Issue link: https://www.massageandbodyworkdigital.com/i/121374
KEY IDEA Give the skin's mechanoreceptor system as much slow, gentle, and continuous stimulation as possible without adding any more nociceptive input. Basics of Skin Stretch When we stretch the skin, we shift multiple tissue layers and the nerves embedded within them, and nerve compression may be relieved. Slow-firing mechanoreceptors, such as Ruffini corpuscles, respond to the sustained pressure of slow skin stretching. Their input to the brain may trigger a positive response: descending modulation of pain and excess muscular contraction. Skin can be stretched in a variety of ways to provide relief. Here are some examples of DNM applied to resolving pain and tightness in common problem areas. Anterior Neck The anterior neck area is frequently involved in varied conditions such as headaches, jaw pain, torticollis, vertigo, whiplash, and many more. This example focuses on providing some relief to the superficial cervical plexus, a complex network of cutaneous nerves that determine whether the muscles will be relaxed or tight, and whether the area feels good, painful, or otherwise. 1. With the client supine, gently palpate the anterior neck, particularly along the sternocleidomastoid (SCM). The tissues may feel firm, ropey, tense, or otherwise irritated. The client may report pain or other discomfort. Choose a side to address. 2. Slowly and gently turn the client's head slightly away from the side you will work on. A few degrees may be enough. The client should not be in any discomfort because of the positioning. 92 massage & bodywork may/june 2013 3. Locate the SCM and lightly place the edge of each hand on either side of it. Gently let the skin of your hands sink in until you feel your skin slightly "adhere" to the client's. 4. Slowly and incrementally shift your hands in opposite directions along either side of the SCM, stopping when you feel a slight resistance, then continuing as it subsides. The hand on the lateral border of the SCM should move caudally toward the clavicle, while the hand on the medial border of the SCM should move cephally toward the ear. 5. Continue for about 2 minutes. Feel for softening of the anterior neck/ SCM; the client may report changes in sensations. If the tissues are slow to respond, continue for another 1–2 minutes. When finished on one side, you may switch sides and repeat this procedure. Posterior Pelvis The posterior pelvis/gluteal area is frequently involved in gluteal pain, impaired gait, low-back pain, sciatica, and other conditions. This example focuses on providing relief to the cluneal nerves—long, lateral branches of dorsal rami extending downward from the lumbar spine that spread over the iliac crests and wrap around the buttocks down to the greater trochanter. 1. With the client prone, find a tender spot near the iliac crest to one side of the sacrum. Use one hand to continue monitoring this spot. The monitoring hand marks the place and feels for changes in the tissues. Stop pressing into the tender point. 2. Place your other hand near the greater trochanter with your palm open. Let your skin gently sink into the client's until you feel it gently adhere.