Issue link: https://www.massageandbodyworkdigital.com/i/790815
THE THERAPIST'S MYOPIA There are a few obvious reasons for this two-dimensional myopia. First, my guess is that your massage school training was a lot like mine: we spent the most time learning about, and practicing on, the back of the body, followed by (significantly less) time on the front of the body and almost no time on the sides of the body. (Think about how much time you spent learning about the rhomboids, as opposed to the pectoralis minor or gluteus medius.) Second, this hierarchy of emphasis is perpetuated by our clients. What do they nearly all complain about? Back. Shoulders. Neck. A few unusually self-aware clients might mention they have tight pectoral muscles, or tight hip flexors, but these are rarely the client's priority. And when was the last time a client asked you for a side- lying massage? Exactly. Or consider a less extreme example: how often do clients ask for work on the sides of their ribs? Even with the explosion of foam rolling, and the surprising number of clients who tell me they have tight iliotibial bands, that awareness is the exception that proves the rule. We all know that to be a good therapist we must listen to our clients, so our work mirrors their awareness. I mention curriculum and clients not to lay blame on any one group in particular. Indeed, the problem is systemic: we as a species are still startlingly oblivious to our sides. Unless we are in pain, or terribly ticklish, we just don't think much about the stuff that links the back and the front—even though it is the sides of our bodies that give us depth and that enable us to exist in all three dimensions. That lack of depth in how we, as humans, perceive our own bodies has a corollary in the lack of variety in how we, as therapists, contact those bodies on our table. Again, our approach matches our perception. Thus, our emphasis on the back (and a bit less, on the front) of the body means we focus on the big muscles close to the center of the body, namely the muscles alongside the spine, and then the hamstrings and quadriceps. And typically, we engage these pronounced midline muscles by pushing them down into the table. Those downward strokes can accomplish a great deal, yet there is an irony here we don't often notice. Our aim is to make our clients feel better in their bodies. But does feeling better mean feeling flattened? We don't actually want to be pinned down against the table or mashed into submission. Many of our clients are coming to us because, whether due to injury, surgery, or just stress, their muscles feel stuck or fixed in place, as if glued to the bones beneath. I fear that in our determination to dig down into these restricted tissues, we risk replicating that feeling: the muscles fixed in place, strapped against the skeleton. Instead, I think what most of us want (even though our clients rarely articulate it as such) is quite the opposite: we want to feel our bodies in all their fullness. We don't want to feel flattened—we want to feel expanded. LATERAL LOGISTICS Sinking down into the anterior and posterior musculature of the body is wonderful, and essential, for successful bodywork. Indeed, all those strokes along the midline we learned in school are still mainstays of my practice. But we don't need to stop there—we can make our habitual techniques more effective. All those standard strokes accomplish more if we contact the sides of the body amidst our contact to the back and front. How often do you work directly on the lateral musculature? On the peroneals? The intercostals? Or the sternocleidomastoid? My guess is, not that often. But with a little determination and a little experimentation, you can add another dimension to your work (without moving the client into a side-lying position). First, a word of warning: working on the lateral musculature (in a way that is comfortable for you and not invasive for the client) can be tricky and requires a shift in how we see the body. As creatures of habit, we get stuck in a routine at our tables, just as our clients get stuck in a routine at their desks and in their lives. Our dominant approach—digging into the big muscles along the midline of the client's body—makes working the sides of the body difficult for one simple reason: gravity. If we are pressing along the erectors, for example, and then want to move laterally to explore the latissimus dorsi or quadratus lumborum, we quickly run into a problem: we begin to "slip" off the side of the client's body. In order to maintain the right amount of pressure, we must contort our own body and push down with a lot more effort. That doesn't feel good—not for us and not for the client—so it is easier to stay close to the midline. Similarly, when working the lower body, we tend to stay close to center as well, lavishing attention on the bellies of those meaty muscles in the front and back of the legs. The more familiar this approach becomes, the more we become ingrained in it, and the more the sides of the body are ignored. But, just as we encourage our clients to change their habits, we should change ours, too. When we challenge our old habits, we 60 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 7