Florence Arnold, LMT

02/06/2026

Boxing and MindfuTherapy. We share an office. https://www.facebook.com/share/1ZaepFjdXX/?mibextid=wwXIfr

Boxing and Mindfulness Therapy with Paul Stubbs, LCSW for trauma, PTSD, Anxiety, Depression and Substance Use Disorders.

02/06/2026

My partner’s page for Boxing and Mindfulness Therapy.
We now share an office.

https://www.facebook.com/share/1ZaepFjdXX/?mibextid=wwXIfr

Boxing and Mindfulness Therapy with Paul Stubbs, LCSW for trauma, PTSD, Anxiety, Depression and Substance Use Disorders.

02/06/2026

Not everyone is sturdy enough for a “deep tissue” massage — not even seemingly healthy people — because many underdiagnosed pathologies, genetic quirks, and medication side effects can make muscle and fascia more fragile at any age.

[UPDATE: Obviously not all strong massage is harmful. No need to comment to that effect. 🙂 That's not the point I’m making. The point is that there is probably more POTENTIAL harm than most people suspect.]

The NON-RARE possibilities include: hypermobility, hypothyroidism, vitamin D and iron deficiencies, a bunch of inflammatory myopathies, and perimenopause or other low-gonadal-hormone states.

The DRUGS that can make us more “breakable” are the statins, oral corticosteroids, and fluoroquinolone antibiotics.

Most of these are minor, but not all, they are EXTREMELY common, and all of them can quietly lower tissue load tolerance, impair repair, and make muscles, connective tissue, and even tendons and ligaments behave less like tough rope and more like aging rubber bands — still stretchable, but slower to rebound, easier to irritate and damage. There are many more examples that are relevant to body pain in other ways, but literal FRAGILITY is the emphasis here: easier tearing.

But wait, there’s more!

There are also several RARE diseases that do this, but they are NOT rare when considered together. All kinds of rarer diseases collectively affect at least 4% of people worldwide — that’s 400 million people, well established as a bare minimum. Several of those cause soft tissue fragility: facioscapulohumeral muscular dystrophy (FSHD), mitochondrial disease, Loeys–Dietz syndrome, Marfan syndrome, eosinophilic fasciitis, and amyloidosis, sarcoidosis, and lupus.

People with these conditions often have body pain that motivates them to seek out help for it. A great many of them don’t know they’re vulnerable, and neither do most of the professionals they hire to, say, dig into their “knots.” But there are elevated risks for all of them if they get deep massage, acupuncture, dry needling, forceful fascial stretching, scraping, or other high-intensity manual therapies. These methods can easily overshoot unsuspected biological limits, provoking soreness, micro-injury, or flare-ups rather than recovery. And occasionally the consequences are even worse.

Even chronic pain itself is a kind of vulnerability: not from physical fragility, but from sensitization. Painful treatment can make a bad situation worse in a neurological way.

These conditions may also make people more vulnerable to postural and ergonomic stresses, but this is probably still a minor concern compared to the risks of intense massage.

This is why manual therapy intensity should be a clinical safety variable, not a badge of therapeutic virtue. Gentler, graded inputs make far more physiological sense in most cases.

That was the “abstract” for a whole new article that I have impulsively written and published in the last couple weeks, somehow finding time in the cracks for something that wasn't even on my project list. The topic has been on my mind for years and it suddenly seemed high time when I referenced it in a recent blog post (“Ideas for improving pain care”).

So there’s plenty more detail where that intro came from, if you’re interested! Ten times the words, references, and a full audio version. Link in the comments.

THE NEW ARTICLE:

“Sneaky Soft-Tissue Fragility: Many underdiagnosed health problems reduce the resilience of muscle and connective tissue, increasing the risks of “deep” massage”

~ Paul Ingraham, PainScience.com publisher

01/29/2026

The massage educator Sandy Fritz recently posted concerns about masssge therapists doing trauma informed massage and scope of practice issues. Trauma informed work is what I do in my private practice. Here was my comment on her post:

Trauma informed massage is not about “releasing trauma from the body”. Identifying myself as a trauma informed massage therapist, in my case, refers to both an approach and the context in which I work. I work out of a psychotherapy office, the focus of which is trauma, and clients may be referred by therapists who work there or find me through the practice website. My stance, which I make clear to my clients, is that the work we do is best as a supplement/enhancer to work done with a talk therapist. The intention of a trauma informed approach to massage is to support regulation of my clients’ nervous systems during the sometimes difficult work with a licensed talk therapist. Massage therapy can help identify somatic patterns (for example patterns of muscle tightness), which may or may not be trauma-related and empower clients in constructing a narrative about and healing from trauma.

I do my best work with a communication style that prioritizes client safety, that stays within scope and that is about collaborative decision making.

Emotional release can happen and takes a variety of forms (crying, shaking, etc) but is not something I try to elicit actively. I do not need to know anything at all about the trauma clients ate being treated for, but sharing is always welcome.

I agree that all massage should be trauma informed, but the reality is that it is not.

MTs are doing “trauma informed” work as a response both to a gap in education an increased awareness of trauma in the cultural zeitgeist.

My understanding and implementation of TIM is that these clients might need accommodation in pressure, positioning, draping, sequencing, pacing, Much like oncology massage. TIM emphasizes collaborative decision making, is mindful of triggering communication (both verbal and nonverbal).

Because of the lack of education about the effects of trauma in massage school curriculum, people with trauma are effectively a special population. They are labeled as “difficult”, “crazy” or “high maintenance”. Sometimes clients are these things for reasons that have nothing to do with trauma, but in my experience over 28 years, many of these clients behave this way for trauma related reasons.

We have MTs that focus on special populations. We should all be comfortable with oncology or prenatal massage, but that is not the reality of the industry currently.

To reduce TIM to a fad reinforces the idea that clients with mental health challenges do not have a “real” condition deserving a modified approach.

TIM is an emerging focus on a special population. It is Wild West right now in terms of training. I had some exposure to Somatic Experiencing in the form of helping to edit a training video for a psychotherapy CE platform and I came to the conclusions that it is a bit woo even for me. It is just not evidence based and it really lost me with the birth trauma (we are talking about the mother here) nonsense. I used other CEU providers for my education around TIM. Shorter courses, and one through a UK instructor, but grounded.

There is a need for an evidence based comprehensive training program for MTs serving clients with mental health needs. I see an opportunity for educators.

01/29/2026

Moving offices to 720 Elkhorn dr soon!!

09/25/2025

A lovely client dropped this off just now. He said he found a word to describe my style of work. It is highly improvisational and personalized.

09/25/2025

Some side lying neck and shoulder work.

04/10/2025

“Trauma is not what happens to us, but what we hold inside in the absence of an empathetic witness.
Healing trauma involves not the banishing of the traumatic imprint, but rather the gradual development of the capacity for presence, for awareness, and for self-regulation.
The patterns that have been laid down over decades cannot be erased, but they can be transformed—not overnight, but through a gentle and persistent process of remembering our fundamental wholeness.”
~ Peter Levine

04/04/2025

“A man, to be greatly good, must imagine intensely and comprehensively; he must put himself in the place of another and many others; the pains and pleasures of his species must become his own. The great instrument of moral good is the imagination.”
― Percy Bysshe Shelley, A Defence of Poetry and Other Essays