Use it or lose it! A bodyworker’s guide to self-rehabilitation after injury – by Noah Karrasch

Picture of Noah KarraschMany years ago when I first met Susan Findlay, owner/director at NLSSM school of massage in London, she told me she would like me to offer a course on knees.  I responded that I didn’t feel I did good work with knees, but focused on getting better hips and ankles; then knees seemed to get better on their own.  Her response:  “If you’re not comfortable with knees, that’s the course you need to teach!”  At the time I wasn’t pleased with her response but I’ve come to see the value in it since.

I’ve recently given myself an opportunity to test my theories about bodywork much more strongly than I might have liked.  A few days ago I severely injured my right knee… working for several hours on a friend’s cold concrete floor, with lots of kneeling and twisting.  After several hours with just the right twist, I heard a loud ‘pop’ and felt that my knee was very unhappy.  As far as I could self-diagnose, it seemed I’d either damaged my lateral collateral ligament or torn the lateral aspect of the meniscus.  Either way I couldn’t put weight into the knee, couldn’t bend or flex, and couldn’t get comfortable for quite some time.

Anyway, what an amazing opportunity to self-rehabilitate!  And I’m pleased to say it’s working:  48 hours after the initial shock, I was back to about 75% function in that knee, and continuing to feel stronger by the hour.  I think the ‘formula’ that’s working for me gives us all something to think about.  While I can now negotiate lifting myself up a step through that leg and knee, I can’t yet sink through the knee without a great deal of pain, and I don’t see the value of too much pain.

So what’s working?  Why am I getting better, without MRI’s and surgery?  Can we all get better with a bit of self care?  I think we can, but we’ve got to do a bit of work instead of expecting the work to happen to us.

1. I’ve not pushed myself too fast or too far… there’s very little twisting involved, and precious little bending and flexing yet.  On day three there’s finally a bit of flexing and extending the foot on a stair step.  Only gradually should we trust ourselves to give a bit of flexion while still doing most of the lifting work through your arms, if your toes, knees or hips are complaining.  You’ll have a pretty good sense of what’s too much and what’s just right in terms of the paces to put yourself through.  The big toe pushups from my book Meet Your Body remain the single most important piece of work I can recommend to rehabilitate one’s entire deep line, but especially the knee.


Meet Your Body by Noah Karrasch – featuring the big toe push up and other exercises for releasing trauma in the body

2. I’m always interested in breathing, or at least in staying relaxed while I work to rehabilitate, and I invite you to look at the same.  Current Heart Rate Variability studies suggest that a great deal of basic health is predicated on remembering to breathe in and out, regularly, approximately 6 times per minute.  This causes a greater HRV which facilitates heart function, strengthens the immune system and reduces inflammation among other wonderful features. When we push too far and too fast, we stop breathing.  It’s that simple.

3. I tend to want to look for longer lines of transmission in my body.  We’ll rehab ourselves faster if we’re as interested in what’s happening in that big toe on that same side foot, and how it relates to what’s going on in our low back, as we are in what the knee itself has to say.  While stretching the big toe hinge by holding onto a table and lifting into the toes, can you also keep your low back back, while stretching your head to the opposite side and looking behind you?  Can you see the value of trying to find lines of holding and getting breath through them to help find that most important holding spot and release and resolve it?

4. Finally, I do subscribe to the ‘use it or lose it’ school of thought.  I’ve seen too many frozen shoulders or creaky knees where patrons told me that it hurt if they moved, so they’d simply quit moving.  Well, how does one expect to get better if one hides from the challenge?  While I can understand the thought process, I can’t condone it.  We must move through pain and fear to get to the other side!  For too many of us too much of what we call debilitating pain is simply fear-based lack of movement into and through a problem spot.  Consider that movement can be seen as oiling rusted hinges throughout the body; they won’t start moving freely right away!  It will take a bit of time and energy to make them work smoothly again.

And so far, this experience of rehabbing a very scary knee injury is bearing me out on these thoughts.  I believe my experience could be duplicated by most of us…those who are serious about getting better, first need to decide to get themselves better.  It seems we’ve become a generation of people who expect others to fix us and take responsibility for us.  A surgery might be easier, but more likely a 4—6 week recovery from a surgery just isn’t as efficient as a 2—3 week recovery from the work one does for oneself… can more of us begin to think this way?  Can we use the simple principle “Use it or lose it” more of the time?  Can we decide to first assess what’s going on in our body, second, remember to keep breath flowing through it, third, slowly ask the body to come back to balance, and last, to keep on keeping on without overdoing?  Such, I think, defines the ability to heal self.

So, the good news:  another learning experience, another healing, another opportunity for me, and possibly you, to practice what I preach.  While I wish we didn’t find ourselves in these situations, I truly believe we can still find our way out of them.  By slowly returning to a regular climbing of stairs, full range of movement through the knee hinge, and general attentiveness to the way we ask our bodies to work, we can heal.  I believe all of us could be inspired to slowly but with purpose, move into and through the pain and fear, and return to function and joy.

Noah Karrasch is a certified Rolfer and licensed massage therapist, and holds a teaching degree from the University of Missouri, Columbia. He teaches core bodywork skills throughout the midwest and also works with the Wren Clinic in East London. Noah has written two books on bodywork: Meet Your Body and Freeing Emotions and Energy Through Myofascial Release.

True Healing: Respecting science while honoring intuition and common sense – An Interview with Noah Karrasch

Noah Karrasch is a certified Rolfer and licensed massage therapist, and holds a teaching degree from the University of Missouri, Columbia. He teaches core bodywork skills throughout the mid-west United States and also works with the Wren Clinic in East London, UK.

In 2009 Noah published Meet Your Body, a practical guide for anyone looking for effective ways to release bodymindcore trauma and improve their health and overall happiness.

In this interview Noah shares some insights from his new book for practitioners, Freeing Emotions and Energy Through Myofascial Release, and explains how his unique but simple approach reflects a paradigm shift towards “true healing”.

This is your second book for Singing Dragon – your first was essentially a self-help book, and this one is for practitioners, and has led away from the purely physical to the emotional plane. What was the impetus to make this transition?

The longer I work, the more convinced I am that the only dis-ease is the slowdown of energy. I’m more and more intrigued with the ‘why’ of that slowdown, and find that introducing the emotional aspect of bodymindcore into my physical work is producing good results. I want to challenge other practitioners to begin trusting both the presence of the emotional component of physical dysfunction and their own intuitive abilities to coax change in clients by honoring and inviting release of these old and often unaddressed emotional wounds.

You have drawn concepts from Indian and Chinese energetic medicine into the book. Could you say something about how you feel this adds to a practitioner’s understanding of their work?

I’m asking practitioners to make a paradigm shift from whatever their personal primary ‘healing’ tool or technique has been; to begin looking at a larger picture—a picture that includes the chakra system, the meridian system and the psychology of the body as well as the myofascial system. The commonality: all four systems represent a whole being, not just a stiff back, a sore hip or a frozen shoulder. I want to know what that shoulder is doing, and feeling, in relation to the meridians, the myofascial lines of stress, the neighboring chakras, and the emotions stored in the shoulder, and arm, and heart, and low back. I want practitioners to think outside their personal techniques box and begin to believe they can respect, understand, and chase energy movement through the bodymindcore, relying on a different set of old, established and proven tools given to us and used by other cultures successfully over the years.

You’ve also introduced a new and imaginative descriptive vocabulary in the book, words like “forwardupback” and “outlong” that make perfect sense when you say them. Can you say more about how you feel you are pushing the borders of language with this work as well as the borders of existing physical practice?

Pushing the borders? Well, maybe, and hopefully—that’s what a good practitioner does. All I really want to do is get therapists thinking that if clients participate, and learn to stretch in several directions at once while the therapist applies pressure (physical or emotional/psychological), energetic blocks are challenged and dissolved! My world has gotten so simple: If one can lift the head out of the heart, pull the groin out of the gut, and create space between all four of these major centers, energetic flow will increase and health will be enhanced. Health really can be as simple as remembering our elders telling us to ‘stand up straight’, and doing it! The more we can learn to think of creating space between disparate segments of the bodymindcore, the less energetic blocks can cause dis-ease and dis-order. The longer one thinks in this model, the more one is able to create their own movement cues that challenge longer, cleaner energy lines through the body.

As a practitioner, do you feel it is important to understand the techniques you practise from the point of view of your own body?

I spend a lot of time just living in and dialoguing with my body. I received a great compliment from my mentor Emmett Hutchins (lead tutor at the Guild For Structural Integration) recently. After reading Meet Your Body, he told me how impressed he was by my clear desire to self-reflect and learn as much as possible about bodies through my experience of my own body. This is tremendously important for a practitioner! Just as I don’t want to be treated by a deep tissue therapist who never allows others to touch him or her, I don’t want to be the therapist who tries techniques out on clients without first having some idea about how these techniques will serve, or inhibit, personal growth. I’ve got to serve as my own taster to see what’s healthy and what’s not.

What do you find is the most challenging aspect of your work?

Actually, currently time management is the biggest problem for me. It’s delightful to be wanted by others; it’s also important to learn to set realistic goals and boundaries of what I can and cannot accomplish. I’ve decided that time and money are commodities; I believe I have enough money, but I’m not sure how much time I have! I get busy and forget to take care of myself in my desire to help others. I can’t fill others from an empty cup.

In terms of bodywork, similarly, my greatest problem is trying to maintain the connections with clients in several states and countries, remembering where we are with each client’s healing process.

In terms of writing, I’m far too artistic! Any published book is merely what I thought at that particular time; several things in my new book, Freeing Emotions and Energy Through Myofascial Release, could probably have been explained more clearly, or have crystallized for me since I’ve written. The acquisition and understanding of knowledge is an ongoing thing. It’s hard to set anything in stone, when tomorrow a new piece may be revealed that sets on its ear everything I believed yesterday!

Having said that, I’m quite pleased with Freeing Emotions and Energy Through Myofascial Release which begins the dialog, gets practitioners thinking of energetic models, and creates more client accountability.

Do you feel this field is expanding into new areas, and if so, where do you think the interesting work is going to be done in the next few years?

Oh, my, yes! When I first read Ida Rolf’s book 28 years ago, and when I started doing bodywork 25 years ago, I was considered pretty ‘far out’. Today, Rolfing and bodywork have become mainstream. Most hospitals have added complementary and alternative medicine departments, because the public is demanding them.

There are those who try to quantify the work I suggest, and ask “What good is a massage or bodywork session if one can’t measure the results?” I’ve never been a fan of forcing results to be quantified, because my clients aren’t research subjects—they’re people! While there’s got to be some meeting of minds between science and spirit, I hope to give more practitioners of any discipline, permission to intuit how to best serve their clients, respecting science, but honoring intuition and common sense. I see this becoming more important to true healing, and where true healing is headed, regardless of technique.

My model is hopefully based on common sense. I encourage clients—and I see this change happening in various disciplines—to take charge of their own process and their own healing. I believe we’re coming to a juncture in our health care system where personal responsibility and gut level, honest self-reflection are the tools that will best allow us to find our way out of dis-ease, and back into the free flow of energy through the bodymindcore. I believe more practitioners are realizing this need for work to free the core of the person instead of trying to fix the external symptoms. It’s liberating even as it’s also harder work for the client. But I truly believe any common sense energy medicine model of the future will demand clients’ participation in their healing; not just their physical presence, but their emotional and energetic presence as well. It’s an exciting new world of healing we’re entering!

Copyright © Singing Dragon 2012.