Insights from Treating Clients on GLP-1 Medication in Myofascial and Manual Therapy
- jennifer Spitz
- May 8
- 6 min read
A handful of the clients I see in my Holistic Physical Therapy Practice have taken the journey on weight loss medication. At the suggestion of one of them, I created this post.
All of the times that these clients started with these GLP-1 medications, they told me about it in advance; as someone who has worked with clients for decades with detoxification support for heavy metals, as well as diet and immune congestion from repeated infections over the years Epstein Barr, Lyme, and autoimmune diagnoses which also have significant detoxification and immune regulation issues. What happens with weight loss is an important detox.
Whenever your body loses weight, it is cleaning the house, which I mean like the home has never been cleaned before! Whether it is intermittent fasting, Weight Watchers, or these new-generation medications, the body has to metabolize and excrete all the stored debris in the fat cells. For example just like we stash things under the bed or in the basement in our homes, sealed in rubber maid bins our bodies do this in the legs, belly fat, long bones, in the fascia and the spaces in between a bone and a muscle or between the loops of the intestine abdominal wall.
Excreting this load is to be respected, and having a healthy reverence for the body when you are asking it to do these tasks is the prep work; before starting the medications, I had my clients prepare for the GLP-1 medication initiation with getting processed sugar, empty carbs and alcohol down while prioritizing organic lower glycemic foods. Silymarin, Vitamin C, green tea, garlic, methyl B vitamins, EPA, DHA, chlorella, and NAC are recommended throughout the process to support the liver, the nervous system, and excretion. Walking is encouraged to take stress down and move fluids and lymph.
I am a systematic biomechanical, visceral, and myofascial practitioner. I work objectively where the restrictions are, not where the person has symptoms. Structurally, over and over again, what presents itself is the respiratory abdominal diaphragm with visceral restrictions from dry scar tissue and the organs' adherence to the abdominal wall and spinal musculature over the years.
As for the organs, here is a quick anatomy lesson. The sphincter of Odie is where the pancreas AND the gallbladder empty into the upper area of the small intestine, just after food passes the stomach. The pancreatic duct with: insulin, protease, lipase, and amylase to the tune of 2 cups of fluid a day has to flow nicely through this sphinctor (Odie) while also playing nicely in the sandbox with the flow coming from the bile duct carrying waste that has already been packaged for disposal from the liver.
The area around the diaphragm to the upper abdomen and the Sphinctor of Odie is a focus of mine generally with my caseload, but especially with these clients who have had their injection that day or the day before and are experiencing reflux/ heartburn. GI pressure chaos has been a common side effect. You may have seen severe complications listed in the commercials. Getting ahead or staying in step with the body's needs to maintain success without overstraining the systems is key.
Regarding the sphincter of Odie again, imagine two rivers with different pressure flows joining into one spot in the intestinal flow. You can see that this can cause chaos in the system, like a major traffic jam! For me, pressure homeostasis via improving the physical space in the area is my goal. I go back and forth through the cavities for pressure regulation, meaning the pressure gradients between the cranium, respiratory thoracic, pelvic, and abdominal cavities generally assist the body with the unloading and metabolism during this major cleanup.
During our work, I have seen these clients speed through the backup process and rewind through old biomechanical upgrades. The autophagy ( the breakdown and recycling of old or damaged cells,) combined with the blood sugar correction, help us move through things we had been working on before the medication in much faster speed. (I also see this sped up process with intermittent fasting, but quick onboarding with these meds needs a healthy respect for the physiologic ask we have presented.)
Biomechanically, I have found that with all of my clients on this protocol, at one point or another, a complete restructuring of the musculature around the diaphragm and ribs. With the fascial and organ spatial relationships freeing up, the usual adherence of their old pattern that was holding stability in a inefficient manner goes away, revealing an opportunity to make big postural and core integration upgrades.
We must work to strengthen new ranges of motion that become available as organs and facial tissues become more pliable and negotiable. Breathing changes, so breathwork goes hand in hand with this process. Pressure changes with fascial restrictions opening up have been especially true in the abdominal pelvic cavity. Sluggish lymph in the lower extremities and axilla to the cranial base, and cycles of detox headaches present themselves, and clear when given intentional support manually and/ or energetically.
If you have access to visceral myofascial therapists in your area, take advantage of the window you find yourself in for results and support during this super important time in your body! My clients have not had the same side effects cited in the literature. The general health of your body is critical to tolerating these medications. On my homepage, I have listed the links to professional networks that I recommend from certified IMTs, as well as other well-known Barral and Upledger Institutes. IMT or Integrative Manual Therapy is my specific certification.
If I were taking GLP-1 medications, I would want to have regular manual therapy. If your location does not have therapists from the lists I provided, schedule a regular weekly massage from someone recommended to you, but not the deep sports type. See if a provider has experience in lymphatic and facial massage.
You can also do some foam rolling and self-face massages. I have also developed a no-cost email progression program for general wellness and has foundational tools for self-release, meditation, nervous system and breathwork, and safe progressive exercises as a Physical Therapist will help you stabilize your body in a whole new way.
Your body will be changing extensively over the time you will be on these medications (or intermittent fasting), which I have seen consistently in my clients, an opening in the whole spine, particularly in the diaphragm area, so think shoulder blades and mid back and ribs, and pelvic floor, hips, and shoulder girdles. Doing my program or work privately with a trainer if possible consistently in its order and progression will support you along the way.
If you have not started these medications, I strongly recommend that you start with intermittent fasting first (talk to your MD first!!)
The book I can recommend here is Fast Like a Girl by Mindy Pelz. She discusses autophagy, blood sugar, cancer, HRT, and natural hormone cycles. This book is also highly recommended to men. The reproductive cycle won't apply obviously, but the rest of the book does, and maybe you can gain more insight into any of the females in your life!
Good research has been done on intermittent fasting for those who may consider quitting medications at some point, so I attached a link to the book which is very well referenced in this area.
What is autophagy? In a nutshell, it is what your body is doing a deep dive into during fasting and these medications—a MAJOR overhaul!! My clients have been going back through decades-old injuries and latent infections during this process—a chance to redo to reduce the stored suppressed, vacuum-sealed injuries and latent infections.
From Google AI summary:
Autophagy is a cellular process in which the body breaks down and recycles its components, such as damaged organelles and proteins, to maintain cell health and energy homeostasis. It's a natural, conserved process found in all eukaryotes and is crucial for cell survival and adaptation to stress.
Key aspects of autophagy:
Recycling:
Autophagy acts as a recycling system, removing damaged or unnecessary cellular components and converting them into usable energy and building blocks.
Cellular Waste Removal:
It helps clear out cellular waste, including misfolded proteins and damaged organelles, which can accumulate and disrupt cell function.
Stress Response:
Autophagy is a key part of the cell's response to stress, such as nutrient deprivation, infection, or damage.
Regulation:
The process is tightly regulated and involves a complex network of proteins called autophagy-related proteins (ATGs).
Types:
There are different types of autophagy, including macroautophagy, microautophagy, and chaperone-mediated autophagy (CMA), each with distinct mechanisms.
Health Implications:
Autophagy is involved in various physiological processes and is implicated in a range of diseases, including cancer, neurodegenerative diseases, and aging.
How autophagy works:
1. Initiation:
A signal triggers autophagy, often in response to stress or nutrient deficiency.
2. Formation of Autophagosomes:
A membrane-bound vesicle called an autophagosome forms and engulfs the cellular components to be degraded.
3. Fusion with Lysosomes:
The autophagosome fuses with a lysosome, an organelle containing enzymes that break down cellular material.
4. Degradation and Recycling:
Lysosome enzymes break down the cargo within the autophagosome, releasing the recycled components back into the cell for reuse or energy production.
In essence, autophagy is a vital cellular process that helps cells maintain their health and function by clearing out damaged or unwanted components and recycling them for essential resources.
Above all...
Listen to your precious magical body, and good luck with the journey.
Jen
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