The Process of Healing

The body is a marvellous machine, able to repair and heal itself. This process of healing happens in stages, and understanding these phases can help ease the frustration and fear of dealing with an injury. There are three main steps of tissue healing: Inflammation, Repair, and Remodeling.

Inflammation: The body immediately begins healing a traumatic injury with inflammation. The injured tissues release chemical signals that dilate blood vessels to bring extra blood flow, white blood cells, and nutrients to help clean up and wall off the injured area. This also serves to limit the function of the injured area, to prevent additional tissue damage. The swelling and pain, as uncomfortable as they are, are a protective process. Bodywork can support this phase by working on associated structures while avoiding the injured tissues. It also will help shift the nervous system out of fight or flight mode into relaxation and repair mode through stimulation of the parasympathetic nervous system, which allows more of the body’s resources to focus on the healing process.

Repair: Once the injured area is walled off and cleaned up, inflammation subsides and construction begins to replace or repair the injured tissue. Temporary blood vessels grow in order to supply the nutrients needed for healing, and special cells called fibroblasts begin producing a fragile form of scar tissue called granulation tissue to fill in the gaps left after the damaged structures were cleaned out by the body. This is when it is easiest to reinjure the tissues, as pain levels have gone down but the repairs are not yet strong enough for full use. Bodywork can begin to gently address the injured areas, being careful of the fragile granulation tissue, and can continue to work on associated structures to maintain function, minimize compensation, and increase circulation.

Remodeling: Once enough granulation tissue is produced, the construction of permanent tissue can begin, usually as strong scar tissue made from a dense network of collagen fibers. At first, the collagen fibers are arranged in all directions, and they adjust according to how the body moves as it heals. Some fibers are reinforced to provide more strength, as others are destroyed to provide more flexibility. This process is best done with a gradual return to functional activities, followed by time for the tissue to adapt. At this point, bodywork treatment can work much more directly on the affected area, focusing on breaking up scar tissue and increasing range of motion, even as it continues to address compensating movement patterns.

There is no specific time frame for each phase of healing, so it is important to be aware of the signs and symptoms of each part of the process in order to treat them effectively. Remodeling in particular can take months or even years, and supporting the body as it finds its best function as it heals can do a lot to help reduce chronic dysfunction and discomfort. Bodywork and self-care are effective ways to support this process, helping us stay in conversation with our bodies and respond to their needs.

On the Psychology of Muscle

Your muscles take on the shape that they are accustomed to being in for hours every day. Any one thing, any repetitive motion, will shape the muscle and shape the fascia that surrounds it. The body responds so that the form follows the function, or that the function will make the form. What we want, then, is for our bodies to assume variable positions and activities throughout the day and throughout our life.

Changing positions can be challenging, though. It takes more than stretching to release a muscle, and we can’t force ourselves into a position when our body isn’t ready. Muscle fibers require a neurological signal in the form of a chemical messenger in order to release, and even though that signal comes from the brain, we don’t necessarily decide if our brain will send that signal. We can’t just tell our hamstrings to be less tight. What needs to happen is that the brain needs to feel that it is safe enough for that muscle to release.

So don’t over-stretch yourself into being over-burdened and over-committed. Dive into a conversation with yourself, befriend yourself, and gain an understanding of what your end stretch is and how much you can take on. There are times when we can take on a whole lot, and life circumstances change and we can take on even more. But nothing is constant, everything ebbs and flows, and it is our responsibility to listen to that ebb and flow and know if we need to back off or engage. What you did last summer may be very different from what you can do this summer, but if we go in with hearts wide open we can find opportunity.

Stay buoyant and responsive to where you and your body are in the process of holding and changing positions. We can’t force these processes, but we can work with them by knowing the parts of ourselves.

Emotional Healing that Starts in the Body

Emotional and physical healing are intertwined. Physical issues can have emotional consequences like depression or anxiety, and the opposite is also true. Strong emotions can become stored in the body, often as tension, pain, or dysfunction.

When you receive bodywork and massage or engage in a self-care practice like yoga, the release of stress and muscle tension can also bring an emotional release. Often, but not always, this release brings up negative feelings that you may have pushed back, like fear, sadness, or anger. This can be a shifting point in your healing process! Even though it is painful to experience old emotions, this can be what you need to get to the other side.

Teachers and bodyworkers are not trained or licensed to provide the therapeutic processing that a mental health counselor could, but they can do a lot to create an opportunity for deep emotional healing. They may slow down or stop the physical process of your session or class in order to let the full emotional release move through. Taking full deep breaths will also help your body release the stored energy on its own, and so they may remind you to breathe. Usually you will calm down after a few minutes, and then be able to rejoin the class or return to the flow of your bodywork treatment.

There is true wisdom in saying, “I need support.” Emotional energy is a factor in our health and our healing process, and feeling safe to release emotional energy can help in so many ways. Having someone just be present and supportive by your side can be exactly what you need.

Be Savvy with your Self-Care

The fundamentals of taking care of yourself are sleeping, eating, and practicing self care. Getting enough sleep is crucial for vitality, mental sharpness, and emotional regulation. Eating well fuels the body for activity, supports healthy organ function, and also helps with emotional regulation. Self-care is just as important as sleeping and eating well. It is how we cultivate health, by listening to the body’s needs and responding appropriately.

What are your self-care mechanisms and are they working for you? These might include meditation or mindfulness practice, exercise routine and activity level, quiet time, quality time with loved ones, receiving bodywork and massage, and any of the other hundreds of things we do to support our mental, emotional, and physical health.

Being savvy with your self-care includes regularly checking in with yourself, and then being proactive about taking action. This means that when you need bodywork and massage, or acupuncture, or a class, you know where to go. You are able to tell when you need it, you know how often you need it, and you probably already have it scheduled, maybe with a standing appointment every 2 or 4 weeks.

What do you need from your self-care? You might need to cultivate a clear, calm mind, or more time to relax and recharge. You might also need a higher activity level, or bodywork to support the activity level you already maintain. Perhaps you need acupuncture to manage pain or reduce stress. Begin with how you feel and how you would like to feel, and then figure out how to make that transition.

Savvy self-care does not wait until we are so uncomfortable that we have to stop our lives to make a change, but instead listens to the smaller discomforts and takes care of them in order to maintain a sense of vitality. It’s about being daring enough to put your self-care first and foremost, in order to be more comfortable in your body. 

 

Treating Plantar Fasciitis

Plantar Fasciitis is foot pain, often in the form of a stabbing pain at the heel, and can be worst in the mornings. The pain comes from the plantar fascia, which is a band of connective tissue that connects the heel to the toes along the bottom of the foot. The arch of the foot is an important part of how the foot absorbs the force of the body against the ground (which can be 3-4 times your body weight with each step while running), and the plantar fascia is an important part of maintaining the right tension in the arch, so that it is neither too loose nor too tight.

The pain of Plantar Fasciitis usually comes from biomechanical issues like imbalanced posture, how you walk, or the shoes you wear. Though plantar fasciitis has traditionally been treated as an inflammatory problem, recent research indicates that it is not inflammation so much as collagen degeneration in the fascia. Treatment, then, needs to focus on the biomechanical dysfunction of the foot and how it relates to the rest of the body.

Bodywork like massage and myofascial release are especially effective at addressing these kinds of issues. There are fascial connections that run all the way from the bottom of the foot, along the back of the calf and thigh, and continue up the back and neck to the head. Tightness anywhere along these connections can then tighten the plantar fascia and cause pain. This means that releasing tight back muscles can relieve foot pain! Working with the body as an interconnected system helps address the dysfunction that is causing the plantar fasciitis in the first place.

The other key to addressing plantar fasciitis is blood and fluid flow. Fascia needs to be hydrated in order to stay healthy, and many shoes constrict circulation in the feet, even as they misalign or stress natural foot structures through raised heels, raised toes, and/or narrowing the toes in a pointed shape. Changing shoes and stimulating the nourishing flow of blood and fluid in the feet can help the fascia repair and rebuild its collagen. Massage, therapy balls, and gua sha are all effective for this kind of stimulation.
Plantar Fasciitis is a symptom, indicating a larger problem in how the body is standing, walking,  and/or running in general. Effective treatment needs to address much more of the body than just the feet and should be customized to the specific needs of each client. Bodywork and massage is especially effective at addressing the body in this way, and at HaLe’, we know how to treat the whole person in order to ease the pain and address the dysfunction of plantar fasciitis.

PreNatal Massage for All 3 Trimesters

Pregnancy involves dramatic physical changes, and Prenatal massage is a form of therapeutic bodywork designed to support and ease the pregnant body through those changes. It provides a wide range of physical, emotional, and mental benefits, and is careful to use special bolsters, pillows, and positions to keep you as comfortable and safe as possible.

Prenatal massage assists with many of the common discomforts of pregnancy, including aches and pains in joints and muscles, headaches, leg cramps, swelling, and constipation. The pregnant body is transitioning to add weight, change the center of gravity, and squish internal organs out of the way. Massage is able to support these transitions by easing muscular discomfort and other distress.

Circulation is also key to pregnancy, and prenatal massage helps to stimulate blood and lymph flow, which nourishes both mother and fetus and helps to remove toxins and increase immunity. It also eases the load on the heart and helps to keep blood pressure in normal ranges. During pregnancy, blood volume may increase up to 60%, and massage is a good way to support blood flow back to the heart.

Also, prenatal massage helps to stabilize hormone levels and the depression or anxiety that hormonal changes can cause, as well as soothing the nervous system into better relaxation and healthier sleep. It also offers drug-free pain relief, and the deep emotional support of nurturing touch.

Prenatal massage is recommended as often as every 2 weeks throughout the pregnancy, increasing to once a week in the third trimester. As your body changes, the specific focus of the sessions will adjust, but the overall goal of every session is to provide healthy support and ease through this time of dramatic change.

 

Yes, HSAs and FSAs cover massage and acupuncture

Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA) can be used to pay for massage and acupuncture treatments, as long as your physician recommends it with a written prescription. At HaLe’, we deeply believe in the effectiveness of our treatments, and are very excited to see bodywork, massage, and acupuncture covered as the health care it is.

To get a written prescription from your medical provider, you will need to talk with them about receiving treatment for a specific medical ailment. Some examples of qualifying issues are: stress, back pain, carpal tunnel syndrome, arthritis, diabetes, hypertension, chronic fatigue, fibromyalgia, anxiety, depression, and chronic pain.  Explain to them that you have an HSA or FSA that you would like to use to pay for bodywork, massage, or acupuncture to address your ailment. If you are already receiving these kinds of treatments, tell your doctor about how much they are helping you and how effective you find them.

To support this conversation, HaLe’ is happy write a letter to bring with you, detailing our suggested treatment plan for that ailment. Your doctor may choose to write the prescription to match that plan or may make adjustments based on their expertise. Either way, the prescription needs to include these 3 pieces of information:

  • Medical necessity: what condition you are treating
  • Frequency: how many sessions per month
  • Duration: how many months

Once you have your prescription, let us know what it says and then file it away with your records in case you are ever asked to back up your expense. You can pay for your sessions at HaLe’ directly with the card or check associated with your health spending account, if you have them. Please note that gratuity is not considered part of the cost and so does not qualify as a qualifying expense. Also, for some people, our classes might also be effective treatments for their ailments, and prescriptions for those could also be appropriate.

At HaLe’, we want you to feel good about what you are doing for your health. These HSA and FSA payment options make our treatments more accessible, which means we can be effective health care for more people, so you can get better and feel good!

How Often Do You Need Self-Care?

Our bodies require regular care in order to thrive and heal, and one of the best ways to make sure we are on top of our self-care is to put it on our schedule instead of trying to fit it in around everything else. As a manual medicine and self-care practice, HaLe’ has experience with what kinds of schedules work best. Here are our recommendations, based on the state of your body:

Acute Pain: 3 classes/wk, bodywork every week

Acute pain is an active, painful flare up or injury. The body needs frequent treatment in order to release secondary tension, stimulate the parasympathetic nervous system, support the lymph system, and generally assist the healing process.

Sub-acute: 1-2 classes/wk, bodywork every 2 weeks

Sub-acute pain falls between acute pain (sudden and awful) and chronic pain (long term, constant/consistent pain). It means that something hurts, but it hasn’t been hurting for a very long time and it isn’t terrible. The body is not in crisis but still in need of support and healing, so regular treatment until it resolves is recommended.

Chronic: Start with 2-3 classes/wk and bodywork every 1-2 weeks, then taper down

Chronic pain is long term pain that is not healing or getting better, and can be anywhere on the spectrum from unbearable to really annoying. Addressing chronic pain involves a combination of treatments to reduce overall pain levels and to treat the root cause of the chronic condition. This usually means coming often at the beginning, and as treatment makes progress at interrupting the pain cycle, tapering off gradually until treatments reach a maintenance level.

Maintenance: 1-2 classes/wk, bodywork every 4 weeks

To maintain a level of general good health and low pain, we recommend a basic self-care schedule. This helps resolve issues before they begin to hurt, reduces baseline stress levels, hydrates the connective tissue (fascia), and promotes a general sense of well-being. People who are very active or athletic may need more frequent self-care maintenance.

The Therapeutic Benefits of Balls and Rollers

Therapy balls and rollers offer many of the benefits of bodywork, but with the accessibility of a self-care practice and classes. Bodywork and massage therapy has a long list of benefits for overall health, pain management, athletic performance, and immune function. Sessions are one on one and highly individualized to each client’s body and what will best support their health.

Not everyone is able to receive bodywork or massage as often as their body needs it, though. A reasonable health maintenance schedule for bodywork is once every 2 or 4 weeks, and busy schedules and finances can make that difficult for everyone to access. That’s where the balls and rollers come in! With a grippy texture and firm (but not hard) to the touch, they can support health in many of the same ways bodywork does.

The ball or roller is able to mimic what the therapist does with their hands and feet, using slow, firm pressure to create length and hydration. They can address pressure points, lengthen fascia, relax muscle tension, and rehydrate tissues. Classes can get anyone started with these tools, as a trained teacher leads students through proper techniques and teaches them what to notice. Each student needs to learn the difference between sensations that create health, and pain that does damage.

Once a student has learned the basics in class, they can begin to integrate balls and rollers into their own self-care practice at home. Self treatments like releasing the IT band after each long run, or addressing pressure points on the hands to relax head and neck tension after a day on the computer, can go a long way to maintaining a daily sense of ease and vitality. This also allows bodywork and massage sessions to become more effective as they can spend more time addressing root causes of discomfort.

At HaLe’, discovering the therapeutic use of balls and rollers was an Aha! moment for us. We had tried for years to figure out a way for clients to continue their treatments off the massage table. Yoga is a great complement to bodywork, but it does not work with the body in the same way. Now we can encourage clients to come to class, learn the techniques, and then use them as often as they need to in order to support and maintain the specialized bodywork they receive on the table.

Boosting the Immune System

Manual Medicine supports deep health in the body, including boosting the immune system. Self care practices like yoga, as well as bodywork, massage, and mindfulness, are all proven to increase immune function.

Bodywork, massage, and self-care practices based on movement specifically promote increased lymph circulation. This supports the removal of pathogens and other waste from the body and helps spread white blood cells throughout the system, where they can respond quickly to immune challenges. This increases a person’s ability to fight infections.

Additionally, all of the manual medicine offerings at HaLe’ are effective for reducing cortisol, which is the hormone produced by high levels of pressure and stress. High levels of cortisol can boost blood pressure and reduce levels of natural killer cells in the immune system. Bringing those levels back down allows the immune system to function without that interference, restoring its effectiveness.

This is the time of year when immune systems can feel especially challenged by the perfect storm of lingering winter viruses and budding pollen allergies. Manual Medicine (literally, medicine you do by hand) provides powerful therapies to help boost and regulate the immune system, keeping it effective against the right kind of challenges.

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