Gut Feeling, Gut Ache, Gut Instinct, Gut Sick, Follow Your Gut…

 

A topic that comes up more personally for me regarding health, touch, and the physical body is an understanding of digestive imbalances; how stress and emotions affect and can create digestive problems, how this affects our muscles and physical posturing, how diet obviously can create digestive imbalances which can in turn maintain difficulties with diet, and how complicated patterns arise from these situations, looping around over and over. With digestion and the abdominal region there’s much to potentially discuss,  so I’d focus as usual on one small area, this time in the upper abdomen. Located directly beneath the sternum, commonly called the solar plexus, or celiac plexus in anatomical terms, covered by the superior aspect of the rectus abdominus, this is the first soft spot in the anterior torso after coming down from the ribs. It seems fitting somehow that this less protected area can be vulnerable to emotional stress along with physical pain showing in our digestive organs and proximal muscles.

Congenital illnesses aside and a physician always recommended when symptoms are severe, imagine the basic upset stomach. Whether from food, stress, emotions, or all the above, and whether the pain is from the stomach versus the intestines, when there’s pain in the abdomen we generally flex forward towards it. Our rib cage tilts in, our abdominals get “cramped” space-wise, and our mid thoracic back gets over-stretched. Already in abdominal pain, now there’s an added strip of muscular pain going across the mid back, below the scapula blades and above the base of the ribs. Since the anterior torso muscles flex us forward and the posterior torso muscles bring us back to being upright or further into extension, the aforementioned posture literally tilts musculoskeletal structure, and thus function, off its balance and creates pain. A challenging posture to come out of depending on how ill digestion is, but when physically able, lying on a flat hard surface can be a nice start to regaining that balance, easing out of muscular pain front to back and giving the abdomen space to breathe, expand, and calm.  Carpeted floor and covering up with a blanket for warmth is a good idea. Warm muscles are easier to bring out of spasm or cramping versus cold tight ones, and the solidity of the ground makes for welcome support as we coax muscles open.

As for touch, again how the digestion is will determine what can be done, but laying a palm on the area right below the sternum is warm and stabilizing. It lends a sense of calm, caring, and even an embracing of the spot while focusing the breath into it and then through into the posterior ribs, expanding the rib cage gently out. This can be done during a massage with the client on the table, too. Once digestion has leveled some, bodywork feels amazing in helping sweep soreness out of the muscles. Taking pain out of the body can also help affect things systemically since less energy is spent by our bodies trying to address pain, and more attention can be directed towards healing system imbalances instead.

  1. After laying a palm on the area and practicing deeper breathing, gentle exploration of the tissue underneath the sternum and along the bottom ribs near the sternum’s base can be done. Gentle is the key as digestive organs once upset generally take a while to calm back down.
  2. Alternating hands, use supported flat fingers with moderate to light pressure and sweep down from the base of the sternum and out along the edges of the medial base of the ribs near the inferior sternum.
  3. Placing easy sustained pressure on any tender spots can help open up this area all the way into the posterior back, acknowledging the interplay between regions.  A common trigger point sometimes resides to the side of the sternal base, close to the edge of the ribs (a trigger point is a hyper irritable, small spot in the muscle fibers that remains contracted). With some gentle sustained pressure held for several seconds on this trigger point – try at least 10 – a pain referral and pattern often light up across that mid back region.
  4. Opening up the soft tissue along the bottom of the anterior ribs, focusing around that celiac plexus zone, mid back pain can start to ebb or even clear away, easier breathing can be restored, the digestive area literally has more room to heal, and a burden all of a sudden seems removed off our backs.

Much of the time when things are complicated, keeping it simple, taking small steps, and moving forward accordingly is not only the best we can do, it might be what we have to do. The very human reality of how we all tend to “get in our own way” comes to mind. Pain pushes us to our limits, so forgiving our own impatience and chaotic thoughts and feelings of that moment, consider the aforementioned simple example as useable support, the kind we often need in these off-balance moments. Breathe, take a simple step, be present, and be kind. Whether via bodywork or self-attendance, the solidity of a warm palm laid to rest on this curled in zone of pain says volumes without ever saying a word.

 

Copyright © by Lara Stillo 2017

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Desk Knees, Theater Knees, Plane Knees, and Etc.

 

As human animals, we’re instinctive. If something on the physical body is sore, we reach to touch the area, lightly rub it to see if pain dissipates, or palpate it to see if we can discover anything. Yet while we’ll instinctively use touch to ease, resolve, and learn, human anatomy is still beautifully complex and addressing pain in our soft tissue (or working on a client’s) can be confusing; it varies per area, per context, and per individual.  Because certain areas tend to make us more nervous when they’re in pain, it’s worthwhile to have an ever-increasing understanding of how our bodies work, how soft tissue can be addressed, and how touch really can promote and be an important aspect of healing and feeling good ongoing.

Aching, painful knees are a great example of an area that once off-balance can take us from irritated to worried. “Have I worn my knees out already? Is there something truly wrong in the joint?  Will my activities be limited?” Think of sitting at a desk, in a theater, or on a plane, no comfortable way to extend the legs into a relieving stretch, and that 90-ish degree angle the legs are bent into begins to make for some “chat” in the joints. Automatically, we may reach to the area surrounding the patella/knee cap and rub the tissue. Actual joint pathologies aside, since generally more than half of knee pain is referred from dysfunction in the upper thigh muscles, rubbing the tissue controlling the movement of the knee-joint ultimately can help. Soft tissue dysfunction in the form of hypertonicity, trigger points, adhesions between muscle fibers, and scar tissue, along with imbalances in strength amongst the upper leg muscles can all refer pain to the knee, pull it off alignment, and create improper movement and wear patterns in the joint.

There are so many good ways to address thigh muscles leading into and controlling movement at the knees: using a foam roller on the muscles, general to focused massage work on the upper legs, strengthening exercises to rebalance how the upper leg muscles are working together, etc. Given that,  I’ll focus this time on the lateral aspect of the knee; an area that can be surprisingly sore, yet we don’t usually feel it until it’s palpated. Because of how the femur/upper leg bone angles from the hip socket to the knee-joint, it creates a stronger pull on the knee laterally/to the outside of the leg. Accumulated soreness from being overly tight can lie deeply in the tissues to the outer side of our knees. Trace your fingers from the outer patella/knee cap to where the upper leg and lower leg meet along the side of the knee, exploring this zone in a circumference of a few inches. It can feel bony with less tissue mass and even “gristly” because different muscle tissues here thin down as they transition into tendons; the quadriceps muscles (which make up the bulk of the anterior upper leg muscles: rectus femoris, vastus intermedius, vastus medialis, and vastus lateralis) actually share a tendon that passes over the knee cap and attaches on the tibia bone below. All this makes for a bony, gristly, lumpy feeling landscape which can feel awkward and daunting to massage. Going back to exploring that outer knee zone, there is often a sore to bruised feeling in a few spaces here. Get lost in this region, seeking these hidden spots. Do small circular or back and forth friction movements with clustered fingertips, a supported thumb, and/or the heel of the hand; changing up how we use our hands is good so as not to overwork them. Spending time feeling where it’s tender, being interested by it, trying to gently move it, following where it may lead us to another spot in this small zone, or even applying several seconds of sustained pressure on a sore spot and then rubbing it away, can all help clear open the tissue.

I would never dissuade a client from checking in with an orthopedist if they had serious symptoms or concerns about their knees (or any other problem area in the musculoskeletal system), but it is important to remember that even if a pathology exists there, the surrounding musculature will respond to this imbalance via bracing or tightening to help offset the problem and maintain some kind of workable biomechanics. Meaning, no matter whether a joint pathology exists or not, if the knees are sore the surrounding tissue will have some dysfunction to address either way, leaving massage as a healthy addition in supporting the knees. And honestly, it feels great to get bodywork from both a therapist and via our own exploration. Giving care to oneself, accepting that the body needs and relishes nurturing, attentive touch, is fulfilling. It’s an emotional kindness back to oneself and a centering back into the physical form; a grounding back into the tangible, into something both simple and miraculously complex, reassuring us of our own solidity, presence, and intrinsic value over and over again.

 

Copyright © by Lara Stillo 2017