Category Archives: Massage Techniques

What Good Would Massage Do?

A friend shared an experience with me. His stiff back had become worse recently. After sitting for a while at his desk, if he turned the wrong way when getting up or reached too far, ZAP! A pain would

shoot down his leg from the low back to the knee.

“It just takes my breath away,” he said. “It really gets my attention.”

This gentleman has played football, fought in the war, and built suburbs. If the pain is bad enough to rob his breath, I am on alert.

A few trips to the doctor and he was diagnosed with foramen stenosis, a term that means osteoarthritis – calcifications and inflammation – were taking up residence in the area where spinal nerves exit L4-L5. The osteoarthritis pushed against the nerve bundle as he tried to move. Hence the ZAP!

I inquired about the plan.

“Well, I went to p.t. and at first the stretches seemed to help, but then they made things worse. It’s not bad enough to operate on yet. I am just trying to move my back as little as possible.”

Good heavens. I had to speak.

“Have you considered doing some massage?”

“What good would massage do?”

Oh yes, sometimes this question comes up. I happily urge all massage therapists to answer it when it does.

Too often people think inflammation and calcifications of osteoarthritis are set in stone. They move less and less, giving the condition a wide-open opportunity to get much, much, worse.

Well, massage therapy alleviates back pain, inflammation and swelling. It is why we train to do what we do. I mentioned a recent study that found general, non-specific massage helped reduce stenosis pain.

He asked if massage could fix the problem.

The study didn’t go long enough to figure that out, I explained. The big result is that people felt better and thus did more and felt healthier.

Do massage therapists think gentle rubbing can reduce osteoarthritis? Or “just“relieve it? I think we know the answer, don’t we?

3 Replies

Massage Up or Down?

At the risk of hearing some strong opinions, or not, I would like to ask the question: is it proper to massage up or down?

I have had many massages, and I am always baffled by the selection. I have had massage up the back, down the back, diagonally and sideways. Does it matter?

Some folks have very fixed ideas on this, particularly teachers who are trying to herd cats (massage students) into some semblance of a class. For every rule to never be broken, however, I find more classes and higher learning invite rules changes with ease.

Personally, I do not enjoy effleurages or neural strokes that go down the arm, although my energetic therapist friends use those to clear energy and swear by it. They seem a little pent up if I ask them not to do that.

I’m happy to offer my palm for some airy, off-skin swirly-dibbles to clear energy, so that seems to keep the peace. But what about those skin riders?

Shudder.

In a discussion, I would avoid answering my own question, but this is a blog and the rules are fluid.

Intent, I think may be the answer. If the intent is Swedish, to move both lymph and blood, then massage upward toward the heart. If the intent is neural, massage down the spine toward the sacrum. If lymphatic, massage in the direction of the lymphatic watershed. If aruveydic, well, then it depends. Well, is that as clear as it gets?

2 Replies

Pick Your Part

A full-body massage is the best in my book. You get your aches and pains rubbed away, your brain has the opportunity to tune into every part in the massage sequence, and the relaxation response is brought from background to foreground.

This massage therapist has always been a fan of the full massage, but sometimes people want all of their massage time spent on the parts that hurt – The back and neck, the hands and feet, the scalp.

I am accommodating, of course, but I always mention the good reasons for a full massage – and offer it as an option available whenever they request it.

Most often it turns out that the subject of the massage slowly learns to trust me, and as that trust builds, I find out why they want a focused massage only. Sometimes it is just practicality – they are having a half-hour session and want the most relief for their achy parts.

Part of that practicality is newness as well. For people new to massage, a half-hour seems less invasive and creepy than getting relaxed by a stranger.

I do hear the occasional horror story – someone has been relaxing during a massage, slowly drifting away when suddenly the therapist climbs up on the table and walks on them.

No, I don’t do that, I explain. If I ever had a reason to do that, I would ask and discuss it first, I say. It would be totally up to the person getting the massage. No, I wouldn’t take offense if told no.

That said, often the client will start getting full-body massages. The client is, of course, coming in to relax.

5 Replies

New Tricks

Sometimes I visit people at home for massages instead of at my therapy office, usually for convenience but sometimes because they are not able to travel. Folks who cannot travel to the office tend to be in recovery from injuries or in a fragile state.

Usually they are getting plenty of homecare from their relatives, visiting therapists, etc. but they are not getting the one thing that might help them feel better faster: nurturing touch.

In addition to the feel-good effects of massage, I like to give folks a few “new tricks” to help them navigate around the home. When you are there solely to make people feel better they tend to be listening and also more likely to remember a few easy steps.

Falling is the biggest danger and worry for people coping with infirmities of age or injury. That leads to Trick Number 1:

When a person has been sitting or lying in bed for a while, the psoas flexor has trouble adjusting to a standing position. Massage therapists know this is the only muscle in the body that works backwards, by controlled lengthening. When arising from a sitting or lying position, stand and give yourself 15-30 seconds for the psoas to adjust before starting to walk. Those few seconds will allow the psoas to kick in and steady those first few steps.

Trick Number 2: Sitting down requires effort, too. Sometimes people find themselves “falling” into a chair rather than sitting down and this can create more injury. Try placing the feet further to the sides than usual, the toes turned slightly out. Then squat to sit, a bit like sitting on a horse. This helps stabilize descent, avoiding the flop!

The “new tricks” added to a home visit has made my massage therapy practice more satisfying both for myself and my clients.

Tools for Massage

As an “old hand” at massage, I am not too impressed with tools sometimes used in massage therapy. I have stayed away from knobbles and thumb covers and even hot stones in my practice, largely because they tend to create elbow and shoulder problems for therapists who are tempted to use too tight a grip.

One of my cohorts in a day spa had chronic extensor tendonitis from using hot stones, which eventually led to surgery on both forearms. It was a career-ending surgery. Rather than use the stones only in hot stone massages, she had begun using stones warmed in the towel cabby during every massage as an added treat.

I feel the pain, having had a 10-year bout with extensor tendonitis myself as a result of working an old computer keyboards at various newspapers. My flying fingers suddenly got stiff one day and the forearms had a toothache-like burn that never went away. It took years of therapy and ice to correct the problem.

Yet here I am feeling rather good about using a device in massages – conservatively – because I think it does some good for the client as well as the therapist.

I recently took a class with esteemed medical massage therapist Boris Prilutsky. He has been experimenting on using silicone cups as a negative pressure tool in massage.

What I like about this technique is that it is not the Chinese cupping. The Chinese method uses fire (scary to the clients) to create a vacuum and then leaves cups on an injured area or blocked meridian for several minutes. Skin is sucked into the cup, creating a bright red mark that can last for several days. Near as I can tell it treats by creating a secondary injury – inflammation and hyperemia – to draw healing factors to the region.

I have seen folks over the years with cupping marks and it has always struck me as not a therapy I would not enjoy doing or having done to me. But I have liked the effects of negative pressure when I have been treated with cups.

Prilutsky brought his massage skills to the table and presented a way of using soft cups made of silicone and very slight vacuum pressure over oiled skin. The technique lifts tissue over adhesed areas and seems to promote both lymphatic and blood movement.

And he advised us to use it slowly, sparingly, and with attention to not creating a tight grip and warring with the tissues.

Good advice, I think.

I’ve been trying the cups here and there on very “stuck” zones and I think it is a tool I will use. Carefully.

Steamrolling the QL

The tough part of massage therapy long-term back pain is chasing trigger points in the quadratus lumborem. This is one of those muscles that not only keep clients awake at night; it keeps the therapist up, too.

I have done prone QL massage, prone with approximation, prone with stretch.

I have massaged the QL sideline with the olecranon. Sideline with directed relaxation. Sideline with directed breathing. Sideline with heat and a tennis ball.

It feels sometimes, that I have done everything except roller-skate to get those pesky points.

Does some massage therapist, somewhere, have a quick and easy method for releasing the QL?

Not to pick on the QL. The multifidus and the longissimuss and iliocostalis contribute to the problems of repeating lumbar pain. I find that if those muscles are skipped, they can recruit the QL back to tension and TrP.

And the opposing muscle, the psoas, can be just as equally weak as the QL is knotted. Bilateral weakness of the psoas and I will definitely have to roll my sleeves up. It is going to be a bumpy ride.

It is some consolation to know that QL problems tend to fester, painless and subclinical for years. The massages are unwinding years of QL spasticity making up for a lack of core strength.

That is a little comforting, I guess. Time to sharpen my elbow.

2 Replies

Loan Mod Trigger Points

I’m making it official: It is possible for massage therapists to map a stress pattern of trigger points related to home loan modifications.

Folks going through that process have had months of fruitless phone calls, waiting on holds, sleepless nights.

When they come in for massages, I have found they have the runaway stress trigger points of legend. I wonder if other massage therapists like myself have noticed this pattern, or any others.

#1 Super Mod Trigger Point: Serratus anterior superior. This is the pain Julius Caesar must have felt when Marc Anthony shivved him. This trigger point, tucked away under the arm and in the middle of the ribs, appears to stem from hours of breathless holding on fruitless phone calls. When it lights up, you can crumple. I have been using lots of warm slow Swedish strokes just to get near it. I like holding the palm of my hand over it until the warmth starts to melt what feels like a half-softball of tense muscle. I note clients start to breathe after a minute or two.

#2 Granite Upper Trap: Yow! Never have I felt such a bolt of tension as in these upper traps. I have actually started rolling shoulders Ida-Rolf-like just to try and get these to move. Rolling the shoulder forward, gently pulling it back, then teeter tottering the entire arm to establish some movement. Standard kneading almost seems to reinforce the rock-like tension. I’m taking suggestions.

#3 Rusted Pectoralis Minor: And sometimes the pec major, too. I usually associate this muscle only in clients with frozen shoulder or heart disease (or retired major league baseball pitchers) – now I find it just stuck all over folks in modification muddles. Slow and steady I go; this area is the most tender of all. Go with moist heat and a little contract-relax PNF.

Working with an emergency loan mod client this past week I had to ask myself: Has the American Dream come to this?

I like to do a little bit of breath-work with clients in this situation. Folks need some self-treatment TLC tips for the next time they call the bank.

2 Replies

Chopsticks: Catching the Posterior Scalene in Action

That’s a lot of old-fashioned chronic inflammation with the posterior scalene stretched far from its anatomical role. Those poor guys are stretched over the precipice and desperately pulling back. Adhesed, unloved, overworked and so far under the trapezius that even a deep tissue massage barely touches it, the posterior scalenes are crying for help.

Massaging many people with neck pain, I have developed a deep respect for the nefarious actions of overstretched posterior scalenes.

Most neck pain folks looking for massage come in with a history of working on computers, lots of driving and an old accident – usually whiplash or cervical strain.

Getting my teddy bear paws in the posterior scalene zone is a tough goal to achieve. First, the trapezuis acts like a prison. Going through from the back of the neck just plain hurts.

With the client supine, I like to flex the neck to the side slightly and slip soft fingers along the posterior scalene. Then I gently shorten the scalene until it can sense that a different way of life is possible. With the scalene approximated for about 30 seconds, I add a light, slow cross-fiber crushing with soft fingers. (I said soft again didn’t I? Ever feel a hard touch on a scalene?)

Anyhow, if there is a hope of redemption here, the scalene should soften, going from concrete to something more like jerky.

I try to get clients to start chin retractions, pushing the chin back while keeping the head level. I find they can do it best on the table, against a wall or even better against the car seat headrest.

Three gentle (that pesky word again) chin retractions of above 5 seconds each, with a five-second relax in between. That should put the head closer to the anatomical position and take the posterior scalene off precipice duty.

It isn’t an easy path, but well worth it to get the neck feeling better. I then suggest the client stop playing piano with their nose.

1 Reply

Adventures in Super-Mobile Massage

Nothing makes fear quake in many massage therapists than the entrance of the super, hyper-mobile client. I too, have experienced the fear, the trepidation and the surprise.

For the record, in Gumby folk symptoms of troubles are completely different than my true forte, people as stuck as me. What I would normally assess test with simple range of motion, these folks will cruise through with exceeding ranges. All orthopedic-based tests are useless. Symptoms are backwards, upside down and inside-out of normal trigger point problems.

The needle is not in the haystack. It may be on the next farm.

As much fun as working with ballerinas and gymnasts may be in terms of their fearlessness, I need a lie-down after they leave.

My latest venture involved a very athletic, very hyper-mobile volleyball player. Good heavens. The assessment symptom was a “cord” pulling the shoulder blade. Normally I would run to the rhomboids or the serratus, but oh no, here was a subscapularis that knew no bounds. She can do anything with these shoulders. They just hurt.

I figured out the problem by following my nose. What do volleyball players do a lot? Hit the ball. Hopefully with hands or forearms. It had to be subscap. Or I am going back to school to take auto mechanics.

And it was a subscapularis of epic proportions. Adhesed and anaerobic yet mobile. Gentle cross-fiber yielded whimpers, adding slow motion got a scream. Would I ever see this client again?

A week later she came back, admitting she wanted to kill me for the first two days and then she felt better. Oh good.

Then my next mobile-as-heck client came in. No sports, no exercise to speak of, just one horrible accident years ago with some seat belt bruising. “I feel like I have a cord pulling my shoulder,” she said.

Hey, it worked once. Gentle cross fiber. Motion added. “That hurts but it seems to be fixing it,” she said. Thank you, patron saint of the hyper mobile for the inspiration. I hope the ballet is not in town next week.

2 Replies

How Massage Therapy can Benefit a Mesothelioma Patient

Mesothelioma patients experience a number of symptoms throughout the progression of their disease. Chest pain, difficulty breathing and anxiety are common, and coughing or reduced chest expansion may also occur. While a number of different treatmentscan help relieve these symptoms, massage therapy is one of the gentlest ways to keep them under control.

Massage therapy is considered a palliative mesothelioma therapy. Although it cannot cure the cancer, it is one of the effective therapies for the management of mesothelioma symptoms.

Therapeutic Massage for Mesothelioma Pain

Pain is one of the most intense mesothelioma symptoms, but it is also one of the symptoms that is most responsive to massage. Mesothelioma pain is often dull and located in the chest. As the cancer spreads, the pain can also spread to nearby parts of the body such as the upper shoulders. Depending on the location of the pain, gentle stimulation of certain pressure points can provide a great deal of relief. Some of the pressure points that can provide the most benefits for mesothelioma patients include:

· Central Treasury pressure point (for chest pain)
· Serratus Posterior muscles (for chest pain)
· Thoracic Paraspinal muscles (for a stiff spine and reduced movement in the chest)

To help prevent causing any additional pain, a trained massage therapist will avoid directly stimulating any areas of the body that are already tender from tumor growth.

Therapeutic Massage for Other Mesothelioma Symptoms

Therapeutic massage may also be able to improve breathing by relaxing the muscles along the back and the chest. Stimulating the Heavenly Rejuvenation point – located between the shoulders – can help boost lung function. Massaging the deep muscles of the back can also help reduce sharp pains that occur during breathing.

Additionally, massage can release stress and promote relaxation. Points such as the Heavenly Pillar below the skull and the Inner Gate on the arm are related to anxiety; stimulating these points can help release nervousness. Stress-related insomnia and fatigue may also be relieved by stimulating the Sea of Vitality pressure point.

Author bio: Faith Franz is a writer for the Mesothelioma Center. She combines her interests in whole-body health and medical research to educate the mesothelioma community about the newest developments in cancer care.

4 Replies