definitely want to avoid the possibility of making things worse.

In 1978, Dr. Gabe Mirkin developed the RICE method (rest, ice, compression, elevation). Since the, RICE has been king in sports medicine. The RICE method counteracted the "walk it off" method and prevented further injury to the soft tissue. However, as we are now learning, it also slows down the healing process. And potentially freezes clotted tissue to the ligaments. In the last few years, science has had a nearly 180 degree turn on RICE (in fact, Dr. Mirkin himself has refuted RICE on his own website). Several studies now show that Ice delays healing, as does anything that reduces inflammation.

Second step...flush the tissue with small light movements to a tolerable level of dull pain, but not sharp acute pain. 

In the case of my ankle sprain this meant:

  • lie on my back and raise the ankle up to elevate it
  • make small tiny circles back and forth with the ankle to a tolerable level of dull pain
  • also point and flex the ankle and the toes to a tolerable level of pain
  • use your hands to assist if needed
  • flush for a few minutes, rest,
  • then lightly (and I do mean lightly) stroke the injury area with your fingertips, moving towards the heart
  • repeat several rounds of flushing and resting
  • check in with your pain levels and your body for 15-20 minutes

If the circles get slightly easier to make and/or larger, and your body starts relaxing a bit more, move on to next phase. If the area does not start to move a little better and calm down a bit, go to a sports doctor to get xrays, there may be smaller hairline fractures or a torn through ligament or tendon. 

The point of the flushing phase is three fold: moving fresh blood with nutrients and proteins to rebuild into the area, break down ripped up tissue and old blood, move the broken down wastes out of the area.

The third step...very gently attempt to put weight on the area

In my case with an ankle sprain, it's best to try to come to hands and knees first, then either with assistance or by grabbing on to something, pull yourself up on the good ankle. Then, while holding on to something or with assistance, try to gently put weight on the bad ankle.

Assess the pain this causes (and it definitely will cause pain)....is it intense but diffuse, or sharply acute on one spot?

  • With intense but diffuse pain, you can attempt to slowly put weight on it and take a step while holding onto a wall or another person
  • With sharply acute pain, take weight back off of it and try flushing it for a few rounds while standing on the good leg, then try to put weight on it again

if putting any weight on it again causes sharp acute pain, such that you can't take a step at all, get to a doctor or hospital. You'll want to get xrays and an MRI to see if there are any hairline fractures and/or torn tendons or ligaments. We recommend a few great NYC physical therapists on our collegues page due to their high level of experience and their philosophy of doing full 60 minute sessions with each patient.

However, if you can hobble on it with tolerable pain, call a car and get yourself home, trying to keep the injured ankle elevated on the back seat. If you don't have a friend with you, call someone and have them meet you at home. You are going to need some help and support.

The fourth step...recovery

My ankle sprain, the day after

Once you are home, elevate the ankle, and make sure that you drink water and eat some food, preferably fruit. This will immediately raise your glucose levels and help keep you from going into shock. Have a blanket handy in case you get cold and start shivering. Absolutely try to get help from a friend, partner or family member to purchase a few needed items. Get a cane and a slip on ankle bandage that provides support and compression. Also an arnica based lotion to apply to help move the bruising through. My personal fav is Topricin:


Why a cane and not a crutch? A crutch will be much easier to move around on at first. However, it will create havoc on your shoulder. In addition, it will be too easy to get moving fast on it, which is a recipe for taking a quick wrong step and re-injuring the ankle. A cane is somewhat humbling, but you can't really move any faster on it than your bad ankle will let you, which is a good thing.

Recovery is all about getting blood to and from the ankle. Move it or lose it is the name of the game. Keep flushing it several times daily with rounds of circles and movement to a tolerable degree of discomfort. Too much and you'll probably just want to vomit. None, and the ankle will heal frozen in place and you'll just have to rip the tissue back open again to get it moving. Slow and steady wins the healing race.

Wear the compression brace whenever you plan to try walking on it. For now you'll need the stability and it will keep the blood pressure from feeling too awful. However, don't wear it 24/7. Take it off and elevate it at home when you can (and should) rest.

A simple brace that slips on like a sock is best. You can still move a bit in it and do recovery exercises and it fits better in shoes which are also going to give support. Here are some great braces:

Recover Faster with less chance of Future Injury

two weeks after injury
four days after injury
ankle sprain massage therapy
My ankle sprain, two days after injury

While it is possible to heal this type of injury on your own, you'll get far better and quicker results working with experienced wellness professionals. Work with an acupuncturist during the initial stages, and use massage therapy for ankle sprains, and a physical therapist as it starts to heal and take weight better.

DO NOT attempt to exercise on it until you can walk comfortably, without pain or discomfort, without wearing the brace. (At least not without direct guidance from a physical therapist.)

The main reason I'm already walking without a cane and almost no limp at 2 weeks is that I've gotten treated 3 times with e-stim by acupuncturist Erika Prinz . I've also had massage therapy sessions from my staff. E-stim (or Electroacupuncture) is especially valuable at the beginning stages to promote healing in the damaged tissue.

Now that I am walking mostly without a limp, and able to take stairs up and down reasonably well, my next move will be getting advanced massage therapy for ankle sprains from my staff in order to keep the injury from adversely affecting my knee and hip on the right leg. Often the biggest impediment to healing an injury all the way through is locked up compensating musculature in the rest of the body. In the beginning, this compensation was necessary to keep you from further injuring the ankle. Now, it's just in your way. A physical therapist colleague introduced me to using a wobble board for ankle sprain recovery and it's a life changer. Highly recommended!


Last but not least...for NYC Marathon Runners

Our tendency is to want to dive right back into our exercise routine once we feel like we have little to no pain. This is just asking for re-injury. Take 4-6 weeks to slowly but surely add back in exercise. Act like you've never worked out before. Start small and steady. My first "rehab" exercise was walking to a cafe down the block with my wife for brunch after being stuck at home for 4 days. If you used to run 6 miles a run 5 times a week, start with a walk to the subway. Then walk a quarter mile a few days later. Then walk a half mile in week 2. Maybe by week 3 you try running around the block once. Maybe.

If at any point you step weird and it feels hurt again (and trust me this will happen), take it easy, continue daily flushing. It's all part of the process of rebuilding a solid working structurally sound ankle.

If you bite off more than you can chew at this stage, you may step wrong, roll the ankle again, this time worse, tearing through already weak ligaments. Do you like the thought of having to take 8-12 MONTHS to recover?! Don't push too hard!

Would you like to schedule a massage in New York City? You can schedule massage therapy for ankle sprains in the Financial District or Midtown West. Contact Bodyworks DW today or click on the button to book online at either of our studios!