I am often asked by patients:
‘What does massage do?’
Well, I like the analogy of a traffic jam to illustrate the point that, if the fibres of the muscle are too densely packed (like cars on the M4 on bank holiday), then the red blood cells, carrying oxygen, and the blood carrying chemical messages and nutrients to the muscle, will not be able to move through the muscle to get to where they needed (in the camper van in the Gower for our example!). There will be a traffic jam.
So, when there is this congestion, and often also dehydration, cellular exchange cannot take place. Your muscles do not get the fuel they need and do not have the waste products of respiration removed, as the blood cannot get through effectively. Massage techniques aim to contact these fibres, loosening them in order to ease congestion and make cellular exchange function optimally.
The term ‘pain’ is also used a great deal in the treatment room, but its meaning is often obscure, being so subjective. Perceived pain levels differ greatly between individuals depending on their constitution, age, diet, stress levels, lifestyle and sporting habits and the rest. The point is, the type of pain we are looking for in a massage, is the type that feels ‘releasing, pulling, stretching or opening’ rather than ‘pinching, bruising, pricking or stitching’. Good signs that treatment is working is to feel a ‘pain referral’ from the area being worked, described by many as a sort of numbing, or dull spreading feeling, radiating from the point at which pressure is being applied.
Pain for a massage therapist is a signpost for when there is disorder within the body’s tissues. Rather than blocking the sensation of pain with drugs, we see pain as presenting an opportunity to reconfigure tissues that are not functioning correctly. If the senses are dulled by strong painkillers, it will be harder to gauge the correct pressure that allows the muscle’s nerve fibres to act, allowing muscle lengthening and restoring function. That is why a massage can feel more beneficial when it focuses on those tender knots that might make you want to leap off the couch.
A knot or trigger point, as defined by Travell and Simons is “a highly irritable spot of exquisite tenderness in a nodule in a palpable taut band of (skeletal) muscle’. A description that certainly rings true in my experience!
So why does the body create trigger points? I like to think of them as vessels that can hold the stress of muscular imbalance in a single location that is identifiable and treatable with therapeutic intervention. Trigger point formation has been comprehensively mapped (with as much as 70% of them found to be the same). The results of treatment are reliably reproduced throughout patients with differing lifestyles and underlying causes for their problems; our bodies intelligently develop recognisable patterns that allow for treatment to be effective in reducing pain levels.
Essentially, the body is a self-healing organism- creating trigger points is it’s best attempt of coping with the stresses and strains we put on our bodies when we adopt unsuitable postures for long periods of time. It is often a combination of too little (sedentary occupation) with bouts of too much (over-exercising), to compensate for sitting down all day, that leads to soft tissue problems, fatigue and the formation of trigger points.