Neuroplasticity, Parkinson’s Disease, Massage

Many years ago, I watched my beloved uncle struggle to control his movements and still play piano while he battled Parkinson’s, PD. In January, 2012, I began a year-long course, Functional Neurology for Bodyworkers, FNB. In February, 2012 I met someone with PD who agreed to be part of a case study. I knew massage helps Parkinson’s symptoms with improved relaxation and sleep, reduced muscle stiffness and spasms, and increased joint range of motion. FNB is a relatively new field, with different approaches.

PD involves a deterioration of cells in the brain that produce dopamine, a necessary neurotransmitter for initiating and controlling movement, although nonmotor signs of PD may show up many years before a diagnosis. PD is usually treated with dopamine-related medications. The nonmotor symptoms often become more problematic as PD progresses.

Neuron theory holds that when properly stimulated or activated, within the metabolic rate of the neuron, nerve cells that aren’t functioning well can become healthier, or develop neuroplasticity. A lowered pulse is a parasympathetic response of the autonomic nervous system–“rest and digest” vs. the arousal/sympathetic response of “fight or flight”. A parasympathetic state paves the way for healing, as relaxation improves how nerves signal to neighboring nerves and fragile nerves can rebuild. Monitoring the pulse with a fingertip pulse oximeter thus provides a window to the nervous system’s response to treatment.

I modified the massage and bodywork techniques that were known to benefit Parkinson’s by the results of functional neurological assessments, using the pulse oximeter. By the end of the study, I noticed changes in functioning: improvements in sleep, digestion, coordination, balance, speech and sense of smell. These are mostly improvements in what are called the nonmotor symptoms of PD.

A small case study cannot yield scientifically meaningful results. I have been researching peer-reviewed literature for articles that indicate how to improve the impact that modified massage can make on motor and nonmotor symptoms of Parkinson’s. A series of informal case research studies are currently underway to explore this further.  Comments and suggestions are welcome.

Rosi Goldsmith, LMT  OR Lic. #16585
2929 SW Multnomah Blvd., Suite 301
Portland, OR 97219
(503) 708-2911
www.integrationmassage.com

QiGong Breath to Release Pain

Introduction, Credits

I learned this from a book loaned to me by a Qi Gong instructor. I use it all the time for my clients with acute localized pain. I apologize to the Qi Master who wrote the book, because I would like to give you credit. However, you don’t need to be a Qi Master to use this. But you do need to focus your attention on the area with intense pain. This does not work so well for diffuse pain.

Focused Attention and Stagnant Qi

Focused attention to one area of the body stimulates the proprioceptors and other nerves which give us awareness of sensation and movement. The more you awaken sensation, the more you can move or release tension. Not moving, poor circulation, accumulation of waste products, excessive firing of nerve endings all may contribute to localized pain. In  Chinese terms, you might have stagnant Qi.

Release Pain with QiGong Breath

If you are a massage therapist, or want to help a friend who has acute localized pain, it is good to practice this on yourself first, several times a day, for several days. Then it will be easy to coach someone else.

1. Put your finger on the painful spot, and intensely focus your mind there.
2. Imagine and visualize your breath going out through that spot. Or feel as though your nostrils are located there, and all your outgoing breath exits your body though that spot. Do not change your breathing pattern or force your breath; just allow.
3. Once that is established and easy, visualize or feel an ice cube at that spot. Allow your outgoing breath to start melting the ice cube.
4. Once the ice cube is melted, continue to send your outgoing breath there, until it turns to vapor.
5. Once it turns to vapor, check to see if there is still pain. If so, repeat the cycle until the pain is gone. If you are practicing to become more skilled at using Qi, find another spot of pain and repeat this exercise.

Rosi Goldsmith, LMT
www.integrationmassage.com
www.facebook.com/IntegrationBodyworkMassage

Therapeutic Breath Work: release tension, find peace

Continued from Therapeutic Breath Work, Part 1

Coordination of the outgoing breath with letting go of tension is an easy way to bring stillness to the body and mind. It relieves pain and stress and relaxes muscles. There are physiological reasons for this.

The ribs attach to the spine at the back, and open and close like little wings with each breath. They are connected by cartilage to the breastbone at the front, and to each other by the intercostal muscles, so they move as a unit. These form the main joints of breathing.

The dome-shaped diaphragm is the main muscle of breathing. It separates the lungs and heart from the guts, and attaches to the ribs at the bottom. It takes effort or tension to contract the diaphragm downwards to compress the viscera (guts) for the inhale. The relaxation of the diaphragm upwards allows the air to leave the lungs. So, letting go of tension follows letting go of the breath.

The muscles at the back of the body, along the spine, gather on the inhale. On the opposite side of the body, muscles coordinate to gently drop the pelvic floor, arch the back, and rock the pelvis anteriorly, to allow more room for the viscera to move downwards. On the exhale, the muscles at the back lengthen, and the other muscles release.

However, all the muscles of your body participate in gathering on the inhale and lengthening on the exhale, unless there has been some trauma and they are reversed. With my hands, I exaggerate the gathering and lengthening with the breath at the back, along the spine, to train clients to release their whole body from tension. It works!

Breath work is used in many forms of meditation to focus, calm and still the mind. It helps coordinate brainwaves for better learning, and releases endorphins and other neurotransmitters that reduce anxiety and relieve pain. Contemplative yoga and conscious massage can also  bring mindful attention to the body and breath.

If you have a way to use the breath to heal, leave me a comment. Thanks!

Below, you will find some resources on how conscious breathing and mindfulness can support the body in healing:
Dr. Jon Kabat-Zinn
Barbara Conable
Alexander Technique
Rosen  Method
Joan Borysenko, Minding the Body, Mending the Mind
Verbal Point Holding and the Emotional Tone Scale
The Qi Gong Breath
Pelvic Power
YouTube on breathing.

Rosi Goldsmith, LMT
www.integrationmassage.com

Therapeutic Breath Work: Let go of tension, pain and stress, Part 1

Most of our breathing is automatic, and we are usually not aware when and how we restrict it. However, we can use the breath as a unique vehicle for responsibly meeting and healing from tension, emotional or physical pain, and trauma. Conscious breathing facilitates processing emotional issues, and helps people stay present for uncomfortable memories, stay in their bodies, or not drift into avoidance when intense experiences come up.

“Once you’ve become mindful and present to the pain, imagine that you can breathe in and out of it just as you can imagine breathing in and out of your belly. Imagine the breath as loving attention–the opposite of trying to push something away.” (Joan Borysenko)

I first learned of therapeutic breath work with ReBirthing in the early 1980’s. We say, “Breathe all the way in and all the way out, slowly and continuously, without stopping.” It allows people to step back and witness their feelings, gives them “breathing room” to have greater awareness, without judgment, and to let tension go on the exhale.

One place where you find pockets of tension with unconscious restriction of breath, is at the bottom of the rib cage where the diaphragm attaches. Persistent, gentle massage there, with an invitation to breathe into the tense spots, will often allow people to release out of old fears as well.

Another place where restricted breath shows up is the anterior and middle scalenes These attach to first and second ribs. When people shorten the muscles at the front of their necks from computer work, texting, or emotional reasons,  the muscles become chronically contracted. They are unable to raise the first rib on forced inhalation.

You can do this simple exercise to relax those muscles:

1.     Put your fingers just above the collarbones at the base of the neck.
2.     Breathe in, forcing the air into the top of your lungs until you can feel the first rib pushing up against your fingers.
3.     Hold for ten seconds.
4.     Breathe out slowly, feeling  the scalenes relax.
5.     Repeat 3x.

To see the updated article with illustrations please go to Integration Massage–Breathwork, main website

Rosi Goldsmith, LMT
www.integrationmassage.com

Functional Neurology–Cutting Edge Massage Therapy

The brain and nervous system may reflect inefficient adaptations to trauma or stress, while assessments and interventions of Functional Neurology can help massage therapists stimulate neuroplasticity in clients. New neural pathways are developed by simple exercises and neuro-focussed massage. How does this work? If a nerve does not have adequate oxygen, nutrients, and stimulation, it will dump some of its functioning in order to conserve resources. Nerves that are weak or fragile may lead to symptoms of fatigue, insomnia, depression, gait disturbance, inflammation, autoimmune issues, hypersensitivity to pain, or difficulty controlling movements. Interventions based on neuro assessments can gently strengthen and retrain the body’s signals so the whole body and nervous system work better.

Functional Neurological Massage has only been recently available as an option for U.S. massage therapists. January 2012 saw the start of the first class offered in Portland, Oregon, although it had been taught for 5 years in Colorado.

The massage is modified by what is learned from the assessments: where, when and how to apply it. There are new ways to think about how emotional, cognitive, and body symptoms interact, and new take home exercises for:

•    Head trauma
•    Brain fog, memory and concentration
•    Numbness and tingling
•    Chronic pain of unknown cause
•    Dizziness or gait imbalance

In the assessment, we will check such things as blood pressure and pulse on both sides. We compare left to right for differences in reflexes or muscle strength and sensation of light touch, pain, vibration. We may observe muscle tone, time to fatigue, or rapidity and smoothness of movements, how your eyes track, how you stand on one leg with eyes closed. We may see how you do with one-sided massage, as we monitor whether your nerves are developing more plasticity, using a pulse-oximeter as a window into the parasympathetic nervous system response.

Balance and eye movement exercises, or one-sided massage may supplement more traditional massage approaches. Brain and neuro plasticity requires repetition to strengthen new nerve pathways, so you may be given take-home exercises to practice between appointments–just like learning a new language!

Rosi Goldsmith, LMT

Please be aware that you will find more recent posts on this topic at:
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Benefits of Massage for Elders

Research studies have shown that massage therapy can make a huge difference in the lives of seniors in Assisted Living, Retirement or long term care. They may have little physical contact in an ordinary day, and most live with pain or various chronic ailments. Comfort, calm and ease can be communicated simply with a loving, informed touch.

Massage has shown to help reduce high blood pressure, recover from surgery or minor injuries, enhance immunity, relieve pain and reduce the need for pain medications, promote relaxation, improve circulation, stimulate bowels, reduce swelling, and relieve muscle tension and stiffness. These are important for people with such varied conditions as diabetes, heart conditions, memory loss, and post-op from hip surgery. It improves both the quality and length of sleep, allowing someone to be more alert and have better daytime social interactions.

Massage and movement improve joint range of motion, and exercise and stretch muscles. This helps people with arthritis and neurological conditions such as Parkinson’s maintain flexibility and release spasms and cramping, while increasing their motivation for self-care and independence in daily activities.

Many seniors are concerned with modesty, or have trouble lying flat on a table. Massages can be given on a table with the head or knees elevated, or adapted for a person sitting in a chair or bedbound.  They can be done fully clothed, or draped to maintain modesty. Licensed massage therapists are skilled at easing achy backs, and tight shoulders, but will only work where the person wants them to—perhaps the neck, hands and feet, or just the low back.

There are psychological benefits, too. Gentle massage, even to the hands, has been shown to decrease agitation and relieve anxiety in people with dementia or Alzheimer’s, and to improve mood.

Rosi Goldsmith, LMT offers a presentation of interest to activity directors and residents on The Benefits of Massage. She also has designed Body Mapping for Elders to be entertaining and educational. Participants increase internal awareness of movement and sensation, improving safety and ease for sit-to-stand movements and walking. And everyone gets a free shoulder massage!

503-708-2911

Body Metaphors to a Massage Therapist

I often listen as people talk for any body metaphors. I investigate: what does that communicate about their tension patterns? Where they are restricting movement? Where does it indicate they need bodywork?

Stiff upper lip—If a person is hiding their feelings in a situation they don’t like, I work on rigid facial muscles. Also, grin and bear it and gritting their teeth, often point to putting up with something unpleasant. I work on softening tension around the jaw, neck and shoulders, and make sure this session is one where they get to express their needs and get them met.

With chronic or persistent neck pain, I may ask, “Who or what is a pain in the neck in your life right now?” I can tell when they figure it out, by how the tension leaves. A person’s shoulder may be raised higher on one side, if they have a chip on their shoulder. Do they have resentments, or feelings of superiority they can release from their body?

On the other hand, if someone claims to have their head on their shoulders, I ask, “Then, where is your neck?” We work on lengthening, stretching neck muscles. I may see a rigid forward neck position in someone who is always sticking their neck out or wanting to get ahead. Stiff-necked means someone is not willing to concede: I work to release their neck, so it can be supple and free.

Are they barely holding themselves together or always backing down in an argument? I might see back pain, rounded or contracted shoulders, or a posterior tilt to the pelvis.

If someone can’t stomach it, would gentle abdominal massage help?

When a person states they are bending over backwards for their boss, I work to release low and mid back muscles, quads and hamstrings, psoas muscles, and teach Body Mapping of the spine.

I recommend Louise Hay’s You Can Heal Your Life.

If this leaves you feeling you don’t have a leg to stand on, then put your best foot forward, and see if you can find your own body metaphors!

Ortho-Bionomy® in a Massage Practice

I took my first Phase 4 Ortho-Bionomy® weekend workshop in April, 2011, with Sara Sunstein. I have since used it in over a hundred client sessions. I often do stand-alone Ortho-Bionomy® sessions, or combine it with massage for such issues as: muscle spasms; neck pain; knots in the shoulders and back; hand, wrist and arm pain; knee, ankle and foot injuries. It is relaxing and safe for even recent motor vehicle injuries.

I love that it encompasses physical, emotional, spiritual and energetic work. Clients release deep issues and knots, without deep pressure. It teaches me to use my body in ways that don’t hurt, consistently, so I attend to my own comfort while being present for and holding a therapeutic relationship with the client. It has been the biggest single factor in reversing my almost-toast career (from ignoring my body’s pain signals) to now enjoying and anticipating longevity as a massage therapist.

I appreciate that it can be done fully clothed, can easily be adapted to sports, chair massage or elders. It has attuned me to subtle signals: I can feel when a tight neck muscle has released just a few fibers, and when it travels down the whole body into the feet.

Phase 4 is similar to Positional Release (aka Strain Counterstrain) as practiced by Osteopaths and Physical Therapists. Ortho-Bionomy® adds a few twists. Dr. Arthur Lincoln Pauls was a judo master, and became an Osteopath to heal judo injuries. He learned Osteopathic Positional Release and combined it with his judo awareness of the direction a body is already going, then to follow and exaggerate it. He taught students to follow principles such as less is more; awaken the self-healing impulses from within the client; do nothing; witness.

I took the Phase 6 class at the end of April, 2011, then took most of a 3-week intensive in Santa Fe, NM. Since January of 2012, I am an Ortho-Bionomy® Associate. I look forward to sharing this awesome path of healing with you. If you want to find an Ortho-Bionomy Associate, Practitioner, or Instructor in your area, check here: SOBI.

Rosi Goldsmith, LMT
www.integrationmassage.com
www.facebook.com/IntegrationBodyworkMassage

Kale Chips Recipe

Kale Chips Credits: Inspiration from Sarah at Pacific NW Kale Chips. I use Gabriel Cousens’ idea of the five flavors for satisfying the palate in raw food recipes.

2 1/2 – 3 gallons of well-washed kale, stems removed and finely cut separately. Can include other mild and tender brassica greens.

Sauce:
1.    3/4 cup brown sesame seeds, soaked 8 hours, drained, rinsed and allowed to barely sprout (with more rinsing) 24 hours at 64°F, 8 hours at 75° F, or 2 hours at 100° F. You should have about 1 1/2 cups soaked and barely sprouted sesame seeds.
2.    1 1/2 cups sunflower seeds, soaked 6 hours, drained, rinsed. Yields 3 cups.
3.    1/4 cup apple cider vinegar or fresh lemon juice, or more to taste
4.    3/4 cup golden flax seeds, soaked in 2 cups water.
5.    1 orange, peeled, seeded.
7.    1 cup nutritional yeast
8.    1  1/2 inches fresh ginger root
9.    1/4 cup cold pressed olive oil
10.   enough water to keep your Vita-Mix from overheating while it grinds up and blends the sesame, sunflower and flax seeds
11.   About 2-4 teaspoons Real Salt, or to taste.
12.   1/2 tsp celery seed
13.   1-2 T. dried or fresh rosemary
14.    (completely optional) 3/4 cup dulse flakes

Blend the sesame seeds, 1 1/2 cups of the sunflower seeds, the orange, the rosemary, celery seed, and the ginger root with enough water to keep your Vita-Mix from overheating. Blend very well until smooth and creamy. Add the rest of the ingredients, and blend well with more water if necessary. Pour over greens in a large bowl (I did it in 3 batches), toss until greens are well coated. (There may be some leftover sauce left. Use as salad dressing or put them on the finely chopped stems for a separate section of the dehydrator.)

Let the sauced-up greens rest and absorb the flavors. Taste and see if you need to add more salt, lemon/vinegar or olive oil. Toss in the rest of the sunflower seeds. Spread on sheets and dehydrate at 113°. After a few hours, remove the crunchiest ones from the top, and separate the remaining greens so they dehydrate well. Store in a tightly sealed container. Share with friends. :-)

Raw foods are anti-inflammatory, and a wonderful component of self-care along with a massage!

Rosi Goldsmith, LMT
www.integrationmassage.com
www.facebook.com/IntegrationBodyworkMassage

“Awaken the Body Sense, Overcome Myths of Aging” Workshop Outline

When we live in a state of chronic stress, we hold chronic contractions and the sensory input to our brain from our muscles goes to habitual pathways outside of our conscious control: a withdrawal response (see Thomas Hanna’s Somatics). To regain voluntary control of our muscles requires waking up to that which we have forgotten.

Myths of Aging

Some of the myths of aging, such as inevitable stiffness, inevitable loss of bodily functions, inevitable decline in cognition, activate a feed forward system. Our bodies manifest what we believe. If we believe that aging brings wisdom and grace, we become more resilient.

Kinesthesia

Kinesthesia is the awareness of sensation of movement in muscles and joints. It coordinates with the vestibular system, so you know if you are balanced and able to move freely, or tense and stiff. A kinesthetic awareness brings more fluidity of movement–the muscles begin to soften and lengthen.

Body Mapping

Body Mapping teaches you the location of your bones and joints and their relation to other body parts. An incorrect body map will create distortions in our shape and movements. (previous post Posture and Body Mapping) A correct body map will allow conscious choice to move out of stress.

Overcome Sensory Motor Amnesia with Selective Voluntary Movements and Awareness

The sensory motor system is a feedback loop. If you have amnesia of areas where you have ignored chronic pain, you cannot sense it and then you cannot move it. And the more you can move it, the more you will sense it. When you regain voluntary control over muscles that have been forgotten, you regain a sense of empowerment– you take charge of your body again.

Exercises

The class consists of a series of interactive exercises: live examples of the myths of aging in our lives; moving with kinesthetic awareness; body mapping of the head, neck, shoulders, arms, wrists, hands, pelvis, hips, knees, ankles, feet; finding areas of your body where you have sensory motor amnesia, and regaining sensation, movement, and awareness of how to consciously create your lives and health.

Rosi Goldsmith, LMT
(503) 708-2911
www.integrationmassage.com
www.facebook.com/IntegrationBodyworkMassage

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