Issue link: https://www.massageandbodyworkdigital.com/i/149404
So, can hands-on work help? Skilled manual therapy can moderate masseter tension and resulting conditions in at least three ways: 1. By gently releasing myofascial restrictions in the muscle itself. 2. y reducing the level of resting tone via the B relaxation caused by direct pressure and massaging of muscles, and by stimulation of Golgi tendon reflexes that help balance muscle-spindle reactivity.4 3. By reducing overall stress and sympathetic nervous system activation. To help you apply this information, I'll describe two techniques from Advanced-Trainings.com's Advanced Myofascial Technique seminars and training DVDs. Both of these techniques appear simple at first glance. If they already seem familiar, take a moment to look for a new or forgotten aspect. Each of these has subtlety and detail that at first may not be apparent. Masseter Technique (Intraoral) There are many ways to work with the masseter from outside the mouth (for example, see "The Temporomandibular Joint, Part 1," Massage & Bodywork July/August 2009, page 110). But working intraorally (inside the mouth) allows access to different parts of the masseter and surrounding tissues, especially its tendinous attachments on the mandible and zygomatic arch where Golgi tendon organs are concentrated. When using this technique, all the customary considerations about intraoral work apply. Be sure to explain the purpose for working this way to your client, and get explicit permission first. Practice sanitary procedures such as glove disposal and hand washing, ask about latex allergies, and be familiar with any local scope-of-practice stipulations (some states require specific training or endorsement to be qualified to work within the mouth, and a small minority prohibit it outright). Keep in mind that the mouth is the only place we work that is even more sensitive than your hands—your clients are feeling you even more acutely than you're feeling them. Move slowly, deliberately, and gently; find a comfortable, supported stance that allows you to keep your neck, back, shoulders, and arms relaxed. Try working on the opposite side from where you're standing—in other words, when standing on your client's right, use your right hand to work intraorally on his or her left masseter (Image 4, page 115). This allows the curve of your hand to better fit the shape of your client's jaw and avoids the "fishhook" effect of pulling the mouth open when working the same side. 116 massage & bodywork september/october 2013 7 The Mandibular Fascia Release technique addresses each tissue layer in turn, from the superficial layers to the mandible. The parotid fascia (green, Image 8) surrounds the parotid glands, and has embedded muscle cells and is contiguous with the superficial fascia of the neck and chest associated with the platysma. Image 7 courtesy Advanced-Trainings. com. Images 8 and 9 courtesy Primal Pictures. Used by permission. 8 9 Gently slide your forefinger along the top teeth, back into the cavity between the teeth and the masseter muscle (Image 5, page 115). Your finger pad is against the teeth, and the nail side is against the medial side (inside) of the masseter. Ask your client to firmly clench his or her teeth together. If you're in the right place, this will squeeze your finger between the masseter and the teeth. Try it on yourself now—this is the best way to understand the placement and active participation needed.