reefRX

New to paddling? Rib injury is a right of passage.

Having just relocated to the North Shore of Oahu, I have had much to learn in the way of stamina and technique. With surfing, developing your ability to read the waves, and how to navigate through a quickly changing ocean comes only by putting ones time in the water. As the body is developing better mechanics to do a task like paddling, there is always a point of exhaustion where poor posture, and improper use of muscle groups can cause injury. In the case of overuse, Latts, a primary muscle in the overhead motion of paddling becomes burned out, and other weaker muscles will compensate and take over for its task. Namely the muscles of the ribs. If you are new to paddling, not to fear. Everyone goes through some version of rib injury when building up strength, or pushing to a new levels.

Ive heard from a handful of surfers about pain under the rib, that becomes sharp when laying on the board, and when breathing. Specifically inhalation. Many North Shore veteran surfers with 3 or 4 winters under their belt will tell you that it’s a rookie injury, and whereas that may be totally true in one sense, a repetitive strain injury of the intercostal muscle can happen to anyone who is surfing a lot. Intercostals is a breathing muscle that assists in inhalation and helps to stabilize the ribs. When the latts become overworked, a surfers stroke can shift from digging into the water under the rails, to dragging a more diagonal line inwards under the board. When a diagonal paddling line is drawn its because other muscles have taken over and are compensating for Latts inability to fire. These muscles typically are intercostals and transverse abdominis (an abdominal muscles located partially under the lateral rib) These muscles aren’t meant to take on so much tension, and if the diagonal stroke is repeated, causes a strain over and over again. Pain, and sending inflammation to these muscles is the bodies way of stopping you from continuing to cause additional injury.

When you’ve experienced an injury it is not just the site locally that is affected, its an entire response from the body. When an inflammatory process is taking place, it can activate immune responses that can cause flareups of chronic conditions, and create physical and mental exhaustion. Properly healing from a strain injury is a full time job. Essentially, you have just messed with the balance of a muscle group, and its ability to perform normal lifestyle tasks. To some athletes, a strain can be a worse scenario than a fracture, because a fracture at least keeps you out of your event. A strain tends to elicit a lackluster healing effort because strains will begin to feel better as the local inflammation goes down. That being said, lower inflammation within the healing process should be looked at as an opportunity to stretch and create better mobility at an injured area, not going from 0-10 and getting back out there. A strain should be treated as a micro tear of a muscle, so when one begins to exert larger forces on the tissue it will compound the original injury. This is why a surfers rib injury can last an entire winter when no real rest period is observed.

How do we heal an intercostal strain? Rest. There is really no way around it. If you want your rib strain to heal you need to start with zero surfing, and gradually work your way back into the water. Since pop ups, and wave time are so much lower than paddling time, it is essential to understand that paddling is what continues to compound your injury, not the surfing itself. You can still practice form outside of the water. What you need to stay away from is paddling with a strained intercostal. Over a seven day period of rest, the inflammation cycle will likely hit its peak and the best thing to do is gentle opening stretches of the rib, the same side hip flexor, abdominals, and latts. Stretching at this point is good in moderation to begin creating space in an area that has become compressed and shortened. With intercostal strains, breathing and movement can be excruciating at times, so take advantage of lower inflammation to achieve some relief through stretching. As far as surfing goes, I can only reccomend getting back out there at the pace that allows longevity in your surfing. Rushing back into heavy paddling sessions will only prolong your injury.

reefRX Medical Massage Therapy Clinic is located on the North Shore of Oahu. Contact the office at 518-344-0396 or email us at reefrxmedical@gmail.com to make an appt in person or over zoom.

Hairstylists and wrist injury- A vicious cycle.

Everyone needs to work to live. We get this, but there are levels to this concept and I think the amount of comparison that happens in our society nowadays is very unhealthy to younger generations coming up in the workforce. For example; how can we feasibly compare the workload of someone who works at a desk all day, to that of manual labor? Both are strenuous in their own way. Neither career is more or less valuable to society, yet we compare these positions and try to rank them in quality. As a manual therapist who treats injuries, I see work as non- linear. Whenever I enter a session with an new person, I get context clues about ones injury from how they spend their time both at work, and in recovery when they have free time. Yes, there are similarities and crossover from those who work in the same career path, but ultimately we must remember to treat everyone as individuals. Individuals with unique stressors, and coping mechanisms for those stressors. Amongst the most overworked in our society are those in the beauty industry, specifically hair stylists, and skin care specialists.

If we focus on what hair stylists do on a daily basis for a moment, its not rocket science as to why they are the most common demographic of people I see coming through my clinic doors. For starters, hair stylists and beauty industry professionals often spend hours on their feet. Cutting, setting foils and performing micro-movements of the hand and wrist that is largely unsupported by the stronger muscle groups of the shoulders, back, and chest. When one overuses muscles (specifically weaker ones like wrist rotators, and finger flexors) with little to no rest or rehabilitation, a scary thing can happen. Repetitive strain injury, or “RSI” for short is the point at which a muscle group is maxed out, and the muscle becomes strained. The difference between a stuck muscle, and a strain is in the name. A strain is an acute injury, and a stuck muscle is a functional limitation that can be fixed through stretching, yoga, and movement. Normally with a strain the pain response is enough to alert the brain that you need to stop and take care of the injury. With hairstylists however, work is on the line, and taking time off is almost never a priority.

When first understanding if you have repetitive strain injury, follow the “Stop, look, and act” rule. This is the first assessment tool I use when deciding how to proceed with treating an injury in my practice. You need to determine whether you are working with a strain (injury), or a functional limitation that can be fixed through stretching. With a strain injury stretching will only aggravate the issue.

STOP- If you are unsure whether you are dealing with repetitive strain injury, but are experiencing pain especially sharp, throbbing, or burning in the wrist, elbow, or shoulder (typically a joint region); play it safe and take the rest of the day off. Continuing to aggravate the area will accelerate the injury. Make a list of your recent strenuous activities, and create a self care plan to lower your stress. If you are in fight or flight, sleep deprived, and dehydrated your body is not equipped for recovery.

LOOK- This portion of assessment applies both to what you can objectively see at the site of injury and the ability to test your own range of motion without pain. This part is really important. Pain, swelling, and other signs of inflammation indicate injury, not restriction alone. Many times with muscular injury, one wont always see obvious signs of swelling or injury on the surface, but that does not mean it is not there. Isolate the joint of suspected injury, and take the joint carefully through every means of external and internal rotation. For the shoulder this would be forward circles, backward circles, lifting the shoulder out away from you, and pressing the arm with pressure straight against the body. This test is testing the AROM (Active Range of Motion) which is most important when determining if you have a strain injury. With a functional limitation the joint will have difficulty performing the task, but without sharp pain, whereas with strain injury the task may cause shooting up the arm or in the wrist, and elbow. The area may feel hot, and create a feeling of stress or panic as the action is recalling the injury itself.

ACT- If it is self determined that you are suffering from a repetitive strain injury it is important to seek out a soft tissue (muscular) therapist as soon as possible to begin treatment. The longer the pattern of use is continued the worse the RSI will become. For hair stylists its the specific overuse of internal rotation at the wrist, and elbow without proper support from stronger muscles of the shoulder and chest. (ie: holding the round brush, blowdrying straight out in front of you). The same can be said about neck RSI. Excessive forward posture of the neck without the support of the thoracic spine. Eventually the neck becomes so strained, one can develop pain in the back, and shoulders.

The best way to correct RSI is to first rest, and secondly work with a neuromuscular specialist to create a plan to strengthen the muscles that arent engaging. With hairstylists for example with the internal rotation issue, creating a routine where the posture is being opened and external rotators are engaging and being strengthened regularly will eventually correct this issue. Take care of yourself. If you suspect yourself of being injured, don’t let anyone pressure you into continuing to work. Take the time you need to rehabilitate.

reefRX Medical Massage Therapy Clinic is located on the North Shore of Oahu, Hawaii. To schedule an in person session, or a free zoom consultation contact Myron at 518-344-0396, or email the clinic at reefrxmedical@gmail.com. We can see patients on zoom anywhere in the world.

Preventative care for gnarly wipeouts.

There are two ways that we hurt vulnerable joints and muscles in a sport in which impact is common:

*Intentional Impact- where the function is to stabilize a maneuver.

*Unintententional impact where there is no function because it is in response to a potentially dangerous wipeout.

Both types of impact can result in injury in commonly compressed joints, the joints with the highest impact compression are the ankles, knees, elbows, and wrists. In skateboarding particularly, impact injury is something to be expected and prepared for if one wants to progress. To understand the prevention of injury it is important to know the major differences between intentional and unintentional impact injury. The intentional impact would be considered a bailout, and unintentional impact, a wipeout. The intentional impact has anticipation and a plan. The unintentional impact is all about muscle memory as a response to something changing in a split second.The most important factor in both types is how to shift our weight to avoid injury.

Wiping out is a skill. There is grace and a magnetic quality to watching a skate athlete pushing to the edge of their abilities. Narrowly avoiding losing control, and working to improve through taking a risk. It is interesting to consider all the experiences an athlete has gone through both on camera, and off. How much raw effort was put into getting a line, and how those are moments the viewer may never understand. A portion of hard work that is deeply personal, and only truly appreciated by those watching with wide eyes at a crucial, and unique moment in time. Cameras rolling, time slows, and the question stands… will they land it, or will they fall short?

Slam! The skater was going front side and gets caught up in the feet because of too much speed. The skater loses control and hurls towards their left side with arms extended, wrists bracing. Every muscle in the body is tense and prepared for pain. In that split second the skater doesn’t properly absorb the fall into stronger parts of the body like the shoulder by keeping arms bent, and the wrist takes the worst beating in the fall. The fall itself could not have been prevented; the impact was unintentional. What could have been done differently is the body’s relaxation. When we tense the body in situations of potential pain, our response becomes an involuntary reaction. Just like on a really cold day when the wind is blowing right through you; when you relax and control your breathe the body is able to deal with the cold much more effectively. The same goes for unintentional impact. Once you are in a situation where you are falling, that split-second decision to relax your muscles, take a deep breath and absorb the impact through relaxed, bent joints the wipeout is far less likely to result in injury. In fact, this concept can be applied to an auto collision. Whiplash is a result of a high-speed impact, but most often the injury from whiplash comes from the neck and shoulder tensing on impact trying to prevent excessive movement of the head.

Waterman who surf, dive, and spend time in the open ocean know the risk. They train with preparedness techniques as well as in their particular skill set knowing it’s fully possible to be held underwater for a long period of time. Having the ability to hold your breath for a prolonged period of time is one part of surviving a situation where you are wiping out and pinned underwater. The other part is the body’s response. Once held down, the waterman who can relax their body and mind, and create a plan for getting to the surface will have a higher chance of survival. Just like wiping out on the pavement, the preparedness for a moment can change everything. When you fall, ultimately the energy of that fall needs to go somewhere. If your body lands and all of that energy is absorbed into high impact joints like the wrist and ankles, you will have a sprain or fracture in your future. In short, movement upon impact is important. If you are thrown from your board and you are going to land on the hip, plan to roll and disperse that energy. If you are falling forward, plan to absorb that energy through relaxing the arms, and bending into the shoulders and elbows. If you drop in and you feel yourself slipping out crumple. In all of these situations, when fear defines our decision making, our body tenses up and we tend to tighten muscles that are attached to high impact joints. This is why ankle and wrist sprains are so common. Most of the muscles that affect those joints are long and are in the forearm and leg, so when we tense and hold our breath as opposed to taking a breath as we fall we tend to stretch these muscles, tendons, and ligaments in ways that they should not be used.

To practice wipeout technique I recommend these three steps:

Check your line- Once you know you are wiping out anticipate how you will distribute your weight and the impact energy. We don’t always have time to check our line, but if you do have the opportunity seize it! It will save you a potentially nasty injury. Practicing maneuvers and tricks is just as important as practicing wiping out. Being skilled at falls is a serious skill in the bowl, and in the street alike. Taking bad beatings is only cool if you can get up and keep skating.
Breathe support- So often in my practice, I will spend entire sessions instructing clients how to breathe from the diaphragm. If you are having difficulty with this concept refer to my “Breathing for Covid-19” blog. Oxygenating the body in a moment of body trauma is one of the best things you can do. Whether you are falling, about to be pinned underwater, or in a situation involving great challenge or fear, oxygenating the body is one of the best ways we can consciously respond. Breathe support will make everything function more optimally, especially the brain.
Relaxation and acceptance- When about to take a gnarley wipeout, it’s best to have accepted it before impact. When we fight this force, we tend to always lose. My first bad wipeout I attempted to run off my board at high speed instead of bending my legs and sliding out. The result was 4-5 high-speed somersaults on the pavement where I tore my hands apart. Most of us have taken a bad one, but if you haven’t my suggestion is to stop being afraid! Wipeouts teach us a valuable skill about acceptance and failure. Once you take a bad wipeout, you might feel apprehensive to try again, but that is the just mind and body’s healthy response attempting to not make the same mistake twice. If you have time to anticipate a wipeout, be relaxed, and avoid tensing muscles.

Practice makes perfect! Don’t let unintentional impact be the first time you make a plan for yourself.

Being healthy takes a team.

Enter phase two of life. Like many other challenging periods of change that have occurred throughout human history, the Covid pandemic has both given refinement to ideas as well as reaped destruction. The difference between now and any other time in modern history is that people have had to relearn how to be alone. Due to the advancement of technology, simply put, we have never been alone. Not truly. At least those who subscribe to having a smartphone anyhow and working a job requiring any sort of community engagement. Before 2020, there was FOMO. As I write to you in the final hours of 2020, as a society we view events through a lens of “when I.” Gone is the “what if’s” that plagued our college or gap year decision, the promotion at work, the five-year plan. These words have been replaced by present tense loneliness, and overstimulation, all from our beloved technology.

View of Albany’s skyline from reefRX clinic.

It was not surprising in the least that when the second wave of Covid was announced I heard in confidence that there was an excitement about shutting down. To many, shutting down the first time was a much needed period of rest for the mind, body, and spirit. A time where it was okay to be reflective and to stay in sweatpants and take a break. However, this was because many of us never knew self-care until it was mandated. We have been in this fight for ten months now. There is obvious emotional exhaustion that is both felt and expressed daily on social media. Sometimes poking fun at rather heavy things is the best coping mechanism for those who are hurting. The real question is; who is hurting, and why?

As someone who specializes in creating self-care plans for clients, the most obvious aspect for me is that “when we are alone, we are sad” here in America. Like it or not, we have a dependence on human attention. If we aren’t getting the attention we need from our partner, we get a different one. Not enough from our friends, we make new friends or sink deeper into social media for comforting posts about rebounding. What we think we need is attention, but what we are truly seeking is recharge. Similar to building a social life, being healthy takes a team. Typically you might have a friend to who you tell secrets, but there is a difference between confiding in someone and using a friend as a place to release your emotions. Typically your partner might be the one who tries to go deep with you about trauma, but is your partner always the right resource for healing that? Exercise is an important part of feeling well and getting stronger, but what happens when sport becomes about coping and not about improvement, and love of the activity? What happens when the passion is all but gone, and you don’t know why you started doing something in the first place?

All of these things come down to balance, and you cannot achieve balance without help. As fulfilling as it may be to do something on your own, when you try to take on your life without a wellness team, burnout is imminent. If not just burnout, beginning to use substances as a crutch. Excessive eating, vaping and smoking, drinking, and retail therapy are a few of the more common crutches. When crutches become involved, your wellness begins to plateau. Learning to replace crutch habits is very challenging, so if you see yourself starting to burnout or plateau it is time to reach out and seek help from a practitioner. Massage therapists, personal trainers, acupuncturists, and therapists are all great places to begin building a team. No one practitioner can do everything, but building a network for YOU is essential to surviving both this period and living the life you want to live. It is okay to not feel okay! Receiving and accepting help and care is so essential to achieving your goals, and it’s normal to be unsure of that initially. If you are used to doing everything solo, suddenly accepting help is going to feel awkward and foreign. It may even feel like you are burdening your practitioner, but rest assured every good practitioner has a team they have built for themselves.

Here are some great practitioners who can help you build your team that I can personally refer you to:

Dylan James LMT- Incline Wellness- Manalapan, New Jersey
Type: Sports Massage Therapy
Instagram: @incline_wellness

Brantz LMT- Built Bodyworx- Taylorsville, Utah
Type: Sports Massage Therapy
Instagram: @builtbodyworx @brantzw

Motus Physical Therapy- Santa Ana, California
Type: Physical Therapy, Rehabilitation
Instagram: @motusspt
Contact: 949-891-1325

Allegra Paris- New York, New York
Type: Personal Training, Online Classes, Wellness
Instagram: @allegraparis

Andrew Alvarado LMT- Bodywork Professionals- Albany, New York
Type: Structural Integration, Massage Therapy
Contact: 518-389-2200

Jammella Anderson- Albany, New York
Type: Doula, Yoga Instructor, Wellness Education
Instagram: @jammella

Hannah Mossop- Albany, New York
Type: Holistic & Herbal Practitioner, Acupuncturist
Contact: 518-859-3697
Temporarily closed or limited scheduling

Chieko Vititow PT- Albany, New York
Type: Manual Physical Therapy
Contact: 518- 545-1401

Myron James LMT- reefRX
Type: Medical Massage Therapy, Online Clinic Sessions, Touch Association & Trauma Release, Energy Work
Instagram: @reefrxathletics
Contact: reefrxmedical@gmail.com

Healing in the time of social implosion

The pandemic has been horrid for a handful of obvious reasons. Widespread disease, and overrun hospitals for starters. Changes in human relations: fear of being physically near one another, or just the opposite; an anti-culture stance towards mask-wearing, and social distancing.
It appears that the social environment is imploding on itself, and people in America are taking cover in their own individual camps, exploring what it is they are made of, and who they are. Despite the political sensory overload that is 2020, this social depolarization may be the healthiest thing that could happen to generations abroad. Now more than ever people are taking self-care very seriously. If we are to continue in this hostile environment, how is it that we will treat ourselves?

Body awareness is a look within a deeper place.
How our bodies feel on a day to day basis is the best tell of how we are managing our mental, and emotional health.
The mind-body connection is the most vulnerable to disconnection. For instance, if we manage our stress poorly, our body ends up suffering from high cortisol levels making it very difficult to sleep properly, recover, and digest food. On the other hand, if the body becomes dangerously dehydrated, the mind will begin to slow, and confusion ensues. The mind-body is a system, and through body awareness, we can become aware of our mental blocks, and bring clarity to where we should be spreading our energy, and in what instances we should be protecting ourselves. To stay healthy we must take care of our bodies first.

As a massage therapist, the most effective way I know of to restore the mind-body connection is through body compression. When a client comes in for a session and is clearly outside themselves, I like to begin bodywork with diaphragm breathing, compression on areas of tension, and active movement on the part of the client to test the range of motion. This type of listening makes clients more aware where they are experiencing restriction, and possibly the trauma, or reason why they have the restriction in the first place. Facing these stored experiences is a very powerful thing. Whether that experience is from an injury, or from something more repressed, there is no replacement for massage and compression when it comes to moving past something that is disrupting our mind-body connection. At times we “bury” stored experiences we aren’t ready to face, but until we look, and determine in what way it’s affecting our bodies, or distracting from our path, we all will continue to be functionally limited.

Learn self-massage techniques, and ways to increase your body awareness with reefRX Clinic Online Classes.

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Inland cities are destroying the ocean.

Upstate New York. Known for spectacular Autumn foliage, and the ability to drive for 15 minutes and be within a civilized urban, or suburban area. For those who live in New York City, upstate serves as a “slow-paced”, clean air rich, rustic farm wedding venue filled hub that is both romanticized for its cleanliness, as well as its diversity of environment. Upstate New York sits in a cozy section of the United States that is seldom prey to natural disaster and often is so far away from negative current events, and dilapidation of forests and waterways it can convince locals that their actions are immune from consequence.
Destruction of forests, and the warming, and pollution of rivers is often invisible to those who live far from the ocean. Any inland community will do in this example: The ignorance of those who don’t see the consequences of their actions in a literal way is the most dangerous among us. Inland communities are destroying the ocean because they have no motivation to change. They have no proof of their toxicity.

The issue here is not awareness. Statistically, most Americans are aware of plastic pollution to the point of some action. Around 75% of citizens recycle according to census data. The real issue boils down to engagement, not awareness. The recycling system in America has been broken for years. Without getting into the nitty-gritty; it is more expensive for townships to recycle than it is to simply landfill plastic waste. Even on a good day, however, the amount of plastic being created daily far outweighs the ability to reuse it functionally. If new plastic stopped being manufactured tomorrow, the United States would still have the massive issue of plastic that is already in circulation, and what should be done with it. That’s the crux right there:
To change the ocean impact, Americans need to learn to live without. What needs to be said more clearly, and more often is that recycling is broken. It has not been for some time now, so what’s next? What should be done instead? Awareness is great until one feels overstimulated and frozen in non-action. Paralyzed by Instagram videos about deforestation, and animals entrapped by garbage. What Americans need is a mental reset and new daily engagement.

In an idealistic world; non-functional plastic manufacturing would be illegal, and the grid would switch to solar, both for home, and industry, as well as transportation.
When I say nonfunctional, I mean plastic that is either single-use, to contain food, medicine, topicals, soap, etc. or could simply be made out of different packaging material. The switch nationwide to reusable shopping bags was huge but has proven to be sporadic depending on the store you frequent. Again, most Americans are fairly aware and have no qualms with bringing a bag, however engagement within that cause is lacking. I would guess that the average person simply feels inconvenienced by the fact that they have to bring their bag to the store, but is not digging deeper into why its an essential component within a larger issue, and what changes should logically follow the impedance of plastic bags.

What I am getting at is; how does it make sense to ban plastic bags, but still have everything in the store packaged in plastic? EVERYTHING. It’s not that Americans don’t feel guilty for doing things that harm the planet, its more so that there is so much stimulation, and accusation around pollution. Historically, humans have never responded well to criticism, and how they are impacting the planet with their lifestyle isn’t any different.
If we are told not to do something, we’re likely going to ignore and keep it moving. To understand how to make a change, I think the psychology of activism is essential to look at. The psychology of how people respond to the suggestion of action change.

In my practice as a sports massage therapist, if I tell someone to go home and do a list of stretches as homework, there is about a 10 percent chance that that individual is going to follow through. Who is that 10 percent? Athletes. Those who already have an investment in wanting to heal quickly. This highlights the issue of modern physical therapy. After a PT session, you are given a list of “homework” assignments. Let’s get real! Patients don’t do these stretches because the connection to tangible healing and feeling better at the moment don’t align. People need value demonstrated before they want to make time for those stretches in their busy lives. Naturally, humans are wired kinesthetically. If we don’t feel better from therapy, if we aren’t engaged in a class or see the value in the material, we simply are not going to do the homework.
To create a more engaged individual, I first have to demonstrate the value of massage therapy, and then engage the client on a personal level with homework. For instance, if you are a drummer, the homework has to relate to improving that function. If you work at a desk, the homework has to feel like a life hack for quick tension relief. Only from this point will people make a longterm change.

So here’s the big picture:
How do we go from awareness of what’s happening around us to collectively engaging in change?
I beleive it begins with inland communities who are far away from the fireball of destruction, but are invisibly a large source of the problem. About 90 percent of plastic that ends up in our ocean begins in local riverways.
Ultimately we have to stop feeding the beast, and if my thought process is correct; only people that kinesthetically feel affected by fish washing up on the shore, watching coral reefs become bleached, bumping into plastic cups while surfing, or live near the ocean feel stimulated in this way to the extent of a full lifestyle change.
If recycling is broken, this change for inland peoples has to come through leadership by example. In layman’s terms, it has to become super uncool to buy produce in plastic bags, and unacceptable to not have companies refill your lotion, and dish soap bottles instead of buying brand new ones.
Plastic was built to be durable, and last forever, and hell, it sure is working perfectly in that regard. Yes, at this point we have created a lot of work for ourselves, but plastic pollution would be loads more manageable if we were only identifying ways to reuse existing plastic, instead of how to get rid of a billion-dollar production industry.
Until it becomes less expensive to reuse existing plastic than it is to manufacture something new, we are all in a bit of a pitfall.
The change begins with influencers. Refuse bags at the store, save plastic cups for home use, bring mason jars to shops where you want a drink, and organize local cleanups. It is possible, and if new engagement truly is kinesthetic, you can be an influencer for three people, and they can be an influencer for three people, and so on. I believe it is how an idea is presented or worn that makes it successful. If that’s the basis for successful fashion trends, and apps, it can also the groundwork for a revolution in the way we consume.
We need to lead local businesses by example, and hold communities accountable for their actions, while not becoming accusatory.
Save the vinegar for manufacturers, and the influencing for your beloved upstate city.

Self care for the responsible activist.

Responsibility, Prioritization, Respect, Communication, Self Care.

Subjectively, these are the modes of a functional, modern activist. Burnout is a term we typically hear in reference to physical strain on the body only. Take on too much manual labor without rest, and suddenly we have no more energy to give to our task. Seems pretty straight forward- Rest, manage your stress, change your diet, take daily walks and according to society you should be good to go until retirement. The factor that is finally coming to light, especially discussed in the millennial population, is the “Body and Mind Connection”. In Chinese medicine, this is the pillar for all things healing, and in recent years with the broader acceptance of holistic therapy in America, the body mind connection has grown in understanding, and is much more widely integrated in lifestyle that includes yoga, massage therapy, meditation, cryotherapy and other forms of self care. What is self care really though?

Self care simply put is the ability for you to become a warrior instead of just a vessel. How can we expect to complete our task with abounding courage, effort, and stamina if our bodies, and minds are not thriving. To fire at 100 percent, we must begin to think of the body and the mind as one entity. One controls the other, and works in equilibrium within the human system. Misalignment of this system is an additional epidemic that has been plaguing humanity far longer than coronaviruses.

Anxiety about illness is one example we can isolate for the purpose of discussing how the body and the mind interact as a system. If we believe we are getting sick, or are fixated on illness as a constant fear- “Does my throat hurt.. I think my throat hurts, and I wonder if Ill get nauseous as well.. oh shit I didn’t wash my hands when I made coffee earlier, WHAT IF I AM INFECTED”. A classic toxic thought pattern to your human system. Inevitably, if we believe mentally that something will happen, our body from stress can inevitably fall ill, our immunity goes down like a firewall unable to protect against an invisible threat. Stress alone is a toxicity within our human system because of one of two nervous states that the body has to choose from. The sympathetic nervous state aka “Fight or Flight”, and Parasympathetic aka “Rest, Sex, and Digest”. Obviously fight or flight is the culprit when it comes to overloading our human system. The sympathetic nervous system is very important when it comes to survival, however there is a broad misuse of this system. When the body goes into fight or flight, a chemical called Cortisol is secreted, which is our stress hormone. This hormone inhibits critical thinking, sleep, and reproductive organs from firing optimally. In a survival situation, this is an awesome function as cortisol increases our ability to defend ourselves, but in the context or anxiety overloading our system with cortisol absolutely effects our ability to heal from injuries, rest, and ultimately.. practice self care.

In reverse, the mind also follows the body. If we continue to subject ourselves to stressful situations without self care, our mental health suffers. Cortisol has overloaded our systems to the point where the mind has no time to recharge, and we are locked into a cycle of stressor, and reaction. To respond is to calculate. To respond is to rest, critically think, and focus ourselves as warriors with great stamina. Within the context of activism how can we best serve others, if we ourselves are broken, and struggling mentally, and physically? The answer is simple. We must recharge. Like a warrior before battle we must strategize, meditate, attack, and follow through.

RESPONSIBILITY- It is our responsibility to be humanitarians. The Black community and indigenous people have suffered long before America was founded. Much of the Black communities’ history has been enslavement, and survival at the hands of white conquerers, and in modern day there is a theme of celebrating culture, without fighting for their rights. It is our responsibiity to be warriors. To practice self care for the purpose of being the strongest fighters we know how to be. To bring change to a world where policing in America, no longer brings violence and fear to a community who deserves equality, and reparations. If you are on social media, you may be feeling overwhelmed, and the truth is that is good. We all need to be. What we must do is make our body mind healthy so that we can handle, and process productive information, protest peacefully, and communicate successfully with others who project racism.

PRIORITIZATION- We must prioritize our input, and output. Our 5 senses can become overloaded, and their is a limit to how much we can absorb at one time. Just like taking an exam, there is only so much studying one can do before you are reading something out loud, and absorbing 0% of the information. This may be one of the easiest ways to practice self care. Just like studying, we need breaks. If you constantly live on social media, you will become overloaded, and I believe thats why activism often will strike very hard at first, and fizzle out over time. People want to get back to personal normalcy. Activism is something thats integrated into lifestyle.Its a long fight that requires mental endurance. In order to be responsible activists, who carry their message effectively for a long period of time, we must rest, and critically think about what we say (output), and how much we can take in at one time (input), as overloading this system is the quickest path to burnout. Meditating at the begging of the day is a great way to practice prioritization. Begin with clearing your mind. Sit with yourself until you can focus on breathing, until you stop thinking about how long you’ve been sitting for, what time you need to be at an appointment etc. and once clear, add one thought at a time and process your feelings, and logical morality about what change you want to prioritize today.

RESPECT- This is a pillar for all things. A foundation for success. A foundation for community, but being apart of a community that dosent respect themselves is a useless cause. Self respect is more of a conversation, than something I can effectively convey in an article, so I will leave it at this: To respect our bodies and minds is essential, and comes down to an individuals needs being met. If our personal needs aren’t being met, we cannot meet the needs of a community. One cog in the machine is malfunctioning, the whole machine fails. To be strong for others, we must respect ourselves, but most importantly we must learn to forgive ourselves for our past. Forgiveness, despite common thought does not mean we must surround ourselves with what has happened in the past, and work on changing it in the present. Forgiveness only means that we can accept, and let go of what we have done, so that we may affect a positive change for the present and future. If there is something that pops up in your thoughts daily that you regret.. good! You are halfway there to confronting it so that you can be a warrior for its positive change now. To free yourself, is to be productive, and use your energy for productivity.

COMMUNICATION- What I really mean is listening. Effective communication is call and response, but as a reform activist, if you aren’t Black, listen to Black voices around you. Wait for direction. Conserve your energy for the right protesting, research where your money is actually effective. If you donate, and feel like you have finally done enough, you just simply have not, and that donation was to satisfy something personally. The keyword here (that I am not seeing thrown around right now) is selflessness. We must donate selflessly, we must act selflessly. God gave us all gifts, and we must be resourceful, and figure out where our gifts fit into this equation. Giving money, and feeling burnt out is a waste of effort. Experiencing a protest, posting about it, and feeling burnt out is also a waste. Use your parasympathetic nervous system: critically examine where you can contribute the most effectively, and worry about fight or flight when you are at the event. To best love on others it is essential that we STOP LOOK & LISTEN. To be a warrior means following strong leadership, whatever your cause. Perhaps there are ways you can lead! Examine your gifts.

reefRX is, and will continue to stand with the Black, and Indigenous communities facing racism. Regulation of police, equality, and justice to those who have committed murder is our top priority. All are welcome at this wonderful event hosted by skater, and activist; Prezi Oki. Start time is 5pm at Blue Banks Skate Park. 623 Madison Ave, Albany New York. Sign making materials will be provided. Look for the reefRX banner, and don’t be shy, we’d love to start a conversation with you.

Boardsports: More than just a lifestyle

Surfing, and skateboarding have a deeply rooted history in the subculture of community. Often looked at through the lens of a counterculture activity, young people for generations have been pushing their sport forward, while often being met with opposition from the majority. “Localism”, or the protection of community skating and surfing rules within an area can vary greatly from place to place. These rules are typically dubbed by those who have developed their personal style here, made claims, and want to protect what that means to them and their community. Localist mindsets vary from city to city, however its nothing to fear as long as you remember that respect is the most important part of being allowed in these sacred places. These places are as important to skaters and surfers, as the quality of the grass in your front lawn, if you are a hard worker who wants to showcase your home. If you’ve worked hard to build and preserve something at all, it feels really discouraging to be told that you are wrong, or to have someone disrespect that. With an ever expanding mindset, social media, and more acceptance and respect from the majority, the evolution of skateboarding and surfing is changing from something that was inherently only a lifestyle, to a broader, more inclusive sport built on firm values of respect, and a commitment to gnar.

reefRX athlete, Brandon Gray at Albany local spot “Snowman”

The term ‘boardsports” isn’t often thrown around in regard to surfing or skating. Why is that? What sets a boundary between skating and soccer for instance? Surfing is on the world stage at the olympics, but outside of coastal places, why is surfing only thought of as a recreational activity you try out at that awkward family reunion in Hawaii? Why does skating only stream events like the Xgames? If you aren’t an adrenaline junky, would you even know what the Xgames were? Likely not. I can answer all of these questions in one statement: Investment in skaters and surfers at the athletic level is pathetic in comparison to other high budget sports. Professional sports teams have an athletic trainer on hand, chiropractors, and often massage therapists to assist and guide in proper technique, immediate treatment of injuries, and bodywork to prevent the onset of chronic injury. Boardsports is in the infancy stage of its sports therapy development. Despite common thought, here are some surprising statistics about boardsports athletes you need to know before you continue to craft an opinion about your local skaters and surfers:

“According to the US National Library of Medicine National Institutes of Health, skateboarding is a comparatively safe sport. Published reports state that an average of 40 people die skateboarding every year. This includes longboarding.” (Statistically more people die every year from cooking dinner, and climbing on ladders, ranking in at 65, and 113 deaths.)
“On average, there are 16 shark attacks per year in the United States, with one fatality every two years.” (Jaws made sharks an unnescary target)
55%-63% of skate injuries occur to the upper extremities. This may immediately make one think that a vast number of riders are hitting their heads, but the most common injuries are actually strain, and impact injuries at the shoulders, elbows, and wrists. These injuries are the ones that can easily become chronic without bodywork, and guidance towards rehabilitation often seen in other professional sports.

reefRX athletes instructing kick turns to younger skaters

In my practice, rotator cuff injuries, and the ensuing nerve impingement that can become a more progressive and common theme from impact injuries have become a focal point for my treatment methods when assessing and treating boardsports injuries. The concept that the root cause of an injury over time, left untreated begins to manifest new, chronic issues is a staple in sports therapy. Eastern, and practical western medicine differ on many fronts, but there are a few key differences. Massage Therapy is a unique field that focuses on both modes to achieve results for clients. Basically, eastern Chinese medicine focuses on looking at body function and cause of injury or disease based on diet, technique, and physical, mental, and emotional stressors on the body. Treatment consists of bodywork, and natural methods of reduction that involve changing ones lifestyle over time to achieve health. Treatment always involves rehabilitation, and then focuses heavily on prevention of further injury. Western medicine focuses on treating the manifestation of an injury in the moment. For instance if you strain your shoulder you should ice it, immobilize it, and plan to get an Xray at some point. The difficulty I have with western medicine is that it rarely looks at the root cause of an injury, and often involves chemical pain management solutions like cortisone injections, and a lazy prognosis in regard to long term rehabilitation. There are great portions of western medicine. Technology has allowed us to treat injuries quickly and effectively in a way that eastern medicine simply cannot. Western medicine is far from evil, however without a lens that looks at both methods, improving as an athlete, and having a fulfilling, lifelong love of sport seems impossible. An injury does not, and should not, knock you out. To address an injury should only involve an ego free plan from the practitioner, and honest conversations with athletes about rehabilitation goals, and increasing functional technique instruction.

reefRX athlete, Harrison Brougham at ” Snowman”

When I say “functional technique instruction”, I don’t mean teaching someone how to do a kickflip. What Im referring to is instructing an athlete how to safely perform a maneuver with better posture that focuses on preventing injury, and getting back on the board safely. This prevention concept includes uninjured athletes who are at the top of their game. Ultimately, practitioners just want to see athletes thriving, however it only takes one high speed hill bomb with poor posture to cause an athlete a muscle tear that takes them out for a month or more. How do we take that scenario, add functional technique instruction, and prevent the injury from happening in the first place? How does a rider take a fall safely? What sports and massage therapy methods can we easily implement to stop an injury from worsening, and becoming chronic? The answer is really really simple:

Postural education, and early onset treatment methods like heat, cryotherapy, and soft tissue manipulation when indicated. Just like whiplash from an auto collision; bruising, strain, and joint compression from impact injury are very treatable with massage therapy, especially if its addressed right away. More often then not nerve impingement, and other conditions that can become chronic are a result of the body compensating from muscular weakness or disfunction from something else. Something else really meaning our root cause of injury. When were saying it out loud, its a bit backwards that boardsports and sports medicine haven’t aligned yet. All conversations need a beginning, and reefRX is grabbing the board, and cruising behind our athletes all the way.

reefRX Owner/Sports Massage Therapist, Myron James at “Snowman”

All photos by Markis Poulen.

Legs & Glutes: The leading cause of Lowback Pain

I could go on an on about this topic, but in the spirit of short reads, I’m going to leave my readers with a concise explanation about low back pain, and that nagging knot in your hip pocket that won’t seem to go away.

Long story short: The reason you have low back pain is actually because of your glutes, hamstrings, and other components that contribute to leg movement, that are immobilized, or not firing due to a lack of movement, or from being in the same position too much. When I say “being in the same position” what I am referring to is sitting, and sleeping in a compressed manor, or exercising, and not engaging the legs properly. Repetitive motion in an incorrect manor can be just as painful as a result as sleeping, and sitting in a compressed way. This idea can be related to any part of the body; particularly common at the neck and shoulders as well. For the purpose of today however, lets focus on that low back pain.

Why: The spinal vertabrae optimally would have full range of motion. When we lift something heavy, the clear solution to this task is to engage the legs in order to save the spine in regard to a more difficult task. What happens when the legs don’t engage? This one is obvious to most people: spinal injury. More commonly? The legs weren’t really functioning properly to begin with. Thats why it takes mental effort to think about using ones legs when lifting an object. Its not really natural, or comfortable to use your legs in 2020 unless your are in a career, sport, or workout program that encourages this. What I’m getting at here is that when the Hamstrings, and Gluteus muscle groups become stuck short, or aren’t really firing to begin with they start to put pressure and tension on the low back. Essentially, muscles of the low back must do a job they were not designed to do in order to compensate for the legs inability to function. Who knew being curled up watching 90 day fiancé for 4 days straight, and then immediately attempting to do yard work could be so dangerous?

Since we can’t get to every muscle of the legs that cause low back pain, were going to put the magnifying glass on the two muscles that have helped me have the most amount of relief in quarantine. The illiopsoas hip flexor muscle, and the Gluteus Medius. Feel free to explore more about hamstring stretches. The internet has an abundance of resources for that. These two muscles are slightly more particular to stretch so below I’d like to offer a regiment I find effective twice a day in quarantine to relieve low back pain, and to open and help reengage muscles that have stopped working while being sedentary.

Spinal Decompression (Lumbar/Sacral Spine)

In this regiment there are two starting positions. Position A is the upward dog yoga pose with the spine fully extended. Position B is a kneeling position with the spine vertical ceiling to floor.
Position A (upward dog) should be taken slowly, and with caution if you are not used to yoga, or are unsure of your flexibility. This is because when the spine and paraspinal muscles are stretched too quickly it can cause strain. From position A take your body into the full range of motion for the upward dog pose. Look towards the ceiling and breathe into the stretch.
Once fully extended in position A, to stretch the gluteus medius muscle (located on the side of the hip) one must inch the hands to the opposite side of the body creating space in the muscle. So if we are stretching the left side we want to inch the hands to the right and bend at the trunk stretching that space in the hip pocket creating a C shape with the body. When I refer to the hip pocket, I am talking about the space nestled into the pelvic cavity where gluteus medius is housed. (See above diagram for clarification).
Position B (kneeling stretch) is intended to open the hip flexors, and to lengthen abdominals. Start in the kneeling position and place the right hand on the right ankle or calf, extending the spine backwards. The illiopsoas muscle is located between the bottom rib and the ASIS (boney prominence at the front of the hip.) This muscle as well as the abdominals will open with back bends as well as moving the body laterally. Lean into this stretch and really feel the spine open when you also bring hips forward in an almost static lunge. To assist with lunging the hips while kneeling, squeeze the glutes. This position will both help to reengage the glutes, and stretch the hip flexor in the front at the same time. Very effective and easy if you are having a lot of discomfort and require a quick solution. I find stretching illiopsoas usually has immediate results for low back pain. Stretch both sides, and remember to control your breathing. Restating: Inhale, reach back to the same side ankle/ calf, and on the exhale extend (bend the spine) and gently twist to unlock abdominals and hip flexors.
For each of these stretches work with good breathing (breathing instruction can be found in the blog at reefrx.health.blog) and attempt to go allitle farther each time you do a repetition. Remember that no stretch or functional excersize can be full proof without repetition and practice. Your muscular system wants to lengthen, but the body follows the mind.

Repetitive Strain Injury: The reason you might not go back to work

One little bad habit, continued over time.. what happens? Well, sometimes nothing. Although anatomically identical, the genetic presentation of the human body from a musculoskeletal perspective varies greatly from person to person. In short, one persons pain does not manifest the same in everyone. Our muscular system takes on strain, lifestyle stress, and injury differently. Now think about that pain you’ve been feeling underneath your shoulder blade, or in the center of your neck that has been persisting for so long that you have become accustomed to living with it. Stop playing the avoidance game, this is your body trying to alert you that you are doing something incorrectly. Moreover, this is your body telling you that something is being severely overused, and NO cracking and manac stretching won’t work this time. What you need to do is stop, think back to when this started, and follow these steps to start on a path of natural pain management, and better living.

Albany, New York (circa 1915) John Dennehey

Living in Albany, New York I treat a lot of skateboarders. Albany is a skate city with lots of fun hill bombs that all lead downtown. As a massage therapist that works at the top of the hill, I see clients both for maintenance work, and in rehabilitation settings. Whether high speed down hill endeavors, an auto collision, or a clumsy fall, what do these results all have in common? Potentially, whiplash. Whiplash is defined as an injury at the neck during high speed when the body stops motion from an impact, but the neck continues movement from momentum. The result is typically inflamed, hyper-shortened, muscles that feel both sore, and overworked, while on the other hand, frozen and weak. Skateboarders, and those who have suffered a collision often ask how both sensations can be possible at the same time. The answer lies within the healing process thats happening inside the injured muscle tissue. If there are no spinal injuries, treatment comes down to two aspects: 1. How do we reduce inflamation, and get these muscles out of spasm so that they are functioning more normally. 2. Since these muscles are inflamed, how do we strengthen them enough so this person can walk away from this experience feeling hopeful that they are returning to normal? Whiplash can be a frustrating injury to recover from, however the good news is that the bodies inflammation process is actually a positive thing. Although painful, the inflammation cycle is very important as it is an alert from the body that we have endured trauma, and need rest and treatment. Whiplash is an acute injury that requires immediate care, but once treated is often one that improves daily with a typically speedy recovery.

Skaters, and auto collision clients are one side of strain injury. The more dangerous category are those with busy lifestyles, and avoidance patterns that only bring them into my clinic when the pain has become debilitating. The silent assailant is RSI or repetitive strain injury. Now, while I’m certainly not coming for them, hair stylists are objectively the highest cases of repetitive strain injury that I see, and here’s why: Repetitive strain injury in essence is doing the same activity or specific motion every day, multiple times a day until strong muscle groups in charge of that action become fatigued, and other muscles begin intervening to compensate. Add time to this scenario, and suddenly you have muscle groups that were compensating, now becoming strained. Back to our beloved hair stylists, and we see RSI developing from holding sheers out in front of the body, for hours every day. When holding sheers with the arm extended in an isolated position, the only points of movement left are rotation at the shoulder, elbow, wrist, and motion at the thumb to move the sheers. Therefore instead of the Pecs, and other strong shoulder movers doing their job to move the shoulders, weaker muscles like the rotator cuff group become overused, then strained. The rotator cuff (specifically the subscapularis rotator cuff muscle) is one of the most common to be effected by RSI. Subscapularis is that nagging muscle we mentioned before located underneath the shoulder blade or “scapula”. Its often confused with back pain, but because its hidden beneath the scapula, it can be difficult to pinpoint what it is you are feeling, and why its happening. RSI pain is not only indicative of overusing weak muscles in an active setting like hair, but also with sedentary behavior like desk work. For example, sitting at a desk for hours a day, your spinal muscles that allow you to sit up straight become fatigued and eventually the neck and shoulder muscles begin overcompensating, and eventually fall into a pattern of repetitive strain. The worst case scenario? The pain becomes so debilitating, that you start missing work, or can’t perform optimally. With sedentation at an all time high because of worldwide quarantine, now is an appropriate time to offer solutions for RSI, and ways to identify how its effecting your life.

Since RSI is all about inflammation, and overuse, the first thing to do is ask yourself how you may have been abusing your body mechanics. Even simple things like compensating with your shoulders when lifting hand weights, crossing your legs because its uncomfortable to sit normally, or not involving shoulders when performing a kick turn while skating, can lead to repetitive strain. First, identify where your repetitive strain might be originating from, and secondly we have to figure out a way to reintegrate stronger muscles, so the strained muscle (like any other strain can heal). The best therapy to treat a strained muscle is cold therapy, rest, and massage therapy. In the comfort of your own home the best solution is creating better habits with posture, and thoughtful stretching and strenghthening. Less is more, as trying to push a strained muscle too much at once will just irritate the issue. Essentially, we must begin thinking about how our strain injury developed from the very beginning. Where did we begin creating a bad habit with posture or action? If we can identify the starting place, one can identify the path that has lead to present day overuse and pain. What were getting at here is identifying bad habits in our everyday performance, breaking them, and replacing them with new habits. Since I can’t be in person with every person reading this, below is a simple stretching regiment to open the rotator cuff that commonly becomes effected by RSI. I hope this may provide some relief, however there is no replacement for a regiment of massage therapy in your lifestyle as a means of treatment and maintainence for repetitive strain injury and muscular dysfunctuon.

Kick turn performed by Harrison Brougham at Blue Banks.

SUBSCAPULARIS OPENING REGIMENT:

Go into a tabletop position with 4 points of contact. (hands and knees on the floor with the back facing towards the ceiling slightly arched) The 4 contact points should be both hands and both knees firmly on the floor.
Start with the right side of the body. Pick up one hand point of contact and place your elbow into the floor gently so that the other 3 points of contact are supporting most of the bodies weight.
Allow more and more weight to ease onto the elbow. The more weight we allow, and more the shoulder should move back and the arm and elbow forward. Ultimately, we want the elbow pointing like an arrow forward in front of us. As the elbow comes forward we should also lean weight from the trunk, and continue to arch the spine.
At this point you should be feeling a stretch in the back of the arm (a tricep stretch), and beginning underneath the scapula where the subscapularis rotator cuff muscle is located.
When you start to feel fatigued, or that the stretch is reaching an end feel, come out of the stretch. It is important to not push a stretch too much all at once especially if its possible that the muscle is strained. If anything the purpose of this regiment is to create space in the shoulder, and the shoulder joints to help relieve tension.
Take a deep breath, and on the exhale take your stretch to its new end feel. (You will notice with repetition, and breathing that your ability to stretch farther will increase.)
Remember to breath as it a lot of the tension we are holding in our body often occurs because we aren’t allowing breath support. Repeat on the left side.