Good day dear folks, clients and friends!

Sunday, April 25, 2021, Posted by Prema

At Integrative Healthcare Providers, we are pleased to continue safe services from our talented and dedicated group of practitioners. If you have been exposed to a person with a known Covid-19 positive status, please reschedule after 14 days.

Our Covid-19 office policies are still in effect!

During this pandemic, we repeatedly sanitize the office, continue using air filters in each of the rooms and hallway; and work in divided “pods” to minimize social contact exposure. You are requested to wait for one of us to greet you outside or on the outside balcony now that there is favorable weather. For clients that are not yet ten days post the Covid-19 vaccines(s), your temperature will still need to be recorded with each visit. Hand sanitizer or hand washing is also required upon entry to the clinic. I will offer a beverage to go rather than offering you water to drink in the massage room.

If convenient for you, Venmo is a ‘touch-less‘ app to provide payment. Having checks made out prior to the visit addressed to “Inner Balance Therapy” is also helpful.

I have received both vaccines and was tested negative prior to my second vaccine. Our staff will continue to wear masks covering our noses and mouths and we require our clients to do the same. Please consider there are vulnerable clients, immune compromised or elderly (not me) or pregnant women seeking our care in this environment. Outside clinical office hours, I wish to let you know that I am conducting my behavior outlined by CDC guidelines. My pod of people are limited to four individuals who are all vaccinated. I am continuing to limit public outings and shop during low activity times wearing a face mask and sanitizing my hands.

We are all so fatigued from the repeated rise of Covid-19 positive cases hospitalizations and deaths. A heartfelt condolence is conveyed to those who have suffered from this virus, lost loved ones or have ill family or friends that have been impacted from this virus.

An article from the New York Times posted March 21, 2021, by Christina Caron highlights safely celebrating spring holidays. When relatives or friends or peers strongly disagree about what is safe or valid, relationships can be damaged long-term. Sharing some helpful reminders maybe useful! Dr. Claudia Allen, clinical psychologist & Director of Family Stress Clinic at University of Virginia School of Medicine, states “remember
the other persons’ good intentions. Some who are willing to take risks are valuing connection; others that are less willing to take risks are prioritizing safety. When I am personally challenged, remembering to be kind is helpful.”

More than ever, it is important to take time daily to do self-care, tell someone you care about them and stay connected.

I look forward to continuing appointment availability and that we can re-enter a more normal lifestyle once again.

Warm regards,

Good day dear folks, clients and friends!

Sunday, July 26, 2020, Posted by Prema

I hope this letter and information finds you and your family healthy and safe.

During this ‘re-entry of coming back to a normal way’ of business, I will be following the protocols of the CDC, Michigan licensure, and the American Massage & Bodywork Practitioners AMBP guidelines. In this era of the pandemic, I will continue to monitor the spikes and flattening of exposures of Covid-19 in the Washtenaw county to modify policies and procedures for safety.

Due to maintaining a safe environment in both my office at Integrative Healthcare Providers, IHPAC, and my home office, availability will be limited. This means all are called upon for patience, kindness and understanding including me. During a cautious and slow re-entry to full time capacity, the extra time disinfecting the areas will require more of my allocated work hours. Keeping a traffic flow of folks safe to minimize exposure with other practitioners and clients will be necessary, too.

A facial mask is required to be worn when arriving, during and leaving your appointment. Hand sanitizers will be available for you to use before entering the massage treatment room. Consider that wearing a mask is advised to protect yourself, others and me while I am offering services. It is my intention that I will abide to the guidelines that my insurance recommends and IHCP require. During the pandemic, I request that you bring your own water with you. I have removed decor as much as possible and will cover areas with washable materials to enhance cleanliness.

At IHPAC, the office staff is requesting all patrons to stay in their cars or nearby to be greeted & get their temperatures taken prior to entering the premises. Please attend your appointment alone and not with a companion. We can text each other at the time of your appointment for me to come outside to you for your temperature reading. If you need to use the bathroom prior to your appointment, please use the restrooms on the far side of the elevator.

Updated forms will need to be completed and temperature readings with each appointment will be documented. I understand that these measures may be tedious and seem overly excessive. I do not wish to convey any mistrust with any of you, only to comply with the upmost confidence that we are all doing the right thing as our Governor Whitmer would say. I have new forms that I can email or mail to you to complete before your scheduled appointment.

New Booking Policy Due to COVID-19

If you are experiencing a fever, cough, or sore throat, please reschedule your appointment for when you are no longer symptomatic. If you have been to a COVID-19-impacted area or have been in close contact with a person infected with COVID-19, I ask that you please reschedule your appointment for 14 days past the date of contact.

I am increasing my rates for the first time in twelve years. For one hour, $95, with credit card usage $98, For one and half hours, $122 and with credit card fees $125. Please make payment in the form of a pre-written & dated check, Venmo, PayPal or exact tender.

Now for some interesting exploration!

During a Fresh Air podcast, Teri Gross interviewed James Nestor, a journalist with a new book “Breath”. His research is fascinating and particularly poignant during these challenging times. I have experienced sleeping more than could very imagine, consistent exercise and practicing breathing exercises have possibly helped me keep up my immunity. I confess being labelled in the ‘at risk group’ (over sixty years old), not volunteering and staying home has been challenging!

Considering Michigan is slowly reducing the quarantine restrictions with our best scientific recommendations, I found this article to be useful.

This quarantine era has been unique for us all. I have had time to relax, enjoy nature, exercise, enjoy cooking, reading and spending time with a few loved ones. I hope we can re-enter safely and wisely into a post-Coved era in a community with support and appreciation.

Please let me know if you have received this email. If you are interested in an appointment or prefer no appointment at this time or if you wish to stay in contact for future appointments, your intentions are appreciated.

I look forward to seeing you soon,

Warm regards,
Prema Lindsay Smith

I have your back. Do you?

Sunday, March 17, 2013, Posted by Prema

You probably are eager to emerge from cabin fever and engage in a warm and colorful spring. This change in physical activity has to be supported with a strong back to provide the greatest chance for a healthy, long life.

First things first! If you have numbness, weakness, tingling, burning or sharp pain radiating down one or both of your legs, this indicates you should have a medical evaluation. Pain can refer proximally (towards your head) as well. If there is constant pain between your lower ribs, waistline or between your spine and lateral torso, this is an urgent indication of a medical assessment. Loss or change in bladder, bowel or sexual function could also be a cause to report to your health care provider.

Much of our musculoskeletal tissue, soft and osseous tissue can be protected with proper posture, biomechanics, physical and psychological conditioning [1]. Nutrition, appropriate weight to skeletal ratio, injuries and genetic background, have a significant influence on the body. Back posture involves the muscles of the spine that provide stabilization against gravity and others that allow movement. To get a better understanding of posture and biomechanics, let’s explore the anatomy.

Basic Low Back Anatomy
The spinal vertebral column is sub-grouped into seven cervical, twelve thoracic, five lumbar, five sacral vertebrae (fused into one) and one coccyx bone. The lumber vertebrae are larger than others and provide a larger mass for the attachment of large muscles. The erector spinae consists of three muscles on each side of the spine [2]. This group assists in stabilization, extension, lateral flexion, ipsilateral rotation, pelvic anterior tilt, and contralateral tilt of the pelvic region. This is just one group of the superficial muscle groups! There are deeper muscles which support many of the same movements and postural stability.

There are a few more muscles that are helpful to know for bio-mechanical understanding. Quadratus lumborum, gluteus maximus and the psoas are significant core muscles that stabilize the torso [3]. Psoas muscle attaches to the anterior side of the lumbar spinal column and bilaterally attaches to another muscle on the inferior sides of our hips. This muscle is a significant player in providing lower torso strength, mobility and flexibility.

Psoas Muscles and It's Role in Low Back Pain
When the psoas contracts, it can allow flexion of the spine or hips depending on the physical position. The analogy of two, liked-sized children balancing on a teeter totter creates a dynamics stabilization can be applied to the bio-mechanics of soft tissue function. This relationship of leverage can be applied to the primary muscles, the erector spinae or gluteus maximus muscles and the antagonist muscle groups, abdominal muscles and the psoas major.

Due to the modern occupational life styles, many of us have contracted tight muscles and over stretched muscles in the wrong locations. Sitting in front of computers, driving cars, et cetera for prolonged periods of time can contribute to weakened back muscles. Posture is best addressed by contracting and relaxing both the primary and antagonist muscles groups. Because of prolonged sitting and leaning forward, the upper abdominals are contracted. Lengthening the upper abdominal muscle elevates the rib cage for increased respiratory ability and space for the thoracic and lumbar region. Contracting the lower abdominals elicits a reciprocal response to the lower erector spinae group.

Just the simplest execution of transferring oneself from lying to sitting or sitting to standing can either reinforce strength or weakness our backs. Instead of rotating the torso and depending on the appendages (the arms) for transferring a position, contract the quadriceps and the psoas for efficient power muscle loading.

Mindful awareness protects the smaller deeper muscles of the spine from improper usage potentially causing repeated, micro-muscle scaring. We have all heard and maybe said,” I just bent down to tie my shoelace and could not move”. As an infant develops, muscular strength increases to hold its head on top of the spine, a normal curvature develops in the cervical, thoracic and lumbar aspects. Being bipedal in our structure provides muscles to stabilize the column-like posture.

Exercise and Stretches for Lower Back Pain
Consider this concept-- if we have strong torso muscles, we do not need to depend on the ‘appendage muscles’, the arms and legs, to keep our bodies upright. When the head is positioned forward (our ears are anterior to our shoulders instead of above our shoulders) the curvatures in the spine are altered. If the curvatures of vertebrae are misaligned, the muscles, over time, cannot function and they change their configuration. Imagine a string attached to the base of your spine; the top of the string is realigning each vertebra, one on top of the other, right up to the base of your skull. Your musculature actively stabilizes your skeleton. The orchestration of movement seems so elementary, mostly because we do not stop to make the mind body connection. Yet, 80 % of Americans report lower back pain some time in their lives; it is the second most frequent cause of loss of time away from employment. It is not uncommon to jeopardize a long, healthy life, to suffer from back pain, degenerative disc disease, arthritis, osteoporosis, disc herniation and facet joint dysfunction.

Are your moves mindful?
Psychological states of mind can affect the circulatory, endocrine and nervous systems. The psoas is referred to as “the fear muscle” ; it clutches to protect vital organs. Many of the mind /body therapies have beneficial impacts on how we conduct our lives. Pain and /or discomfort have an understated effect on our mental capability and emotional composure [4]. Avoiding or mitigating chronic pain requires awareness and a multifaceted approach.

For additional information, visit the following site:

Stretch for Lower Back Pain

More Information about Low Back Pain and When to Seek Medical Attention:

Alternative Therapies

[1] Barker, MD, Victor. Posture Makes Perfect. Third ed. Waiwera International Limited, 2005. pages 12-14.
[2] Granger, Jocelyn. Neuromuscular Therapy Manual. 1 Pap/Psc ed. Baltimore, MD: Lippincott Williams & Wilkins, 2011. pages 233-240.
[3] Gray, Henry. Gray’s Anatomy, The Anatomy of the Human Body. 29th ed. Ed. Charles Mayo Goss. US: Lea & Febiger, 1973. pages 488-9.
[4] Koch, Liz. The Psoas Book. Third ed. Felton, CA: Guinea Pig Publications, 1997. pages 37-42.

Disclaimer: This blog provides recipients with the opportunity to learn about the benefits of massage therapy. Inner Balance Therapy is not a medical organization and the contents of this blog should not be construed as medical advice or diagnosis, nor should it be interpreted as a substitute for physician consultation, evaluation or treatment.