01/31/2024
I Can Relate by Alessandra Nisco Jacobson
Living and working in an athletically active mountain community as Telluride, I see a lot of physical injuries amongst my clients and friends. I consider myself one of the lucky ones, grateful to have not yet undergone a traumatic injury or surgery. However, over the past couple of decades, like most mortals in my age group, I’ve accumulated a collection of aches and minor injuries, some chronic, others acute or temporary. Several have been resolved, others persist and demand attention, and some come and go, depending on my physical activity du jour. While I believe in the importance of self-care such as stretching, targeted strengthening, and regular massage, we don’t always have the time in our schedules to be poster-children of maintenance routines. The effects of repetitive motion, high impact activities, muscular strain, postural misalignment, lactic acid buildup, stress and inflammation, all catch up to us, especially when we fall short in our personal wellness practices. While these painful ailments are a nuisance, they have all helped me to relate to clients with similar symptoms, and thus deliver and recommend methods which have proven effective to me personally.
Our beautiful community of middle-aged mountain-motion enthusiasts often share similar pain patterns. Take for example, persistent hip and lumbar pain, which for me, seemed to onset one summer while training for a race. Hip and lumbar pain are common, and can have many causes. Through months of seeking relief and doing physical therapy, I was gradually able to alleviate the problem, caused by weaknesses and imbalance of my core, iliosacral joint and hip muscles. My solution came through strengthening my gluteal, low-back and psoas muscles, which provided more stability, while stretching and releasing my over-compensating piriformis and hip rotator muscles through massage and stretching. This allowed one group of over-recruited muscles to work less, while newly strengthened muscles learned how to actively engage. Equally important, I used postural realignment practices; allowing for more space between my vertebrae, better pelvic and sacro-lumbar alignment, improved standing, sitting and sleeping posture, and a better running cadence with less impact. I find most of my clients with similar symptoms have at least some of the same imbalance patterns I had, and at a bare minimum, I am able to give the effective hip-releasing massage that I had craved, as well as some helpful advice!
Another common ailment; rounded, or forward shoulder syndrome, affects so many in our society for several reasons, and can present as persistent neck, shoulder and/or upper-back and scapular pain. Associated ailments from forward shoulder posture can take many forms, and cause malalignment, tension and dysfunction in the entire upper body region. When I was first “diagnosed” ages ago, I was told that it was from overuse; likely from years of mothering three little ones. It is also known as “mom posture”, and is commonly associated with overuse of our electronic devices, as we slump forward into our screens. Essentially, the pain of the misaligned shoulders is caused by the chronic shortening of the pectoral major and minor muscles, rounding the shoulders forward and inward. This stresses the frontal neck muscles, weakens the upper back and posterior neck muscles, and completely compromises the shoulders. For me, it’s constant issue I have to diligently try to keep in check, since my work pulls me into the forward shoulder position, which can even trigger an incessant neck injury I have. To combat these symptoms, I stretch open and palpate my pecs, chest, neck and shoulders, and do rhomboid and posterior neck strengthening exercises to pull the shoulders back into place. I also have to pay close attention to the alignment of my head and shoulders, to keep myself properly stacked vertically upwards. Effective therapeutic massage can work wonders to increase circulation and relieve tension to the musculature involved, and an occasional chiropractor adjustment helps to alleviate structurally misalignment. Although caring for our injuries is a lot of work, it can be done, and is well worth the vigilance!
Lastly for now, my two-year experience with plantar fasciitis, a most bothersome condition that I find to be prevalent amongst my clients, is worth mentioning. Plantar fasciitis is the painful inflammation of the tissue on the bottom of the foot. Professionals recommend staying off your feet, which is not possible for most. The pain usually starts in the heel, feels like a bruise on the bottom of the foot, and is at its worst upon getting out of bed in the morning. I tried everything over the course of my misery (except staying off my feet and getting a cortisone shot, said to be excruciating and only sometimes helpful). I wore a boot to bed, putting my foot at 90-degrees for 8 months, rolled my foot on frozen water bottles and spikey balls, applied CBD and other topicals, and stretched my foot, achilles and calf regularly. None of these helped, and the pain grew worse and traveled all the way up my lateral leg and into my upper body, presumably from the compensation of limping. Through my experience, a few things that did help were gentle massage (deep work made things worse), custom orthotic footbeds, and wearing well-padded insole shoes. It wasn’t until almost two years in, that I did a gluten-free dietary cleanse for 30 days, and all of my pain miraculously subsided. For me, inflammation due to gluten intake was the cause of the persisting plantar fasciitis. No doubt, this is not the cure for everyone, but it is worth exploring what dietary sensitivity could be involved.
While I have barely scratched the surface of my list of relatable aches and pains, I consider myself so fortunate to have never had a major mishap and to be in good general health. My discomforts have been helpful to my massage practice, enabling me to better relate to clients’ common issues with their tissues! When I can understand the pain my clients are enduring, I feel I can deliver a more effective treatment, as alleviating discomfort is ultimately my goal in these circumstances.
