Massage, Bodywork, Ethics of Touch, Service
One of the rules of body mechanics for massage therapists is Line of Force. This rule stipulates that all of the transfer of movement from the body of the massage therapist to the client is done with the therapist’s body in a single line of force. This is done by aiming the hips in the direction of the movement, as well as shoulders, elbows, wrists, hands, and fingers. Stacking the joints, as it were.
A client and I sat down to talk about some test results he recently received and how that would impact our work moving forward. I am concerned about doing certain kinds of spinal movement on him, and changed my strategy of today’s session as a result. One of my favorite things to do to a client is a Thai Cobra.
As seen in this photo from www.teamsugar.com, the therapist kneels on the client’s hamstrings and glutes and extends the spine and shoulders. Well, I do an entire series of moves while I knee upon the client’s body like this and culminate in the cobra move. With this client, this sort of spinal extension is contraindicated for the time being.
I did some psoas release work on this client to help balance out the interplay between erector spinae and iliopsoas. I am going to have to do some work on the muscles that do ankle plantar flexion, as well as glutei minimi and more abdominal work, although I did do a decent amount of abdominal work on this client today before I did the psoas release.
The psoas and abdominal muscles are sometimes antagonists and sometimes synergists, and it’s important to keep them in balance. Having a six-pack can actually be unhealthy for a person. It’s not uncommon for people with really tight abdominal muscles and psoas muscles to be chronically constipated, as tight psoas muscles can impinge upon the lumbar plexus, which controls the intestines. As well, overtight abdominals can restrict breathing, as the ribcage is pulled down and forward, and also can cause the body to waste energy by engaging the erector spinae in having to work harder to keep the body upright to counterbalance the abdominals’ flexion motion of the spine.
As the iliopsoas muscles are rotators of the femur, the glutei minimi can also be very tight, as they are antagonists in rotation as well as synergists in hip flexion. So it’s important to get them to relax as well when doing a release of the psoas muscles.
With good attention to detail, balance can be brought to this important system, and a dramatic reduction in back pain can be introduced. The flexibility of the pelvic region cannot be stressed enough in maintaining a high quality of life as we age, and psoas release techniques, combined with work on the abdominals, glutei minini, and plantar flexors will help keep us pain free.
Trigger points in the piriformis muscle, a deep lateral rotator muscle in the pelvis, was shown to be responsible for the vast majority of sciatic pain (sciatica), and was able to be successfully treated without back surgery, a 2005 study by the Cedars-Sinai Institute for Spinal Disorders revealed.
In the study, 239 patients were evaluated - these patients either had not improved after diagnosis or treatment for a herniated or damaged disc. 7 of the patients were found to have torn disc related conditions, such as annular tears, and were successfully treated with spine surgery.
The 232 patients who remained underwent a new kind of magnetic resonance technology called magnetic resonance neurography to evaluate the sciatic nerve. 69 percent of the patients - 162 - were found to have piriformis syndrome (where the piriformis muscle traps or irritates the sciatic nerve), and the remaining 31 percent had a number of other nerve, muscle, or joint conditions in varying locations that were not seen by a standard MRI.
Only 62 patients needed surgery to correct the piriformis syndrome - such surgery included Open MRI guided imagery, where the MRI scanner guides a deep injection of a pain medication into the muscle or nerve. This treatment corresponds with what Janet Travell and David Simons recommend in their groundbreaking book, Myofascial Pain and Dysfunction - the Trigger Point Manual. In the book, they recommend a physician inject a local anesthetic into the location of a trigger point, causing its release.
The other patients in the study received manual therapies, such as physical therapy and exercise, and had successful outcomes as well.
A massage therapist who is trained in releasing trigger points can effect the kinds of changes brought on by the Open MRI guided imagery, as well, by using ischemic compression and other techniques. The beauty of science research is that for over 70 years, medical professionals thought that sciatica was caused by damaged or herniated discs. Now we know that the vast majority of cases are muscular in origin, and that other methods of treatment are as or more effective than surgery.
Cedars-Sinai Medical Center (2005, February 2). New Way To Diagnose Sciatica May Point To A Different Cause. ScienceDaily. Retrieved December 12, 2007, from http://www.sciencedaily.com /releases/2005/02/050201192443.htm
Winter is nearly here, and with all the shortening of the days comes the winter blahs. Fortunately, there are easy ways to fight off the blues.
Receiving regular massage can help keep you feeling at your peak!
From June 1-7, 2008, I'm bicycling in AIDS/LifeCycle. It's a 7-day, 545-mile bike ride from San Francisco to Los Angeles to make a world of difference in the lives of people living with HIV and AIDS.
Help me support the San Francisco AIDS Foundation by giving what you can. We'll keep riding until AIDS and HIV are a thing of the past.