May-Thurner Syndrome and Massage Therapy for Pain Relief

Posted on July 3, 2026     Leave a Comment

Massage Therapy, Therapeutic Exercise, and May-Thurner Syndrome: Supporting Comfort Safely

May-Thurner syndrome is a vascular condition, not a muscle injury. It happens when the left iliac vein is compressed in the pelvis, which can make it harder for blood to return from the left leg back toward the heart. Because of this impaired venous return, some people experience swelling, heaviness, aching, throbbing, tenderness, or fatigue in the affected leg. May-Thurner syndrome is also important because it can increase the risk of deep vein thrombosis, also called DVT.

Because May-Thurner syndrome is a circulation problem, massage therapy does not “fix” the vein compression itself. That part of care belongs with the client’s physician, vascular specialist, or medical team. However, massage may still have a helpful supportive role when it is performed carefully and appropriately.

Many people with venous conditions feel discomfort that they describe as muscle pain. Sometimes the pain is related to swelling, pressure, heaviness, or impaired circulation. Other times, the person may develop secondary muscle tension because they are changing how they stand, walk, sit, or move. If one leg feels heavy or uncomfortable, the hips, low back, glutes, hamstrings, calves, and pelvic stabilizing muscles may begin to compensate. Over time, that compensation can create real muscle tenderness, trigger points, guarding, and restricted movement.

Massage therapy may help by reducing muscular guarding, calming the nervous system, improving comfort, and addressing the secondary soft-tissue strain that can develop around the hips, low back, and legs. The goal is not to force circulation or aggressively “move fluid,” but to support the body gently while respecting the vascular diagnosis.

For clients with May-Thurner syndrome, massage should be conservative. Light to moderate pressure is usually more appropriate than deep, aggressive work, especially on the affected leg. Direct deep pressure over swollen, tender, warm, discolored, or visibly congested areas should be avoided. Massage over large varicose veins or fragile superficial veins should also be avoided.

The biggest safety concern is DVT. A current or suspected blood clot is a contraindication for massage over the affected limb. Warning signs may include sudden or increased swelling, warmth, redness, discoloration, calf tenderness, new pain, or a leg that feels noticeably different from the other side. Emergency symptoms such as chest pain, shortness of breath, rapid heartbeat, dizziness, or coughing blood require immediate medical attention. May-Thurner syndrome can be associated with DVT and, in serious cases, pulmonary embolism, so these symptoms should never be ignored.

Therapeutic exercise may also be useful as part of a conservative wellness plan, depending on the client’s medical clearance. Gentle movement helps the calf muscles act as a “muscle pump,” assisting venous return from the legs. Walking, ankle pumps, heel raises, gentle range-of-motion exercises, and gradual strengthening may help support circulation and reduce the effects of prolonged sitting or standing. Research on venous conditions has found that exercise focused on calf strength and ankle mobility can improve calf muscle pump function.

For many clients, the most helpful exercises are simple and consistent. Examples may include ankle circles, ankle pumps, gentle calf raises, seated marching, short walks, hip mobility, glute activation, and light stretching. These exercises should not cause increased swelling, heaviness, sharp pain, or unusual fatigue. If symptoms increase, the activity should be stopped and discussed with the client’s medical provider.

A careful massage and movement plan may include:

Gentle massage for the low back, hips, glutes, hamstrings, and calf muscles when appropriate.

Avoidance of aggressive deep tissue work on the affected leg.

Comfortable positioning that does not compress the groin, back of the knee, or affected limb.

Gentle therapeutic exercise to encourage movement, strength, and circulation.

Attention to symptoms before, during, and after the session.

Coordination with the client’s physician, especially if there is a history of DVT, blood thinner use, stent placement, or recent vascular procedure.

The most important point is that May-Thurner syndrome requires respect and caution. A client may be told, “This condition should not cause muscle pain,” but that does not mean the client’s pain is not real. The pain may be vascular, muscular, neurological, orthopedic, or a combination of factors. Massage therapy can help support the muscular and nervous system components, while therapeutic exercise can help support movement and function.

Massage therapy and therapeutic exercise should be viewed as supportive care, not a replacement for vascular treatment. With proper screening, medical clearance when needed, and a conservative approach, bodywork may help clients with May-Thurner syndrome feel more comfortable, move better, and manage some of the secondary muscle tension that can come with living with a chronic vascular condition.

The Healing Power of Music in Healthcare

Posted on July 2, 2026     Leave a Comment

Dr. Mei Rui is a Yale-trained molecular biophysicist, concert pianist, and clinical researcher at MD Anderson Cancer Center, where she runs trials on the measurable effects of music on the human body. In this conversation, we explore what actually happens in the brain the moment music enters it, why the auditory system is the first sense to develop in the womb and the last to go when we die, and how something as accessible as a curated playlist can outperform FDA-approved pharmaceuticals in reducing cortisol. What We Dive Into: 1. Music is not a supplement to healing. In the right context, it is the intervention. 2. The brain responds differently when you actually show up for the music. 3. A longitudinal study in twins showed that three to four years of musical training reduced the risk of Alzheimer’s and cognitive decline by 64%, an effect size found in no other single activity. THANK YOU TO OUR SPONSORS: Oneskin — Code KNOWTHYSELF for 15% off https://oneskin.co/KNOWTHYSELF

What Can Two Very Different Songs Teach Us?

Posted on July 1, 2026     Leave a Comment

Comparing “Speechless” and “Helpless” in Music Therapy

Every once in a while I’ll hear a song and think, “That reminds me of something else.” Recently, I found myself listening to Speechless by Dan + Shay and I knew it reminded me of another song. A few hours later I found myself thinking about Helpless from the Broadway musical Hamilton.

At first glance, these songs couldn’t be more different. One is a country-pop love ballad often played at weddings. The other is an upbeat Broadway number with strong R&B and hip-hop influences. Yet there is something about the choruses that creates a similar emotional feeling.

Both songs build toward a memorable, soaring chorus centered around a single powerful word: speechless and helpless. Each chorus rises emotionally and musically, giving the listener the feeling that the character has reached a moment where words alone are no longer enough. Although the melodies are not the same, they use similar musical techniques to create excitement, anticipation, and emotional release.

As music therapists, these similarities give us wonderful opportunities to help clients explore how music communicates emotion.

Listening for Emotional Expression

One activity is to simply play the choruses back-to-back and ask clients:

• How do these songs make you feel?
• What emotions do you hear in the singers’ voices?
• If you didn’t know the lyrics, what emotion would you guess each song is expressing?
• How are they alike? How are they different?

Many clients are surprised to discover that two songs from completely different genres can evoke similar emotional responses.

Exploring the Power of One Word

Both songs are built around one emotionally charged word.

In Speechless, being speechless is a positive experience. The singer is overwhelmed by love and admiration.

In Helpless, the word reflects being swept away by powerful emotions and falling in love so quickly that it feels almost beyond one’s control.

This can lead to meaningful discussion questions:

• Have you ever been speechless?
• Have you ever felt helpless?
• Were those positive or negative experiences?
• What other single word describes an important feeling in your life?

Clients can then write their own chorus around one meaningful word such as hopeful, grateful, fearless, confused, peaceful, or strong.

Songwriting Activity

Invite clients to write a short chorus using this simple format:

I was ____________________.

Then ______________________.

Now I feel ________________.

Encourage them to repeat their chosen feeling word just as these songs do. Repetition often makes a lyric feel stronger and helps reinforce the emotional message.

Musical Analysis

For clients who enjoy learning about music, these songs also provide an excellent opportunity to discuss songwriting.

Even though they come from different genres, both songs use familiar pop chord progressions and gradually build musical intensity before reaching the emotional high point of the chorus. This illustrates that great songwriting often relies less on originality alone and more on using familiar musical tools to tell a story in a compelling way.

Why This Matters in Music Therapy

One of the beautiful things about music therapy is discovering connections where we don’t expect them. Clients often believe that only people who listen to the same style of music can relate to one another. Comparing songs like these demonstrates that emotional experiences transcend genre.

Whether someone enjoys country music, Broadway, pop, or something entirely different, music has a remarkable ability to express universal human experiences.

Sometimes all it takes is one word, one melody, or one chorus to help someone recognize an emotion they haven’t been able to put into words themselves. And once that happens, meaningful therapeutic work can begin.

Ear worms…again

Posted on June 22, 2026     Leave a Comment

Why do we get songs in our head and what does it mean?

I started singing Me and Julio down by the school yard last week (we’ll almost 2 weeks ago now) when I was preparing for my trip to Missouri to Big Creek

So I wondered about this song and asked ChatGPT to tell me about it. I also wanted to know about the squeaky instrument in the background. Here is what I got

Me and Julio Down by the Schoolyard is one of those songs where the mystery is part of the point.

What is the song actually about?

The story appears to be about two boys (“me and Julio”) who have done something scandalous or illegal. A mother sees it, the police get involved, the father is furious, the narrator gets taken away, and eventually a “radical priest” helps get him released. The incident becomes so notorious that it supposedly lands them on the cover of Newsweek.  

The catch is that Paul Simon never decided what the boys actually did.

When asked what “Mama Pajama” saw, Simon told Rolling Stone:

“I have no idea what it is.”

He added that he imagined it was “something sexual,” but he never worked out the details because it didn’t matter to the song.  

So the song is less about a specific event and more about:

• youthful rebellion,
• adults overreacting,
• getting into trouble,
• and the narrator’s carefree attitude despite the chaos.  

Many fans have spent decades trying to solve the mystery, but Simon himself says there is no solution because he never wrote one.  

Who is Julio?

Probably nobody in particular.

Simon has never identified a real Julio who inspired the song. Most interpretations treat Julio as simply a friend or accomplice in the story.  

What is the squeaky sound?

That famous squeaky, almost laughing sound in the background is a Brazilian percussion instrument called a:

Cuíca

A cuíca is a friction drum. Instead of striking it, the player rubs a stick attached to the drumhead from the inside. That creates the distinctive squealing, chirping, almost monkey-like sound heard throughout the song.  

Paul Simon wanted a sound that was almost vocal or human. Brazilian percussionist Airto Moreira played the cuíca on the recording. Simon reportedly asked him for an instrument that sounded like a human voice, and the cuíca was the result.  

Why it works so well

The genius of the song is that the music feels joyful and playful while the lyrics describe getting arrested and becoming a public scandal.

The cuíca contributes a lot to that feeling. Its squeaks almost sound like kids laughing at the adults’ outrage, which perfectly matches the narrator’s attitude:

“I’m on my way, I don’t know where I’m going…”

The narrator never seems particularly worried about what happened. That’s why the song feels so carefree even though the plot sounds serious.

And once you know it’s a cuíca, you’ll start hearing that same squeaky sound in a lot of Brazilian samba music.  

Photo of the Cuíca

How has a failure, or apparent failure, set you up for later success?

Posted on June 19, 2026     Leave a Comment

I started this post over a year ago and abandoned it without finishing. For some reason it struck a cord today.

I’m currently listening to a Mel Robbins podcast about being successful NOW in work no matter what stage of life you are in. She is interviewing Carla A. Harris. I’m just getting started in the podcast but I have already bought her book called Strategize to Win.

I have a terrible habit of buying all kinds of books and not finishing them but I am determined to read this one all the way through. To help me in the endeavor I also bought the audio book so I can go back and forth.

Here is the link to the podcast episode

I find Mel’s podcasts to be so uplifting and helpful. She is so inspiring and brings hope to so many people. Her book, Let them, has been so helpful to me. I don’t always remember to follow the principles she lays out in the book but when I do I always end up better off.

Since we are talking books another one I finished recently was by Jefferson Fisher called The Next Conversation. I listened to this book on my trip to MO. I have been wrestling with a personal friendship that fell apart after a series of arguments and had hoped this book would help me find a resolution. It did not help me in the way I had hoped because I think that for now that relationship needs to be over. However, the book made me aware of ways that I don’t use my self confidence properly and words that I use that are unnecessary. One of the ways I’m working on this is to get ride of the word ‘just’ and sounding overly apologetic for the purpose of appearing humble. For example, I make an effort to sound non-authoritative even when I know that I am an authority. I often sacrifice clarity in an effort to appear conciliatory.

Next post…ear worms again. I have had the song Me and Julio down by the school yard in my head for a week now.

The 42 pound head–Client’s assessment

Posted on April 29, 2026     Leave a Comment