Myo-Fascial Pain

Northwest Advanced Medical Massage provides both effective Pain Remediation and exquisitely effective Relaxation Therapy.

Orthopedic Bodywork is THE most effective way to resolve most pain, range of motion, or muscle tension issues. Orthopedic Body Work starts with basic Swedish (relaxation) massage strokes but adds assessment and treatment techniques within the scope of practice of massage therapy.

A few gifted massage therapists have intuitively deduced some effective assessment and treatment techniques. However, in my personal experience, only a small percentage take classes that teach effective, specific, assessment and treatment techniques for dealing with range of motion and chronic pain. The trained orthopedic body worker uses standard, selective, assessment protocols, then they specifically treat the condition revealed by the assessment.

Bodywork should NEVER CAUSE, OR INCREASE PAIN. Harder is not better. Contrary to a popular belief, deep tissue work should never be painful.

In my experience,most pain symptoms have some combination of four primary and two secondary, causes.

  • Minor muscle strains.Muscle Strain

    • Client is able to identify an exact spot where pain originates when contracting a muscle against resistance. This indicates some scar tissue (randomly organized fibers) in the muscle or fascia. James Waslaski teaches a strain protocol that instantly aligns muscle strain scar tissue with the intact muscle fibers. When this is done, pain sensors no longer detect abnormal muscle tension, and stop sending a pain signal to the brain.
    • Please note: Wikipedia does a great job of explaining muscle strains. However, it apparently is as uninformed as many medical practitioners of the near instantaneous pain relief achieved using James Waslaski’s muscle strain protocol.
    • When a client complains of pain, I almost always find one or more muscle strains during assessment. Re-assessment immediately after treatment indicates the pain is either significantly reduced, or eliminated. Further re-assessment sometimes reveals a secondary, masked strain, which also disappears with treatment. Results last, as long as the muscle in not re injured before it has a chance to fully consolidate healing.
  • Adhesions.

    • Either a joint capsule, or an intramuscular adhesion. James Waslaski developed, and teaches, a very specific technique for treating the condition a doctor might diagnose as “joint capsulitis”, i.e. frozen shoulder or frozen hip. A trained body worker can return pain free, full range of motion to a frozen shoulder during a single therapy session. This is demonstrable fact, not conjecture. Watch the video in the link.
    • Please note: In general, Wikipedia usually offers pretty good information. However, the adhesion article does not address the effectiveness and near instantaneous results of Jams Waslaski’s frozen shoulder protocol. Watch the video in the “demonstrable fact” link above as James corrects a frozen shoulder in a matter of minutes.
  • Hypertensive (locked short) muscles; almost always flexors.
    • IMG_20160310_095326Common example: tight pectoral muscles resulting in rounded shoulders and a head forward posture. This usually results in either pain or tension in the opposing, locked long muscles at the base of the neck, and upper back and shoulders.
      • Have you ever noticed how many people, both male and female, stand with the palms of their hands rotated to the rear? They look ready to catch a ball thrown at their back. These people have hypertensive (locked short) pectoral muscles and hypotensive (locked long) upper trapezius and rhomboid muscles. You can almost see the locked short chest muscles in this photo. You can easily see the anterior rotated right shoulder. This photo amply illustrates the chronic, less than optimal function of my right shoulder. I have the knowledge, and skill, to dramatically improve the existing condition. Sadly, I can not effectively work on it myself.
      • Experience indicates that face down massage and working the upper back further relaxes the locked long back muscles. This is counterproductive. Instead, working, relaxing and lengthening the pectoral (chest) muscles, and strengthening (toning) the upper back muscles achieves much better pain and tension relief.
    • Knee PainPain just below the middle of the knee cap is most often caused by a hypertensive (locked short) rectus femoris or the underlying vastus intermedius. Pain just below the knee cap, on either the medial or lateral side, on the knobs (condyles) at the top tibia and fibula of the lower leg is most often caused by either the vastus medialis or vastus lateralis  Click on this link to view these muscle on Wikipedia.
      • You can easily self work those three (four, counting the vastus intermedius located under the rectus femoris) muscles. Use non painful compression strokes. Start on the appropriate muscle, at the top (proximal end) of the thigh, compress with finger tips or the heel of your hand, move down an inch or so, compress again. Repeat all the way to the knee.
      • Follow this with a side to side, deep, but not painful, stroke. You are trying to hook into the fascia, not gliding over the surface of the skin. Visualize spreading and lengthening all the fibers of the worked muscle. A drop or two of olive oil makes a pretty good, make do, deep tissue, massage lotion.
      •  I have taught the above technique to several people. Their relief is often fast, and dramatic. The most recent, was the technician when I took my car in for service. I could see how much pain he was in when he walked. I asked his permission to do an informal assessment. It only took moments for me to conclude that his condition was the result of hypertensive thigh muscles. In less than a minute, I showed him how to self treat. He called me the next day and told me “my knees haven’t been this pain free in over 3 months.
      • I can think of at least 8 separate conditions that cause knee pain. Each of them can accurately be assessed without fancy MRI’s or X-rays. The three mentioned above are the ones most easily treated with orthopedic body work. Most of the others require medical, sometimes surgical intervention. I do advocate self care where appropriate. However, it is important to understand that medical evaluation and intervention can be important. But, I think it is always in a client’s best interest to rule out the simple, easy therapy before relying on expensive, sometimes ineffective therapy.
  • Hypotensive (locked long), therefore weak and inhibited muscles; almost always extensors.
    • Common example: upper back and base of neck tension. Tight pectoral
      IMG_20160310_095306muscles have stretched the middle trapezius and rhomboid muscles — similar to a taunt hunters bow.
      • With careful observation of this photo, you can almost see the weak, inhibited, and stretched, (hypotensive) upper back muscles. I exaggerated my pose for this photo. However, I have seen many men, and more than a few women walking around with this exact same posture.
      • Both the chest and the back muscles might well be described as tight. Tight in the same way a relaxed thick rubber band is short and tight before being stretched. That same rubber band also feels tight when stretched to its full length. Warming it, and making it longer, does not reduce the damage created by being overstretched.
      • I find the terms hypertensive and hypotensive much more accurately describes muscle length dysfunction.
      • Most humans, unless they mindfully stretch the pecs, and strengthen the upper back, have some degree of chest hypertensive muscles. This is one of reasons I start nearly all bodywork therapy face up. I spend a minimal amount of time on the upper back muscles. Most of my upper back work is aimed at stimulating, and activating the upper back muscles.
    • NOTE: When a primary mover contracts, the nervous system automatically inhibits (turns off) the opposing muscle. i.e. a biceps curl is impossible if the triceps muscle is not turned off (inhibited). Consistently hypertensive muscles result in consistently inhibited hypotensive muscles. Hypotensive (habitually inhibited) muscles are easily turned back on by stimulating gama motor neurons.
  • Fascial restrictions to normal muscle length.
    • A doctor might diagnose this as a form of compartmental syndrome. Over time, the fascia encasing a specific muscle can sometimes squeeze the muscle. The muscle can not contract normally because there is nowhere to go. Picture too much sausage squeezed into too small of a casing. The results of deep fascia therapy for this condition is simply amazing.
  • Aggravated Bursa.
    • There are more than 100 bursa scattered throughout the body. They act like a living pulley, easing tendons and ligaments over bone edges.
    • The bursa may or may not actually be inflamed. An aggravated burs is most easily identified by a painful arc during movement. I.e. some degree of little or no pain, an arc of intense pain, then reduced pain once through that arc.
    • Bursa pain is often relieved by treating an overlying hypertensive muscle that is compressing the bursa. However, impact, or overuse, (too much tension held for too long) can cause a bursa to become inflamed. Once a bursa is actually inflamed, it takes time to heal. Even once the compressive forces that triggered the bursitis have been removed.
    • EXAMPLE: Pain just under the deltoid muscle, when lifting (abducting), or lowering (adducting) the upper arm.
    • Treatment:
      • First, reduce tension on the offending tendon by reducing the tendons muscle tension.
      • Bursa, because of very limited blood flow, need time to heal. Period. The process cannot be rushed.
      • Submit to cortisone injections only as a last resort. This link explains the disadvantages and side effects of cortisone injections?.

Click here to schedule your appointment.