Issue link: https://www.massageandbodyworkdigital.com/i/790815
C h e c k o u t A B M P 's l a t e s t n e w s a n d b l o g p o s t s . Av a i l a b l e a t w w w. a b m p . c o m . 63 next segment of tissue, again, allowing it to slowly slip through your fingers (Image 2). Repeat this gradual alternating of your hands until you've moved superiorly all the way up to the level of the scapula. This time, as you lean back, you are mobilizing those upper ribs. As their ribs slide through your fingers, you'll find that your fingers are left holding the lateral edge of the scapula. Now, when you lean back, you can actually lift the scapula itself posteriorly and medially, bringing the bone and its muscular attachments up off of the posterior ribs and toward the spine (Image 3). This position—likely one the client has never experienced before—shortens many of the upper-back tissues that always feel tight. If you lean back and hold the scapula in this retracted position, with no tension in your own body—again, imagine you are doing nothing more than slowly sitting down in a chair—your client will respond in kind. After a few slow breaths, often you'll feel this whole area of chronic tension, now slackened and relaxed, simply go limp—as if the client is letting go of that "weight of the world" that has long been on their shoulders. With this simple sequence, you have accomplished two things that are too often ignored in our work. First, you have contacted the intercostal muscles of the ribs, as well as the lateral muscles of the shoulder blade—the latissimus dorsi, the teres major and minor, perhaps even the edge of the serratus anterior. Most clients are completely unaware these muscles exist, let alone that they are using them all the time. And those clients with the tightest upper backs are often the ones for whom this lateral area is the most locked in place, and thus tender and in need of sensitive attention. Though the client feels the tension in the top of the shoulders or between the shoulder blades, the habituated posture of these lateral muscles—glued against the scapula and ribs—perpetuates the upper-back tension that brought them into your office. By leaning back slowly, we are encouraging these muscles to be mobile, rather than rigid; to be stabilizers, rather than just be stuck. Again, in our effort to make the client feel fuller, rather than flattened, it can be a great gift simply to unstick these tissues from their surrounding structures, and remind them of their potential for pliability. Second, as we move these lateral muscles up and away from the bone, you are placing all the client's strained, stressed midline muscles on the slack—a position that happens rarely as we slouch forward toward our computer screens and as we rush headlong to fulfill our endless to-do lists. That passive, and novel, slack position floods the client with new proprioceptive possibility. As an added bonus, after you've held this retracted scapula position for a few breaths and allowed the client to feel this unusual sense of ease, your old work along the midline will immediately be more effective. Feel that difference by now reversing direction and working as you are used to, from medial to lateral: release your hands and let the scapula sink back onto the ribs. Now, place the heel of one palm (or your fingertips) between the spine and the medial border of the scapula (Image 4). As you lean your body weight into this area, the client's scapula will sink laterally, often farther and more easily than it would have moved using only those usual strokes along the spine. With this sequence, you have attended to the specific area where the client feels tension. But, just as important, you have illuminated an area of the body totally different from (yet inextricably linked to) their area of complaint. In the process, you've demonstrated to your client their body's capacity to move in new directions and to get unstuck in new ways. A few minutes of this work, I find, is often sufficient to awaken the client's curiosity. After this work, clients tell me things like: "I had no idea the tightness in my back came from my armpit." Or, "I haven't been breathing all this time!" Or they'll place their hands on the sides of their ribs and say simply, "That was amazing—what is going on in there?" Now I know this client is hooked—that they have been awakened to an enlarged sense of what is happening in their body, and that they are curious about how they might inhabit their body with greater ease. Then, in subsequent sessions, I can do deeper and more specific lateral work, using the second position (Same-Side Sink). SAME SIDE SINK PROTOCOL Continuing with our rib cage and scapula example, in your next session with this client (again in prone position), after doing a minute or two of general work to the back, try the following protocol. Come again to the side of the table, but now you should be on the same side that you want to work (in this example, on the left side of the table). Either kneeling on your knees, or sitting on a stool or a yoga ball, position yourself so you are level with the client's middle ribs, but keep your body turned slightly so you are facing their occiput. You should be far enough from their body so that, with your arms straight, your hands just touch their lateral ribs. From this position, you can reach all of those same lateral muscles from the first sequence, but with greater depth and specificity. In the first position, you were standing on the opposite (right) side of the client's body you were addressing, leaning away from their body in order to mobilize the muscles and lift the rib cage slightly off the table. Here, you are on the same (left) side of the body, leaning into their lateral musculature. And yet, the general angle, or direction, of your work is the same.