Hello, I'm Leah Knowles, LMP, Licensed Massage Therapist. I graduated in 2001 from The Heartwood Institute School of Massage after completing the Massage Therapy and Holistic Health Practitioner 1000 hour program, which exceeds the 550 hour licensing requirement in the state of Washington.
During that time and since, I have studied a variety of modalities preparing me to work with patients aged infant to elder, supporting health care needs for people with conditions ranging from happy, healthy, and fit without compromise, including pregnant women; to people with health concerns including severe injuries, chronic pain, chronic illness, cancer, lymphedema, or other compromise to health, both specific and complex.
When I began my study at the Heartwood Institute in Northern California, I was looking for a life changing experience. After completing a Bachelor of Science in Environmental Biology and Botany at Eastern Washington University, I had been living out in the hills of the Okanogan Highlands dabbling in herbalism and Reiki with friends, and I wanted to be able to take my interest in natural health and well being to a wider population, and earn a living while doing something I loved. For that I would need some kind of a license.
Little did I know that up to this day studying and practicing massage therapy would become the love of my life, a bolster to my own spirit, and my dream.
When I started out, in 2001, quite honestly, other than menstrual cramps, an occasional head ache, and wisdom teeth, I knew very little about pain, yet relief from pain became my specialty.
During these years my favorite modality was Neuromuscular Therapy (NMT), the study of my teacher being the research of Janet Travell, MD, which I enjoyed combining with Myofascial Release (MFR), both employing a deep pressure over a sustained period of time, NMT with a sustained pointed acupressure technique on 'trigger points', and MFR utilizing direct, often broad pressure to creating a sustained stretch, which can often be employed upon a trigger point.
I still utilize the philosophy of holding and working with a pattern over a sustained period of time, as in these modalities, usually 1 1/2 to 3 minutes if I feel I'm onto something good. This concept of staying with a dysfunctional pattern or relationship for a duration is applied to other modalities as well, which require less pressure than NMT or MFR. So, with my love for the other modalities, I have gone the way of using less pressure to achieve optimal results.
This transition in the nature of my work has occurred due to a combination of factors including my love for other modalities which require less pressure, and all the things that I have learned I can do utilizing those modalities for which deep tissue work blocks sensitivity to intrinsic movements of the anatomy, and changes in the flow or rhythm of fluids, the palpation of which is required in order to do this work.
Oh, and finally, the transition leading me to say "Good-bye" to deep tissue therapy was directed by my own sudden introduction to injury and pain. It happened in the blink of an eye, just as fast as you can say "Hya" while hitting a 20 pound hard falling object as though it were a volley ball.
Since that moment I have learned there are many facets to pain, which I wish I had never known, that I wish no one ever had to know. Pain that keeps a person awake at night. I now have pages of descriptive words for describing pain, when before I only had a few.
Also, I gained firsthand knowledge regarding the associated sense of loss that can accompany painful injuries and loss of function, as I had to let go of massage therapy, my life's dream. I also learned a fair deal about the patience, frustration, perseverance and letting go that is involved while a patient is waiting to get strong from healing.
During my leave of absence I became a nanny, and my days became filled with the joy of a growing family, while my desire to provide care for others was fulfilled. My little charge, who was 8 months when I met him, helped make me strong again, as he grew up to be a boy. Well, by the time he was 2 1/2, and his brother 4 months, those two boys helped me realize that if I can take care of these two young fellows, I'm strong enough to return to service in the field of massage therapy.
Often, my friends and their friends ask me to take care of their kids. Kids like me. I'm patient, and kind. For this reason, you may hear about me juggling other people's kids into my schedule. It's common.
When I am working with a child, I create time to let them be a kid. Often, things go best with children, when I take the time to follow their lead, interjecting my agenda at spontaneous intervals. Just as in making a peaceful bedtime transition, sometimes this is what it takes to do bodywork with infants and children. For this reason, in the event you find that your child may be in need of massage care, you can expect me to schedule extra time. Even if your little one is only likely to accept 1/2 hour of actual massage work in a session. Often on order for body work to happen with this group, there also has to be time alloted for a natural flow to occur, including nursing an infant, or games and toys with toddlers.
Also, during my absence from massage, I studied some chemistry, cell biology, microbiology, anatomy and physiology at Wenatchee Valley Community College (WVCC) in Omak, and began studying nutrition in prerequisite to what then became the dream, which is to complete a degree program in nutrition, so I can become a registered dietician, and meet the local needs in our community for a nutritional counselor.
Currently the dream to become a dietician is on hold. Time has been healing, and once again, massage therapy is the current dream, and the center of my attention. At this time I feel more authorized than ever to say I specialize in pain management, knowing that I have real life experience in many of the varied ways of pain, and a solid knowledge base and skill set to address painful issues.
Even though the Nutrition degree is currently on hold, I've been quite pleased with how the WVCC science classes have melded into how I think about bodies, and the insight that has been added to my current work in massage. Though I have observed and worked in regard to people's posture and walking gait since early in my career, I am feeling keener than ever when it comes to finding priorities in working with postural distortions, which we all have, except perhaps the newborn.
Postural analysis is the art of observing posture, with the intention of prioritizing techniques for bringing change to postural distortions. Examples of postural distortions can be found in all three planes of anatomy, creating tensions throughout the entire body, which can lead to pain or a decrease in strength and function. Tensions that arise from below, often stack up affecting the top. For that reason, if I notice something about lower extremities, often enough that is where I will start, even if you arrived with a head ache.
For example, if I notice that one foot is externally rotated more than the other, I may start by exploring that hip, where rotation of the leg occurs, knowing that a rotation in the lower body, will often affect the neck, which maintains a primary goal of always keeping the eyes looking straight forward, even though it means the neck must remain rotated to compensate for the twisting that occurs closer to the ground.
Conversely, if I notice that one hip is held higher than the other, I may start at the foot and ankle, and if I find that the fibula (smaller of the two lower leg bones) is jammed upward or lacking in motility as compared to the other, I’m likely to work on that, before doing anything with the hip.
For an up slip in the hip, however, I am just as likely to find a tension in the mesentery surrounding the small intestines causing tension to the hip, especially if there is a rotation accompanying the uplift. However, often enough, an up slip, may benefit from a decrease in tension in the ascending or descending colon, which often can be accommodated by enhancing the motilityof these organs, in conjunction with the circulation of blood or lymph to or from the these organs.
These are simply a few examples of what my work is like. It does not involve long relaxing well oiled strokes, as in a spa massage, though if someone offered me that type of massage, I would love every minute of it. This is a different type of work. It is, however, profoundly relaxing. Every massage is a little different, as every person is changing all the time, so the priorities will change for any person over time, and the work I do will vary, based on problem solving regarding motility of structures and fluid pressure dynamics.
One noticable benefit of this work may be a greater ease in maintaining a comfortable and healthy posture. Sometimes postural distortions become more obvious to an observer when a patient is moving. For this reason, I am likely to ask a patient to walk while I observe, if I don't get a good look at a person’s gait as they are walking toward the therapy room.
Also, sometimes I may ask you to get up and walk around during the massage. This is both to help your body integrate changes, and also to help you notice changes. If you have come to see me about a specific complaint, such as low back pain, you will know that I am very motivated and goal oriented to see some change happen, if I ask you to get up and walk around in the middle of your session.
If you are visiting from out of town, and wanting to add massage as a relaxing or rejuvenative addition to your stay, I am happy to accomodate that sentiment. In this event, I am less likely to ask you to get up off the table to demonstrate your new found freedom, and more likely to let you slip away into deep relaxation, if that is what your vacation orders. I'll still find many wonderful relaxing ways to support your health, while you get the stillness in time that you deserve.
Back to science, regarding massage. Physiology and cell biology really fascinate me, as so much of how we function is based on diffusion, osmosis, the movement of fluids, and the effects of solutes. Have I mentioned yet my love for the movement of fluids, as your waters travel around the body?
So, let me digress. Part of my 1000 hour program at the Heartwood Institute included Cranial Sacral Therapy (CST), as researched and taught by John Upledger, DO, http://www.upledger.com/content.asp?id=26 . This is perhaps the best known of light handed therapies, though it is not to be mistaken for energy work. It is fluid work. One part of CST has to do with the flow or waves of cerebral spinal fluid as it baths the brain and spinal cord, between the cranium (head) and the sacrum (lowest back bone, above the tail bone). Cerebral spinal fluid is responsible for delivering essential nutrients to the brain and spinal cord, while removing waste, all at the same time lubricating the tissues of these structures, including the beginning of the nerve roots as they exit the spinal column.
This study is where my fascination and love for the movement of fluids began.
CST also includes aspects of treating the peripheral joint motility by utilizing palpable nerve motility that occurs in conjunction with cerebral spinal fluid as it moves up and down the spine, and also the motility of all the bony structures, including work that can be done on individual vertebrae.
You may hear me talk about motility as it pertains to many things, as other than fluid pressure dynamics, enhancing motility of structures is really what my work is all about. Motility is the inherent movement of any body structure, which occurs at all times even when we are not moving. For most structures, it can be best palpated while the patient is still and relaxing, and the therapist is using just the right amount of pressure to access a structure without actually stalling the motility.
It turns out there are all kinds of ways to take the jam out of an injury or other dysfunction that include utilizing either an awareness or enhancement of fluid motion with the motility of structures, thereby creating greater function and ease.
The structures of the body are always moving, some just slightly, and some in obvious ways, however, everything is always moving, usually in three different planes, even when the body is still. The word structures include muscles, bones, organs, nerves, blood vessels, and anything else that is in a body other than the fluids.
My fascination with the motility of structures, and also posture and gait, began during my study of Visceral Manipulation, as researched and taught by Jean-Pierre Barral, DO, http://www.barralinstitute.com/about/vm.php. It is my job to find structures that are somehow restricted, and to help enhance the motility of these structures in the three planes. Since the motility is what the body is already doing, I'm not forcing anything when I am fostering enhancement to motility; I'm simply inviting the improvement or change to happen, which makes ‘manipulating’ motility of structures a very gentle work.
Alongside ‘motility’ a word often used in Visceral Manipulation and other modalities is 'mobility'. This is how the patient or the therapist are able to move a structure through it’s ranges of motion with intention. Most often referred to regarding joints, these are the tests I may do if I move an arm or a leg to see how how movement feels (perhaps gliding or stiff), or what the range is in the three planes of motion. I may also ask you to move in these planes, so I can watch for restrictions, and also the compensations that come with restriction.
Mobility can also refer to organs. There are techniques where an organ can be held in my hands and moved in the three planes of motion. I rarely use these techniques, they are however available.
My preference is to utilize techniques applying fluid pressure dynamics to structure motility. It's such a gentle work, to which the body readily responds. So that is usually my first choice.
Sometimes however, as an example, I may find some stubborn ligament. perhaps it's got a little scar tissue keeping it from being free to pursue it's greater purpose, which is to allow freedom in motility, at the same time as provinding stability. Let's say for example, the ligament is suspending the liver from the diaphragm, thereby affecting the left shoulder everytime the liver would naturally roll forward with some rotation. Sometimes, if a dynamic is not improved through my mild invitations while working with motility in conjunction with fluid flow, or with lymph drainage, which ought to enhance scar tissue clean up, I may feel compelled to get a hold of the liver and give that ligament a specific nudge, which may eventually soften back into a motility game with some more lymph drainage, before I bid your liver adieu.
Over the years and recently, I've continued to study with teachers of Lowen Systems: Dynamic Manual Interface. Frank Lowen taught for years under both Doctors Upledger and Barral, and has created his own system, which is highly reliant on his understanding of these modalities, honing the skills of his well studied students by focusing on the ability of the hands to palpate with gentle touch even the finest or deepest of structural motilities, as well as helping the student to prioritize techniques from the above lineage of study, based on what each patient presents.
Though Frank Lowen addresses therapy from many different perspectives, my favorite study through his course work includes circulation, and fluid pressure dynamics. Part of this work has to do with enhancing the hepatic portal system, which is a series of veins that carry the blood in the capillaries of the digestive system to the liver to be filtered, before returning to the heart. This work is applicable in many instances. For instance, if I feel the intestines are creating tension on a hip, I might employ this as a means of getting the intestines to relax or soften in tone. Often enough, tension can be the result of stagnancy in the fluids surrounding a structure.
This brings us to the specialty that your doctor will be most interested to hear about, Lymph Drainage Therapy (LDT) as researched and taught by Bruno Chikly, MD, DO, http://chiklyinstitute.org/ldt/discover.htm. This is the modality I am currently still most known for, even though you can tell from the above there is a lot more going on in my tactics at any moment than any one single approach.
I first became interested in exploring Lymph Drainage Therapy as a remedy for people who are prone to getting a raw reaction after deep tissue therapies. It happens quite a bit for all kinds of folks including athletes, many of whom may enjoy feeling a little raw after a massage or a good workout.
However, amongst my patient population, Fibromyalgia was a reoccurring theme, as was inflammation, and I could not stand the notion of sending these folks away feeling raw, when they have ussually already been feeling raw for too long by the time they find me. Often times rawness can occur due to the release of toxins or the breaking down of scar tissue. When I first approached this modality, the idea was that after I did some really thorough deep tissue, I could do some lymph drainage around the area, to help move away the offending chemistry and debris in a timely manner.
It turns out LDT is really what the person suffering from Fibromyalgia or prone to inflammation really needs to begin with. I immediately took deep tissue out of my protocol for folks confronted with these types of issues, and the benefits of massage for these kinds of complaints are so much greater with less pain involved after massage therapy.
Once I started studying LDT, I started hearing more about lymphedema, which is a condition normally contraindicated for massage, as a limb with lymphedema is prone to tissue damage with pressure, and also infections. It takes a series of classes to learn about the prevention and management of lymphedema, before doctors typically will refer a patient with this condition for massage. LDT for lymphedema most often involves helping the body to find a new path for the lymph to travel, once lymph nodes are lost or otherwise impaired. Most often the loss of lymph nodes is due to radiation or removal of lymph nodes during treatment for cancer.
I realized that no one else in our community had studied this important work, which meant that people in our community who need either prevention or management of this condition were forced to drive or actually move to a city to be closer to this imperative care, as lymphedema can be a life or limb threatening condition. Early treatment or prevention of this condition is essential to quality of life.
As I mentioned, most often these patients are cancer survivors who are already tired of driving from our rural community for medical treatment, by the time lymphedema becomes an issue. They've been looking forward for their entire journey to the simplicity of being able to stay home for their health care needs. Lymphedema had the capacity to be a crushing blow to an already exhausted individual, who was longing to stay at home, here in the Methow Valley.
Well, I knew I had to participate in allowing these folks to stay home however I could, so I went ahead and took the series of classes required. As a result, in the past I have had doctors refer their cancer patients to me for lymphedema care from across the region, coming to the Methow Valley to see me all the way from Oroville, Republic, Grand Coulee, and Chelan.
This is how I got to be known for Lymph Drainage Therapy, and why many people think this is one of the most important things I do. Indeed, I do feel very proud to be able to contribute to our community’s health care needs in this way. LDT also has a great appeal for people who have no complaints, as well as for those who have faced hard core sickness.
LDT is an excellent health tonic for anyone who is concerned about improving their overall health, or as an immune booster during periods of feeling prone to colds or allergies. I do of course utilize it in my approach to any injury or illness, yet it can also be used by active athletes to help with muscle recovery before and after a race, competition, or strenuous workout.
On that note, people who are starting a new exercise program or a diet may benefit from LDT, as those pesky cellular wastes that are released sometimes during a workout can be a deterrent to the determination and perseverance required to stay on track with your goals no matter what your fitness level. This can be particularly rough sometimes breaking out from the start, when it comes to creating a new exercise routine. I'm wondering if I might be able to help you with that.
Also, sometimes losing weight can be painful or cause fatigue. As your adipose tissues decrease in volume, their contents are released. One of the duties of adipose tissue is to protect the surrounding tissues from toxins and wastes, so as fat cells lose volume, these substances are part of the volume that may be released. When these substances are released, often enough it does not feel good, and the sooner you get that unnecessary chemistry moving away from your surrounding tissues, and flush them out of your body, the sooner you can get on with enjoying the benefits of all your hard work and determination. I'm wondering if I might be able to help expedite your realization regarding all the things about weight loss which you are hoping will feel good.
Pregnant ladies find LDT useful early on to help alleviate morning sickness, and later in the pregnancy to help alleviate swelling of the lower extremities. Even without these dilemmas, LDT is a gentle and comforting way to nurture yourself during this precious time.
Other uses for LDT include for the enhancement of beauty, by optimizing skin health and clarity, and decreasing bags, sags, and wrinkles. Scar tissue responds beautifully to LDT as well, by increasing freedom around the scar, and removal of scar tissue debris, which may be replaced by more congruent fibers.
Lymph Drainage Therapy has so many uses, the list still continues. Check out this list of applications, to see if LDT might benefit some of your health concerns. http://chiklyinstitute.org/ldt/applications.htm.
At the very least, LDT promotes an enhanced sense of relaxation, which is comparable to floating on water, and tends leave the body feeling rejuvenated, and the mind clear.
When I am not studying about human bodies and health, and practicing massage, I am most often enjoying all the gifts the beautiful Methow Valley has to offer. I am a member of the National Ski Patrol and volunteer at Loup Loup Ski Bowl, and also enjoy the many miles of cross country ski trails in the area, when I'm not sliding down hill. Outside of winter, I enjoy hiking, swimming, rafting, time in my garden, watching my chickens, and random moments hanging out by the river.
Often joining me on an adventure is my border collie, Lilly. Yes it is true what they say about border collies, and no, a dog does not always take after their person, or vice versa. I am much calmer, quieter, and more far more gentle with my paws. Lilly definitely has her own way of doing things. Perhaps in this way, we are similar.
Curious to find ways I might support your personal needs for wellness? Please allow me to be of service in your injury, illness, or well health needs.
Leah Knowles, LMP,
Winthrop, WA 98862
*Same day booking available only by phone.