Posted on Sat, Apr 17, 2010
Anatomy Review: Massage and Shoulder Pain aka The Trapezius and the Wings of Life, Part Two (Please see Anatomy Review: Massage and Shoulder Pain, Part One for anatomical informational about the trapezius.)
Massage bridges the worlds of action and language. We deliver healthcare through skilled, caring touch with shoulders, arms and hands. Freeing the shoulder girdle is essential for health.
Trapezius Fulcrum
Massage Therapists should begin comfortably seated at head of the table. The Client should be supine (if neck is lordotic – chin higher than forehead – please put a small pillow under the head).
Before putting your hands on, center yourself. Breathe. Position your body so that, even when seated, you can use your body’s weight and gravity for your pressure – rather than effort. Position your treatment chair or stool to allow room between your body and that of the client. Let your joints be gently rounded, wrists aligned, elbows slightly bent, shoulders and breath relaxed, with an open space between the outside of the rib cage and the insides of your arms. Get grounded with ease in the hips and knees and the soles of your feet on the floor.
Briefly review in your mind the life stresses this client may have revealed in the pre-session interview/history-taking and in past sessions if this is a repeat client. Realize you are not just touching the trapezius, a muscle positioned in the space of the client’s body. You are equally touching time – that is, the tensions accumulated from their many years of life. In this sense, every touch that impacts the client’s ongoing life takes place at the intersection of space and time.
Engage the Nervous System
Using the fulcrum model you are engaging the nervous system, especially the autonomic, as well as the physical structure.
- Let your fingers rest on the clavicles and upper ribs. With your thumbs begin an exploration of the belly of the trapezius. Start near the base of the neck and work your way out with mindful, caring touch, using light to moderate pressure. Note any associations and observations that palpating this client here evokes for you. Sometimes I feel like I’m a prospector, palpating for the long-lost treasures underlying our tension. Work your way out in successive points near to where the clavicles and scapulae meet.
- Now return to the belly of the trapezius immediately lateral to T1. Be conscious to touch clearly with both your physical structure and your energy (i.e. being mentally, emotionally, and spiritually engaged in what you’re doing.). Press in slowly with both thumbs, then pause. You are now engaging the touch receptors.
- If you find no tension, clearly disengage and explore points more lateral. But do make sure you devote some caring time and attention to each place. If you do find tension on either or both sides, engage it with a bit more pressure. At this point, commonly the client may say something like, “Now you’ve got it!” or you can see from their breathing and facial expression that they are engaged. Pause. You are now engaging both the touch and pressure-receptors.
- Now, having entered their realm of tension, rest into it. First, rest yourself. Deepen your breathing. Sink in with your thumbs, lean gracefully in toward the client, letting gravity be the therapist, rather than forcing your way in by adding tension to your shoulder girdle, back, arms or hands. Find the optimum depth for this fulcrum, this person, this place. Pause, without letting go of any vectors. Give the person some time in which let go from the inside out. During this time it is important that you the therapist go to a “witness” state, not moving, patiently allowing the client to let go of successively deeper sedimentary layers of tension developed here over the span of his/her life. You are now engaging receptors for touch, pressure, and the proprioceptors. Through them you are affecting the limbic system, cerebellum and possibly the cerebrum as well.
- When you sense it’s been long enough – five seconds is usually more than enough in a given place – clearly disengage and move on. Then press in an inch more laterally on both sides. Repeat the steps above. Keep alive your sensitivity and patience. Tensions here accumulate over a lifetime. Clients need the gift of time and touch to let go of the layers and years of accumulated tensions.
- Continue working the belly of the trapezius in successively more lateral areas until you’ve given attention to at least four or five areas bilaterally. Even if you find more tension on one side than another, maintain conscious contact with both sides. The bilaterality of contact is important since we are looking to restore the experience of having wings, rather than yokes. Two wings are needed for flight!
Wonderfully, this fulcrum with the trapezius is physically quite easy to perform. However, approached with reverence, respect, and patience, it will have global consequences for your clients. Through this nexus of time and space we are given the opportunity to let go of lifetimes of stress and to regain the sense of lightness in our lives.
Learn how to work the trapezius in a massage chair. Chair massage ceu's are offered annually at Lauterstein-Conway Massage School.
Posted on Fri, Apr 16, 2010
Anatomy Review: Massage and Shoulder Pain aka The Trapezius and the Wings of Life, Part One.
The upper limb and its girdle play an intermediary role in life. On the one hand, we use shoulders, arms and hands to get things done at home and work. On the other, we use the upper limbs for linguistic and gestural functions. Peaceful or forceful movements of shoulders, arms and hands reveal with connotative clarity what we really mean. And, in writing and sign language, we see an entirely linguistic use.
Massage bridges the worlds of action and language. We deliver healthcare through skilled, caring touch with shoulders, arms and hands. Our touch also communicates to clients valuable anatomical information, feedback and non-verbal suggestions for how they can become more relaxed, free, and balanced.
Freeing the shoulder girdle is essential for health. We all have seen clients whose shoulder blades have become adherent to the ribcage. Structurally and energetically, there is enormous importance in the scapulas’ ability to glide freely over the ribs. Without that space, everyday stress, instead of “rolling” off our backs, can become “impacted”, affecting the free movement of the ribs and spine, ultimately even affecting the heart and lungs.
Character of the Trapezius
The trapezius muscle is, for many people, the body’s energetic shock absorber, just as the legs and feet are the body’s main physical shock absorbers. As stress comes and goes, tension in the trapezius ordinarily increases, then quickly dissipates.
However, with excessively sustained stress or sudden overwhelming trauma, the body begins to absorb stress, holding on instead of dissipating it. Then trapezius and other stress indicator muscles begin to have a chronically higher tonus.
Virtually every adult carries the residue of past life tensions in the trapezius with a resultant diminished capacity for dissipating everyday stress. When our shock absorbers start losing resilience, stresses begin to stay longer, going potentially deeper into the bodymind.
A primary purpose of working with trapezius then is to let go of any residue of the past that no longer serves us. Also to learn new habits of handling stress by letting go, rather than by absorbing it.
Anatomy of the Trapezius
The trapezius originates along the body’s centerline, as low as T 12 and from each spinuous process all the way up to the back of the occiput. It extends out finally to insert along the scapular spine and the lateral third of the clavicle.
The thickest part of the trapezius is its “belly” just above the scapulae. This is an anatomical vantage point from which therapists can assess how clients cope with their stress.
The healthy trapezius is like a sail floating freely in the winds of life. It allows the full excursion of breath beneath it. It allows for the healthy movement of the head, neck, thorax and shoulder blades. Let us restore free-floatingness to our wings!
If you don't have a massage table available to you, seated or chair massage is also a wonderful way to work the trapezius. Lauterstein-Conway Massage School offers a two-day chair massage ce workshop annually.
To get "how-to" information about how to release the shoulder girdle, subscribe to David's The Enlightened Body Blog! Part Two of Massage and Shoulder Pain will be released tomorrow morning.
Posted on Fri, Mar 19, 2010
Origin: Lateral Tibia
Insertion: Medial cuneiform and first metatarsal
Action: Dorsiflexes, supinates foot, lifts up medial margin of foot, supporting medial
longitudinal arch (Excessive: shin splints)
Antagonist: Peroneus Longus
Like many modern conveniences the concrete sidewalks and roadways of our civilization take back almost as much as they give. They allow for the fairly safe and speedy passage of vehicles, goods and services. They save the pedestrian the chore of slopping through the mud. However, the earth no longer absorbs the impact of our step. We have developed footwear to remedy this situation and in so doing have elevated our so recent paws to the level of high fashion. Still the body and especially the feet, being the closest to the ground, do absorb more than their healthy share of impact. The result is a fantastic rise in foot problems and medical specialists happy to deal with them.
The problem of high heels illuminates the interesting relation of fashion and nature. High heels, like most of our fashions, are designed to increase the sexual attractiveness of the wearer. They accomplish this by elegantly combining human artifice with the imagery of nature. When you wear high heels, which resemble and have a similar feeling to hooves, you cannot safely flex and extend your ankles. Therefore, the prime movers here have to be at the knee and, especially, the hip. As a result, walking in high heels forces one to exaggerate motions of the hip joint and the pelvis lying above it, causing (usually) male attention to be drawn to the suggestively swaying buttocks. However, since the shoes absorb virtually none of the impact of walking, smash the ball of the foot into the pavement, keep the heel in an unnaturally lifted position, causing an abnormal shortening of the whole back of the leg, and, with such rigidities induced, decrease natural circulatory flow – eventually these legs and feet become so hardened and inflexible that they lose the very attractiveness they were intended to accentuate.
The lesson of high heels – if we depend on human technology to provide for us what nature has already abundantly guaranteed – in this case sexual attractiveness – we end up creating sickness.
Motion of the ankle is the key to the health of the lower leg. The tibialis anterior, far from being the dead wooden shin of the cement-walker, can be instead sleek, juicy, powerful…positively edible! Make your client aware that the lower leg is essentially the ankle mover lifting the foot up, brining it down, and side to side. Most people think the lower leg is just there and don’t know what it does. With slow deep friction attempt to convey the sensuality, the full length, strength and the three dimensionality of the tibialis anterior and its partners in dorsiflexion (extensor hallucis longus and extensor digitorum longus).
Above, around the front and the sides of the ankle, the superficial fascia of the leg thickens to break the tendons on their way into the foot. Again our four-leggedness is underlined, as these are basically the same structures as found above the wrist – retinacula. Abnormal thickening of the retinacula of the lower leg and foot may not only create pain due to a strangulation of muscles and vessels, it may also pin down tendons whose freedom is essential for the appropriate alignment of the foot. The tibialis anterior, by pulling up on the medial cuneiform and first metatarsal, helps create the medial longitudinal arch. If it is pinned down by the retinacula, it will in effect lose the contractibility of its lower segment, because the tendon will be functionally separated from the muscle belly, which lies above the retinacula.
One famous story of Ida Rolf is of her working for full hour on just the retinacula of one foot. This shows how important she considered it in the health of the lower limb. Carefully study an illustration of the lower leg, and using it as a guide, try working on the retinacula of a client whose ankles seem to you thick or rigid. Work on and around the retinacula basically as you would on other thickening connective tissues. Use finger pads mostly there, although the flat of the fist may work well on the superior extensor retinaculum. Have the client compare the experience range of motion before and after. Sometimes the change is remarkable!
Posted on Fri, Feb 12, 2010
The scalenes are actually the uppermost of the intercostals muscles, those muscles lying between your ribs that assist inhalation and exhalation. However, big surprise, there are no ribs in the neck! Actually a number of books say the scalenes attach to the vestigial ribs of the cervical vertebrae. That is, little buds appear on the cervical vertebrae that in fish, for instance, would develop into ribs, but in humans they end up being just little bumps to which the scalene muscles attach.
Who ordinarily thinks about breathing with their neck? Yet scalenes do have a very important respiratory function. They may indeed be, next to the diaphragm, the second most important muscles of respiration. The scalenes move the ribcage from above, while the thoracic diaphragm moves it from below.
The anterior scalene runs from the side of the second cervical vertebrae down to the first rib beneath the clavicle. Because it attaches to the front of that rib, the chronic contraction of the anterior scalene is one of the muscles that pulls our head forward; in chronic head-forward posture it is useful to address this muscle among others. The medial and posterior scalenes are more along the side of the neck and therefore have more to do with tilting the head to one side or the other.
It is common in whiplash that the scalenes are injured as the head is whipped forward then forcefully back, slightly tearing some of these muscle fibers through a sudden excessive stretch.
Energetically, the scalenes can be connected with all the virtues and challenges of the neck. The head forward posture can signify sadness, self-esteem issues, reactions to recent or long-held defeats. General neck tension will also manifest in the scalenes. That tension points to all the various reasons for inhibitions or tensions people may have about expressing themselves.
Try this Massage Technique
Here is a very helpful Deep Massage fulcrum which affects the scalenes as well as the superficial posterior neck muscles.
-
Therapist: seated at the head of the table
- Client: supine
- Center yourself
Working on the left side of the scalenes, place your middle finger, assisted by your other fingers, near the origin of the sternocleidomastoid, just above the sternal end of the clavicle. Take out the looseness.
THROUGHOUT THIS TECHNIQUE IT WILL BE BETTER TO USE LESS, RATHER THAN MORE PRESSURE. HONOR THE DELICACY OF THE MUSCLES AND VESSELS HERE!
This fulcrum utilizes the active movement of the client. Ask the client to lift the chin as if looking up. This will take up the slack, stretching the anterior scalenes particularly. Now let us add additional vectors, again in a movement partnership. Ask the client to slowly turn the head to their right, as if to look over the right shoulder. As they move draw your fingers horizontally through the tissues on the left side of the neck. For this whole pass you are at the level of C6 and 7.
You may continue with your tractioning of the fascia all the way back as far as the spinous processes at the center of the neck. In this case, you will have gone considerably past the scalenes, but you will more completely address the soft tissues of the neck pulling them back and with them the head comes back more of top of the body instead of being projected out in front of it.
Now ask your client to bring their head back to center. Begin a second fulcrum, now at the level of the middle of the neck, around C3-5. Repeat each of the steps above. Finally, asking your client to return to center again, begin a third fulcrum at the level of C1-2.
You should repeat these steps on the other side - with the client turning their head to the left, drawing your fingers through the right side of the neck in three passes with movement as described above.
Posted on Tue, Jan 19, 2010
Part three of Massage and the Nervous System. (See parts two and one.)
As massage therapists we know how to get our hands on muscles and connective tissues. But now we see somehow we have to get our hands on the nervous system because otherwise it’s a bit like flipping light switches with no electricity – some action but no deeper change.
So how do we get our hands on the nervous system?
Autonomic Nervous System
The diencephalon houses among other amazing objects, the hypothalamus. The hypothalamus is the primary orienter in our lives toward pleasure and away from pain. A pea-sized structure, it nonetheless is in charge of the endocrine system and the autonomic nervous system. The autonomic nervous system is a full spectrum system which goes to glands, smooth and cardiac muscles, and other organs. It is largely responsible for our most profound reactions to the world. Its experiential spectrum inclines us to the deepest relaxations, to everyday balance, and at its most extreme, to emergency reactions.
A high level of massage therapy can affect the autonomic system in dramatic ways:
- Change the set point – most people are too highly strung and under stress. Massage, especially repeated applications, will change the “set point” of the autonomic nervous system. We slowly begin to feel that more relaxed is more our normal and preferred state rather than being more tense.
- Inhabit the full spectrum – some people have difficulty relaxing; others fully experiencing their excitement. By relieving tension from the muscles and the nervous system, massage facilitates the autonomic “range of motion” so that the person can more fluidly move from one energy state to another.
- Cultivate the fertile mid-ground – “Between living and dreaming there is a third thing.” the poet Machado wrote. Edison used to go to sleep with a rock in his hand. When he fell asleep it would drop and wake him up. He persisted until he could be almost asleep and yet not drop the rock. Why? That was the state, he found, out of which all his inventions flowed. When our unconscious and conscious minds are in communication with each other in this fertile midground of awareness, we are at our most creative.
Massage, inducing more balanced states of mind, emotion and body, allows for the creative utilization of the fertile mid-ground in problem-solving and growth.
Some Controversy
Lately, there has been some controversy over whether the energy-based approach has the same legitimacy as the orthopedic approach to massage.
“Energy” is a commonsense word we all use to describe, among other things, the nervous system and the role of emotion, mind, and electrical intelligence in our lives. We could reduce our understanding of energy to chemistry, but who would rather for example want to give up the term “love”, preferring to tell those you care about that you have a predominance of phenylethylamines in their presence? The language of energy comes closer to capturing and understanding experience, than does that of chemistry.
When we consider the critical role of energy and the nervous system, we see that the myofascial system constitutes just one part of what we need to affect as therapists. To fully support health we need to address both energy and structure.
Let us honor both of these wondrous human worlds. Let us see their unity; affirm that good science takes the whole into account, not just the part; and that good art - and massage is undoubtedly an art as well as a science – empowers peace and promotes harmony in our whole being. That touch which knows how to contact our deepest energy and structure bears the promise of a better life for one and all.
Posted on Fri, Jan 15, 2010
This article was originally published as Back to the Basics: Basics of the Back in Heartland Journal in the summer of 1984.
Our culture over-emphasizes image, appearances, "fronts." The cosmetics and the clothes we wear, even some of the psycho-spiritual trainings around are oriented especially toward the fronts we present. However, the more we focus on the front, the more we neglect backs. The more we ignore our backs, the more thoughtlessness may translate into back pain and/or cowardice, i.e. spinelessness.
Tipping the Scales Backward
The back is a little like chickens crossing roads. It's not that the chicken needs to get to the other side - it is the other side. The chicken is Side B to the front's Side A. Or is it?
Usually, we identify the back with the "backbone," the vertebral column. I once watched a dissection of a man's abdomen and was amazed - slit open the skin of the gut, remove a bit of intestine and what you see there, not deep at all below the surface of the abdomen - the front of the lumbar vertebrae! The spine runs up through the middle of the body. This is an incredibly important corrective to the usual misconception - we ordinarily then the backbone is located at the surface of the back. The reason for this is that the rational mind, naive for all its hight-powered reason, sing those little protrusions running down the middle of the back, concludes those must be the backbone. Actually, they are just the tips of bony tails extending back a considerable distance from the cylindrical bodies of the vertebrae. If the main weight-bearing parts of the spine were all the way in the back, we would be imbalanced, under constant strain not to fall over backward. Now, if you think about it, it's obvious - the backbone's gotta be running up through the center of the body just as the centrality of the main pole in circus tent assures the symmetry, grace and lift of the whole structure.
Leonardo's famous sketch underscores this point. For me it is fascination lies in his depiction of the human as a five-limbed creature, each limb radiating out from the center ("hara" or "tan tein" in the East). Each limb, in it turn, is a long series of bones ending with a structure used at varying stages of evolution for grasping and/or expression. The leg bones end with feet, the arm bones with hands, and the back bones with the head. With this in mind, begin to feel the evolved gesture of the spine - it's really our fifth limb thrusting up through the center of our being, elevating the head so that we may survey the distance from the highest possible vantage point.
The skeletal structure of the back consists of the spinal column and the ribcage. The rear of the ribcage obviously underlies most of the back's surface, but that too seldom is recognized as people identify ribs and notice their movement in the front of the body, but rarely think about or feel the back of the ribcage and its graceful response to breathing.
Five Divisions of the Spine
- The coccyx or tailbone.
- The sacrum, five fused vertebrae lying between the rear wings or ilia of the pelvis.
- The five lumbar vertebrae, running through the center of the waist.
- The 12 thorasic vertebrae, each of which has joints with a rib to either side.
- The seven cervical vertebrae or neck ones.
Although our cervical as well as lumbar vertebrae have no ribs attaching to them now they did at the fishy point of evolution. Therefore these areas are the most free, but by the same token, the most open to distortion. Through injury, postural ignorance or chronic muscle tension, the cervical and/or lumbar vertebrae will often become compressed excessively curved or twisted.
Owning Your Back
To re-own the freedom of your back, remember to appreciate with your self-image and in your movement:
- Your rear ribcage rising and falling, expanding and contracting with each inhale and exhale:
- The beautiful open span of the waist between the ribcage and the pelvis:
- Your neck as a continuation of the back bone gently rising up through he body and up through the middle of your head.
Truly, nature displays her genius in the way our backs work if we will move from malignant neglect to benign appreciation, the back will become a source of beauty, pleasure and strength in our lives.
Get back to your back: Randy Cummins will be teaching a massage continuing education class Thai-Shiatsu Techniques for the Low Back and Hip in February 2010.
Posted on Tue, Jan 12, 2010
Part two of Massage and the Nervous System. (See part one.)
As massage therapists we know how to get our hands on muscles and connective tissues. But now we see somehow we have to get our hands on the nervous system because otherwise it’s a bit like flipping light switches with no electricity – some action but no deeper change.
So how do we get our hands on the nervous system?
Diencephalon
This area in the center of the brain is the seat of emotion, memory, and our “drives”. It is, in spite of the vanity of the cerebral cortex’s verbal narrations, largely what moves us in our lives. The diencephalon lives deeper than words - housing hunger, thirst, anger, sexual desire, sleep-wake cycle, anxiety, all our memories, our deepest convictions, desires, our pleasure, our pain, and our dreams.
The diencephalon is the residence of the “unconscious” of which the great psychotherapist Milton Erickson provocatively said, “The conscious mind is brilliant but the unconscious mind is a hell of a lot smarter.”
The first sense to develop in the embryo is the sense of touch. Touch forms our earliest sensory experiences of the world - these in turn shape the unconscious world of the diencephalon. So, the art and science of touch therapy, at its best, is an ideal medium for communicating with the diencephalon.
Moishe Feldenkrais said a person can’t change without new experience. Expert massage and bodywork is new experience. Our world, initially formed by the ways we are touched, undergoes new, awakening experiences through bodywork which go immediately deeper than the conscious mind and influence our deepest beliefs, motivations, and dreams.
Cerebrum
The cerebrum gives rise to language, self-reflection, conscious thoughts, plans, decisions, and the synthesizing of imagination and logic. With the cerebrum we find the words for what we are feeling. We find support for bringing the tool of language to bear in our problem-solving. Often changes initiated by bodywork at the level of the diencephalon bubble up into cerebral, conscious rememberings, re-examined beliefs, changes of plans, and new insights about one’s body, emotion, mind and spirit.
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Posted on Fri, Oct 16, 2009
Origin: Sacrum and iliac crest of pelvis, Insertion: All ribs, transverse and spinous processes of all vertebrae up to C2; mastoid process of the temporal bone, Action: Bilateral: extension of the spine, (Excessive – lumbar and cervical lordosis; thoracic kyphosis), Unilateral: lateral flexion (Excessive – scoliosis), Antagonist: Rectus abdominis (or gravity)
The erector spinae is more a whole muscle system than a single muscle. This system arises from the sacrum and pelvis and creeps up attaching like so many vines to the spine, ribs and back of the skull. There are three tracts. The iliocostalis is the lateral tract, the awareness of which can help the client sense how broad the back actually is. Often the sense of broadness will be lost with the preoccupation born of pain toward the center of the back. The longissimus (the “longest”), the intermediate tract, attaches to the ribs and transverse processes of the vertebrae. In its uppermost portion it actually attaches to the mastoid process under the sternocliedomastoid. Awareness of the tract can therefore help on sense how very long the back is, in truth extending there are the way from the tailbone to the back of the head! The medial tract, the spinalis, attaches to the spinous processes up to the axis.
Because, in our work and postural habits, most of us lean forward with our trunks, the erector spinae are often kept in a state of chronic eccentric contraction. That is, while being lengthened as we hunch over, they must yet contract so we don’t fall forward altogether. As mentioned earlier, chronic eccentric contraction is often a source of musculo-skeletal pain as the muscle is being given a double message – let go/hold on.
Imagine the strain involved in forever trying to reel in a fish that will never give up. This is too often the predicament of the erector spinae and the other muscles of the back. Imagine a yet more unfortunate fisherman, who, after years of holding this tireless fish at bay, is finally yanked off the boat, uprooted by superior force. This is often what is occurring in lower back pain. After years of holding us up, the muscles of the back, overwhelmed finally by gravity’s tireless force, start literally to uproot via tiny tears in the muscles and connective tissues attaching to the sacrum and pelvis. At this point, if this is what is happening, toe touches, the yoga posture “the plough and such stretches will only aggravate the problem, further tearing the fibers of the lower back.
The task of the massage therapist here would be to “re-root” the spine, stroking “in” toward the spine and down toward the sacrum. This is only one possible cause of lower back pain, however. Techniques of massage, anatomical analyses and exercises must be carefully tailored for each individual problem.
Review anatomy or learn a new modality.
Posted on Fri, Sep 18, 2009
Did you know it is basically a law of structure that under compression fascia will "migrate" laterally? Think of pressing down on a beach ball. The more you press, the further out each of its color segments would get.
This is exactly what happens to the pregnant woman under the compression of the extra weight carried during pregnancy. The muscles and fascia under compression particularly in the abdomen and waist migrate laterally.
This means, particularly with back work with this special population, you may need to change the directions of some of your strokes. Particularly many therapists have the habit, which ordinarily feels good, of taking their thumbs and, starting medially near the spinous processes pushing out laterally stretching and spreading the back muscles out.
Ordinarily this can feel quite good. But in the case of pregnancy where these muscles often are already stretched beyond their normal limits and, migrating laterally, the last thing you want to do is make their lives harder.
Instead concentrate on gently pushing the muscles on the lower and mid-back in toward the center. We have a technique in Deep Massage that we teach here that is really effective with these lower back muscles.
Nine Points: Erector Spinae, Multifidus, Quadratus Lumborum
With the client side-lying with pillows supporting the "upper arm" and comfortably between the legs, and the massage therapist along client's right side, facing head (reverse direction for other side).
Gently encourage client to breathe and bring their awareness to the lumbar region. Then place your hand alongside the lateral margin of the lumbar muscles on the side of the body. It is useful to start gently focusing first into the lateral margin of iliocostalis (the lateral-most of the erector spinae muscles).
With the finger pads of your middle finger supported by the first and ring fingers (or with the middle phalange of the first finger supported by the thumb), gently melt down into the lateral margins of the lumbar muscles at three levels in the side: just under the 12th rib, halfway between the 12th rib and the iliac crest, and just above the iliac crest. Your pressure is medial-ward, toward the spine.
First work into the erector spinae, then the multifidus, and finally, the quadratus lumborum. Where you find tension, work gently into it and spend more time melting into these areas with gently curved fingers (or supported middle phalange of first finger).
Regularly check in with client regarding appropriate pressure and movement. Always err on the side of conservativeness, using too little pressure rather than too much. Less is more!
Repeat on the opposite side.
Kate Jordan's 4-day pregnancy massage certification course Bodywork for the Childbearing Year begins in October.
Posted on Sat, Aug 15, 2009
Origin: Minor: Medial border of scapula above spine, Major: Medial border of scapula below spine Insertion: Minor: C7 & T1, Major: T2 –T5 Action: Retraction of scapula (Excessive: pain between scapula) Antagonist: Serratus Anterior and Pectoralis Major
The usual mechanistic approach to rounded shoulders is to strengthen the rhomboids thus theoretically “squaring” the shoulders. This is based on following reasoning. If the shoulders are rounded, then pectoralis major must be too tight, overwhelming the rhomboids. Therefore, the rhomboids must be strengthened in order to better compete with the “pecs.” That reasoning, which implies that a problem of too much tension on one side should be solved by introducing too much tension to the other is the same mentality that keeps the arms race alive. But the real solution is, whenever possible, relieve tension, don’t just balance it out.
When you hunch over, the ribcage falls forward as do the arms and shoulder girdle. The scapulae slide around (called protracting) toward the front of the body and are restrained only by the trapezius and especially the rhomboids contracting eccentrically.
To make the life of the rhomboids easier, gently straighten the thoracic spine, relax the front of the chest, shoulders and neck. Take in a nice breath and let your wingspan increase. Now the rhomboids and pecs can balance.
Similarly I find once the client is clear on the postural solution, the best way to give him/her the experience of increased wingspan isto simultaneously work on the pecs and rhomboids.
With the client supine, place finger pads of one hand on the chest just lateral to the sternum and those of the other hand below the body just lateral to the spine around the level of T3-6. Now gently press in from both sides, “melt” when appropriate and simultaneously pull the tissues on away from the spine and sternum. Keep on melting and abducting until your top hand is pulling out just medial to the head of the humerus and your bottom hand is simultaneously abducting medial border of the scapula. Use this breathing of your client to deepen their experience of wingspan. This feels great and is a fast way to give someone atotally different experience of their shoulders.