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Why Incorporate Therapeutic Ultrasound into a Massage Treatment?

Why Incorporate Therapeutic Ultrasound into a Massage Treatment?

By Linda Chang, RMT

Registered Massage Therapist
Certified Therapeutic Ultrasound Practitioner


Therapeutic ultrasound is one of the most widely used modalities for the treatment of soft tissue injury, joint dysfunction and pain, which has been used in North America for over 40 years.  Therapeutic ultrasound is the use of sound waves to elicit therapeutic benefits to specific target tissues.

In addition to massage therapy, I also obtained professional training and certification as a certified therapeutic ultrasound practitioner.  In my practice, I integrate Swedish and deep tissue massage, Shiatsu (basic), and therapeutic ultrasound (if indicated) into one multi-faceted treatment.

According to a client’s condition, I apply the thermal and/or non-thermal effects of therapeutic ultrasound to treat specific conditions.  In the meantime, depending on the different target body parts, protein and collagen contents of the structure I am treating, it is crucial to formulate the right dosage with an articulate combination of frequency, power density, duty cycle and treatment time to achieve safe and effective results.

Incorporating therapeutic ultrasound (only if indicated, and consented by the client) into a massage treatment reinforces the relief of musculoskeletal pain and tension, joint stiffness, muscle spasm by increasing metabolic rate, blood flow, vasodilation, permeability through cell membranes, and enzymatic activities; therefore it enhances cellular functions to remove tissue debris and repair the target area.

Massage with therapeutic ultrasound can be helpful for a number of acute, subacute and chronic conditions, including musculoskeletal pain and tension, tendinitis, frozen shoulder, Sciatica, knee pain, headaches, plantar fasciitis, neurological symptoms (numbness and tingling), deep adhesion, etc.  When a short therapeutic ultrasound session is combined into a Swedish and deep tissue massage session, you may be pleasantly surprised about the next level the entire treatment can reach!


Prior to joining The Pacific Wellness Institute in November 2014, Linda practiced massage therapy at physiotherapy and chiropractic clinics respectively.  Other than helping clients de-stress, Linda has extensive clinical experiences working with clients through their journeys to recovery.  If you have any questions about a combination treatment of massage with therapeutic ultrasound (if indicated) for your specific condition, please contact Claudia at The Pacific Wellness Institute at (416) 929-6958.

Joanna Completed Lomi Lomi Massage Course in Hawaii

Joanna Completed Lomi Lomi Massage Course in Hawaii

Our registered massage therapist, Joanna Rogowska has recently returned from her trip to Hawaii where she studied Lomi Lomi massage.

In 2013 I traveled with my family to Thailand. While there I took the opportunity to complete a course on Thai Massage at the well known Massage School of Chiang Mai. My clients so enjoyed some of the new techniques I learned that I thought when we were traveling to Hawaii this year I should further my education of massage by taking a course in the great ancient Hawaiian healing technic of Lomi Lomi.

We traveled directly to Maui and after a day to adjust and rest I was off to school at Ho’omana. The school is owned and operated by Jeana Iwalani Naluai, MPT, LM, a very well known Lomi Lomi therapist in Hawaii. She has been practicing bodywork for over 20 years and been an instructor in the Hawaiian Lomi Lomi massage since 2005. She is now traveling around the world teaching Lomi Lomi.

The course was an amazing experience with many new techniques, which I hope to use in my work with all my clients. The gentle but firm approach of Lomi Lomi has been helping to heal Hawaiians for centuries.

Our holiday was a total success. We enjoyed our time on Maui, hiking to the bottom of a very old volcanic crater, hiking up rivers to swimming in freshwater pools under the waterfalls and of course whale watching and exploring different beaches. We finished the holiday visiting Honolulu and then flew home.

I look forward to putting some of the new techniques I learned into practice with all my clients.

It was a great holiday and one that will always bring back fond memories.

 To arrange an appointment with Joanna Rogowska, RMT, Cr, Dipl. ST (Hon) for Swedish Massage, Shiatsu, Reflexology or integrated bodywork please call us at 416-929-6958

Joanna in Thailand

Joanna in Thailand

My family and I were on a holiday in the wonderful country of Thailand in mid-March.
We traveled from Bangkok to Chiang Mai and then to the very south to the island of Koh Lanta. The weather was high 30’s most days with brilliant sun.

What made it particularly memorable was that I had the opportunity to continue my education in the art of massage. I contacted the Thai Massage School of Chiang Mai which is internationally recognized by many organizations including the College of Massage Therapists of Ontario, CMTO. I registered for the  Thai Chair Massage course and spent time one on one with Dr. Futoshi Tsuyukubo who is a visiting teacher from Japan where he practices bone medicine. He is also one of the original graduates from the Thai Massage School of Chiang Mai.

The course covered many aspects of Thai massage with the main focus on performing back, shoulder, neck, head arms and hand massage on a massage chair or on a regular chair. The school was a highlight of my vacation and even more so, as I was able to have the full attention of Dr. Tsuyukubo.

I now look forward to putting some of the techniques learned into practice and of course for any of my clients who wish to sit they can now do so and benefit from my learnings in Thailand.

It was a great holiday, one of my family will always look back with fondness.

To arrange your appointment with Joanna Rogowska, RMT, CR, Dipl.ST (Hon),  for a Swedish Massage, Shiatsu, Reflexology or integrated bodywork, please call us at 416-929-6958 or submit your appointment request online.

Massage Therapy Can Help You

Massage Therapy Can Help You!

Nicole Basque, B.A. RMT

As a Registered Massage Therapist, I feel that a thorough treatment includes educating my clients about their bodies. Most people are curious to know how massage can help, and what suggestions I have for them as their health care professional. I am always eager to suggest different ways my clients can maximize their massage therapy experience, and work with me towards well being. Here are a few tips I like to share:

Our bodies react and adapt to repetitive actions

It may sound bizarre, but muscles have memory. The more you put your body through movement, the easier it will become to perform that motion. For example, as soon as you learn how to walk, you practice and practice, and it eventually becomes automatic. Other examples of muscle memory include learning to play a sport, learning to play a new instrument or writing.

Many of us have been trained to sit at a desk for five to eight hours a day, allowing us to be at ease in the seated position. As a result, standing becomes difficult, and at times even painful. Performing any activity for more hours than not on a daily basis creates habits in your body. These habits manifest as constant muscle contraction and can perpetuate even when you aren’t performing specific activities. The most active muscles in the body, therefore, tend to remain contracted even at rest.

Our bodies crave balance

Simply, the muscles in our body can be categorized as pushers and pullers. Ideally, both groups are equally strong and can compensate for each other. Commonly, one set is overused, the other underused or even weak.

If the pullers work hard all day, the pushers become lazy. When it is time for the pushers to take over, they are unable to do so properly. This usually causes pain, improper motion, and can trigger other unrelated muscles to become involved.

Our bodies are adaptive, so muscles will constantly compensate for each other. This can continue until the root problem resurfaces and we are forced to seek treatment.

Massage Therapy can help you

Swedish Massage Techniques (which most RMTs use as base techniques), aims to increase circulation, decrease anxiety and increase well-being. The strokes flow from the origin and insertion points of the muscle towards the heart so that the muscles can be brought back to their resting length. Massage calms tense muscles and helps the client feel centered within their body.

The goal of massage therapy is to help return the muscles of the body to their resting length. It can help remind the body that it should be at ease with its muscles working in balance.

Massage can also help with anxiety. Stress is often the main cause of muscle tension. Massage therapy is a way to calm the muscles manually, which in turn will help ease the mind. The increase in circulation helps you feel refreshed and soothed. The dissolved muscle tension helps you feel connected to your body.

YOU can help yourself too

Self-care is the key for massage therapy to be fully effective for clients. Because massage therapy appointments are generally an hour every 2-6 weeks (depending on the condition), the rest of the healing is mainly done by the client at home. Suggested strengthening and stretching exercises are paramount in helping clients maximize the benefits of massage therapy. It doesn’t take very much time to do (usually 15-30 minutes a day, maximum), and it will help you achieve your pain-free goals quickly.

Attitude is also essential in helping yourself deal with physical pain. If stress is the main cause of muscle pain, find the cause of stress and deal with it. It is never too late to create a happy life for yourself.

Massage Therapy is a great, natural way to get to know your body and to take care of it.

Nicole Basque has been working at The Pacific Wellness Institute since November 2009. She loves to treat the body as a whole and believes in holistic wellness. She is experienced in many treatments including simple relaxation, injuries, chronic conditions, and pregnancy.

Massage Therapy and Gestalt Therapy

Similarities and Differences

“Hello John”

“Hi Rahel”

John looks different today. He’s walking slowly as we head into the clinic space. I walk behind him to check for any altered Gait. I also happened to notice when we said hello that his face looks strained. He’s holding in pain, I’ve seen pain many times before and I can recognize it.

We enter the treatment room and face each other.

“How are you feeling? You look like you’re struggling today? That’s a change from our last appointment…what happened?”

“Yeah, just yesterday, I threw my back out. I can hardly move. I’m desperate.”

“How did this come to be?”

“Well, you know me. Always lifting boxes, I never pay attention and I don’t bend from the knees like you said I should. I guess my Back finally gave up on me.”

I want to say, you gave up on yourself. Actually I want to pit his resignation and effort against each other in a two-chair cage match and my top dog wants to bet $100 on effort. On a less I-it note, I want the two to come together and hug it out. I wonder if my client’s physical suffering might be better suited to such treatment, instead of a massage. Who’s to know? I can’t go there. Not in this role. Not at the risk of toppling the CMTO (College of massage therapists), a fragile house of cards…and the regulatory body of my profession. But, excuse me for I digress (it’s a primary interjector thing).

With some further assessment, I inform John of my goals regarding treatment and how I intend to reach them. Though I’m almost sure by the glazed look on his face that some of my treatment plans sound like, garbled gook, he unquestioningly nods yes. This makes me feel uncomfortable.

I leave momentarily so he can undress and get on the table, face down.

One of my favourite things about the job, a small thing, is the variation in response I get upon re-entering the treatment space:

“Come in”



“Come on In”

Some people use different inflection. Some don’t say a thing. I project that it has to do with how a client owns the space and owns their treatment.

John says “I think I’m ready” he’s the type to wait for things to happen to him (resignation?) maybe.

I turn the lights down, increase the soothing sound, and approach John. I always like to start by introducing my hands to a client’s body which is also a method of assessment. I sheer my hands over the entire body and feel for any discrepancies, anywhere that is not integrated.

I can tell when something is not integrated from varying factors. The tone of the tissue, its temperature, the texture of the tissue, its responsiveness to my touch or to guided movement, and if any of these things together or apart are appropriate within the context of their location. These factors can be sensed through my hands, sometimes my eyes, even the sounds the client makes, or the sound of cracking etc.

Then there’s something else. There’s something intuitive. Though all the above indicators dictate the areas I am to work on, it is my intuition that determines how I do that work.

It is essential to working in the “here and now” because a person such as John might come in with usual areas of tension, but needing different pressure or styles of technique from time to time.

And speaking of John…

After my hands-intro/assessment, I decided to start from the neck and work down. His neck is stiff like a group of full water hoses. This leads into his shoulders, down the middle of his back along the sides of his spine, and into a mass of hard tension that forms a constrictive band across his low back. I imagine a giant has John in the palm of its grasp and is squeezing fiercely. I imagine that wouldn’t be very comfortable, and almost a total loss of control (or a giving up of control? hehe sorry I can’t help myself…maybe I’m a primary projector?..hmm)

When I begin firmly kneading John’s neck the first thing I notice is resistance from the tissue to my pressure (Quel surprise/eye roll, Gee something about other people’s resistance really makes me smug…)

This means as is usually the case, that I cannot just dive in, I must softly enter from the side, getting deeper as the tissue warms to me.  That’s cool. We’ll get nowhere if I am attached to my version of what John needs and I don’t involve him.

In fact, this is the only way I can truly be creative. My creativity is indelibly connected to all the techniques I am capable of and aware that I have, as well as the needs that call them. So the toolbox is open, the state of John’s tissue in each moment and my sense of what’s needed dictate how the techniques and which tools I use, flow from my hands to/with him. We create a symbiotic fulfillment. A harmony or balance where both our needs are met all the while our integrity is maintained. To do my job, I must afford this commitment to all the clients I work with. I always pull out all the stops. No matter who the client is, I am committed to balance and integration. Worst case scenario, I refuse to treat someone.

Slowly, on a moment to moment basis, the path to balance is revealed. The sounds John makes have become warmer and softer, and flow like his oxygenated, lively tissue. His breathing is deeper and rhythmical. His body reminds me of the environment in which it lays. As it turns out, we have dealt a large focus to his upper back, neck and shoulders. His Low back received the attention of course, but by the time we got there, it had relaxed. Sometimes this will happen if I focus on compensatory structures first. Curious is it not?

Though there is still some residual tension, we stop for now.

The hour has just about finished. Enough time remains for John to change, and for him and me to address his current state of being.

I leave the room and let him do so.

Shortly after this, he opens the door fully dressed, a relaxed expression. He says “wow” and thanks me. I am split between joy and discomfort. Joy at his obvious harmony, discomfort at his obvious gratitude. We did it together…

I enter the room and close the door for this last piece of work. I explain what was discovered, and he tells me he is no longer in pain. I recommend a treatment next week for the residual tension and advise him not to overdo it. Then I give him some homework to accentuate the treatment, and I escort him back out to the foyer.

In Massage Therapy, as in Gestalt, the role of contact is dynamic. There is an opportunity for freshness around each turn. What I love about being a Therapist in all forms and variations is the opportunity to work with Universal manifestations of stuckness, so as to co-create wholeness. I’m pretty good at massaging through all the knots.

Rahel Kay, RMT, CR, CYI is a Registered Massage Therapist, Certified Reflexologist and Yoga Instructor.  She has been studying Gestalt Therapy at the Gestalt Institute of Toronto to expand learning and add depth to her practice.  She is available for Swedish massage, deep tissue massage, trigger point, lymphatic drainage and reflexology treatments at The Pacific Wellness Institute.  To arrange your session with Rahel call us at 416-929-6958.

What You Didn’t Know About Low Back Pain?

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), back pain affects approximately 8 in 10 people. Lack of regular exercise and the presence of other diseases (e.g. arthritis, osteoporosis, disc disease) may contribute to back pain. However, one of the most common factors is often related to poor posture, occupations that require heavy lifting or simply sitting through most of the day at a desk or in a car. Sitting for long periods of time shortens and tightens a muscle called iliopsoas (il-e-o-SO-us).

What is the iliopsoas?

It is composed of three muscles: psoas major, psoas minor, and iliac. Psoas major and psoas minor lie in the back wall of the abdomen; whereas, the iliacus attaches to the inside of the hip bone. These muscles join together to insert in the leg bone called the femur. We rely on this particular muscle for standing, walking, and running. It is a very strong muscle that brings your knee up toward your chest, similar to a sitting position. It also bends the trunk forward and it can raise the trunk like when you are doing a sit-up. Moreover, iliopsoas helps stabilize posture while standing.

How does the iliopsoas lead to back pain?

Iliopsoas has often been clinically implicated in low back pain. As mentioned above, prolonged sitting and heavy lifting overwork the muscle. As a result, it shortens the length of the muscle which may rotate the pelvis forward and downward. This increases the curve in the lower back which bears more weight and stress onto the spine, also known as lumbar lordosis. The shortened muscle may limit hip extension and develop trigger points that may mimic deep and achy pain to the hip, leg and low back. Furthermore, there is a lot of discomforts when you go from sitting to standing position.

RELATED: Lower back pain and Osteopathy

What can I do?

Massage therapy is effective in addressing low back stiffness. On the other hand, if you feel that the relief is short-lived or that there are no improvements with further treatments, then perhaps a massage for the back alone is not enough. Ask your RMT to include the iliopsoas in the treatment. Since it is located deep in the abdomen, it involves putting firm pressure on the muscle which may feel very tender. However, with slow deep breathing, the muscle will loosen up fairly quickly and the end result is usually positive. Regular treatments to this area will remove trigger points and prevent them from returning, which will ultimately minimize pain referring to the lower back. Although massage therapy is beneficial, it is also important to be active in maintaining your own wellbeing. Here are some of the following things you can do to help reduce the stiffness in the low back.

RELATED: Chiropractic Care for Sciatica

1) Sleeping posture
Avoid sleeping on your side in a tight fetal position because it shortens the iliopsoas to the point of pain. Instead, on your back with a pillow under your knees to lessen the tension in the muscle.

2) Heat therapy
A heating pack, hot bath, or sauna are a few examples of heat applications that you can use to alleviate pain, decrease muscle tension, and increase blood flow which promotes soft tissue healing. Plus, it is easy, relaxing, and inexpensive to do.

3) Stretching
Stretching is essential to minimizing low back stiffness. It helps increase flexibility and range of motion; as well, it allows the body to move more efficiently. As a reminder, stretches should be pain-free and held for about 30 seconds. Never hold your breath; instead, breathe slowly and regularly. An Iliopsoas stretch may be useful.*

4) Strengthening exercises
In order to provide a strong core to help stabilize the spine, it is important to strengthen the abdominals and lower back. The plank exercise increases the strength of the abdominals and the lower back simultaneously.*

Low back stiffness is a common condition that results in persistent pain that can be disabling. Many of us assume the location of the pain is often the source of the pain and as a result, we tend to overlook the iliopsoas. Next time when you come in for a massage session and fit the description of symptoms mentioned above, be sure to ask our RMTs at the Pacific Wellness Institute to include the iliopsoas in the treatment.

* If you have any history of chronic back pain, it is recommended that you perform this exercise under the supervision of a professional. Please ask your registered massage therapist for detailed instructions.

Monica Yeoh holds a bachelor’s degree in kinesiology from York University and completed the Registered Massage Therapy program at Sutherland Chan massage therapy school. To arrange a therapeutic massage session and iliopsoas exercise demonstration with Monica, call The Pacific Wellness Institute at 416-929-6958.