| This is the UN-edited article
published in the July 2002 issue of Massage Magazine
Mid Back Tension
"Intention and Imagination"
by Taum Sayers
One of the keys to success within the art of bodywork appears to be
utilizing intention and imagination. Rumor has it that we humans utilize
only a small percentage of our potential abilities. I believe that
we can increase that percentage when we exercise, and thus promote,
our ability to imagine, intend and see outside the box. Portions of
the following information serve to encourage the innate ability to
listen to and utilize the clues your client's tissue is providing.
My primary mentor, Lauren Berry Sr., RPT and Structural Engineer,
often described a successful therapist as part detective and part
mechanic. It would appear that intuition and imagination aid both
of these roles.
One of the primary goals of The Lauren Berry Method® of Corrective
massage is to enhance the body's health by addressing it's constant
balancing act regarding its relationship to gravity. These techniques
serve to reduce tension and nourish the body's innate repair mechanisms
by encouraging the body to return to a state of balanced posture and
ease. Practitioners never claim to "fix" anything, but rather
to reduce the obstacles that interfere with the body's incredible
natural healing abilities.
This unique approach to relieving soft tissue tension also recognizes
that the point of pain is often the result of a regional or distant
tension. We can apply a bit of creative visualization to understand
this point with what I call my "nose ring analogy." Imagine
you have your nose ring in today. Now imagine there is a ten-foot
long chain attached to your nose ring. Now pretend someone on the
other end of the chain pulling and applying a rather uncomfortable
tension. Where is the pain? Most likely in your nose. What is the
source of that pain? Obviously, from the tension exerted at the other
end of the chain. Many pains throughout the body can be compared to
this situation, for the point of most noticeable pain for your client
is often the result of a distant tension.
A good foundation includes knowing your anatomy so that when a client
points and says "It hurts here", you can 'see' the pertinent
muscles in your minds eye and then tactilely follow along the length
of the muscle attached near that point of tenderness and address the
various tensions, adhesions and distortions that might be contributing
factors. This approach recognizes, respects, and addresses this situation
throughout the body, often reducing pain and restoring function with
remarkable speed.
Lets take a walk thru several of the numerous considerations when
I apply a portion of The Lauren Berry Method® approach to a
very common concern, tension between the shoulder blades.
In focusing on any of the common concerns among clients, there are
numerous considerations to take into account. First, when there is
trauma and stress to tissue, the surrounding tissue often goes into
a protective mode and immobilizes to protect the area from further
damage. This is similar to a cast on a broken arm. This natural 'casting'
serves the useful purpose of allowing the body momentary protection
from further injury so that it may adapt quickly, deal with the present
situation and then begin it's repair process. This appears to be part
of the body's innate survival program.
While this protective adaptation initially serves its purpose well,
it is similar to applying duct tape to mend a tear. A useful yet transitory
solution, rarely efficient for long-term healthy function. Problems
often arise when the tension (duct tape) remains long past the body's
need for that protective mode. Therapists asked to work on long standing
concerns of their clients can often add to their successful rate of
pain reduction by respecting that we are often not so much addressing
the initial problem, as we are the body's historical adaptations and
compensations.
The Rhomboids are not necessarily the culprits in Mid back tension.
The thoracic region often has a long history of protective contraction.
Consider that each time our body has fallen, beginning with the
first time we fell off our tricycle, we automatically stuck our
arm out to protect our face from hitting the sidewalk. Someone
may have bandaged the scrape on our hand or put a band-aid on
our elbow, but it is a rare parent that thinks of massaging the
area where some of the unseen shockwave traveled up that arm and
settled -- the upper back. Additionally, many of the actions and
postures taken on with common daily routines have a tendency to
stress this area. As example of the bodies ongoing balancing act,
if you were to adopt an imbalanced posture such as leaning over
the sink to wash the dishes or brushing your teeth, your hamstrings
and a variety of muscles throughout your back may go into minor
contraction to keep you from falling forward into the sink.
 
Sure, we humans can adapt to the various insults
to our upper back, but not without an accumulative cost. In this
case, the price is often an ongoing tension between the shoulder
blades.
Let us address this situation using two techniques within this Lauren
Berry Method® Practitioner's approach that work together rather
well:
1) Encouraging the muscle to relax; and
2) Repositioning misplaced tissue.
This article will focus specifically on several of the muscles
often associated with tension in the thoracic area, the Iliocostalis
Thoracis and Iliocostalis Lumborum.
With thoracic tension, these two muscles, in addition to commonly
being in a state of tension due to postural imbalances, appear to
frequently distort in a lateral/inferior direction. The resultant
tension is felt by the client most noticeably between the shoulder
blades where these muscles attach. As part of any client's session,
Lauren often suggested we massage the attachment points of a muscle
before correcting its position. He explained this action would increase
the blood flow to the muscle. After further anatomy investigation,
it would appear to this author that massaging the attachments can
also stimulate the properties within the Golgi Tendon Organ (GTO)
(see GTO illustration) thus reducing the tension on the attachment
points. Consider…within the neural/muscular mechanism, the
stretch reflex regulates the length of skeletal muscle. The tendon
reflex monitors the tension produced during a muscular contraction
and prevents damage. The sensory receptors for this are the GTO's.
They are located among the collagen fibers within the tendon near
its muscular junction and serve to monitor the external tension
on skeletal muscle. Their associated neuron is stimulated when the
collagen fibers are under stress. They are more susceptible to activation
during contraction than stretching, when the energy comes from within
the muscle as opposed to an external force. Within the spinal cord,
these neurons stimulate inhibitory interneurons that innervate motor
neurons controlling the muscle. The greater the tension in the tendon,
the greater the inhibitory effect on the motor neurons. Consequently,
skeletal muscles are generally prevented from developing enough
tension to damage their tendons. This serves as a built-in relief
switch. (As an example of this protective mechanism, consider why
you cannot hang onto a pull-up bar forever. At some point, the GT0
sends the message to your nervous system that the stress of holding
on is reaching a point of muscular/tendinous damage. The brain responds
by overriding your wish to continue hanging on and reprograms the
muscle into a relaxed mode thus weakening your grip and you let
go.)
 
It would appear that Lauren's technique also stimulates the mechanisms
within the GTO to manually reduce a muscle's internal tension. This
technique intends not so much to stretch the muscle as much as simulate
a stress within a particular muscle. By applying a specific cross-fiber
massage, similar to pulling the string on a bow and arrow, this
approach stimulates the natural properties with-in the neural/muscular
mechanism to set off the GT0's response and persuade the muscle
to relax. This technique is most successful when your intention
is focused thru the surface tissue layers to your target fibers.
I personally have a lot of admiration for bodyworkers who are very
specific with their intent and their capacity to "see"
with their fingers. An ongoing study of anatomy followed with practice
in the field is an excellent way to nurture and refine these abilities.
For example, you might find and palpate the two muscles discussed
here on each of your next day's clients. I highly recommend that
you begin with a clear intention and a light touch. Initiate by
palpating the insertions of the iliocostalis thoracis and iliocostalis
lumborum, acknowledging your client's feedback as to levels of discomfort.
(I recommend an agreement so that should your pressure cross the
line from therapeutic discomfort into pain, your client notify you
with the code word 'ouch' and you will stop to assess the information.
This serves two purposes…assisting you in your assessment
with their feed back and allowing your client to relax further knowing
they have a say in this process.) This includes the attachments
shared with the common tendon of the erector spinae. Though you
probably will not be directly working on the GTO itself, the tendon
is dense enough that your localized pressure can be transmitted
to it to stimulate the desired response. This work is done without
oil, allowing for a precise manipulation of the tissue.
"Repositioning"
Part of the uniqueness of The Lauren Berry Method® is found
in directly addressing and correcting soft tissue misplacement and
distortion. In this situation, your direction of intention and pressure
is medial/superior, focusing along the muscle belly.
A useful image is one of pushing or nudging dried strings of glue
across glass with your fingertips. Consider that the attachment
points of the tendon represent a concentration of force in one small
area (the entire force of the muscle focuses tension on the bone
through the tendon at its attachment). Because of this, the tension/force
(pounds per square inch) at the attachment point is higher than
at any point in the body of the muscle itself. There are pain receptors
at the bone surface (periosteum), which in turn can make the insertion
point very sensitive. It is thus helpful to expect these points
to be tender and adjust your pressure accordingly. Consider that
you are not so much repositioning the fibers to an exact position
as much as you are introducing movement towards a balanced situation,
thus reducing adhesions and removing distortion. The muscle tissue
upon having the 'duct tape' removed will most often be able to nestle
back to its optimal location. Note that one indication of a misplaced
and distorted muscle is when the fibers tactily 'stand out' with
that all too familiar stringy/ropey feeling. Additionally, when
muscle fibers are in their most functional position, they usually
blends back in with the surrounding fibers and 'tactily disappear'.
The attachment points can serve as an important reference, so after
addressing the surrounding regional tensions and distortions within
the belly of the tender muscle you can often return to a previously
tender attachment to find it has relaxed. This can also serve to
instill confidence in your client that there is benefit to the process.
By applying these techniques, you will have tapped some of the innate
intelligence of the body, intentionally encouraging the muscle fiber
to release chronic tension by overriding its protective state of
contraction via the GTO, thus "reprogramming" it via the
nervous system to relax. You will also have encouraged the muscle
out of a distorted position and back towards a situation where it
has a better opportunity to relax and repair.
Access and work on as many of the attachment points as you can and
repeat the move on each. Be aware of scapula positioning so as not
to strain the shoulder joint. Should a point be overly sensitive,
work the surrounding region including the body of that muscle and
return for another pass; chances are it will be less sensitive the
second time around. This qualifies as a deep tissue technique, so
respect it as such. As you study these two muscles, consider how
related muscle tension throughout the body can have the 'nose ring'
affect up into the region between the shoulder blades. Get out your
anatomy books and take a close look at the Iliocostalis Cervicis.
Observe the attachment points near this area of concern. Take the
above information and apply with my observation that these fibers
usually distort in a medial/inferior direction. Also, consider that
if you have not addressed distortions in the lower back, your success
rate will relate accordingly. Following these techniques with longitudinal
oil work is a good way to bring this process to closure.
*Mirka Knaster, Discovering the Body's Wisdom (Bantam Books, 1996),
p. 171
** The Institute of Integral Health, Inc.®, is a non-profit
educational corporation located in Berkeley, CA, that continues
to teach and certify practitioners in The Lauren Berry Method®.
Footnotes
1. James Cyriax, Textbook of Orthopaedic Medicine, 8th edition,
1982, Volume One, Diagnosis of Soft Tissue Lesions, Bailliére
Tindall, 24-28 Oval Road, London NW1 7DX.
2. Palastanga, N.; Field F.; Soames R., Anatomy and Human Movement-
Structure and Function, 2nd edition, 1994, Butterrworth-Heinemann
Ltd., Linacre House, Jordan Hill, Oxford, OX2 8DP.
3. Licht, S.H., Massage, Manipulation and Traction, Fourth printing,
1976, Robert E Krieger Publishing Co. Inc., 645 New York Avenue,
Huntington, New York 11743.
4. Martini, F.H., Fundamentals of Anatomy and Physiology, 4th edition,
1998, Prentice Hall, Inc. Simon & Schuster / A Viacom Company,
Upper Saddle River, New Jersey 07458
5. Alter, M.J., Science of Stretching, 1988, Human Kinetics Publishing,
Box 5076, Champaign, Il 61820.
6) http://www.imc.gsm.com/
Taum Sayers is a certified Lauren Berry Method® practitioner,
instructor, President of The Institute of Integral Health, Inc.®,
and author who continues to practice and present workshops nationally
and near his home in North Lake Tahoe, California. The foundation
of his practice is primarily influenced by his apprentice ship with
Lauren Berry Sr. RPT and his ongoing association with his fellow
board members, teachers and students within The Institute's ongoing
educational programs. For more information … www.musclemanagement.com
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