The term "Deep Tissue Massage" is among the most misunderstood, misused, and misapplied in the world of massage and bodywork. When a client calls to make an appointment for a “deep tissue” massage, all that it tells me is that we need to have a longer conversation to make sure that I clearly understand their needs and expectations.
Most people seem to assume that deep tissue simply means intense pressure (frequently in the upper back, shoulder and neck region) that may very well require them to endure pain and discomfort in order for the massage to be effective. They are looking for a therapist who is strong and willing to use force. A colleague of mine has a client who said to her at his first deep tissue appointment, “If I’m not crying, you’re not trying.”
In fact, nothing could be further from the truth. Deep pressure alone, applied broadly and blindly, is NOT going to solve the problem. The efficacy of any bodywork treatment relies upon two things: accurate assessment and specificity of treatment.
Pain in one area of the body is usually the result of imbalance elsewhere in the body. So while we will certainly address and treat the painful area to reduce discomfort (which does not always require deep pressure), long term recovery requires that we address the causative factors as well. Effective massage will consist of strategic positioning of the limbs, careful selection of techniques and strokes to be employed, and application of pressure that will release tissue without causing bruising and without causing the body to resist or brace against the threat of injury (in the form of too much depth of pressure).
In order to determine how much pressure to apply to a body structure, I take a lot of information into account. At the very least I am evaluating the warmth of the tissue, the preparedness of the skin over the tissue, and I am watching the client’s breath to determine their level of relaxation and readiness. But the only way that I can really know is if I ask. And often when I check in with clients during deep work to see if the pressure is too much, the response I will hear is something along the lines of, “It hurts, but it's okay. I know I need it.”
This is a common misunderstanding. You should never endure pain or discomfort during a massage in my office. There are reflexes in the body which are more powerful than any amount of pressure that I can apply. As soon as your body perceives pain these reflexes will act to defend you whether you realize it or not. And rather than being soothed and released, the muscles and structures being treated will grip and hold to protect.
Your body is intelligent. We do not aim to fight it, to force it, or to hurt it during our treatments. We engage in a dialogue with it. We work regularly, consistently, and patiently with the understanding that every aspect of your lifestyle (your relationships, your stress level, your diet, your sleep schedule, your psycho/emotional state) contributes to those sensations perceived as pain or tightness. In the course of a one hour massage it is not possible to release every single fiber of every single muscle- and I believe it would be irresponsible and dangerous to try.
The manual manipulation of tissues that I employ is only one half of the healing equation in a massage treatment. Of equal importance is the gradual mind-body awareness that is developed within you from session to session. Over time, your muscles and tissues will begin to let go of all that they are holding and they will begin to remember and retain a state of balance and ease. Too much pressure applied to quickly or for too long will only inhibit and impair this process.
As always, I invite and welcome your questions or comments on this, or any other, massage issue.
Friday, May 7, 2010
Sunday, May 2, 2010
Why does stress make my neck and upper back hurt?
The part of our anatomy that copes with stress is called the Sympathetic Nervous System. It’s also known as the Fight or Flight system. It is a primitive and intelligent network of neurological reflexes that empower the “animal” in us to escape threat and danger.
In the wild, when an animal perceives danger and begins to fight or run from a predator, its body secretes massive amounts of the hormones and neurotransmitters- predominantly cortisol, epinephrine, and norepinephrine- which cause a cascade of physiological and psychological changes which empower the animal to prioritize the need to survive. This chemistry rushes in to its bloodstream giving it bursts of power and focus to fight or to flee.
When the animal realizes that it has reached safety, it stops, quivers and shakes to process and purge any remaining stress hormones that were not eliminated during its intense fight or flight. Then the exhausted animal collapses and rests for many hours.
For us humans, with our more complex cerebral existence, things are not so simple. Our stress is not caused by lions and tigers and bears, but by the everyday demands of our lives. Nevertheless, we respond to this “everyday” stress (a long to-do list, a huge credit card bill, a busy day at the office, or a challenging deadline) with the same physiological urgency with which we would respond if we were being attacked by a predator. The same stress hormones that would empower us to fight or flee for our lives surge in to our blood stream in response to even the most benign of life’s frustrations- like missing our train on a morning when we’re already running late for work.
When you’re feeling frustrated or stressed, these chemicals surge through your body causing blood to be siphoned away from digestive and reproductive organs and directed straight to the muscles (because your body thinks you need to fight or flee, not rest, digest, and reproduce). This leads to suppression of the immune, digestive, and reproductive systems and increased muscle tone which you begin to perceive as “tightness”. Your heart rate and respiratory rate increases (in order to help you run and fight harder). This leads to INCREASED BLOOD PRESSURE as well as the overuse of what are called ACCESSORY BREATHING MUSCLES which connect the ribs, neck, head, jaw, back, and shoulder girdle. As you breathe harder and harder under prolonged periods of stress, these, accessory breathing muscles are forced to work overtime- something they are not designed to do. You start to feel the results of this in your TENSION HEADACHES, YOUR JAW PAIN, AND YOUR NECK AND SHOULDER PAIN. The more rapidly you breathe, the more you perpetuate the signal of danger to your nervous system, and so more stress hormones continue to be released in to your blood stream.
If our every day stress was actually being caused by a predator threatening our lives, our physical efforts to escape or to defend ourselves would adequately burn off the surge of stress chemistry in the bloodstream. And afterwards, we would be exhausted enough to sleep for hours, during which time the body would return to a state of equilibrium reflected in a slower heart and respiratory rate and subsequent blood chemistry regulation. But unlike endangered animals in the wild, we are not burning off the stress hormones which perpetuate chemical imbalance. Instead we are grinding our teeth, trying to stay calm and professional on the surface, holding in our frustrations as long as we can, and moving on to the next stressful task.
Without adequate exertion followed by adequate rest, we seek stimulants for energy (thank goodness for coffee and sweets!) and often cocktails to help us unwind at days end. More stress leads to more stress hormones causing more rapid upper chest breathing and more muscle soreness (especially in our necks and upper backs). We can’t sleep well because of so many stress hormones in our bodies and so much physical discomfort in our muscles. So, we turn to more medication (prescribed or otherwise) to alleviate physical pain and to help us sleep, followed by morning stimulants to help keep us going.
The introduction of artificial stimulants and depressants actually put the body under still more stress, perpetuating what is called a positive feedback system. This positive feedback loop which traps your body in a state of stress can only be broken by convincing your nervous system that there is no present threat to your safety.
Any activity that helps encourages diaphragmatic breathing, slowing your respiratory and heart rates will convince the body that the threat it has been perceiving is no longer present. Ultimately, body chemistry will regulate, and sleep, appetite, digestion, libido, and immune function will return to a healthier state.
This is why consistent bodywork and/or yoga, meditation and breath work reduces your body’s stress level over time. When you’re lying on a massage table- still, held, taken care of- your body has a chance to note that you are not, in fact, in danger. Your mind starts to take note of the inappropriate amount of tension in your jaw, your shoulders and your hips. Slowly, organically, held muscles, emotions, and thoughts begin to soften and adapt to the reality of their safe surroundings.
Long walks with focused attention on your breath, meditation, pranayama, a regular sleep pattern, and any activity that calms you (fishing, reading, writing?) are all wonderful ways of incorporating stress reduction in to your everyday life, if regular bodywork and/or yoga is undesirable or unrealistic for you. I am always happy to advise you one-on-one (gratis, of course!) as to how you might incorporate daily stress reduction in to your busy lives. Please contact me individually by phone or email if you would like to begin to explore new lifestyle habits that will be easy and pleasant to incorporate in to your daily routine.
In the wild, when an animal perceives danger and begins to fight or run from a predator, its body secretes massive amounts of the hormones and neurotransmitters- predominantly cortisol, epinephrine, and norepinephrine- which cause a cascade of physiological and psychological changes which empower the animal to prioritize the need to survive. This chemistry rushes in to its bloodstream giving it bursts of power and focus to fight or to flee.
When the animal realizes that it has reached safety, it stops, quivers and shakes to process and purge any remaining stress hormones that were not eliminated during its intense fight or flight. Then the exhausted animal collapses and rests for many hours.
For us humans, with our more complex cerebral existence, things are not so simple. Our stress is not caused by lions and tigers and bears, but by the everyday demands of our lives. Nevertheless, we respond to this “everyday” stress (a long to-do list, a huge credit card bill, a busy day at the office, or a challenging deadline) with the same physiological urgency with which we would respond if we were being attacked by a predator. The same stress hormones that would empower us to fight or flee for our lives surge in to our blood stream in response to even the most benign of life’s frustrations- like missing our train on a morning when we’re already running late for work.
When you’re feeling frustrated or stressed, these chemicals surge through your body causing blood to be siphoned away from digestive and reproductive organs and directed straight to the muscles (because your body thinks you need to fight or flee, not rest, digest, and reproduce). This leads to suppression of the immune, digestive, and reproductive systems and increased muscle tone which you begin to perceive as “tightness”. Your heart rate and respiratory rate increases (in order to help you run and fight harder). This leads to INCREASED BLOOD PRESSURE as well as the overuse of what are called ACCESSORY BREATHING MUSCLES which connect the ribs, neck, head, jaw, back, and shoulder girdle. As you breathe harder and harder under prolonged periods of stress, these, accessory breathing muscles are forced to work overtime- something they are not designed to do. You start to feel the results of this in your TENSION HEADACHES, YOUR JAW PAIN, AND YOUR NECK AND SHOULDER PAIN. The more rapidly you breathe, the more you perpetuate the signal of danger to your nervous system, and so more stress hormones continue to be released in to your blood stream.
If our every day stress was actually being caused by a predator threatening our lives, our physical efforts to escape or to defend ourselves would adequately burn off the surge of stress chemistry in the bloodstream. And afterwards, we would be exhausted enough to sleep for hours, during which time the body would return to a state of equilibrium reflected in a slower heart and respiratory rate and subsequent blood chemistry regulation. But unlike endangered animals in the wild, we are not burning off the stress hormones which perpetuate chemical imbalance. Instead we are grinding our teeth, trying to stay calm and professional on the surface, holding in our frustrations as long as we can, and moving on to the next stressful task.
Without adequate exertion followed by adequate rest, we seek stimulants for energy (thank goodness for coffee and sweets!) and often cocktails to help us unwind at days end. More stress leads to more stress hormones causing more rapid upper chest breathing and more muscle soreness (especially in our necks and upper backs). We can’t sleep well because of so many stress hormones in our bodies and so much physical discomfort in our muscles. So, we turn to more medication (prescribed or otherwise) to alleviate physical pain and to help us sleep, followed by morning stimulants to help keep us going.
The introduction of artificial stimulants and depressants actually put the body under still more stress, perpetuating what is called a positive feedback system. This positive feedback loop which traps your body in a state of stress can only be broken by convincing your nervous system that there is no present threat to your safety.
Any activity that helps encourages diaphragmatic breathing, slowing your respiratory and heart rates will convince the body that the threat it has been perceiving is no longer present. Ultimately, body chemistry will regulate, and sleep, appetite, digestion, libido, and immune function will return to a healthier state.
This is why consistent bodywork and/or yoga, meditation and breath work reduces your body’s stress level over time. When you’re lying on a massage table- still, held, taken care of- your body has a chance to note that you are not, in fact, in danger. Your mind starts to take note of the inappropriate amount of tension in your jaw, your shoulders and your hips. Slowly, organically, held muscles, emotions, and thoughts begin to soften and adapt to the reality of their safe surroundings.
Long walks with focused attention on your breath, meditation, pranayama, a regular sleep pattern, and any activity that calms you (fishing, reading, writing?) are all wonderful ways of incorporating stress reduction in to your everyday life, if regular bodywork and/or yoga is undesirable or unrealistic for you. I am always happy to advise you one-on-one (gratis, of course!) as to how you might incorporate daily stress reduction in to your busy lives. Please contact me individually by phone or email if you would like to begin to explore new lifestyle habits that will be easy and pleasant to incorporate in to your daily routine.
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