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The Most Common Problems Clients Have Presented

Physical activity demands regular bodywork. The following examples illustrate some cases I have addressed that have shown positive outcomes through therapeutic massage. Positive outcomes in this case would mean: increased range of motion, decreased or completely alleviated pain, deepened the individual’s understanding of the presenting problem, faster recovery from injury, and improved overall sense of well being. Consult your health care provider for an accurate diagnosis before you see me or any other bodyworker for presenting problems such as these. It is beyond the legal scope of practice for massage therapists to diagnose any health conditions.

Rotator Cuff Injuries

The muscles of the rotator cuff do not just rotate the arm at the shoulder joint. These muscles are the primary stabilizers of the humerus at the gleno-humeral joint. Without them, your arm would flail around every time you tried to do some sort of over-head lifting or throwing action. Even micro tears in one or multiple of your rotator cuff muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) can lead to a freezing up of the shoulder and produce tremendous pain that can radiate down the arm and into the neck. Injury to these muscles will invariably lead to a structural misalignment in the body, which first will present as the arm appearing to be rotated abnormally when at rest (usually rotated forward), and then the spine and the ribs will be affected because of muscle attachments that connect your scapula and your arm (humerus) to your trunk.

Massage techniques can release the myofascial adhesions that form when a bone is no longer moving properly in its respective joint, and when muscle has been injured through repetitive misuse and structural misalignment. The goals of the massage session are to (1) address both the structural misalignment by locating and releasing other areas of the body that are contributing to misalignment (normally in the pelvic region) and (2) to liberate the affected bones (scapula, humerus, clavicle, vertebrae) using various types of therapeutic massage techniques on the relevant musculature.

Working in a gym environment, and working with active adults, I see a lot of injured rotator cuffs, and without exception, all of them benefit greatly from focused therapeutic massage. Rotator cuff injuries are directly correlated with aging, so a person doesn’t have to do anything particularly athletic to sustain a rotator cuff injury except get older.

Sciatica

Prolonged sitting to drive and to use a computer can put tremendous stress on the bones and other tissue of the low back and pelvis, which can lead to compression of the sciatic nerve. Pain then leads a person to move in certain ways (or to not move at all) to try to ease the pain, which causes structural misalignments throughout the pelvic region.

Therapeutic massage addresses some of the underlying structural misalignments to bring the body back to more easeful movement. Additionally, releasing the muscles along the spine and throughout the pelvic region has the effect of helping to ease the compression on the sciatic nerve. By relaxing and deeply breathing, an individual can promote their own recovery from the musculoskeletal restrictions that contribute to symptoms of sciatica. I find that many folks with sciatica respond very well to deep tissue massage, as well as to techniques that gently mobilize and loosen the sacro-iliac and ilio-lumbar regions of the low back.

General Chronic Low Back Pain and Sacro-iliac Problems

This is the type of condition I see most often. Everyone experiences their pain for different reasons because everyone moves differently and holds their stress in unique ways. With older clients, arthritic conditions can exacerbate symptoms, making the issue more complex for the individual. While it is certainly true that the person’s underlying orthopedic issues contribute to low back pain, other factors such as gait, postural tendencies, and the extent and type of one’s physical activity also play a definite role. I see low back pain equally among persons who work long hours at computers as well as persons who are quite active from day to day. With a little bit of time and patience on the table, it is possible to identify clearly whether the pelvis is rotated in such a way and how that rotation plays out in the musculature of the torso more generally. There are some usual muscle culprits, but often it is a surprise to the individual to feel where in their bodies they are “locked up,” as I often hear.

With low back pain I normally work creatively by positioning and propping a person in various ways both to give access to certain muscle groups but also because specific positioning of limbs and spine along with manual palpation will produce a release of specific muscles, and the bones of the pelvis and spine can settle back into their normal correct alignment. This normally brings relief from pain or a significant decrease in the pain.

Lateral Knee Pain/Iliotibial Band (ITB) Syndrome

This type of pain can be tricky to treat, and massage therapy itself is no magic pill. However, if the cause of the ITB syndrome is related to muscle shortening (for example, from insufficient or improper stretching), then focused sports massage on the affected muscles (the gluteal muscles, the tensor fascia latae, hamstrings, and quadriceps, and the ITB itself) can play a crucial role in relief from the symptoms of this problem.

A functional assessment of the affected individual’s hips, knees, and general comportment is necessary prior to the massage. Generally, the goal is to release myofascial adhesions and muscle congestion in the pelvic region, including those muscles identified in the preceding paragraph.

Migraines and Tension Headaches

Several of my female clients have experienced relief from headache pain through custom massage. Everyone holds their stress in different ways, and my experience is that, while a person might feel an intense headache, other parts of the body are equally constricted to where the breath has become shallow and the mind cannot relax. In this case, a massage that integrates the most affected muscles of the head, neck, face, and jaw with the rest of the body—the arms, low back, pelvis, and lower legs/feet—is the most effective way to stop the vicious cycle of headache pain and pressure. Creating space in the body for deeper breath and a calming of the nervous system is just as important as giving pressure to “pressure points” in the region of the face, neck, and jaw.