Often when clients are hurting they want the massage therapist to go immediately to the location of the pain and work to relieve it.
1 Comment
My husband does a lot of "around the house" projects, and I am his trusty assistant. Most times I am the one he is doing the project for, in order to get them off the "Honey Do" list. So it is only right that I am there to "go for" tools and hold the other end of tape measures.
What I have learned in watching him work, is that it is very important to MEASURE TWICE, CUT ONCE. I guess that is some famous carpenter saying. Fewer "Ooops!" are made when this rule is followed. More boards fit perfectly the first time. There is less throwing tools and screaming - just kidding. Well, kind of just kidding. <><><><> So what business does this handyman information have on THIS blog? What has it to do with fascia? Really nothing...except as I watched my husband work one day I realized a way to better describe the importance of exercise/stretching to carpenters. It is okay if you just chuckled. But please bear with me a tiny bit longer.... I am getting to the point. STRETCH TWICE, EXERCISE ONCE.....that is actually what I explain to clients everyday, just in different words. That is the example I try to maintain in my own exercise and fitness. It is a formula that I have found works. I am convinced the body needs to stretch before and after activity. And it is easy to remember this saying, formatted the same as the old famous carpentry quote. And SO MY POINT:. In my massage practice I like to link what people already know to how the body works. Using a person's existing knowledge to either remember or to better understand something new is an old technique. The Ancient Greeks used acronyms to remember - and I have read that when in the Dark Ages acronym usage was revived it was considered Dark Art. Now that is funny..... probably would not have been good to tell this to my Third Grade History Teacher who told us HOMES stood for the Great Lakes (Huron, Ontario, Michigan, Erie, Superior)...I can only imagine the trouble I would have gotten into if I had told her that it was a form of witchcraft. Probably another note home to my mother....that I could 'accidentally' have forgetten on the school bus. Haha. But anyways.... Mnemonic techniques have been used for thousands of years - using a known word or phrase to associate/link new information to something already known, and thus more easily remember the new information. Measure Twice, Cut Once. Stretch Twice, Exercise Once. In the course of work as therapists we usually find out the occupation or habits/hobbies of our clients. I try to study/inform myself as to what those occupations/habits/hobbies involve. So when it is needed I can create links and similarities with the information I feel is valuable for the client to remember. For example, Auto Mechanics know all about car engines. If I say a mechanic's (client's) body is giving signs it is extremely dehydrated, the mechanic often will reply, "Yeah, I have been told that I need to drink more water." Or if I say, "Keeping well hydrated (drinking more water throughout the day) could possibly make you feel better and help the stiffness in your joints".....does that really SPEAK to the mechanic? I have found it does not. It lacks meaning. It does not say "THIS IS VITAL, THIS IS IMPORTANT." But a blinking light on a car dashboard does. So when I say, what would happen to an engine if you ran it out of oil and then just kept running it? They are immediately engaged - "It would lock up!" "It would create heat from the friction of the moving parts and it would ruin it." "Blow it up." "It would not run very long and you would have major costly problems." They have lots of responses to that scenario...the blinking light on the dashboard. And so then I say, "Water to your body is like the oil to your car." "It is the lubricant that keeps the body tissues moving freely. Keeps friction from heating it up and causing extra wear and tear." And let it sink in for a moment...... And invariably they Get It! And the next time they make an appointment, almost always they tell me they are drinking or trying to drink more water during the day. And most tell me they can REALLY tell a difference in how they feel. The importance is...I made it important for them. Something unimportant became understandable and then important when linked to what they already knew. They would NEVER run an engine out of oil. They know oil is crucial. Yet in their own bodies - merely they did not see the connection or the importance of water...other than when they were thirsty - they drank. Sometime then I further ask them, "If your oil light is on how critical is that? Can it be ignored for a while?" Well, BEING THIRSTY is like the oil light being on for my car....the body is saying it is a "low oil" condition. However critical low oil is, that is how critical the body saying it is thirsty is. And to me, that THIRSTY condition in my body is a serious condition. Although, thankfully, our bodies are very forgiving of our neglect. I do not want to run my car low on oil and I do not want to run my body low on water. I am convinced low engine oil and low body water wear parts faster and reduce the quality usage life of both engine and human body. Anyways, these are just a couple examples. I am sure you can think of more parallels. Always, of course, as massage therapists we have to watch our phrasing and be sure to never diagnose or prescribe. We CAN tell stories and give examples, cite information, point clients to information sources. We can explain and demystify information for clients to the extent of our studies, training, and experience. For example, many times I have told clients that "ITIS" is just a fancy word for Swelling or Inflammation. -ITIS gets attached to whatever body part is inflamed. So you have sinusITIS (swelling in the sinuses), tendonITIS (swelling in tendons), bursITIS (swelling of bursa), etc.....it sounds a whole lot less scary. It even, I think, empowers them to believe they can do something to help their conditions - that they are not just helpless to this big scary-sounding word that afflicts them. I think this also encourages them to do what their doctor has told them - because they have a picture in their minds now of what is going on with their body. I thank you for reading my posts and considering my perspectives. I hope you have a very good day. At the bottom of this narrative is a link to a short video that shows a finger stretch. I tried it and it does loosen up the joints, which tells me that it is stretching the fascia. Without fascia we would fall to pieces, but with our fascia too tight and binding - we do not move as much as we should. Often we do the same activities everyday with our hands. Our hands and wrists are so versatile and can move in so many directions. This is great. However, the fascia develops patterns of movement, just like we develop patterns of movement in our lives. If you do not think so, try brushing your teeth with your "other" hand. When I brush my teeth with my left hand it is as if the toothbrush no longer fits my mouth. My left hand/wrist does not have the "bend-i-ness" (flexibility) to make the angle as well as my right hand that practices this action every day. Over time I believe our hands not only adapt the fascial shape and even "grow" the fascia to better accommodate whatever our use patterns are. This is great also. It is designed, I think, so we can perform tasks with our hands more efficiently as we continue to practice certain repeated tasks. But then if we ask our hands to break out of those use patterns and do something different - our hands (and their fascia) complain. Over the past 10 years or so my hands have exhibited some swelling after a "different" use. This complaining in my finger joints has become especially noticeable since I saw past that 45th birthday. Some would say that is just old Arthur Itis.....yeah, that old guy. Haha. And it may well be, but I am not giving in to Arthur. Keep stretching and wiggling. I am. https://www.youtube.com/watch?v=yJsU2bed6FM My Story: A while back, maybe even a year ago I caught the tread of my right shoe in thick carpet. It hung up enough that my knee moved funny and "popped". No pain though....at the time. However, since then my right knee has acted kind of crazy. And over the last couple of months - severe pain, expanding pain up into my hamstrings and down into my arch, and swelling under my knee.
----------- My complaint: For no apparent reason now, my knee "pops" and then swells....it is like the bones have shifted or something and when I go up and down (more down than up) stairs it feels like the bones no longer match together correctly. I catch myself wanting to keep my leg straight, it hurts to bend my knee all the way. ----------- My dilemma: As a massage therapist I can observe and assess from the outside of myself imbalances of muscle, fascia, etc. with clients.....but it is very hard to objectively be your own client. Plus, my knowledge is limited.....yes, I do not know it all. But everyday I do know more - because I am paying attention. This situation with my knee had me baffled. So I sought help from a Chiropractor, because it seemed to be somewhat misaligned. And he told me it was a muscle problem. ---------------------- My disclaimer: Well, these symptoms could accompany several problems with differing solutions. And I am not a doctor, and this is not medical advice in any way, shape or form. I am merely telling a true story about my knee and giving you a couple of video links where I found some information that I found pertinent to MY situation. If you need a doctor, I encourage you to find a doctor. ---------- My fix: Anyways, I recently found out from my Chiropractor that my symptoms, noted above, were stemming from my popliteus muscle. According to him, I had probably "deactivated" it when I originally twisted as the foot caught in the carpet, which then allowed my tibia (the larger bone in the lower leg) to shift. Then as I continued to use my leg without engaging the popliteus. And thus by not keeping the popliteus toned and strong from usage.....the swelling and pain and even more shifting around of structures started. This explained to me why the pain was expanding above and below the knee now. So now the Chiropractor has me doing exercises to re-strengthen my popliteus muscle. And the first two days of 10 reps, I had a terrible time with pain and swelling. But it seems that this was only a small initial rebellion, as everything had gotten used to the incorrect positioning.....because from day 3 until now (day 7)....no pain, no swelling, it is like my old knee is back. ---------------- The first video below is a great anatomical explanation of the popliteus muscle. https://www.youtube.com/watch?v=jcoDfCqTeCU The second video link has the exercises the Chiropractor suggested and that I am doing. The only difference is the Chiropractor has me putting a very slight resistance against my foot. The exercises make "under my knee" feel weird and sort of hot and achy while I do the exercise.....but it is only then, and it seems to be helping my knee. https://www.youtube.com/watch?v=yNJvWhD1xzQ --------------- And I am happy, because my hamstrings are not complaining. My knee is not swelling . The arch of my foot is feeling better. And I am again already running up and down stairs.....on a limited basis. Limited, because I know it takes time to build back to 100%, but at least, I can do it now. Have a great day everyone. Hope this helps someone. PS- I am adding both these videos to the Interesting & Informative Links page on this website.
I am not going to say much about the article linked above, it is thick to read, full of information......I invite you to read it.......however, I found it searching for documentation and research comparing the speeds of nerve impulses versus communication along the body's fascia.
I have seen estimates of speeds 20x faster by fascia than by nerve.....amazing! But that is not what grabbed me in this article. Instead, what caught my eye in the link above was the role of pH levels in myofibroblasts' contractile activity and development..... and I began to think about some of my own clinic experiences. Some people are more sensitive to pressure, their muscles are more "jumpy", they have more unexplained pain (from the client reporting and my observation/palpation of the muscles which do not show cause for the pain - but they really do have pain)......and now I am wondering .....are they the ones who have told me their diet is very acidic? Diet Coke everyday, a lot of fast foods and sugar? And I remember more than several, who reported that although they did not know why or how - but ever since "the traumatic event" (auto accident, fall, surgery, etc) it seems like their whole body has just gone crazy with pain. And yet the injury from "the traumatic event" has long been healed. Again, they described it and I observed it as "unexplained" pain, with no observable/palpable cause. I need to review my notes and see........ Hmmmm. It is something to think about and to question. We have been told about muscle memory for years. But because of study and practice, I have become increasingly convinced that muscles do less remembering, and the fascia does more.
It is difficult to directly access living fascia. within a living and moving being. Much medical teaching is done using cadavers. But in a cadaver the fascia is dehydrated, it is only changing in a life-less way, shrinking back and even disappearing. The fascia changes during and after surgeries on a living being. The intertwining connections seek to build back the tissue linkages constantly. These connections often thicken or stick to other structures after surgery. That is why it is important to keep the tissues mobile after surgery - so they heal maintaining mobility....otherwise they become like concrete as they "re-twine" the body back together. Part of the reason for medicine's overlooking of fascia is this access limitation. When an organism dies its fascia very quickly dehydrates and sort of "disappears". Another part is that there is just an enormous amount of fascia.....it has so many names, thicknesses, purposes (even other than connecting)......for me, I consider the edging of everything fascia....from the edge of a cell wall outward to the edge of the inside of the outermost layer of skin. That may or may not be a perfectly true assessment, but that is how I view it after study and practice. I also include callouses and scars - they grow in response to friction to cushion and ,to seal after cutting. Basically, if it functions like fascia - I call it fascia for my purposes. Running a finger or any "solid" object against fascia melts it back, and once it is melted back it does not rebound in post-living tissue. You can see this in Gil Hedley's "The Fuzz Speech". I am a hunter, and when you kill an animal you commonly 'let it cool" before skinning it. I had never really wondered why, except it was just easier that way. And this was the way I was taught a long time ago. Now I know why - it is because of the nature of fascia. I have gotten in a hurry before, and started to work on a squirrel or rabbit quickly....... and the tissues are stretchy and sticky when the body is still warm. It is really hard to work with until the body actually "cools down". After the body has lost its life heat and the fascia melts easily back with touch.....the fascia is then more solid and more non-reviving. The fascia becomes a less clinging medium. We know that warmth and coolness affect all tissues to some extent. However, fascia is very heat-affected.....more so than even muscle. The linking "bridges" or "diaphragms" collapse and become substantially less sticky a short time after death. The interconnected webbing stiffens and shrinks. Layers and links that would have been supported and held apart by body liquids during life, upon the coolness of death solidify together and become relatively rigid. That is the challenge of working with fascia - relativeness and constant change.. Everything is relative concerning fascia. Everything about fascia in a living being constantly changes. To work with fascia I have found you have to work within the parameters of this relativeness and change. Which appeals to me as a massage therapist, for I see our profession standing within the bounds of both Art and Science. We maintain a foot in each as we practice our chosen craft. This is why we must Study Science and Practice Artfully being always present and aware "in the moment" of these shifting factors. It is much like surfing waves of the ocean. You take what it gives you, educated by the science you know, and go from there minute to minute. Our bodies are so much like living miry clay. The temperature, moisture, historical amount of modeling and remodeling.....all define how the clay will act, react and adapt (as in the case of our living bodies) - like living sticky clay. You have probably noticed how fascia reacts to heat - like clay reacts to heat. If you cook with beef you know this. It is easier to thinly slice beef when it is chilled, even better slightly frozen. When it is cooled it becomes more solid. When it is warmer it is so floppy that it is hard to cut evenly, because it wriggles around as you try to pull or push the knife through it. When beef is partially cooked (medium rare) it becomes both pliable and solid. " Well done" is even more solid. What is gristle in beef? Really thick fascia. Think about how tough gristle is to chew. When I think of that toughness, and then I think of a person's shoulder that is "fasciaed down" after being immobilized in a cast for weeks - it is no wonder the shoulder will not move. The body has essentially glued it down by fascia, tough unyielding fascia. Gristle. Fascia immobilizes our bodies and body parts when we cease to move it about constantly. Plus the fascia adapts its thickness according to what we need it to do. It builds when we need cushioning or marathon endurance strength. It also builds to encapsulate foreign substances. I have a friend who once harvested a deer and while preparing the meat found a broadhead (a metal arrow end) inside the muscle. It was completely encapsulated in layer after layer of white webbing. The webbing was a complete container around broadhead. Until he cut open the webbing pocket he could not see the broadhead at all. It was described to me as sort of like an oyster making a pearl, layer upon layer upon layer. Apparently the deer had been shot with an arrow at some time, and it was not a fatal wound. The shaft of the arrow must have broken off and left the broadhead inside the deer's flesh. The skin closed up. Then the deer's body wrapped the foreign object in fascia webbing and just kept going. I so much would have loved to have had a photo of this....but did not know the hunter at the time. The fascia webbing network is all over the inside of living bodies. It is everywhere. Each cell, each sarcomere, each muscle fiber bundle, every tendon, every bone, every organ, every epidermal layer......every edge of every thing is fascia. And every part has an inside and an outside edge - one edge touching the Without and one containing the Within. Our connective tissues are the great highway system of the body. The fascial "pockets" contain our muscles, tendons, ligaments, organs, and bones. All of this fascia has different names, but it is connective tissue still - fascia. And it all communicates with itself from head to toe. That is why I contend that fascial memory is more prevalent than muscle memory. Although I am doubtful at this time, that it will catch on and surpass muscle memory as a term for a while yet. The gastrocnemius, hamstrings, quadriceps, glutes, latisimus dorsi, trapezius - all fascially connected with each other and many additional structures. It is fascial memory which notes where the body holds in space, the pressures within and without, the tension and torsion present. It is the one common link of all body structure. Our "fascia suit" is both the limit and expansion of us. Isn't the living body amazing? Our sinews binding us together....our fascia. References: Gil Hedley, "The Fuzz Speech"https://www.youtube.com/watch?v=BdRqLrCF_Ys
Consider this:
When a person prepares venison (mostly any wild meat) it is good to soak it first in brine water or buttermilk to remove the 'wild' taste. You want to remove as much of the blood from the muscle tissue as possible. The meat lightens in color when you do this. When you cook the meat it goes from floppy-pliable to stiff. Which is strange if you think about it. Usually heat makes objects more pliable. But in this case the heat is excessive and actually dries out the tissues. The heat shrinks the fascial 'pockets' and they squeeze out the water. Liquid will appear from seemingly nowhere into the skillet. Yes? So why does a sauna or tanning bed tighten skin? So why is massage good for skin tone? Why is hydration within the fascial "pockets" important? Why do the wrinkles on babies disappear and yet my wrinkles want to stay? I will leave you with these questions to chew on today. Have a great day. Those two vertical wrinkles between my eyebrows keep coming back. But next month I turn 51 years old.....perhaps I deserve a couple of vertical wrinkles.
Well, the big positive in this is that they "keep coming back"......which implies that at times they are not there. And they are not. Of course, I hydrate plenty and manually free the fascial bindings under the skin so the middle and deepest part of the creases are not pulled down into the notch at the bottom of the wrinkles and pinned down (aka: stuck and bound by tiny fascia webbings). And I keep at it....staying hydrated and working those wrinkles......because the day, weeks and years keep at me. And it works. Just like my receding gums, that I do not have anymore. Yay!! Those hurt! Was at a massage CEU class once and the instructor said the gums were muscles....and I thought "of course they are!!!...anything that is flesh is muscle". So I started gently, but fiercely rubbing my gums everyday....and they dropped back down over my teeth. And again, I keep at it. Because otherwise they would tighten, thus shorten, and pull back off of my teeth. But only if I let them have their way and did not monitor it. So, here is an interesting article from 2010.....there is so much more available about fascia now than "Way" back then.....only 5 short years ago. Have a great day! https://massagemag.com/massage-blog/myofascial-release/2010/07/30/how-to-look-and-feel-younger/ Find my other blogs at: www.PjSwinkWriter.weebly.com (essays, short stories, etc.) www.ICanYouCanWeCan.weebly.com (notes and essays to inspire) Good Day! There is more to the human body, its movement, and its functioning than the old familiar muscle charts reveal..... The Classical Muscle Chart we hang on our clinic walls, and see in our physician's offices was created/illustrated by Peter Bachin in 1947. It has been revised, recolored, and reprinted over the years, but has mostly remained the same. And while it shows muscle location.... It does not show the fascia....well, it shows some of it, but not the most of it. In fact, the individual depicted in the chart could not move if they were real. Their muscles, ligaments, and tendons are static, frozen in position. The structures are stacked like blocks on top of each other, drawn strictly as a compression structure. In reality, the body is not held together that way and would crumple into a heap. The living human body stands using a combination of compression and tensegrity. The old song we sang as kids..... "The toe bone connected to the heel bone, The heel bone connected to the foot bone, The foot bone connected to the leg bone,....." Not technically true, it does not account for the fascial structures/tissues in between which actually do the connecting. And while compression forces are truly at work in the human body, our bodies also stand by tensegrity. The body's fascial system holds us together and utilizes tensegrity to promote the movement and balance necessary for our ranges of motions and functioning. We can appreciate the Classical Muscle Chart for what it is....a great illustrative tool showing the locations of muscles. It, like much medical research of previous times, was based on cadaver research. However, there is another fascial level of anatomy we deal with as Massage Therapists. We work with living and moving human beings. You know what I mean if you have tended a client's feet at the first and the last of a massage session. Quite likely you have found the feet to have changed during the session. The human body is constantly changing. To study only the Classical Muscle Chart would be like studying a telephone pole to understand a living/growing tree. That is why I contend that our profession is as much art as science. We stand with one foot in art and one foot in science. We work within a constantly altered context. Below is a video by Thomas Myers showing a tensegrity model, introducing how tensegrity works in the functioning of the human body. When we stretch a toe it effects the neck and shoulders, and this is why. We are connected, living, changing....contained within our fascia. References: 1. https://www.youtube.com/watch? v=BzgxYpDyO0M
2. https://www.mooremedical.com/index.cfm?/Muscular-System-Giant- Chart/&PG=CTL&CS=HOM&FN=ProductDetail&PID=27529&spx=1 3. https://en.wikipedia.org/wiki/Compression_(physics) 4. https://en.wikipedia.org/wiki/Tensegrity |
Author:Pj Swink © Pj Swink and RenewingFascia.com, 2020. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited.
Excerpts and links may be used, provided that full and clear credit is given to Pj Swink and RenewingFascia.com with appropriate and specific direction to the original content. Categories |