Category: Anatomy trains

Grace

I used to be a dancer. Got bitten by ballet at the age of four, and pursued it with pathological focus until the age of seventeen, when I abruptly quit and devoted myself to breakdancing at indy-rock clubs instead.

At the same time, I studied anatomy and physiology in a pre-med level of detail, complete–I suppose–with all the kinesiology any good bodyworker might need. Muscular origin, insertion, action, antagonist. I memorized enough to ace the exams, but none of it made any intuitive sense to me.

Because any being who inhabits movement–which is all of us–rarely, if ever, flexes a muscle in isolation. We move in curves. Long, seamless, coordinated curves. Watch a cat when it makes a considering remark with its tail, and ask if it knows from infra-spinous flexion, or if it’s got calculus wired into its brain.

Murmuration from Sophie Windsor Clive on Vimeo.

Calculus, now, that makes sense. You determine a curve by calculating the rate of change at every point along it–by measuring movement. And movement is meaningless unless it is relative to something else, maybe everything else.

Grace of movement, then, is about connection. An injury is a violent disconnection; a block or a restriction is a subtle one. The practice of bodywork is the re-integration of broken connections.

Last week I checked in with a regular client who lives with chronic pain. I was concerned that, on an objective scale, he wasn’t seeing sufficient improvement over time, and wondered if the work was valuable to him.

“Oh, it’s priceless,” he replied. “Every week, when I am on the table and for several hours afterward, I feel no pain. I feel light, my mind is clear. It’s the best I feel, ever.”

The Great Bell Chant (The End of Suffering) from R Smittenaar on Vimeo.

May you experience grace in every moment.

After the Fall

Recently a new client, Susie M., booked a four-session package sight unseen. “When I read about your ankle, I knew you were the one for me,” she said.

Susie sprained, and possibly broke, her right ankle four years ago. There was some confusion as to whether there was a bone chip floating around in there or not; what was certain was that she hadn’t been able to work out since. The ankle was chronically swollen and painful even after four years of treatment, including physical therapy and six months of myofascial release. Doctors had given her steroid injections to ease the swelling, but these did nothing but cause burn marks at the injection site.

As soon as I started work, I noticed that the anatomy train leading from her swollen ankle, up the right peroneal compartment, threading through her hip, and crossing the body to her left shoulder was bunched, knotted and compressed. There were so many adhesions in her right peroneals that I suspected the swelling was almost entirely a result of impaired circulation. Muscles and fascia don’t operate independently of the circulatory system; if they are compressed, they’re compressing everything around them.

After her first session, Susie declared, “I think you released more in one session than happened in six months of myofascial release.” She reported sharp pains in her left leg, hip and groin during the next few days, but on her next visit the swelling in the right ankle was 80% gone. She kept coming regularly as things unwound, and every week there was a different issue to confront, but ankle pain was not one of them. After four years, she was able to go back to the gym.

This re-confirms a long-held observation – that if one part of your body is injured, the trauma doesn’t just stay in one place. The body quickly redistributes strain to deal with it, but once the original injury heals, your body is still out of balance. This imbalance can then create a whole host of other problems unless it is addressed.

(“Confusion,” oil on linen, 36″x 48″, 2008 by Stephanie Lee Jackson, www.stephart.com

Massaging the Violin

Science has finally come around to studying massage, sort of:

Massages Ease Low Back Pain – NYTimes.com.

…Each of the massage groups received 10 weeks of treatment, and at the end of that period, all three groups had some improvement, as measured by their answers to 23 questions about performing routine activities without help — for example, climbing stairs without using a handrail or getting out of an easy chair by themselves. They were also asked to rate the degree of their back pain symptoms on a 10-point scale.

Those who received massage scored significantly better on both symptom and function tests, and they spent less time in bed, used less medicine and were more satisfied with their current level of back pain.

As much as this supports my bias, I have a quibble with studies which look at ‘massage’ as a generic unit, as though it were the functional equivalent of taking a pill. All massages are not created equal, just as every body is unique. There’s as much difference between a rub-down by rote and a master massage as there is between a C-major scale and an encore by Itzak Perlman.

Recently I got a Swedish massage at a local spa, courtesy of Groupon. It was a screamingly frustrating experience. The therapist applied some standard moves to the surface of my skin, regardless of whether the muscles underneath were tense, knotted, spasming, or comparatively relaxed. Areas which needed little attention got far too much of it (why spend 10 minutes frictioning the iliac crest? Because it’s there?) whereas the problem spots felt all the worse for having been teased. The aggregate effect was to bring all my imbalances into sharp relief, and leave me feeling desperate for another massage.

This may be an effective marketing tactic, but it sells massage therapy terribly short. A good massage therapist will be able to feel those knots, adhesions and spasms, and perform any number of targeted actions to release them. As I havewritten at length, the area where a client hurts may not be the actual source of the problem; lower back pain can often be traced to restrictions in the legs, hips, chest and even the feet. Although it’s difficult to figure out where these restrictions might be from an initial assessment, it’s pretty obvious once you get your hands on them.

The article goes on to state, “It is unclear how massage eases back pain, but the researchers suggest it may stimulate tissue locally or cause a more generalized central nervous system response.” Hello? How much more vague can you get?Obviously massage is ‘stimulating tissue locally’ and causing a ‘generalized central nervous system response’ (it’s frequently called ‘sleep,’) but if the researchers can’t pinpoint anything more specific than that, there’s a communication breakdown somewhere. Either they’re not asking the massage therapists any questions, or the therapists themselves aren’t clear about what they’re doing.

The Mechanics of Miracles

After twelve years of practice, I’m finally getting around to reading Anatomy Trains, by Tom Myers. It’s blowing my mind–not so much because it’s giving me new information, but because it’s describing why my way of doing bodywork has the results it does.

For example, it’s a common thing for a client to come in complaining of neck pain, and wonder why I spend so much time working on their feet. Actually, they don’t wonder; they say things like, “wow, I can feel that all the way up to the top of my head.” They go away thinking I did magic.

But I’m not a magician; neither do I have an encyclopedic knowledge of anatomy (though I’m working to remedy that.) My hands know how to seek the areas of strain in your body, and I don’t assume I know where all of them are. If you have a pain in your hip, I’ll work your hip, but I’ll also work every area that connects to your hip in any direction, which means your whole body.

Because the human body is not built like a brick warehouse. It’s not a pile of units that stack linearly on top of one other from the ground up, dependent upon gravity to keep them stable. It’s more like a knot of Tinker Toys held together by rubber bands; it’s flexible, resilient, and held together by all-over tension. This kind of structure is called tensegrity.

villella-234x300

Edward Villella: not a brick warehouse.

What this means in practice is that when one area of your body comes under strain, the whole structure adjusts to distribute that strain. This means that you are capable of absorbing considerably more shock per square inch than a brick warehouse. It also means that your whole body is only as strong as its weakest link. If you’re putting inordinate strain on your right arm over a long period of time, it’s quite possible for this to manifest as chronic failure of your left ankle. (It happened to me.)

One of the phrases in the book that I loved was, “The victim screams, not the thug.” Just because you’re hurting in one place doesn’t mean that spot is the source of the problem. Particularly if you’ve been in pain for more than a day or two, and particularly if the pain isn’t resulting from an obvious, sudden injury, it’s much more likely to be a result of compensatory strain.

Recently I had a client–a dancer–declare, “when I cough, I get an agonizing pain in my piriformis.” I worked her piriformis, of course, but didn’t find any significant adhesions, certainly nothing that would cause ‘agonizing pain.’ So in addition to my regular sequence of back, hips, legs, feet, arms and neck, I worked her rib cage. She said, “that’s interesting, nobody has done this before. Feels amazing.”

While she was dressing, I heard experimental coughing sounds coming from the treatment room. She emerged to report, “I can cough without crippling myself!” Further experiments will continue.