No matter how much you stretch, it never gets any easier to touch your toes. Even after a painfully deep massage on those rigid hamstrings you barely see an improvement, and if you do it is only short-lived. Does this sound familiar? This, my friend is a battle against your own nervous system and the truth is, there is only ever going to be one winner in this situation.

Don’t get me wrong, stretching is a highly important part of maintaining physical health in general and is something that should be done mindfully and regularly. It’s just that sometimes stretching just doesn’t work to release tight muscle. Massage too is a fantastic therapeutic intervention, and one of the most wonderfully satisfying ways of breathing new life into tired, restricted and hypertonic musculature. But again, sometimes you just can’t get the result…

The human nervous system has a phenomenal healing capacity, much more than we often give it credit for. In fact, the times that we berate it the most is when it is in actuality, protecting us from a much worse fate. The truth is that to function to its full capacity, the human body needs stability, and when that stability is present, our nervous system will naturally allow us as much range of movement as we need.

So…back to those hamstrings. The ‘core’ of the body is where we need stability the most, and where good muscle activation is vital. From the flexion of a contracting psoas, and the thrust of good gluteal function, this core forms the initiation of the most vital and basic of all movements- walking forwards. Without these basic functions in place the body if forced to look elsewhere firstly for stability, so, when this becomes a priority over range of movement we get a purposeful stiffening of certain muscles (in this case the ‘troublesome’ hamstring) to make up for this instability. Secondly the movement side will also have to become a compensation, and in place of the thrusting gluteus maximus creating extension through the hip, we have a tired and tight hamstring working in tandem with lower back muscles to create this auxiliary movement pattern.

Now we can see that without this tightening of the hamstrings we are left open not only to a much more serious injury we would barely be able to generate the power to walk up a flight of stairs. We can also see that constantly trying to release these muscles without addressing the issues of muscle activation and core stability, is pretty much like trying to kick away your own crutches. Once we start working with the nervous system and not against it we can see dramatic and powerful results in literally seconds. How amazing does that sound? That is exactly what I achieve with my clients on a daily basis, using techniques that activate muscles and allow the nervous system to ‘turn off’ it’s damage limitation and auxiliary movement features.

By Alex Boylan

Alex is one of Manchester’s leading physical therapists and uses muscle activating techniques as a foundation for treating all manner of chronic and acute physical ailments.
 

Find out more about sports massage and related techniques here

http://www.massagemanchester.org.uk/services/sports-massage/

Why are the benefits of standard massage only short lived?

You could argue that the fact the person is just returning to the situation that caused the problem and that a return to pain is inevitable. I would suggest that with a course of treatment working in all the correct areas, coupled with regular excercise and stretching we can achieve results that last weeks or months meaning that you can make it to that all important top-up treatment without returning to square 1. If we just concentrate on massaging the area where it is painful (eg. shoulders) then we are just working with symptoms and not the causing factors of the problem, so if we want to achieve lasting relief we will need a savvy therapist and a client who is willing to show a little patience.

So where should we be treating?

As with any good therapy session, there is no recipe as each and every client presents an individual and unique situation and should therefore be treated as such. However, there are specific areas we can explore to find resolution to the presenting sypmtoms. If we have a client who's shoulders are hunched forwards, immediately we should be looking to a shortening of tissue in the chest area (pec major & minor) so this would be a really good area to start a treatment, not only softening the tissue but using lengthening strokes going from superficial to deep. Pec minor work is best done slowly and gently, combining it with breathing cues for the client. This presentation would be typical for someone with pain across the tops of the shoulders (traps), because as the pecs shorten, the traps are pulled into an uncomfortable stretch.

For those with pain mainly between the shoulder blades we look to the tissues which are responsible for pulling the shoulder blades away from the midline and leaving the section between the shoulder blades and spine (rhomboids) stretched, overworked and painful. Again the pecs would be a good place to start, but more specifically we could look to musculature such as subscapularis and serratus anterior which are located around the front side and outside edge of the shoulder blade respectively. Subscapularis in particular can be a 'challenging' one for the client, but as with most areas that may cause the client discomfort- it brings its own reward following the work.

Some people may present with a distinct curve or hunch in the mid/upper back (kyphosis), and will most likely complain of aching around the mid-back or bra strap line. In this situation it is important to work into the diaphragm area and do work to 'lift' the ribcage.

Obviously there are many more areas that we may need to work, to gain a satisfactory result but I just thought I would highlight some of the less obvious connections. To put it in a nutshell, it is imperative to have massage done on the front of the body as well as the back when working with computer-related shoulder pain.

What can the client do to help progress?

The antidote to a sedentary lifestyle is to keep the shoulders, neck and back mobile by taking them through a few full ranges of movement before you start work, at dinner and when you finish in the evening. If this is coupled with a couple of sessions a week of exercise (swimming/gym) or even better, something that works on full body flexibilty such as Qi Gong or Yoga we can really start to see the maintenance of results following treatment.

All you need to be free of computer-related shoulder pain:

- A course of treatment addressing both the front and back of the body

- Monthly maintenance sessions

- Daily mobilty exercises/stretches

- Weekly exercise/flexibilty programs

by Alex Boylan owner of Re-Creation http://www.massagemanchester.org.uk

I am one of those people who have had ALOT of massage. I practice what I preach, what can I say? In my wealth of experience of recieving, I too have sampled both ends of the scale, the good the bad and the one where I feel like a basted turkey. I'll start by talking about the qualities we need to consider as massage therapists, to ensure the client is blown away by the treatment and if it's their first sampling of your skills, the only question on their lips will be "Wow! What kind of massage was that!?"

Listen to the client

The consultation whether 2 minutes or 20 minutes should not be considered a mere formality, but is an opportunity for us to really listen to and get a feel for the client sat before us. Where do they want the work concentrated, where have they had injuries, what experience of massage have they enjoyed, do they like the deeper pressure, do they have a senstive areas (most often feet/toes or front of neck)? The latter is equally as important as the others because even if we deliver a great massage but finish out by freaking them out...do you think they will want to come back? This is the first hurdle you will fall down at if you just have one routine or work to any routine for that matter. To actually deliver what the client has just asked for, the treatment will have to be an individual experience.

Observe the client

Observation of the client is an equally important part of the consultation, as this allows you really fine-tune your treatment plan. How do they behave and talk? Are there any evident signs of high stress levels such as high pitch to the voice, talking quickly or seeming a little curt? This might mean that you add in a little 5 minutes extra relaxation work at the end to really round off the session. Physically how do they look? Do they have the shoulders pulled right back in a 'military posture'? If this is the case you immediately know that work will need to be done to open up the area around the thoracic spine, encourage the erectors to move laterally, and lengthening the rhomboids will bring great reward and benefit. Or are they shoulders forwards, collapsed chest with raised traps? In this case we obviously need to spend more time opening up the chest, lengthening traps and encouraging the tissue back and downwards to gain any lasting benefit. Is there a head-forwards posture? Maybe if they're comfortable with it you could try a little gentle lengthening of SCM and scalenes.

Use just a little oil/lotion, listen with your hands

I prefer to use lotion to oil, as rather than feeling greasy it is partially absorbed and gives the skin a silky texture which is really great to work with. If you do use oil, the worst thing you can do is slather it on as you would to baste a turkey and re-apply every ten minutes. All this does is create a barrier between you and the client, making it very difficult to feel tension patterns in the tissue and when you do try and do some slow specific work you will just end up sliding over the tissue and doing very little to release it. I tend to apply just a little lotion to the palm of my hand, and  never directly onto the client and use the first sweeps of my hand to detect the tension patterns in the tissue and use the information to build my strategy. I always work slowly, first sinking to the level of the tissue I want to work with and then either stretching shortened muscle or working cross-fibre and muscles which are 'locked long'.

Stay mindful

A good treatment is all about the connection between you and your client so enetering the treatment with a settled mind and remaining mindful between the treatment is paramount. It's can be tempting at times to zone out and use repetitive strokes to while the time away, but staying focused on the tissues you are working with will bring much more benefit to your client and will work much more in your favour as you build a reputation as 'the therapist to see'.

by Alex Boylan BSc(Hons) MBAcC
 

The new site is more user friendly and has up-to date information on all the massage-related services here at Re-Creation. I firmly believe that we represent the gold standard of massage here in Manchester, and it only makes sense that we have a website that reflects that and does us justice. The site also promises to be more interactive, as we will be able to upload videos and pictures of us at work, and regular blog entrys will hopefully stimulate some questions and dicussion.

Feel free to browse the site, and as always drop us a line if you have any comments or queries! Onwards and upwards my friends!

Alex http://www.re-creation.org.uk