By Ashley Mitchell

Caryn Friedlander, an art professor at Whatcom Community College, has spent years trying to combat chronic pain and tension in her upper neck and back. After sustaining an injury from a hard hit to the head, the pain and tension grew into a much bigger problem: a herniated disk and intense neck spasms.

Friedlander shopped around for potential help. She visited a chiropractor, but the pain and pressure weren’t relieved. She also visited a physical therapist in the Seattle area, massage therapists, a sports and spine doctor and multiple neurosurgeons. It wasn’t until she visited a craniosacral specialist that she remembered a somewhat similar, yet more rigorous form of rehabilitation she tried 15 years ago, known as Rolfing.

Rolfing is one of multiple options available for Bellingham residents suffering with chronic, injury-related, and occupational-related body pain. Brad Jones, a Bellingham-based certified advanced Rolfer, works with his hands, fingers, elbows and knuckles to provide a specific type of massage to improve structural integration.

“I can sit and talk with a patient for an hour to figure out the source of structural problems, but seeing them in their real environment or work station for just 15 minutes can tell me a lot more.” —Brad Jones, certified advanced Rolfer

Jones said Rolfers work with the connective tissue on the muscles, or myofascial system. This muscular tissue, which is akin to the thin white coating on a piece of chicken, can take on patterns that affect body structure depending on how someone uses their body. Rolfers work with muscles and deep-connective tissue in order to re-teach the body how to move.

“Imagine the tissue is like a tight wet suit on your body,” Jones said. “If you pull at one end, the entire body suit moves; one thing sets off another. The body work is a global approach, it involves working with the entire body to fix [a localized problem].”

This type of approach involves more than just weekly sessions of body work; it involves an understanding of how the patient moves, sits and stands in their daily lives. Many of Jones’ patients have developed pain and body discomfort from daily and occupational habits such as sitting in front of a computer for eight hours a day or wearing heavy utility belts and moving around incorrectly.

Sometimes understanding the core of a patient’s problem can even involve the practitioner visiting their place of occupation or viewing daily activities in order to help them.

“I can sit and talk with a patient for an hour to figure out the source of structural problems, but seeing them in their real environment or work station for just 15 minutes can tell me a lot more,” Jones said.

All about ergonomics

Mike Poulos, a certified hand and occupational therapist, also echoed Jones’ line of thinking; fully understanding a patient’s movement in their daily life is key to identifying their pain and discomfort. Poulos said no matter what the treatment, patients should always leave with a basic understanding of ergonomics, which involves teaching people how to move within and design their workspace, equipment and living environments in a way to prevent repetitive injuries.

Some basic ergonomic principles involve keeping ears over shoulders and shoulders over hips when standing, sitting and moving around, Poulos said. When lifting and carrying things, keeping nose and toes facing the same direction and holding objects close to the body are important. A person who spends a lot of time in front of a computer should remember to keep their shoulders relaxed, elbows bent and wrists neutral and straight, he said.

An understanding of ergonomics, appropriate equipment and consistent exercise and stretching help to keep the heart pumping and blood flowing throughout the body, Poulos said. This is particularly important in his line of work because hand therapy is usually a treatment for an injury or surgery, and blood flow is a large aid for healing tissue and muscle, he said.

Both Rolfing and occupational therapy involve a lot of outpatient work. Jones said a patient needs to understand that the work done during a session must be coupled with changes in their daily lives to provide maximum change. For the most part, this involves being open to “mixing things up.”

The body is not in a neutral state when sitting or lying down. Many patients often sit up too straight or slumped over, causing a string of problems throughout the body. No matter how properly someone sits, excessive sitting can be damaging to body structure. An easy solution is simply moving around.

Jones said one of his patients, whose job requires an abundance of time in front of his computer, has a computer stand that allows him to switch between standing and sitting throughout the day. The patient can sit for a period of time, then adjust the computer stand higher, allowing him to stand.

Poulos has often recommended similar equipment to his patients. This equipment can include anything from a certain type of chair, keyboard or mouse to a gel mat for those in standing occupations.

Be proactive about posture

Another, and arguably the most common, option many patients choose for structural and postural care is chiropractic work. Chiropractic focuses on spinal adjustments to re-align the spine and correct problems throughout the body. Brian Boyd, chiropractor at Southside Chiropractic of Fairhaven, has a slightly different view on the source of body problems.

Boyd, who practices a postural approach to chiropractic work, said during crucial developmental years most children are in school nine months out of the year and it is primarily a sitting activity. As a result, he said, much of the pain adults feel began in their childhood, not from their daily lives or occupations.

For example, natural body posture is supposed to involve a neck curvature, or a C-shape facing toward the back that measures 60 degrees. In his 14 years of work he hasn’t seen any patient walk into the clinic with the proper measurement, and this is believed to be caused by a lack of posture during childhood, a source of many ailments.

He said he feels the idea that spinal adjustment is too abrasive for the body is a misunderstanding guided by health care providers. Boyd has followed multiple studies and believes many ailments, such as earaches and headaches, can be cured with a subtle adjustment to the spine as opposed to medication.

Regardless of the treatment, all three practitioners agree that chasing symptoms and waiting for them to appear is a reactive way of approaching any sort of occupational therapy. Being proactive about how your body moves within its environment is the key point to avoiding injury.

“Injury and surgery are one thing, but many people only seek out care when they finally have a pain problem and it’s usually the result of years of damage,” Boyd said. “Symptoms are there to tell you your body is off balance, but there are ways to prevent injury daily and it’s a matter of carrying through with them.”

Chronic pain sufferer Friedlander, who admits being more inclined to find alternative ways of healing other than chiropractic work and surgery, found Rolfing to personally be the most effective solution.

After receiving a cortisone shot to ultimately cure the inflammation from the herniated disk, Rolfing provided tension release she wasn’t able to find elsewhere. She said she tried so many different avenues of healing but it was important to find something that suited her needs because everyone reacts differently to body work.

“Chiropractic work and massage therapy are definitely helpful for some people, but I needed something different,” Friedlander said. “I have my personal beliefs with medical care, as do others, but all I know is finally finding a source of relief and continuing to seek care has helped keep me almost completely asymptomatic.”