There’s the Rub

You know, Hippocrates was a massage therapist,” says the woman who, moments before, had been gently rubbing my toes.

“Sure,” I think. “And he also believed that all illness resulted from an imbalance of blood, black bile, yellow bile and phlegm.” A skeptic and a massage therapist could have a shaky relationship, but I’m not a diehard skeptic and she was obviously very good at massage, even if it turned out not to be the cure for my particular problem.

Some weeks earlier I had gone to a doctor to finally treat some foot pain I’d experienced for years. The diagnosis was hammer toe. This can be a crippling (and ugly) syndrome, but in my case it was just a slight deformity that caused my toes to press the tops of my shoes until the joints became sore — very sore. The cure? Get used to pain and wear big clunky shoes, or else have surgery. The surgery? Well, it’s probably got a technical name, but it basically consists of having the toe removed, the joints whittled down and then stuck back together like a peg in a tube and strung together for a month with a wire.

“Ugh,” I said to the surgeon.

“Don’t bother with toe exercises,” said the surgeon. “That won’t help. Don’t bother buying products to put on your toes to straighten them out. They won’t work.”

I mentioned, hopefully, that I had heard that massage therapy was sometimes used for such problems. “Couldn’t therapy relax my muscles to loosen up on those toes?”

“Don’t bother with that,” he said. “Those muscles and tendons have been taking shape over your whole life and it’s finally started to get to where it bothers you. How long do you think it will take for you to retrain them after 55 years of growth and development?”

Actually it was just a few days earlier in my diagnosis that a nurse practitioner had recommended to me a massage therapist who had helped her with a foot problem. I figured that even if it was a slim chance that it could help my hammer toes, it would at least be a more pleasant experience than foot surgery.

Patricia Garcia is one of about 1,200 therapists in the state certified by the National Certification Board for Therapeutic Massage & Bodywork. I met her at her office in Bow, although she’s something of an itinerant healer. Travel helps when you are trying to make a living in this field, which she does as a single mom. It also helps if you are very good and that is her reputation: Lots of doctors refer patients to her. No pun intended, I figured I’d be in good hands with Patricia.

She evaluated me in a cheerful manner and admitted that she hadn’t done a lot of work on hammer toes. Still, she felt confident she could help. Her treatments were $65 each. No, insurance doesn’t cover massage therapy — an ironic fact since many of them practice alongside, and in complementary relationship to, chiropractors, who have pretty much won the battle for insurance coverage.

I told her that it would be worth it if I could avoid the surgery and keep on doing the kinds of activities that I wanted to do.

“What kind of activities?” she asked. I listed gardening, walking, oh — I had recently taken up mountain climbing. In fact a group of my co-workers and I were planning on a corporate bonding expedition to climb Mt. Eisenhower in a couple of months. I told her that the price was a little high for me, but that I could invest in a couple of months of treatment if she thought that would be enough to make an improvement.

How much of an improvement? Well, I said, a cure would be nice, but I’d be satisfied if I could just make it up and back down the mountain without having to be carried.

There are 87,000 licensed massage therapists in the country practicing in specialties ranging from Acupressure, Bodywork, Chakra, Craniosacral, Deep Tissue Massage, Energy Balancing, Energy Healing, Lymphatic Drainage, Reflexology, Reiki, Stone Therapy, Therapeutic Touch, Swedish Massage, Trigger Point Massage. Patricia shrugs off the labels. She dips into a number of these techniques, but her emphasis is a specialty called Ortho-Bionomy, which seeks to change acquired patterns of stress to relieve pain, improve circulation and help the body heal. She’s taught about 50 people the principles and techniques.

Medical science doesn’t support many of the assumptions of massage therapy. The idea of channeling beneficial human energy to cure disease is considered suspect, at best, but even a skeptical observer such as Stephen Barrett, M.D., who operates the www.QuackWatch.org Web site says the ancient practice has its place for relieving pain and stress.

Patricia’s sessions took place in a dim room with the requisite New Age music. It was all very warm and comforting. I lay in my boxer shorts, under a sheet while she circled the table, applying various soothing strokes to my back, shoulders, legs and feet.

Patricia allows patients to remain fully clothed if they prefer. Her manipulations were never abrupt or painful. A few minutes into a session, I’d usually feel alert but totally relaxed, like wax on the table. Sometimes I’d fall asleep.

“I always consider it a compliment if my patients fall asleep or drool,” says Patricia. “It means I’m doing my job.”

My sessions began and ended with a little talk to discuss my health history and my progress. She would make occasional comments on my posture. Once while sitting, she caught me propping my heel on the chair leg with my toes supporting my leg like a goat hoof. “Don’t do that,” she said. “But I’ve always sat like that,” I replied. “Then stop,” she insisted. I chuckled to think I could just suddenly cease a mannerism that I had affected my entire life, but from that point on her words came back to me whenever I’d prop my foot and I would replace it flat on the floor.

Sometimes during these interviews, I’d find myself visualizing a scene from my youth — perhaps observing a posture that my mother always had, or an impression I once had about my own body. This is normal, she explained. Not only am I thinking about my body in new ways, but the manipulations she is performing are probing into decades of stored muscle memories. “The way your body is now is the result of everything your body has done up to this point,” she says. “And it’s not just physical. Emotions are stored in the bones.” She says it’s not unusual for her gentle manipulations to release some long-pent-up memories that bring the person on the table to tears.

The weekend of the mountain climbing outing arrived and I was nervous. I was still feeling some pain in my toes, even just while hoeing the garden, but this was the test I had set, so I wanted to see it through. Still, I didn’t want to have to be airlifted from the mountainside.

I took the climb as she recommended: one step at a time. I repeated a simple mantra she had given me to correct my walking pattern: heel, little toe, big toe; heel, little toe, big toe.

My legs grew tired. My old knees cracked a bit on the way down, but amazingly, up and down a 4,600-foot mountain, my weary feet felt no pain.

Then, the next week, while puttering in my garden, the pain returned.

Healing, says Patricia, is always a process and it happens just like the accumulation of problems that lead to sickness and injury, only in reverse. “The body knows how to heal itself and it wants to heal itself,” she say. “My job is just to help it do what it wants to do.”

Am I convinced massage therapy works? Not yet, but I’m continuing treatment. Maybe I’m just putting off an inevitable course of surgery, or maybe I’m learning to cope with a problem, walking step by step away from pain.

Of course patients seeking a massage therapist for medical reasons should talk with their primary health care provider. References and training history should be checked before starting any therapeutic program. A list of board-certified practitioners can be found at www.ncbtmb.com.

Oh, and Patricia Garcia’s office number is 226-6430. Tell her I sent you. NH