Issue link: https://www.massageandbodyworkdigital.com/i/1501042
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 63 1 Calf Twist Our fi tness levels naturally decline after our 20s and nosedive once we hit our 70s. Along the way, we're drying up, growing stiffer, enduring injuries, and spending less time moving around. A saying from orthopedics, "Motion is lotion," reminds us that muscle and connective tissue shorten and tighten if we don't regularly move them through their full range. Both exercise and the skilled hands of a manual therapist produce physical movement that lubricates joints and soft tissue. Pin, twist, sling, and resist is a fun way to describe several manual techniques that lubricate joints and soft tissue by generating warmth in the tissue and rolling fascial sacs across associated structures. Some of these methods restore capsular f lexibility, enhance joint play, and encourage pain-free range of motion. Others stimulate muscle spindles to turn on weak muscles and improve their firing patterns. WHEN CLIENTS VIEW MOVEMENT AS THREATENING While motion's ability to act like "lotion" for joints and muscles makes pin, twist, sling, and resist techniques useful in any bodywork system, they are uniquely effective for clients who perceive movement as painful and threatening. Many clients avoid activities they love because they fear it will increase their chronic pain. These methods seem to reset faulty pain perception and reduce nervous system hyperactivity. Research demonstrates that in many chronic pain states, pain persists without an objective threat to the body. 1 Instead, pain perception results from faulty brain network interactions that continue long after an injury has resolved. 2 No one area of the brain is solely responsible for a person's experience of pain. 3 Instead, the brain generates pain from a complex network of neurons and structures, including the somatosensory, insular, cingulate, and prefrontal cortex; the thalamus; the amygdala; and the brain stem. The structures in this expansive system perform many functions other than pain perception. When necessary, they temporarily come together to produce the sensation of pain. 4 Most manual therapists know that factors like anger levels, grief, stress, or fear of severe disease can increase someone's pain experience with or without tissue injury and inf lammation. 5 Conversely, a motivating goal like running a marathon can decrease someone's pain experience with or without physiological threat. 6 When we think of pain perception as a dynamic multi-structure system, it is easier to understand clients who continue to feel pain long after an injury has healed. While the causes of complex long-term pain without evidence of tissue damage are not fully understood, central sensitization often plays a role. 7 Central sensitization is a broad term referring to hyperexcitability of the nervous system, including hyperalgesia (increased sensitivity to pain) and allodynia (perception of pain from exposure to nonpainful stimuli). In musculoskeletal conditions, central sensitization results in defensive muscle spasms that lead to muscle imbalances and compensatory issues. Techniques that pin, twist, sling, and resist help clients engage with painful movement barriers by introducing novel stimuli that hold the brain's attention. While other mechanisms underlying the efficacy of these techniques are unclear, they help the brain down-regulate sympathetic nervous system hyperactivity, releasing regions of dysfunction from protective muscle guarding. EIGHT TECHNIQUES CLIENTS ENJOY Let's look at eight pin, twist, sling, and resist methods clients almost always enjoy. Incorporate these techniques into your bodywork toolbox to lubricate joints and muscles, reduce unnecessary protective guarding, and encourage clients to move. Calf Twist (Image 1) With the client prone, stand by the client's knee and grasp their calf with the hand closest to their foot. Make a soft fist with the other hand and place it on the client's hamstring muscles. Rhythmically twist their calf by pulling O Our fi tness levels naturally decline after our 20s O Our fi tness levels naturally decline after our 20s and nosedive once we hit our 70s. Along the way, O and nosedive once we hit our 70s. Along the way, we're drying up, growing stiffer, enduring injuries, O we're drying up, growing stiffer, enduring injuries, and spending less time moving around. O and spending less time moving around.