I frequently get requests for deep tissue massage and I'm going to be honest in saying that I had no idea what that means so I looked it up online. Turns out the term covers a host of techniques with the intention of either addressing adhesions and scar tissue, the deepest layers of muscles and fascia, lengthening the large muscles groups in the body or any number or similar and sometimes opposite effects, depending on which source you're reading. Some of those effects could just as easily be reached by techniques of a different name and while some sources say that deep pressure is not necessary, others claim it is. Some techniques used are listed as myofascial release, stripping, cross fibre work, breath work, active and passive ranges of motion, the use of bolsters, gravity, but also knuckles and elbows. That covers a lot of ground. It seems to me that 'deep tissue massage' is a bit of an umbrella term for any massage with an intention to 'fix' rather than to relax.
I don't ever call it deep tissue, but every time I do a massage, my intention is to bring more balance to the body - loosen off areas that have become stuck down to other tissue, lengthen shortened muscle or fascia, break up some sticky scar tissue, get joints moving in all their ranges, and bring circulation to areas that have started to resemble rawhide.
There's still a problem though - I have a nagging feeling that what people are often looking for when they ask for a deep tissue massage is actually deep pressure. We tend to equate more sensation with greater effectiveness but this isn't actually the case with massage. Pain does not equal gain, (some therapists work on the principle that less is more,) but some discomfort is normal when working through areas that have become fibrosed, stiff, or overused. How do you tell the difference? You can breath through discomfort and the rest of your body doesn't become tense - you're not gritting your teeth or crying into your face rest.
Every therapist has a different approach, a different style, uses different pressure. And every client has a different tolerance to pressure and pain. What works for one person might leave the next person feeling unsatisfied. And fortunately in BC we have a great number of RMT's to meet diverse needs. So by all means, find what works for your body, but ask yourself whether you're seeking a solution to your body's complaints or whether you're seeking intensity. And I urge you to suspend the ideas about what you think you need and be open to other sensations and techniques and what your RMT has to offer you - you might be surprised.
Some interesting in-depth articles:
"The Pressure Question"
"Why Do Muscles Feel Tight?"
Some sources on deep tissue massage:
It's not that I'm copping out on writing today, it's just that I agree with all the content in this podcast and want to share it. It's by Katy Bowman, who I've written about before, and this podcast is like a synopsis of her philosophy and books and outlook. Perfect for a snowy day, if you're stuck on the highway or not skiing the powder. Or cooking a surprise birthday cake, like me.
I view my job as a massage therapist as a facilitator for my clients to be able to incorporate healthy changes into their lives. I know that I cannot make their bodies healthier as a whole, but if you have started walking more and your feet are telling you that they've been unused for too long, I can help those joints, muscles and ligaments out so you can continue improving your lifestyle.
I've been meaning to write out what some of my clients receive as a bit of a rant; it is my pet peeve and creates a lot of chaos. I'm talking about the often improper use of the hip joint. Now, we're not coming up with terrible biomechanics in this region all on our own, our culture has been teaching us how to (not) use our hip joints since we were young, and not just us, but our parents too. Furniture has even changed to reflect the changes in our society around acceptable posture and common biomechanics in the past century. But as little children, we still knew how to move in a way that keeps our spines open and healthy and our strongest muscles working. We can get back to that, we can work to undo the years of misunderstanding our bodies.
The hip (the ball and socket where the femur meets the pelvis) is the strongest joint in the body, has almost as much inherent mobility as the shoulder, but supports the weight of the body in dynamic and unbalanced actions. Yet we often outsource movement from the hips to other, less appropriate areas, like the mid back. The next time you reach for something across the table, check in if the movement started from the sit bones, or whether most of the action came from somewhere around your bra line. Your spine isn't meant to be doing all that flexing and extending and lifting and twisting, and it will be telling you about it in the form of shallow breathing, internally rotated shoulders, achy upper traps, or headaches. Our hips are built for movement! Let's use them!
The number one biggest change you can make in regards to low back (actually, your whole back) health... and hip health, AND knee health, (ok, it's really good to do) is keep your lumbar curve from rounding out. AKA don't tuck your bum! You probably do this more than you realize. Moving the pelvis into a posterior tilt changes the normal spinal curvature to a seriously wonky position, which means all sorts of changes. It weakens the low back: the most common mechanism of injury for 'putting your back out' is to have a tucked bum/reversed lordotic (low back) curve and then be reaching and twisting for something. Of course, it was probably the millionth time you've done that exact movement sequence and your spinal discs just couldn't take the pressure anymore. The tucked bum position also affects the strength of the pelvic floor, takes away space from the diaphragm, and changes your neck and jaw alignment. THAT leads to a whole other list of issues, such as TMJ dysfunctions and tensions headaches.
Here's an example of sitting with a posterior tilt, bum tuck, followed by an upright pelvis, normal lumbar curve and stacked joints.
You might need to make some changes to your work station, home furniture or car seat to get you out of that backward pelvic position. Try moving your bum closer to the edge of your chair, raising or lowering the height to balance your weight between sit bones and feet, or maybe placing a towel roll under your sit bones to give your low back a break. That last one might come in handy for car seats, as well as raising the back support closer to vertical.
And what about lifting and reaching? Notice what you do when you're sitting and doing up shoelaces - are you hinging at your mid back or flexing forward from the hip joint?
And the classic: picking something up with the back instead of the hips. If you use the much stronger hip muscles and the joint that is built for this action, you will get stronger glutes and core, your low back won't be one sneeze away from a disc bulge, and your back will thank you.
If you're finding it difficult to even get out of the bum tuck position, start small, stretch hamstrings and glutes, get a registered massage therapist to work on the area and give you the space to move into this new position.
I recently picked up a book that piqued my interest a couple years ago and I've not been able to put it down since. The book is Alignment Matters by Katy Bowman who is a biomechanist and very funny and intelligent writer. She's written eight books to date with Move Your DNA being the flagship piece and the one recommended for people to start with.
I love reading what Katy has to say; she breaks down medical knowledge and complex issues into understandable, and funny, bite sized chunks. She looks at the body through an engineer's lens and presents a common sense and uncomplicated model for healthy pain free living. She's definitely got a few pet peeves and writes extensively about feet (a quarter of the bones in our bodies are below the ankle!) and the problems associated with heeled footwear. She's also got a lot to say about natural movement (walking, climbing, squatting) versus exercise (sports, jogging, gym workouts); the latter being a modern invention to make up for the lack of the former. Among other topics she delves into are pelvic floor issues, knees and hips, and pregnancy. I love that she makes healthy changes simple and easy.
As I read, I am reminded of the importance of the basics - proper breathing, sufficient sleep, hydration and movement. Imagine the changes we'd experience if we focused on excelling at even those few things! The body is always striving for homeostasis, which is balance, and is constantly sending us signals when we're upsetting the balance. We're really good at ignoring those little memo's about how that posture is not working for your shoulders, or how those shoes are a pain in the low back or that you're burning the candle at both ends and your adrenals can't keep up. The more aware we become, the more we listen, the sooner we can adjust to a healthier version of our habits and lives, and it's a lot easier to listen to the little nudges from the body now, (such as headaches, digestive complaints, mood swings, spasms, persistent tightness) before they becomes more insistent, urgent messages which can stop us in our tracks. It's also wise to make changes now so the body doesn't chronically adapt around the issue over time. In my work, I've seen the domino effect of bodies compensating for a few years (or a few decades) trying to keep us functional in less than ideal circumstances. It can also take more resources, therapists, time and effort to get back to balance at that point.
So this is not an endorsement for Katy Bowman! But reading her book has reignited my passion for enabling others to move more and hurt less and I think she's a great resource in this endeavour. She's got an extensive website with videos, classes, articles, and exercises, plus great books and podcasts. And she can explain things way better than I can!
Hopefully she inspires change in you as she's done in my life and my work.
It's the beginning of another Revelstoke winter. Hopefully you're prepared and have winterized the vehicles, gear, the yard, the house, but maybe your body too. Now is a great time for "prehab", an effective form of injury prevention. This can take a variety of forms, whether it's with a physiotherapist, massage therapist or other bodyworker, through yoga or maybe solo, but the focus is the same; increase functional range of motion, even out muscle imbalances and strengthen core. It means getting that knee looked at, the one you nursed through the final month of last ski season. Or maybe it's a more recent summer injury that you won't want to be dealing with on those epic winter days. With any active lifestyle comes a higher risk of injury and while seeing a registered massage therapist (RMT) won't keep you out of harm's way, it can help your body be more resilient to the bumps and bruises collected along the way. An RMT can find areas of the body that aren't functional, the bits that aren't sliding and gliding the way they should, areas of inflammation or scar tissue that need a bit of a helping hand (or elbow) to get back to good working order.
"An ounce of prevention is worth a pound of cure," and now is a great time to sort out those pre season niggles before they flare up and stop you from enjoying your winter.
I look forward to seeing you at our clinic.