The AR Response to COVID-19

To our clients, friends, and community!

First, we know no words will do justice to everyone's individual experience over the last couple weeks. All of us at AR Massage Services feel the weight of our responsibility to the community, particularly right now. We know that during such a difficult time, many are feeling stressed and overwhelmed by the circumstances. We share your worry. But we also want you to know that we’re still here for you.

During times of chaos, our bodies often respond with lowered immunity. And while it’s vitally important to maintain a sense of balance during these periods, it can sometimes be difficult to determine how to do so. Research has shown us that getting a massage not only helps you relax, it can also benefit your immune system. Receiving a massage decreases levels of cortisol, a stress hormone , and vasopressin, a hormone believed to play a role in aggressive behavior.

And because we know that many of our clients are dealing with very serious physical conditions and chronic pain. We still want to be of service to you. In order to do so, and with great respect for COVID-19, we have implemented a few changes to the way we can serve our clients going forward.

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Booking Appointments:

• Existing clients may still book appointments through our online scheduling system. (We are accepting new clients on a case by case basis. Please contact us if you have never used our services.)

• We will only see one individual and/or corporate client per day. This excludes partner appointments in the same home.

Preventative Practices in place:

To help protect our clients and our therapists, we have implemented a few new safety procedures as well. We ask that our clients observe the following practices:

• All clients must shower immediately before his/her treatment and we ask that you avoid new interactions after doing so.

• We will arrive 10-15 minutes early for your appointment to sanitize our equipment and/or anything necessary in the surrounding areas.

• If you are feeling unwell or experience even the mildest of symptoms, we ask that you please contact us to reschedule your appointment. The 24 hour rule does not apply durning this time.

• If you, or anyone living in your home, have knowingly had contact with anyone who has tested positive for COVID, please reschedule your appointment until after you have properly quarantined.

• In warm weather conditions, we encourage clients to experience a massage in any private outdoor spaces they may have on their property. Massage under the sun can be amazing for the soul!

• Finally, we will remain in the home for 5-10 minutes post your treatment in order to re-sanitize our equipment and any other areas we may have touched.

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We sincerely hope that you are doing well and practicing self-care, now more than ever. We want to remind you that we are here to help if we can.

Feel free to email or call us with any questions or concerns. We appreciate each and every one of you.

Be well,

Aaron & Mskindness (Kay) Ramirez

AR Massage Services

Massage and Pregnancy: A Powerful Combination

Maureen Salamon, June 26, 2018

Pregnancy is often depicted as a joyful nine months, but the physical reality of gestating another person often includes a myriad complaints that can benefit from a massage therapist’s expertise.

Women’s bodies change on many levels through each trimester of pregnancy, and these changes sometimes require massage therapists to make adjustments both before and during massage sessions. Even with the need for heightened awareness and a more in-depth understanding of pregnancy, however, an expansive body of research firmly supports massage therapy’s many advantages for pregnant women, which run the gamut from reduced discomfort, anxiety and depression to shorter labors.

Robust Research

Research dating back two decades began to confirm the benefits of massage therapy during pregnancy, with a 1999 study in the Journal of Psychosomatic Obstetrics & Gynecology finding reduced anxiety, improved mood, better sleep and less back pain among expectant mothers who received massage twice weekly for five weeks. Such results don’t surprise experts like Gail Pezzullo-Burgs, M.D., an obstetrician in Boca Raton, Florida, whose practice incorporates massage therapy.

“We’re firm believers in stress-reduction techniques, and massage therapy increases the sense of well-being,” Dr. Pezzullo-Burgs says. “And pregnant women often have complaints of pain and decreased circulation that massage therapy really helps.”

Dr. Pezzullo-Burgs began incorporating massage and other integrative therapies into her practice about six years ago when transitioning into a wellness center approach. “Pain is probably the main thing that drives patients to get massage, such as sciatica from the extra weight or position of the baby,” Dr. Pezzullo-Burgs explains. “People go through pregnancy in different mindsets, and some are more anxious than others, but I think it also helps reduce their anxiety even if they’re not having pain.”

Additional early research added even more insight into massage’s role in facilitating a healthier pregnancy. A small 2006 study in the Scandinavian Journal of Caring Sciencesshowed massage was a solid integrative treatment for severe pregnancy- related nausea and vomiting, while a 2009 study in the Journal of Bodywork and Movement Therapies on 112 pregnant women diagnosed with depression suggested those receiving psychotherapy plus massage over a six-week period experienced greater drops in depression than those getting psychotherapy alone.

Meanwhile, a 2009 study in Infant Behavior & Development also focused on pregnant women with depression, finding those undergoing massage therapy not only experienced less depression at the end of 12 weeks, but also carried that benefit into the postpartum period. And a 2010 literature review in Expert Reviews in Obstetrics and Gynecology showed massage therapy decreased depression, anxiety, and leg and back pain in pregnant women, also indicating those in labor used less pain medication and had labors averaging three hours shorter than average.

“Women today are often told in their pregnancy they must ‘just deal’ with any ache, pain or discomfort that comes up . . . but this is where massage can help them,” says Kimberly Corpus, an educator in pregnancy and infant massage and massage therapist from Rochester, New York, who frequently works with pregnant clients. She notes that massage can also reduce swelling, lessen sciatic pain and ease insomnia.

“The No. 1 benefit is obviously relaxation,” says Stephen Abate, a massage therapist from Washington, D.C., who has been working with pregnant clients since 2015. “One of the big issues for moms-to-be is sleeping, so it’s a chance to close their eyes and be truly comfortable.”

Comprehensive Intake Process

Why can pregnancy be so physically taxing? Some of the most pervasive changes are due to increased joint mobility from the body’s profuse production of the hormone relaxin to prepare for childbirth. Relaxin has a loosening effect on ligaments all over the body, Corpus explains, making joints more pliable but also increasing their risk of being overstretched.

“Combining relaxin with having the weight of a growing fetus on the front of the abdomen can cause many different painful and biomechanical dysfunctions,” she explains, including an increase in lumbar lordosis. “This causes compensatory shifts in all of the structures both above and below the lumbar spine. It is these compensations, which the body isn’t used to, that are responsible for pain.”

Experts advise a thorough intake process for pregnant clients, documenting factors such as gestational stage, prenatal diagnoses, past pregnancy problems, medication use, prior bodily trauma, exercise habits and prior massage history. Corpus asks clients to update information at each subsequent session regarding blood pressure, medications and other potential changes. Additionally, if a client has any complications, massage therapists should consider requiring a medical release from the client’s physician.

“When you think of how many changes are happening to them and the baby over nine months,” she says, “it’s important to understand what’s happening clinically because we want to make sure we’re giving the safest, most appropriate massage to that woman.”

Massage Modifications or Contraindications

What types of pathologies are associated with pregnancy, and how might they change your approach? Even the most typical complaints resulting from hormonal and structural changes in the body may require modifications. These include:

• Morning sickness: Much evidence indicates massage reduces this highly common issue, says Susan Salvo, Ph.D., a massage therapist from Lake Charles, Louisiana, who presented on pregnancy massage at the 2017 AMTA NationalConvention. She recommends elevating the client’s upper body. “Don’t use techniques that rock or shake her,” she says, adding that it’s wise to keep a vomit bag in the room.

• Heartburn: Prop clients into an incline to ease any reflux, Abate advises. “Propping under the abdomen when they’re in a side-lying position can lift the abdomen, taking tension back from the gastric sphincter, which can alleviate discomfort,” he says.

• Lower back pain: With this prominent issue, working deeply in the lower back helps—but only to a point, Abate notes.

• Varicose veins: Avoid massaging on top of these, experts caution. “Varicose veins can be a sign of blood pooling and potentially a blood clot,” Abate says. “If there are significant varicose veins or swelling in the legs, I won’t do long effleurage strokes up the legs. You can work on just the feet, but don’t work starting from the ankle and gliding up to the hip.”

• Gestational diabetes: Blood sugar levels need to be under control before massage is allowable, experts say. Salvo keeps honey packets handy during a session in case sugar levels drop and sometimes asks pregnant clients to check their blood sugar if they have a glycometer.

• Edema (swelling): Swelling typically occurs halfway through or later in the pregnancy, primarily in the calves and feet, but in the face or hands it can indicate pre-eclampsia, which is marked by a potentially dangerous rise in blood pressure. Normal edema “sometimes is responsive to techniques that will improve the client’s pelvic alignment,” says Carole Osborne, a massage therapist in San Diego, California, and author of Pre- and Perinatal Massage Therapy & Deep Tissue Sculpting.

Only a handful of pregnancy complications are contraindications to massage, experts say.
These include:

• Pre-eclampsia: The aforementioned condition, which develops after 20 weeks, can also damage blood vessels and cause stroke or even death. Massage may be performed in affected clients with a doctor’s permission, experts note.

• Deep vein thrombosis (DVT): Salvo checks pregnant clients for DVT by looking for differences between the left and right legs, including swelling or heat in only one. “If you have a DVT diagnosis or have a positive screening, you postpone the massage until it resolves,” she says.

• Placenta problems (including previa, accreta or abruption): These rare conditions involving the placenta can lead to dangerous bleeding. “Postpone the massage or get the physician’s OK,” Salvo advises.

Beneficial Positioning and Techniques

Positioning for pregnant clients should never be an afterthought. The side-lying position is recommended by doctors and midwives to help ensure placental and fetal circulation, Corpus says, and the left side-lying position is safest since it allows maximum cardiac function and fetal oxygenation. Positioning clients on their back can trigger supine hypotensive syndrome, which can leave them feeling dizzy, weak, nauseated and short of breath when blood pressure drops due to compression of the vena cava.

“When they get to about 20 weeks of pregnancy, depending on how large they are, I always massage in the side-lying position because of a drop in blood pressure by putting pressure on the abdominal vessels in the supine position,” Salvo says. “It’s a universal precautions approach: Assume they will have it, and plan for it. Put a rolled-up pillow or towel or baby pillow under the right hip to tilt them to the left.”

Corpus and other experts employ a wide variety of massage strokes on pregnant women, including petrissage, effleurage, compression, feathering, gentle stretching, lengthening and cranial sacral therapy.

“The majority of clients seek massage therapy for pain relief—in particular, pelvic pain,” Osborne says. “Techniques that address the varied structures of the pelvis and lumbar area are probably going to be most beneficial . . . including deep tissue, myofascial work, active and passive stretching, neuromuscular trigger point work and various types of rhythmic movement.”

Source: https://www.amtamassage.org/articles/3/MTJ/detail/3852/massage-and-pregnancy-a-powerful-combination

Boost your Mobility with PNF

PNF stretching is an extremely effective, time-efficient way to implement mobility training after your workouts. We'll show you how to do it!

You can't spend too much time trolling fitness websites without coming across the word "mobility." Want to squat better? Mobilize. Want to learn how to do cleans? Mobilize. Want to feel less sore after a workout? Foam roll and then mobilize. 

We agree that mobility and your muscles' range of motion are important factors in fitness. If you want to do an exercise correctly, chances are you're going to want your muscles and joints to move through the motion as smoothly and easily as possible. 

The trouble is that, for most of us, stretching is painful and boring. You know you're supposed to stretch after you work out, so you sit on your butt, touch your toes a few times, and maybe do some arm circles. "Is this even doing anything?" you wonder. "Eh, that's probably good. Time to eat." 

We've been there, too.

The answer to your problems may be proprioceptive neuromuscular facilitation (PNF) stretching. PNF stretching, also called "active assisted stretching" has been found to better increase range of motion (ROM) than ballistic and static stretching.1-3 Although utilizing PNF stretching can't help you feel motivated to mobilize, it can help you make sure that what you're doing is time efficient and actually working. 

WTF IS PNF? 

PNF stretching is always done in the same pattern: 10-second stretch, 6-second contraction, 30-second stretch. The first stretch should be just to the point of discomfort. The 6-second contraction is an active isometric contraction at submaximal effort (around 20-50 percent of your max effort) against a partner's or other implement's resistance. The final 30-second passive stretch should go beyond the range of your first stretch. This style of PNF is called "contract-relax."

Still a little unclear? We'll use a partner hamstring stretch as the real-world example: 

1. Lie on your back with your legs and arms on the floor. Lift one leg and allow your partner to push against it until you feel slight discomfort in your hamstring, and stay in this position for 10 seconds.

2. Next, push with your hamstrings against your partner's resistance for 6 seconds. Think about driving your heel towards the ground.

3. Follow that contraction by relaxing into a passive stretch by your partner for 30 seconds. After the contraction, you should be able to move your muscle into a greater ROM during the passive stretch. 

This basic pattern can be implemented by pretty much anyone. However, there are a few variations you can use depending on your flexibility and comfort level:

1. For the first variation, begin your PNF stretch just like you normally do by having your partner stretch your hamstring for 10 seconds. Then, instead of isometrically contracting against your partner, have him or her push against you just hard enough that you can contract and move your leg all the way down to the floor against their resistance. After you've moved your muscle through its entire ROM, you'll move into another 30-second passive stretch.

2. The second variation, referred to as "contract relax agonist contract" (CRAC), calls for you to contract the opposing muscle of the target muscle, or the muscle being stretched. You'll go through the 10-second passive stretch and the 6-second contraction like usual. But as your partner begins pushing your leg into the 30-second stretch, you'll contract your quads to pull the hamstrings into a greater stretch.

Contracting the opposing muscle as the target muscle stretches can actually help increase that muscle's ROM, so you can get even more bang for your buck with this dual focus. 

HOW PNF WORKS 

Your muscles communicate with your nervous system by relaying messages from both sensory and motor neurons. Sensory neurons send sensory information—sight, sound, feeling, and more—to the brain or spinal cord.

Motor neurons, on the other hand, are responsible for stimulating a muscle contraction. When the communication between a motor neuron and muscle is reduced, the muscle relaxes. One of the ways this happens is through activation of golgi tendon organs.

Golgi tendon organs (GTOs) are sensory receptors located within muscle tendons. GTOs respond to changes in muscle tension and provide feedback to your brain to regulate muscle force. Think of it as a safety mechanism: When tension in the muscle reaches levels that could pose a potential risk of injury, GTOs are stimulated to cause the muscle to relax. 

PNF stretching works because the isometric contraction activates the GTO, ultimately allowing the muscle to lengthen and experience a greater ROM. This technique utilizes "autogenic inhibition," which relaxes a muscle after a sustained contraction is held for 6 seconds. This process allows your muscle to be stretched beyond its initial maximum.1-4

PNF can also work through what's called "reciprocal inhibition," which means one side of a joint relaxes to allow for the contraction of the other. Voluntary contraction of the opposing muscle has been shown to reduce activation levels in the target muscle, allowing it to lengthen and achieve greater gains in ROM.5,6

It's a pretty neat way to use those innate body processes to improve your mobility. 

IMPLEMENTING PNF STRETCHING 

Because PNF stretching may challenge your flexibility beyond your usual ability, it's not a good idea to do it when you're cold. The best time to implement PNF stretching is after you've trained, when your muscles are already warm. One full repetition of PNF for each target muscle is enough to increase your ROM. 

Start by implementing PNF stretching into your routine twice per week. Because you're challenging your muscles through a larger ROM, they may need a little time to recover before you hit them again, so wait a day or two between bouts of PNF. Whether you use PNF for a few weeks or a year, changes in ROM will occur.

The best way to use PNF stretching is to grab a partner. If you have a training partner, then you already have a PNF stretching partner!

By Cassie Smith And Krissy Kendall, PhD

Benefits of Sports Massage

By Michelle Fletcher

An Athlete’s peak performance may be dependent upon the proper use and application of sports massage. More than a treatment for injuries, sports massage produces overwhelming benefits for athletes physically, physiologically, and psychologically.

Sports massage is designed to prepare the athlete for their best performance, reduce fatigue, and relieve muscle swelling and tension. During physical activity—especially strenuous—muscle tension builds up in the body’s soft tissues. Due to overextension or overuse, minor injuries and lesions occur in these tissues that can cause a great deal of pain and poor athletic performance. Sports massage helps alleviate pain and prevent such injuries that greatly affect flexibility, mobility, response time, and overall performance in athletic events.

One of the most common setbacks for athletes is delayed-onset muscle soreness, more commonly known as DOMS. This refers to muscle pain that typically develops several hours postexercise and consists of predominantly eccentric muscle actions—especially if the exercise in unfamiliar. Although DOMS is likely a symptom eccentric-exercise-induced muscle damage, it does not necessarily affect muscle damage. Recent studies have concluded that sports massage may help reduce and prevent the often-painful and debilitating effects of DOMS in athletes.

An Australian study involving 5 healthy men and women who performed a variety of new exercises, has concluded that massage played a key role in easing DOMS. “Massage was effective in alleviating DOMS by approximately 30% and reducing swelling.” Massage can reduce this though the improved blood and lymphatic system circulation that assists in the removal of metabolites and other toxins.

Heavily exercised muscles may also lose their capacity to relax. This causes chronically tight muscles, and loss of flexibility. Lack of flexibility is often linked to muscle soreness, and predisposes athletes to injuries-- especially muscle pulls and tears. Blood flow through tight muscles is poor (ischemia), which also causes pain.  A regular routine of massage therapy is very effective in combating these effects of heavy exercised muscles.

“Muscular strain is a common sports-related injury with the potential to chronically impair performance when sound principles of injury recognition, immediate treatment, rehabilitation, and prevention are ignored.” When preventive techniques such as sports massage are applied, according to Glen A Halvorson, MD, severe muscular strain may be avoided.

Sports massage should be applied before and after athletic events, with many “maintenance” sessions in-between meets or competitions. Pre-event sports massage is focuses on warming-up the major muscles to be used and improves tissue pliability. It also helps get the athlete in a good mental state for competition and prepares them to reach their athletic performance potential.  Post-event sports massage is given following an athletic event and is mainly focused upon recovery. This type of sports massage is geared toward reducing muscle spasms and metabolic build-up that occur with vigorous exercise.

Integrated into a weekly training regimen, athletes may avoid DOMS, relax and revitalize muscles, and feel calmer and more focused before and after events.