LET'S BEGIN TO FIGURE IT OUT.

Teaching can be lots of fun.

 

 

 

 

BASED ON MANY COMMMENTS I AM GOING TO EDIT THIS BLOG POST FOR SOME CLARIFICATION.  I AM OFFERING A WORKING DEFINITION OF MASSAGE THAT I WILL ADD BELOW.

 

Big picture:  Massage/bodywork as a method uses physical applications to the body to create mechanical forces that act on the body tissues which then affect the body through multiple pathways including but not limited to the nervous system, endocrine system, connective system and fluid systems of the body .

 Massage therapy or therapeutic massage is the intelligent, compassionate and respectful process of using massage to support another along the continuum of health and wellness - . Therefore massage therapy is a multidimensional  therapeutic relationship consisting of  observable and measurable mechanical aspects and an interpersonal more subjective experience both of which have therapeutic value for the client through multiple interacting specific and nonspecific pathways/

http://www.rnpedia.com/home/notes/fundamentals-of-nursing-notes/health-and-wellness 

Check out the link for excellent explanation of the wellness continuum

Following is the original blog which suggests a way of finding common ground on the mechanical aspect of massage /bodywork . I intend to follow with another blog about what we do to create the mechanical forces in the tissues such as gliding (and the multiple names for it) kneading (and multiple names involved) and movement and you guessed it( the multiple names used). This series of blogs is looking only at the potential of common ground related to physical aspect of massage application.

ORIGINAL BLOG.
It appears at least at some level that we are beginning to agree on the term massage even if it is confused with bodywork.  The Federation of State Massage Boards, The National Certification Board for  Therapeutic Massage and Bodywork, The Association of Bodywork and Massage Therapy  have the concept of massage and bodywork lumped together and reluctantly I am going to have to live with this confusion for a while I think.  

The age old problem of differentiating between massage and bodywork may indirectly be defined however.   Based on the ELAP work group‘s presentation at the Federation of State Massage Boards  and the AMTA convention the concept of forms and styles is going to  be built on the platform of mechanical forces that act on the soft tissue .  There will be a learning curve and the need to think just a bit differently and learn a slightly different language. But it will not be that complex. I applaud the work group’s diligence and efforts in this huge undertaking. 

 So first, if the the approach is going to be considered massage/bodywork it needs to fit this criteria-  creates mechanical forces that act on soft tissue ----!

If this is the case, then the approach has to at the very least change the physical shape of the tissue.  I submit to you that a very light touch will create a very tiny deformation of soft tissue. With observation then we can determine if an approach is on the massage and bodywork continuum.  If actual physical contact is not made and the tissue does not at least change shape a little bit (deformation) then it is not massage and bodywork.  Just this differentiation would clear up a lot of confusion.  

The fundamentals presented in this blog can be used to explain ANY style or form of massage and bodywork regardless of the history /culture of the approach, underlying philosophy and claims or evidence for or against the approach.  Remember now, the only thing that matters at this particular stage of analysis in this blog post is observation of what mechanical forces are generated by the method.  YES THERE ARE MORE FACTORS----ONE STEP AT A TIME HERE.

NOTE;  The ethics  and potential harm of making unreasonable claims  about a particular system of massage and bodywork  is a very important issue and I will eventually blog on these topics again. HOWEVER-ONLY WATCHING WHAT SOMEONE DOES AND BUILDING  THE DESCRIPTION FROM WHAT IS OBSERVED CAN BE A TREMENDOUS HELP IN IDENTIFYING CORE COMPETENCIES  FOR MASSAGE EDUCATION AND CRITICAL THINKING ABOUT THE CONFUSING, FRUSTRATING TENDENCY TO LABEL THE SAME FUNDAMENTAL APPLICATIONS AS SOMETHING NEW OR UNIQUE.

OK, let’s get started.

There are five mechanical forces. I have blogged on this before so check out past posts.  Mechanical forces are pretty universally understood and agreed upon so that really helps.  If you ask an engineer what a shear force is for example she or he will understand what you are talking about..

The five kinds of force that can affect body tissues are compression, tension, bending, shear, and torsion. Not all tissue is affected the same way by each type of force.  Eventually we will need to look at each of the five types of forces, the ways they produce important therapeutic benefits when applied by a skilled massage/bodywork practitioner and the different ways they can cause tissue harm.

Compression

Compressive forces occur when two structures are pressed together

Tension

Tension forces (also called tensile forces) occur when two ends of a structure are pulled in opposite directions. Tension force is used during massage with applications that drag, glide, lengthen, and stretch tissue to elongate connective tissues and lengthen short muscles

Bending

Bending forces are a combination of compression and tension. One side of a structure is exposed to compressive forces as the other side is exposed to tensile forces

Shear

Shear is a sliding force, and significant friction often is created between the structures that slide against each other.

Torsion

Torsion forces are best understood as twisting forces.

 

Now for the justification for professional training and core competencies. 

Mechanical forces are generic.  When I push down on a key on my computer keyboard I am generating a compressive force with my finger that will then cause something to occur.  The key moves down and a letter shows up on the screen. To be honest with you, I am not quite sure what happens as the key responds to the applied force.   I am also sure that there are a multitude of events that occur so that the letter ends up on the screen.  Now about the only thing that can be observed in this whole process is that compressive force is the mechanical force required to move the letter key down.  Then a whole bunch of unseen things happen and then the next observable thing is the appearance of the letter.  Yea! 

How effectively I apply the compressive force is huge consideration.  Right now I am using my finger. It fits the key.    I could use my elbow, my toes, my forehead or an implement or tool like a pencil and as long as I can get the correct letter to appear on the screen the outcome is appropriate.  The anatomy of my laptop makes it cumbersome to use my elbow or other body part but I have seen people that are able to use other parts of their body or a tool to create the compressive force to move the key.  So it is not so much how the compressive force is applied as long as the key moves down. 

I also have to apply compressive force to the correct key and in the right intensity.  If the application is too surface or light then the key does not move. Too much intensity and effort is wasted, I could hurt my finger or even break the computer.   I also need to make decision about what key I want to compress so the outcome is understood.  Some pretty odd messages can occur or unexpected results if the wrong letter is used or if auto correct takes over.

OK enough metaphor.   Hopefully you are starting to appreciate why massage /bodywork education needs to include an understanding of the anatomy, physiology and pathology, how tissue and related physiology responds to the mechanical forces and how each application needs to be modified to achieve an expected outcome without causing harm.

The hundreds of methods of massage /bodywork introduce one or a combination of the five types of mechanical force into the body to achieve a therapeutic benefit. The application is modified for safety and benefit by altering the   depth of pressure, drag, duration, speed, rhythm, direction, location and frequency.  The intended outcome should make sense by, at the very least, mimicking normal physiological function. For example, if you think the result is going to increase a joint’s range of motion than the application should at least have a chance of achieving that outcome.

The variety of massage and bodywork forms and styles in the profession can be clarified by describing intended outcome, what is done during the application, how it is adapted, mechanical forces, and mode of application.

I challenge you to describe a. particular method this way. For example: myofascial release, shiatsu, lymphatic drainage, Swedish, cupping, foam rolling and so forth.  Grief, there are hundreds to choose from.  Forget right now the names, creators and teachers, theory and physiology.  Just observe what is being done and what the end result was.  What mechanical forces are being created? How are the forces generated? How is the application modified and adapted?  Where and for how long are the methods applied?

Following are some helps so you can break down any massage bodywork system into it’s fundamental elements.

·         Depth of pressure (compressive force) can be light, moderate, deep, or variable.

 

·         Drag is the amount of pull (stretch) on the tissue (tensile force). In this context the term drag refers to the effort required to overcome resistance. Lots of drag-little slipping no slack. Lots of lubricant little drag.

·         Direction means that the massage may proceed from the center of the body outward (centrifugal) or from the extremities inward to the center of the body (centripetal). It can proceed from proximal to distal attachments of the muscle (or vice versa) following the muscle fibers, transverse to the tissue fibers, or in circular motions.

·         Speed of techniques can be fast, slow, or variable.

·         Rhythm refers to the regularity of application of the technique. A method that is applied at regular intervals is considered even, or rhythmic. A method that is disjointed, or irregular, is considered uneven, or nonrhythmic.

·         Frequency is the rate at which the method repeats itself within a given time frame .

·         Duration is the length of time the method is applied or that the technique remains in one location.

·         Location. When the application is being applied. Leg, abdomen, head etc. What structures are in the area.

·         Intended outcome.  What is supposed to happen and what happened.

Here are figures of the mechanical forces.