Category Archives: massage

Our Rehab Approach

This month, I wanted to offer an inside look into our approach to rehab at Corpo Kinetic.  While most readers of this blog are most likely familiar with Pilates and the benefits it can offer to core strength as well as overall fitness and flexibility, you may not be as familiar with how a Pilates studio approaches injury rehabilitation.

Let’s start with the basics:  What is Rehab?

Rehab is a broad term which relates to treatments intended to aid in recovery.  For us, we’re talking more specifically about recovery from musculoskeletal injury.  Many professionals can help you recover from such an injury, including your medical doctor, a physical therapist, and a chiropractor.  Massage therapists and fitness professionals who have been trained in how to work with injuries can also be a part of your rehab team.

The musculoskeletal injury treatment team

When you have an acute injury (acute = just happened, as opposed to chronic = been with you awhile), a medical doctor is usually your first go-to.  Your doctor can diagnose your injury, which is helpful because diagnoses often come with a treatment plan.  You now have years of medical research at your side telling you what has and has not worked for other people with your condition!

Depending on the injury (and, getting real here, depending on your insurance plan…), a medical doctor may refer you to a physical therapist for treatment.  These days, recent physical therapist graduates have gone through a three-year program, and are doctors themselves.  While physical therapists will use the application of heat, cold, stem machines, and more to treat injury (there are some cool tools out there!), the majority of their treatment time is in manual therapy and exercise.  In many cases, a physical therapists will perform the manual therapy and assign exercises, which will be taught and/or supervised by a physical therapist aide (often a young student who’s hoping to be accepted to a physical therapist doctorate program).

If you’re more into the alternative health route, you may start by taking your injury to a chiropractor.  Chiropractors are also doctors and can diagnose injuries.  All chiropractors are trained in joint manipulation, and if your injury is caused by or exasperated by a joint being out of place, they can help.  Some chiropractors (and, IMHO, the best chiropractors) also treat muscles and other soft tissues (ligaments, tendons, and fascia – the stuff that connects stuff).  In my experience, treating muscles as well as bones works better because tightness in the soft tissues may be pulling the bones out of alignment, and just treating the bones may leave you with a tight muscular structure which will pull you back into your misalignment soon after you leave the chiropractic office.

And now we get to who we are at Corpo Kinetic: massage therapists and Pilates instructors who have been trained to work with injuries.  That is quite a mouthful!  The reason for it is that not all massage therapists or Pilates instructors have the training to specifically work in a rehabilitative manner.  Learning about rehab care in the massage and Pilates world is continuing education – it is additional to the basic training required in order to be certified.

The trainers who offer rehab services at Corpo Kinetic are unique in that we are BOTH massage therapists AND Pilates instructors, AND we have additional training in each field to work with injuries.

The tools we use at Corpo Kinetic in our rehab services are two-fold.  As certified massage therapists, we can use massage and manual therapy to release tension in the soft tissues (muscles, fascia, ligaments, and tendons), and as certified Pilates instructors we can help you strengthen areas which need strengthening as well.  This two-fold approach can be very powerful in getting past injury.

Why would you see us as opposed to a physical therapist or chiropractor?  Your health care team is ultimately up to you.  Pilates and massage, even when combined in a rehab setting, should not replace an evaluation from a trained medical professional such as your doctor, a physical therapist, or a chiropractor.  Depending on your injury, our rehab services may be a good fit for you either as your main source or rehabilitative care or as an addition to the care you are getting in a medical setting.  Here are some examples of the types of clients who see us for rehab:

  1. Physical therapy has helped!  But you’re still not back to your full functioning.  Unfortunately, many insurances will only pay for a certain amount of physical therapy per injury.  If you’re better but still not back to all the physical activities you’d like to do, you may just need more care.  We can help pick up where your physical therapy left off.
  2. You’re currently doing physical therapy, but you want more supervised movement.  If you’re lucky, you get to see your physical therapists twice a week, but often PT appointments are weekly or even less frequent.  To get past an injury, you need to be doing your physical therapy exercises more frequently, and for best results you want to make sure that you’re doing your exercises with the best form and alignment.  In these cases, our rehab trainers make a great addition to your team, helping you maintain good form and strengthen the appropriate muscles in between your physical therapy appointments.
  3. Your doctor has offered medical interventions such as steroids and surgery, but you’d like to try a more conservative approach first.  Because surgery has risk of complication, and is essentially another injury the body will have to recover from, many people would like to avoid surgery if possible, or delay it as long as possible.  Some people also believe that steroids do more to mask symptoms than treat the cause of injury.  Many people turn to Pilates when they are seeking to avoid back surgery, and adding manual therapy with our rehab services can be even more effective.  Even in cases of more advanced osteoarthritis, where eventually a joint may need to be replaced, I have seen our rehab services decrease pain, increase mobility, and push back a surgery date, adding years of healthy function.  Manual therapy and strengthening exercises can help make sure that the musculature around the joint isn’t pulling it out of alignment, which would increase the bone-on-bone rubbing which causes pain and lack of mobility.
  4. You’re seeing a chiropractor, and you both feel strengthening is the next step towards getting you back to full functioning. If you keep getting adjusted and the pain or injury keeps coming back, you may need to strengthen the musculature around the area.  Increased muscular support can help you resist the loads you’re placing on your body as you go about your daily life, helping you hold your adjustment for longer.
  5. You have a chronic injury you’d like to address.  Let’s go back to semantics: acute and chronic injuries raise different alarm bells in the treatment world.  For acute injuries, think:  this just happened!  lots of pain!  need help now!  Acute injuries are best initially evaluated by a medical doctor or chiropractor for diagnosis.  For chronic injuries, think of the old ankle sprain that keeps acting up, the “bad back” you’ve had ever since becoming a mom, your “weak knee,” or the old shoulder injury from playing football in high school.  These types of injuries often don’t require immediate medical attention: in many cases you’ve already gotten help from a medical professional back when the injury initially occurred.  However, as we age with injury, the scar tissue that originally helped stabilize the area can get “gummy,” restricting mobility and causing compensation patters.  The result can be unbalanced areas of weakness and restriction, which can be addressed very well with a combination of manual therapy to release the “gummy” areas and strengthening exercises to correct the years-old compensation patterns.

How do rehab services work at Corpo Kinetic?

When a new rehab client comes to our studio, we start with a 90 minute initial appointment.  This longer session allows us to do a thorough intake and assessment.  We’ll start with a conversation with you.  We want to know the history of the injury, what you’ve done so far to help it, what has helped, what hasn’t, and very importantly: your goals.  Are you looking for pain relief?  Are you looking to be able to return to your full athletic functioning?  Both?  Assessments might include evaluating your range of motion, a postural analysis, watching you move, and muscle testing to determine relative strength.  Then, depending on your injury, the session will proceed with a combination of manual therapy and Pilates strengthening exercises.

Follow up appointments are typically an hour.  We always do a quick intake and assessment to make sure things are progressing as expected, or allow us to change course if need be.  Often, as injuries improve, clients will find themselves receiving less manual therapy and doing more rehabilitative Pilates.  As appropriate for you and your injury, we may suggest some exercises to do at home, or even lifestyle changes if it seems like some simple changes could improve your progress.  (These changes are usually simple, such as changing shoes to addressing how or how much  you sit.)  If possible, we suggest rehab appointments be scheduled twice a week.  If scheduling only allows a weekly visit, we may be able work with that as well, but we will likely spend more time developing a home program and making sure you are confident with doing those exercises well on your own.  When exercising, frequency matters, and if you’re recovering from injury we want to be sure you get the benefit of adequate frequency.

That’s it for this month!  I hope you have a better idea of how our rehab services work, and how they can fit in with your current plan for injury recovery.  If you are wondering if we may be able to help you, please do not hesitate to give us a call at 510-463-1473 or email us at info@corpokinetic.com.

Anatomy Moment: A Trip Around the Hip

As we get into the summer months, I thought, what better time to write about the hip?  Just kidding -there’s no seasonal reason for my post, but I am inspired to spend some time breaking down the anatomy of the hip and pelvis, as I find in my classes and sessions that is it an often misunderstood (or not-well-understood) area.  As you know if you’ve been reading these posts for awhile, we are anatomy nerds here at Corpo Kinetic, and we love sharing.  Here we go!

What exactly is the hip?  In everyday language, it tends to reference a very broad area of the body including the boney points in the front where we would rest a belt, the musculature on the sides of the pelvis, and occasionally the glutes (butt muscles) as well.  Somewhere in that broad structure of bones and muscle we know there’s a joint called the hip socket or hip joint.  Are the muscles on the insides of our legs part of the hip?  What about the boney structure slightly above the glutes, in the center?  Is that low back or hip?

The general amorphous quality of the word “hip” explains why, if someone comes into our studio complaining of hip pain, our first question will likely be, “where in the hip?”  Outside of the Pilates studio, there may be no need to be so specific, but inside the studio, knowing specifically what part of your anatomy is bothering you can help us to better treat the cause of your discomfort.  When my anatomy brain starts to break down and explain the colloquial term “hip,” the first thing I go to is:

It’s actually many parts.

Look at that!  Look at how many labels there are!  And those are just the bones!  Those labels are just some of the many smaller parts which make up what we think of as the “hip.”  Labels and names are a fun thing to think about if you’re an anatomy nerd.  However, whether you’re ready to dive deep into learning anatomy or not, some basic knowledge about the function of our hip is useful in understanding why we have all those labeled parts.  When I think function of the hip, two things come to mind:

  • The hip is responsible for transferring the load of the upper body to the lower body.  (And that load includes the weight of the upper body as well as everything the upper body is carrying, from grocery bags to backpacks.)
  • Fluid mobility of the hip is crucial for keeping stress out of our knees, feet, and lower back as we bend, get up from sitting, go down stairs, and more.

Pilates works on creating stability in parts which are too mobile and mobility in parts which are too sticky.  When we look at core function, hip musculature which is not mobile enough can decrease the ability of your core to fire correctly.  On the flip side, hips which are too mobile can transfer unwanted movement up into the lower back, potentially causing pain and injury.  It’s all about balance, and luckily that’s something we thrive at in Pilates – creating balanced support for the body.

Let’s get down to business.  Here is our picture from before, a side view of the right hip.

If we were to have this person take a quarter turn and face us, we would see something like this, a picture of the right and left hips, connected by the pelvis:

Let’s break it down!  My first matter of business is a small clarification from the perspective of anatomical language.  “Hip” is a vague term, as discussed above, so for clarity I prefer to talk about the “hip sockets and pelvis.”  Remember all that other stuff from my initial question, “What is the hip?”  We had:

  1. boney points in the front where we would rest a belt
  2. the musculature on the sides of the pelvis
  3. the glutes (butt muscles)
  4. a joint called the hip socket or hip joint
  5. the muscles on the insides of our legs
  6. the boney structure slightly above the glutes, in the center

Number 4 from above is the hip socket.  The rest of the bones listed above (1 & 6), are part of the pelvis.  Numbers 2, 3 and 5 I would call muscles which move the hip socket.  Are all of these part of the hip?  Yes because that’s how we tend to talk about it in everyday language, and no because the hip socket is actually a very small component of the area we tend to refer to when we say hip, and the rest of our boney structure is the pelvis.

Starting with the pelvis, if you were to sassily put your hands on your hips, they would most likely land on a ridge of bone which wraps around the sides of your body, including the back and the front.  That ridge is part of one of the most easily felt bones of the pelvis called the ilium (actually, you have two, a right and left ilium).  Your hands are resting on a part of the bone called the iliac crest.  It’s easily felt because it’s not densely covered in muscle, as is the majority of the rest of the ilium.  The ilium bones serve several important functions, including housing and protecting our pelvic organs (those are important!), and providing large surface areas for muscles which move the hip socket to attach.

If you follow that ridge to the front and down a couple inches or so from the top, you’ll find a more pointy part which sticks out to the front.  This point is called the “anterior superior iliac spine.”  (Got that?  Anatomists often call it ASIS for short, so let’s follow their lead.)

The parts of bones which are easily felt and sort of “stick out” are often referred to as “boney landmarks” because they give us information on the placement of things we can’t as easily feel or see beneath the surface.  The ASISs are an important boney landmark for looking at the levelness of your pelvis.  Your Pilates instructor might check the levelness of your right and left ASISs to determine if your pelvis is level side to side.  We can also use the ASIS with other boney landmarks to determine if your pelvis is level front to back.

If you walk your hands back up to the top of your iliac crests (where you put your hands sassily on your hips earlier) and then follow the crest towards your back, they will slope down and together.  As you follow those slopes, you might feel two little dimples.  These are your sacroiliac joints, or SI joints for short.  In very close proximity to the SI joints are the posterior superior iliac spines (PSISs).  When you are standing and the PSIS and ASIS are level, then your pelvis is level front to back.

Did you have a hard time feeling the dimples or PSISs?  Don’t worry.  They are far less prominent than the ASISs.  When I was a new instructor, it took me quite some time and checking multiple different pelvises before I felt confident that I was on the right spot.  We use the PSISs as instructors because it is more precise, however a far easier way to check where your pelvis is on your own (and for everyday use precise enough) is to use a different boney landmark.

So – come back to your sassy hands on hips position.  Follow that boney ridge, your iliac crest down to your ASISs.  Keep walking your hands down and together.  We have more muscle here, so you may loose track of the iliac crest – you can use the crease in your pants where the leg meets the pelvis as a guide.  When your hands meet in the center, you’ll be on what we often refer to in the Pilates studio as the pubic bone.  If you look back at our front-facing picture above, they’ve labeled the point in the center as the “pubic symphysis.”  We actually have two pubic bones, a right and a left, which are connected by a dense and fibrous tissue called the pubic symphysis.  This connection is mostly immobile (and should be).  Fun fact, during pregnancy the body releases a hormone which relaxes all ligaments in preparation for birth, including the fibrous pubic symphysis.  This is why we modify certain leg exercises for momma’s-to-be.  Mommas need to be strong, and in most cases can work out hard, but we want to promote that strength without creating shearing at the pubic symphysis.

So – you know where your pubic bone is and where your ASISs are.  If you put the heels of your hands on your ASIS’s and your fingertips on your pubic bone, you can now line up your ASISs and your pubic bones in a vertical plane.  This is another way to tell if your pelvis is level front/back, and usually fairly easy for us to check on our own.

Let’s land on the iliac crests again (sassy hips), then take our trip back around to the PSISs and SI joints.  Walk your hands one more time down and together along the iliac crests and eventually land on those dimples.  Remember that the name of those dimples is the Sacro-Iliac Joint.  Iliac stands from the ilium part of the joint, which we’ve already visited.  Sacro stands for the sacrum, which is the broad flat part in the center back of your pelvis.  Here’s a view of the pelvis and hip joints from the back, as if the person were facing away from us.

It provides a good view of the slope down from the iliac crest (sassy hips!) to the sacroiliac joints, and the sacrum nestled in between the right and left iliums.   At the base of the sacrum lies the tail bone, or coccyx.  There is actually also a joint between the sacrum and coccyx, and the tailbone can move, occasionally being displaced.  The name of this joint is kind of fun:  sacrococcygeal.

At this point, we’ve visited three joints of the hips and pelvis which we often don’t think of as joints: the pubic symphysis (front, down, and center), the sacroiliac joint (on the back, the dimples at the top of the sacrum), and the sacrococcygeal joint (between the sacrum and tailbone).  These three are joints because they do move, but key to their health is that they actually don’t move very much.  Most of the movement in our hips and pelvis should come from the true hip joint – where the thigh bone meets the pelvis.  This joint is a classic “ball in socket” joint, and it’s mobility allows us to squat to the floor, climb mountains, ride horses, and much more.  This is the joint that we want to keep mobile, in all planes of motion, so that our smaller, less mobile joints are not overly stressed.

Phew!  I hope you’ve enjoyed this trip around the hip.  Now take your newfound knowledge and move it!  If you’re not coming to the Pilates studio today, taking a walk up some serious hills is a great way to get mobility and strength in your hips.  See you soon!

Anatomy Moment: Fascia Matters – but what is it?

roll-release4I have the pleasure of working with several clients whose work lives are in marketing.  One of them told me recently that “fascia is trending!”  I was secretly thrilled by this news, because anything trending that has to do with anatomy is just right up my alley.

If you’re like many of us, you may have heard of fascia, but you may be somewhat confused about what exactly it is, or why rolling on a foam roller or pinky ball helps your body. On that note, I give you Corpo Kinetic’s most recent Anatomy Moment: Fascia Matters.

Fascia’s family.  Fascia is classified as a “connective tissue.”  Connective tissue is a large, somewhat convoluted category which includes: bone, cartilage, ligaments, tendons, blood, lymph, fat, and fascia.  One of the main roles of connective tissue is to provide physical support for the body, and the network of fascia is no exception.

What is fascia? Fascia surrounds all structures in our body.  It is a slippery material which reduces friction and permits easy movement.

For example, as you bend your arm, your bicep contracts, and as the muscle shortens it must glide easily across the underlying arm bone and the overlying skin.  If we didn’t have fascia, as we moved our muscles would rub on bone, nerves, skin, and blood vessels.  Think of an old track of carpet in the main passageway of the house which, after years and years of being walked on, has worn down to the threads.  Fascia prevents friction from causing a similar phenomenon in our bodies.
What is an adhesion?  If there is a problem in the fascial layers and they aren’t gliding properly, the fascia layers will adhere.  While this does prevent friction, it can create problems down the line.  Imagine pushing a shopping cart easily down the aisles – all four wheels spinning equally.  Now imagine that one of the wheels is sticky and no longer gliding right.  Instead of an effortless stroll, you’d be contorted and working unevenly to get that cart to roll in a straight line.

An adhesion is kind of like a “sticky wheel” inside the body.  If one part isn’t moving due to an adhesion, other parts will be moving or working too much, and pain can develop.  Some people feel pain around the adhesion or stuck area, and others feel pain around the part which is overworking.

roll-release2What is myofascial release? “Myo” stands for muscle, “fascial” is for fascia.  A myofascial release addresses fascial adhesions and tight muscles, working to release areas of tension.  Massage therapists perform myfascial release, and Pilates instructors will often use foam rollers and massage balls to show you how to perform releases on your own.

Ok, I have a foam roller and a pinky ball… Now: How often should I use it? For how long? When will I feel better?  

Rolling doesn’t have to take long, and is actually more effective if you do it more frequently for shorter periods of time than less frequently for longer periods of time – aim for 5-10 minutes a day.  While the length of recovery depends on many factors, I’ve seen significant improvement with rolling every day for only two weeks.

roll-releaseWhat should I roll?  How do I roll _______? You’re in luck!  Starting June 6, Corpo Kinetic will be offering monthly Roll & Release workshops.  Each workshop will include a brief anatomy discussion – what are we rolling and why? – before diving into 45 minutes of pure rolling bliss.  You’ll leave feeling better, and will have tools for self-care at home.

Corpo Kinetic Turns One!

As of today, Corpo Kinetic Pilates & Wellness Studio has officially been open for a year!  To our clients, friends, and family:  thank you for making it a great one.  We love what we do, and look forward to spending many years to come helping you move better & feel better.

In the past year:

  • We’ve extended the hours we offer Private Sessions.  Whether you’re a weekend warrior or want a mid-week retreat, Corpo Kinetic’s trainers are here 7 days a week for you.
  • We’ve expanded our Small Group Class Schedule.  Not only are our classes practically a private, with a full array of props and creative, intelligent instructors, they are also varied enough to keep things interesting. (See schedule.)
  • This Spring, we debuted workshops: focused time on areas of particular interest.  Janet Das just led her Low Back Care workshop in April, and Jenna Anjali will be teaching Fabulous Feet in just 8 days!  (Sign up here.)
  • We’ve hosted many talented body workers who can help ease persistent aches and pains through massage and other forms of manual therapy.

… and we’re still at it.  Read below for upcoming workshops, events, and special offers from us to you.

Thank you!


 

Pilates Party
Save the Date
Corpo Kinetic’s “First Birthday” Open House
Sun, June 28th, 4-7pm

Stop on by for a glass of “Pilate Pale” (a beer brewed specifically to be enjoyed after a Pilates session), enjoy some healthy snacks, and play some Pilates-themed games.  Short demos of our favorite moves and techniques throughout the evening.


joe-windoSummer Deals

treat your body well this summer
Remember when summer was a care-free wonderland full of camping trips, lazy days by the pool, Popsicles, and other cool treats?

Adults deserve treats too, and this summer we recommend you give yourself one by taking advantage of some excellent deals on Bodywork and Pilates combo packages.  These “Treat Yourself Packages” are available for purchase through the end of July and won’t expire until the end of the year, so even if you have a current package, you can take advantage of this offer.  Simply ask at the studio, and we can set you up.

Intro Treat: $195
1 Body Work Session
1 Private Pilates Session
2 Group Classes
Super Treat: $535
3 Bodywork Sessions
3 Private Pilates Sessions
6 Group Classes
Group Class Treat: $265
6 Group Classes
2 Bodywork Sessions
Just Me Treat: $395
3 Bodywork Sessions
3 Private Pilates Sessions

“Physical fitness is the first requisite of happiness.”
 -Joseph Pilates


Our Studio Gets a Summer Makeover

door
Julia Hollas PILATES” becomes “Corpo Kinetic”

You may have heard through the grapevine — there are a few changes afoot at our cozy studio on Telegraph and Alcatraz. Rosie Liebe, owner of The Body Praxis, closed her Oakland business on Wednesday, April 30th in order to embark on an adventure to India. Today, the studio opens its doors for business as Corpo Kinetic.

I am thrilled to welcome Janet Das and Jenna Anjali as teachers at the “new” Corpo Kinetic studio. and to welcome Jennifer Mirich and Julie True – massage therapists who will be working on Tuesdays and Thursdays. If you are looking for rejuvenating Pilates or body work, the “J team” here has got you covered. Watch your inbox as the summer progresses for discounted offers for you to sample the Corpo Kinetic practitioners!