Category Archives: Massage Techniques

If This Bicep Could Sing….

When a massage therapist has been working for a while, it can seem as if some body parts are talking during the session. Well, not verbally, of course, but spinning a yarn, letting it hang, somehow bringing their troubles up on the table.

Hey, we touch folks know verbiage and the written word are not the only ways we communicate, and the muscles sometimes give me what almost sounds like a wail. Kind of like the people who can hear colors instead of just seeing them.

Well, sometimes a client is bliss-unaware of what the muscle is saying and in me finds an audience. Like a good therapist, I listen. Last week this bicep had a certain ring to it, like it had been overworked, wrung and pressed. It had a field of adhesions running the length right past the inner elbow. This muscle was hot, thread-y and tired.

I was doing my best to open up the circulation, which created some good faces on my client. I mentioned to my client that what I “heard” was almost like a song.

Hyperextension Blues, by Bi-Cep.

I woke up this morning,

Ba-da-da-dum (Muddy Waters?)

Elbow extended again.

Bad-da-da-dum

No hope of performing,

Ba-da-da-dum

Feeling totally un-Zen….

Now both my heads are twitchy,

Bad-da-da-dum

I don’t know how I can move.

Bad-da-da-dum

It makes my throws off pitchy,

Bad-da-da-dum

And my body hates to lose.

I got the hyperextension blues

Hyperextension blues

I got the hyperextension blues

Hyperextension blues.

Well, I fixed the rhymes a bit, but you get the idea. My client and I had a good laugh about the bicep blues, and she told me not to quit my day job. Isn’t it fun when the body tells its own story?

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Offering Reassurance and Hope to Your Clients

When will this get better? When will my pain be gone? When can I do what I want to do – when I want to?

Tough questions for us massage therapists to handle. Truth, we don’t usually know. Massage does marvelous things for the mind, body and soul – but what it does is often entirely up to the person receiving the massage – and the intent and skill of the person giving the massage.

The timeline? That may be set by many other things – perhaps even a higher authority.

When clients drop these questions on me I look them right in the eye and tell them all I can do is try to help them feel better. As pain drops, function returns. One can’t predict the time involved in healing.

It’s not a very satisfactory answer for some clients impatient to going back to doing the exact thing that brought them in feeling wounded. With as soft a tread as possible, as we develop a therapeutic relationship, I have a few ways to explain further. These come in handy with sticky troubles such as fibromyalgia or other conditions that vary day by day.

Answer # 1: You will turn the corner, but you may not realize it. Often you realize it afterward. You will discover that some pain or restriction has been gone for a while.

The body really heals itself in its own time. All we can do is try to make it easier to get there.

Is that fair to clients? I think so. I have rarely ever seen someone making no progress from massage. But I have often observed one factor in common with the impatient client: A chronic problem has often been ignored for so long it takes time to create an awareness of how to heal and avoid re-injury.

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Effleurage & the Flaming Snowplow

Most massage therapists make a habit of getting massages, as do I. A good massage is always appreciated, but at times it is hard not to be a “back-seat” massage therapist.

Recently I was looking forward to some relief for a strained deltoid when the effleurage began on my forearm. It started as a delicate, slow Swedish stroke. It treaded middle depth along the bicep and suddenly plunged head-on into a flaming snowplow of death over the coracoid process.

Oh my. My therapist made eye contact, I suspected to see if I was impressed. I writhed. Another effleurage. I cringed.

“Are you okay?”

“Well, no. The stroke feels really good on the arm, but then it feels like the pressure suddenly increases and it is very painful,” I said.

My therapist suggested skipping the area. As delicately as I could, I explained that shoulder soreness was what really brought me in for a massage.

My therapist looked perplexed. I offered that perhaps less pressure on the sorest area would work better. More perplexed look.

As a bad stroke, the flaming snowplow does double duty. First, it is very uncomfortable for the client. Second, as the therapist increases pressure away from his or her body, the stroke goes beyond the ergonomic zone. That places more strain on the therapist’s neck, back, wrist and arms. The pressure is produced from the upper body, instead of the feet, creating strain.

I don’t know where the flaming snowplow effleurage comes from. As a student I committed it once and got roundly screamed at by my instructor.

Effleurages feel best with constant, comfortable pressure along an effleurage. They are often the first stroke to be used and set the tone for other techniques such as MFR or trigger point. If I can effleurage without pain, I can usually treat the sore spot with other means. A win for the massage therapist, a win for the client.

Now, about the time I got the flaming snowplow effleurage up the arm followed by the Reverse Flaming Snowplow down the arm….

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Give the Gift of Stretch

My massage clients are much smarter than I, and that is why they need my help.

I am, of course, very smart myself, that is why my spouse likes to call me “hala kahiki po’o” (pineapple head) when I’ve done Einstein-ed myself into some predicament.

Case in point: When I was learning to stretch, I would try, try, and try my darndest to stretch only to feel more pain and less flexibility. Stretching, I thought, just doesn’t work for me. It might work for people who are naturally stretchy, but not for tight, inflexible me. So thought the pineapple head.

Later on when training as a massage therapist, I was introduced to the art and science of stretch – how to, how not to, and when. My assumptions about stretch not working had to go out the window.

Yes stretching does help. And the people like myself who are stretch-proof are the people who need it the most.

In true pineapple head tradition, I found the answer to why stretching is difficult for many people right under my nose. Before I had just skipped to the illustrations in the stretching book without learning the basics first. This time I actually read the book we studied on stretching and learned the steps I missed.

So now when my clients come in with furled hamstrings, I freely tell them about my foible, how I missed the basics, then found them. And I explain that for stretching to work, you must focus, breathe out with the stretch and stay in a pain-free zone, no matter how miniscule, until the muscles allow the stretch.

Then we practice.

As a massage therapist, I take pride in my skills to get people to relax and unwind knots. And I love to give the gift that can give clients relief every day, no matter where they are.

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Seated and Ready

A regular table massage client loves to two-time this massage therapist every chance she gets. I do not mind at all. My client has fibromyalgia, travels frequently and loves to get chair massages.

The service she uses most often is at an airport near her employer’s national headquarters. She looks forward, especially on a day-hopper trip, to stopping in for 20 minutes of relief.

Initially I was scared to use them, she said, worried they might not understand someone like me. But I just did it one day when I was desperate – and it really was very good.

There are two therapists at the terminal chair massage shop she loves to get – and so far most of the ones she doesn’t know have been pretty good, too.

Given the opportunity, I’ll ask questions. Market research? Perhaps. So what’s good about a good chair massage?

I like that they look at me and talk to me before I sit down, checking in on what I want and don’t want, she said. My name is in their computer so they can check on what I’ve had done before.

Most of the time I need firm pressure, especially to relieve the burning spots in my shoulder. They know that too much pressure increases my pain, but just the right amount helps.

The good ones seem to know the pressure, but they always ask me if it’s right. I like being asked.

The only time I didn’t like the chair massage, I think it was this guy’s first day. Probably his last. He wouldn’t look me in the eye and didn’t ask me anything. I had to tell him I have fibro and pointed at my left shoulder burner. He just nailed me with the point of his elbow, no warm up or rocking in. My shoulder went off like a flare gun.

When I told him it was too painful, he switched to super-light and annoying. I finally just got up from the chair and left. The receptionist said I didn’t have to pay, which was good because it was a one-minute torture massage. Aargh.

I still go there, and I love my regular massage therapists. I make sure I give them good tips, so they will be there when I am in town, she said.

You can’t beat the relief after a bunch of meetings. I can tell them I want my arms, neck and back, or focus on neck and shoulders and less time on the other areas. It helps keep me sane, she said.

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Playground Moves

We massage therapists see a lot of people seeking relief. If it isn’t the upper back and neck, it is the lower back and legs. I’m a fan of giving people something they can do, on their own, to loosen up.

Most people go from doing a lot of movement in their salad days to increasingly stiffening marathons of driving, sitting or standing as they grow into their occupations. My loosen-up moves are an attempt to get some wiggle back into the muscles and joints we freeze up with age.

Like most massage therapists, I freely steal moves – giving credit of course – to multiple disciplines. My go-to sources range from Tai Chi Ch’uan, Yoga, Pilates and Hula to Islam. Give a girl credit for observation.

The ground rules are: everything in slow motion, no pain, exhale with effort and keep breathing normally. I practice with my clients so they get the rules in their head and can mirror me. This is also my secret way to get some stretches in for myself between massages.

For example, the hula roll-about allows people to balance abdominal, oblique and back muscles. Standing in neutral, use the tummy, then the side muscles and then back muscles to rotate the hips in a slow circle. The shoulders stay still and the breathing relaxed. If you can do the slow hula, you can swing a golf club.

I like to frame warming moves and stretches not as work, but an opportunity to revive our latent desire to play. Hula hip circles are a blast. When you get a bunch of serious golfers laughing while rotating their hips, you get a serious jolt of fun. And when those scores drop, the golf guys keep coming back….

The back flexion warm-up borrows from Yoga and Islam – start out on your knees on a soft surface like a bed or mat. Lean forward and extend your arms on the surface in front of you, slowly lowering your upper body into a stretch. Just like the Moslem prayer position, and a bit like the yoga child pose. To stretch the QLs, move one hand to the left, while aiming the hips back to the right. Then reverse hands and hips to stretch the other QL.

Heck, that’s a very good thing to do three times a day for your back. Funny how a move associated with a religious ritual can be so good for the body.

What about Tai Chi? My go-to is “Wave Hands Like Clouds.” This move helps people with balance and fluidity as well as peripheral vision and coordination. All you do is hold your palm in front of your face and look at it as you turn from center to one side. As you turn to reverse, you raise your other palm and look at it as you turn back to center and to the opposite side.

Simple yet complex, this move builds core and balance. Hmmmm. Who thought goofing around and playing could be so liberating and healthy?

Please send me some of your go-to play moves in the blog comments section. I’ll steal it, and give you credit, of course. Hula!

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Negative Pressure Massage

Massage therapists learn many ways to push on trigger points and stuck areas. I’ve often wanted to see if pulling on these spots would help open them up.

Yet, of course, we are taught that pulling is bad body mechanics. Massage therapists who pull rather than push don’t last long on the job. They develop carpal-like syndromes and spinal issues very quickly. Pulling also draws energy from the client toward the therapist, a big no-no.

In thinking about these issues, I have been looking at two techniques that allow a massage therapist to “pull” without fear of injury. One method is quite old. It is called “furling,” and allows gathering skin, often with adipose and fascia, between the fingers to release adhesions and increase blood flow.

Ida Rolf added some lift to furling, calling the technique skin rolling and introducing a way to loosen sections of abnormal tightness, adhesions and scarring.

The way I have seen these techniques used is to furl or roll away from the therapist, often over a large area of muscular dysfunction such as the lats, or over the shoulder or hip rotators.

But the true act of pull has eluded us therapists, until the introduction of massage cupping. Once sort of exotic, cupping classes have brought the method to more therapists. In this technique, the therapist uses soft silicone cups and massage oil. The cups are compressed slightly to create a light vacuum along lubricated skin.

The vacuum area moves with the therapist’s hands, following muscle, fascia or lymphatic pathways. I have found the cups to be intensely relieving to a large number of conditions such as sluggish lymph, scarring, scarring with adhesions, etc. The simple act of gently lifting the skin activates lymph movement.

Lots of “stuck” tissues found in fibromyalgia, repetitive over-use and traumatic injury seem to respond well.

As my long-distance-runner client said: “Boy, this treatment really sucks.”

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Best Intentions? Massage and Permission

Is it OK to stretch a client’s adductors? What if the client is female, the therapist male, and the wind is whistling through openings in the drape?

Oh my, the topics that come up for question in a massage clinic. One of my friends had a complaint from the husband of a couple whom had simultaneous massages. The female client had a massage from a male therapist, and during the massage he stretched her adductors.

The client complained to her husband that there was something wrong about it. The therapist stretched her, said nothing before, during and after the stretch. She could feel an air gap between her draping and her crotch. First, it is unusual for people to complain about such tactics in a massage. Often the response is simply to never use that clinic or spa again.

My friend noted that she received the complaint because the husband was a long-time client and they had a good professional relationship. When my therapist friend talked to the male therapist about the massage, he just said that he felt her adductors needed stretching and did not consider it a big deal. The client said nothing, and the massage continued as usual. It can happen that we may have the best of intentions in a massage, but our efforts are interpreted differently. It is also quite possible that someone doing a massage is not being honest about intentions.

The therapist may be using the massage as an opportunity to play games, such as intimidation games, sexual games, etc. Those games – and the appearance of games – have no place on a massage table under any circumstances. A good way to make sure your intentions are clear is to ask permission of the client first. Explain what you want to do, why, and emphasize the person’s draping will not be revealing. Then wait for an audible answer and accept the answer. No means no.

My friend decided not to call in the male therapist, a contractor, again to her clinic. His answers about the massage were not satisfying, and she told him that. Hopefully he was not playing games and learned something from the experience. It cost him an opportunity to work.

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Dizzy Chair Massage

A client stopped in last week a bit worried about her neck. She had been on vacation, feeling very tight in the neck and shoulders and stopped for a chair massage.
Eager to get rid of the tension, she asked for a 30-minute massage. Toward the end of the massage, she started to feel faint and had an overall feeling of serious un-wellness.
“I thought I was going to die,” she said. “I felt terrible. It took several minutes of just sitting to feel like I was getting better.”
She wanted to know if I had any idea why she felt so bad.
Oh boy. Great. Just ask me. I have never seen anyone get sick from a chair massage. During classes the instructors have mentioned that rarely a few folks might experience a low blood sugar after a chair massage. But that’s really it.
And my client had eaten about a half-hour before her massage.
I suggested that if the massage was the cause of her spell, perhaps the headrest was in a tilted back or too far forward position, compressing her suboccipitals.
But the client said the position of the face cradle felt fine.
Another problem might have been if the therapist was using pressure directly into the neck, rather than at an oblique angle, and pressed on the vertebral artery. Stepping off the massage chair and sitting down in a chair for a few minutes would dissipate the feelings.
But heck, I really have no idea because I wasn’t there. Her experience was odd.
Her therapist, she said, was very attentive and very surprised that she didn’t feel well. She sat with her, gave her some water, and offered to call an ambulance. My client said no, she would be fine. And in a few minutes she was. But what happened?
I would like to know if any therapists have ever seen this sort of reaction from a chair massage. Or is it possible it was not related to the massage?
Here’s my very speculative guess as to what happened, barring other causes. This particular client has a very prominent bilateral knot at C2-C3, a souvenir of an old car accident. If pressure was placed directly into the neck from a standing position, it is possible the vertebral artery was compressed. Vaso-compression can cause a myriad of sickly feelings.
My only experience with this was with another therapist when I worked at a spa. Her client came out of her session and had to sit in the hallway for about 20 minutes to recover. She also had a knotty laminal groove near C-3.
After we both helped the client recover and she left, the other therapist and I went over the work done on the neck. My therapist co-worker had stood over the table and with her arms straight down had pressed directly down into the knot in an effort to release it, a method she used on other knots in the back and legs.
This stance is not only bad for the client; it also loads tension on the therapist at about C-6-C-7. Done often enough, it can create numb arms and hands in the therapist as well as unpleasant symptoms in the client.
My co-worker, of course, had just adapted a way of treating knots in one area to another and wasn’t very studied on neck release techniques. I showed her how to treat the neck with oblique angles, anywhere from 35 to 55 degrees to the prone client. This technique, of course, requires the therapist to bend knees and unlock joints in the arms and back.
The oblique approach is healthy body mechanics for the therapist and client as well, and it applies to chair or table treatments. Oblique pressure rises from the feet pushing on the floor, with the joints relaxed rather than locked. Basic? Yes.

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Whys and What Knots

Knots have the element of surprise. Massage clients are often very perturbed that they have a knot, and then the inevitable question…why is that knot there?

I try to offer some explanations – to much time using a mouse, too many repeat micro-movements of muscles in a static hold, etc. Working under too much deadline pressure is a very common circumstance.

But why do knots occur and stick around for so long?

Massage therapists see thousands of knots over the years, and yes, I think they each have their own unique origins.

For reasons I cannot easily explain, I can feel when knots are old – from a long-gone by car accident for example – these older knots are more established and habituated to the body’s daily existence. They need some extra attention and therapeutic touch to loosen and return their host tissues to normal.

That said these older knots seem to be more than simply forgotten dysfunctional areas of muscle. Something has happened along with the formation of the knot to make it last. Perhaps, if knots form like memories, they become more robust when a person is excited or energized.

Having read and seen many interviews of people who remember what they were doing 50 years ago when they heard President John F. Kennedy was assassinated, I suspect the major knots also had a sudden, sharp focus of attention.

Perhaps the chemicals of surprise or fear also help muscles retain knots, as people retain memories of the JFK assassination in more vivid detail than any other days in 1964 or beyond.

Could some knots have a date-and-time stamp?

Sometimes I wonder. I know my massage clients do.

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