Soft Tissue Therapy in action

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Tim Budd, Sports & Remedial Massage Therapist at Global Therapies, shown here providing soft tissue therapy to Sean Keefe, Co-Founder of Strength & Performance.

Global Therapies provide sports and remedial massage, soft tissue therapy and advice to clients at S&P on Mondays and Thursdays.

December Reading - Fascial Release

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My book for December's reading was Fascial Release for Structural Balance by James Earls & Thomas Myers. Tom Myers is well known to me because of his work with integrative structural therapy. His book Anatomy Trains should be in every massage and soft tissue therapists library. This months book is also worthy of a place in the library. James Earls studied with Tom Myers and also follows the anatomy trains approach to bodywork, something we incorporate in our work too. Knowing the authors credentials alone gave me confidence that my book for the month was going to be a good read.

As with Tim's book choice, this is one which I have dipped in on numerous occasions. The bulk of the book is made up of chapters corresponding to individual areas of the body - a review of anatomy and a look at relevant techniques and concepts of fascial release that are applicable. In the introduction the authors are keen to note that the body is not made up on separate and isolated components. Comparing the body to a car is an oft used analogy, but humans are not the same - we cannot simply take out a muscle when injured and replace it like a broken spark plug. There are much wider reaching implications for damage to one part of the body, and it is those connections - through the fascial webbing which pervades all of our body - which Earls & Myers explore in this text.  Paraphrasing them, the reality of human anatomy is that we have one muscle poured into 600 (or so) pockets of fascial webbing - the distinctions between muscles are useful, but the reductive process shouldn't block the reality of the unifying and connected whole.

Key messages I will take from this book (some of which reinforce reading from other sources):

• Fascial webbing that pervades our bodies has been building, refolding and remodelling since the foetus was 2 weeks old - it remains constant (ever present) and changing (adapting) throughout all our life.
• Everything is a compromise - the stability vs mobility balance is always being played out in our body.
• Congestion and mechanical strain often affects the body in distant parts - because the fascial web is altered.
• Fascia is contractile*.
• Tensegrity** is key; "The body is designed to distribute strain globally, not focus it locally".
• The fascial system is a repository for chronic issues because of its ability to accept change slowly and retain the changes it makes. Chronic tension because of inappropriate fascial shortness can lead to trigger points, fascial thickening and compensation patterns throughout the body.
• Fascial tissue deforms because of injury, abuse, misuse or disuse - but because of its plasticity it can be reformed with manual therapy, stretching and awareness (such as changing postural habits).

* Until recently it was thought that only muscles contracted but it is now known that myofibroblasts exert a force on the fascia causing contractions. Not as quick to respond as muscles (perhaps 20mins), fascia does however retain the contraction for hours - leading to sustained mechanical tension and postural changes.

** A word on tensegrity - engineers build houses and structures to withstand forces applied to them, just as the body does - but, the body is able to maintain its structure when, for example, held upside down or when pressure it exerted on one area.  Through deforming one part of the body small amounts of deformation are felt throughout the body, and a tensegrity model can demonstration this. An amazing Christmas present was given to me this year which allows me to demonstrate this to our clients:

No tension applied

Tension applied by right hand

The two photos above aim to demonstrate what happens when there is tension applied to one area of the tensegrity model. The right hand is pulling on a cord at the top, and you can imagine this is a tight muscle, tendon or area of restricted fascia within the body. On a quick glance you will notice that the whole structure has become deformed, squashed and distorted a little if you like. On closer inspection you will see that there are changes visible throughout the model. As one example, take the yellow node held in the left hand - it forms a triangle with a blue node above and another out of sight node; see how that triangle has altered in size. So while the cord at the top of the model is being pulled it has affected this distant area, just as fascial restrictions in for example the calf can affect the hip, lower back or elsewhere. It is difficult to demonstrate a 3D model with a photograph, but I hope you can see the basic idea behind strain being applied globally, not just locally. It is this principle which we apply in our massage and remedial treatments.

I will be continuing to read this book over the coming months - there are six chapters on the different body areas (foot & lower leg; knee & thigh; hip; abdomen, thorax & breathing; spine; and shoulder & arm). There is good guidance on postural assessment and clear diagrams on various anatomical structures - so don't be surprised if I show you this book (or the tensegrity model) when you come for a treatment. It really is a good tool for all manual therapists who are keen to educate their clients and give them the best possible treatment and home care advice.

Lynne Taylor

December Reading - Shirley Sahrmann

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For my December reading I was slightly inspired by Lynne going to see Shirley Sahrmann in Manchester, and raving about the experience and everything that she learnt. We have had her book, Diagnosis and Treatment of Movement Impairment Syndromes for quite a while, and while I have dipped into it from time to time, I haven't really got to grips with the meat of the book.

It's quite a tome, and heavy going if you try to read the whole thing. Considering it is more like a reference/text book, I decided to take only one section of the book in order to give myself something to get into and understand as comprehensively as possible, rather than spread myself out across the whole thing, and only really get a general understanding of the general content.

In the past few months I have been seeing more and more people with various issues and pain patterns with the Shoulder Complex. Rotator Cuff Syndrome, bicipital tendonitis/tendonosus, painful shoulder syndrome, call it what you will, there are a large number of issues that could well impact on the whole area. My decision was based upon this, and so I chose to look at the introductory chapter, to get the general concepts behind the book, and also the final chapter, about the Shoulder and various Movement Impairment Syndromes that can be seen, diagnosed and corrected.

Having skipped through the chapters in the past, in a fairly cursory manner, the deep and specific reading that I was doing threw up a number of very interesting and exciting things about various muscles, syndromes, and issues that affect the shoulder.

I will not go into more specific detail here, but suffice to say, since reading this part of the book, my knowledge of the musculature, how the whole joint fits together, what can, and indeed does go wrong, and how to identify potential issues has gone through the roof. I thought I knew a fair bit about the shoulder, having had a few injuries in the past, (climbing and snowboarding have that effect...) but this is a whole new level. I have a lot more confidence now, speaking with clients about their shoulders and what may or may not be wrong with them, and am much more specific in terms of looking at particular points of the musculature and how it affects the shoulder, and also the body, as a whole.

Although this book is titles "Diagnosis....." I am under no illusions that I am now able to diagnose. As a Massage Therapist I can have an idea of what may be wrong, and just by reading and understanding a text such as this, it does not change that stand point.

I suspect that in the next few months I will be going back to this resource time and again to refresh my memory. Also, I will definitely be using the other chapters as specific reading material later on this year.
This is an excellent book for all types of manual therapists and PT's alike. It can be a little difficult to get into if you are not academically minded, but persevere and your knowledge of movement and impairment of movement will be transformed.

Last race report of the year

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Sorry, there are no pictures on this one, but Lynne was running... not taking pictures, might have to get used to that in the next year... unless I manage to work out how to run and shoot at the same time... Instead, you can have a link to my Garmin track

The Map

Its been a while since I did a race report, mainly because I haven't been racing since September/October. (For various reasons including, but not limited to, minor injuries to toes, heels, and other less important running parts, not being in the right place at the right time, and generally there not being a whole lot of races in the area to jump in on).
However, the last race of the year, the Peak "O" trial is just in our back garden, starting from the Grouse Inn, just up the hill, and organised by the indefatigable Des of Wormstones and Chunal race route fame. The new thing about this race is that Lynne was also running it, and has just finished her report which is on her blog here.

We got up to the Grouse in plenty of time, registered and stood around for a bit. I realised that I hadn't brought full body cover, so jumped in the car for a quick journey home to pick up some trousers.... and also a whistle that I had neglected to switch from one bumbag to the other, and straight back up the hill again. Once again ensconced in the pub, Lynne was chatting with Andy from Pennine, and admiring his rather impressive scar on his knee- caused by falling off a bike onto a metal gridded bridge - not a pretty sight - think bone, and we generally chatted with a number of people who wandered in.
Good to see Nick (baba) there, I'm sure he has something on his blog, so I'll link to that one too, Julien, Mark Ollerenshaw, Ian, Carl and Beryl were there from Glossopdale, also great to see our wandering companion Carl Bedson back from Africa and Dave, and Rory who I haven't seen in ages. And of course Andy A turned up pretty much as he was due to start. Perfect timing. (or not, depending on your perspective).

It was an Orienteering/ timetrial format, so a number of people got their maps and left in 2 minute intervals. There were 2 routes, Long Score, with 7 checkpoints and Short Score, with 5, missing out the 2 checkpoints furthest South on the Long Score.
I lined up at 1022, got the map and had the 2 minute mantadory map looking time, deciding the best direction to take, attack points and general information before heading off into the countryside. All too soon we were told GO! and we ran off up the road. I had had enough time to take in the general gist of the map, what was going to be up and down, the direction of the wind, and how that was going to affect the direction of travel (not too much fun running into the wind in the second half of the race), and what it would be like at the end. (either a slight downward run, or an uphill slog) I decided on the uphill slog at the end. Why not? Everyone else was going to be tired at that point, and maybe I could use that to my advantage if it came to a "sprint" finish.

Off to Monks road and then up and over into access land to get to the first checkpoint, there were a lot of people milling around making unsuccessful forays into places where the dibber might have been, and a few running around like headless chickens, while others seemingly stood around waiting for others to work out where it was. I wandered around for a short while, looking for the obvious, and while doing that, Nick, who started out 2 mins after me, caught up. Damn.
Another minute of idiocy - I blatently hadn't got my attack points sorted out in the slightest, I orientated myself and where the point was most likely to be, over a fence, and pretty much straight on to it. That took far too long.
Next stop, Lantern Pike, I know my way there from various races, and also a bit of Mountain Biking in the area, so I hammered away, taking care not to overdo the pace, watching Nick become further and further away - he's got a bit good recently. As I got most of the way up to the top of the hill, he came bounding down past me, but I thought I had a better line from there to the next Check point, we'll have to see how it goes. Although in Orienteering you shouldn't really compare yourself to someone else, it was nice to get to the top of the hill before another couple of people who started climbing it before me. Clip the dibber (by now I had decided that I REALLY couldnt be bothered to take the map out of the plastic I had brought with me when clipping, too much faff taking off gloves and trying to get it back in the right way round etc.) so I just clipped it straight through the plastic. Boom.
Off on a slightly different line to Nick, and within the next couple of km I had gained a fair amount of time and distance on him, passing another runner, and getting to the next point in Rowarth before 2 others that I recognised from earlier on in the race.

We had a little bit of trouble finding the dibber at the pub, it wasn't exactly where it was meant to be- round the corner and down the way a bit, but after a brief look, all was fine and we dibbed in. Nick shot off, and I doggedly carried on. From here to the next point was a part of the Coombs tor race, and also I had run a portion of this in the Rowarth O event back in the summer, so navigation wasn't too much of an issue. Up the hill and over for a decent few km, pulling back a couple of other runners, and seeing a couple of navigational mistakes by others which helped me pull more time back. Over to the plantation and I passed Ian from Glossopdale in his BRIGHT luminous top. He was running into the sun and didn't see me.
Clipped the point, over the fence and along the top of Cown Edge rocks, Nick was disappearing from view, and the wind was buffetting strongly from the West - thankfully blowing us runners away from the edge, not towards. Along and down, down, down, the next point was in a Quarry, and I figured going all the way down, and in from the road. I noted a couple of runners heading off toward the top of the quarry, wondered what they were doing, and, in the best O spirit, I thought "ignore the others, stick to the plan". Ran to the bottom and a local bloke, washing his car (or some such thing) commented that you couldn't get into the quarry that way, you need to go back up the track and in over the wall...

Argh.

Back up the hill, find a small divot in the wall, through and into the quarry. The people I was catching up with, all done, been and gone. Dammit. Nothing to do but run down into the quarry, clip, up and out.
Next- choices... do I go straight to the road and up it, Monks Road, cycled up that... its a bit damn steep. Or, up the path I've just come from, and through the path at the top. The path wins out, and as I churn up the path, overtaking 2 who caught up with me, I catch sight of Carl, storming down the path- impressive considering he appeared to be wearing road shoes!
Up the hill, retracing steps to the top, with the wind blowing in my right ear... the buff got taken off my arm and pulled firmly down over my ears - a welcome relief from potential earache... then, at the top a guy in a bright orange top is gains on me quite significantly. I paused on the crest as I decide that the original line to the next control that I had in mind - a direct bash following fence lines, probably isn't going to be as expedient as going down the hill a little way and using the path across to the Nab and he takes the opportunity to run ahead.
Down to the path, and overtaking the same guy as he stops to check his map. Down past the farm, and a choice of going left or right around the trees. I go left, and overtake another person, and then a delightful horrendously steep descent down the top part of the Nab over rough and broken ground with all kinds of craziness. Just my kind of terrain. I shot down to the control, dibbed my bit of paper and back off up the hill. From here, its just a reverse Wormstones race route home, I'll only need the map for dibbing. The guy ahead of me is walking. My legs are burning, but, he is walking. That means, if I run, I can catch him up. Right, faster feet, and run. Up the hill, I can see the optimal line across to the next gate, he goes too high, still plodding away, I break off, still maintaining my stride (if you can call it a stride), and over to the gate. I don't stop to look back, I know that there are now at least 3 in relatively close pursuit.

Up and up, over the top and I can see the Grouse. It's on the other side of a not inconsiderable valley that I have to go down and up to finish. Still, I need that final check point before I can consider that. Below me I see another runner, contouring around, I have the altitude advantage and use it well, charging down the hill to the corner where the checkpoint is. Hang on, am I in the right place? I look at the shape of the hill, and realise that I've come down just a bit too early, run along the wall, ah, here it is, the hill on the other side drops away almost like a precipice, over the fence, and there is a runner coming up behind. So this is going to be the final run off then. I dib, and launch down the ridiculously steep hill, 3 steps, slide, fall, slide on my bum, up again, and repeat until at the bottom. Not even mudclaws were gripping on part of that descent, but no time to think of that now, up and across the river, and up the other side.
The hill was over in a surprisingly short time, though I have no idea what was going on behind me, up, through a gate, again up, and through a gate to the road, and the final 400metres against the wind, traffic inches from my feet, and up to the pub.

Lynne with her winnings

Finish in 1:46:58 by my watch. 16.93km.

Soup, rolls, cake, scones and drinks were laid on by the Grouse, and very much appreciated by all who ran, there was some good sharing of knowledge around open fires, and great conversation. Congrats to Nick who came in Second, and Mark Ollerenshaw who was Third by the smallest of margins. Lynne did herself well and won the Ladies Short Score event, so we at least have a bottle of wine to celebrate with.
Thanks again to Des who organised the whole thing, and to Gordon who printed the maps and was a route advisor - or some such thing.
A great turn out for a last race of the year, good to see you all out.

Benefits of Sport & Remedial Massage: an overview

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Benefits of Sport & Remedial Massage

• Injury prevention
• Enhanced training
• Greater energy
• Pain reduction & management
• Faster recovery
• Increased flexibility & agility
• Improved mobility & range of movement
• Functional muscle balance
• Normalised fluid movement (blood & lymph)
• Emotional relaxation and stimulation
• Increased body stamina
• Reduced soft tissue tension & binding
• Improved physical & mental performances

Benefits for systems of the body:

• Skeletal system: reduced thickening of connective tissue, restore range of movement, decrease stress on joints and bones, improve muscle tone balance 
• Muscular system: release tension, decrease stiffness, decrease spasms, decrease restrictions, decrease adhesions, normalise scar tissue, improve tissue functionality 
• Cardiovascular system: increase blood flow, increase oxygen and nutrient uptake, remove of toxins and waste products 
• Nervous system: increase endorphin production, stimulate and soothe sensory receptors (decrease pain), proprioceptive balance restoration, deactivate trigger points 
• Digestive system: improve peristalis and fluid movement 
• Lymphatic system: increase white blood count & lymph movement

Rockover Growl 2

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On Saturday I went over to Rock Over Climbing wall to help out with their second GROWL competition. After the success of the first one, which I blogged about here, I was really looking forward to seeing some interesting route setting, good climbing, and a lot of people having fun.

Lynne and I provided free arm and shoulder massages at the last one, so I knew there would be some demand for us there again. Unfortunately Lynne couldn't be there this time, so it was just me holding the fort. I got there nice and early, watching the first competitors float through the door, from the cold outside to the not every so much warmer inside, filling out their forms and taking in the look of the problems on the walls.
The guys had excelled themselves in terms of routes, and the very obvious amusement was "the Death Star", or, alternatively known as "Simons dangly bits". A hanging sphere of plastic volume between 2 walls. According to Simon, getting onto and across was the easy part of the problem. Excellent.

The "death star"

As more and more climbers came in, I set up the table and talked with a lot of the guys and girls wandering around. The temperature slowly began to rise, and at 11am the competition was kicked off.

As ever, the first hour or so was spent talking to the injured climbers, looking at injuries and giving advice on what to do, and, more often than not, what not to do. Then, as things began to get swinging (as it were) there was an influx of competitors for massage and de-pumps.

The general consensus from the guys I was talking to was that it was a bit harder than last time, but just as enjoyable. I certainly had a good time, and I'm looking forward to trying out a load of the problems on my next visit.

December Book of the Month

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This month sees us reading the following books:

Tim's choice: focusing on shoulders after seeing a sudden increase in rotator cuff injuries

Lynne's choice - more depth being added to her knowledge of fascia