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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

I recently had a fantastic massage from Mysti Cobb at our Working Well Massage station inside Whole Foods Lincoln Park. One of the reason I like getting massage from Mysti is that she knows her anatomy and kineseology. When I told her I was having pain in my wrist and my pecs were tight, she knew exactly where to work and how to position me on the massage chair to get maximum exposure of my pectoral muscles. (She sat me facing away from the chair as opposed to how you would normally sit, facing the chair.) I have had experience both receiving and giving massage for chronic tension and injury rehab, and Mysti has had similar experiences as both a patient and a massage therapist.

Mysti Cobb-smiling and providng pain relief at Working Well Massage. Image by Sue Shekut

A personal trainer and Pilates instructor as well as a massage therapists, I think Mysti brings more to the massage session than your average massage therapist. (Or course, we don’t have any average massage therapists in our booths!) Since Mysti is female and has a fantastic smile,  some people think Mysti is a lightweight massage therapist. Those people would be sadly incorrect! Mysti is STRONG and can give super deep tissue massages or she can back off the pressure and give a more gentle relaxation massage. For me, I go to Mysti for deep work though!

Mysti hard at work, concentrating on releasing muscle tension. Image by Sue Shekut

Mysti Cobb’s Bio

Tall and lean, it’s no surprise that Mysti’s passion for movement began in her ballet classes at age 4.  Her years of practice and love of dance led  to a full dance scholarship with the Joseph Holmes Dance Company in 1993. Unfortunately for Mystia, she later tore her ACL while studying at Millikin University and that put an end to a full-time dance career. After six months of physical therapy and rehabilitation, Mysti realized strength training was a new way for her to incorporate movement into her daily life and career.  In 2003, Mysti began studying at the Personal Training Institute in Chicago. In 2004, Mysti completed her personal training (NSCA) certification. Between her dance injury and experience as a personal train, Mysti decided to  add a therapeutic and healing dimension to her work by becoming a licensed massage therapist in 2005 through the Soma Institute of Clinical Massage Therapy.

While rehabbing, dancing and strength training,  Pilates had been an core element of Mysti’s personal fitness routine. In2009, Mysti became certified through the Body Arts and Science program as a comprehensively certified Pilates Instructor. For Mysti, the Pilates certification has added analytical and intuitive tools to help her clients gain strength, eliminate pain, and fine tune body alignment, finding focus in their sessions which carries over into their daily lives.

You can try out a massage session with Mysti at Whole Foods Lincoln Park every Tuesday from 4pm to 8pm. But come in soon because with skills like these, Mysti tends to book up fast!

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Wellness Coach, ACSM Personal Trainer

As a massage therapist and personal trainer, I am NOT a doctor. According to the State of Illinois, I have no medical credentials beyond licensure for massage therapy. However, I see my clients more often than many of them see their doctors. I see more of my client’s skin than they can see themselves (especially their backs).  I  palpate my clients’ muscles and limbs when I massage them. Over the years I have run into several situations where I’ve noticed skin problems, suspicious bumps and lesions, odd body odors and general changes in my clients complexion and energy level that indicated disease. Some of my clients are serious athletes, others are desk jockeys with very little physical activity. All of my clients come to me with some issue, pain or injury and often they come to help handle stress.

Before I go on let me throw out a HUGE derriere-covering disclaimer: I don’t think that massage therapy is a substitute for medical care. I don’t think you should run to your massage therapist instead of to your doctor. What I do think is that massage therapists see your body, feel changes in your tissue and have a more intimate working knowledge of your body as it changes over time more so than the medical doctor you see maybe once per year.  Below I have listed some of the situations where massage therapists can be your first line of defense and awareness of health issues.
Skin Cancer
In massage school, we were taught to identify suspicious skin conditions and look for moles or freckles that fit the ABCD rule. (The ABCD rule helps identify potential areas of skin cancer: if a mole/freckle is asymmetrical, is bigger than a pencil eraser, is multicolored or dark black and is larger in diameter than a pencil eraser, it may be skin cancer.) I can’t treat or diagnose skin cancer, but I can tell my clients about a suspicious looking mole on his or her back. Melanoma is a serious form of skin cancer. If you have a mole or discoloration on your back or other hard to see area (back of knees for example), your massage therapist can notice your skin and changes in your skin each time you receive a massage.

Tension Headaches

Often times, tense neck and upper back muscles can lead to tension headaches. Some of my clients have chronic headaches and have been to doctors  and neurologists that find no known causes. If the pain in a client’s head is caused by tight muscles triggering the pain to their temples, a few minutes of massage can really help relieve their pain. And as a massage therapist, I know that I can’t “treat” a headache and I don’t pretend to be able to diagnose allergies or neurological conditions. I refer my clients to doctors that can do that. But when headache pain is just a general condition causes by muscle pain and my client has already ruled out any serious illness, relieving muscle tension can make my clients’ lives much easier.

Cysts and Tumors

One of the benefits of going to the same massage therapist regularly is that your massage therapist gets to know your body–and knows when something is not normal. I’ve had quite a few clients with  sebaceous cysts (usually benign pockets of fat encapsulated by a cyst). Massaging these cysts is painful and not advised. But when I first see or feel a new cyst, I’ve been able to advise my clients to seek medical attention. Usually the doctor tells them that just a fatty tumor and it’s not a big deal. But there have been times when a client has had a fatty tumor growing into a nerve or growing so fast it causes them pain and discomfort. Again, having a regular massage therapist that notices these changes can help you get to a doctor before the tumor grows too large. In cases where the tumor is not benign, I’ve been glad that I told my client about the cyst right away so he or she can seek medical attention. In one case, my client told me the doctor removed it immediately  and the tumor did turn out to be serious.

Repetitive Use Injuries

Frequently clients come to me with complaints of neck pain, shoulder pain and wrist pain. Many of my clients are heavy computer and smart phone users with little time to stretch or exercise. Again, I do not diagnose nor do I treat carpel tunnel syndrome. But I can loosen the tense muscles around my clients cervical spine, the muscles in their forearms and the scalene muscles in their necks. Often times the pain disappears in just a few massage sessions. As a personal trainer, I can also give my clients exercises and stretches to do to keep their upper bodies from getting too tense again.

Muscle Injuries

When clients injure themselves in accidents or during exercise, my first advise is to see the doctor, then RICE (Rest, Ice, Compression and Elevate the injured limb). I don’t massage acutely injured muscles, especially if there is any chance of the muscle being torn or of the limb being broken. I also don’t massage bruises which any well-trained massage therapists knows is a contraindicated condition for massage. But after my client has seen his/her doctor or chiropractor, or if the injury is a week old and the client is on the mend, a few sessions of massage can send fresh blood to the effected area and help speed the healing process of my client’ own body. Using a combination of therapeutic techniques I can also release some of the muscle tension in the injured area and help ease my client’s scar tissue adhesions.

Scar Tissue

While I was in massage school I over exercised and ended up with a pretty serious groin pull. And after visiting two medical doctors that could not find out what was wrong, and after an MRI and an X-ray that did not show the scare tissue area clearly, I recovered thanks to the help of my massage teacher and my Chinese Medicine Doctor. It turns out my injury was bad enough to cause me pain and restrict my movement but not show up on an X-ray or MRI. After a few scar tissue massages, I was walking easier and my pain subsided.

I am not one of those people who think alternative medicine is the only way nor do I refuse medical treatment. If I need surgery, antibiotics, or have any serious medical condition, I go to the doctor. Bet most of my issues these days are not medical. They don’t require radiation explosing X-rays, doctors visits, pharmaceutical drugs nor surgery. In my own daily life, muscle tension is likely my number one complaint. And for that, I prefer massage therapy to muscle relaxers!

Colds and Flues

When I am working on my clients I notice their energy level and body temperature. A few weeks ago one of my regular clients was very rundown and quiet. When I worked her neck and back she feel very warm. I asked her is she was coming down with something and she said she didn’t think so. But something felt off and I worked on her more lightly. A few days later I got an email that she indeed did have a bad cold.

When someone has a fever, it’s often the first sign of the body fighting off a virus or infection. But in the summer heat it’s hard to tell if you are warm or feverish. Massage is contraindicated for a fever because it takes energy away from your body and your body needs that energy to fight the illness. Similar to working out when you are sick or run down. it can put your body into a healing crisis aka make you really really sick really really fast! When  feel a client is warm or seems low energy I change my focus and work with lighter strokes. I try to give them more of a relaxation massage versus a deep tissue massage. I can’t cure their cold and I can’t even diagnose what’s wrong with them. But I can modify my massage to fit their condition that day and that can help make them feel better or at the very least less sick than if I worked their muscles very deep that day.

Referrals

Sometimes people are reluctant to go to their doctor or a specialist. They think their problems will go away over time. They don’t want to take the time to get an MRI or leave work to see their doctor. In this case, your massage therapist can nudge you to see your doc and verify that indeed your condition does require medical attention. If I massage someone who has muscle pain and there is not a noticable improvement in 1 or 2 sessions, of if the condition worsens, I advise them to see a doctor. For muscle and bones issues, I refer them to chiropractors or orthopedic doctors. By referring my clients to other health care providers, I let them know that yes their condition does require a doctor’s care. I also give them a second opinion (aside form their own) that yes they need to take the time to take care of their problem. Sometimes people are looking for an outsider to give them permission to take care of themselves. As a licensed massage therapist, in many people’s eyes, I have more credibility than say,Jimmy the Bartender, when it comes to body issues like injured muscles. Again, I am not treating or diagnosing, but I do notice, bring awareness to my clients and refer them to various other health care providers depending on their problem.

Emotional Issues

Lastly, for some people, being touched and having their muscles massages brings up emotions or memories of past traumas. For people dealing with addictions like compulsive overeating or smoking addiction, getting a massage brings their awareness to their body and may even make them want to take better care of their bodies. In these cases, I can refer my clients to licensed psychologists or counselors to help them better cope with their issues.

Overall, I look at massage therapists as partners in wellness with medical doctors, chiropractors and physical therapists. We are not doctors, but we do see clients more frequently than other health care providers and we do care about our clients health and well being!

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By Sue Shekut, Owner, Working Well Massage, Licensed Massage Therapist, Certified Wellness Coach, ACSM Personal Trainer

Cat massage!

Although I no longer have cats, I do enjoy a good cat massage! (And a good laugh!)

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Injured soldiers find relief through massage and other “alternative therapies.”

By Michael Devitt from Massage Today magazine

Wars have been fought since time immemorial. From simple sticks and rocks to guided missiles and uranium-tipped artillery shells, the methods civilized nations have used to annihilate one another have changed dramatically over the centuries.

Despite the advances in modern warfare, the types and degrees of injury suffered in combat have remained frighteningly constant. Surprisingly, research suggests a major cause of attrition (a reduction in number or strength) among military personnel in recent wars has resulted not from injuries incurred on the battlefield, but, rather to more typical conditions such as accidents and musculoskeletal complaints.

To determine what types of painful conditions affect soldiers during wartime, researchers in the United States and Germany examined 162 soldiers engaged in Operation Iraqi Freedom who were evacuated to pain treatment centers outside the theater of combat. Results of the study, published in the journal of Anesthesia & Analgesia, show that many of the injuries suffered by military personnel during conflict are indeed similar to those sustained by people in the civilian sector. Even more important, the use of alternative therapies in the treatment of pain among injured soldiers appears to be growing, with massage the most common alternative therapy used for pain relief.

All of the soldiers included in the study had been injured during OIF between March 2003 and June 2004, and were medically evacuated to one of two treatment facilities: Walter Reed Army Medical Center in Bethesda, Md., and Landstuhl Regional Army Medical Center in Landstuhl, Germany. Most of the injured personnel received “consultations for treatment recommendations to be implemented at military treatment facilities located at the patient’s home duty station.”

Analysis of the complaints showed most soldiers suffered injuries comparable to those that would have been sustained by similarly aged civilians. Not surprisingly, more than half of the pain complaints reported by the soldiers (53 percent) involved the low back. The second most common complaint was “nonradicular extremety pain,” which accounted for 23 percent of the presenting complaints.

The most common diagnosis of injury was lumbar herniated disk which, according to the researchers,” accounted for almost one-quarter of all pain disorders.” Postsurgical pain was the second most common diagnosis, and was experienced by 14 percent of all patients.

More than three dozen treatment modalities were utilized for pain relief; on average, each soldier was treated with 3.5 different therapies. Not surprisingly, drugs were the most popular form of pain relief, beginning with nonsteroidal anti-inflammatory drugs (NSAIDs), which were given to 91 service members. Seventy-nine patients received opiods; 66 patients received some kind of neuropathic pain medication.

Drugs and surgical procedures weren’t the only treatment options available, however. According to the study authors, 28 soldiers (17 percent of the study population) were treated with “some type of alternative therapy.” The most common alternative therapy offered was therapeutic massage, which was performed on 13 soldiers, and administered more frequently than chiropractic manipulation, acupuncture and glucosamine/chondroitin supplements combined. More than half of these patients treated with alternative therapies (15) were diagnosed with postsurgical pain or lumbar herniated disk before receiving care. In fact, more than one-third of all military personnel diagnosed with postsurgical pain were treated with massage.

The study pointed out the number of injuries suffered during combat was significantly less than the number of non-combat injuries; in fact, only 17 percent of the patients stated they were injured during battle.

Such nonbattle-related injuries, or NBIs, can take a serious toll on overall troop strength in modern warfare. According to the authors, “Among the 21,655 soldiers admitted to army hospitals in Southwest Asia during the Persian Gulf War, acute NBI comprised 25 percent of all hospitalizations, with musculoskeletal conditions ranking second at 13 percent.”

Presenting Pain Complaints in Soldiers Injured in Operation Iraqi Freedom*
Pain Presentation (n=162) Frequency Percentage
Lumbar radicular pain 49 30.2%
Axial low back pain 37 22.8%
Nonradicular leg pain 24 14.8%
Nonradicular arm pain 16 9.9%
Groin pain 15 9.3%
Thoracic pain 10 6.2%
Neck pain 10 6.2%
Abdominal pain 8 4.9%
Cervical radicular pain 6 3.7%
Headache 6 3.7%
Thoracic radicular pain 2 1.2%
Polyarthralgia 1 0.6%
Facial pain 1 0.6%
* The percentage of pain complaints is based on the number of patients (162), not the number of presenting symptoms (185).

Taking these numbers into account, this would mean that more than 2,800 soldiers were hospitalized due to musculoskeletal complaints during the Gulf War. Given the increasing number of low back and other musculoskeletal injuries that seem to be the norm in modern warfare, and given that these conditions often are seen by massage therapists in the civilian sector, it would appear that massage therapists are just as qualified as other health care providers in helping to ease the pain and suffering of injured military personnel.

For more information, go to the article here.

Resources

  1. Cohen SP, Griffith S, Larkin TM, Villena F, Larkin R. Presentation, diagnoses, mechanisms of injury, and treatment of soldiers injured in Operation Iraqi Freedom: An epidemiological study conducted at two military pain management centers. Anesth Analg 2005;101:1098-1103.
  2. Hoeffler DF, Melton LJ. Changes in the distribution of Navy and Marine Corps casualties from World War I through the Vietnam conflict. Mil Med 1981;146:776-9.
  3. Writer JV, DeFraites RF, Keep LW. Non-battle injury casualties during the Persian Gulf War and other deployments. Am J Prev Med 2000;18:64-70.

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By Sue Shekut, Licensed Massage Therapist, ACSM Personal Trainer, Certified Wellness Coach, Owner, Working Well Massage

I like to think of myself as not only a good massage therapist but also a good judge of massage therapists. I’ve had thousands of massages and given thousands of massages. As the owner of a wellness company, I interview many massage therapists and receive regular massage myself. Often, when clients travel or move out of town, they ask me how to find a good massage therapist.

It’s a question very similar to “how do I find a good dentist or a good doctor”. Since massage is a personal service, my first impulse is to say, ask your friends and coworkers who they go to and start there. But then, we’ve all had referrals to service people that our friends liked that were not a good fit for us. (One person may like a deep massage and you may like a lighter touch or vice versa. One person’s fantastic hair stylist may be great for that person but be unable to cut your style of hair well.)

Before you search out massage therapists, take a minute to think about what you want from a massage experience. Then when you call different therapists or massage centers, ask questions to make sure you get the massage therapist that best fits your needs.

Good questions to consider:

1. Are you going for stress relief or pain relief or both? Swedish massage or “relaxation massage” tends to be best for stress relief. Deep tissue or therapeutic massage tends to be best for pain relief. If you have a specific injury or chronic pain pattern, you will want a massage therapist with skill in relieving muscle pain, not just in relaxation therapy.

2. What’s your budget for massage?
Can you afford a weekly full hour (prices ranging from $65 to $120) or only mini-sessions (like the 15-20 minute $1 per minute chair massages offered at Whole Foods and similar places). If you have a chronic neck and shoulder pain, it’s often more cost effective to get weekly 20-minute massages than a one hour once a month.

3. Do you want someone you can go to regularly or just on a pamper yourself basis?
Spas tend to charge the most for massages and tend to be the place people go for pampering. However, some independent massage therapists may be able to offer you better prices and a really personalized pampering experience. Spas charge the most but they will give you the whole pamper yourself experience. However, if you want a regular massage your best bet is to find a good practitioner that is reasonably priced. If you can’t afford an hour regularly, try chair massage for 15-20 minutes if you want more frequent upper body massages.

4. How much do you care about the quality of the massage?
If you just want someone to pamper you and rub oil on your back while you relax and snooze away your stress, you don’t need someone with extensive experience or medical massage training. If you want someone to help you recover from an injury or deal with a chronic tension issue, you will likely want someone with a good deal of experience and skill working with similar conditions. Make sure you massage therapist meets minimal licensing and certifications standards if you want more than just relaxation massage!

5. Do you want the whole massage enchilada: the robe, slippers, the soothing music and spa environment? Or do you care more about the environment or more about the actual massage?

For the slippers and robe, go to a spa like Urban Oasis or Exhale in Chicago. For a great therapeutic massage, it’s more important to find a good practitioner. Use the locator services below and then speak with the therapist about his or her skill before you commit to the appointment.

Massage Locator Services
My top sources for great massage therapists are massage locator services (versus Google or any other search engine). Massage therapists that register with these services must meet minimum standards of training, normally 500 hours or more and have graduated from an accredited massage school.

One of the best is the Association of Bodywork and Massage Professionals massage practioner site here.

Massage Today also has a great service as well here.

Insider Pages is a review site that provides user comments about massage and spa services.

How Do I know if My Massage Therapist is Qualified?
In the State of Illinois, Licensed Massage Therapists are required by law to have at least 500 hours of training and graduate from an approved school. You can look up your therapists to see if he or she is licensed at this site. This site will also display a Y or N to indicate whether the massage therapist has ever undergone disciplinary action by the state of Illinois’s Department of Financial and Processional Regulation.

Other states vary in requirements. Some states do not require a license at all and allow municipalities to regulate massage. For example, in California, there is no state license. Hours of training required vary depending on the city. So some therapists in Northern California only have 100 hour of actual massage training! The Truth About California Massage Licensing here. However, at the other end of the spectrum is New York State, which requires 1000 hours of training. New York Licensing Requirements here

Still Unsure, Try a Sample Massage
Lastly, if you want to try a sample massage, your best bet is to try a chair massage at Whole Foods Gold Coast or Lincoln Park in Chicago. Or at a local health food store or mall. You can get a few minutes of massage, determine if the therapists fits your needs, then ask for his or her business card to set up a longer massage!

If you have questions about Chicago area massage therapists, feel free to contact Working Well Massage here!

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by Sue Shekut, Licensed Massage Therapist, ACSM Personal Trainer, Certified Wellness Coach, Owner, Working Well Massage

Through the years I’ve had a number of massage therapy clients say things like, “I know it has to hurt to be effective,” and “no pain no gain, right?” Actually, massage does not, and should not ,“hurt” to be effective. In fact, if the massage you are receiving is so painful you have to grit your teeth or hold your breath, it likely isn’t going to be very effective.

The idea that we have to experience pain in order to heal is a holdover from the 1980’s when people were “going for the burn” and many bodywork modalities were just starting to take root. Some massage therapy schools of thought held that people were experiencing deep emotional breakthroughs if they cried out or had an emotional “release” during a particularly intense bodywork session. This led to the idea that you HAD to have a deep emotional outburst or had to feel pain to have a really “good” bodywork experience.

Since then, somatic psychology and bodywork has matured. As have bodywork practitioners. Many realize that, especially for people that have already had a physical trauma such as a car accident or injury, the body has already been through deep trauma. Working too deep, giving too much pressure, or expecting clients to have radical transformation from a single session can be retraumatizing.

Some massage therapists still hold to the belief that trigger points need intense compression to release the knot. Sometimes this is true. But holding a trigger point for too long, or pressing too deeply into a sore muscle area can cause more pain and damage than healing. (Trigger points are areas of the muscles that have a cluster of muscular adhesions or “knots” that refer pain elsewhere when compressed.)

Good Pain Versus Bad Pain
Does that mean that massage should be painless? Well herein lies the rub (pun intended). Massage is not painless any more than working out is painless. There can be muscle soreness. When we first press on a sore or extremely tight muscle area, there may be tenderness or soreness. We call this “good pain” similar to the soreness you may experience when you lift weights or do a prolonged cardio session. However, if you are working out and you “pull” a muscle or sprain your ankle, that would be “bad pain.” That type of pain indicates an injury to the tissue and requires medical attention. Muscle soreness during an exercise or massage session is not abnormal and can indicate that healing is occurring.

What About Soreness?
When a tight muscle is massaged, at first you may notice the sensation of soreness or tenderness. Initially you become more aware of that muscle area and that may include an awareness of just how very tight and sore the muscle is. Then as the massage therapist continues to work with the muscle tissue, fresh blood flows into the muscle area as the therapist presses down (as in compressions or gliding strokes). This fresh blood helps “loosen” the muscle tissue and also helps bring nutrients and oxygen into the muscle. At this point, especially in a deep tissue massage, you will likely notice less soreness in the area. If the muscle gets more and more sore, the massage therapist may be overworking the area and it’s best if you tell him or her to stop massaging that area and to move elsewhere!

That all said, after a deep tissue massage, you may feel some muscle soreness a day or two afterwards, just as you may feel sore after a workout. In essence, a deep tissue massage is like having someone else give your body a workout. Soreness or bruising lasting longer than a day or so may indicate the massage was too intense. Let your massage therapist know if this happens so he or she knows to work with less pressure for your next massage. (If you go back to him or her at all!)

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