Western Massage for Musicians

Okay I said I would post about Western massage several posts ago. I got a bit distracted, but I am back on track! Here it is! I hope it is helpful. There are a number of places where you can try out a massage. Many malls have a chair massage station where there will be therapists that will give you a massage lasting from 10 to 30 minute. These are done without the oils and while the client is fully clothed. It is a good way to see if massage can help your condition without too much commitment. If someone has a specific condition, it is very important to find an experienced therapist who can work specifically with that condition.

Western Massage - Tradition and Practice
There are a number of physical and psychological effects that are obtained from Western styles of massage. Overworked, tense or strained muscles produce lactic acid. This and other waste products can accumulate in the muscles. This, in turn, can produce stiffness, soreness and even muscle spasms. Massage can improve the circulation in the area, increasing the removal of waste products from the muscles. Improvement in circulation also increases the flow of oxygen and other nutrients to the muscles, helping them heal faster. It also stimulates the lymphatic system, which is the body's waste removal system. This also causes waste matter to be removed more quickly. Massage also is useful in relaxing tight, constricted muscles. Muscles that are tight, constricted or in spasm, can restrict blood flow, or they may entrap nerves, causing a cycle of increasing pain. Nerve entrapment causes pain, which causes the muscles to constrict which causes more pain, creating a cycle of pain. Massage is very useful for this type of condition. There are also a number of psychological benefits associated with massage. Massage has been shown to reduce stress and tension in the client. Stress and tension are common problems among musicians and can exacerbate any physical condition that is affecting the ability to play. This, of course, is another cyclical problem. Stress causes muscle tension, which causes pain, which affects the ability to perform or practice, which in turn causes more stress, creating a cycle of increasing stress. Therefore, as a stress reducer, massage can be invaluable for the performer.
Western types of massage use specific manipulative techniques to move or affect the various muscles, the ligaments, the cardiovascular system and the lymphatic system. The most common type of Western massage is Swedish massage. This therapy was developed by a nineteenth century Swedish physician, Per Henrik Ling. He developed his technique using ideas based on gymnastics, physiology, and a study of techniques from Egypt, China, Greece and Rome. Swedish massage uses five different types of strokes. The first, efflurage, is a long gliding stroke done with the thumb or with the entire hand. Petrissage utilizes compression and kneading motions. Friction is a penetrating movement in which deep circles are made into the muscles of the recipient. The therapist uses the thumb or fingertips for this motion. Vibration uses rapid, very confined shaking movements, and tapotement is a series of "taps" performed very quickly in succession. All techniques may not be used in a session. The therapist will use those strokes that benefit the client. They will also communicate with the client and find which strokes they prefer.
Many times, massage is performed in conjunction with aromatherapy. The therapist will use a scented oil and/or there may be an oil diffuser present that scents the room. This is not simply for ambiance. Certain essential oils (derived from plants, not synthetics) have been shown to reduce or enhance brain-wave activity and even to have an analgesic effect.34 These include lavender, lemongrass, rosemary and juniper. The therapist will take into consideration the condition of the client, as well as their preferences when using particular oils.
Massage therapists do not usually diagnose a client. If the client is referred by another practitioner, then the therapist has a diagnosis that comes with the referral. If the client is self-referred, then the therapist will ask certain questions in order to understand what it is that the client is seeking. There are certain conditions which require particular forms of massage. Carpal Tunnel Syndrome is one such condition. This will be addressed later in this section. There are also certain conditions in which massage is contraindicated. Among these are a history of blood clots in the legs (phlebitis), fever, malignancy, or jaundice. Other conditions, such as varicose veins, bruises, burns and rashes or a recent injury require that direct massage over these areas be avoided. While massage is used as a stress reducer in patients with cancer, it should only be done with a referral from a physician and with a therapist who is familiar with this type of treatment. Massage can be very useful for stress reduction and pain relief during pregnancy and labor, but pregnant women should consult their doctor and make sure that they inform the massage therapist of their condition before receiving a massage. Massage has been known to cause contractions. From the above information, one can ascertain that it is very important to have a licensed massage therapist and that the client communicate fully with the massage therapist regarding any health issues.
In a typical Western or Swedish massage, the client is fully or partially disrobed. The therapist will have communicated with the client before beginning the session regarding any injuries or conditions that the therapist may need to know about. Only the part of the body that is being massaged is exposed. The rest is covered with a towel. The therapist will continue to communicate with the client throughout the session, particularly the first session, in order to ascertain which strokes the client prefers and how hard the therapist can massage. The room should be warm, as this will help the client relax and make the muscles more receptive to the massage. The frequency of the treatment may vary. If the treatment has been prescribed by another professional for an acute condition, it may be as frequent as three times a week. If it is initiated by the client, the frequency may range from once or twice a week to once a month. Those interested in finding a licensed massage therapist in their area can contact the American Massage Therapy Association.
There is a vast amount of literature regarding massage and body work. The paper will review that which deals specifically with wind players, musicians and/or the specific problems which wind players may experience.
The article "How to Relieve Carpal Tunnel Syndrome" in the Massage Therapy Journal is written mainly for the massage therapist. It gives the definition of Carpal Tunnel Syndrome from the Merck Manual as "Carpal Tunnel Syndrome is caused by deposition of mucinous ground substance in the ligaments around the wrist and ankle, producing nerve compression".35 This definition may help the patient as may the description of how Carpal Tunnel Syndrome happens that follows. The author explains the physiological process of the condition and the treatment. He uses analogies that the layperson can understand, which is helpful, since some medical texts can be difficult to follow. The author then goes on to explain the system of massage for Carpal Tunnel Syndrome. Again, this is an article for massage therapists, so it is somewhat technical. Nevertheless, it is good for the patient to know what type of treatment they should be receiving. The massage treatment for Carpal Tunnel Syndrome differs from that of other conditions in that it requires a light touch that moves the lymphatic fluid, rather than a heavier touch designed to relieve muscle spasm. The article also includes instruction for self-massage for the same condition, but again it may be somewhat technical in nature. The article is important in that it demonstrates the need for a correct diagnosis of Carpal Tunnel Syndrome, not just a guess. As these conditions can be difficult to diagnose, it is important that the patient be persistent in the search for a name for the condition from which they suffer. Carpal Tunnel Syndrome is over diagnosed, according to many specialists, therefore the second opinion is of paramount importance. The thrust of the information in the article is that a massage for Carpal Tunnel Syndrome will not harm the patient even if the problem is ultimately diagnosed as something else. On the other hand, a massage that is performed on a patient who has Carpal Tunnel Syndrome and is unaware of the condition or does not communicate this to the therapist, can have the opposite effect.
Massage is briefly mentioned in the book The Musician's Survival Manual: a Guide to Preventing and Treating Injuries in the Instrumentalist by Richard Norris, MD.. He states "Massage is useful in stimulating blood flow, reducing edema, and breaking up localized areas of muscle spasm known as trigger points. Massage is also helpful for general relaxation and reduction of overall tension."36
The book Head, Neck and Shoulders Massage: a step-by-step guide is written so that one can learn to massage others or oneself. It also includes visualization techniques that can be used with or without the massage. The author has included different visualization exercises for various ailments or areas of the body. There is a massage and visualization sequence that the author recommends for muscle problems, including Repetitive Strain Injury. The massage indicated would need to be performed by a second person, but the visualization could be used by the patient by themselves. There is also a sequence in the book that teaches the reader how to self-massage the neck, head and shoulders. The book is illustrated with excellent photographs showing the various strokes. The book also informs the reader of those situations in which massage would be contraindicated. Other problems that the book addresses include headaches, migraines, weight loss, circulatory problems and a host of other ailments.
The "Hands On!" website has different articles that discuss different aspects of flute playing. The article "Pain Management Using Massage Therapy" discusses several types of massage that can be used to relieve pain resulting from soft tissue injuries. One type is "cross fiber friction." Another is trigger point massage. The article also mentions the Alexander Technique and the Feldenkrais Method as avenues for the musician struggling with painful hands. Most importantly, the article suggests a team approach to therapy, utilizing physical therapists, a massage therapist as well as the two approaches mentioned above.

Yes It Took That Long!

Okay so it has been almost 3 months since the car accident, and it is only now that I am beginning to feel almost back to normal. Although it was a relatively minor accident, with less than $5000 damage, because I saw it coming and braced for the impact I actually was more injured than if I had not seen it coming. Here is a list of the therapies I have been getting: chiropractic care, (adjustments, TENS stimulation, heat and trigger point work) Neuro Modulation Technique (an amazing therapy that treats the emotional as well as the physical aspects of the pain), massage and acupuncture. I also was given supplements, Sequoia, to strengthen the legs and hip area, and Ribes Nigram to assist with adrenal depletion and build back emotional and physical strength and endurance. The other thing in my favor was that because it is summer, it is slow, I am not teaching a full schedule and there aren't as many gigs. I was able to rest more than I would have been if this had happened during "the season". The chiropractor is impressed and says I am doing better than most people my age who have an accident of this type. In the last two weeks I have finally been able to conduct a rehearsal without being in pain the next day, play a gig with out being in pain the next day and have a normal practice session where I didn't have to make sure that I stopped and changed position every 15 minutes! I feel so fortunate to have these wonderful therapists to work with. From the beginning, my goal was to get well, not "make money"! I didn't go to a lawyer, I picked the therapists that I knew would heal me rather than ones recommended by a legal professional. If you or someone you know is ever in an accident, healing is the prime point. In Florida, with no-fault insurance your company must pay for your therapies. I was also lucky because I pay a bit more (maybe $15?) to have extra coverage that pays for 100% of the cost of the therapy. It really paid off! Many musicians struggle with health insurance. We just have hospitalization, so I decided to pay the little extra for the full coverage on the car insurance. Everything was done and no one needed to wait for the other party to come through etc.. I am sure that this also made it easier for the therapists to decide to treat me.

As musicians, our bodies are at least 1/2 of the equation. If we hurt, then we cannot play our best. At the very least, the pain distracts us from really concentrating on the music. Accidents happen. Any musician who drives a lot, (that is most of us) runs the risk of this and most of the musicians I know have had some sort auto accident. Some of them never fully recover from these, even if they seem minor at the time. Alternative therapies can provide a wonderful option for traumatic injury. Even if there is a severe injury requiring hospitalization or surgery, alternative therapies can help to support the traditional therapies that may be needed. The interesting thing about alternative therapy is that even as they are treating the injury, other aspects of your health also benefit as they treat the person not just the injury. I strongly recommend them for any one who has had an accident of any kind that inhibits their daily activity. Good luck!