All posts by astenger1112

Side-lying Massage for the Shoulder

A couple weekends ago I attended a side-lying and para-spinal class taught by Brian Utting. Before taking this call I was some what intimidated by side-techniques mostly because of The class came during a time where majority of my current clients were coming to me for shoulder pain. While majority of side-lying techniques are utilized for expectant mothers, massage while lying on the side offers an advantage to the shoulder girdle the typical face up/face down position does not.
Before taking this class I was intimidated by the idea of asking a client to roll on their side for a couple reasons. Properly draping a client so that they feel comfortable takes practice and when I applied the techniques it was difficult to judge pressure and keep consistent. After leaving Brian’s class I had all the confidence to bring these new techniques into my practice.

The biggest advantages of side-lying for shoulder pain are:

1. The ability to take the shoulder into full range of motion.

Because the shoulder isshoulder_ff made up of three bones the collar bone, scapula and humerus side-lying facilitates taking the shoulder in front, behind, above and to the side of the body.

2. Access to the arm pit and rib cage is greater.

3. The client becomes extremely comfortable on the table allowing them to relax and receive the work. (Majority of  my clients sleep on their side and once they are bolstered with a pillow between the arm and legs they are really able to let go of tension and stress.)

As I’ve been using these new techniques clients receive the shoulder  in a deeper way while they remain relaxed on their side with the support of pillows.  Not only is side-lying great for shoulder work, but it also feels great on the neck, low back and muscles along the spine.

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Websitebillingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebookfacebook.com/billingsmassage/

 

Identifying Pain with the Comparative Pain Scale

What is pain to you? How do you experience pain? What does pain feel like? Where is your pain on a scale of 1-10. Almost every patient in the ER has been asked this, and questions like these can be very difficult for massage clients to answer during an interview.

Let’s face it, pain is subjective. Have you ever heard someone say ‘I have a high pain tolerance’? I hear it all the time in the treatment room and this can make it very difficult to gauge the client based on what level of pain they are experiencing.
Thankfully, there are pain scale’s out there to help client and therapist better communicate pain.

Some of my favorites are the funny meme pain scales with the Lego faces or the funny looking stick figures. They make me laugh, but when it comes to my client’s pain I’m not laughing and neither are they.

lego pain scale

The most effective pain scale I like to use is one an instructor in massage school gave to me, and was very useful when working with my Case Study client called the  Comparative Pain Scale. The scale is broken down so the client has context to which they can relate the experience they are having. For example: minor, moderate or severe pain if 1-10 is too broad. If numbers are easy for you then the descriptive word associated with a number is helpful ex. 3=tolerable, 6=intense or 9=unbearable. Further the scale lists descriptions you can compare you’re current experience to.

Understanding the client’s pain isn’t the only reason why therapists use a pain scale. As I was working with my case study client in research class, the number the client gave to me before and after the treatment was used as measurable data. Something that is very difficult to gather in massage therapy because so much is subjective. This information is very valuable down the road when I look back at your SOAP charts (a post about SOAP charting and why massage therapists chart will be linked here). It’s one of the ways we can track a client’s progress over time. So if I seem real pushy about where you are on the pain scale and insist a number, please remember it’s because achieving measurable results really matters to me.

The comparative pain scale is printed and laminated in my office for clients to use as a tool together in understanding pain, for specific techniques and has been proven useful in gaining results in my massage practice.

 

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Websitebillingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebookfacebook.com/billingsmassage/

 

Benefits of Cold Stone Massage

This summer I’m offering a cold marble stone massage. This therapeutic treatment is a great way to relieve the body of discomfort associated with hot temperatures. Cold stone massage is not as common as the hot stone massage, but everyone enjoys it just the same.

Cryotherapy (cold therapy) has many physiological benefits to soft tissue, and most people don’t understand what they are. Cryotherapy is the application of cold for the first aid of trauma to the musculoskeletal system to promote healing.

What exactly happens to the tissue when ice is applied? Initially, the opposite of what happens when you apply heat. Vasoconstriction. The blood vessels and capillary beds constrict the passage way for blood to travel. Next is vasodilation or widening of the vessels. Followed again by constriction and finally numbness when the ice is then removed. The application of ice allows new blood from the heart that is nutrient and oxygen rich to rush back into the tissues to initiate the healing process. 
There are four stages of the skin’s response to cold.ince-massage

1. Cold sensation with vasoconstriction
0 to 3 minutes.
2. Mild burning, aching with vasodilation
2 to 7 minutes.
3. Stinging sensation with vasoconstriction
5 to 12 minutes.
4. Numbness  7 to 20 minutes.

Although the intention is not to achieve all four stages and numbness of the skin, the use of cold stones as a form of cryotherapy during massage can have many of the same benefits.

The benefits of cryotherapy include: decreases swelling, decreases pain, decreases bruising, decreases muscle spasm, reduces fever, increases resistance to disease, speed up recover time (sprains, strains, contusions, fractures) speeds healing of minor burns, increases removal of wastes, decreases secondary injury causes by inflammatory response.

 

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Websitebillingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebookfacebook.com/billingsmassage/

FAQ: Massage at BalanceDiet, Billings

Below are some of the most frequently asked questions from massage therapy clients. If you have unanswered questions please leave a comment below.

What should I expect during my first massage treatment (tx)? 
Completed paperwork (contact info, health history, allergies) is required before your first treatment only. It is very important for you to list all past and current health concerns and medications for the therapist to meet your specific needs.
Arrive early to use facilities and begin the interview process on time. A brief Q & A together of your health history, what your goals are, if massage therapy is appropriate
 for you and creating a tx plan can take 2-10 minutes and begins every massage thereafter. An exit interview concludes each visit, and is a follow up of the initial interview.

What is appropriate to wear?
Wear loose fitted clothing as if you were to exercise. The massage therapist may use techniques that require clothing that do not restrict range of motion. Basic Swedish massage techniques are performed undressed between sheets, and draping that respectfully exposes only the body parts being treated. 

Please practice proper hygiene or use shower facilities (only offered for women), or request a wet towel.

How long is a massage?
30, 60 and 90 minute massage time slots are available. All times include enter & exit interviews.

How often do I received massage tx?
As often as seems necessary. If you are in acute pain from whiplash, multiple 30 minutes treatments in a week may be recommended. If you suffer from chronic work related stress it may take longer to meet your goals and a long-term treatment plan can be created. All plans take into consideration your wellness goals, budget, time allowance and convenience.

Can my doctor prescribe treatments?
Many of my clients are referred by another health care professional to receive massage. This is NOT a prescription for massage. You’re primary care physician can write you a RX that includes how many and how often to receive a massage treatment related to the current medical condition being treated by your doctor. With your permission the massage therapist may contact your doctor.

Does insurance cover my massage?
Check with your insurance provider to find out if massage is covered. Insurance billing is not offered through the massage therapist. A receipt for your records will be issued to you for later submission if you choose. All charting and documentation is available to you upon request and stored within HIPPA privacy guidelines.

When should I NOT receive massage tx?
You should not book a massage if you have a fever, cold/flu, or contagious skin infection. Always ask your primary care physician if massage would benefit/harm your current health conditions.

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Websitebillingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebookfacebook.com/billingsmassage/

 

A Year in the Books

This month marks the first successful year of my massage therapy practice. I wouldn’t be here without the wonderful support of all my clients and the people at BalanceDiet Billings.

Two weeks before I graduated from Health Works Institute I decided to no longer work at the spa in Big Sky. Working there over the past 2 years was such a wonderful time spent with the owner Jacque and all the therapists and estheticians, but there was something calling me back to Billings, MT where I am from.

When the original location in a salon fell through, I was relieved because I knew my practice wasn’t the type to be in that particular location. I had training in clinical massage therapy and the luxurious type of massage (a lot of Swedish) wasn’t what I wanted to do.  So,  I replied to a craigslist ad at BalanceDiet, a women’s weight loss facility, and after the interview I knew this is exactly where my practice could grow.

Since graduating I’ve received certification as an Integrative Reflexologist. This is something my grandmother taught herself and practiced many years of her life and I watched growing up. To now offer reflexology to clients is rewarding on so many levels. I have’t decided what continuing education I will pursue this coming year, so if you know of a modality or training you’d like to see me offer please comment below!

What I love the most about my practice over the year is the wonderful variety of people I meet and help. Their needs are all so different and I constantly reference my text books, the internet and latest massage research for new or forgotten techniques to help them with their pain.

What I like the least about my practice over the year, and a new client told me this the other day “It’s so hard to get in to see you.” Now, I understand there is a compliment below the surface of that statement, but when someone is experiencing discomfort and pain in that moment and it takes 3-4 days to get in to see me the compliment goes from sweet to salty real fast.

 

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Website: billingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebook: facebook.com/billingsmassage/

Lower Back Pain, Repetitive Motion and Massage Therapy: A Case Study

This is a retrospective case study of a client who came in for low back pain. I prefer to present the data in a story format without the SOAP charting jargon for those of you who are not familiar with charting terms. If you would like more information on the objective findings and exact treatment please contact me.

The study is a 57 year old female who works full time at UPS in shipment/package processing. She complained of low back, upper shoulder and neck pain. She described a feeling of her breath ‘taken away’ when laying on her back.  Her job at the time was very stressful as it was the beginning of November and the busiest season for shipping.  She describes to me what her job consists of daily. Lifting boxes with both hands and twisting to the left to place them elsewhere. Over and over again.

The postural assessment revealed a short leg of about 1 inch difference.  The left side of the back was severely elevated in comparison to the right (see photo below). She also presented very limited neck, shoulder and hip ROM.

benson_1
Severe L side elevation causing low back pain and tension in the shoulders and neck.

Over the next 5 months the client received a 30 minute treatment once a week. During the first month we were able to decrease pain symptoms in the low back, shoulders and neck with Swedish Massage and Trigger Point Therapy allowing her to lie flat on her back without the sensation of not being able to breath. We then addressed the leg length discrepancy and balanced the hips with Myofascial Release. Around month 2 the short leg length began to decrease and stay consistent of 1/2 inch. The following months consisted of maintenance massage over the entire back, shoulders, neck and hips.

At month 5 we were able to increase the time between massage to 2-3 weeks. The client began yoga at home, and exercised regularly. She was no longer feeling the neck and shoulder tension, some low back pain on occasion and commented that she was finally able to enjoy the massage without the presence of therapeutic pain.

benson_2
Change in elevation treated with Swedish Massage, Trigger Point Therapy and Myofascial Release.

This case study was 100% dedicated to finding relief through massage therapy.  With patience and persistence she is now taking control of life with out the pain.

 

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Website: billingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebook: facebook.com/billingsmassage/

Enjoy Balance and Aging with Massage Therapy

Falls are the primary cause of accidental death in persons older than 65 years of age, often resulting in hip fractures, decreased mobility and independence, and increased morbidity. Age-related factors may include modification of the nervous and muscular system function with resulting changes in mobility, gait, and strength. These factors, along with disease and the increased use of medications that tend to come with aging, combine to make falls in this population a serious healthcare issue.

footbalanceWhen the muscles in charge of proper posture become more rigid and flexed our center of gravity moves farther forward and postural instability increases. Massage therapy has proven to produce short-term improvements in balance, neurological, and cardiovascular measures in older persons. A cost effective treatment in comparison to the billions of dollars in annual medical costs for persons who fall.

A single 60- minute, full-body massage therapy treatment was shown to have a stabilizing effect on measures of balance and physiological factors related to stability in older adults. As massage therapy has been shown to decrease stress and anxiety and improve mental state, these factors may also have a positive influence on balance. With massage therapy, proper exercise and nutrition you can greatly decrease your risk of falling and enjoy aging!

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Website: billingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebook: facebook.com/billingsmassage/

Restorative Yoga @ BalanceDiet Billings

Yoga is one of my favorite complementary forms of exercise I love to suggest to massage clients. What I like most about yoga is that it offers many different styles just like massage offers different modalities. Like Swedish, Deep Tissue or Trigger Point yoga has Vinyasa, Flow or Restorative (and much more) so you’re sure to find a perfect fit for you!

Recently, BalanceDiet Billings began offering yoga videos for members to try together or alone in their fitness room through The Yoga Collective. A website with a library of yoga videos for every level of yogi to try.

I recently fell in love with restorative yoga through a client who came to me describing shoulder pain that was causing her to lose sleep and back off using weights in the upper body. She explained how she wasn’t able to do yoga either, which she was really enjoying.

After her massage treatment and some relief I offered to dig around in The Yoga Collective for some videos that don’t require your body to feel the deepest stretch with each pose. That’s when I found Gentle Yoga (20 minutes) and Relax and Restore (30 minutes) which left me feeling like I did yoga and had a massage all at the same time!

I began with GY and finished with RR yoga for a total of 50 minutes. I found I could take my time and stay longer in a certain pose if needed. The RR poses offered enough of a stretch to release muscle groups but supported my body the whole time through the use of blocks and multiple blankets. The perfect way to self massage the body!

This type of yoga is great for those who have difficulty with balance (check out Sierra’s Balance class on Tuesday), shoulder impingement, hip displacement or low weight bearing on any area of the spine. If you’re a beginner at yoga this is a great way to ease into level 1+ videos.

yogaprops
Yoga accessories: blocks, blankets, straps.

Check out BalanceDiet Billing’s Group fitness class schedule here to see the other classes they have to offer.

Please, let me know if you try out these yoga videos and what you think! Both videos have been added to favorites for quick and easy access. Stop by to see me in the massage room if you have any questions or would like to book an appointment!

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Contact or booking: Office: (406) 652-9142 Cell:(406) 780-0535

Website: billingsmassage.amtamembers.com

Facebook: facebook.com/billingsmassage/

 

Sleep and Massage

A very common question I ask before or during a massage is how did you sleep last night? The all too common answer is not very well followed by I couldn’t stop thinking about work, my partner snores, the animals are bed hogs, etc.

When life gets in the way of our sleep habits there can be big consequences to our overall health. One of the biggest consequences for women who struggle with weight loss is when our sleep deprived body releases the hormone ghrellin which increases our appetite.  

So how can massage therapy help us sleep better and possibly manage hunger? Because massage has been found to directly increase the body’s production of serotonin, which is essential for the production of melatonin, the client experiences improved sleep.

There are many types of massage that can help including these:

  • Swedish
  • Deep Tissue
  • Sports
  • Trigger Point
  • Reflexology

Skip the pills and sleep better knowing there are alternative and complementary methods of medicine like massage to get more restoration and rejuvenation through the night.

 

Alex Stenger is a licensed Massage Therapist practicing inside BalanceDiet Billings.

Website: billingsmassage.amtamembers.com 

Contact: Office (406) 652-9142 Cell (406) 780-0535

Facebook: facebook.com/embodimentmassage/

 

A Fictional Case Study. Massage Therapy.

My Physiology/Pathology class has assigned a fictional case study assignment in the past in order to better understand a symptom picture in a massage therapy setting. For a massage therapist, we are always assessing the subjective and objective information to create a treatment plan targeted at relieving the client’s signs and symptoms.

Below is a fictional case study I have written pertaining to a pathological disorder of the Nervous System. At the end I have written 5 discussion question and answers.

Traumatic Brain Injury: Concussion

Rhonda is 46 years old. She called in the late evening to make an appointment complaining of a headache not allowing her to sleep. Her speech was slurred and difficult to understand. Rhonda arrived the next day an hour early for an afternoon appointment. When she signed the logbook she seemed very confused when told in fact the day’s date was Monday. not Sunday. and that her appointment was booked for 12 pm and not 11 pm. When standing up Rhonda asked for assistance to her treatment. She steadied herself along the walls and complained of feeling dizziness after standing up. The entire time Rhonda was in the office she was wearing her sunglasses and mentioned the light irritates her headache. When she removed her sunglasses in the treatment room both  pupils were dilated.

 

  • How do I interact with Rhonda during  the conversation over the phone?
    • Because of Rhonda’s slurred speech I should gather as much subjective information as possible in a few minutes regarding why she needs to get a massage as soon as possible and when she can get in.
  • What do I suspect?
    • Rhonda is a long – time client who does not drink regularly. The possibility of her slurred speech due to over consumption of alcohol is unlikely.  The headache she explains could be a migraine causing the slurred speech. The abnormality of her late night call to make an appointment and slurred speech is a sign something severe is going on and I make a note to very carefully observe her  tomorrow.
  • What other symptoms of a migraine does Rhonda present?
    • Her loss of motor control and dizziness after standing up and complaining of sensitivity to light are symptoms of migraines but her confusion over  the date and time of the appointment has lead me to believe her symptoms are not due to a migraine, but something much severe.
  • Has Rhonda suffered from any acute injuries?
    • While asking Rhonda about all the things she had done in the past 24 hours she mentioned going to church, having lunch with her daughter and then spending the rest of the afternoon in the barn. While outside  the wind picked up and a stall door swung and hit her on the forehead. She did not lose consciousness and decided to take aspirin and continue her chores. After dinner is when she started to get a headache, decided to lie down and could not fall asleep.
  • What do I suspect?
    • An acute injury to her frontal lobes could be the cause of her slurred speech, motor dysfunction, and dilated pupils. The loss of brain function could be due to a Traumatic Brain Injury and a possible concussion. It is important that Rhonda see her primary care physician to assess the severity of the impact on her brain before massage can be performed. Rhonda should be taken to the hospital as soon as possible.