Friday, September 21, 2012


 Two questions come to mind when I think about “advance massage”.


What is the goal of the massage?

Why is the body functioning the way it is?


One of my teacher’s years ago said.” Every behavior, physiology shift and anatomical change is an attempt at a solution.”

I consider this every time I approach a massage client. 

So for a simple example: A client has a grade one medial collateral ligament sprain in the sub-acute healing stage. 

Now if you do not know what this means you need to look it up.  It is impossible to do so called “advanced massage” if you do not have a handle on anatomy, physiology and pathology.   I think the best way to do this is to always look up any condition a client may have even if you think you know what it is. 

The client is complaining about her calf aching.   So my next thought is ,”What purpose does an aching calf have related to a knee sprain?”

Well, a sprain is a tear-which makes a hole-which has to knit together to heal.  A grade one is a little hole and sub-acute means the connective tissue repair is occurring but is a little fragile.  An aching calf would restrict movement so that the healing edges of the tear do not separate. Maybe the aching calf is a good solution right now.    Think I will leave it alone.   However, the change in how she is walking is making her hip sore.  Maybe massage could help to normalize the soft tissue changes occurring secondary to the primary injury and local protective response (aching calf).  Let’s check and see if there are some changes in the tissues around the hips and because of the gait reflexes that link hip movement with arm movement I think to also assess the shoulders.   Yup it is tender to moderate palpation in both places.  I ask if her neck been a little stiff since the IT band on the injured leg will also be involved in knee stabilization and that structure weaves into the glut soft tissue which weaves into the lumbar dorsal fascia and affects the resting length of the latissimus dorsi especially on the opposite side which alters position of the arm at the shoulder joint which then influences scapular movement resulting in trapezius and associated soft tissue shortening and since the upper trap attaches into the skull and scalp it would seem logical that she might have neck stiffness and even a headache.

In this case I think I will give her a really good full body massage, target areas that are logically part of compensation, gently mobilize soft tissue around the injured knee. Carefully massage the calf just to calm it down and manage some of the aching but not really change the muscle tone and then reevaluate the progression next session.   

So advanced massage is a way of thinking—not advanced methods.


What do you think?