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Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 103 than some of the deep intrinsic muscles along the spine (Image 5). Most of the multifidus is directly below the erector spinae, so it is not as easy to access. You can work the multifidus to some degree with pressure directly on the spinal extensors. You can also reach some portions of it by working with a small contact surface, such as a thumb or fingertip, directly in the lamina groove. The multifidus sometimes gets ignored because people are apprehensive of working so close to the spine. As long as appropriate pressure is used along with good client communication, this is a safe area for massage. Massage is often used in conjunction with spinal manipulative therapy. However, biomechanical analysis suggests that pain relief and enhanced movement from manipulations are most likely from improved motion segment mobility, not from pushing vertebrae back into a particular position. Vertebrae are bound together with strong ligaments. In addition, the intervertebral disks have fibers embedded into the vertebral bodies above and below. Muscles also cross the joints of the motion segments to provide additional stability. As such, it is very difficult for one vertebra to be out of position in relation to those adjacent to it. Consequently, the understanding of spinal manipulative therapy has evolved to look at other mechanisms. Low-back pain is one of the primary reasons people seek the care of a massage therapist, so it is beneficial to understand key components of spinal mechanics. Even when clients have a more serious complication, such as a herniated intervertebral disk, massage can help resolve hypertonicity and restore optimal spinal mechanics and mobility. The more we understand about these functional relationships, the better we can employ appropriate strategies in the treatment room and offer home-care suggestions for our clients. Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His text and programs have been used by professionals and schools for almost 30 years. Learn more at CLINICAL E XPLORATIONS 4 Intervertebral disk herniation. Image courtesy Wikimedia Commons. Nucleus pushing out against bordering annulus 5 Deep muscles controlling the lumbar motion segment. Image from 3D4Medical's Complete Anatomy application. Multifidus Quadratus lumborum ABMP members can take advantage of in-depth training with an exclusive discount on Whitney Lowe's 130-hour Orthopedic Massage online program. Normally $750, ABMP members pay only $650. Use this code when purchasing: ABMP PRO.

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