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I’ve been in this business for ten years (well, almost), and there are some massage techniques and strategies that I’ve stopped using. In this video I talk about 5 of them, along with the practices I’ve used to replace them. If you’d like to skip ahead, click the time codes below.
0:45 1) Aggressive massage and stretching of the neck. This is something commonly taught in massage school, but I’ve seen no good justification for it over my years of practice. In fact, I’ve seen a lot of sore necks and headaches (including my own!) that could have been avoided if the massage therapist had chosen a more moderate approach. Neck range of motion isn’t something that can be changed in a single session, so I tend to respect it as I work. I find that gentle myofascial release, staying within that ROM, can reduce the frequency of neck cricks and headaches, without all of the pain the next day.
5:29 2) Using trigger point therapy first. These days, I keep neuromuscular therapy (NMT) in my back pocket as another useful tool, rather than as the first line of defense against every type of pain. It’s definitely a useful discipline to learn about—the referral patterns of pain and the clues they give you about the relevant muscles are invaluable. I just no longer consider prolonged/repeated ischemic compression to be worth the immediate discomfort or next-day soreness. That said, I will work directly with trigger points if other approaches fail, and with clients who have found such work useful in the past, as long as they tolerate it well.
7:43 3) Postural assessment and correction. My days of giving my clients a posture complex are over. The scientific literature on posture indicates that there are a wide variety of spinal configurations (exaggerated kyphosis or lordosis, scoliosis of varying degrees) that can be symptom-free. Indeed, even “ideal” postures can co-exist with substantial pain. In cases where slumped posture and pain co-exist, the answer doesn’t seem to be posture correction, but rather an increase in activity, and increase in the variety of activities, and interventions such as massage. While the posture may remain the same, the pain is likely to decrease over time. Please note that there is merit in attempts to prevent progression of scoliosis, and of kyphosis associated with aging. This is associated with better outcomes over time.
11:29 4) Psoas massage as a first-line strategy. Don’t get me wrong, I love abdominal work. I just no longer consider it worth the time and potential discomfort to work directly with psoas every time a client has low back pain. These days, I’ll work broadly with related structures (QL, the posterior and lateral hips, tensor fasciae latae, and iliacus), and I find that I’m able to help with low back and hip pain in most cases. The idea that we need to “deactivate trigger points” or “strip out adhesions” is based on conjecture, and I would be very surprised if it held up to close scrutiny. That said, some clients respond well to psoas work, or have had success with it in the past. For these clients, I’ll happily offer broad, slow contact.
13:42 5) Overloading my clients with stretching and self-massage advice. These days, I’ll offer a single stretch at a time, erring on the side of giving them too little. This gives them a chance to actually incorporate them into their lives and benefit from them, and it lets me see whether they’re the kind of client who even wants homework! If not, I simply allow massage to do its work.
Thanks for watching (and reading all this)! Let me know if there are any massage practices you’ve abandoned in the comments, and if you disagree with any of mine. Let’s talk about it.
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