Archive for Deep Tissue Massage

Save Your Body!

Bodywork is hard on the body! Sounds almost like an oxymoron doesn’t it? Lower backs, arms, wrists, thumbs and feet can all scream for a massage or at least a hot Epsom salts bath at the end of the day. Here’s some tips and tricks to help you respect your ecology of movement. And remember, every time you find a stance or position that is more aligned with good body mechanics, that sensation is immediately transferred to your client. Every time you take care of you, you are also serving your clients.

1. Sit down whenever possible

2. I remember taking a workshop with the late, great Bob King and being amazed that he never flexed his spine. He always hinged at the hips.

3. The three L’s: lunging, leaning and leverage

4. Need to exert more pressure? From a lunge position, lean into your back foot. This one is a bit counter-intuitive because our impulse is to lean forward which stresses the arms, shoulders and back. Leaning into your back foot allows the marvelous mechanism of leverage to achieve more pressure.

Speaking of saving your body, my newest book, Stabilizing the Core and the SI Joint is coming soon. Incorporating the six core assessment tests and muscle energy technique corrections featured in the book before I do my deep tissue/trigger point work completely changed my practice. The tissue was more responsive to my work and I could work smarter, not harder. Stay tuned for more details.

Stabilizing the Core and the SI Joint

Stabilizing the Core and the SI Joint

The Obstinate Pectoralis Minor

The obstinate pectoralis minor (PMI) can produce a hailstorm of problems throughout the body especially in the shoulders, arm, neck and respiration. Working with it effectively goes a long way in helping you help your clients with neck and shoulder issues, breathing restrictions and even wrist and elbow pain. If the iliopsoas is the hidden prankster of low back pain (Travell and Simons), the PMI is the hidden trickster of the shoulder girdle. This article reviews the anatomy of the PMI, common pathology and suggestions for working with it.

Imagine three long fingers extending on an inferior and medial diagonal path from the coracoid process to ribs 3-5 (attachments have been found on ribs 2 and 6 on some folks). This multitasking stabilizer connects the shoulder girdle (scapula and clavicle) to the thorax. The PMI seems to glory in pulling the coracoid process towards the ribs (whether it needs it or not) causing a profusion of myofascial and bio-mechanical distortions. PMI drags the glenohumeral (GH) joint with it as it pulls the coracoid process towards the ribs.

Restrictions in blood flow can occur—a portion of the axillary artery lies beneath PMI. Tingling and numbness (the distal portion of the brachial plexus passes deep to the coracoid process) can also result from the pec minor’s predilection for locking short. When the arm is abducted and externally rotated the artery and nerves are stretched around the PMI close to its coracoid attachment –hence the tingling and numbness.

A tight PMI restricts scapular mobility, interferes with the scapulo-humeral rhythm, cause limited humeral mobility and scapular winging. Humeral mobility depends on both scapular mobility and fixation of the scapula at the right time and place.

The GH joint follows the scapula. Wherever the scapula goes, the GH joint is sure to tag along. If the scapula is super-glued to the ribs GH joint movement is comprised. My mantra is “Restore scapula mobility and stability and you’ll go a long way to restoring GH joint function”.

Let’s do this kinesthetic exercise: Place one hand on the greater tubercle on top of your humerus. Now depress and protract your scapula (the actions of PMI). Can you feel how the head of the humerus went along for the ride? Next abduct the humerus to at least ninety degrees. Feels yucky, right? When the scapula is protracted and depressed the GH joint internally rotates and the greater tubercle moves anterior. That yucky feeling is the greater tubercle colliding with the acromion process. Repeated fender benders between the greater tubercle and the acromion process can result in impingement syndrome, impaired rotator cuff function, disturbances up the kinetic chain to the neck and down the kinetic chain to the elbows, wrists and hands.

One of my clients is a hairdresser who had chronic elbow and wrist pain for years. In addition to treating the plethora of trigger points in the flexors and extensors of her wrist and elbows, I treated her massively locked- short PMI, rotator cuff and serratus anterior to restore scapular mobility and weight/energy transfer throughout her upper body. She’s been pain free for several months. If I had just concentrated on her elbows and wrists the results would have been temporary. The moral of this story: always check out pec minor with any neck, shoulder, wrist and elbow pain!

My Releasing the Rotator Cuff book and DVD offers an in-depth protocol for releasing this stubborn muscle. Attract and retain awesome clients with stellar skills in working with the shoulders!

Retire Atilla The Thumb and go Muscle Swimming!

Do your hands and body hurt after working with clients? You are not alone. It’s time for all bodyworkers to work smarter, not harder with minimum effort and maximum results. Since every muscle has an automatic sensory reflex whose job it is to resist sudden change from external forces, let’s retire Atilla the Thumb and go Muscle Swimming instead.

As manual therapists we all face the question, “How can I best facilitate tissue release and allow the muscle to return to its happy, healthy resting state while maintaining my own ecology of movement?” I stumbled across an answer to that dilemma about twelve years ago and have been refining my approach ever since in both my private practice and CE seminars. I call it Muscle Swimming because I was delightfully amazed by how effortlessly I “swam” through tissue layers when I implemented the two primary techniques of Muscle Swimming, Pin and Rock and Pin and Move. Utilizing these strategies completely transformed my sessions, both for my clients and me. My clients loved how easily and painlessly I achieved tissue depth and release. Therapeutic effects of sessions lasted longer and outcomes were easier to achieve. I felt more energetic and present since I wasn’t working so hard. I smiled more!

Muscle Swimming uses physiology to facilitate release of myofascial structures allowing the therapist to work smarter and the client to have co-ownership of the session. Active and passive movement strategies are essential ingredients in all the Muscle Swimming protocols. This powerful combination of active and passive movement maneuvers turns off hyperactivity in muscles and joint receptors. It also facilitates the separation and lifting of fascial layers. In this article we’ll focus on the wondrous portal of Pin and Rock.

Pin and Rock is a compelling strategy that serves as a portal to deep tissue work. The therapist gradually presses to find the tissue’s first barrier. Then the muscle is gently pinned, and the therapist adds slow rocking. Rocking has an immediate calming effect. It stimulates the parasympathetic system, harking us back to the time when we were rocked for nine months in the womb. Think of it as a way of introducing yourself and saying hello to the tissue.

Our first encounter with a stressed myofascial unit should be gentle and non-threatening. Passively shorten the muscle, gently pin it with multiple fingers for a broad, dispersed pressure and add a slow rhythmic rocking of the joint. In fact, the first nerves to myelinate in the human fetus are the vestibular nerves which sense movement. Our first consciousness is that we are moving beings. Be patient – wait for the tissue to soften and yield before moving to the Pin and Move protocol. Come back to this Pin and Rock maneuver whenever you sense guarding in your client. Watch the video below to see an example of Pin and Rock to melt through myofascial layers to access the iliopsoas.

Next month we’ll look at Pin and Move – using active movement to release myofascial contractures and improve proprioception.