COVID-19 CLOSURES

To our patient community, 

We would like to thank you for choosing Marcy and Mike at Well+Able as your RMTs and we remain committed to ensuring that we continue to keep all of you front of mind in our decisions. Because of the unprecedented and unforeseeable COVID-19 global pandemic that is putting you, your loved ones, and our own health at risk, we are unable to provide our role in your care and maintain social distance. It is for this reason that we have no choice but to close our clinic effective at 9 pm Thursday, March 19 until we are legislated to go back to work. We do not take this situation lightly as we understand the impact that this can have on your healthcare. Please email us directly at michael@wellandable.ca or marcy.reoch@gmail.com if you have any comments or questions about future appointments. 

If you would like to help support us through this difficult time please click HERE or on the gift certificate banner and buy an RMT treatment for yourself or your loved one.

Thank you for your understanding as we come together as a  community to fight this virus pandemic.

Yours in health,

Marcy Reoch, RMT and Mike Reoch, RMT at Well+Able

Price Changes for 2019

Please be aware that the prices for RMT services starting January 15, 2019 will be changed to reflect our increased expenses and comply with our RMT fee schedule. Thank you for your understanding.

‣ 20 minutes massage Therapy $45.00 ‣ 30 minutes Massage Therapy $70.00 ‣ 45 minutes Massage Therapy $100.00 ‣ 60 minutes Massage Therapy $120.00 ‣ 90 minutes Massage Therapy $190.00 ‣ 120 minutes Massage Therapy $190.00

What to expect with your first Massage Therapy visit

A short video by the RMTBC on what to expect from a Massage Therapy visit with an RMT

What to expect from your RMT during your Massage Therapy visit

Are Tension-Type Headaches Treated by Massage Therapists?

Tension-Type Headaches: what can you expect?

 

According to the International Association of the Study of Pain (IASP), Tension type headaches (TTH) are:

“headache attacks with mild to moderate pain intensity and is often described as having a pressing or tightening (non-pulsating) quality that is not aggravated by routine physical activity, such as walking or climbing stairs. The pain lasts for at least several hours to days and is predominantly felt bilaterally.”

 TTH originates from a combination of tissue sensitivities in the head and neck as well as how the nervous system interprets the signals from those tissues.  Development from episodic to chronic TTH is thought to be accompanied by increasing Central Nervous System sensitivity to the tissue signals like a car alarm that is triggered by a loud truck. Diagnosis of TTH is based on a “featureless” headache and normally results in a neurological examination. Most commonly found are tender spots around the head and neck. Additional diagnostic workup by your doctor is important if you have additional symptoms other than headache.  Chronic TTH is often associated with medication overuse.

Tension-type headache is the most common form of headache. It can be categorized into three subtypes according to the International Classification of Headache Disorders based on headache frequency:

(1) infrequent episodic TTH (<12 headache days/year), (2) frequent episodic TTH (12-180 days/year), and (3) chronic TTH (>180 days/year)

(2) frequent episodic TTH (12-180 days/year)

(3) chronic TTH (>180 days/year).

 Stress seems to play a big role in Tension Headaches. Managing that stress can be beneficial in reducing frequency and duration of these headaches.

According to the International Association of the Study ofPain:

 The lifetime prevalence of episodic TTH is almost 80%, and that of chronic TTH is 3%. Women are slightly more affected than men. The age of onset peaks between 35 and 40 years, and prevalence declines with age in both sexes

o   Headaches are the most prevalent neurological disorders and among the most frequent symptoms seen in general practice.

o   50% of the general population have headaches during any given year, and more than 90% report a lifetime history of headache.

o   The average lifetime prevalence of migraine is 18%, and the estimated average prevalence in the past year is 13%.

o    The prevalence of migraine in children and adolescents is 7.7%.

o   Tension-type headache is more common than migraine, with a lifetime prevalence of about 52%. However, only frequent or chronic tension-type headaches are disabling.

o   3% of the general population have chronic headache, i.e., a headache ≥15 days per month. They are the most severely disabled.

Clinically, this is the most easily and effective type of headache for an RMT to treat. In our experience, after an initial assessment and treatment, future treatments usually should be around 30 minutes 1-3x a week with a follow up in 1-2 weeks depending on severity and chronicity. After your first visit the normal course is of at least a 50-80% resolution of head pain around 30 minutes after the massage treatment. This relief should last from 3 days to 2 weeks and will increase with future treatment.

Make sure to ask for some home care such as exercises and or movements which will depend on the tissues and structures that are sensitized then work together with your Massage Therapist to create a plan of action that is effective and obtainable.

Our Aging Population: Mobility, Wellness and Independence

What a Great Weekend!

We are always looking at increasing our skills and knowledge to better serve our patients. On May 5th, Marcy and Mike attended the sold-out RMTBC symposium: Our Aging Population: Mobility, Wellness and Independence. 

Registration at the beautiful Anvil Centre in New West

After a rousing First Nations welcome by Coastal Wolfpack, Isobel Mackenzie, B.C. Seniors Advocate started off the day with a fascinating, in depth look at the demographics and conditions of todays' seniors population. Her talk was a great start to the days theme that Massage Therapy can play a key role in keeping mobility and wellness in seniors thus helping you keep your independence as you age. 

The first keynote address was Dr. Lorimer Moseley, one of the most respected pain researchers in the study of pain. Dr. Moseley is a fantastic presenter. He has been a strong promoter in giving people with persistent pain more tools to manage their pain.  

 The second Keynote was with Dr. Karim Khan who is a MD at UBC as well as the editor of the British Journal of Sports Medicine. He gave a great talk on how diet and exercise is very strong medicine in preventing illness. The day ended with an esteemed panel of Andrew Nemeth, Yvonne Poulin and Dr. John Sloan who provided tremendous information on their work with seniors.

simple lifestyle modulators: diet, exercise, avoidance of smoking and excess alcohol, together with moderate physical activity reduce colorectal cancer by 50%

- Karim Kahn

From left: Gordon MacDonald, Peter Behr RMT, Yvonne Poulin RMT, Dr. John Sloan,
Andrew Nemeth RMT.

Mike catching up with colleagues

We had a fun and informative Saturday! Thanks to the RMTBC who always put on a world class symposium every year. Also, I would like to thank them for some of the photos and content of this post. 

What is DNM? By: Michael Reoch, RMT →

The term DNM Stands for Dermo (skin) Neuro (nervous system) Modulation (a change from one state to another). It is a method of manual therapy/massage therapy used to change the state of the nervous system from a painful hyperactive state to a less painful and reactive one through the skin receptors. Diane Jacobs, a Canadian PT with 40 years experience developed DNM as a way to better treat people with chronic and persistent pain. I have had the lucky pleasure to directly learn from and work with Diane over the last four years.
She explains the background of the method:

     

    The nervous system is comprised of 72 km of nerves, a brain 5 times bigger than it needs to be to run a critter our size. Even with all this length, even with the huge brain, it's tiny, only 2% of the whole body, but because it's busy 24/7, even when we're asleep, and because it runs all operations, it sucks up an amazing 20% (!) of all available oxygen and glucose, all the time, at speeds of about 270 miles per hour, so it's a big energy suck. You are part of it. It's not part of 'you' the way we usually think of our body parts. You are part of it. 'You' are the human bit in there, but most of it we have in common with all the other critters out there that have vertebrate nervous systems. It runs 'you'. It looks after 'you'. It keeps 'you' alive. It puts 'you' to sleep at night so it can do other things, but it keeps your heart beating and your lungs working, right? It's your survival machine and your threat detector. It wakes 'you' up in the morning because it needs you to get it something to eat. It never shuts off! It's your operating system. It's an old evolved thing and some parts are really old while other parts are quite new and they're all hooked together and sometimes it can get itself into a glitch. Usually that's all that's the matter. So, we do a systems check and help it fix itself. 
This amazing nervous system goes all the way from the brain to the skin and back. There are Billions of sensors in our skin. On average sensors are one to two cells apart. These sensors tell our brain what is happening in the world around us, what is happening within us and what is happening to us. There are many different sensors and each have specific rolls. There are sensors for just heat others for just cold, there are sensors for just heavy pressure others for light pressure, ones for quick stretch others for slow stretch and so on...

DNM is a method of manual care that puts the patient and their needs first. Instead of operating a recipe treatment the treatment is an interaction between the patient and the therapist. We work together to find the areas that need attention and remove the tenderness and pain felt in that area. The focus is on changing the signaling within the nervous system to decrease your pain. Pain does not happen in the muscles and other tissue but in the nervous system itself; therefore, weather or not the area of pain is damaged we can reduce that pain with DNM.
 
The manual part of DNM is to change the input signaling from some of these receptors to help the brain get a better picture of what is happening to/in the body. What we want to do is show the Brain that the area where you feel pain is not under the threat that the brain perceives it to be in. 

Some effects of an effective DNM treatment:

You will get sleepy
You will have less swelling/inflammation after
You will feel warming, an ease of movement, and a softening of hardened muscles
Your pain relief will continue throughout the day of the treatment and will usually peak 72 hours after the treatment.

See it in action

Pain BC Blog Talk Radio

Michael Reoch will be featured on the Pain Waves Radio Show Thursday February 6th, 2014 at noon-1pm. He will be talking about Massage Therapy for chronic pain. If you miss the show you can listen later at your convenience. If you do get the chance to listen live you can phone in and ask a question and Michael will do his best to answer.

How does stress make pain worse?

Do you ever have neck or back pain after a stressful day? Maybe a headache?
Why do you get tight muscles when something stresses you out?

There are nerve receptors that are involved in pain generation. There job is to send a signal to the brain that they have been stimulated. The brain knows that a signal from these receptors in the body is usually a sign of danger and will usually then decide that the body is in pain, specifically to that area. In his talks, David Butler often brings up adrenaline sensitive peripheral nerves and the amazing ion channel turnover. Specifically, this means that these nerve receptors can become extra sensitive to the chemical adrenaline, also called epinephrine. With this sensitivity, less stimulation is needed to send a danger signal to the brain. Think of a car alarm that is set to go off when someone breaks the window. When the alarm is hypersensitive the alarm may go off if a loud truck drives by. No damage happened to the car but the alarm still went off. When we are stressed out our body produces more adrenaline. This can be a good thing because it helps us to prepare for action. Unfortunately, if a nerve is damaged, stretched, or pressed on for too long it will create "baskets" of adrenaline sensitive fibers. As David says here:
"If a person has a highly adrenoreactive area of peripheral nerve and if they are in a state of persistent elevated stress then repeated firing into the CNS will occur. And if the person is stressed, central inhibitory controls will probably be lifted anyway and a persistent neuropathic pain state may ensue."

What this means is that if someone has a nerve that is sensitive to adrenaline and if they are always stressed out then the danger signal to the brain will be almost constant. If that is the case then the Drug Cabinet in the brain will be lifted away and persistent pain will likely develop. Not fun.

Fortunately, you have some control over this. The first line of defense is to reduce your stress level  thus reducing your adrenaline. Also, just knowing that your pain is not from a damaged muscle but stress chemicals, your brain will then be less likely to think of the signal as pain. Third, if you get out and move your body in a way that reduces any specific nerve perturbations you will have less chance of a future sensitivity. Most good Manual Therapists (RMT, Chiro, PT, etc) will know how to help you do this.

Most forms of massage therapy have good evidence behind them on their ability to reduce stress. Two of the modalities Michael implements, DNM and Simple Contact, work on a model that directly addresses pain and adrenal sensitive nerves.
If you have any questions about this feel free to contact us at well+able and we would love to help you out if we can. It would also be of benefit to watch the previous stress video, the Drug cabinet video and the What is pain video.

A short video on managing stress

Dr Mike Evens has set up a youtube channel with some great health tips. Here is his 11 minute video full of some fantastic ideas for managing stress

Welcome to Well+Able

After months of hard work getting the clinic up and running we now have a website. Please look around and check it out. 

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