Frequently Asked Questions

Where Will My Massage or Bodywork Session Take Place?
Who Will Perform the Massage or Bodywork?
What is your cancellation policy?
Must I Be Completely Undressed?
Will the Practitioner Be Present When I Disrobe?
Will I Be Covered During the Session?
What Parts of My Body Will Be Massaged?
Why do I need to drink water after my massage?
What Will the Massage or Bodywork Feel Like?
Are There Different Kinds of Massage and Bodywork?
How Long Will the Session Last?
Why should I care if a massage therapist is licensed?
What Should I Do During the Massage or Bodywork Session?
How Will I Feel After the Massage or Bodywork Session?
What Are the Benefits of Massage and Bodywork?
Are There Any Medical Conditions That Would Make Massage or Bodywork Inadvisable?
Will I be completely covered during my massage or will I be nude ?
Does health insurance cover massage therapy?
Will I be oily after a massage?
Is it safe for anyone to get a massage?
Why should I get a massage?
Is all massage the same?
Will massage cause any discomfort?
Can massage really reduce stress?
How does massage lower blood pressure?
How does massage effect the immune response?
What do I wear while getting a massage?
Will there be a (sexual) release?
How is the massage done?
How often should I get a massage?
Here are some useful questions you may want to ask before going to a massage
Here are some tips for during the massage:
Here are some tips for after the massage:
What is infant massage?
What causes headaches?
How do I recover from an injury?
Why does my hand go to sleep when I put my arm over my head?
What causes low back pain?
Why do women have more hip problems than men do (Including Hip Replacement Surgeries!)?
How does the shoulder work?
What muscles can cause pelvic or lower abdominal pain?
What are the pain referral zones of the Posterior Neck Muscles?
What are the muscles of the posterior neck?

Where Will My Massage or Bodywork Session Take Place?
Your massage or bodywork session will take place in a professional office, Prairielands Chiropractic Clinic, 300 W. Broadway, Suite 712, Council Bluffs, IA 51503.  Your session will be done in a warm, comfortable, quiet room. Soft music will be played to help you relax. You will lie on a table especially designed for your comfort.  


Who Will Perform the Massage or Bodywork?
Your session will be conducted by a professional who has received proper training - Shamani Langille, M.A., Ed., LMT, NCTMB.  She graduated from one of the best massage schools in the country.  She has 850 hours of massage school training, taken additional training, and works alongside Chiropractor Dr. Tonweya Langille.  She is committed to continuing her education in the massage field with different techniques to better serve her clients' needs.  

Iowa does have state licensure.  Shamani has an Iowa State Massage Therapist License.  Iowa has very strict rules and requirements governing massage.  You must complete 500 hours of massage school (S completed 850 hours!), take the National Exam, and also complete 24 hours in continuing education every two years to renew your license.  This is to protect the consumer.  She is also nationally certified. For more information on national certification, click here.
 

What is your cancellation policy?
Please understand that your time commitment begins at the moment you reserve a massage.  In order to make it fair for everyone, please consider your schedule carefully and don’t commit to a time that you feel may be questionable.  There are times when a cancellation is, of course, necessary; but please give advanced notice whenever possible.  Missed or cancelled appointments (medical emergencies excluded) without four (4) hour notice will be charged in full for the missed session.
 

Must I Be Completely Undressed?
Most massage and bodywork techniques are traditionally performed with the client unclothed; however, it is entirely up to you what you want to wear. You should undress to your level of comfort.  You will be properly draped during the entire session.  Only the area being worked on will be exposed.
 

Will the Practitioner Be Present When I Disrobe?
The practitioner will leave the room while you undress, relax onto the table, and cover yourself with a clean sheet.
 

Will I Be Covered During the Session?
You will be properly draped at all times to keep you warm and comfortable. Only the area being worked on will be exposed.
 
What Parts of My Body Will Be Massaged?
You and the practitioner will discuss the desired outcome of your session. This will determine which parts of your body require massage.  A typical full body session will include work on your back, arms, legs, feet, hands, head, neck, and shoulders.  You will not be touched on or near your genitals (male or female) or breasts (female).
 

Why do I need to drink water after my massage?
It is important to drink a lot of water after a massage.  Massage helps to push toxins out of your muscles and into your lymphatic system to be removed as waste; drinking water after a massage aids in the flushing of the lymph system and the removal of these toxins.  Remember it is essential to drink adequate amounts of water at all times, not just after a massage.

Consider these other important water facts:

The human body is made up of about 66% of water.

75% of the human brain is water; 83% of the blood is composed of water; bones are made of 25% water; 70% of your skin is water and 70% of your lean muscle tissue is water.

Water plays many roles in the human body—it acts as a solvent, carries nutrients and oxygen to cells, aids in temperature regulation, provides
lubrication and shock protection for joints, participates in chemical reactions, protects organs and tissues, and removes waste.

The body’s thirst signal is an indication that it is already dehydrated.

Mild dehydration (<5% loss of body weight) can account for lack of energy, weakness, muscle soreness, rapid pulse and rough, dry skin. Water losses of 9-12% total body weight can be fatal.

With strenuous exercise the body can lose 2 quarts of water per hour. If fluids are not replaced, the body’s cells will lose water, which will lead to dehydration and overheating.

An average adult needs to drink a minimum of 64 ounces of water per day. Coffee, soda pop and alcohol are dehydrators. For every glass of these beverages that you drink, you need to drink an extra glass of water to compensate.

You can survive a month without food, but only 5-7 days without water.

Are you drinking enough water?

 

What Will the Massage or Bodywork Feel Like?
It depends on the techniques used.  Many massage therapists use a form of Swedish massage, which is often a baseline for practitioners. In a general Swedish massage, your session may start with broad, flowing strokes that will help calm your nervous system and relax exterior muscle tension.  As your body becomes relaxed, pressure will gradually be increased to relax specific areas and relieve areas of muscular tension.  Often, a light oil or lotion is used to allow your muscles to be massaged without causing excessive friction to the skin.  The oil also helps hydrate your skin. You should communicate immediately if you feel any discomfort so that another approach may be taken. Massage and bodywork are most effective when your body is not resisting.


Are There Different Kinds of Massage and Bodywork?
There are numerous types of massage and bodywork; various techniques utilize different strokes, including basic rubbing strokes, rocking movement, posture and movement re-education, application of pressure to specific points, and more. 
 

How Long Will the Session Last?
The average full-body massage or bodywork session lasts 60 minutes.  A 30 minute appointment only allows time for a partial massage session, such as neck and shoulders, back or legs and feet. Many people prefer a 60- to 90-minute session for optimal relaxation. Always allow relaxation time prior to and after the session.  Hot tubs, steam baths and saunas can assist in the relaxation process.
 

What Should I Do During the Massage or Bodywork Session?
Make yourself comfortable.  The practitioner will either gently move you or tell you what is needed throughout the session (such as lifting your arm).  Many people just close their eyes and completely relax.  Others like to talk during their session.  Feel free to ask the practitioner questions about massage and bodywork in general or about the particular technique you are receiving.
 

How Will I Feel After the Massage or Bodywork Session?
    These are several theories, none of them with universal support, about the exact physiological cause of this delayed onset muscle soreness (DOMS). An old theory suggests that excess lactic acid in the muscle is the cause of this soreness. However, studies conducted by exercise physiologist, Dr. George A. Brooks, have concluded that “lactic acid does not cause muscle soreness, fatigue or the “burn” of intense exercise.” Nor does it cause post-massage soreness. While excess lactic acid is typically present in sore muscles, it is not the cause of the soreness itself.
    More research must be conducted before the exact mechanisms can be determined, but it is most commonly believed that post-massage muscle soreness is due to tight muscles having been stretched down correctly, and/or deep pressure having been applied to an injured muscle to release spasm. All such procedures help muscles to relax and heal. However, they can also cause muscled soreness the next day. This delayed onset muscle soreness is not unlike what a person experiences after intense exercise.
    Any time muscle tenderness occurs, place one cup of Epsom salts in hot bath water. Soak for 20 minutes and follow with a cool shower. (This soak/bath is contraindicated for anyone with cardiovascular problems or any other condition that might respond negatively to forms of heat therapy.)


What Are the Benefits of Massage and Bodywork?
Massage and bodywork can help release chronic muscular tension and pain, improve circulation, increase joint flexibility, reduce mental and physical fatigue and stress, promote faster healing of injured muscular tissue, improve posture, and reduce blood pressure. Massage and bodywork is also known to promote better sleep, improve concentration, reduce anxiety and create an overall sense of well-being. Click here for more details on the benefits of massage.
 

Are There Any Medical Conditions That Would Make Massage or Bodywork Inadvisable?
Yes. That's why it's imperative that, before you begin your session, the practitioner asks general health questions. It is very important that you inform the practitioner of any health problems or medications you are taking. If you are under a doctor's care, it is strongly advised that you receive a written recommendation for massage or bodywork prior to any session. Your practitioner may require a recommendation or approval from your doctor.
 

Will I be completely covered during my massage or will I be nude ?
For a Swedish or neuromuscular massage session, you should be completely draped, with the exception of the part that is being worked on. We use sheets (or very large bath towels) for draping ALL clients. We assure you that your complete privacy will be preserved at all times. You will have the opportunity to undress to your comfort level and get under the sheet while the massage therapist is out of the room washing hands and preparing for the session.

For the nudist and 'free body' inquirers, there are no exceptions to this policy. There is only ONE form of bodywork that we know of where the draping requirement can be much looser (depending on the practitioner) and that is Esalen massage. Please visit the Esalen Massage & Bodywork Association website or the Esalen Institute website for more information on their services.  ALL other forms of bodywork will either require you to be under a sheet, large towel or in some cases leave all of your clothes on (for instance with Thai Massage, Shiatsu, chair massage, etc.).
 

Does health insurance cover massage therapy?
The answer to this question is - it depends. Some health insurance companies are starting to offer massage therapy as a discounted service while a few others will cover massage therapy for medical reasons if you have a physicians referral. The best thing that you can do is to check your benefits manual, call a representative for your health insurance, or possibly even ask your doctor.  There are times that Dr. Tonweya Langille, D.C. prescribes massage.  Depending on your insurance, you may need a physical therapist or chiropractor to perform the massage.  However, some insurance companies allow a licensed massage therapist to perform the massage.

     Discounted service - That means that instead of paying a co-pay, you are required to pay, in full, for the session at the time of your appointment minus the discount that the massage practitioner has agreed to give participants in your health plan. For instance, let's say you are a member of the ABC insurance company and ABC insurance company offers a 15% discount on massage therapy. The massage therapist that you see has a normal rate of $75 per hour, so you would just pay 15% less than $75 at the time of your appointment.

     Physician referral - This is where things can get a little tricky. Issue number one is that your insurance has to cover massage therapy as an approved modality. Many companies still see massage therapy as experimental. Issue number two is that most massage practitioners will not file this for you. They will give you a receipt or a 'superbill' that you can file with your insurance company for reimbursement. Why? Because just because your insurance company says that they will cover the payment for your massage sessions does not mean that they actually will once the bill comes in. Why would they approve it over the phone and then not pay? We have absolutely no idea.

     Note: Many massage practitioners are vehemently against taking insurance for massage therapy. Why? Some of them come from other medical professions where they feel that health insurance has ruined the quality of care for the patients through their restrictions, treatment guidelines, etc.. As they say, he who pays the bill makes the rules. This is still under quite a heated debate in the massage profession. Ask your massage therapist if they have an opinion about it. We can almost assure you that they do!
 

Deeper styles of bodywork (such as neuromuscular massage therapy or deep tissue require less lubricant so that the therapist can work deeper into the tissues. Lighter styles such as Swedish massage generally require more lubricant because the stokes glide over the body a lot more.

There are a couple of things you can do however. Ask your therapist BEFORE beginning the session what types of lubricants they have. Every therapist we know keeps several choices: lotion, oil, creme, and perhaps even powder. You can request a particular type of lubricant if you would like. If that is just absolutely not possible, ask them if they can provide you with a towel so that you may thoroughly wipe down after your session.
 

If you have certain health conditions, they could be aggravated by massage therapy, so always make sure to inform your massage therapist or bodyworker about what is going on with you and your body. This includes letting them know about any medications that you might be taking at the time. If either of you have your doubts, a quick call to your physician should clear things up. Most massage therapists even keep a pathology book (or several) in their office that they can refer to for situations just like this.

Remember, a massage therapist or bodyworker is considered a health care professional. There is no reason to keep any of your medical information from them and it is very important that you don't. Don't ever underestimate anything.
 

Why should I get a massage?
Almost everyone will enjoy the positive effects from receiving a massage. The benefits are numerous for people of all ages and activity levels. Therapeutic massage feels wonderful and is very healthful.  Click here for more details on the benefits of massage. 
 

Is all massage the same?
No. Therapists use many different methods, and individual styles vary. Therapists also have different levels of training and talent. Massage is a very personal service and should be adjusted to suit each client's needs.  Click here for more information on the types of massages we offer.


Will massage cause any discomfort?
Massaging healthy tissue feels very good. Some deep tissue massage to areas of trauma or inflammation might be uncomfortable, but should never be extremely painful. Trained therapists know how to minimize discomfort while accomplishing the greatest amount of relief.


Can massage really reduce stress?
Absolutely! We all experience tension and stress in many different aspects of our lives, and people react negatively when under constant pressure.


How does massage lower blood pressure?
Continued high levels of stress increase blood pressure, so by relieving this stress blood pressure too may be affected. There are physiological and psychological responses to therapeutic massage that enhance our abilities to adjust, cope and gain control over stimuli that would otherwise be overwhelming.


How does massage affect the immune response?
The manual aspect of therapeutic touch serves to push toxins and debris out of muscle tissue and into the lymphatic system faster. The lymphatic system works very hard to rid the body of toxins, infection and debris such as dead cells.
 

What do I wear while getting a massage?
Clients should be allowed to be as dressed or undressed as they feel comfortable, however they should always be covered with a sheet or draping. Less clothing is usually preferable as the client will be less constricted and the therapist will not have to be concerned with lubricants staining clothes or massage strokes shortened by waistbands, bra straps etc.
 

Will there be a (sexual) release?
NO!!. This is therapeutic massage. The genital area is never addressed in any type of therapeutic bodywork.


How is the massage done?
The massage is done on a specially designed table, using hypoallergenic massage creams.

How often should I get a massage?
How you feel and how much you can afford will decide this. Most of our regular clients come in about every two weeks. Some more often, and some less often. You will be the best judge of your own needs.
 

Massage Tips
If possible, rest or take a walk after a massage to allow some time to adjust to your new relaxed state. We find this helps get the most out of a massage.
 

Here are some useful questions you may want to ask before going to a massage:

• Is this type of bodywork done fully clothed?
• How much does it cost?
• How long are appointments?
• Are you willing to do this work at my house?
• Do you have a waiting room?
• Is this a non-sexual type of massage?
• Is this a gentle massage?
• What is your cancellation policy?
• Do you use scented oil? What type of oil do you use? (Note: some massage such as Thai do NOT use oil.)
  Different types of oils can really affect a massage. If you have sensitivities to smells, be sure to ask for unscented oils or oils that agree with you. Some oils have herbs (lavender is very common for relaxation). Others are said to have healing properties such as Emu oil. Depending on what works on you, you may request specific types of oils or bring your own.
   

Here are some tips for during the massage:

• If the massage is too light or too hard, ask to have the pressure changed. Some massages are only light (Rosen, Feldenkrais, etc.) but asking is appropriate.
• If you are uncomfortable (need heat turned up, less blankets, light moved), say something.
• Tell the practitioner where you hurt. This way the massage can focus on where you need it most.
• Spending time during the massage being grateful can help one make huge changes.
• Often breathing deeply can help you get the most out of a massage. Breathe into every cell of your body.
• Combining either aromatherapy or flower essences can enable even more change if so desired.
   

Here are some tips for after the massage:

• Drink lots of water. This helps the body flush out toxins that you were able to release during the massage.
• Plan to take the first 20 minutes after a massage lightly. For example, go on a short walk or sit quietly. This allows the massage to settle into the body.
• After many massages, a nice warm bath, sauna, steam room or jacuzzi  is very refreshing. 
   

What is infant massage?
A Holistic Approach to Infant Health

Infant Massage is a holistic and natural way to promote infant health, improve parenting skills, deepen bonding, strengthen family bonds, and to create a future generation that is more caring and compassionate.  Infant massage incorporates  nurturing touch, massage, and reflexology in a loving, fun, one-on-one interaction that is nourishment for baby's  healthy development of mind, body and spirit. Vimala McClure, founder of the International Association of Infant Massage, Tiffany Field, Ruth Rice, and Ashley Montagu have contributed to the body of knowledge and growing interest in infant massage and nurturing touch.   Research shows that infants benefit psychosocially, developmentally, and physiologically with infant massage.  Cultures practicing infant massage have adults that are less aggressive and violent.  Infant massage is easily learned.  Information for Premature Infant Massage Instruction and Certification is  available.  

Most headaches are caused by trigger points in the neck and head.

We have had many clients tell us what causes their headaches: sinuses, food, coffee, odors, hunger, lack of sleep - the list goes on. But no one can tell us how these things cause headaches. That is, what actually mediates the pain, or makes a link between the causal factor and the pain itself. Obviously there is still much information missing. But in most cases, the pain itself comes from trigger points in the neck and head. And pain from trigger points in the neck and head can be relieved by releasing those trigger points.

There are three categories of headache people (oversimplifying):
severe headache people
ordinary headache people
no headache people

No headache people may have very tight, even painful, muscles in their necks, but they seldom if ever get headaches.

Ordinary headache people are people who get a headache now and then -- perhaps once or twice a month -- which is seldom severe enough to interfere significantly with work or activities, and which usually responds to over-the-counter pain relievers.

Severe headache people suffer tremendously. Not only do they suffer from the pain of the headaches, which is often disabling, but they suffer from loss of work, loss of the pleasure of leisure activities, and sometimes the thinly disguised impatience of others who don't understand what they're going through.

Medical authorities have studied and categorized severe headaches to a high degree. I am certainly not an expert on the medical classification of headaches and their symptoms, but I suggest that, in addition to whatever regimen a patient's physician may prescribe, massage therapy (particularly along the lines of neuromuscular or trigger point work, is well worth a try. Soft-tissue pain can mimic the symptoms of many disorders, and can also contribute to pain from other causes. In addition, many people engage in self-diagnosis. The word "migraine" has come to mean "a really, really bad headache" to many people. My professional experience is that massage therapy can often relieve a wide variety of headaches -- even migraines, even when medically diagnosed as such. And it is risk-free.

Before we can intelligently discuss headaches, it is imperative that we understand what type of headache we are addressing. There are three types of headaches. First, there are tension headaches, which account for over fifty percent of all primary health care providers' visits. Second, there are sinus headaches, which are attributed to allergies and the flu. Third, and the most serious of all headaches, migraine headaches.

There are as many reasons to experience tension headaches as there are personalities and lifestyles. Whether the cause is emotional or physical the result is the same, throbbing temples and mental discomfort. We are certainly not at our creative best when our head hurts. Massage addresses tension headaches by relaxing the neck and shoulders. As we relax, we soften our muscles and headaches disappear. These are the easiest headaches for us to address.

Sinus headaches are best addressed by face massage. As the sinus cavities become relaxed, the fluids that are trapped in these spaces release and begin to flow, allowing us to drain and cleanse the sinuses. This is a slow process and usually takes a few massage sessions. Between massages, you will find relief with a few minutes of self-massage done on a regular basis.

Migraine headaches can be caused by either impingement of the nerves in the neck or by chemical imbalances. Massage can address the impinged nerve problem by releasing the Levator Scapula Muscles. It is often necessary to address either the left or right Levator muscle for several hours to achieve complete relief. Be sure to ask your massage professional if they have had experience eliminating migraine headaches. You will probably need to shop around a bit to find a massage professional who is willing to work just one muscle for two hours at a time.

Headaches cripple our ability to function optimally and are probably the most common form of what could be called discomfort. Now is a good time to allow a massage professional the opportunity to rid you of your headache discomfort naturally.

Splenius capitis (neck pain, headaches)

Splenius capitis originates on the transverse processes of the cervical vertebrae and inserts at the base of the skull. Trigger points in splenius capitis typically refer pain to the top of the head. Other adjacent and overlapping neck muscles refer pain to other parts of the head.

Translation: "Splenius capitis" means "bandage of the head." It attaches below to the sides of the vertebrae of your neck and above to the base your skull. Trigger points in this muscle can cause pain (headache) at the top of your head. It is one among many overlapping neck muscles that can cause headaches.

In your life, you may know individuals who have been injured who have never completely recovered from their injury. They still walk with a limp, or their posture is distorted, or they may still have pain or stiffness. If you see them in an athletic setting, you may notice that they may not move as well as before or that they may be prone to re-injury.

What does it mean?    To answer that question, we should take a look at what happens in an injury situation. Whether the injury occurred in a sports situation, in a vehicle accident, or on the operating table, similar things happen.  Number one is tissue damage. Bones get broken, ligaments get sprained, tendons get strained, muscles get torn, skin gets cut, etc. The usual stuff of injuries.

Tissue damage heals. So why do the effects linger?    Adhesions and Trauma Reflex.  

One commonly advanced explanation is “adhesions”.  Adhesions are the body’s way of bandaging itself. Layers of connective tissue become “glued” to one another during the healing process, and that gluing restricts movement-especially desirable during healing.  Adhesions can easily be freed by massage, and those who have received physical therapy after an injury often receive massage -  especially athletes.  Why, then, do the effects of injury remain?  Here is where the number two explanation comes in, and it is at least as significant as the first: People cringe during and after injury and guard the injured part during healing. That action of cringing, known as “Trauma Reflex”, is a muscular act that often becomes a protective tension habit maintained as a learned response stored in the brain.  Such a tension habit prevents a person from moving as freely after injury as before; more than that, it predisposes the tense muscles to contract first and to relax last in times of stress. It prevents full recovery from injury and may predispose a person to further soft-tissue injuries. More than that, the heightened tension in those muscles creates muscle fatigue and soreness—lingering pain.  Failure to release the cringing response predisposes one to further injury and creates the sensation of lingering injury.

Releasing the Cringing Response (Trauma Reflex) The cringing response cannot be released by tissue manipulation because it doesn’t originate in the tissue; it originates in the brain.  The brain is largely an organ of learning or conditioning. Unlearning it can only end the cringing response.  The idea of “unlearning” is an odd one. We are used to thinking of learning, of gaining new abilities. But consider this: every time you learn something, you unlearn something else; that is, you cease to do things the way you used to do them.

Since habitual cringing is a learned action, a learning-based approach is necessary for complete recovery from injury. The term for this type of bodily learning approach is “somatic education”. The word, “somatic” has to do with the experience of the body from within. That kind of experience is familiar to all of us-we have it when chewing, yawning, and in fact in any kind of action we control by feel. The word, “education” means “the development of greater competence or ability”. Somatic education increases ones control over ones own body. It is just that which is needed to release the cringing response.

For a more technical look at therapeutic methods of addressing the residual effects of injuries and a comparison to somatic education, read A Functional Look at Back Pain and Treatment Methods.
 

Why does your hand go to sleep when you put your arm over your head?
If there is any shortening or tightness in pectoralis minor, it can entrap the brachial nerve when you put your arm over your head. This can cause numbness in parts of your forearm, hand and fingers. Where the numbness occurs depends on what part of the nerve is entrapped. Pectoralis minor is fairly easy to treat in clinical massage therapy.

 

What causes low back pain?
As any neurosurgeon, orthopedist or chiropractor will tell you, there can be many, many sources of low back pain involving vertebrae, intervertebral disks, and nerves. They will all point out some of these problems on your x-rays, surgeons will be delighted to operate on you for them, and chiropractors will be more than happy to manipulate them for you. But there are two things that are seldom acknowledged:

1)  The anomolies of the spine seen on x-rays -- bulging disks, slipped disks, herniated disks, bone spurs, calcium deposits, subluxations -- may or may not be the cause of your pain. They are fairly common, even in people who have no pain at all. It is very tempting, when there is pain, to fix on some abnormality found in diagnostic images and assume that it is the cause of the pain. But in any given case, that may or may not be true.

2) Most low back pain originates in the soft tissues.
In any case, whether one's back pain is muscular or vertebral in origin, the basic rule remains: first do no harm. It only makes sense to begin with the least risky, least invasive treatment available, then escalate if necessary. And that treatment is medical massage therapy. If it isn't effective, the other treatments are still available. But if it is effective, a lot of time and pain and risk and money have been saved.

Low back pain caused by soft-tissue problems is likely to originate in one (or more) of three different locations:

1) Quadratus lumborum and its neighbors. Quadratus lumborum is the muscle between the bottom rib and the top of the pelvis; it is a key muscle in coordinating upper and lower body movements. It is a deep muscle, and is situated underneath (deep to) the lumbar paraspinal muscles. If there are problems in quadratus lumborum, there are also likely to be problems in those thick muscles near the surface on either side of the spine. In addition, muscle problems are invariably accompanied by connective tissue problems. This area, unprotected as it is by any skeletal structures, is thick with connective tissue: the thoracolumbar fascia, the gluteal aponeurosis, and other tough connective tissue cover and surround these muscles.

2) The buttock muscles. These include the three gluteal muscles (gluteus maximus, medius and minimus), and the deep lateral rotators of the hip, especially piriformis.

3) Iliopsoas. This is the primary hip flexor (its chief assistant being rectus femoris), running down through the abdominal cavity and the groin to the lesser trochanter. But its origins, meaning in this case its anchor points, are the inner surface of the ilium (iliacus muscle) and the transverse processes of the lumbar vertebrae -- which means that every lifting of the leg pulls on the pelvis and the lumbar spine.

Certainly other muscles can and do get into the low back pain act, but these three muscle groups, all very heavily involved in the day-to-day demands we make on our bodies, are the chief sources. Careful examination by a skilled and knowledgeable clinical massage therapist can find the trouble spots, and appropriate treatment can yield relief that many people had despaired of finding.
 

Why do women have more hip problems than men do (Including Hip Replacement Surgeries!)?
Little girls - probably because it’s considered a "cute" posture - tend to stand with their tummies out. They do that by tilting their pelvises forward. Reinforced by admiring grownups, this posture tends to stick, so that most girls and women have more forward pelvic tilt that boys and men do - anywhere from 5º to 20º more. And things that some women do, such as wearing high heels, tend to increase that tilt.

SO WHAT’S THE PROBLEM?
The problem is that, at that angle, the head of the femur (thighbone) doesn’t sit properly in its socket, so, to begin with, the muscles that stabilize the hip have to work overtime, resulting in hip, buttock, low back, abdominal, pelvic, sciatic or other pain. Secondly, this odd angle, with tightened hip muscles, is likely to cause increased wear in the hip joint, leading to arthritic conditions and possibly the need for hip replacement surgery. In addition, that forward tilt is hardly an ideal angle for easy childbirth.

SO WHAT’S THE SOLUTION?
The solution is posture therapy. When the soft tissues — muscles and fascia — that are holding the body in this unfriendly alignment are released, the pelvis can move into a more natural and relaxed position, allowing the hips to work as smoothly and easily as they are meant to.

If you would put braces on your daughter’s teeth to give her a nice smile, what about posture therapy to give her a better looking, better functioning and longer-lasting body?
 

According to the American Medical Association, more than half of all visits to physicians are for stress-related complaints. In an interview in the Massage Therapy Journal, expressing the view that " Examining lifestyles with an eye to prevention is a key focus for good health," internationally known research pharmacologist and professor, Dr Candace Pert, said: "I think we could replace 90% of mainstream medicine with a weekly massage . . ." And, explains Bruria Ginton, LicMT, founder, MT WEB CENTRAL: "With MT already being one of the three most used alternative forms of healthcare, a growing number of serious MTs and consumers have been promoting the meaningful, democratic regulation of an expanding, revitalized ancient healing art which proves to be THE link between conventional Western and traditional Eastern medicine."

If you ask, "Why should I care about a professional license?" it is because a state professional license exists for the protection of the consumer. It demonstrates that a health professional is not merely a self-proclaimed healer, but someone who has passed a test of proficiency and is committed to a set of professional standards and regulations. An MT license is more likely to usher in badly needed insurance reimbursements for legitimate, physician-prescribed MT services and to generate research funding. As Dr Candace Pert puts it: ". . . it is tragic that there is a huge potential for what is considered enlightened or complementary medicine, and yet the research that is being done on it is still so small." Clearly, therefore, when seeking any form of MT or "bodymind healthwork"--Asian, European, American, ancient, recent, deep, light, etc-- in states under an MT law, it is in the consumer's best interest to refrain from patronizing non-licensed individuals. For that matter, all such manipulation of soft-tissue is MT.

In the growing number of states in the USA which require an MT license, it is your right to see--not just to be told about--a valid professional license. A professional license is usually validated with a renewable Registration certificate. Such registration is issued by the state board for MT. Don't  be confused with an MT business license or all sorts of brand-name certificates, which are different from a professional MT license and registration. Professional licensing is a Public Policy matter. A note to your local government representative urging greater consumer health protection via an MT licensing law is, therefore, also helpful and highly recommended.

Iowa does have state licensure.  Shamani Langille does have an Iowa State Massage Therapist License.  Iowa has very strict rules and requirements governing massage.  You must complete 500 hours of massage school (Shamani completed 850 hours!), take the National Exam, and also complete 24 hours in continuing education every two years to renew your license.  This is to protect the consumer.  Shamani is also nationally certified.  For more information on national certification, click here.
 

How does the shoulder work?
It seldom occurs to us, if we knew it at all, that the arm and shoulder structure is attached to the rest of the body skeletally at only one joint: the sternoclavicular joint, which is the joint of the clavicle (collarbone) with the sternum (breastbone). That's those two knobby protrusions on the upper chest just under the throat. The only other connections of the arm and shoulder are by means of soft tissue -- muscles, tendons, ligaments and fascia. This design gives us tremendous freedom and range of motion in our arms and shoulders, but it also presents challenges and dangers for the soft tissues involved.

The shoulder muscles can be divided into two groups:

1. Muscles that act on the arm:
   Rotator cuff:
   • Supraspinatus
   • Infraspinatus
   • Teres minor
   • Subscapularis

   Pectoralis major
   Latissimus dorsi
   Teres major
   Deltoids

2. Muscles that act on the scapula (shoulderblade):
   Trapezius | Trapezius upper back & shoulder pain | Muscles of the posterior neck
   Trapezius neck pain referral zones
   Pectoralis minor
   Corachobrachialis
   Biceps brachii
   Triceps brachii
   Major and minor rhomboids
   Levator scapulae: Pain Referral & Therapy | Illustration of Internal Anatomy

The one muscle left over is the subclavius, which stabilizes the sternoclavicular joint. There are many other muscles which are in the region of the shoulder and which affect it, of course, but they are not, strictly speaking, shoulder muscles: serratus posterior superior, scalenes, serratus anterior, iliocostalis thoracis, etc.
 

What muscles can cause pelvic or lower abdominal pain?

• Rectus abdominis: this is the straight muscle that goes down the middle of the abdomen from the ribs and breastbone to the pubic bone. It can refer pain to the sides or middle of the lower abdomen, and within the abdomen itself.
• Obliquus externus abdominis: this muscle runs diagonally across the abdomen from the ribs down to the pubic region. It can refer pain to the side of the lower abdomen, down across the groin to the genital region, and even into the inner upper thigh. The pain may be deep, and may seem to come from the pelvic organs.
• Obliquus internus abdominis - a fan-shaped muscle underneath the externus muscle above, it has a similar pain referral zone.
• Quadratus lumborum: this is a muscle of the lower back, between the last rib and the crest of the pelvis. It can refer pain into the side of the lower abdomen and the groin.
• Pyramidalis: this is a small muscle in the center of the lower abdomen attaching to the pubic bone. It refers pain to that region.
• Iliopsoas: this is the hip flexor, attaching to the vertebrae in the lower back and the inner surface of the pelvis, then passing through the groin to the inner upper thigh. It can refer pain into the side of the lower abdomen and the groin.
• Coccygeus and levator ani - the muscles of the pelvic floor, of which these are two, form a kind of sling or hammock supporting the pelvic organs, anchored to the sacrum and coccyx (tailbone) in the rear, the ischial tuberosities (sitbones) on the sides, and the pubic bone in the front. The pelvic diaphragm, as it is called, has openings to admit the anus, the vagina and the urethra. These muscles also serve as sphincters (Greek for "band" or "lace", sphincters are muscles that control openings) for the anus, the vagina and the urethra. Trigger points in these muscles can cause pain over any or all parts of the pelvic floor region, as well as in and around the anus and around the coccyx. A skilled and knowledgeable massage therapist will be able to discuss the problem with you and suggest options for treatment.
• Obturator internus - this is one of the deep lateral rotators of the hip, and as such it is discussed elsewhere. But because it originates at the obturator foramen (that's that prominent hole in the pelvis just above the sitbone) and passes through the lesser sciatic foramen (an opening that lets the sciatic nerve through to the leg), this inner part of it can get very involved in pain problems in the pelvic floor region. The same note applies to this part of this muscle as to the coccygeus and levator ani, although this muscle is somewhat easier to treat.
• Adductor magnus - this is an adductor ("puller-toward") of the hip joint, which means it pulls the leg toward the center line. It attaches below along the inner part of the thigh-bone, and above to the pubic arch, which is an arch of bone going from the pubic bone above and in front to the sitbone (ischial tuberosity) below and behind. Trigger points in this muscle can refer pain into the groin and throughout the pelvic organs.
• Piriformis - this is the prime lateral rotator of the hip. "Piriformis syndrome" can cause pain in the low back, groin, perineum, buttock, hip and other areas, and can also cause dyspareunia (painful intercourse) and pain in the rectum during defecation. Piriformis problems are very diverse and very common, and fortunately respond very well to treatment in massage therapy.
• Iliocostalis thoracis - this is one of the erector spinae ("straightener of the spine") muscles, which are the superficial, or surface, paraspinal ("next to the spine") muscles. It attaches to the seventh cervical (neck) vertebra, and to the upper and lower six ribs. Besides referring pain up and down the back, it can cause pain in the side of the abdomen midway between the ribs and the pelvis that feels like internal abdominal pain.
• Multifidi - these are among the deep paraspinal muscles. They attach to the bony protrusions in the middle of the vertebrae and then diagonally cross two to four vertebrae to attach to the protrusions on the sides of lower vertebrae. They help to rotate the spine (although that job is done mainly by the abdominal muscles). In addition to areas of the back, those along the lower part of the spine can refer pain to the upper abdomen near the ribs and the lower abdomen near the groin. The multifidi are found the whole length of the spine; to see them in the neck area, go to Muscles of the Posterior Neck (below).
   

What are the muscles of the Posterior Neck?

What are the pain referral zones of the Posterior Neck Muscles? 


Note:  The red highlighted areas are the areas where pain will occur from the 
posterior neck muscles being tight.  This pain can be lessened and/or eliminated 
by massaging these muscles.