Issue link: https://www.massageandbodyworkdigital.com/i/87297
Q & ART Take advantage of side-lying work. Especially for low-back complaints, I often only use side-lying positions, allowing clients to choose a position in the neutral, pain-free range. As muscles relax, have your client move knees forward or back to decrease or increase pelvic tilt, which helps override spasm and offers freedom in the lumbar vertebrae. Use frequent movement throughout sessions. Painful areas aren't happy being immobile for extended time periods. I often have people change position four or fi ve times during a session, moving from prone to supine to side-lying, and back to either prone or supine. Work satellite areas. I rarely begin work on specifi c areas of complaint; instead, I often begin on the neck in a supine position to introduce the client to my touch and relax the nervous system. As you sense the development of trust and relaxation, move toward the problem area, sensing any defensiveness and sometimes retreating to other areas for a while to give the body a chance to assimilate the work. Ask for active movement rather than passively moving joints through range of motion. This is critically important for recent acute injuries involving joints, especially with the low back and neck. When working to increase range of motion, such as for shoulder restrictions, have your client move back and forth from comfort Patiently learn the skills to work with injuries and complaints, but remember that there is a human being behind the symptoms. into restricted areas of movement rather than continually working at end range. Spend time on areas of primary tightness or compensatory holding that may solidify movement patterns. For example, posterior neck pain may be a response to tightness in the anterior muscles of the pectoral area or scalenes. Apply gentle work to the area of complaint. Fear and defensiveness of painful areas often exacerbate symptoms. Of course, appropriate deep and specifi c work are often helpful, but initially, just addressing the area with a nurturing touch can do wonders to relax holding patterns and recalibrate perceptions of pain. Finish with relaxation work. It is always a good idea to fi nish the session with work to nonsymptomatic areas, rather than having your client suddenly jump up and face the world. I believe relaxation work actually stimulates the pleasure centers of the brain, calming the sympathetic nervous system and diverting attention from the problem area. "Striving," my biggest concern is that many massage therapists are frightened of the reactions you mention, and therefore do a great disservice to both themselves and their clients by shying away from working with injuries. More research is authenticating the power of our work. Your client's state of mind is crucial in healing. You don't have to "fi x" someone to provide great benefi t. Patiently learn the skills to work in partnership with injuries and complaints, but remember there is a human being behind those symptoms. Your caring humanity is a gift many people just don't receive in a typical medical setting. Art Riggs teaches at the San Francisco School of Massage and is the author of the textbook Deep Tissue Massage: A Visual Guide to Techniques (North Atlantic Books, 2007), which has been translated into seven languages, and the seven- volume DVD series Deep Tissue Massage and Myofascial Release: A Video Guide to Techniques. Visit his website at www.deeptissuemassagemanual.com. 34 massage & bodywork november/december 2012