Issue link: https://www.massageandbodyworkdigital.com/i/790815
We'll start by sinking into the intercostal muscles between the lower ribs. Rest the base of your right-hand palm on the table. Your fingertips should be pointing roughly toward the opposite-side shoulder and contacting the intercostal spaces at the lateral-most curve of the ribs. If you are in the right place, your whole hand will be pointing up at about a 45-degree angle relative to the table. Sink into the intercostals by leaning forward from your hips. Think of your fingers being in line with those intercostal spaces—not poking into the ribs, but rather suggesting greater movement along and between the ribs, encouraging the intercostals up and away from their current (likely stuck) position. Once again, you are suggesting the tissue move up and off, or away, from the bone. As muscle fiber and fascia start to soften, you can adjust your right hand superiorly, into the upper ribs, and then eventually into the axilla (as we'll see in a minute), 64 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 sinking between the posterior ribs and the anterior surface of the shoulder blade. The client's tissue will only allow you in if you are merely leaning, never pressing, and delivering the necessary pressure by tipping forward from your hips, rather than pushing with the muscles of your arms (just as how, in the first position, you were leaning away from the client with your whole body, rather than just yanking the client off the table with your arms). That leaning, or what I call "pouring" (see my article "Pour, Don't Push" in the November/December 2016 issue of Massage & Bodywork), is especially crucial here; we can all imagine how unpleasant it would feel to have a therapist poking and prodding between our ribs. But, if you establish a contact that is soft, in which you are pouring your body weight into the client, rather than pushing with your muscles, adhesions will loosen, and even more importantly, the client will begin to let go of those strands of excess tension that we too often maintain, even when we are doing nothing at all. I believe that unconscious holding is at the heart of many of our ongoing aches and pains. The greatest test comes when your fingertips get to the lateral edge of the client's shoulder blade. If you have been merely leaning thus far, encouraging the client's tissues to soften as they are ready, rather than forcing them or "fixing" them, then your client's tissues will likely allow you into the axilla— and in particular, between the anterior surface of the scapula and the posterior surface of the ribs—a place that is rarely touched and nearly always guarded. Avoiding the axilla is easy. It is likely sensitive or tender or ticklish, and sometimes all three, and rare is the client who will ask you to work there. But even just a bit of work here will change your own perspective, and your client's. If you lean your right fingertips with patience, that space between ribs and shoulder blade will gradually accept your fingertips (Image 5). If the client is particularly guarded, you can cup the top of their left shoulder with your left palm and then move your left palm and right fingertips in synchrony back and forth, rocking the shoulder superiorly and inferiorly to help the client loosen and allow you in further. If your client is ready for even more specific work, replace your fingertips with your thumb (Image 6). Do this unsticking work for as long as you are able. This area is physically tiny, but somatically vast. In my experience, the more I sink into the lateral ribs, the more surprised, and then released, my clients are after the session. As for time, 2 minutes on each side is great; 8 minutes is that much better. Your client's serratus anterior and subscapularis—not to mention their whole understanding of how they hold tension—will thank you. Melting the rib and rotator cuff musculature using the Same-Side Sink position. 5 6