Tag Archives: tensegrity

Better Bodywork: Muscle Tug-of-War

TL;DR Version: Know your anatomy, and always know (and carefully check) the antagonist if someone is coming to see you for pain and/or tight muscles. Pain and tension are often symptoms, not the cause of their issue.

KEY: People often feel pain/tension where tissue is overstretched or stretched tightly (often referred to as “locked long”). Think about this for a moment. Really…. think about the implications of digging in and stretching these tight muscles even more. This is often what clients ask us to do. RESIST THE URGE to dig in. Ultimately they want relief, but some clients (and some therapists) think it is to be done by digging into the tight tissue where clients are feeling the pain. This WILL provide temporary relief, but it will exacerbate the problem over time… remember, this tissue is stretched tight.

After seeing thousands of clients (I keep track, so I know that statement is accurate) I’ve seen this pattern again and again to the point where it has completely changed my approach to bodywork, and it is proving to be fast, effective, and unlike anything my clients or medical professionals I work with have seen or experienced before.

The body functions as a dance of opposites. Muscles rarely, if ever, pull in only one direction. In almost all instances when performing a movement, there are the agonists (muscle(s) performing an action), and antagonists (muscle(s) doing the opposite action). Examples of this would be Quadricepts vs. Hamstrings, Forearm Flexors vs. Forearm Extensors, Calves vs. Tibialis Anterior, etc.

This is an example and direct use (and simplified version) of the tensegrity principle, but hopefully one that will help your clients immediately if you aren’t already using it.

Put it to use immediately: Most clients will see a therapist for pain/tension in the shoulders, either on top of the shoulders, or between the scapulae.

Pain/tension at the top of the shoulder blades at the base of the neck: follow that line of tension to the other side of the shoulder blade (inferior lateral), and in about 90% of cases, there will be shortened, bound tissue. When you relieve this, the top of the shoulders relax. Remember: Long/tight is symptom; short/bound/immobile non-local tissue is often the underlying cause.

Pain/tension between the scapulae: AGAIN: RESIST THE URGE TO DIG IN between the blades. First: Check Pectoralis Minor, and release if tight. Second: If the scapulae have drifted laterally, work and release tissue on the lateral border to allow the scapula to move back into a more neutral position, thus relieving tension where the client’s pain area is located (the medial border).

When you address the underlying issue where the tissue is bound/short, get the blood moving through it, and give it an appropriate length, the tight/overstretched tissue should immediately relax/decrease in tension. Palpate to confirm this.
Will this fix the issue long term? Probably not, but the issue will not be exacerbated over time utilizing this style of bodywork.

What WILL fix the problem long term? This style of postural corrective bodywork COMBINED WITH conscious functional/postural improvements on the part of the client. If you stop doing the thing that puts you in compromised posture, longterm results are likely.  If your job or hobbies put you in compromised positions, see a therapist regularly for maintence.

Better Bodywork: How to know you’ve found a great massage therapist

A few months ago, nearly 100 people took my survey on the best and worst experiences of massage therapy. The results of which were great to know, and I’ve passed on to many therapists on how they can make your experience better, based upon your feedback.

Today I’m taking a different approach, a series of questions to ask yourself when receiving bodywork from your massage therapist. These are the criteria that I personally use when seeking a massage therapist for myself.

I am coming from a medical massage/pain relief background. If you receive massage for stress management, and not pain relief/injury recovery/prevention, then some of these may not apply.

So here they are, my top 10 for determining whether you’ve found yourself a massage therapist worth their weight in gold.

  1. How much does my massage therapist know about my health and conditions? Did I fill out a health intake when I first came to see them? Have you taken any since? (I personally ask for a new intake every 6 months for my clients, or if a new injury occurs.)
  2. Does my therapist do a verbal intake before each session (even to just check in.)
  3. Does my therapist do any tests, posture/gait assessment, or palpation prior to working?
  4. Is my therapist charting our sessions so we can determine what works for me, what doesn’t, and how sessions need to change over time? (This is usually done after you leave, so you may not know unless you ask.)
  5. Is my therapist asking for feedback during the session?
  6. Does my therapist focus just where my pain is, or do they take into account structural components to my pain? (Rarely does chronic pain stem from where the pain is. You feel the tired and tight stretch receptors that are chronically overstretched. Working the opposing muscle group will often bring longer-lasting relief.) 
  7. Do I just lie there while the therapist works on me, or am I involved in my healing process? (There is research that suggests that fascial remoldeling only occurs with an awake/aware nervous system.)
  8. Does my therapist stay current and utilize research in bodywork?
  9. Does my therapist further their education regularly to expand their depth of knowledge?
  10. Does my therapist refer me out to other practitioners who might be better suited to my conditions?

I kept this to 10 for succinctness, but another good indicator would be if they give me exercises that will help me over the long haul. Even when I already know certain stretches/exercises that will help, occasionally I need reminders to actually DO them, and I often learn new ways and techniques of doing stretches.

Please Note: These are probably the most important things I personally look for, and your criteria are likely different. That doesn’t mean they are not a good therapist for you. If you love your therapist, I encourage you to go see them!

Are there other questions you’d add? I’d love to hear them. Any you don’t think aren’t good indicators for medical massage? Why or why not?
A note for the massage therapists: Use this guide and see how you rank based upon my criteria. Are you passionate about medical massage? I’d love your feedback on this list and to learn what your criteria are when you receive bodywork. Are you in the Portland, Oregon area and meet these standards on a regular basis? I’d love to network with you, and see you for a session.

Medical practitioners: Are the massage therapists in your office living up to these standards? I’ve been to therapists working in medical centers doing little more than stress relief when the client is coming in for specific pain/ailments. I’ve also been to fantastic independent therapists who are truly top notch. If you’re needing a therapist to refer to, I’d be happy to work with your patients, or refer them to a therapist I trust.