Monthly Archives: August 2009

Which Massage is Right for Me? – Exploring the Relaxation Massage

Working in my practice (Hawaiian Experience Spa, in Scottsdale, AZ) where we offer over 80 different treatments including many types of massages, I find that new clients are often confused about the meaning of relaxation massage. Obviously, receiving the right type of massage for your needs is critical to receiving the experience and benefits from the massage that you are seeking. To help with this quest I have reduced all massages into four basic categories; relaxation, therapeutic or deep tissue, medical, and specialty massages. Understanding these basic categories will help you choose the right massage each and every time. Read more on my page…

Relaxation Massage

Article written by:

Steve Ibach, Licensed Massage Therapist, Nationally Certified in Therapeutic Massage

Hawaiian Experience Spa
10855 N. 116th St., Ste 130
Scottsdale, AZ 85259

IMPORTANT – Nothing you read in our blog, on our web site, in our newsletter, etc., as well as nothing we discuss with you individually is meant to treat, diagnose, cure, or prevent any disease. You should consult with a physician or other qualified professional for all medical advise.


Medical Massage Therapy, A Growing Field in Health Care

Massage Therapy, a recognized medical treatment in many parts of the world for thousands of years, is finally beginning to take its proper place as a medical treatment in the United States including Scottsdale, Arizona where my practice is located.

massageSimply put, Medical Massage Therapy is the focused use of advanced massage techniques to treat a specific condition and achieve a specific outcome. In some cases the condition treated is first diagnosed by the patient’s physician. In other cases the medical massage therapist simply treats the patient based on the patient’s subjective description of his symptoms and following a thorough assessment of the patient’s muscles, posture, etc.

Techniques used during a medical massage often include neuromuscular therapy, myofascial release, and lymphatic drainage massage among many others; however they can also include more common techniques such as Swedish Massage. The main difference between a medical massage and a regular massage is that it is performed by therapists with advanced training and the treatment is structured to obtain a specific outcome. Examples of specific outcomes include; decreasing low back pain, increasing range of motion in the shoulder, eliminating tingling in the hands, reducing swelling, reducing leg cramps, etc.

There is still no specific licensing requirement anywhere in Scottsdale, or anywhere else in the United States that I am aware of, that specifically licenses or recognizes “Medical Massage Therapists” over any other duly licensed massage therapist. This means that the term “Medical Massage Therapist” is still more of a self imposed description of the therapist’s focus rather then an official designation or recognition by any authority. Any massage therapist with a proper license in his jurisdiction can usually legally perform any type of massage.

Despite this it is very helpful to seek out a Medical Massage Therapist if you require massage therapy to treat a specific symptom. Any therapist using this term to describe himself or his practice is clearly advertising that he focuses on medical massage. This will narrow down your search for the proper massage therapist for your needs from among the tens of thousands of therapists that mainly focus on relaxation or general therapeutic massage techniques. You can think of the term Medical Massage Therapist as a specialty among massage therapy. It is similar to a family practice Medical Doctor advertising that they specialize in “medical care for women”. The MD is still just an MD like any other, however, knowing her focus is a great help to the patient when seeking a doctor.

Treating Pain
backpainMany of my clients first visit me because they are experiencing pain. The pain can be the result of a medically diagnosed condition such as tendonitis, a muscle strain, fibromyalgia, a herniated disc, etc. It can also be from general muscle tension, a previous car accident or injury, or can be from no known cause.

In many cases, medical massage therapy can eliminate the client’s pain permanently in only a few visits by releasing chronically hypertonic (tight) muscles, and bringing proper muscle balance back into your body. Muscles encompass about 60% of your total body mass and much of the pain we experience emanates from nerve endings in muscle tissue. When muscles are out of balance (meaning that one muscle is tight compared to an opposing muscle) your body can physically shift out or alignment (hip can rotate forward, shoulder can elevate, etc.) causing nerve compression and pain. By applying medically proven Neuromuscular massage techniques, among others, we can alleviate muscle tension, helping to correct your posture, and eliminating unnatural pressure on your nerve pathways. This process can often be accomplished in only a few visits and improvement is usually seen by the client after only a single visit.

For more information on medical massage, along with some client testimonials of how medical massage has helped them, I suggest visiting the Hawaiian Experience Spa Medical Massage Page.

Some of the conditions that can be successfully treated with medical massage include:

  • Low Back Pain
  • Stress
  • TMJ Pain
  • Sciatica and Piriformis Syndrome
  • Tingling in Hands
  • Neck Tension
  • Reduced Range of Motion
  • Postural Imbalances
  • Recovery after Surgery
  • Chronic Pain in any area
  • Lymphedema
  • Joint Aches
  • Fibromyalgia Pain
  • Headaches
  • Carpal Tunnel Syndrome
  • Tendonitis
  • Constipation
  • Much more..



Proper Use of Heat and Ice for Injuries

By: Steve Ibach

Both heat and ice have been used for thousands of years to treat injury and pain, but how do you know which one to use? Read this brief article to gain a general understanding of the injury process in your body, then follow a few simple rules and you can make the right decision each time.


There are two basic types of injuries; acute and chronic. An acute injury is a sudden injury that has just occurred such as a sprained ankle. You will usually know when have sustained an acute injury. A chronic injury is a more “long term” injury. It can be a former acute injury that is healing, or a long term aching back. These two types of injuries are treated differently.

Acute Injury – Use Ice!

If you injured yourself during the last 48 hours, or if your injury shows any signs of redness or swelling (inflammation) use ice on your injury. Ice reduces swelling by constricting your blood vessels and slowing the leakage of fluids into your tissues from the injury. Reducing swelling helps the injury heal quicker and reduces the amount of pain you experience. Ice should also be used on chronic injuries that have been inflamed or “reinjured”. For example, let’s say you are recovering from a sprained ankle that occurred several weeks ago (therefore, it is now in the chronic stage). Then today you decide to hike to Humphreys Peak (highest point in Arizona) and your ankle is killing you when you finish. Well, the chances are that you reinjured your ankle to some degree and now require ice. Anytime your chronic pain flares up after exercise, ice is the appropriate treatment. As a rule, it never hurts to put ice on an injury or area of pain, as long as you follow the correct procedures (shown later in this article).

When to use Ice

1. Immediately after an injury (sooner the better)

2. The first 48 hours after an injury

3. Anytime there is swelling or other signs of inflammation

4. After exercise or exertion when you experience a flare up of a chronic pain

When Not to Use Ice

1. Never use on a sore muscle before exercise. This will increase the risk of injury.

2. Never use ice while sleeping.

Does and Don’ts of Applying Ice

1. Don’t put ice directly against your skin unless you are performing an ice massage. An ice massage requires you to move the ice around on the affected area continuously (Ice Massage works great…Just use something to hold the ice so your hand does not freeze). Never leave an ice pack, etc. directly on your skin. Always place a towel or other material between the ice and your skin.

2. Don’t use ice for more than 20 minutes at one time (less time on a smaller muscle or on small children). Longer usage can cause frostbite resulting in severe damage to your tissues.

3. Do allow your body to warm up to room temperature naturally after applying ice (warm up takes 45 minutes to an hour).

4. Do apply ice several times during the day as long as you let the area warm up in between uses.

5. Don’t apply ice before exercise! This will increase your risk of injury.

6. Do use a container (like a zip lock bag) that will contour to your body. A small amount of water can be placed in a zip lock bag with the ice to help this.

Other Information

When you are injured, follow this simple rule called R.I.C.E.

R – Rest the affected area and your whole body if possible

I – Ice the affected area

C – Compression with an ACE Bandage, etc. helps limit swelling

E – Elevate the affected area above the level of your heart.

When using ice you may experience the following sensations, which are very natural (C.B.A.N.):

C – Cold!

B – Burning

A – Aching

N – Numbness – When you are numb you are done and can take the ice off! (Don’t exceed 20 minutes even if you don’t feel numb).

Chronic Injury – Use Heat (usually!)

Chronic pain or long term injuries usually respond best to heat. Stiff, sore muscles or joint pain is the ideal case to use heat. Heat dilates your blood vessels and increases circulation bringing blood, oxygen, and nutrients to the affected area. Basic massage therapy works the same way. One of the main goals when massaging sore muscles is to increase circulation to the muscle. Heat helps relax your muscles, increases flexibility, and reduces pain and soreness.

Once your formerly acute injury begins to heal and the inflammation goes down, you should start using heat (about 48 hours after the injury). For that sore back with no apparent acute injury that caused it, heat is also great.

Unlike ice, which can be used almost anytime safely, using heat at the wrong time will make your situation worse. Never use heat when swelling, redness, or other signs of inflammation are present. Heat will increase your inflammation, irritating your injury.

When to use Heat

1. On sore muscles and joints that have not be recently injured

2. On stiff and inflexible muscles (some causes of pain and inflexibility are related to chronic contractions or trigger points that can only be relieved by Neuromuscular Massage Therapy (NMT)).

3. Before exercise on muscles that chronically cause you problems (this is another way to warm up first).

When Not to Use Heat

1. Never use when an injury has just occurred

2. Never use when there are signs of inflammation (swelling, redness, heat).

3. Never use on someone with sensory problems (they could be burned inadvertently)

4. Never use heat while sleeping

Does and Don’ts of Applying Heat

1. Do put the heat directly against your skin. Hot towels and heating pads work great.

2. Do use heat for as long as you wish, as many times as you wish.

3. Don’t burn yourself! The temperature of the heat can be as hot as you can take it without burning yourself. Be careful, especially with children and the elderly.

4. Don’t apply heat after exercise. Use ice after and heat before exercise.

IMPORTANT INFORMATION – The above information is general advice only. If you are injured you should seek specific advice from a doctor or other medical professional.


The Cure for Everything

By: Steve Ibach

A conversation with a client yesterday reminded me of an important part of modern medicine – a part so important that it indeed may be the cure for everything. It is so important that doctors use this invention of modern medicine above everything else, and patients often demand it, whether they need it or not. I am referring, or course, to the pill. Not “the pill” in the sense of keeping babies from away, but the more general sense of the cure all for everything – the pill for whatever.

The solution to nearly every ailment in modern medicine is to write a prescription. Does your back hurt? Here is a muscle relaxer and a pain killer. Do you have a cold? Here is a decongestant, antihistamine, and a maybe even an antibiotic. Are you stressed at work? A little Xanax will make you feel great!

Don’t get me wrong, I love modern medicine. Drugs are a wonderful invention and the measured use of them is very helpful in treating patients. However, in part because our health care system only allows for 10 minutes of consultation with your doctor per visit, prescriptions, which take about 10 seconds to write, have become the cure all for everything.

My client yesterday is a perfect example of doctors overusing, or even misusing, their prescription writing power. My client is a young women who has been suffering from low back pain for years. The cause of this pain was not diagnosed by her physician – instead he has given her narcotic pain killers. She tried a chiropractor on her own (yickes!) which did not help and finally ended up with me. In the absence of a doctor’s diagnosis I performed my own assessment and found a severe imbalance in her muscles – one that can easily be corrected by a few neuromuscular massage sessions, exercise, and stretching. This is a story that we see so frequently that we are almost numb to it.

Medical Doctors are among the most educated professionals in the world. They have extensive training in biology, chemistry, biochemistry, microbiology, human anatomy and physiology, pathologies, and much, much more. However, after medical school it seems that these highly trained professionals forget the basics and don’t concern themselves with finding the cause of a medical problem when a pill will get the patient on his way so he or she can move onto the next patient. After all to make any money these days under our health insurance system, doctors have to treat a bazillion patients every day – there is no time to spend with you.

Every medical problem has an underlying cause. If your back hurts there is a reason. If your leg is swollen there is a reason. If you are getting headaches there is a reason. Many doctors no longer spend the time looking for these reasons. They don’t even try when a pill will appease the patient and at least partially alleviate his symptoms.

I could go on and on about the unnecessary dispensement of prescription drugs and the lack of diagnose by doctors. I have dozens of examples from clients.

The point of this post, however, is this: you need to take charge of your own heath care and demand the answers you need. We need to stop pretending we are satisfied when the doctor gives us a prescription. Demand answers!

Why is my back hurting? Maybe, you have a bulging disc, week hamstring muscles, a compressed nerve, etc. Once you know the cause you can find a real treatment.

Why is my child always sick? Maybe she is allergic to something in your home? Shouldn’t your doctor help you find out instead of constantly giving your child an antibiotic without also working on finding the source of her constant ear infections?

Ask the questions and find the route cause of your problem. If your doctor cannot or will not spend enough time with you, you should consider changing doctors. Ask to see a specialist, physical therapist, massage therapist, etc. Ask to get blood work or other lab tests done. This is especially important if you have a chronic problem – one that is recurring or won’t go away. It may not be practical to spend the time and money to get to the route cause of your one time back ache (taking a pain killer might been an acceptable solution for a week or so), but if you have chronic back pain don’t you deserve an answer?

Remember this is your responsibility as much as your doctors. If you go in expecting, or even demanding, a prescription from your doctor, that is probably what you will get. If you go in looking for answers, you will have a harder road ahead of you, but the answers can be found. Medical Doctors usually get into medicine because they want to help people. If we show them that we want real help, we can help them change the system and get back to the basics – diagnose and find a cure.


The Killer TENS Belt

Have you ever considered using electricity, in the form of a TENS Belt, to tighten those muscles? If so you might want to think again. TENS, which stands for Transcutaneous Electrical Nerve Stimulation, is a method of treating pain used by physical therapists. However, America being what it is, this medical device has made its way to the general public in the form of a TENS Belt which is used to tighten abs without working out. You can even tighten those abs while watching TV – or so the ads go.

My article today is about a client of mine who used such a device with unexpected results. Last week she called the spa to make an appointment with me for a Neuromuscular Massage Treatment because she was getting severe pain in her left leg. She had seen her doctor the previous day for the pain and he diagnosed her with phlebitis (an inflammation of a vein). My assessment of her leg showed extreme sensitivity to pressure (the slightest touch caused severe shooting pains) and hypertonic (tight) muscles in the adductors (inner thigh muscles) and gluteal areas.

I work on clients daily with pain caused by a vast variety of reasons, however, I had never seen anything quite like this. If my client did not just come from her doctor I would have recommended that she see one. However, something else was different this time. My client told me she had been using a TENS belt. Obviously, I have no clinical evidence of this, however I believe, and her doctor has subsequently agreed, that there is a high probability that the TENS belt over stimulated the client’s nervous system causing her symptoms. I was able to release the muscles in the area and calm the nerves down using heat and ice, however, that was not the end of it. Her pain in her leg was gone, but pain in her abdominal area started.

It is still not clear what is causing this pain but she did find out something new yesterday about the TENS belt. Hidden among its approximately eight pages of warnings – warnings which include such things as don’t put this belt around your neck – was a warning relevant to her: Don’t use this device if you have a hernia. Due to the vast number of warnings, many of which were simply ridiculous or common sense, she had missed this one. My client was diagnosed with a hernia about two years ago.

Whether or not her pain is related to using the TENS belt with a hernia, or whether it just over stimulated her abdominal muscles or nerves is not clear. Again, we do not actually have clinical evidence that the TENS belt caused all of this – maybe it was all a huge coincidence.

So what is the point of this whole post? Well the point is this. There are no safe shortcuts to fitness. The further you move away from simple mainstream exercises by adding electronic devices, taking wonder supplements, using a 3 minute a day super exercise routine, or whatever, the more careful you have to be. Every warning must be read in detail, and the device, supplement, or routine should be discussed with your doctor and/or someone with the training to understand the new fangled exercise enhancer you are considering using.

Better yet, just stick to the simple stuff. Sit ups, push up, and squats may not be sexy but you can do them while watching TV if you want. They will get you in shape in a healthy and natural way. If you are struggling with getting in shape, invest that money you where going to spend on QVC in a session with a personal trainer. He can show you how to tighten those abs safely – lets save the electricity to power your iPod while on the treadmill.

Hawaiian Experience Spa Web Site


Too Far Gone for Physical Therapy

By: Steve Ibach

I am treating a client who came to the spa with severe and debilitating pain in the left gluteal area. She was in constant pain and could not perform many regular everyday activities. Upon assessing her muscle condition I could immediately tell there was an extreme imbalance between various muscles that act on the hip area. Some muscles were severely hypertonic (overly tight) and others were hypotonic (less tone than normal). This imbalance was causing postural abnormalities including elevation and anterior rotation of the hip among other areas.

After a few minutes of working on the client and discussing her condition and background a little more, I suggested she speak with her doctor about seeing a physical therapist. Although I was certain that massage therapy techniques would be a great help to her, and perhaps alleviate her pain completely in the near term, the client also needed strengthening of the hypotonic muscles to help correct some of her symptoms. Although I have no problem recommending general exercise to clients, physical therapists are the appropriate health care professionals to work with when seeking specific rehabilitation exercises.

So that brings me to the whole point of this post. According to my client, her medical doctor told her she “was too far gone for physical therapy”. This is not a joke? In my opinion my 75 year old mother who had heart valve replacement surgery is not too far gone from physical therapy. What does that even mean? Is the doctor saying death is imminent? My client is in her 30’s – 40’s. Instead her doctor thought it was better to give her cortisone shots! Cortisone shots, while they are useful under some circumstance, are much more invasive then physical or massage therapy. They have many possible side effects.

Why would a doctor recommend such a course of action? Certainly he will make more money from the insurance company giving her cortisone shots compared to giving her a referral. Did he really believe that was the best course for my client, before even at least trying physical therapy?

This is an example of a failure of our medical system. Family practice Medical Doctors, whom I greatly respect as a group, are not the foremost experts in the musculoskeletal system. This client should have been referred to a massage therapist, physical therapists, or another medical doctor who specializes in this type of condition.

My client has seen me for a few weeks in a row and is now greatly improved. The debilitating pain is gone and she is beginning to do normal activities again. Despite the fact that she was “too far gone for physical therapy” she has started an exercise program of her own to strengthen her muscles.

Regardless of how we improve the medical system, there will always be some doctors, physical therapists, nurses, massage therapists, etc. who give bad advice. My recommendation is to not accept everything your healthcare provider says as absolute fact. Educate yourself on your condition, speak with a variety of people, get second opinions, etc. Your healthcare is your responsibility and you cannot depend on your doctor to always be right. There are varying opinions among the most qualified physicians and specialists so always evaluate all your options – especially if an invasive treatment such as surgery, shots, or medication is recommended over physical therapy, massage therapy, etc.


Use Alternating Heat and Ice to Help your Muscles

Try this little trick the next time your muscles or joints are sore – alternate heat and ice. Apply three minutes of heat, followed by one minute of ice to the affected area. This technique forces blood in and out of the capillaries bringing nutrition to the affected muscles and flushing waste out of the affected area. You can use this technique 1 – 3 times in succession, then repeat it every few hours if desired. If your feet or ankles (or hands/wrists) are sore you can use a big bucket of hot water and a big bucket of ice water. Dip your foot in the hot water for three minutes then in the cold water for one minute. Always end in the cold and don’t make the heat so hot that you burn yourself! Always use common sense. If you have any serious medical condition, are in poor health, or have any diagnosed condition effecting the area (such as tendonitis, arthritis, etc.), consult with a medical professional before performing any self therapy.


Welcome and Mahalo for reading my blog

By: Steve Ibach

As a massage therapist with a strong medical focus I encounter many interesting questions and stories regarding health, fitness, and the general state of our medical system. People with chronic pain and other symptoms that have been through the medical system (sometimes for years) finally end up, often by accident, seeing me or another therapist on our team. Using neuromuscular and other advanced massage techniques, along with common sense and general health advice, we are often able to provide relief to their symptoms that they have not found elsewhere. We have hundreds of client testimonials attesting to this fact.

The purpose of this blog is to share my knowledge and incites on health, fitness, and pain relief and to share as many helpful tidbits of information as possible. I will explore where I believe the medical system has failed (based or my client’s experiences) and where it is succeeding, and what you can do to help yourself when you encounter a medical problem – especially one involving any type of pain. I will also post tips on general fitness, weight loss, anatomy and physiology, and much more.

All information provided in this blog is obviously general in nature. Nothing posted by me is intended to diagnose, treat, prevent, or cure any disease. I have a strong appreciation for the education and training of health care professionals in all fields of scientifically based medicine and believe that everyone should work with a qualified physician in managing their own health care.

I am not a doctor, but that really is the whole point of this blog – exploring heath and fitness from a different perspective. My greatest hope is that the information I am able to provide will help people have a healthier, happier, and more pain free life.


Weight Loss Quick Tip

by: Steve Ibach

Build muscle tissue and burn more calories even when you are not exercising. It is absolutely true that muscle tissue burns more calories than fat, even when you are not active. That means if you can increase the amount of muscle tissue in your body, compared to the amount of fat tissue, you will burn more calories every minute of the day just to maintain your body’s systems.

How do I do this? Add weight lifting to your exercise routine in the right proportions and you will build muscle tissue and lose fat tissue without building huge muscles. Simply starting a weight lifting routine where you do 20 repetition of each exercise at the heaviest weight you can properly handle and still do 20 repetitions. Then work out those muscles twice a week until you can do 25 repetitions. Once you can do 25 reps, increase the weight so you can only do 20 reps again. This routine will build muscle tone (not bulk) and will help you lose weight along with a proper diet.

Always consult a doctor before starting an exercise routine and seek professional training on how to properly perform weight lifting exercises.