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Never underestimate the depth and breadth of understanding clients may bring to the table! recoiled in response to very gentle palpation, I decided to pursue a more indirect approach, addressing other ipsilateral rotators (synergists) that were not as tender. Usually, when I discover the epicenter of a client's pain and move to other muscles, the client tries to redirect me to the original area of discomfort. In their mind, I am on the "right spot" and have now wandered away from what is most important. This usually requires an explanation of what I am doing and why. Not only did Ms. K. not ask that question, I had no sense she was concerned about my choice of strategy. Because I have always needed to explain myself in the past, I did so again. "You might be wondering why I am treating areas that aren't as painful as the one we initially found," I said. "Very often, when the offending muscle is hypersensitive to intervention, it is best to address other muscles in its relative ecosystem, hoping to indirectly downregulate the super-sensitive muscle." Ms. K. did not respond verbally; she just gave me an understanding nod. Slightly surprised, I still felt the need to continue explaining. "As an example, imagine a volatile situation," I said. "Let's say, perhaps, involving a crime. There might be one main instigator, but they are so agitated that any direct negotiation carries a high risk of escalating the problem. "One strategy is to use the influence of others who may be more amenable to intervention. In this case, I am addressing other muscles that have the same function as our original culprit. If we are successful, then direct intervention will be possible." Again, Ms. K. gave me a smile and a nod that revealed deep understanding. I probably looked a little confused at her complete acceptance of the approach, and she noticed my perplexity. "I'm a retired FBI agent," she replied. "One of my main roles was hostage negotiation." "OK then," I replied, sheepishly. "I guess you pretty much understand the strategy." "Very much so," she replied. "It's an approach we employed to great advantage in volatile situations. It makes sense to apply it now." There are two lessons here. First, principles of great problem-solving span multiple disciplines, and we can learn much from the experience of others. Second, never underestimate the depth and breadth of understanding clients may bring to the table! Douglas Nelson is the founder and principal instructor for Precision Neuromuscular Therapy Seminars, president of the 16-therapist clinic BodyWork Associates in Champaign, Illinois, and president of the Massage Therapy Foundation. His clinic, seminars, and research endeavors explore the science behind this work. Visit, or email him at N e w ! A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 25 TABLE LESSONS

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