TMJ fascial workshop

Those of you that I have seen and worked with are probably very bored of me talking on and on about Fascia, but I find the subject fascinating. It is even more fun to work with, especially using the techniques taught by the lovely people of Myofascial UK who ran the course I attended on the Tempro Mandibular Joint (TMJ) back in February. I have used the techniques and information that I mention here with a number of people all with great success in relieving pain around the jaw area.

The TMJ is where the jawbone meets the skull and can be an area we hold a lot of tension in and this can lead to a number of issues including chronic sinus pain (as I personally have suffered from), head aches, jaw misalignment and TMJ Dysfunction (TMJD).

There are four main muscles that work in this area are the:

• masseter, temporalis, and medial pterygoid, which closes the jaw
• lateral pterygoid, which is the only muscle that opens the jaw.

The day started off with introductions within the small group and assessments of each others jaws.  Apparently my jaw was slightly swollen on the right side, and moved to the left and had a couple of popping noises as it closed (which caused some squeamishness from one of the follow attendees)

The fascial techniques are all very slow and seemingly gentle, though they can take you through some very tender moments as you reach, release and move through binds and adhesions.  It was a great group to work with, though trying to keep a straight face and not laugh when someone was working on you sometimes proved harder.

The intra-oral (inside the mouth) work on the pterygoids was a case in point, I found it very hard not to laugh nervously as my partner for approached snapping on a pair of latex gloves.  The laughter did not last very long as once her finger was working on releasing my pterygoid muscles the pain took over (this is, in my humble opinion, one of the most painful techniques I know) The basic technique was something we’d learnt on the Level 3 iMFT course, but with some added techniques to work with the sphenoid at the same time.

The other most peculiar thing that day, which followed the rules of the John Barnes style of Myofascial Release of following where the body leads, was having my hair pulled to release something because my forehead had flushed with a red flare that is one of the signs we look for, it felt weird but much better afterwards.

At the end of the day, my jaw felt much looser and was better positioned.  Though I did have some rather unusual red marks around my face from some of the techniques. The marks have now faded (thankfully) but the relief and freedom is still here 3 months on and that feels great.

Next up for me is the Spine & Sacrum and Abdominal Scarring workshops in June. I really can't wait

Musings after a visit to an Office

I had a different, and great lunchtime this week: I visited the office of a well known International Charity (not sure if I can mention them, but you really will have heard of them) with some of my fellow practitioners from Clerkenwell and Islington Chiropractic Clinics. We were there as part of the clinic's Workplace Wellness offer where some of the therapists will come and provide tasters in the office, and that is what the charity had done as part of their own internal "Well-being Week". So along we went: Shaheeda, Francesca & Leila (Chiropractors offering Spinal Screenings), Juliette (Acupuncturist offering ear needling), Annie (Yoga teacher doing chair yoga), and Charlotte and I were offering Massage.

We were really pleased as we were shown to two large rooms with plenty of natural light.  I have done this sort of thing in a dark basement meeting room before now, but this was some much nicer.  This was definitely a nice place to work.  Charlotte and I set up the chairs in the same room as the Chiropractors, with the yoga and acupuncture in the adjacent room.

It didn't take long for the first people came in (there had been such a great demand that they had been allocated 10 minute slots) and after the initially awkward "everyone is looking at me" stage things get off to a great start.  It is strange to start massaging someone in a meeting room: there is always the feeling of everyone is staring at me (for both me and the person I'm working on), is my boss going to walk in?  This vanishes fairly soon after the back rub starts.

Most of the people had tight shoulders as they spend far too much time stuck working on a computer, and a number of ladies had one shoulder significantly tighter than the other because of their handbags and these were straight forward to work with and all were surprised at how quickly things relaxed.  Phrases such as  "Can I stay here all day" or "Can you do this all afternoon?" or "When are you coming back?" were heard a number of times from the people that Charlotte and I were working on.

A couple of the people had particular issues, such as a shoulder hurt in a fall or a bad hip. We weren't able to really get to work on these issues in the short amount of time we had, however we could show that improvements could be made.

Nearly everyone I worked on had been spoken to by one of the chiropractors so they knew that they were "wonky" or "compressed" in one area or another.  It was fun to then show them which muscles were involved and that these could actually let go (albeit only briefly) and trying to get them to imagine what a proper treatment would be like.

In the few spare moments I had (everybody wants a massage) I could see the relaxed expressions on the people who had experienced the ear needling, and a few people exclaiming how much they could feel (and that the needles were not as painful/scarey as they were expecting).

The people who had done the yoga class also had a rather blissed out expression on their faces (I didn't have a chance to see what they were actually doing, but it really seemed to work)

I do enjoy doing these sorts of events, but at the same time I prefer to spend a bit longer with each of my clients and really get to know and understand their bodies, the way that they use them and also working with them to correct and change what can be done.

I know that the clinic strongly believe that people should be encouraged to look after themselves. So if you have an office in the City/Clerkenwell/Islington areas of London and you'd like to encourage  and if you'd like them to come and visit then please get in contact with them:

Website: clerkenwellislingtonclinics.co.uk
Phone: 020 7490 4042

More information on what they offer as part of their Workplace Wellness approach can be found here

What is meditation?

Meditation is the practice of focusing and training your mind to achieve an alteration in mental state, whether bring the mind to focus on an image, or trying to still the mind so that other areas become more apparent and you “become one with the universe”.  The images you probably have of meditation probably involve sitting cross legged for hours at a time, chanting “OM” constantly and this is often how it is presented in popular culture, but it really doesn’t have to be like this.

There are lots of different types of meditation that can be practiced by people wanting to meditate and they are ways that give you something to focus on and then allow it to drift away and the constant chatter that happens disappears.  Most of them are ways to encourage you to “live in the present” rather than worrying about the past or future.  This living in the now is the reason I frequently suggest people do some sort of meditation if they are stressed or anxious. Some of the different types are:

• Visualisation: Your focus is to see images in your minds eye.  This can be imagining a candle flame in your mind, or a walk in your favourite woodland/park/outdoor space.  This can be quite difficult to start with, as your mind is likely to struggle
• Guided: This is a mixture of methods where you are talked through the techniques by someone else.  This can be someone leading a meditation group or a CD/tape of someone (it could even be yourself reading through a meditation technique you want to do).  Having someone telling you what to do can be a very good way of keeping the mind focused on the meditation and not getting caught up in your thoughts.
• Breathing: Focusing on the breath is one of the most basic forms of meditation and is something that is practiced all around the world.
• Mindfulness: This is the buddhist form of meditation and its focus is many forms of living in the present.  Breathing is used as a focus initially, but the stillness that this creates is then taken to other areas of your life and you become aware of what you are doing throughout many other aspects of your life.
• Chanting: This could be the saying of a religious prayer, repeating an uplifting motivational statement or chanting a short phrase (mantra) or making and experiencing a sound (such as OM or Aum) to act as the focus for the mind.
• Transcendental Meditation: This is a form of mantra meditation that became popular in the 1950s and 1960s and is still widely taught and practiced to this day.
• Other forms: This is the extension of mindfulness so that all areas of your life can become a form of meditation.  You can meditate on the sensations of texture/smell/taste as you eat a meal (or start with a grape if that’s too much). The feelings/sounds/smells that surround you as you walk, and even the footsteps that you take can be the focus (though this should only be done somewhere safe, not on a busy high street).  Some even talk about meditating when washing up.  Anything can be used as your focus for your mind.

I am also of the firm belief that you can spend a shorter amount of time doing “quality” meditation more frequently rather than feeling guilty about not being able to spend an hour each day doing it.  Things like breathing style meditations, walking meditations can be slipped into your daily routine in short bursts, but it is always good to have time to spend on other areas such as visualisation that need more time given to them to really benefit.

Short Breathing exercise:

Try focusing on your breathing for ten breaths three times a day:

• really feel how the air moves into and through the body,
• what parts of the spine move and at what point in the breathing cycle
• do you feel your ribs moving? if so where (top, middle or bottom)
• Do any thoughts crowd into your head? if so then note what they’re about and return to watching your breath, you can deal with what they were about after you’ve done the 10 breaths.
• When you finish do you feel any different?  

 Then when you have more time try doing the same for longer, or search out and attend a meditation group.

I run a drop in meditation group every Monday at the Clerkenwell Clinic at 1pm.

7 well-being tips for surviving the office

For all the office workers out there... I feel your pain having worked in a job where I was sat in front of a computer all day for 7 years and developing the lovely aches and pains in neck, back and wrists that you might be suffering from.  I thought that I would share a few ideas to help you look after yourself whilst you’re at work.  Since changing my career to body work I have realised that a lot of my clients work behind desks and these are some of suggestions that I give to them to help keep as relaxed as possible as most people can’t afford to have a massage every day/week.  So to help you maintain your well-being try adding these to your day:

1. Get up at least once an hour.  This can be tricky if you’re really involved in something or you’re fixed to your phone but try to get up from your chair and ideally leave your desk on an hourly basis.  This could be to go and get a glass of water, talk to a colleague rather than sending an email to them or even standing up to make a phone call.  Your body gets used to being kept in a sitting position and the hip flexors get very used to being shortened when sitting and protest when you stand up, so keeping moving keeps them active and they’ll be able to keep you doing what you enjoy.

2. The 20:20:20 rule.  This is to help keep your eyes healthy and the full rule states  “Every 20 minutes, look 20 feet away for 20 seconds.”  Constantly focussing on a computer screen gets the eyes used to seeing that distance and we’ve not evolved for it we’re meant to be looking all around and at different distances from close up work to long distance.  So looking at something in the distance exercises the eye muscles and prevents them getting lazy.

3. Sit at your desk properly. I know how easy it is to slump when sitting in front of your computer, but this sitting position really doesn’t help your back and neck. Your back muscles will weaken over time and your vertebrae will be more likely to become displaced possibly leading to slipped disks and agony.  The head is often held in a forward position putting extra strain on the shoulder muscles leading to aches and pains in the upper back and possibly headaches.  Remember:

• that your spine should be more upright and take the weight vertically down through the bones.  
• There should be natural curves in the spine so don’t sit bolt upright.  
• The spine should feel lighter when all muscles and bones are working together to keep you upright (using less energy in the process). This lightness is something I introduce to my clients after a massage so they know what it should feel like, as I find it is easier to understand once you’ve experienced it.

I know from experience that changing the way you sit isn’t easy to maintain all the time, at least to start with so it is easier to try to change it in small stages.  Start by sitting better each time you sit down , which will be at least once an hour (see tip 1) and over time you will get better at it until you start to catch yourself sitting badly.

4. Get your desk properly set up.  Having your desk organised properly and your chair at the right height can really help to reduce the strains and stresses we put on our bodies, however the workstation assessment is seen as a chore by many office workers and is seen as a box to tick off by everybody concerned, and many companies are now using an online self assessment which means that corrections aren’t checked.  I know that when my HR department came and checked my workstation I did everything correctly until they had left the room when I went back to my old habits.  What I didn’t appreciate when I was younger was that getting my mouse/keyboard/monitor/chair set up properly meant I wouldn’t develop aches and pains as quickly.  I will be spending more blog time on this, but in summary::

• when sitting up properly with your shoulders nicely relaxed, your arms should be at the keyboard height with your elbows at approximately 90 degrees,
• your arms shouldn’t be constantly reaching forward to the keyboard or mouse. If the arms of your chair hit the desk and prevent you getting close enough then get rid of the chair arms!
• move your mouse closer so you don’t have your arms constantly extended, and if your mouse mat constantly migrates away from you then try tacking it into position with something like white tack.
• if you need to raise your chair to get your arms at the right height and this means your feet come off the floor then put something underneath them (you do not want to cut off the blood supply to the backs of your legs),
• have the top of your monitor at eye height when you are sitting up properly (see tip 3) you should be looking very slightly down

5. Rest the backs of your hands. We’re typing away for long periods and often our wrists are bent slightly.  The finger muscles start in the forearm and they are constantly being used to hold the fingers off the keyboard so when you need to break from tyling whilst you think about what you’re going to write next turn your hands through 90 degrees so you rest them on the side of the palm. This then gives the muscles on the back of your forearms a well earned rest and doesn’t take a great deal of effort.

6 Keep yourself hydrated.  We are about 60% water and this needs to be maintained to allow good functioning of the body.  Modern office environments are warm and dry so tend to dehydrate people.  There are a lot of articles about how much you need to take in and 2 litres is often given as the minimum amount that you need to drink of water.  I know that I feel better if I do consistently drink plenty of fluids but I also know that:

• a lot of the food we eat contains water, though bear in mind that salty foods like crisps can make us need more liquids,
• tea and coffee and alcohol provide liquids that the body can use, though they also make up pass more liquid out than they provide as well as overload the body with toxins that need to be excreted.
• Drink little and often, that way you don’t overload your kidneys.
• Your kidneys will constantly work to keep your body in homeostatis (balance) with regards to fluid levels meaning you need to pee less when you need to take in more and pee more when you’ve drunk too much.  The colour of your urine is the best indicator of how hydrated you are, and during the day it should be straw coloured, darker than this and you should drink more, paler than this and you’re drinking too much and placing too much strain on your kidneys.

7. Take a breather.  Getting stressed, mind losing its focus.  Then stop what you’re doing and focus on your breathing, feel how it enters the body, travels down to the lungs, a short pause before you start to breath out, a pause before air enters the body again and travels down to your lungs, etc  Do this “observation” of the breath for 10 inhalations/exhalations and then return to your work.  You should feel more in control, less stressed or at least slightly fresher in mind than before.

Look after yourself on a daily basis and you will hopefully not suffer with too many aches and pain.  If you do start to get pains or over stressed do something about it.  You really don’t want it to build up to such an extent that your body shuts itself down in an effort to protect itself. Have regular massages/reiki treatments to maintain a healthy body and mind.

What is a muscle knot?

What is a muscle knot?
We’ve all probably suffered from an area (oh so frequently in the shoulders or upper back) of what we think is muscle but is really painful and hard feeling.  This is what is described as a muscle “knot”: an area of muscle that is contracted and constricted and causing pain.  
These points of pain can also be called Myofascial Trigger Points and they can be referring pain to a distant part of the body in recognisable patterns (to those that know anyway).  These points only form in muscles but their impact can be felt elsewhere as they can pull on tendons and other connective tissue so that they pain they cause is felt remote to the actual site of the problem.

What causes the knots to form?
There are still a number of theories as to what is causing them but something triggers to the muscle to contract but then not switch off again so it remains contracted and this leads to muscle spasms.  Ideas about formation of trigger points include

• acute or chronic muscle overload.  Acute overload might be due to lifting or moving a heavy object leading to a spasm; chronic overload can be holding a phone between your ear and your shoulder, poor posture, raising your shoulders due to stress or badly positioned equipment.
• activation by other trigger points. The body is great at adapting and compensating so that it continues to function, so a pain in one muscle can cause problems in another as it is having to do more work than normal, or a task it really isn’t suited for.
• homeostatic imbalance. Homeostasis is the body’s control mechanism for temperature, glucose/salt/mineral blood levels, hydration levels etc.
• trauma. Either direct trauma to the muscle such as an impact or puncture or accidental, for example the impact of a car crash puts a lot of strain on the muscles.
• micro trauma caused during poor usage of the muscle damaging one or more fibre (a small component of the muscle) that then causes the surrounding fibres to work harder, which then quickly become fatigued and prone to damage so the issue spreads.

What can I do to treat them?
Massage is a great treatment for muscular knots and trigger points as there are a number of techniques that can be used by the massage therapist to get the muscle to relax.  These can be from direct pressure on the trigger point itself, which can be painful initially, to manipulation of the surrounding tissues to trigger a relaxation response in the muscle.  Massage also has the benefit in that it can help reduce any mental stresses that might be contributing to the formation of the trigger point.
Dry needling is also an option where an acupuncture needle is applied to the trigger point in the muscle itself.  This is different to acupuncture in that the underlying theory on the siting of needles does not follow meridians but is directly into the trigger point.

How many treatments should I have?

I frequently get asked “How often should I have a massage?” or “How often should I have a reiki done?” and I always get a little anxious in answering it. Why do I not like answering? I am not a natural salesman, and I don’t like to come across as pushy so people asking how often they should come makes me feel like I’m going to be fleecing them if I say come back too often.  Depending on the person asking I might joke and say “Everyday!”, which would be wonderful (and not only because I would be intensely busy) and it would be really nice if we could all do that (one reason to learn Reiki for yourself is that this can become a reality)

It is a question that is normally asked by those who are not suffering an acute episode, but not always.  I generally suggest that you come back for three sessions in short succession (generally once a week) and then we review what is going on and make a decision on when next to arrange an appointment.  The reasoning behind this is slightly different depending on the treatment:

Massage: The first session is where I find out about you, what your history is, what the problem is and I start to treat the most obvious causes for that issue.  However as we are all individuals the problem might not be that straightforward and be caused by something else, this is then covered by the second session after a review of how things have been since the previous session, any necessary alterations to the treatment plan.  The third session would then be aimed at reinforcing the good work that has been done and ironing out anything that has come up in the meantime.  Having a series of massages in close succession does mean that any tensions in your body caused by poor usage have little chance to redevelop and overall the pain/discomfort they cause during the massage won’t be as intense.  After this then we can discuss what is going to be best for you, and what you’re wanting treating.

Reiki: Again the first session includes a discussion about you, your history, what the problem is, your expectations, and gives you an opportunity to ask any questions you might have (generally if you haven’t had reiki before). The subtle energy of the reiki starts working straightaway, and continues to work for a couple of days.  Having a series of three allows a greater build up of that energy to work at clearing the blockages in the energy system (think how water gentle laps at things and erodes it away)

After that initial series of treatments we can review the treatment plan and adjust it to suit you and your situation.  I always want to get you to a point where you’re not coming to see me every week. This is often done in stages and I try to remind you that you can (and in fact should)  come back earlier if the situation changes for the worse.  

I like my clients and enjoy what I do but I really do want you all to get better and not see me all the time, but I would like you to come back and see me for maintenance. Your body remembers the treatments that you give it, and generally I would suggest an ongoing treatment plan of having something done every six weeks to couple of months.  Some clients realise that what they most enjoy is a treatment every month, else it spirals downwards and their problem returns.

You look after your car and give it an annual service, why not do the same for your body?

A Reiki Overview

What is Reiki?

In the West, Reiki (pronounced “ray -key”) is used to describe two things: the Reiki energy that is used within the Reiki system of healing.Reiki energy is present in everything within the whole universe and is similar to “Chi” of Chinese tradition and “prana” of the Indian yoga/ayurvedic traditions and is a “life-force”.  However the “feel” of Reiki is slightly different to either of these, but the concept is similar.  Reiki is normally translated as “Universal” or “Sacred Energy”The system of Reiki is a natural healing and spiritual development approach created by Usui Mikao in the early 20th Century in Japan.  It involves training (called an attunement) where an individuals ability to connect to the Reiki energy is formed and enhanced.Usui Mikao used Reiki to heal others and taught it to a number of students before he passed away and all people who have been attuned to Reiki have a direct connection (teacher to student) from Usui Mikao this is referred to as a Reiki Lineage.Usui Mikao passed on a buddhist approach to his students (as was typical in Japan at the time) with an emphasis on improving the self through various techniques of hands on healing, meditation, mantras, attunements/blessings and the Reiki Precepts: “Just for today: do not anger, do not worry, be grateful, work hard and be compassionate”.

What does Reiki do?

The reiki is channelled by the practitioner through their hands and into the recipient.  The recipient’s body then directs the energy to where it is needed to remove and clear away blocks in the energy system.  This process helps calm the mind of the recipient and aids the release of emotions that are preventing the body being “in balance”, this can often result in the recipient having a sense of greater energy, calm and peace.

So what can it treat?

The Reiki energy stimulates the clearance of emotional blockages to promote a strong sense of well-being, which allows the natural healing mechanisms to function.  It can help in times of stress (whether emotional or physical stress) and at times when a person feels run down.  Providing a period of relaxation from the stress allows the body’s own natural systems to return closer to an equilibrium, alleviating the symptoms that have been caused by the stress.