After some firm prodding, she’s back on course
The knot in my upper right back had become as constant and loyal as a best friend.
I blamed it on writer’s schlump -- that slouchy way I sit at the computer and type my heart out on a regular basis. My chiropractor told me I have arthritis in my neck and shoulders; his adjustments helped, but the pain always came back. My yoga teacher said my posture wasn’t centered; I leaned too far forward with my head, thereby straining the shoulder.
After aggravating the area two years ago playing kickball with my kids (reaching up to catch a fly ball, I wrenched my shoulder), the problem went from bad to worse until I could lift my arm only halfway. My doctor prescribed a course of muscle relaxants and shoulder exercises. The exercises helped, but in no time, I felt sad and weepy. Reading up on the drug, I learned that it had been linked to mood disorders and depression. I quit taking it.
Next, I saw an orthopedist who said I had probably damaged my rotator cuff in the kickball incident. He injected cortisone into the shoulder and sent me for weeks of physical therapy. Partial relief followed -- I could lift my arm again -- but the knot never left. Then, several months ago, my friend Kate (a three-time Olympian in the javelin) suggested I see a bodywork practitioner. It sounded a bit New-Agey, but I figured Kate knows shoulder pain.
“Bodywork,” I learned, is a generic term for many kinds of healing-touch practices. Typically, it involves deep-tissue therapeutic massage and may include other treatments, many of which “walk the fence” of nontraditional medicine, says Dr. Michael Hirt, founder and director of the Center for Integrated Medicine in Tarzana, which incorporates traditional and alternative medicine.
These treatments, he adds, may include reflexology, cranio-sacral work, acupressure, Rolfing (the practice of aligning the body with the gravitational field of the Earth) and Reiki (the Eastern practice of aligning chakras and attuning energy systems).
“Bodywork involves a therapeutic relationship between the practitioner and patient in ways that are intensely physical, and can be spiritual as well,” Hirt says.
As a healing practice, bodywork traces its roots back 5,000 years to traditional Chinese medicine. It began to gain attention in the West, Pasadena bodywork practitioner Philip Mitchell says, when the coach of the Swedish gymnastics team for the 1896 Olympics employed it with his athletes, thus earning recognition as the father of Swedish massage.
I was interested -- and suffering -- enough to pursue the therapy, so Kate put me in touch with Nancy Braver, a licensed massage therapist specializing in bodywork who sees clients at Wellness Works, a holistic health center in Glendale.
Braver has more than a decade of experience with bodywork, which she describes as similar to deep-tissue massage, “a way of unwinding the body. It’s not about pushing muscle, it’s about sculpting.” She evaluates a client’s posture and vitality, considers what the client says about what hurts, and is able to see patterns in the body that she can address.
“Pain is a symptom of something,” she says. “It’s the body’s way of screaming.” If you’ve ignored the scream for some time, the muscles get traumatized. “I show the muscles a new way.” Braver uses massage, reflexology, yoga techniques, cranio-sacral work and acupressure.
During my first session, I expected Braver to work the daylights out of my shoulder, to pummel and pound the knot into submission; it was nothing like that. I lay on my back and she aligned my feet and legs. She rocked my hipbones back and forth and rotated each leg in its hip socket, assessing my alignment. She touched my feet, using reflexology techniques. When she moved onto the sore shoulder area, she worked not on my back but over the collarbone region, smoothing my shoulder backward, out of its forward rotation.
Evan Ross, a board-certified acupuncturist and doctor of Oriental medicine at Cedars-Sinai Medical Center, says that, as in acupuncture, a bodywork practitioner might need to work on an area near, not on, the sore spot, because directly massaging the sore area could cause too much inflammation. “You can basically loosen up and sneak up on area that’s inflamed,” Ross says.
Braver’s actions weren’t rough, nor were they as distinctively soothing as “normal” massage. In fact, the experience was nothing like a traditional full-body massage. I wasn’t sure if it was helping and worried that I was wasting my time and money. (Bodywork costs: $75 to $125 an hour, and many clients require multiple sessions before relief comes, and then maintenance afterward.) That evening, though, hours after my session, I began feeling an occasional clicking sensation in my collarbone. It frightened me at first, but my shoulder was moving more freely with every click. When the clicking stopped, 20 minutes later, the knot was still there, but less painful. The shoulder itself was more relaxed than it had been in years.
When I asked Hirt what the medical profession thinks of bodywork, the physician was diplomatic but neutral. “There comes a time with persistent pain, like a knot in the shoulder, when you have to put hands on it,” he says. “Pills, potions and lotions are not sufficient.”
Though some forms of hands-on therapies, like therapeutic massage, are regarded as traditional forms of medicine, he says, most physicians consider things like cranio-sacral work, reflexology and Reiki akin to shamanism. His mind, though, remains open. “Like anything else in medicine, some things will work for some people, and some things won’t. Penicillin doesn’t work for all infections, but we don’t throw it out.”
Hirt says he has seen many people helped by these therapies. “Oftentimes different techniques from a different philosophical perspective can help when Western medicine ... has failed.” The problem, he says, is knowing which kind of therapies will work. To address a knot in the shoulder, there might be 50 or 150 therapies that could help. “But which ones? It’s difficult to know,” he says.
That is why it’s important to choose a practitioner with care, especially in California where laws governing such things are inconsistent. Massage therapists, Hirt tells me, are licensed by the city in which they practice and this license doesn’t necessarily guarantee anything except that they’ve taken the time to file for it.
“Check references. Ask questions,” he says. “You don’t want to throw away your money, or worse, put your health in the care of someone not qualified.”
He recommends that people with muscle aches or similar problems first be examined by a physician, a chiropractor or an acupuncturist, before moving on to bodywork practitioners, who, like massage therapists, are not qualified to offer diagnoses.
Before choosing a therapist, however, check their credentials. Mitchell, the Pasadena bodywork practitioner, recommends asking candidates whether they’re certified by the National Certification Board for Therapeutic Massage and Body Work or whether they’re members of the American Massage Therapy Assn. (The board requires 500 hours of training as well as a written exam; the association requires 500 hours of training at a member school.)
Some people visit bodywork practitioners for head, neck and shoulder pain, recurring headaches and shoulder tension, often the result of sitting and staring at computers.
Others consider bodywork as a kind of psychology for the body and may visit a bodywork practitioner on a long-term basis, the way one might see a psychotherapist.
I was obviously in the first camp.
In session two, Braver worked to lengthen the muscles, helping the muscles and the shoulder to relax. She wasn’t gentle this time, prodding the forearm with intensity and digging deep into my shoulder joint and underarm. It hurt, but an hour later, the shoulder felt good, almost normal. My arm rested differently in the shoulder joint, slotting itself into place lower and farther back than before.
By the third visit, I was no longer analyzing Braver’s actions; rather, I relaxed and let go.
A few days later, I could cradle a phone again (though Braver has suggested I invest in a hands-free model). I was startled to realize I hadn’t taken ibuprofen since I began seeing her.
I don’t know if this progress will last, or if, like the cortisone shot, I’ll experience only temporary relief. It’s been a few months, though, since I’ve seen Braver and I’m still moving well. I can even jog during my kids’ track team workouts, something that would have been far too jarring on the shoulder before. The knot’s not fully gone, but the pain flares only occasionally.
I’m still a bit skeptical, but something good is happening.