Thursday 28 August 2014

Erm….what exactly is myotherapy, Dr Les?


When people see our sign or business card they tend to understand the ‘dog massage’ bit – although nearly all didn’t know such a service existed – but ‘myotherapy’ confuses them. So what is it and why do I say massage AND myotherapy?

Massage is easy to explain but the explanation I like best is ““The scientific manipulation of the soft tissues of the body, as apart from mere rubbing” (Prosser, E.M. (1941) A manual of Massage and Movement. 2nd ed. Faber & Faber: London). The effects and benefits of massage can be mechanical, physiological and psychological varying according to the intent with which massage is given, the selection of techniques used, the condition of the client and the frequency of sessions.

Another quote that I found when I first started my path along canine therapy was “A practitioner of massage may choose to be either a technician or a therapist. A technician is competent to administer massage as a manual skill. A therapist, in addition to being competent in the manual techniques, understands human anatomy, physiology, pathology and psychosocial issues, and will apply this knowledge when practicing massage. For the therapist, massage is one tool available to choose when, following a full assessment of the client’s needs, an evaluated problem-based treatment plan is designed”. (Holey, E., Cook, E. (2011) Evidence-Based Therapeutic Massage. 3rd ed. Churchill Livingston: Elsevier). I aim to be a therapist rather than a technician. Which is where the myotherapy comes in.

Myotherapy describes muscle therapy or, as I like to explain it, the therapist exercising the muscle for the client. It is a form of manual therapy focussing on the assessment, treatment and rehabilitation of musculoskeletal pain. The term is not just a technique taught at a particular school but was originally used in the 1970’s by Bonnie Prudden to describe a specific type of trigger point therapy which she developed following earlier research and studies into pain and from myofascial trigger points.

Used today, the term myotherapy incorporates a wider range of techniques including massage, joint mobilization, therapeutic stretching, exercise, postural advice and, most important for me, education.

After I have given the dog a massage, to ensure everything is mobile and warm, I typically incorporate some myotherapy and stretching into my treatment session. Stretching serves a very important function in the proper workings of the body; hydration, circulation, oxygenation & detoxification. Passive movements – stretches undertaken by the therapist on the client - aim to improve joint function, blood flow and flexibility and maintain the existing range of movement of the muscles and joints involved rather than to push them further or stimulate nerve receptors. Active stretches are those undertaken by the client themselves and may take the form of simple and safe exercises, which is where education comes in. They shouldn’t be too hard but just enough to help the dog exercising safely. The easiest are weight-bearing exercises.

Demonstrating a few appropriate exercises to the owner that they can do with their dog to stretch and mobilise appropriate joints and muscles can then be their ‘homework’ to build on the therapy session with me and maintain the mobility until the next session. These exercises don’t have to be expensive with lots of kit. They can be simple walking, sitting or standing exercises. Our Sam loves the beach and loves digging in the sand. This is a great free exercise that is under my control. When I think he has had enough, I take the ball away. But while he is digging he is exercising his shoulders, back and rear leg muscles…..and it is free and fun.

Look at this YouTube clip – see how our Sam uses his back, shoulder, neck and thigh muscles while getting a good workout. And all I have to do is watch, video him and grin. Result!

Monday 25 August 2014

Canine massage – prevention, rehabilitation, maintenance or holistic?


I read a post (well, more a rant) recently from a canine professional which niggled me as it said that dog massage should only focus on prevention. I thought that was rather narrow-minded. Even though I’ve only been working in this field for a year now I have quite a variety of clients in my portfolio.

Some come regularly for maintenance massage session. This suits those who have arthritis which cannot be prevented as such but massage and myotherapy can help maintain their mobility and ease out any compensatory issues the dog might have. One of my case studies was an old German Shepherd who was a real lady but was beginning to not be able to enjoy walking. She had several sessions with me, not working on any muscle in particular but easing out her stiffness, helping to stretch her muscles and joints and generally allowing her to go “Ooooooo….that is what I needed”. After each session her owners would send me a picture of her lying flat out on the floor in what I call the Superman pose (arms outstretched in front) fast asleep instead of being in a stiff ball or being restless not being able to settle down. In a way she was healing herself. When she finally woke up she was ready for that long walk again. OK, she will never catch that rabbit again, but she could certainly move. When I last saw her, a year after her initial therapy, she was still mobile and happy. Prevention or maintenance?

Others come with a specific injury. Massage and muscle therapy can target the area that the vet has diagnosed as being the cause of the injury. Again, it is too late to prevent that injury…it has happened. But what the sessions can do is promote and hopefully hasten the natural healing process. Also by showing the owner what techniques are beneficial to that particular issue, hopefully the injury should not recur. Prevention or rehabilitation?

Four of my clients have been amputees. In these cases you have to use your skills to think what muscles and joints are possibly being overworked to compensate for the lack of one limb. As well as that, there is the back and spine to consider. The spine of amputee dogs often bends slightly to help balance. So that area should also be looked at to assess for any undue strain and tension. Prevention, maintenance, rehabilitation or what?

Other clients I have are canine athletes. They attend agility events where they have to jump walls or hurdles. In these cases maybe prevention of injury is the best therapy. I usually schedule a therapy session before or after their event to make sure everything is in working order. I also teach the owners the importance of warm-up and cool-down massage routines just before and after the actual event. So maybe this could be classed as prevention but it is also maintenance and well-being.

Finally there are the clients who come to me for relaxation. I have quite a few nervous clients who were not able to be touched or were just antsy. Often it takes several sessions to build up the trust with these clients but over the course of these sessions they visibly change from nervous excitable dogs to massage divas who run to the massage mat when they come in and lay down as though to say “OK….I’m ready now Dr Les. Start your work”. One such client is a small Chihuahua who, at the age of 5, was still not pick-upable by anyone other than the owner. She has been coming for some months now and this time the owner said that she actually feels that she would be able to leave the dog with a groomer without her getting too anxious. That was a great result. When she sits in my lap for her session, her eyes go googly immediately now and every muscle and joint relaxes so she is all floppy. Prevention, maintenance, rehabilition, behaviour or maybe just holistic?

Personally I think to pigeon- hole the rationale behind canine massage and myotherapy as having one benefit is not the way to go. I prefer to think holistically – where my therapy can work on the whole body since everything is ultimately interrelated and interconnected.  The focus should be on the dog and the many ways that massage & myotherapy can help them.

Sunday 24 August 2014

Our Sarah's Story...

......or how a grumpy dog turned back into a Diva dog who loves massage

We have two collie/spaniel dogs – brother and sister, Sam and Sarah. We were warned that they would develop obsessive behaviour so knew what to expect. As it happened they developed different obsessions. Sam soon discovered seagulls – which is fortunate as we live right by the beach and sea. His goal in life is to chase each and every seagull in Sussex, barking at the top of his voice. Why? We have never figured that out. He hasn’t a hope of catching them unless he develops wings. But the smile on his face as he runs, weaving up and down the beach, in and out of the sea is enough reason (and pleasure) for us. Sarah is not so fussed with seagulls – she discovered the delights of tennis balls. Being a good Dad (or so I thought at the time) I used to encourage her obsession by carrying a ball in every pocket and constantly giving in to her demands of ‘Throw it Dad...now”.

One day we noticed that Sarah was beginning to stiffen as she got up or walked up stairs after a heavy ball playing session. I’m a qualified masseur so automatically used to rub her down after such a session but didn’t really know what I was doing dog-wise (dogs are different from humans....they have more legs and muscles are in different places!).

We attended a very basic dog massage introductory workshop and took along Sam and Sarah for practice. Although they are siblings they are surprisingly different. Sam is a ‘normal dog’ – you can pick up his skin, it is loose. He has soft fur. Sarah was quite abnormal. Her skin was like it was superglued to her. It wouldn’t pick up. And her fur was like rubbing a loo brush. This was a classic case of the Good Dad being a Bad Dad and causing unknown injury by constantly throwing the ball. Because her exercise was largely jumping (rather than Sam’s weaving and running) she had developed what would be called a stiff neck and back in human-terms – a VERY stiff back. Because her skin was so adhered like Velcro, her fur was suffering as well and was becoming coarse and loo brush-like. Although we were only shown one technique, skin roling, this helped to lift the adhered skin to allow fresh nutrients to circulate

 
Sarah loved her massage and instead of having to chase her around, began to demand a massage...daily, hourly, all the time. Yes, she developed a new obsession – but a healthy one this time.  After just one week we noticed the difference in her skin – it was getting easy to lift. After a month it was not just her skin and fur but her personality which had changed. She was now back to the bright eyed, happy, loving dog we started out with and not the grumpy tired dog she had become. This change was not only visible to us but others as well. The groomer and dog walker both asked what we had done with the ‘old’ Sarah as this ‘new’ model seemed so much better. The groomer in particular said that when she used to cut Sarah’s fur it was like sandpaper but is now like running a hot knife through butter.

In the meantime, I took, and passed, a diploma course in canine massage plus a number of more advanced workshops and courses - as many as I could find to expand my toolkit of techniques and skills.


Fast forward several months later and we had our girl back. She started to drive her brother mad by constantly teasing him again. At night she slept with both eyes closed in a total relaxed state. She still gets a ball – but on my terms and for limited times only and rolled along the ground not thrown so she would have to jump. The Bad Dad has learned to be a Good Dad. And all this through canine massage and myotherapy. OK...we now have a Massage Diva but we can live with that.  She even seemed to become younger - while out walking she prances, she struts, she waggles her tail, she rounds up the rabbits for her brother....she makes me smile!

This is what convinced me to start dog massage and to qualify as a professional canine myotherapist. Yes, I still get strange looks from people when they ask me what I do and I reply that I am a professional dog massage therapist but their opinion changes when I explain what it does and how it helps. And now my skills are being put to use on more dogs and give them the same new quality of life our Sarah has.  Plus I now deliver my own workshops and courses to empower other dog owners with some of the tips and skills to bring the massage diva out in their dog.  

The chance to spend my working days with dogs was impossible to resist.

Friday 22 August 2014

Complementing the Complementary Therapist

When our Mr Sam went to see the veterinary orthopaedic specialists recently to diagnose what had caused his sudden lameness, I was like an anxious father all day waiting for the phone to call to let me know the results. At 11:00 the specialist called and said it could be a number of things from Osteochondritis Dissecans (OCD) – he is half collie – or soft tissue damage or arthritis or something else. He said there were a variety of investigations they could do with varying degrees of invasion. X-Rays would show skeletal issues, radiographs with injected dye would show any soft tissue issues, injection of steroid into the joint capsule would help with the pain and biopsy of the large lipoma (fatty lump) that has been growing under his armpit would help diagnose if there were any malignant cells. I told them to do the lot while Sam was sedated as I didn’t want the diagnosis to be inconclusive meaning Mr Sam would have to go through the ordeal again.

The outcome was that he does have arthritis in his shoulder, not too bad, and the biopsy showed that the fatty lump was just that, fat with no malignant cells. Big phew! When I brought Sam home he was totally out of it. I carried him into the car and he seemed to forget how to lie down. He just stood there looking vacantly out of the car window. When he got home I carried him into his bed and sat with him. As he came round he really didn’t want to know me. I was “BAD DAD”. Instead he went to over to Chris for his cuddles. The next morning he was still anti-me and only wanted a short walk. So I brought him back and left him while I took his sister out for a longer walk. She thought that was way cool. When we came home she strutted up to her twin brother as though to say “I’m special….Daddy took me out on my own…nya nya nya”. Such a caring girl is our Sarah!!!


The caring Sarah


Fortunately Mr Sam is never one to hold grudges for long and later in the morning I was sitting on the step outside when I felt his head nudge under my arm and he snuggled in for a hug. Clearly he had decided the steroids were working and I was an “OK DAD” after all.

Now we knew what the cause of his lameness was I started doing my geek stuff and researching things we could do to help his arthritis as well as his daily massage. I started by looking up lipomas and the use of frankincense came up repeatedly. So we bought a bottle and he now gets that rubbed into his lumps twice a day. As well as making him smell rather nice it seems to have helped. One of his lumps is decidedly smaller while the big one under his arm is a lot freer so will not be such an obstruction to his movement. I also read that giving your dog filtered water could help so now they only drink freshly filtered water. I’m not sure if that is doing them any good but they seem to love it and get through a lot more each day – there are far more dribbles all over our floor now. The addition of fish oil and bee pollen tablets was also mentioned so they are given those too as well as Rhus Tox homeopathic pills.

They have always been on glucosamine and chondroitin supplements but I found that,in the research I was doing for arthritis, the addition of a variety of tablets including turmeric/curcumin, boswellia, cat’s claw, devil’s claw and ginger could all help alleviate the aches.

We are working through this list, seeing which work best and which seem to make little difference. We can’t give him too many at one time as we are running out of food to hide the tablets in. One of the other things we were told is that they need to lose some weight – about 3 kg each would be good over the next 9 months. So we can’t keep topping up their diet with cheese spread which is our normal subterfuge method for hiding tablets.

Adding these components to my toolkit of therapies has helped me enormously too. I always thought that massage therapy for dogs was the only thing that would work. But I now realise the clue is in the name we are given – Complementary Therapists. I am far more open to adding other therapies into the mix. Chris has taken a course in Reiki which is something else we use while he has his nightly massage.

I’m not going to be using frankincense on my AchyPaw clients but it sits alongside my MSM gel and massage cream with lavender, arnica and comfrey so I can offer it as an appropriate option for the owner to try. And if the supplements start to take effect on Mr Sam, then they can be added to the list of suggestions as well. Maybe some of the other therapists or dog owners in The Pet Shop Connection community could offer me some advice for things you have found useful? I'm guessing that not every dog will respond to the same complementary treatment but knowledge of what has worked for some and not for others would be handy.


My handsome man

Wednesday 20 August 2014

How and why I started as a canine therapist


“Best job in the world” – absolutely! 

We have two dogs – active (very) collie spaniel crosses, brother & sister. Sam has always been the seagull chaser, which is lucky as we live by the sea. Sarah was the ball catcher. A couple of years ago, when they were around 6 years old, Sarah started to change in personality and gait – she became grumpy, stiff walking and generally seemed ‘old before her time’. As a qualified human masseur I attempted some techniques on her which she seemed to appreciate. So I attended an introduction to dog massage workshop to learn if it was possible to adapt my human skills for a dog. That was it – I was hooked. I took and passed the diploma course and then gave up full-time work as surely nothing could be as rewarding as helping dogs to regain their quality of life, like our Sarah now has (having been massaged almost every day for the past 2 years – actively demanding it). We have our dog back, in fact we have a ‘new’ dog – a happy, bright eyed, loving, bouncy Sarah who doesn’t get the ball so often and when she does it is on my terms and rolled (not thrown).

I didn’t want to be part of a larger business or franchise so set up my own dog massage and muscle therapy service called AchyPaw so that I could offer a personalised service benefitting both dog and owner.

When I was researching about canine massage I constantly read that dogs will present you with their problem or they will show their gratitude and ‘give’ themselves to you. I wasn’t sure what that meant until I started – but they DO. Once you have gained their trust they seem to say “Oh….Dr Les is cool….I’ll give him my back leg now” or “Hmm…I’ve got two sides you know…work on that one now” while giving me big eyes and constant reassuring licks.

My very first client was a deaf Dalmatian so all my interaction had to be by touch and sight – saying soothing words would not work. She was a bit reluctant at first but the second and subsequent times she visited, she saw the massage bed and made a bee-line jump to it – “It’s massage time!” This happens so often I have given up being surprised…it just is. I still get quizzical looks from the owners who say “How did my dog know……?” I shrug and say it is doggy instinct.

Since qualification, I have taken several CPD workshops to further my skills and techniques and each time you learn a little more, to help a little more. In my first year I undertook classes to learn how to give a full holistic massage to a dog and about stretching and flexing exercises.

These came in useful the other day when we were attending a local dog show to promote the service and get dog massage into the local consciousness rather than people thinking that vets are the sole source of help. Of course vets are the professionals, they do the diagnosis but we are there to complement and maintain.

Our tent was a few stalls away from a Greyhound Rescue tent. In that tent was a handsome greyhound called Dick. Unfortunately he had only one front leg but the gorgeous big eyes and lovely personality of greyhounds. His owner bought him over to me and he shuffled himself down on the massage bed – clearly ready for some pampering. Over the next hour or so I was giving him a massage and some passive stretches while people at the dog show were going “Oooo” and “Ahhhh” as they passed – he was generating quite the interest.

As well as only having 3 legs, he also had been attacked by another dog leaving him with some nasty injuries plus he has bone cancer. But did he seem to mind? Not at all. He just settled in for his therapy session and loved every minute – as did I. It didn’t feel like a ‘job’ but a real privilege to be able to work on such a hero.

He was entered into the 6 legged competition which should be one dog / one owner (do the maths to count the legs). But there was a clear problem with Dick – only 3 legs. So his two owners each tied one of their legs together. Now do the maths – yes...it makes 6. Of course Dick won and his owners brought him over to us to show us his rosette. Dick saw me and the massage bed and leapt onto it with a big soppy grin as though to say “Now give me my prize”. That was a real tear-jerker of a moment. A dog who I had only met a few hours before trusted me and enjoyed the massage so much he wanted more.

So have I got the best job in the world? Absolutely!

Tuesday 19 August 2014

Being Your Own Therapist


When I started canine myotherapy I realised I had an uphill battle to get the word out there that such a service exists. People know about dog behaviourists and groomers but dog massage needed promotion. As well as speaking to local dog walkers and pet stores and using social networking we thought the personal approach would be the best one, where we take the AchyPaw team (my partner and I plus our two dogs) to dog shows and fairs. We started with a small gazebo which was basically just 4 poles with a lid. After a couple of shows we progressed to a bigger one which had 3 sides and even windows plus extra supports because the British weather is notoriously unpredictable. But sometimes even that won’t do. One event in May was a day like that.

We had been invited to attend the Plumpton College Open Day. Plumpton College teaches land based and related subjects so there were displays of things like horses, forestry, animals, tractor rides, piglets, fish, plants, lizards, birds, climbing, terrier racing and us. But when we arrived at 7:00 the rain was bucketing down and the wind was gusting like crazy. There would be no way we could remain on the ground…we’d be airborne within minutes. We must have looked rather pathetic because the organiser said that they would try and find us a classroom. After a while they came back and said all classrooms were busy but how would we like the old grooming shed? They took us to this old wooden building which was full of junk but was perfect for us. And waterproof. So we started cleaning it up and making it our AchyPaw @ Plumpton College studio for the day.

When the event opened we weren’t sure how busy we would be. But within a short while we realised this would be our best day ever. Clearly the idea of seeing dog massage and being able to bring their dogs to ask questions and shown techniques from professionals caught the imagination. We didn’t stop from 9 to 5 and even had people queuing outside to come and ask our advice.


I felt like a celebrity! “Les…what can you recommend for Rover’s limp?”…”Les...Rex has a slight scoliosis in his lumbar area, are there any exercises that could help?”…”Les, my dog is very excitable, are there any techniques you can show me that could help him relax?” and more. Fortunately I had space in our new studio to display all the exercise and stretches that I had recently compiled and printed out.

But all the time part of my attention was on one of our own dogs. Mr Sam has developed a huge fatty lump (lipoma) under the axillary region of his front leg. It has grown in size over the past couple of months to the size of a tennis ball and all of a sudden 5 weeks ago he developed a limp. Now we should be able to fix his limp. It is what we do. But we simply couldn’t get to the cause of the issue. Was it a strain, was the lipoma restricting his movement, was it something else? When I was learning my canine anatomy I found it easiest to get on all fours and see what muscles moved. Then I came up with the great idea of sticking yellow Post-Its with muscle names all over Mr Sam and watching him move. He was not amused.  This time I tried sticking a tennis ball under my own arm and tried to walk on all fours to see what it must feel like for our Sam. I can assure you it hurt.



One of the things I was taught in my diploma course was that I am a therapist…a professional specialist but I cannot diagnose. That is the role of veterinarians and what they have trained for. So we took Mr Sam along to our vets who repeated the things we had been doing – extending and flexing his joints testing for range of motion while looking out for signs for discomfort. Anyone who has a dog will know how stoic they are. They don’t like showing pain, especially to their owners. Mr Sam was still putting on a brave face with the vet but was clearly uncomfortable. They thought he had some arthritis in his elbow and he was not too happy when they stretched it. The vet said that they would start by treating the injury as a muscle strain and prescribed NSAIDs with a follow-up another appointment for 2 weeks. In that time, with medication and daily massage from us, the limp improved slightly but was still evident so we were prescribed a second dose of NSAIDs. 2 weeks later he was better still but the limp was still there so the vets decided it was time for a full scan of the joint and limb and a thorough examination of his lipoma. 


The outcome was that the lipomas are not malignant and that he has mild arthritis in his shoulder.  But now I know and can treat things accordingly.  Getting that opinion from the expert is vital.

Monday 18 August 2014

"So what do you really do, Dr Les?"


The handsome Obi
Obi relaxed

“No…dog massage is not pampering your pet”.
“No…I am not a dog groomer”.
“No…I’m not kidding, I really do spend my days massaging dogs”.
"No...I don't whisper to dogs".
“Yes…I am a professionally qualified specialist for dog massage & muscle therapy”.
“Yes…our dogs do look chilled because they have been massaged regularly for the past year or so”.

These are some of the questions I have to answer when we take our AchyPaw Dog Massage service (http://achypaw.com) to dog shows and events and set up our tent. If I had a £ for every person who goes past, reads our signs and says….”Ooo…dog massage….I didn’t know about that” then we could buy an even bigger tent. But luckily I love to talk about the benefits of canine massage and myotherapy. I guess that is the academic in me, having spent 21 years at the University of Brighton training others. At the shows we attend I seem to spend a lot of time kneeling down stroking dogs I have never met before while chatting to their owners. I always start my conversation with the dog usually telling them how beautiful or handsome they are because, to me, they usually are and before I start to feel them I always ask the dog if it is OK to touch them. Seems polite to me. At one event I asked a dog that and his owner replied, “OK…but wait until my husband has gone”. She thought I was talking to her! I’m not sure who was more embarrassed…me or her. So now I make it clear that I’m talking to the dog.

It’s the same when I work on a dog, even one that has had massage several times before from me. I always ask first if it is OK to touch them. They may be in a bad mood that day, they may be extra tense, they may just be tired and want to be alone. This week I was asked to visit one of my favourite boxer dogs who has had many treatments from me. Obi is a big handsome dog who had a collision with a car some months back which crumpled his back. He also has lumbosacral disease and is in his senior years. But he still chases his ball and he still loves his walks. He just has to stop sometimes on a long walk while he and his owner sit down for a rest. Seems quite a good idea to me. Anyway, he loves his massage and usually ends up fast asleep snoring. 


The other evening when I went to his house he seemed slightly less happy and didn’t throw himself dramatically on my massage mat as usual. Instead he wandered around the room. I never force a dog to have a massage but wait, chatting to them, until they decide the time is right for their therapy. After 5 minutes or so, Obi came across to me and sat in my lap which means “OK Dr Les…NOW you can start”. Interestingly he seemed quite stiff in his rear end as he sat down and I could feel slight muscle wastage in his gluteals. When I asked the owners about it they agreed that they had noticed that too but didn’t want to put ideas into my head. Clearly Obi was not happy back there and so I started by working on areas I know he enjoys, like his neck which holds up his broad handsome head.

As he started relaxing and sinking into the massage mat I was able to work down towards the areas of issue. There is a lot of stealth involved in this canine therapy job. I know that if I’d gone straight for his tight back end muscles, he would simply have walked away. I needed to get his trust first. Using compression and kneading techniques I gradually eased out his aches and brought some fresh nutrients to his muscles and joints. Rather than focussing on that area for the rest of the session, I kept moving around to other parts of his body and returning – stealth tactics again. 

After the session he seemed a lot happier and wandered into the garden. However, he always comes to say goodbye to me which means so much as I know I’m leaving my dog client happier and more comfortable.