Deep Pressure or Deep Tissue Massage

I recently saw an advert in an online directory for "Excellent Firm Pressure Massage" and it got me to thinking about the differences between a professional deep tissue massage and a Swedish or therapeutic style massage performed with additional pressure. Many people like to get a deep and also invigorating massage as opposed to a gentle relaxing massage and will ask their therapist to apply more pressure or go deeper, this can be difficult for a lot of therapists as they haven't been properly trained in the techniques and methods of proper deep tissue massage and will just use the same strokes they have been taught for applying Swedish massage but with greater force.

First, it has to be said that any therapist who is using the techniques learned from Swedish and therapeutic massage to apply greater force is risking injury and is also likely to substantially shorten their career. When applying increased pressure during a massage it is important that you do so in a safe and effective way, the most vulnerable areas when apply pressure are the thumbs and wrists both of which are not actually that strong and can easily become inflamed and injured with excessive use.

So how is a professional deep tissue massage different?

A professionally trained deep tissue massage therapist should have a greater understanding of how the human body works, especially the muscles, ligaments, fascia, other soft tissues, bones and joints.

They should be able to palpate for each individual muscle and identify any tight and tense areas, taut bands, trigger points, scar tissue or tears within that muscle.

They will work at a much slower pace when working deep in the muscles. This is for several reasons, to allow the body to become accustomed to the deeper work, to enable the tissues to release at their own rate and to reduce any unnecessary damage to the muscle and therefore soreness the following day. You may find that sometimes your therapist may come to a complete stop to wait for the release of fascia or muscle tissue before continuing with a stroke.

The therapist will usually work with a couch that seems lower than that used by other therapist, this allows the therapist to better use their body weight to apply pressure. A deep tissue therapist will use there own body weight and body mechanics to effortlessly apply pressure and also support the clients body whilst they are working. They may at points during the treatment sit on the couch, crouch on there knees, sit on a stool or place there knee or foot on the couch.

Deep tissue therapists use a wide range of massage strokes with a treatment, this is what they call their toolbox. It will include strokes taken from Swedish massage such as long flowing effluarage to help warm the muscles and to calm the central nervous system before and after more pointed work.

The main techniques used during a treatment for deeper work will include knuckles, fists, the ulna border of the forearm and the more pointed elbow, although this is just a very short list of possibilities and each therapist will develop there own favorite techniques over time.

Your therapist might request you to actively move limbs whilst they are working to aid the techniques they are applying or they may just passively move your limbs through range of motion whilst they perform certain strokes.

There is no real set sequence to a deep tissue massage, your therapist may work the front and then the back of the body as in a traditional Swedish massage, or they may move you around the table far more so they can hang limbs over the side of the couch. They might want you in a side lying position to enable them to more easily access specific muscles or areas.

One of the main differences you will notice is that deep tissue therapist use very little oil if any at all. Depending on the therapist and the work they are doing at that moment they may use no oil at all, a small amount of lotion or as myself a wax product. This is to enable them to have grip and not be sliding around on top of the skin as soon as they want to go in deeper.

They may apply more oil as they are coming toward the end of the treatment to enable the Swedish style strokes that help calm the central nervous system after the deep work at the end of the treatment.

A professional deep tissue massage is totally different from a deep pressure massage.

If you are one of those people who prefers a deep massage, seek out a professionally trained deep tissue massage therapist, you can be sure the treatment will be more effective and less sore the following day!

Semi-Supine Position - The Alexander Technique

In a previous post I wrote about the Egoscue Method and an exercise know as Static Back, today I am going to describe a very similar exercise this time taken from The Alexander Technique and called the Semi-Supine Position, it is very similar in lots of ways to the Egoscue exercise.

It is a very simple exercise that doesn't require much space or time but can be very benefitial to anyone suffering from back pain. With the Semi-Supine position you lie on your back on a firm flat surface, with your feet flat on the floor and your knees pointing up to the ceiling. The knees and feet are approximately hip width and a half apart.

Initially you I would recommend experimenting with how far apart you have your knees and find out what feels most comfortable to you. Ideally you would place a thin book under your head, this book would initially be about as thick as your little finger is long. The book is there to help align the cervical (neck) vertebrae, so that the neck lies flatter against the floor. Allow your arms to drop and your hands to automatically find a resting position on your body, with your elbows on the floor.

It is important to note, that although the aim is to relax during semi-supine, it is more beneficial if you maintain awareness throughout the exercise, rather than drifting off into sleep or semi-sleep. Become aware of how your body is lying against the floor; Noticing which parts are in contact with the floor, and then allowing your body to be supported at these places, letting your body sink into the floor.

Breathe and Relax – Don’t go to sleep or drift off!

It is best to remain in this position for 20 minutes if possible to get the full therapeutic benefits, however 5 or 10 minutes a day will still be effective. When coming out of semi-supine, do so slowly. Roll to one side first before bring your body to a sitting position.

The main benefits of doing the semi-supine position is to realign and lengthen the spine and so reduce unnecessary tension in the muscles. By releasing and freeing up the neck your head can move forward and upward, relative to the neck, and the spine can lengthen and the back widen. This position encourages your body to move out of any habitual postural patterns of rigidity and undue tension, so that your musculature can work appropriately. You might experience increased energy levels due to a decrease in muscular effort and excess tension.

If you would like to learn more about the Semi-Supine position or how The Alexander Technique could help you please contact a qualified teacher within your area.
If you are in Glasgow Scotland, I would highly recommend Barbera Harrington who is available for appointments in Langside and also at Woodland Herbs.

Running Tips

Everyone these days who decides they need to get fit seems to decide to start running. So many people are training for their first 5k or 10k run. This is great, everyone should invest a little in their health and fitness and running is an excellent exercise for the cardiovascular system and also a great calorie burner for those of us that are trying to shed a few pounds.

However I see a huge amount of people out running who have extremely poor running technique, many people aren't actually running at all but are shuffling very fast! Poor running technique means you are using your body inefficiently. Bio-mechanical inefficiencies lead to repetitive motions that can put extra strains and stresses on bones, joints, ligaments and muscles, increasing the likelihood of pain and discomfort and ultimately injury that could stop you running.

Below are just a few tips and ideas to have in your mind when running, things that might help you improve your technique and avoid injury.

1. Above all, run tall and keep your body relaxed.  And stay alert and aware of your surroundings.
   
2. Hold your head erect and don’t stick your chin out – this will create tension in your shoulders. Look ahead, scanning the horizon, not at your feet. Keep the back of your neck and spine in a straight line, perpendicular to the ground. Leaning forward may lead to lower back strain.  Leaning back will cause pronounced heal strike (see below), which can put your joints at risk.
3. Watch out for rounded or hunched shoulders and for ‘shrugging’ when you run. Keep them relaxed. Tense, raised shoulders will slow you down, waste energy and prevent your lungs from expanding to their fullest range, thereby depriving your muscles of oxygen.
4. Keep your arms relaxed at your sides with elbows flexed at 90º. Let your arms swing freely in a forwards/backwards motion ie. in the direction you are running and not laterally across your body. Don’t exaggerate the arm swing - as you bring one foot forward, swing the opposite hand forward and up just below sternum (mid-chest) level.
5. Try to keep your hands in a relaxed fist, letting the thumbs rest on your index fingers and your finger tips gently connecting with your palms – clenched fists will create unnecessary tension throughout your whole body.
6. Don’t twist in your midriff from side-to-side – this causes imbalances in your body, which place stress on all the major joint areas. This is also extremely inefficient as it displaces your forward momentum sideways. The same goes for a bouncing gait – it displaces your momentum upwards.
7. The knees and feet should be aligned generally in a straight-ahead direction.
8. Take short steps and land your feet approximately under your body/hips with each stride. If your lower leg lands ahead of the knee, you are over striding and increasing your risk of injuries. Keep your knees slightly bent at all times and do not lift them too high.
9. Don’t strike the ground with your toes. Instead, strike softly with your midfoot and roll through to your forefoot smoothly.  A heel to toe foot strike means that the leg is straight when the heel makes contact with the floor sending the shock directly into your back and causing you to lose speed as you literally brake each time your foot lands. This is bad for your joints and affects your speed.
10. Reduce your times by increasing pace/cadence (number of steps per minute) rather than stride length. As mentioned above overstriding increases the likelihood of injury.
    

These are just some general guidelines and ideas to experiment with.
For individual training programmes and recommendations, consult a personal trainer who specialises in running, join a running club or take running lessons, it will be well worth it in the long run!

Why Full Body Massage

The reason many people come in for their first massage treatment is because they're experiencing some form of pain, stiffness or discomfort. Whether it be shoulder or neck pain, lower back problems, constant headaches, sports injuries or perhaps Sciatica or some other painful condition.

It is common for most people to only expect the area that is painful to be treated. So if experiencing shoulder and neck pain, most would expect to only receive a back, shoulders and neck massage.

Although this kind of treatment often referred to as "spot work" can be effective at relieving some of the symptoms you are experiencing it is unlikely to create lasting change or address the root causes of your problem. It is extremely common to find that in cases of pain and discomfort there are many postural issues and muscle imbalances that also need addressing and are often a major causal factor.

When viewing the diagrams to the right you are able to see how muscle imbalances can be at the root of many painful postural conditions. It doesn't take much for a sprained ankle to shorten the muscles on the inside of the ankle and lower leg which can over time create stress patterns and muscle imbalances all the way up the body through the knee joint and pelvis to start effecting the lower back and even shoulders and neck. In such a case if we only treated the site of the pain, say the lower back, we would never get round to treating the main causal factor, in this case, the muscles, tendons and ligaments of the lower leg.

Another consideration when we are experiencing pain and discomfort is how we change our body mechanics to avoid intensifying the pain, we will often try to avoid certain movements or positions that aggravate the condition. The body also has a protective mechanism which will often naturally tighten muscles in the region of an injury to reduce movement and the possibility of further injury, this is a process generally referred to as "natural splinting". With the example of the sprained ankle, these could both lead to us adopting a limp in the way we walk, placing more weight on the "good" foot and leg. This in turn will put additional stresses on the muscles and joints of the opposite leg which can often result in that area exhibiting aches and pains of its own.

This is where the importance of full body massage comes in. Although it is important to treat the site of the pain and release tension in the muscles of that region it is equally important to release tensions in any compensatory muscle groups and discover the root cause of the problem, in this way we are treating the whole body as the integrated mechanism that it is. This involves working through the body loosening off tension and restriction wherever we find it from the base of the foot right up to the top of the head.

During a full body massage we are able to easily identify areas of tension, tightness and restriction within the body. An in-depth full body treatment will often incorporate facilitated stretches such as Active Isolated Stretching, MET and PNF stretches to free joint restrictions and lengthen short, tight muscles.

The added benefits of a full body massage is the sense of rejuvenation and restoration felt after the treatment. The body will often feel freer and more open, with range of motion vastly improved and muscle tensions eased. Many people also experience the additional benefit of a long and restorative sleep the night after a treatment, due to the release of deep seated tensions.

It is recommended when booking in for an in-depth full body massage that you request a 2 hour appointment, it is often the case when trying to fit a full body treatment in to a 1 hour session that it is impossible to give each area of the body the attention it requires. However it is always my aim to make each and every treatment, whether it be a 2 hour in-depth full body massage or some "spot work" as effective as possible in relieving any discomfort you are experiencing.

What is Myofascial Release

Myofascial release or connective tissue massage as it is know by some is a technique for working with the connective tissue of the body. It is highly effective at increasing range of motion, improving posture and re-aligning the body. One of the great by-products of these effects is a reduction in chronic pain and discomfort.

Myofascial release is therefore often used in cases of chronic pain and discomfort. It is different in many respects to what we consider as normal massage, firstly the intention is different, Myofascial release focuses on effecting a release in the connective tissue of the body, this is usually done with what feels like a combination of a massage stroke with stretching of the skin, it is however working on a layer deeper that the skin that surrounds the muscles. Usually no oil or lubricant will be used, but some therapist will use a very small amount of lotion which actually helps with gripping the skin.

Depending on the therapist and type of Myofascial release being performed it can give a slight warming feeling with a slight drag to the skin right up to a burning sensation that can sometimes be quite intense with intense stretching feeling.


So what is connective tissue I hear you ask. When we are taught about anatomy at school we are taught about the bones and muscles that attach to the bones to hold them in place and move them, but this misses the vital all important soft tissue of the body the connective tissue. Connective tissue surrounds every muscle in the body like a skin to the muscle, when it reaches the end of the muscle it will thicken and become tendons which attach the muscle to the bone. It divides areas of the body up, covers our bones and joints. Without it we wouldn't be able to function, muscles create motion, bones create structure but connective tissue brings it all together, enables it to work smoothly and gives us true function. It should be a fluid, moist and flexible substance, fluffy even, a bit like candy floss, but just like candy floss it can become just a sticky, gooey mess that rather than facilitating function starts to restrict it. With Myofascial release we are trying to return it to its fluffy state.
In the image to the right the white layers surrounding the red muscles is connective tissue, as you can see it encompasses everything.

I incorporate Myofascial Release into my treatments as I believe it is extremely effective. The type I practice comes from the background of Rolfing and Structural Integrity although in a slightly gentler form. There are numerous different Myofascial Release styles, some of which are more effective that others and some more intense. On its own I believe Myofascial Release doesn't cover everything required in a treatment in cases of chronic pain as Trigger Points are more often than not also a major issue.