I was delighted to see the March 2010 of Massage Today feature an article titled “Evaluating Neurological Symptoms” by Whitney Lowe, founder of the Orthopedic Massage Education and Research Institute.
In this article, he stresses a point that I often commnicate to my clients:
Massage is not just about relaxing muscles and massaging where the client feels pain. Often, the place of the pain is NOT where you want to be massaging.
In addition to direct pain relief, massage is also about helping the nervous system be in a healthy state where it is “plugged into” the muscle fibers and not being “short circuited”. Sometimes pain can be in one place, one muscle can be weak where the pain is, but it is because another muscle in another place is tight, resulting in weakness of another muscle which then causes pain in the area.
Sound complicated? It is. Let’s look at an example:
The same nerve that innervates the serratus anterior in the back (which holds the scapula against the wall of the ribs), runs under the scalenes in the neck. When the scalenes get tight, they can compress the nerve and cause weakness in the serratus anterior. The signals are not getting through.
When the serratus anterior is weak, the scapula “wings” (the bottom point sticks out from the ribs), and the movement of raising the arm to the side begins to be impaired. This can actually go as far as to result in symptoms that look like impingement syndrome.
Impingement is, technically, a mechanical issue in the shoulder joint, but the root problem can be neurological compression and muscle weakness.
This can result in frustrating therapy that does not help, MRIs that show nothing is wrong, and you are left with pain that supposedly “shouldn’t be there” but is “bigger than life” real to you.
Another example of the nervous system being involved in pain is when the gluteal muscles are weak and not firing properly in a person’s gait. It may be that the gluteals just need strengthening and the nerves need to be innervated to the muscle fibers again, but it also can result from the hamstrings being too tight. When the hamstrings are tight, the gluteals shut down.
These are just two examples of how an understanding and evaluation of the neurological component is important in a strategy for massage and/or exercise for a client.
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To your health and happy muscles,
It’s me, Cynthia Mealy. I am a massage therapist and medical exercise specialist in Oakland, CA. This is my first blog, I’m going to use this space as a place where I write my reflections on questions asked by clients, and on various articles and resources that may be helpful to my readers.
Clients often ask me whether they need to see a doctor when they are experiencing pain. I just saw a great article on this by Ben Benjamin, (a PhD in education and sports medicine) in the Massage Today newspaper.
Did you know that you can’t just go to a physical therapist without being referred by a physician? Many people are not aware of this, and often feel like it is some part of the crazy red tape system called “healthcare”. I don’t blame them for thinking that, but in this case, there is a very good reason – it is the same reason why I sometimes refer people back to a doctor before I feel good about seeing them for massage again, or beginning an exercise program.
Why should you go to a doctor first if you have pain?
Because pain can indicate serious medical conditions that need to be ruled out.
There are a lot of medical conditions that I don’t know about, that a physician will. Some examples that are listed in the article:
- pain in both heels can be a sign of gonorrhea (who knew? you don’t want to be wasting time with a massage therapist in this case)
- pain in the shoulder when lifting the arm might be musculoskeltal injury (frozen shoulder, rotator cuff injury, etc.) but it could also be a sign of cancer in the lung.
- pain when rotating the neck may be a result of injury, but one massage therapist ensured that her client went to a doctor, and they found they had a brain tumor.
- I learned from another doctor that pain at night can indicate cancer (go figure, but there you are)
When it comes to this kind of thing, there’s a lot that we don’t know, but physicians do. I’m not wanting anyone to be alarmed, but I always say “I don’t know what I don’t know”, so seeing a physician is the right thing to do.
You don’t want to waste precious time on therapies that will not be effective when something potentially serious can be caught and dealt with in the early stages.
There. I’ve written my first blog, I hope you find it helpful for yourself or loved ones
Supporting your muscles that support you,
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