Monthly Archives: January 2009

Do you have muscle pain when you wake up in the morning?

Many of the clients coming to my Seattle massage practice are suffering from pain and/or muscle tension when they first wake up in the morning. Some people have low back pain and many have shoulder pain. It leads to reason that they are doing something while they are sleeping to cause themselves this discomfort. Unless they have a serious sleep walking issue, it probably has to do with the position their body is lying in.

 To support your body better while sleeping breaks down to what angle best takes care of your individual joints and how to achieve that optimal angle.

neck-aligment-while-sleepingTo care for your neck while sleeping on your side, it must be in a neutral position like the picture to the left. There are many types of pillows that can help you achieve this. Ikea has a few and you can try them on a bed the store provides next to the pillows display.

 The best angle for shoulder support when sleeping on your side is for the shoulder to not cave in or angle back. Keeping a neutral position across your chest and upper back as much as possible is better. To do this you can hug a pillow while you sleep. This will help keep your shoulders from curving inward.

When you are also sleeping on your side, the best angle for your legs  is with your knees hip length apart. You can create this angle by placing a pillow the correct amount of thickness between your knees. To support your low back, your legs bent at the hip between a slight and a 90 degree angle is preferred.

When you are sleeping on your back, a great way to support your low back is to put a pillow under your knees.

Now these are just some general ideas. As usual, talk to your health care practitioner for more in depth suggestions. Thank you for reading. PJ Harris, LMP,


Do your feet hurt?

Do the bottoms of your feet or heels hurt, especially in the morning? You may have what is known as Plantar Fasciitis. This is inflammation of the plantar fascia, also known as the connective tissue on the bottom of your feet. I see this a lot in my Seattle massage practice.

What is the cause of this painful condition?

  1. A rolling in of the foot, known as pronation.
  2. Repeated high intesity of the foot due to high impact (jogging and skiing) or repeated quick turning (basketball).
  3. Tight calves or quadriceps.
  4. Unsupportive shoes.

There are a few things you can do to take better care of your feet and help reduce the pain of Plantar Fasciitis.

  1. First of all start by seeing your doctor to make sure you actually have Plantar Fasciitis.
  2. Give your feet a break. Try lower impact, more gentle activities that are kinder to them until you get this under control.
  3. See a massage therapist who can break up the stuck fascia in your feet and work on relaxing those calves and hamstrings.
  4. While sitting, gently stretch your feet by placing a towel on the bottom of your foot and pull on both ends of the towel. Another way to stretch your feet is to roll them on a footsie roller
  5. Perform ice massage on the bottom of your feet by placing a mostly but not quite full water bottle in the freezer and rolling your feet on it. This is especially helpful in the morning when Plantar Fasciitis can be more painful.
  6. Talk to your doctor about your shoes and whether or not you need arch support or orthodics.
  7. Increase your flexibility by picking up items like pencils or towels with your bare feet.
  8. Stretch your calves. See images below.Calf Stretch 1

I stress the importance of creating healthy foot care habits. soleus

Be good to your feet and they will be good to you.


Thank you for reading. PJ Harris, LMP

Why is it taking so long for your injury to heal?

While I don’t have a definitive answer today, I have some theories to run by you.

Have you had an injury and taken good care of it for a week, only to re-injure it afterwards? Then, you take care of it for two weeks and bam there you are again. Ouch! Many times when this happens to people they develop what is called muscle guarding. This is when the muscles of your injury become stiff to protect the injury from re-occurring. That is fine and dandy for a short interim, but in the long haul it can get in the way of your muscle developing healthy strength.

Muscle guarding can cause continued actual weakness in your injured muscle and inhibit a long term recovery. How can you break the muscle guarding cycle?

1. By receiving regular massage. Massage can decrease muscle guarding by relaxing your muscles so that they will let go. Another way massage therapists can facilitate a decrease in muscle guarding is by helping you to use reciprocal inhibition. This is when muscles on one side of a joint relax to provide contraction of the muscles on the other side of the joint. For example: if you flex your bicep your tricep will relax.

2. By strengthening the area. Muscle guarding is not true nor efficient muscle strength. When you truly strengthen the muscle, it will get the message that it no longer needs to guard. Always do this by starting off slow. It is also extremely important that you are under the supervision of a health practitioner.

Ask your massage therapist or other appropriate health practitioner if you have muscle guarding and see how they can help you. If you live in the Seattle area feel free to contact me with any questions regarding this blog or massage. Thank you for reading, PJ Harris, LMP.

Do you need a prescription for massage to have it covered under your insurance?

My short answer is yes.

Many people say to me that their previous massage therapist did not ask for a prescription. Some of my clients have even called their insurance companies and were told they don’t need one. Yet, I still ask for a prescription in my Seattle massage practice.

Why the conflicting policies? Because not everyone, including insurance company employees, understand the laws in my state of Washington regarding scope of practice for a massage therapist. When I submit my paperwork regarding my clients case to the insurance company, I need to provide a diagnoses code.

The Revised Code of Washington (RCW) is the compilation of all permanent laws now in force. The RCW number 18.108.010 definitions states that the scope of practice for massage therapist specifically does not include diagnosis. Therefore, if I were to fill out a diagnosis code on the insurance form without a primary provider’s diagnosis, I would be in violation of the law.

If you don’t have a prescription and you don’t have a primary care provider, ask your massage therapist for a referral to someone who can help you with this. Thank you for reading, PJ Harris, LMP.