Issue link: https://www.massageandbodyworkdigital.com/i/1299745
the educated massage therapist, with their many hours of kinesiology, would have the critical thinking skills to work with and advise their clients as to how to increase the strength of their weakened muscles. After all, strengthening a muscle is simply asking for it to undergo its concentric joint action(s) against some resistance. A muscle's actions are something that all massage therapists learn in core curriculum. Figuring out how to add resistance is a simple matter. Granted, there are longer fitness strength-training certification programs out there, but the central understanding of strength training, and how to create it lies within the conceptual seeds of the massage therapist's core curriculum. Similarly, the essence of massage therapy—using our hands to manipulate myofascial tissues—is a fairly simple technique that, if not taught to movement professionals in their core curriculum, can be safely taught in continuing education workshops. Aside from specific contraindications and precaution sites, working into myofascial tissues is a fairly straightforward technique— especially for someone who has already learned the underlying musculoskeletal anatomy and physiology, which well- trained movement professionals do. I realize that some of these statements might be viewed as controversial. I am one of the biggest proponents of education and training, but I do believe that the application of any manual or movement technique is relatively simple and straightforward, as long as the therapist/trainer/instructor has learned the underlying foundational kinesiology and pathology, and can critically think through the mechanics to creatively apply the appropriate techniques. In our current world, manual therapists have massage, movement professionals have strength training, and both worlds share the technique of stretching. I believe it would be better to combine these worlds into one of both manual and movement therapy. C h e c k o u t 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 . 59 Massage Can Strengthen; Strength Training Can Loosen Massage therapy is primarily aimed at loosening myofascial tissue to increase flexibility; it does not directly increase muscle strength. After all, beyond breaking up fascial adhesions, the principal goal of massage is to lessen baseline muscle tone; in other words, to inhibit the nervous system's control of musculature. But it could also be argued that massage can indirectly strengthen musculature. If musculature is painful or dysfunctional (perhaps due to a myofascial trigger point), then by healing the trigger point, the pain and dysfunction will be lessened, allowing for improved muscle function, and therefore greater strength. Similarly, strength training's principal goal is to strengthen musculature by increasing facilitation of muscle tone, so it is usually not thought of as loosening musculature. By strengthening musculature, though, we allow it to better deal with the demands placed on it. Strengthening decreases the likelihood that musculature will become dysfunctional and painful, which might otherwise result in protective muscle spasming with the resultant increased baseline tone tightness. So, strength training can indirectly loosen muscle tone. this position of shoulder girdle retraction and would fall back into protraction. On the other hand, a major focus of the fitness trainer would be to strengthen the retractor musculature to bring the shoulder girdles back into retraction. But if this is all that is done, their efforts will be thwarted by tight pectoral shoulder girdle protraction musculature that would not allow for the retractor muscles to bring the shoulder girdles back into retraction. The Chicken and the Egg It is clear that a balanced approach to treating this client would be to massage and stretch the pectoralis muscles to loosen them, and then strengthen the retractor musculature with resistance training to increase the strength of its baseline tone. We might call this a yin-and-yang approach, or perhaps look at it as the chicken and the egg. Is upper-crossed syndrome caused by tight protractors, or is it caused by weak retractors? The answer is, of course, both. And if one is present, the other will develop, which will then reinforce the first, and so on, causing a vicious cycle. For true healing, we need to address the chicken and the egg. Curriculum Conundrum Let's take a look at a typical massage therapy curriculum. If someone attends a 700-hour massage therapy curriculum, it will contain approximately 150–200 hours of kinesiology (musculoskeletal anatomy and physiology), which is the basis for understanding muscle function. In many states, the graduate of this program is not legally/ethically allowed to recommend simple strength- training exercises to their clients under their massage therapy license. But, if this same person attends a weeklong or perhaps even a two-day weekend workshop for fitness training, they can attain a Certification in Fitness Training that would then legally allow them to work with clients for strength training. This is ironic because