Sports Massage / page two Musculature Said the Olympic trainer and “dean” of sports massage Jack Meagher: Professional athletes exist in a constant state of overextension of their muscular and nervous systems. Admittedly, overextension is a specific term, used imprecisely in this case, so let’s substitute it with the word “over-taxation.” The key issue, regardless, is how to settle down this over-exertion. A tight muscle – one that’s habitually over-taxed – fatigues easily, as Mosso demonstrated by 1888. Moreover, it’s susceptible to developing torsion (twisting), as described by Thomas Hendrickson in his Massage for Orthopedic Conditions (2003). Author/masseur Rich Phaigh (Athletic Massage, 1984) calls the torquing a protective mechanism from over-exertion. The torsion can now spread, leading to a protracted shortening of the muscle. At this point we can pull or tear the muscle under just normal use. It's interesting to note that from an etymological viewpoint the word 'torque' is related not only to 'twisting' but to 'torture.' Torsion affects not only muscle but ligaments and tendons as well, decreasing their water content and leading to adhesions (Hendrickson). Per Ida Rolf, a landmark educator in the field of bodywork, under-used tendon has a nasty habit of accumulating deposits that hinder free movement. By the way, did you ever notice how a stick of Twizzler licorice has built-in torsion? Try to eliminate this twist by mere stretching and you’ll see how muscle would react in similar situations. Hendrickson adds that when erector spinae muscles tense up, they tend to torque toward the midline. In addition, the hamstrings on most people are typically short and tight, also torquing toward the midline. (Any shortened muscle is a vulnerable one.) As on a rope or even a Twizzler, some degree of torsion adds to structural efficiency; over-torsion induces fibers to fray and snap. According to Phaigh, this "snap-back" is a key indicator of tightened or problematic muscle. Healthier tissue will more readily roll over onto adjacent muscle, and note that fascia does not display this snap-back characteristic. "Most people have a torqued pelvis from a very early age." – instructor John Barnes, Massage Today magazine, 3 May 2021 Shortened muscle tissue (picture tightened-up slinkies) can do no work. (From Basic Clinical Massage Therapy: Integrating Anatomy and Treatment, 2003, by James Clay.) Further, if there's a problem in any particular muscle, says Clay, the issue is always compounded since there's also a problem in its antagonist. For instance, a hammie problem will get reflected into the quads. One common hammie problem is when individual muscles of the group bind together, reducing function and increasing the risk of injury. Before working directly on the hammies, however, start by addressing the plantar (bottom) surface of the foot. Per Cash, sometimes a chronic leg, hip or back condition can be alleviated only after treating the foot problem first. Archer (2007) clarified the matter a bit when she noted that shortened muscle cannot contract with as much force as a muscle at normal resting length. Why? Because its actin-myosin bonding sites have been maxed out. Actin and myosin are motor proteins that convert chemical energy into mechanical work. An individual muscle sarcomere contains many parallel actin (thin) and myosin (thick) filaments. The 'sliding interaction' of these proteins, a theory dating back to about 1954, lies at the core of our current understanding of sarcomere shortening and muscle efficiency. In a balanced body, one that’s working efficiently, the agonist contracts while the antagonist lengthens, as any massage student is taught in their first hour of class. For example, it’s not difficult to picture the biceps contract while the triceps extend. However, says Ida Rolf, in most people the tendency is for all involved muscles to contract. The result is inhibited, therefore unbalanced and uncoordinated movement. As a corollary, she says, true strength is not a function of heavily defined musculature. It is marked by elasticity, which allows quick recuperation from our old arch-nemesis named fatigue. (Rolf's role model for elasticity and optimal performance was the great dancer from the Golden Age of movie musicals, Fred Astaire.) "The entertainment industry’s best-ever pool player . . . which is hardly surprising in view of his fantastic coordination, was Fred Astaire." – Ned Polsky, Hustlers, Beats, and Others, 1998 "The most important attribute of the legs is flexibility, not strength." – martial-arts master Toshitsugu Takamatsu (1889-1972) Now let's clear up a misunderstanding we all operate under: We tend to think of muscle as our source of strength. However, it’s actually the tendon that provides the strength, according to Synthia Andrews, instructor at the Connecticut Center for Massage Therapy and author of Acupressure & Reflexology for Dummies (2007). The muscle itself, when operating at peak efficiency she says, simply provides the elasticity needed to perform a movement. The critical point is actually the tendon/muscle junction, which in biomechanical terms is the weak point of the structure. "The Eastern front is like a house of cards. If the front is broken through at one point all the rest will collapse." – Nazi general Heinz Guderian "In critical moments even the most powerful have need of the weakest." – Aesop "As craftsmen say, even the largest stones need smaller ones to support them." – Plato "Every (army) unit that is not supported is a defeated unit." – German officer Maurice de Saxe (1696-1750) As Phaigh points out, tendons themselves don’t shorten with exercise. It’s the shortened muscle that can lead to a tendon tear at its attachment point. (Tendons themselves can actually tolerate a stretch of about five percent, per Mel Cash in 1996's Sport & Remedial Massage Therapy, though Gray's Anatomy 2005 puts the figure at around eight percent. Tendon can also dry up and become less pliable with age.) Our intent then is to lengthen the muscle that pulls on the tendon, relieving the strain at this critical way-station between muscle and tendon. (Within a tendon itself, the fibers tend to line up like "toy soldiers," per Thomas Myers in his noteworthy 2001 text Anatomy Trains.) It's also worth noting that muscle typically has a tensile strength (point at which it snaps) of about 80 pounds per square inch. Tendon averages around 13,000 pounds per square inch, a strength ratio of about 166:1 (Foran). Fascia stands somewhere in-between, one reason why surgeons thread their sutures here, not through muscle itself. Jelvéus (2011) notes that fascial connective tissues are not passive structures, citing evidence they contain contractile cells. Barnes (Massage Today, 1-14-21) has estimated the tensile strength of fascia as up to 2,000 pounds per square inch. Jack Meagher seems to concur with this viewpoint when he says that although muscle contraction is achieved easily, in most cases, it’s the fibers at the ends of muscle that have less elasticity and thus break down faster. It’s here where we concentrate our efforts. When this point breaks down, the tendon can’t carry on its job of transferring a muscle’s power over a longer distance. Per Ylinen & Cash (Sports Massage, 1988), this junction is where strains and scar tissue most commonly show up, mainly because the tissues are more compact (and tensile strength is rapidly increasing), resulting in less movement between fibers. This muscle/tendon junction, if my understanding of anatomy is correct, is also the location of a sensory apparatus whose role in sports performance has not garnered the full amount of attention it deserves. It goes by the name of Golgi tendon organ, or GTO, with all due respects to the 1964 hit single about the Pontiac of the same same by Ronnie and the Daytonas. More about the GTO when we talk about the medulla oblongata later on. Please note that not only muscle exerts contractile force. Our webwork of fascia (picture vines running up the sides of a country estate) performs this role as well, and it’s the repetitive compressions of sports massage that help keep fascia (Saran Wrap) elastic and viscous (having a thick, sticky consistency somewhere between solid and liquid, as with lava). Rolf went one step further when she said fascia itself is the organ of posture. “Nobody ever says this," she says. “All the talk is about muscles.” Myers, echoing his Rolf training, concurs by saying that muscle itself is merely "ground beef" without the surrounding and investing fascia which is arranged in planes and jumps from one depth to another. Thixotropy: the property of becoming less viscous when subjected to an external stimulus, then returning to a more viscous state over time. As an aside, Meagher has also noted that the “weak link” in the circulatory system is the point where blood filters into tissue fiber before being reintroduced into the venous system. This is the “combat zone,” he says, headquarters for nutrition and cleansing. Sports massage aims to assist this interchange at the capillary level, which is compromised by muscular and fascial compression. Per Gibbons (2014), the flow of blood through a muscle is inversely proportional to the level of contraction or activity, reaching almost zero at 50-60% of contraction. Some studies indicate that the body cannot maintain homeostasis with a sustained isometric contraction of a mere 10%. As a final thought, it was Philip Latey, author of Muscular Manifesto (1982) who said that muscles shouldn't be thought of as purely mechanical in function; they are at least as important as sensory organs. One last note about musculature for the moment: It's estimated that a muscle dehydrated by 3% loses 10% of strength and 8% of speed. Another study claims that a 2% level of dehydration leads to a performance drop of twenty percent (as mentioned in The Runner's Body, Jonathan Dugas et al., 2009). And as mentioned above, dehydration even inhibits our thinking processes. I do recall years ago my high school biology teacher who doubled as the mayor of a small town and shot pistols in competition. He once said that no shooter worth his salt would drink the diuretic of caffeine on the morning of an event. (Are thinking and musculature intertwined?) “In shooting with a young sportsman or a stranger, always allow him to precede you in getting over the fences. It may be that you save your life, or a limb.” – Dead Shot magazine, 1861 At a minimum, although some writers suggest a link between massage and the prospect of thinking with greater clarity, perhaps this outlook keeps us on safer ground: that while massage may not be capable of improving thinking per se, it helps foster the conditions under which better thinking can occur. These conditions may include enhanced creativity, concentration, imagination, and reduced resistance to novel and alternate perceptions, allowing us to entertain options not previously considered. “The trouble with life isn't that there is no answer, it's that there are so many answers.” – anthropologist Ruth Benedict (1887-1948) “A sly rabbit will have three openings to its den.” – Chinese proverb “The eternal gulf between being and idea can only be bridged by the rainbow of imagination.” – Johan Huizinga, Dutch historian “The real voyage of discovery consists not in seeking new landscapes but in having new eyes.” – French master novelist Marcel Proust “The windows need washing.” – Hattie Wyatt Caraway, first elected female U.S. senator, upon arriving at the capitol, 1931 Pre-existing imbalances If our car is out of alignment, how will it ride? For starters, it will deviate from driving along a straight line, causing the tires to wear down unevenly. No longer can we zip down the highway at 70 miles per hour with just one finger nudging the steering wheel, which itself might be vibrating. Basically there is increased resistance between tire and road, and the residual effects can be felt right up through the steering column. The analogy to the human body should not be lost on anyone reading to this point. Now remember our sports massage mantra: “Decrease resistance to movement.” “Through years of experience I have found that air offers less resistance than dirt.” – Jack Nicklaus, on why he tees his (golf) balls high “The uglier a man’s legs are, the better he plays golf – it’s almost a law.” – English writer H.G. Wells (1866-1946) “Golf is a game whose aim is to hit a very small ball into an even smaller hole, with weapons singularly ill-designed for the purpose.” – Winston Churchill “Outdoor pool sharks.” – Jim Murray, Los Angeles Times, regarding out-of-shape pro golfers Just as we know ahead of time that not all cars on the road are in alignment, we can assume pretty much the same for athletes, pros included. For instance, we simply cannot assume that muscle groups are in balance and that we’re built symmetrically (Kit Laughlin, Overcome Neck & Back Pain, 1995). We can actually take this point a step further and assume the opposite, that imbalances predictably occur throughout even a well-toned body, constantly deviating from the straight line of efficient (and aesthetically pleasing) movement. For instance, over half the population has one leg that’s a speck longer than the other. In fact, Bruce Lee’s right leg was an inch shorter than his left, a supposed detriment he deftly used to his advantage. “If the bones are not in good alignment, the muscle groups needed to achieve the action are at a mechanical disadvantage.” – dancer and choreographer Martha Myers, Dancemagazine, June 1982. (Myers was conveying a core principle of the influential dance instructor and physical therapist Irmgard Bartenieff of Berlin.) “Any time a structure departs from the balanced state, energy is wasted and efficiency is reduced.” – Dr. Joel Goldthwait et al, Body Mechanics in the Study and Treatment of Disease, 1943 “Disease is a disturbed state, not a thing or entity.” – Daniel David Palmer (1845-1913), Canadian-born "father" of chiropractic (An early way of saying that disease is a dynamic process set off by lack of equilibrium.) “If you know the point of balance, the details fall into place.” – Mencius (Meng Tzu), 4th century BC Fitness expert and author Craig Ramsay has noticed the phenomena among professional dancers. Nearly every professional has one leg that’s more flexible than the other, he observes. This leg gets favored during the high kicks of auditions and important performances, creating a structural imbalance that can lead to injury or a shortened career (Anatomy of Stretching, 2012). “You are never a hundred percent on stage, so you have to learn to dance with missing parts.” – Rudolph Nureyev, 'lord of the dance,' speaking of the debilitating effects of chronic pain and injury “I’ve never seen a company, platoon or squad take a hill at a hundred-percent strength.” – lieutenant-general Arthur Collins, Common Sense Training, 1978 Even Plato noticed the problem and its relation to back pain. Plato of course never had to replace all-season radials, but he likely noticed the eventual wear-down (wear-up?) effect upon ankles, hips and the neck, all stemming from misalignment where the rubber (or the sandal) meets the road. Per Mel Cash in 1996's Sport & Remedial Massage Therapy, nearly every musculoskeletal problem involves some type of imbalance. Gibbons (Vital Glutes, 2014), offers the same viewpoint, asserting that most any imbalance involves the gluteals. (Our back pockets typically cover three or four active trigger points each.) “Plato was a bore.” – Nietzsche “Nietzsche was stupid and abnormal.” – Tolstoy “The only normal people are the ones you don’t know very well.” – Alfred Adler, Austrian psychotherapist (1870-1937) “To be normal is the ultimate aim of the unsuccessful.” – Carl Jung, preeminent Swiss psychotherapist “Back pain is just a tension headache that has slipped down.” – John Basmajian, McMaster University, Hamilton, Ontario (In his book Muscles Alive [1962], Basmajian observed that when a nerve supplying a muscle is cut, the muscle doesn’t stop firing. What’s lost is the ability to regulate the firing and relaxation. The muscle now fires at will with less chance of settling down. Basmajian also asserted that even single muscle cells can be controlled by volition, a topic we'll explore later on.) Trainer Michael McGillicuddy, author of Massage for Sports Performance (2011), takes the discussion of pre-existing imbalances a speck further. He notes that lateral (towards the arm) rotators in the shoulder (infraspinatus, posterior delt, teres minor) are always weaker and tighter than the medial (toward the spine) ones. The medials are generally more flexible as well, and it’s this pre-existing imbalance that often contributes to pain and stiffness in the rotator cuff area. Injury here, by the way, is sometimes mislabeled as "frozen shoulder" (per Mel Cash, and some doctors prefer the term "adhesive capsulitis"). We also see imprecise language with the expression "torn rotator cuff." In general usage, rotator cuff tends to mean the entire muscle group that surrounds the scapula. However, when one speaks of "torn" rotator cuff, they usually mean the shared tendon that envelops the top of the humerus. This tendon, at least on many charts, is of a lighter color texture than the muscle it connects to and thus gives the appearance of a cuff at the end of a fancy shirt sleeve. “Guys don’t pay enough protection to the secondary muscles that take them down: rotator cuff, lower back, knee or elbow tendons for instance. They never train the little muscles that protect these areas.” – Owen McKibbin, Men’s Health Cover Model Workout, 2003. (To this day, McKibbin and his editors are probably unaware of the role of trigger points in taking athletes down.) “Gymnastics uses every single part of your body ... every little tiny muscle you never even knew.” – Shannon Miller, gymnastic gold medalist for the USA, 1996 “Deep short muscles are less powerful, but they set the tone and pattern of firing of the larger, more powerful muscles superficial to them.” – Earls & Myers, 2010 Elsewhere in the literature, and not necessarily in the literature directly attributed as that of “sports massage,” author Clair “Trigger Point” Davies notes that for the shoulder joint to operate freely, the pull of all four rotators must be in balance. A helpful way to remember the names of these four main rotators is the acronym SITS: supraspinatus, infraspinatus, teres minor and subscapularis, the last of which provides at least 50% of rotator cuff power, especially during overhead lifts, and is the strongest inward rotator of the arm. (One is grateful that the second muscle of this group is not the obscure hyoglossus.) That said, the SITS group acts primarily as a fine-tuner of movement for larger surrounding muscle such as the delts and lats. Predictably, when the SITS balance breaks down, the larger muscle is forced to pick up the slack, at their peril. Note how iconic baseball pitcher Dizzy Dean (1910-1974) ruined his arm by muscular overcompensation – substituting wrong muscles after sustaining a broken toe. “Fractured, hell. The damn thing's broken!" – Dizzy Dean Aside: Pain from the teres minor (‘little wheel’) can sometimes radiate down to the fingers. Being a small muscle the width of a pinkie finger, it is prone to strains usually located near the attachment with the upper arm, at the coracoid process. (In the front of the body the coracoid, meaning 'raven's beak,' feels more like a glorified marble.) Massage treatments usually concentrate on the belly of the teres minor, where some pain is felt, but the source is usually the attachment area (source: Ylinen/Cash, 1988). The authors also advise that when working the triceps, give more attention closer to the olecranon (elbow). These pre-existing imbalances occur elsewhere on the body as well, a rather insidious situation given the typical mistaken assumption that our physical starting point is one of symmetry. For instance, says McGillicuddy, the quads (front of leg) are a stronger group than the hamstrings (rear), so-named because of their string-like tendons. When the hammies tighten up, the grip of the quads can overwhelm them, leading to a season-shortening pull. Picture outfielder Paul O'Neill of the Yankees hobbling around like a lame duck during the 1996 World Series vs. the Atlanta Braves and you stop asking questions. “The hamstrings are essentially a pelvic muscle.” – Julian Baker, Bowen (Technique) Unravelled, 2013 “A friend gave me seats to the World Series. From where I sat, the game was just a rumor.” – comedian Henny Youngman Deviations from the quad/hammie balance can also place unequal forces upon the ball-like head of the femur as it attaches to the pelvis (weak hip flexors can do the same, as can the obturator, a hip rotator). The head is designed to conjoin centrally within the acetabulum, or socket of the hip, and the name comes from the Latin for "vinegar container." When its myofascial "support group" is pulled off-center, usually forward and upward, the lower back can report pain. As the center point of the femoral head is now pulled forward, or sometimes too deeply, we see undue pressure on the raised labrum (Latin for 'lip"), the outside rim of the vinegar container. This lip deepens the socket and creates suction around the head of the femur for greater holding power. Degeneration here (as in a labral tear) breaks down the cartilage and thus the sucking action (as it were). Per Osar in 2017, achieving "centration" and proper alignment within this socket is more advantageous than stretching. Let us also surmise that centration of the femoral head, similar to balance within the rotator cuff, can help us generate more speed in the legs without increased effort. This matter has not received its proper amount of attention in the popular massage literature, and it also applies to the humeral head of the arm. (See The Psoas Solution, 2017, by Evan Osar) "Psoas helps anchor and centrate the head of the femur in the acetabulum. When distorted, TFL and rectus femoris are forced to pick up the slack." – national-level massage instructor Peggy Lamb "He runs with almost no effort … there’s no ‘gathering of muscle’ for an extra lunge." – sports writer Grantland Rice, describing iconic football halfback Red Grange, University of Illinois, 1920s We can spend the next couple hours discussing potential spots for imbalance, but let’s assume we can find them anywhere on the body’s multitude of agonist/antagonist (ego/alter-ego, if you will) muscular relationships. For instance, the levator scapula muscle (scapula – shoulder blade – to neck / call it the 'scapula elevator') is the alter-ego to the serratus anterior (scapula to ribs / it's 'serrated' like a knife or saw, and it's sometimes been called the "boxer's muscle"). Less predictably, though noteworthy, the deltoids (delta/triangle) are the alter-ego of the gluteus maximus. (Taken from Relax Your Neck, Liberate Your Shoulders, [2000] by Eric Franklin.) To diminish tension in one is to improve functionality of the other. Ditto for the pairing of infraspinatus/subscapularis. It's also been suggested that the quad/adductor combination acts as an antagonist (co-conspirator?) to the psoas and thus may be one of the gateways to help release this harder-to-palpate – and perhaps inadvisable to palpate – latter muscle whose central role in movement cannot be underestimated. (Perhaps masseurs and instructors who dive right in and palpate a psoas in knee-jerk fashion, without considering alternative approaches, are guilty of over-estimating their overall effectiveness.) Here's a case, by the way, where psoas acts as a fixator, meaning it triangulates a paired-muscle function for greater stability. It would take the analytic skills of the proverbial rocket scientist to systematically disengage all existing muscular imbalances within the relatively short timeframe a client spends on the massage table. Fortunately we need neither the time nor the turbocharged analytic skills. The reason is that toward the end of a comprehensive and well-structured massage, the body spontaneously begins to let go of pre-existing imbalances – with minimal conscious effort on our part. We've begun to restore functionality to our feet, ankles, hips and neck, with the proprioceptive enhancements the latter aspect entails. Without addressing the neck, it should be emphasized, we're passing up the opportunity to hone in on one of our primary control centers of movement. Also, we're now seeing but one of several physical phenomena associated with the "hidden reserves" school of thought. "Treatment consists of stimulating the dormant vital energy in the patient and restoring its circulation to normal." – Ryokyu Endo, Tao Shiatsu, 1995 "This art of resting the mind – and the power of dismissing it from all care and worry – is probably one of the secrets of energy in our great men." – Captain J.A. Hadfield, The Psychology of Power, 1933 "In every culture and in every medical tradition before ours, healing was accomplished by moving energy." – Hungarian physiologist Albert Szent-Györgyi, Nobel Prize winner, 1937 The ramifications of restoring muscular balance carries a more urgent significance than mere physical coordination, says Rolf. It is the outward and visible sign that vital internal communications are functioning freely, and communication of this variety is one of the key indicators of that elusive state known as well-being. Communication in this sense, says Rolf, refers to the actual flow of body fluids in their role of transmitting metabolic and hormonal substances, as well as to the free transmission of nervous currents. An imbalanced state, on the other hand, heads these transmissions off at the pass. However, as balance is restored, work is now being performed with less effort, with less drain on the body’s energy, less fatigue. (Taken from the journal article Structural Integration [1963] by Rolf.) "Turn yourself into a material as soft as putty, and then just sort of slop the club-head through. You’ll hit much further and with less effort." – Johnny Miller, golf hall-of-famer and TV analyst "Don’t try to hit the ball far. Instead, develop a feeling that the ball is going to go a long way without your really trying." – golfer Byron Nelson, winner of the Congressional Gold Medal Rolf's assertions are backed up by no less than the renowned Dr. Hans Selye, whose work (along with Dr. Leon Chaitow and Deane Juhan) ranks among the most cited in the field of bodywork. Says Selye, muscular contraction itself is influenced by these hormone-like substances that differ from the hormones produced by the endocrine system. These substances are released at the minute end-points of each nerve branch. This observation allowed Selye to assert that even nerves themselves act through hormones (The Stress of Life, 1956). "Stress, in addition to being itself and the result of itself, is also the cause of itself." – Hans Selye A definition of stress: Anything that requires a muscle to adapt to it. – Hans Selye "Half the battle with stress is that you think you’re under stress." – Sir Ian Botham, Cricket Hall of Fame "What stress really does is deplete your willpower." – psychologist Roy Baumeister (who may have meant to say 'sabotage your ki flow and intention') This end-result of performing more work with less expenditure of energy is our leverage tool, or gateway toward the realm of enhanced and superior performance. This is a land that weekend warriors shall never have the privilege of visiting, except for fleeting glimpses at odd times. Rarely will they experience the pleasure of driving to their next event with but one finger nudging the steering wheel. “I'm going cheap.” – Depeche Mode, Behind the Wheel Oscillation / pulsation Just as acupressure charts can mislead us into thinking we know precisely where pressure points are located, anatomy charts can seduce us into thinking of muscle as a rather static entity that does little more than stretch or contract. Per Myers (Anatomy Trains), divisions between individual muscles are frequently indiscernable, except on artificial charts. Though we're trained to think in terms of individual muscles and their attachments, the body itself doesn’t see things this way. Seeing muscles as isolated discrete units is simply a holdover, he says, from the days of knives and scalpels carving up cadavers. “When a magician lets you notice something on your own, his lie becomes impenetrable." – Teller (magician) “The mind is let on, step by step, to defeat its own logic.” – Dai Vernon, Canadian magician “The behavior of an isolated part is, in general, different from its behavior within the context of the whole.” – Ludwig von Bertalanffy (1901-1972), Austria, developer of general systems theory “How can a part know the whole?” – Blaise Pascal, French mathematician (1623-1662) “The principles governing the behavior of systems are not widely understood.” – Jay Wright Forrester, 'founder' of system dynamics, MIT scientist “It is not so much that the cells make the plant. It is rather that the plant makes the cells.” – Hienrich Anton de Bary, German botanist/physician (1831-88) “Not a sentence or a word is independent of the circumstances under which it is uttered.” – Alfred North Whitehead, English philosopher/mathematician (1861-1947) Moreover, muscle can take on a mind of its own, twisting and over-torquing, gluing itself to bone, tearing, and breaking down. Not only is it imbalanced on most bodies, an aspect that charts lack the capacity to reveal, it is never completely at rest. It is optimally in a constant state of vibration, of oscillation, ready to spring into action at a moment’s notice. Not just muscle but the body as a whole exists in a constant state of flux, namely expansion and contraction, a point we should touch upon before discussing certain muscle groups in and of themselves. “Constant rhythmical movement is necessary to health and harmony. Much ill health is due to emotional congestion." – Emmet Fox, ‘New Thought’ leader (1886-1951) “My emotional tendencies enter into my neuromuscular calculations just as surely as do physical forces." – Deane Juhan, Job's Body, 1987/2003 “I believe that the physical is the geography of the being." – Louise Nevelson, Ukrainian-American sculptor (1899-1988) “Grace is to the body what clear thinking is to the mind." – Rochefoucauld, French man of letters (1613-1680) “Rhythm is as much a part of our structure as our flesh and bones." – psychiatrist Bertram S. Brown, National Institute of Mental Health, 1970 If this state of oscillation (and its cousin, pulsation) is disturbed, if our body engine is revving either too high or too low, the equilibrium of the body begins to break down. Remember that physical equilibrium is the counterpart of mental equanimity – a clear and steady mind – as expressed by the ancient Stoic concept of apatheia, a loosening from the shackles of emotion. Any distruption to our thermostat sets us up for a state of nervous anxiety, which in the clutch can express itself as choking (or losing the sale), not to mention the activation of trigger points in the diaphragm. We now see an additional attribute of choking: a resistance to or disruption of this normal flow of expansion and contraction – oscillation and pulsation – much like we see in a jellyfish. (Earls/Myers use the jellyfish analogy in describing movement of the diaphragm.) “I am not optimistic or pessimistic. I feel that optimism and pessimism are very unbalanced. I am a very hard engineer. I am a mechanic. I am a sailor. I am an air pilot. I don't tell people I can get you across the ocean with my ship unless I know what I'm talking about.” – Buckminster Fuller (Scholars have lost sleep trying to define 'apatheia', and probably not one of them is truly conversant with Fuller, who just nailed the definition while they keep struggling.) "The place where optimism most flourishes is the lunatic asylum." – Havelock Ellis, English physician/scholar (1859-1939) "Optimism and stupidity are nearly synonymous." – navy admiral Hyman Rickover (1900-1986) "The gods love the sober-minded." – Sophocles (whose work was on a par with Aristophanes, Euripides, and Testicles) "There’s a good example of testicle fortitude." – pitcher Dizzy Dean (1910-74), regarding a daring outfield catch In an individual who performs at sub-par levels, the normal function of pulsation is more or less restricted, not just in individual muscle groups but throughout the entire body. As a result energetic currents, possibly including sensorimotor loops that process physical cues to the brain and back again, to borrow the words of Led Zeppelin, become dazed and confused. This phenomena was noticed as far back as the 1700s by the German Anton Mesmer (whose name gave us the word ‘mesmerize’) who concluded that muscular restrictions impeded the pulsatile flow of the body’s “life force,” a.k.a. ki. One area in particular that breaks down fast is the calves, which can feel like wooden blocks rather than elastic conduits of vital fluids and energies. These breakdowns, wherever they occur, impede the body's ability to take localized strains and distribute them to the point of diminishment. When localized, say in the case of whiplash, the tension may remain in the neck for a few weeks, after which it may spread to the spine. Within a few months we're seeing stress and strain throughout the entire body, a scenario we could have prevented if our blockages were addressed earlier (Anatomy Trains, 2001, by Thomas Myers). Note that four out of five whiplash patients exhibit trigger points (kinky slinkies) in their scalenes (per Davies, who used the apt analogy of the scalenes forming a veritable skirt around the neck). “Protecting under-performers always backfires.” – Jack Welch, former chairman of General Electric To borrow the famous Wilhelm Reich example: Pinch a worm in the middle of its body. You are now interrupting its energetic flow. The back end of the worm now moves side to side instead of up and down. Meanwhile, the head pulls in (shades of the startle pattern). Humans would act the same if this were done to them, and it’s no coincidence that we express the word “No” by shaking our heads sideways – contrary to the vertical direction of the energetic flow or “life force.” We think to ourselves, “I can’t do this.” In this situation the pelvic area lacks vitality; its muscles lose their normal levels of pulsation, the body becomes addled, our point of view is negative. (If Elvis were an adjective, would it be Elvic, repudiating nay-sayers who called him Elvis the Pelvis?) “I never looked at the consequences of missing a big shot.... When you think about the consequences you always think of a negative result.” – Michael Jordan, Chicago Bulls “I never visualize the possibility of anybody getting me out.” – Sir Don Bradman, Australian cricketer “My philosophy is never start talking about 'if,' 'and,' 'but' or the past, because 90 percent of what follows will be negative.” – hockey hall-of-famer Gordie Howe, originally from Saskatchewan, Canada “Talk of the wolf and his tail appears.” – Dutch proverb “If you expect a bad lie, for even one second, the gods will know it and give you ... a bad lie.” – pro golfer Michelle Wie “Strictly avoid frightening ideas.” – Aulus Cornelius Celsus, Roman medical writer, first century AD “On the course, what is feared is like a magnet. Water, bunkers, trees, ravines, high grass – whatever you fear turns magnetic.” – pro golfer Margaret ‘Wiffi’ Smith “Of all the hazards, the worst is fear.” – golf great Sam Snead “I am not a crook.” – Richard Nixon One day out on the links, Yogi Berra predicted his golf ball would land in the water. A friend said, "Don't be like that, think positively." Yogi replied, "OK, I'm positive my shot is going into the water." “Stop being afraid of what could go wrong and start being positive about what can go right.” – sales trainer/author Zig Ziglar According to Reich and others, the path back to normal functioning begins with dissolving our attitude of holding back. A successful plan of attack appears to be two-folded: 1) Slow things down a moment to gather ourselves (move backwards in order to move forward). Working slowly sends an unspoken message to the body that it's OK to chill out. Words in themselves lack the capacity to achieve this result. If we slow things down physically, we can tap into slower pulsations or undulations, characteristic of the more efficacious alpha state, rather than the rapid contractions (beta/hyper state) we’re accustomed to. Said the young wolf to the father wolf, upon seeing a herd of sheep down in the valley: “Let’s run down and get ourselves one!” Said the father to the son, “Let’s walk down and get ‘em all.” "To drive a racing car, you must be conservative. You cannot be a radical, someone who’s given to spontaneity or enthusiasms." – Jackie Stewart, the 'Flying Scot' "Bold objectives require conservative engineering." – James Webb, NASA director for whom the space telescope is named "To win a race in the slowest possible time." – Australian auto racer Sir Jack Brabham "When I look slow, I am smooth and going fast." – Alain Prost, French Formula One champ "The really good drivers win races in the slowest times, not the quickest." – Alan Jones, Formula One champ, Melbourne "Slow motion gets you there faster." – composer and bandleader Hoagy Carmichael "One must practice slowly, then more slowly, and finally ... slowly." – Camille Saint-Saëns, French composer  (1835-1921) 2) Once we collect ourselves, we go for it in spirit. Norman Vincent Peale, quoting the Canadian coach Ace Percival, has noticed that most athletes, to some degree or other, are "holdouts." They always keep something in reserve and don't invest themselves 100% in competition. Red Barber, the classic-era baseball announcer who called thousands of games in his career, said he had known few athletes who totally give themselves, which might be defined as totally surrendering ourselves to our goals and commitments. Said Peale, throw your heart into a situation and the body will follow, including, one would assume, reestablished levels of muscular pulsation and oscillation. "Why are you stingy with yourselves? Why are you holding back?" – George Balanchine, “father of American ballet,” born in St. Petersburg "Sometimes a man imagines that he will lose himself if he gives himself, and keep himself if he hides himself. But the contrary takes place with terrible exactitude." – Ernest Hello (1828-1885), French writer on religion and philosophy "Photographers stop photographing a subject too soon before they have exhausted the possibilities." – photographer Dorothea Lange, 1895-1965 "We are oscillatory beings in an oscillatory universe . . . linearity leads to dysfunction and death." – Jim Loehr and Tony Schwartz, The Power of Full Engagement (2003) "Fixation is the way to death. Fluidity is the way to life." – sword master Miyamoto Musashi (1584-1645) "Life – God – in its essence is vibration." – Edgar Cayce, American clairvoyant (1877-1945) "The eternal is omni-embracing and permeative; the temporal is linear." – Buckminster Fuller Psoas (slow-ass minus the L): the grandaddy of movement One of the key muscles to lose its ability to oscillate is the lesser-known psoas, whose name comes from the Greek for “loin.” The psoas, illustrated atop page one, extends from the discs and vertebra of the lower back (T12 to L5) down to the inner part of the hip region, attaching to the speedbump known as the lesser trochanter (from the Greek for “to run”). Note that roughly 40% of the population has what’s termed a “psoas minor,” which for our purposes today can be lumped under the general psoas (or iliopsoas region) as a whole. In various traditions, the physical location of the psoas is often considered "sacred space." Ditto, by the way, for the nearby and aptly named sacrum. Someday perhaps we'll take this space one step further and discover an etymological connection between the word 'mystic' and the Greek mys, which is the root of our word 'muscle.' The psoas saga begins here: In the average person, the psoas tends to be structurally "retired," glued to the pelvic brim, shortened, throwing the glutes out of wack. A stick of pepperoni would now do a better job, and unfortunately this is what a languishing psoas resembles, minus the benefit of being displayed beneath the deli counter for all to admire. Compounding the situation is the fact that traditional massage gives the psoas superficial attention at best. Our job therefore is to give it systematic treatment on a regular basis, which in turn takes pressure off the legs when it comes to forward movement. (If you cover your ears and pay enough attention, you can actually hear the crepitant sounds of a stuck psoas.) We assume that our legs alone provide this movement, and this is a safe assumption to rest upon if we’re to remain content with lower levels of performance. However, in the walk of a balanced body, movement is actually initiated in the trunk, as most any master of the martial arts will attest, if only by his actions. Movement, as Rolf has demonstrated, is then transmitted to the legs through the medium of the psoas, the muscle that unifies torso and thigh. The legs merely support and follow. We cannot underestimate the importance of this statement, one that defies conventional understanding. “Without the trunk you’re just swinging with your arms and hands.” – golf great Bobby Jones, On Golf (paraphrased), 1966 “Runners don’t run with their legs, they run ON their legs. In reality they run with their arms.” – Percy Cerutti, Olympic track coach from Australia “A man who has attained mastery of an art reveals it in his every action.” – samurai maxim “The problem with assumptions is that we believe they are the truth.” – Don Miguel Ruiz, author of The Four Agreements “You cannot question an assumption you do not know you have made.” – Buckminster Fuller “The world will persist in exhibiting before you what you persist in affirming the world is.” – Emma Curtis Hopkins, ‘New Thought’ writer (1849-1925) Rolf's student Thomas Myers, whose work is mentioned throughout this page, goes so far as to suggest that the legs actually begin at the T12/L1 junction, where the psoas originates, near the solar plexus. To this day, Myers adds, the full role of the psoas resists complete understanding and meets with professional disagreement on several fronts. (See Myers' online series of articles entitled "The Opinionated Psoas" found in Massage and Bodywork magazine during 2001. This series marked a refreshing change from much of the downright uninformed but smug disinformation about the psoas that's frequently found in the popular literature.) Rolf adds that “aberrative” body patterns in the area of the groin always involve the psoas, which blends fascially into the pelvic floor. This fact also illustrates the importance of balance between the psoas and rectus abdominis, sometimes called our “6-pack.” Adds psychologist Ken Dychtwald, author of Bodymind (1986 edition), the psoas muscle is crucial to pelvic movement and body balance. Bodywork writer Jo Ann Staugaard-Jones (The Vital Psoas Muscle, 2012), calls the 16-inch-long psoas the most important skeletal muscle in the body, given that it’s the only muscle that connects the spine to the legs. She adds that psoas plays the role of a keystone in an arch and she also makes the key observation that it torques, a factor generally not indicated on charts. Perhaps that's one reason some people call it "the merry prankster," and it would certainly take a prankster to pop the top stone out of an arch and watch the entire structure tumble down. Early in her book, Staugaard-Jones makes a key point that we'll run with until better evidence presents itself: we don't strengthen or stretch the psoas; we free it. "There are no straight lines in nature." – Buckminster Fuller "Nature creates curved lines while humans create straight ones." – Hideki Yukawa, Nobel Prize winner in physics, 1949 "The straight line belongs to man, the curved line belongs to God." – Antoni Gaudí, Spanish architect (1852-1926) "Hence no force, however great, can stretch a cord, however fine, into a horizontal line which is accurately straight; there will always be bending downwards." (And maybe some torquing?) – William Whewell, Elementary Treatise on Mechanics (1819) In the forward to Staugaard's book, Dr. Gary Mascilak of New Jersey makes another noteworthy observation: psoas is not just a hip flexor but a stabilizer for body movement. (Julian Baker, 2013, makes the same point, perhaps borrowing from Mascilak.) On a plane or ship, a stabilizer, particularly the tail section, reduces roll or sway. On the human body, we can therefore see its role in reducing herky-jerky movement (a prime indicator of physical & emotional dysfunction). As a stabilizer, psoas can help keep us steady on our feet, but just as important, we can see implications toward our developing definition of well-being: steady on our feet translates into steadfast in our minds. "You can’t do nothing without good footwork." – Peter Westbrook, Olympic fencer "People pay so much attention to hitting the ball, when movement (including footwork) is really the key." – tennis great Martina Navratilova "Move with your feet, the hands will follow." – martial-arts master Masaaki Hatsumi "The power in your punch comes from the power in your ankles." – Joe Lewis, karate champ In this regard, psoas can be seen as THE crucial overlooked muscle that helps clear our path toward that elusive state known as well-being, which virtually no one on the planet can adequately define, often because they neglect the essential physical correlates. Mascilak, by the way, also calls the psoas “the front butt.” "It is probably through its support of the autonomic lumbar plexus that the psoas exerts its major impact. Through the viscera innervated by this plexus, this muscle can exert a vital influence on bodily well-being." – Ida Rolf "This is the mark of a really admirable man: steadfastness in the face of trouble." – Beethoven "The real test of a bridge player isn't in keeping out of trouble, but in escaping once he's in." – Alfred Sheinwold, syndicated bridge columnist "Problems are the price of progress. Don't bring me anything but trouble. Good news weakens me." – inventor Charles Kettering (1876-1958) "Invention, it must be humbly admitted, does not consist in creating out of void, but out of chaos." – Mary Wollstonecraft Shelley, Frankenstein, 1818 The hip flexors, particularly the psoas/iliopsoas, tend to be one of the tightest muscle groups in our body. When they become permanently tight, we risk excessive curve in the lower spine. This leads to a tight lower back and it weakens and disengages the abdominals. Some even claim the psoas is responsible for half of all back pain. When the psoas is tight, some people will also report a stitching pain around the inguinal ligament in the crotch area. (As discussed by Dr. James Mally of California in his video entitled Sports Massage, released around 1996.) Carl Dubitsky, author of 1997's Bodywork Shiatsu, offers a slightly different take toward a similar outcome: A dysfunctional psoas, he claims, can sponsor overdeveloped quads and shortened hammies that develop in compensatory fashion. This leads to what he terms "swayback" – lordosis – and the chronic low back pain that it can present. Meanwhile, the rest of us will reserve the term swayback for horses and we'll pay greater respect to Earls' assertion that the hammies are virtually continuous with the erector spinaes. (When's the last time your coach told you this?) The word 'coach' was once a slang term at Oxford University in the mid-1800s. It described a tutor who "carried" a student through an exam, just as a rail coach or horse coach carries a traveller from point A to point B. "I can’t tell who’s leading – it’s either Oxford or Cambridge." – John Snagge, calling the Oxford/Cambridge boat race, 1949 "Getting to number-one in the world without a coach is highly unlikely." – Jim Courier, International Tennis Hall of Fame Along with piriformis (the arch-enemy of sciatica sufferers), psoas is among the first muscles to go out of alignment in our body, and it's among the last to regain it (Fascial Release for Structural Balance, 2010, by Earls & Myers). Perhaps someday masseurs can get side jobs at the neighborhood repair shop performing auto alignments (which address suspension systems, not the tires themselves, and let's not let the analogy escape us). After these masseurs-turned-grease-monkeys take the wobble out of a couple cars, then perhaps they can return to their massage tables with a keener understanding of human non-alignment, which may well be centered in the PC muscle, a matter we'll get to soon. As a side note, the psoas can behave at times as if it were an internal organ. It even reproduces the pain of gallbladder disease. So says Dr. Leon Chaitow, one of the seminal figures in the field of bodywork (Soft Tissue Manipulation, 1988). To help rescue the psoas from its “glued” stance, we don’t want to work it directly, that is by probing medial to the ASIS, or front hip bone. Although we may locate a trigger point or two, this approach does not adequately address the length and breadth of this muscle unit. Instead, let’s work the psoas indirectly with a PNF stretch. The acronym stands for proprioceptive neuromuscular facilitation, a technique that does not enjoy universal accolades among the bodywork community, by the way. The doubters (devil's advocates?) include Travell & Simons, Chaitow, and Davies, who calls the term "pretentious" and the practice "needlessly complex." Robert McAtee (Facilitated Stretching, 1993) suggests that the potential palaver known as PNF succeeds no better than pure stretching, which may be a more effective approach. Davies adds that PNF, in our haste and impatience for quick results, can actually increase the level of contraction and induce cramping. Dr. James Mally of California, a leader in sports massage training, is however at last check still a strong advocate. “In my sport, the quick are too often listed among the dead.” – Jackie Stewart, Formula One racer “He who goes the oftenest 'round Cape Horn goes the most circumspectly.” – novelist Herman Melville “Do not always be thinking of attack! Moves that safeguard your position are often far more prudent.” – Danish chess grandmaster Aron Nimzowitsch (1886-1935) “I could have pushed hard and attacked, but then I’d have a good chance of making a mistake.” – Alain Prost, Formula One champ from France “Angels never attack, as infernal (devilish) spirits do. Angels only ward off and defend.” – Emanuel Swedenborg (1688-1772), Swedish scientist/philosopher “Our defense is made to neutralize aggression.” – Hélio Gracie, Brazilian martial artist and instructor A PNF movement, it is claimed, essentially fatigues a muscle in strategic fashion. Some would even say it helps "fool" a muscle into relaxing its grip. Note that a PNF is not simply a matter of moving and limbering up muscle. It goes much deeper, into the realm of redefining neurological processes (per national-level massage instructor Art Riggs). Per Chaitow, PNF was originally developed for stroke victims and was later discovered helpful for children with cerebral palsy. [For the record, PNF was originally developed by Dr. Herman Kabat of New York (1913-1995) as a method for stroke rehab. Kabat built upon the findings of Charles Sherrington (1857-1952), a Nobel laureate.] When tense, muscle spindles conspire to send a message to the central nervous system, saying "keep me in check until the cows come home." However, muscle spindles work in tandem with the local field marshal known as the GTO (Golgi tendon organ), whose assignment is to issue the "OK to relax" signal when stimulated. When we apply an isometric contraction, using up to 50% of the client's muscle strength, we're "waking up" the GTO by encouraging more motor units to fire. It takes about 10 to 12 seconds to wake up the GTOs in this fashion, whose "relax" message is now taken more seriously than the pleas for sustained contraction. It may sound devious and underhanded, but it produces results. Although GTOs can be scattered throughout the length of a muscle, most of these proprioceptors are found either in tendons or at musculo-tendinous junctions (Archer 2007). Followed up by an assisted contraction of a muscle, it’s not unusual to regain 10% or more of stretch capacity during a single session. The ability of our legs to propel our body forward is now enhanced to a commensurate degree. According to Liz Koch, author of The Psoas Book, our ability to generate speed is now enhanced through relaxation rather than our customary exertion, which merely generates more tension. Previous to this moment, the pelvis and leg tended to move as one cumbersome unit. We can also see a similar phenomena at work in the neck. When properly loosened and balanced, the head is no longer controlled by superficial muscles such as the SCM (Rolf). Rotation is now determined by deeper muscle such as splenius capitus. (In general, aren't we aiming across the board to transfer movement to deeper muscle and let the superficial ones act as fine-tuners of motion? Remember a fundamental principle: Speed radiates from core to periphery.) “It's not the size of the bat that gets home runs, it's the speed with which you can swing it.” – Stan Musial, St. Louis Cardinals “Many conditioning programs emphasize addressing superficial muscles at the expense of the deeper ones.” – Evan Osar, The Psoas Solution (2017) “Movement must be initiated internally with the intrinsic muscles.” – Ida Rolf “After several years of training, students have responded in shock: 'You mean those are the muscles I should have been using? I can't even feel them!' ” – dancer and choreographer Martha Myers, Dancemagazine, June 1982 As yet another side note, the indirect route is often the only effective means of reaching well-protected and relatively inaccessible muscle such as lateral rotators in the hip. One such indirect route is the common knee-to-chest stretch, followed by rotations. Back to the psoas, Cash says another indirect route to this barely accessible psoas is through working the quadratus lumborum, named not because they're square but rather are squared off at the ilium attachment point. (Meanwhile, don't forget the earlier suggestion that the adductor/quad combo can act as an antagonist to psoas, qualifying this spot as a possible gateway toward psoas release.) Chaitow suggests another indirect route, namely through treating the thoraco-lumbars, which in this case we'll read to mean the spinae erectors (Muscle Energy Techniques, 1996). Cash, probably influenced in this regard by Rolf, adds that postural imbalances almost always involve the psoas. Whenever dealing with pain in the lower back or hip, always place the iliopsoas on your list of suspects. The 'ilio' portion of iliopsoas, namely the iliacus, is a triangular inner-hip muscle that functions in many ways like the subscapularis beneath the shoulder blade (Myers). Its fascial fibers can easily weave into those of the psoas, reducing their interdependence. “If this stone won’t budge at present and is wedged in, move some of the other stones around it.” – Austrian philosopher Ludwig Wittgenstein (1889-1951) “The most effective indirect approach is one that lures or startles the opponent into a false move.” – Sir Basil Liddell Hart, military theorist “Where you think the pain is, the problem is not.” – Ida Rolf “Thank you, sir. May I have another?” – Animal House To help protect the lower back from excessive strain, we can ask our partner, while facing up, to bend and hold their opposite leg toward their chest. The most simple maneuver among a couple possibilities is to then cup our hands over the ankle and ask our partner to press the leg up, against our resistance, for just a few moments. The upward press need not be strenuous nor lengthy. Now let’s bend this knee upward and toward the chest, performing what’s called a passive (aka ‘assisted’) contraction. We can then apply one more PNF (I go three to five seconds). If you’re saying to yourself that what we’re describing here is “reciprocal inhibition,” remember that such a technique is yet another form of PNF. Trainer/author John Gibbons (2014) reminds us that reciprocal inhibition is currently considered less powerful than the contractions of post-isometric relaxation (PIR). PIR he says is usually the "technique of choice" for muscles that are classified as short and tight. Traumatized and injured muscle, it should be noted, is more often short and tight rather than overstretched, per osteopathic physician Lawrence Jones. By the way, author Liz Koch of the so-so Psoas Book describes a similar loosening technique for the psoas, minus the PNF aspect. She advises raising the foot/leg no more than three to five inches. This simple sequence, designed to help unglue the psoas and coax it out of premature retirement, can be the most productive few moments of a sports massage session. “The easiest solutions are often tried last.” – heard on the street “It is the mark of a good action that it appears inevitable in retrospect.” – Scottish author Robert Louis Stevenson (1850-1894) “When I have finished, if the solution is not beautiful, I know it is wrong.” – Buckminster Fuller Says Mally, PNFs are the fastest way to increase flexibility. They can be applied to adductors (which help pull our thighs back inward), placing our partner in the familiar frog-leg position of yoga. Our partner (or victim, as the case may be), then simply pulls their legs together against our resistance. For the piriformis, we place our client's foot on the table on the opposite side of the other leg. We can now apply a crossover stretch (for instance, moving the right knee toward the left edge of the table) before asking our guinea pig to press back against our resistance. This movement works all rotators, by the way, or as Rolf expressed it, "so-called" rotators because of their multiplicity of function. We now "jiggle and shake" the muscle to help "re-pattern" it, says Malley. As expressed by Victoria Jordan Stone in 2007's Complete Idiot’s Guide to Massage (Illustrated), a small text that's not especially informative, vibrations help "confuse" musculature in a positive direction (as we aim toward the null point). Phaigh calls this shake-rattle-roll "jostling," designed to help break down the muscle's protective reflex response (myotatic stretch reflex), which appears related to the well-documented and defensive startle pattern, a phenomena we'll discuss later on this page. The myotatic stretch reflex describes our natural tendency to tighten or contract a muscle when touched (more specifically, a spindle when stretched). When this happens, the sheath of the muscle gets the main benefit of the massage, says Phaigh – at the expense of the muscle itself which responds more favorably to an unforced demeanor. “A genuine smile usually means a genuine hand; a forced smile is a bluff.” – poker champ/author Mike Caro “Behind the smile there’s a hidden knife.” – Chinese proverb “The more hidden the venom the more dangerous it is.” – Margaret de Valois, Queen of France (1553-1615) “To the tennis court: and there saw the King play at tennis; but to see how the King’s play was extolled, without any cause at all, was a loathsome sight.” – diary entry of Samuel Pepys, 1664 “One should always play fairly when one has the winning cards.” – Oscar Wilde Although (according to Lamp & Benjamin) some studies have raised serious questions whether PNFs are more effective than static stretching, we can at a minimum apply PNFs with high precision. Obviously, we'll never apply excessive force during a stretch, particularly during times of muscle cramp. Regarding any befuddlement about the alphabet soup of PNF vs. MET, or muscle energy technique, MET is simply a broader definition meaning the isometric (tension with minimal movement) contraction of muscle against resistance. Its primary purpose is to facilitate range of motion (Gibbons, 2014), and it carries few contra-indications when applied without recklessness. Jelvéus makes a similar point when he says it's "virtually impossible" to injure or traumatize a client using positional release techniques (PRT). Instructor Archer (2007), it should be noted, mentions that the common factors among the various NMR (neuromuscular release) techniques easily outweigh their differences. Static stretching can often fire off protective anti-stretch reflexes, and strengthening exercises can leave muscle weaker: shortened fibers get shorter and over-stretched ones get longer. However, stretching against resistance helps pull over-stretched sarcomeres back together while pulling shortened ones apart. – Schifflett 2011, as cited in Starlanyl 2013 (Starling’s Law suggests that optimal muscle firing depends upon a neutral/optimal spacing between sarcomeres – neither too wide nor narrow. The concept was posited by the eminent English physiologist Ernest Starling (1866-1927). It should appear self-evident that neither stretching in itself nor pumping iron are effective gateways toward this dynamic-neutral of sorts.) An MET, first developed in 1948 by an osteopath named Fred Mitchell, typically calls upon the athlete to apply about 20% to 30% force against resistance. This amount is relatively benign, and Chaitow acknowledges this lower level of force may fail to activate a necessary threshold of fibers housing a trigger point. (This point even helps call into question the very justification for using METs as the primary line of attack vs. TPs, but we'll save that discussion for another day.) Though the lines of definition are blurred depending upon whom you ask, PNFs generally call for a higher level of resistance, 50% or more, with Vladimir Janda (Czech doctor/researcher) way off the charts at around 100% when called for. Another rule of thumb, as presented by Chaitow, is that with an MET the therapist can feel the resistance but the client can’t. By the time the client can feel the stretch you’re now in PNF territory. "If pain persists, don’t use PNF until you know the cause of the pain." – Robert McAtee, Facilitated Stretching, 1993 "The upper reaches of the psoas meet the lower crura of the diaphragm. . . . This is where walking meets breathing." – Thomas Myers, Anatomy Trains (2009) Pelvic basin "In the pelvis lies the key to our well-being." – Ida Rolf A fundamental principle of movement, not yet assimilated by the mainstream, is that effective action stems not from the legs nor the arms but vice versa, that is from the core outward. Thus, to achieve higher levels of performance we need to let go of holding patterns not so much in our extremities but in our core. In fact, the functionality of the entire body is determined by the generative power of the lower abdomen and more generally the pelvic region. For instance, when preparing dough for large groups of people, Italian women were traditionally known to conserve energy by working from their legs rather than their arms. If they worked the dough merely with their arms they’d burn out quickly. Any action that feels overly strenuous is calling upon the smaller muscles of the periphery (arms, legs, feet) to perform a greater share of the work than they were designed for (see Moshe Feldenkrais, The Potent Self, 1985). For example, said Feldenkrais, some great judo experts are also masters in the art of pelvic control. The ascendancy they display over less adroit (and sometimes much younger) people is bewildering, much as the Italian women knew instinctively. “If you aren’t comfortable dealing with an opponent fifty pounds heavier than you, there’s something wrong with your jiu-itsu.” – Rickson Gracie (Brazil), mixed martial arts hall of fame If Feldenkrais had the time and diagnostic tools, he may have discovered that these experts also had a more limber psoas compared to their less-capable competitors whose psoas muscles were cemented to their pelvic bones. The deck was stacked. Noted the massage therapist Lucinda Lidell in her Book of Massage (1984): a pelvis that’s full of constrictions cannot freely swing back and forth when we move. It moves as one solid block, causing the legs to move stiffly, with a marked absence of rhythm or grace. Such a pelvis would likely express shock at even the tamest forms of Latin dancing. “I went to a massage parlor. It was self-service.” – comedian Rodney Dangerfield From High-Performance Sports Conditioning (2001) edited by Bill Foran: Many of the muscles contributing to quickness are relatively small, particularly the lateral and medial rotators of the pelvic region (which permit our legs to move in a 360-degree arc), as well as the adductors and abductors (the deltoids of the hip). Myers goes so far as to say our "entire postural set" is determined more by deeper and shorter muscles such as these as opposed to the more superficial, longer ones. (In general, the deeper the muscle the shorter the fibers.) The ramifications are clear: 1) that speed can be enhanced by reducing excessive tension in these rotators found in the pelvic basin; and 2) that even speed itself radiates from core to periphery. "You don't need a lot of speed to be a good base runner." – former Yankee David Cone, 5/13/14 "Speed slows down the game." – catcher/announcer Tim McCarver "Speed is a great asset, but it's greater when it's combined with quickness – and there's a big difference." – Ty Cobb (1886-1961), Detroit Tigers; master base-stealer "Speed is often confused with insight. When I start running earlier than the others, I appear faster." – Johann Cruyff, Dutch football great "I wasn't real quick, and I wasn't real strong . . . so I beat them with my mind and my fundamentals." – basketball hall-of-famer Larry Bird "No, he just got there in time." – Yogi Berra, when asked if Joe DiMaggio was fast "The master of strategy does not appear fast." – Miyamoto Musashi, The Book of Five Rings "Shooting at a man who is returning the compliment means going into action with the greatest speed of which a man’s muscles are capable, but mentally unflustered by an urge to hurry." – Wyatt Earp, lawman/gunslinger/gambler (1848-1929) As Feldenkrais pointed out, by eliminating contraction and rigidity in the pelvic region the path to optimal performance, not to mention emotional maturity, is cleared. To achieve anything as direct as this by “emotional reeducation” alone (aka ‘words’ and coaching) is simply not feasible. Toning and restoring balance to the pelvic region, particularly the pelvic floor (which pulsates in tandem with the diaphragm, courtesy of the psoas), not only restores elasticity to the body, it also increases our general sense of well-being. It can show on the face, and there may even be a marked difference in the way we walk. One with poor tone in the pelvic floor walks as if she's carrying a bag of groceries between her legs (or something up her butt). One with good tone has a spring in their step, and perhaps even a shopping cart as well. Strictly speaking, tone refers to the amount of tension or resistance to movement within a muscle. In general usage, however, it refers to the normal state of balanced tension within a single muscle unit or extended muscular group, just as the poles and ropes of a tent co-exist in a state of mutually supportive equilibrium. "You don't carry in your countenance a letter of recommendation." – Charles Dickens, Barnaby Rudge "There are times when the simple dignity of movement can fulfill the function of a volume of words." – Doris Humphrey, dancer/choreographer (1895-1958) "Style is the physiognomy of the mind, and a safer index to character than the face." – German philosopher Arthur Schopenhauer (1788-1860) (physiognomy: indicator of character) Martha Graham (1884-1991), a pivotal figure in the history of dance, noticed the central role of the diaphragm as well, in stark contrast to most of her predecessors and contemporaries. Graham called the torso "the house of pelvic truth," and her breakthrough levels of instruction were centered here, particularly on the diaphragm (Robert Greene, Mastery, 2012). The custom of her day, primarily mid-20th century, had been to focus on the face and arms. Notice her intuitive awareness that speed and movement germinate in the core then expand to the periphery, contrary to common wisdom. Notice also how this awareness represents a contextual shift in thought, turning the bubble inside out, or if you prefer, thinking outside the pelvis. And certainly Graham would not be averse to an effective exercise for the diaphragm: blowing up balloons on occasion (and notice how you'd feel the effects right down to the perineum). “When asked what single event was most helpful in developing the Theory of Relativity, Einstein replied, ‘Figuring out how to think about the problem’." – management consultant W. Edwards Deming “When the fact doesn't meet the theory, then let go the theory." – Agatha Christie “It is amazing how much theory we can do without when work actually begins." – German-born economist E.F. Schumacher, author of Small Is Beautiful, 1973 “ 'Trying' is only emphasizing the thing we know." – movement educator F.M. Alexander “ 'Trying' is just a noisy way of not doing something." – Ken Blanchard, author of The One Minute Manager "Self-taught mechanics (are) so superior to institute-trained men who have learned how to handle everything except a new situation." – Robert Pirsig, Zen and the Art of Motorcycle Maintenance “If one knows only what one is told, one does not know enough to arrive at a well-balanced decision." – Hungarian-born physicist Leo Szilard (1898-1964) Our plan of action for the pelvic basin begins with medium-to-deep presses to the buttocks, through the towel, using fingers, fists and forearms. The buttocks contain the most powerful muscles in the body, and releasing these will help free up tension and energy stored throughout the entire pelvic area, with an ancillary effect toward the legs and back. (Somewhat ironically, butt muscles rarely extend to their limit during competition. As a result they're less susceptible to micro-tears in their fibers as compared to other tissues. Source: Phaigh.) Second, we will perform a variety of leg mobilizations (assisted stretching, if you will, including moderate-level PNFs). These include knee-to-chest stretches, piriformis/rotator stretches, and leg ROMs (range-of-motion exercises). This is the indirect path toward loosening rotators that play the “I dare you to find me” game (gemelli, obturator, quadratus femoris etc., "deep six" core muscles that act as shock absorbers for the hip joint), but indirect works. Said Philip Latey in his Muscular Manifesto (1982): Articulation (mobilization) of a joint is often as effective as relaxing the soft tissues directly. This is particularly true when the muscle is in spasm. As we work the basin, we’re also enabling the strongest muscles of the body (the glutes and quads) to do their work more efficiently. These two muscle groups articulate (form, join with, and help express) the pelvic joints. They also house the largest cross-sections of all our muscles. (Note that an acceptable professional synonym for subluxation is dis-articulation.) Aside: Obturator A review of massage literature reveals a hitherto unnoticed dearth of material related to the obturator, whether internus or externus. As with the hard-to-reach psoas, Starlanyl acknowledges that obturator also likes to camp out just beneath our radar screens of palpability. The word itself comes from the Latin for 'to close up' or plug an opening or gap. (In photography, an obturator is a camera shutter.) According to Earls & Myers, the deceptively large obturator and the gemelli, in conjunction with the pelvic floor, act as a shock absorber system for the hip joint. Gemellus, like its cousin gemini, basically means 'coupled' or 'twin,' and indeed this paired rotator has a superior and inferior aspect, not to mention a palindrome. If we say there’s a gap between the two gemelli, it’s the obturator that plugs it. Per Ida Rolf, balance between gemelli and obturator (perhaps including their ability to slide over each other), plays a major role in aligning the vertical and horizontal axes of the pelvis. A properly behaved obturator also helps steady and centralize the head of the femur within the hip socket. Chaitow has also noted how the fascia of obturator internus blends "intimately" with that of psoas, whose fascia blends with that of the pelvic floor. So perhaps one strategy for reaching the obturator necessitates releasing the psoas first ('Soft Tissue Manipulation and Pelvic Pain,' Massage Today, November 2010). Another advantage to working the hip and its associated rotators is that stiffness in the hip joints prevents the knees from opening to their full skeletal limit or maximum potential (source: Feldenkrais, who seriously injured a knee while playing soccer). One wonders out loud what percentage of the running community is aware of this assertion. Stiffness in the hip joints also inhibits the energetic flow of ki energy down to the legs, and note that when knees and ankles are constricted it can take 40% more of our energy just to walk. “There is one point that ought to be noticed in which the better players are alike and the dubs (duffers) are uniformly out of step. That point has solely to do with the degree of rigidity to be found in the knee joints.” – Bobby Jones, World Golf Hall of Fame “As we move to a more relaxed stance the knees become flexed rather than straight.” – performance coach Dave Alred, The Pressure Principle, 2016 “The key to a player’s longevity in this game is his legs.” – Rich Reichardt, California Angels (baseball) “A pitcher is only as good as his legs.” – Early Wynn, baseball hall-of-famer "Death begins in the legs." – saying from India "Victory depends on the legs. The hands are merely the instruments of victory." – Russian field marshal Aleksandr Suvorov (1730-1800) "A woman is as young as her knee." – English fashion designer Mary Quant (who never knew that knee pain starts with trigger points in the quads) "My joints are ten years older than me." – Darcey Bussell, English ballerina In general, ki flows much more easily through joints that move freely and have space within them than through those that are stiff and contracted. In the Eastern view, ki also flows like water: it can't be pushed, only led (like a herd of cats). When pushed, it will flood and enter the wrong paths (Dr. Yang). “A piece of spaghetti – or a military unit – can only be led from the front end.” – general George Patton Finally, if we're ever looking for evidence that ki is beginning to reestablish a healthy flow in our partner or client, take notice of slight wavy motions in the body (per Paul Lundberg, The Book of Shiatsu, 1992). “Loose lips sink ships.” – World War II poster “Loose hips save ships.” – heard among kayakers “Hips and hands.” – baseball icon Ted Williams, when asked for some professional hitting advice Note: Ki (or chi, or qi) is the life force flowing through our bodies, and at least 49 cultures around the world have some kind of name for it. The West has none, though French philosopher Henri Bergson famously coined the expression élan vital. This term has usually been translated as 'vital impulse,' though 'vital glow' seems to work better, the word 'élan' suggesting panache and energy. One synonym for élan is 'verve,' defined as the spirit animating artistic performance. In the realm of sports massage, let's suggest that chi can be translated as 'high intention coupled with visualization.' In terms of acupressure, we work points that align with and are found above the sacrum. In combination with the Sea of Vitality points that extend across the back at the same level as the belly button, the sacral points can help open a frozen, rigid pelvis. These two sets of points form a triangle on the lower back. (Taken from Acupressure’s Potent Points, 1990, by Michael Reed Gach.) Earlier we talked about the desire for a balanced relationship between the psoas (or if you’re a purist, just ‘psoas’ without the definite article ‘the’) and the rectus abdominis (uptown bus). Located deep to the internal obliques, rectus abdominis is basically a corset or girdle upholding our midsection. (Joseph Muscolino, Muscle & Bone Palpation Manual, 2009. Muscolino is an instructor at the Connecticut Center for Massage Therapy.) However, it is now believed that the neighboring pelvic floor muscles function better when working in conjunction with the transverse abdominis (crosstown bus), which under optimal conditions is contracted constantly during Pilates exercises. (From Pilates & Yoga, 2004, by Judy Smith, Emily Kelly & Jonathan Monks.) Among other goals, particularly the development of concentration, Pilates aims to strengthen the muscles of the pelvic floor. Evans & Myers, previously cited, agree that the pelvic floor is designed to co-contract with the transverse abdominis. (Myers calls the pelvic floor a muscular 'funnel'. Others have described it as a hammock or trampoline.) This entire pulsation mechanism/partnership, particularly in the pelvic basin, can shut down when our body perceives a threat, says Dubitsky (Bodywork Shiatsu). The sympathetic nervous system can activate the well-known fight-or-flight mechanism, in effect turning on all its switches at once (throwing the baby out with the bath water), a phenomena known as mass discharge. In addition to other known responses, the diaphragm locks, the pelvis goes rigid, the anus tightens, genitals go numb, leg muscles lose their equilibrium, we go “into our heads,” peristalsis is suspended, and we nosedive into the more hyperactive/reactive beta mode. One can only surmise the effect upon the transverse abdominis, which operates in tandem with both the pelvic floor and the diaphragm in conjunction with psoas. Diaphragm (definition): "A muscular partition separating disorders of the chest from disorders of the bowels." – Ambrose Bierce, The Devil's Dictionary, 1906 "Choking occurs when the anxiety of the situation causes a player to become conscious of and unpick things that had hitherto been automatic (going into our heads)." – performance coach Dave Alred, The Pressure Principle, 2016 This scenario can offer us a glimpse into the actual choking mechanism that can grip certain athletes, and performers of most any persuasion, just as the proverbial finish line comes into sight. It seems reasonable therefore that a relaxed and loosened pelvic basin can help forestall the choke. Choking is nothing more than paying attention to your physiology when you should be focusing on your opponent and the task. – Gary Mack, Mind Gym, 2001 Choking: a failure to organize one’s thoughts when the pressure is on. – performance coach Dave Alred, The Pressure Principle, 2016 Indicators of choking: forgetting details and resorting to old habits that don't work. – (Harris, 1984) Physically, we are now better positioned to respond to the moment at hand – to widen the gap between stimuli and response – without interpreting the scenario as a danger or threat. Some athletes take years to approach this level where they can choose between responding to the immediate moment or going into automatic pilot, aka their mental machinery, or as Selye put it, "stereotyped reactions." We are now better prepared to relax even in the face of threat, danger and attack, a prerequisite for proper execution of aikido movements (Dan Millman, Body Mind Mastery, 1999). "Unlike puppets, we have the possibility of stopping in our movements, looking up and perceiving the machinery by which we have been moved. In this act lies the first steps towards freedom." – Peter L. Berger, Austrian-born sociologist/theologian "Neanderthals can win certain kinds of wars, but they’ll lose some they should win if you force them to make enough choices." – Bill Parcells, head coach, New York Giants "The mere athlete becomes too much of a savage." – Plato "Motivation alone is not enough. If you have an idiot and you motivate him, now you have a motivated idiot." – Jim Rohn, motivational speaker "I just wanted to give my players some technical advice. I told them the game had started." – Ron Atkinson, manager for Oxford United "Not infrequently ... the theoretical is a synonym for the stereotyped. For the 'theoretical' in chess is nothing more than that which can be found in the textbooks and to which players try to conform because they cannot think up anything better or equal, anything original." – Mikhail Chigorin, Russian chess master (1850-1908) "Mediocre men often have the most acquired knowledge." – French physiologist Claude Bernard (1813-78) That all said, perhaps there’s more to the Biblical admonition “gird up your loins” than first meets the eye. "A lot of guys who have never choked have never been in the position to do so." – golfer Tom Watson, winner of eight majors “It’s good sportsmanship not to pick up lost golf balls while they are still rolling.” – Mark Twain “I regard golf as an expensive way of playing marbles." – G.K. Chesterton, English man of letters (1874-1936) “Golf is a mental disorder." – author Edgar Rice Burroughs, creator of Tarzan Abdomen "The abdomen is the reason why man does not readily take himself to be a god." – Nietzsche Whereas the concept and reality of tightness in the pelvic region is relatively easy to grasp (as it were), it’s within the abdomen that we really hit paydirt from the point of view of sports massage. While we’re not here to reinvent the wheel while our friend is lying on the massage table – as if we have all day – we can and will concentrate on freeing up an obstruction or two that hinders effective movement from the core outward. There are a lot of dynamics at play here, and our approach will basically be an indirect one. In a nod to visualization, it helps to picture the core of our body as forming a "tin can" around the torso. So suggests Manhattan personal trainer Jon Giswold in Beyond Basic Training: Fitness Strategies for Men (2004). Giswold also repeats the assertion that the abdomen is the place from which effective movement emanates. Now let’s set up the physical boundaries for this scenario, remaining fully aware that setting up parameters can be a self-limiting process at times. "A boundary is not that at which something stops, but that from which something begins." – Martin Heidegger, German philosopher Abdomen: A word originating around the 1540s whose origin is not fully understood. It could be taken to mean "concealment of viscera." First, the lower boundary for the abdomen is the pelvic floor, notably its figure-8-shaped pubo-coccygeal (PC) muscle. If our floor is either overstretched (flaccid) or gripping like dried leather (aka “anal retentive”), if it cannot relax or contract, we lack a solid base of support and oscillation. We can even lose our balance more easily, and some would say a well-toned PC protects against prostate disease, frigidity and impotence (Prudden, et al). Strapping around our cylinder, our tin can, are the transverse abdominus (the girdle/corset, or crosstown bus) and the multifidus (the thin muscle that's 'multiply splintered,' hence the name). Multifidus (aka the multifidi) lies deep to the spinal erectors, the “backstrap” muscles that run up either side of our spine like a two-lane interstate, with the spine acting as the median strip. These two muscle groups work in tandem, co-contracting, working as a team to support the midsection and, echoing the legacy of Ida Rolf, provide the spine with a gentle lift. Giswold says that strengthening these core muscles is a vital – and often overlooked – part of an effective exercise regimen. “Anyone who lets themselves get fat and out of shape is immature in some way.” – Jack LaLanne, fitness pioneer from the golden age of television (Fat = 'gravitationally challenged') “The preservation of health is a duty. Few seem conscious that there is such a thing as physical morality.” – Herbert Spencer, English philosopher/biologist (1820-1903) “You should cut down on your porklife, mate. Get some exercise.” – Blur, Parklife, their masterpiece from 1994 Giswold adds that it’s easier to strengthen the transverse abdominus and the obliques than the abs. In addition, they give us a slimmer look when they're toned, whereas abs have little to do with the size of our waists. Obviously our job on the massage table is not to strengthen these units. Our task is to help loosen and free the body from any pre-existing misalignments and imbalances (road construction) that hinder these muscle groups, in conjunction with the rectus abdominis (uptown bus), the muscle area that helps complete our core, from performing the work they were designed for. Due to their relative inaccessibility, deep back muscles such as the multifidi are difficult to palpate directly. The way to induce relaxation here is to address the more superficial erectors (Ylinen/Cash), which may also play a role in proprioception. Whereas Giswold evokes the metaphor of the tin can, Earls & Myers whip out (as it were) an even more precise metaphor: the Union Jack, aka the British flag, aka the cross of St. Andrew. The cross itself is formed by the rectus (as in erect / aka uptown bus) and transverse (crosstown bus) abdomini, whereas the X is formed by the internal and external obliques. Let’s not forget the literal definition of oblique, which basically means moving neither vertically nor horizontally but at an angle. Likewise, an oblique statement, like Congress, never gets right to the point (nor perhaps does this web page). "I hold that the parentheses are the most important parts of a non-business letter." – English writer D.H. Lawrence (1885-1930) "Disease often tells its secrets in a casual parenthesis." – Wilfred Trotter, English surgeon (1872-1939) What’s key about these metaphors is not a crash course in anatomy nor bus routes nor a Senate debate for that matter, rather it’s how they can help us visualize lines of force. These lines, by the way, are said to criss-cross at the sacrum, more specifically at the first sacral vertebra. In all cases of dysfunction/malfunction, including the emotional, there is compulsive fixity and rigidity here. (Does your shrink talk like this?) “When I played pool I was like a good psychiatrist. I cured 'em of all their daydreams and delusions.” – Minnesota Fats “Mistakes are often made when a player persists in his delusions.” – Nikolai Krogius, Russian grandmaster, author of the well-regarded Psychology in Chess (1976) “Neuroscientists are novices at deception.” – Teller (magician) “The art of badminton is to deceive.” –Sir George Thomas, International Badminton Federation “All warfare is based on deception.” – Sun Tzu, The Art of War “Misdirect ALL the time.” – Fred Kaps, Dutch magician “Deliberate tactical errors and minor losses are the means by which to bait the enemy.” – Sun Bin, Chinese military strategist, fourth century BC “Who makes the fairest show means most deceit.” – Pericles (495-429 BC) The dissolution of anxiety is subjectively felt as recovering freedom of motion – they are one and the same – at this point (first sacral vertebra). To assist the release of this area, however, it does work to release the entire body (Feldenkrais, The Potent Self, 1985). What's even more fascinating about this dynamic is the highly credible postulation of a direct physical/emotional juncture (portal?), namely the first (highest) vertebra of the sacrum (bus depot). Note: The sacrum in adults is one fused unit comprised of five distinct vertebra which were separate units at birth. The fusing begins around age 16 and is generally complete by age 34. Stiffness typically begins around age 40. The sacrum was once called the "holy bone" in various languages ('immortal bone' in Chinese) for reasons that are still not established with any degree of finality. Here's an effective sacral loosener, by the way: With the client face down on the table, stand to the side and cup the leg (underside) at the point just north of the kneecap. With one hand gently pressing on the sacrum for support, lift the opposite leg for a few moments, about three times. Feel free to add rotations, using the weight of the leg to apply the appropriate downward pressure. You can't see the client's face, but you can still detect a whiff of contentment from this move. Now back to the abdomen. Our starting point, from which our attention stems outward, is the transverse abdominis. All movement starts here, says trainer Mark Verstegen in his 2004 book Core Performance, though some might argue persuasively that movement originates in the ilio-psoas. Transverse abdominis also boasts a neurological connection with the pelvic floor; they often co-contract (Earls & Myers). So now we’ve spotted a tri-partite co-contraction, if you will, that reaches from the PC to the multifidi which help to both stabilize the spine as well as skyhook it (provide it with lift against gravity). "Practitioners of structural integration do not feel ourselves to be therapists. The gravitational field is the therapist. What we do is prepare the body to receive the support from the gravitational field which gives a greater sense of well-being." – Ida Rolf (whom psychiatrist Fritz Perls called 'Mrs. Elbow') (How many psychologists have been astute enough to equate well-being with "receptivity to the gravitational field"?) Regarding the starchy term 'massage therapist' as opposed to masseur: – author and instructor Clare Maxwell Hudson: uses the term 'masseur' – publisher Noah Calvert: massage practitioner – author Gordon Inkeles: masseur – author Jack Meagher: masseur – Dr. Jwing-Ming Yang, author: masseur – sports massage author Michael McGillicudy: trainer – Ida Rolf considered herself not a ‘therapist’ but an educator "We are all children of gravity. Sagging skin and organs, varicose veins, arthritis, failing hearts – these all come from the lost battle against gravity." – Ralph Pelligra, director of medical research, NASA Our overall aim, borrowing the lines of thought of Earls & Myers, is to induce a client to “relax into length”; as a side effect, we are fostering optimal joint alignment and function. (Before long we’ll go into the concept of side effects – aka precession.) For now we’ve discovered, virtually by accident (precessionally), the physical corollary to the emotional concept of “letting go.” Contrast this dynamic (dynamic the noun, not the adjective) with the force required for stretching, whose results may be of shorter duration as well. Force, by the way, requires a bit of hubris and ego; "relaxing into length," the counterpart of "relaxing into results," demands and develops patience and humility, not to mention painstaking attention to detail when called for. “It is the care we bestow upon apparently trifling, unattractive detail and very troublesome minutiae which determines the result.” – pathologist Theobald Smith (1859-1934) “The smaller the detail the greater the value.” – NFL quarterback Doug Johnson “If I have made any improvement in the sciences, it is owing more to paying attention than to anything beside.” – Sir Isaac Newton “Little things, so called, are the hinges of the universe.” – Fanny Fern, American writer, 1811-1872 “The statistical method gives only mediocre results.” – French psychologist Alfred Binet (1857-1911) Similarly, when working trigger points we trust they will release, after our intervention, with minimal stretching. Stretching, which Davies sardonically calls the "favorite weapon" of some, can actually be an impediment to recovery. When forced, such stretching can easily reactivate trigger points that are either dormant or recently treated. “A handful of patience is worth more than a bushel of brains.” – Dutch proverb "Lying in wait is the secret of success in poker." – Richard A. Proctor, English astronomer (1837-1888) "When you see a good move . . . wait . . . and look for a better one." – German chess master Emanuel Lasker (1868-1941) "The most patient man in loss, the most coldest that ever turned up ace." – Shakespeare, Cymbeline "The sophomores are good, but they haven’t learned the humility of crew yet." – John Biglow, Olympic rower "He is free from self-display, and therefore he shines." – Lao Tsu, sixth century BC "Sometimes a player's greatest challenge is coming to grips with his role on the team." – Scottie Pippen, NBA Hall of Fame "The object of a bunker or trap is not only to punish a physical mistake, to punish lack of control, but also to punish pride and egotism." – Charles Macdonald (1855-1939), pioneer golf-course architect Further, by encouraging a client to relax into length, we’re even helping to provide the “structural substrate” for emotional and psychological balance (Edward Maupin, Elements of Structural Integration, 2006; Maupin is a certified Rolfing instructor). Remember the fundamental principle of well-being: Physical equilibrium engenders mental equanimity. You can't have one without the other. “Equilibrium is the profoundest tendency of all human activity.” – Swiss psychologist Jean Piaget (1896-1980) (an extraordinary statement) "There exists everywhere a medium in things, determined by equilibrium." – Russian chemist Dmitri Mendeleev (1834-1907), “father” of the periodic table of the elements "I saw in a dream a table where all elements fell into place as required. Awakening, I immediately wrote it down on a piece of paper. Only in one place did a correction later seem necessary." – Mendeleev "Male players must not only retain equanimity on their side of the net, but create dissension on the other." – Art Hoppe, San Francisco Chronicle, on tennis mixed doubles To reiterate, not to mention say again, we’re not here to strengthen muscle per se. That’s the job of trainers. Let’s instead concentrate on freeing up energy restrictions, pathways of blocked force and energy, from our core, our hara, outward. Contrary to popular wisdom, this approach may be just as effective as strengthening when it comes to injury prevention. Says Allan Menezes in his 2004 guide to Pilates techniques and conditioning: Tennis players usually generate their force from their arms and shoulders. They would be better served by including the abdominals in their motions. Abdominal control (which goes hand-in-hand with abdominal awareness) is preferable to abdominal strength. It’s control, not strength, that provides fluidity of movement from the center. Menezes' claim should not get lost on pitching coaches: When throwing a scorching fastball, a pitcher's humerus can actually leave its socket for a moment, given the inherent instability of the gleno-humeral joint. By working from the abdomen, perhaps the pitcher won't lose an entire season to reconstructive surgery after just five years on the mound. "Pitching is the art of instilling fear by making a man flinch." – Sandy Koufax, Los Angeles Dodgers “Control, control, you must learn control!” – Yoda “You can be as wise as Solomon, with the most iron character, and still lose control.” – Fyodor Dostoevsky "Control the movement . . . concentrate on the form." – from the video exercise series 'The Firm' "Controlled motion and elimination of heroics." – Jackie Stewart, Formula One champ, regarding elements of sporting excellence Let’s start by helping to disengage any stucknesses in the pelvic floor, if only indirectly, so don't get nervous. Our approach is through the adductors, located on the inner upper thighs. We want to first knead them with discretion (but without trepidation), which serves the function of warming them up. In the process we’re also on a search-and-destroy mission for a trigger point or two, though we're not out to beat them into submission. “I'm on a submarine mission for you, baby.” – The Sex Pistols, Sub-Mission Now let's add some standard compressions, a key component of most any book or course on sports massage. Once warmed up, only then do we want to stretch the leg laterally outward, just beyond the point a person can stretch it unassisted, a core principle of Thai massage. Note that if this stretch ends slowly and softly, like an elevator, we're most likely dealing with restriction of a muscular variety. But if we come to a harder and quicker end, the restriction more likely involves a ligament or joint, so we skate more gingerly. If in your judgement as a practitioner you prefer applying range-of-motion exercises instead of a traditional stretch, by all means go ahead and do so. To not finish up with such stretches/ROMs is tantamount to applying no treatment in the first place (Doggweiler 2004, as cited in Starlanyl 2013). “Pull gently at a weak rope.” – Dutch proverb Now we ask our friend (or adversary, for that matter) on the table to pull the leg back inward against our resistance – only for a few moments with slight pressure – in PNF fashion. This series of movements, along with other leg rotations, will help reset normal tonicity (normal firmness or functional readiness) in the pelvic floor, to a degree perhaps as effective, if not more, than standard Kegel exercises. The most vulnerable of our adductors is the adductor longus (located between adductor brevis and magnus), particularly at its attachment to the pubic bone. (Because of its greater length, some of us might suspect the magnus as being most vulnerable.) Given its fascial overlap, tenderness can continue from this attachment point onto the nearby attachments of the rectus abdominis (Cash), not to mention the psoas. Per Travell & Simons, unresolved trigger points in adductor longus lead to a disproportionate number of athletes getting benched by their coaches. Aside: The word 'trepidation' comes from the Latin trepidare, meaning to hurry with a sense of alarm. It's also a cousin of the word 'tremor,' as in quivering movement. So we can see that the word originally emphasized the physical aspect, whereas today the behavioral emphasis is more prevalent. An acceptable antonym for trepidation is 'equanimity,' one of our stated goals for sports massage. Putting 2 & 2 together, we see that equanimity is fostered by diminished quivering, which most any masseur can accomplish in 60 minutes on the table, depending on his or her degree of trepidation. "The muscles of the spiritual athlete pant for such exertion; and without it, they would dwindle into trepid imbecility." – Martin Farquhar Tupper, English writer (1810-1889) "Hurrying and delaying are alike ways of trying to resist the present." – Alan Watts, Zen educator "Don't be in such a hurry. That little white ball isn't going to run away from you." – Patty Berg, World Golf Hall of Fame "The next time you see a good player stalking backward and forwards on the green, do not be led away by the idea that he is especially painstaking, but rather pity him for a nervous individual who is putting off the evil moment as long as he possibly can." – Ted Ray (1877-1943), winner of two majors, captain for Britain in the first Ryder Cup "Most men are in a coma when they are at rest and mad when they act." – Epicurus (341-270 BC) "One universal feature is to be found in the games of all great players . . . they never seem to be hurried." – tennis great Bill Tilden (1893-1953) According to Cash, during a PNF ask for about 50% exertion on the part of the client, though Mally asks for a little more force. Hold for about 10 seconds to fatigue out the stretch receptors, which is a speck longer than Cash's time frame from a decade earlier. This approach of less effort for a longer time appears more effective, Cash contends, than the “more intense for a shorter time” approach. The governing factor appears to be time as opposed to intensity. (Here’s another reason why it’s difficult to adequately treat an aching client within the standard 60-minute time frame.) When muscle tissue becomes fibrotic through overuse (and underuse as well), the fibers become matted together and cannot glide independently. It takes a powerful and precise force to break up this Gorilla Glue, namely a PNF-variety force and the shear that it provides. (Shear: a strain in the structure of a substance, produced by pressure, when its layers are laterally shifted in relation to each other. Picture a plank of wood that's been crushed. Wind shear: a sudden change in wind velocity and/or direction.) Increasing the duration of a contraction – up to 20 seconds – may be more effective than any increase in force. – Leon Chaitow, Muscle Energy Techniques, 1996 Definition of matted: entangled in a thick mass, as in unruly muscle fiber; comprised of adhering filaments; overcooked spaghetti sticking together (as well as to the pot) A line of force that helps transmit the strength of the legs to the arms now faces one less degree of obstruction, one less toll-booth. We’re also helping to address a pre-existing imbalance between the hip flexors (muscles that bring the leg toward the trunk) and the abs, a game the flexors nearly always win. As a side benefit, by loosening hip flexors we have one more tool in our arsenal in the ongoing battle against lower back pain (source: Laughlin). Note that tight back muscles, particularly the quadratus lumborum at the rear pelvic crest, can inhibit deep breathing, which of course is often necessary for higher levels of performance and requires the cooperation of up to 90 muscles. Earls & Myers, by the way (2010), point out that QL muscle is less often ‘tight’. More often it’s fascially short, a crucial distinction. Either way, tight or short, a compromised QL restricts pelvic freedom. Note: Tom 'Anatomy Trains' Myers credits the role of the French physiotherapist Françoise Mézières (1909-1991) in establishing the 'train' or 'chain' model of muscular action. Per Mézières, muscle rarely acts as a discrete unit. In practice, muscles are organized in chains, overlapping like tiles on a roof. Mézières noted that blockages manifest in front of the body, caused by an excess of strength/tone in posterior musculature. Her work is now carried on under the name Postural Reconstruction. On the side of the body, the iliac crest is a frequent site of connective tissue matting and accumulation, hence "cleaning & scrubbing" these layers off the bone can help coax more length (and lift) from the body (Myers). By working the iliac crest, we can also help relax deep hip extensors (muscles that extend or straighten) that are generally inaccessible to direct palpation. Per Cash, this is an effective technique for traumatized muscle that won't tolerate direct pressure. A primary culprit in this regard would be the upper regions of adductor magnus. Now let’s “Hit the North,” so to speak, with all due respects to Mark E. Smith and The Fall. Having worked the pelvic floor, it now works to address tensions in and around the solar plexus (middle tan den), found in the hollow beneath the wedge at the bottom of the ribcage. This helps bring greater awareness to any constrictions in the diaphragm, the functional first cousin and co-contractor with the pelvic floor. Let’s also stop thinking of the diaphragm as a horizontal structure. Structurally it’s more like a big umbrella you might see at the beach, or better yet, a double umbrella. This umbrella is also prone to occasional cramping, which can be experienced as a stitch in the side when its trigger points kick up (Neil-Asher, 2005). We can amplify this work by also working the solar plexus points on the feet as the client inhales deeply (center of foot, just under the ball). Per Eunice Ingham, the "godmother" of American reflexology, this movement helps jumpstart the process of relaxation, particularly when we work both feet simultaneously (Ingham, Stories the Feet Can Tell Thru Reflexology, 1938). Davies notes that it’s usually the "weekend warriors" who get a stitch in the side, not the well-conditioned, and the source is often serratus anterior. The main trigger point for serratus anterior (front knifeblade or "puppeteer" for the arm) is located approximately here (top two illustrations), though note that both acupoint and trigger-point charts assume a degree of variation from person to person. Especially in the case of acupoints, such charts are guideposts developed over centuries, designed for matters of practicality. Instructor/author James Clay, previously cited, says that this spot located just inferior and medial to the scapula is one of the most common areas in need of trigger-point release. This spot, Spleen 21, also happens to be a key acupressure point, going by the names Great Embracement, Da Bao, and/or Universal Luo (luo means 'net'). It is considered a balancing point for all meridians and helps to redistribute energies. (I've found this spot to be frequently sore, often to the surprise of the client.) As such, it may play an effective role in getting us "out of our heads." More important, we've established a deeper beachhead in the attempt to delineate a strong correlation between acupoints/meridians and trigger-points/referred-pain-patterns. The charts of the former may simply be precursors of the latter. Case in point, Universal Luo just happens to be located virtually atop the prime trigger point of serratus anterior, which leads to the "stitch in the side" so familiar to runners. Definition of worry: Carrying tomorrow's load on today's truck. – Eunice Ingham "Worry is the stomach’s worst poison." – Alfred Nobel "We do not worry just in our heads, our whole body worries." – Dorothy & Bette Harris, Sports Psychology, 1984 "Bacteria and other microorganisms find it easier to infect people who worry and fret." – Leo Rangell, Freudian psychoanalyst The main cause of worry is confusion. – Dale Carnegie ‘Worry’ is a word that I don’t allow myself to use. – president Dwight Eisenhower “Your mind gets stuck when you're trying to do too many things at once.” – Robert Pirsig, Zen and the Art of Motorcycle Maintenance “This one thing I do.” – Philippians 3:13 The diaphragm is connected to the lumbar (lower) spine courtesy of five ligaments (glorified bandages). One of these ligaments, the medial arcuate (aka middle arch), wraps around the psoas in arch-like fashion. The fascia in this region thus provides a bridge between the diaphragm and the psoas, which leaves us yet another linkage point extending south to the pelvic basin. It is believed that enhancing the pliancy of this linkage point can improve not only posture, breathing and walking, but organ function as well. “It is not age that causes a stooped posture and shallow breathing. It is accumulated response to negative stress.” (Beneficial stress, by the way, has been termed 'eustress' by Hans Selye.) – Thomas Hanna, Somatics, 1988 Eustress ‘turns on’ individuals, it releases energy, mobilizes it. Most people don’t realize they have to power to generate energy. – sport psychologist Dorothy ‘Dot’ Harris, Involvement in Sport, 1973 The implications for runners should be immediately apparent. It is also a potential topic for exploration whether a simultaneous low-grade PNF aimed toward the psoas though applied at the ankles, combined with direct manipulation just below the ribcage, can help produce a degree of release conducive to more effortless forward movement in an athlete. At a minimum we've discovered yet one more "plex" within the solar plexus, a name that means interwoven combination or network of parts. (Note that a double house is called a "du-plex.") Said Marion Rosen, author of 2003’s Rosen Method Bodywork, and despite the fact when a practitioner places their own name upon a modality the cheesy/ego factor is running off the charts: Something in the movement of the diaphragm and breath seems to reach the subconscious, which happens to be the spot where we place our deep intentions and visualizations (which don't work very well for most people). "He who builds a church to God and not to fame, Will never mark the marble with his name." – Alexander Pope (1688-1744) "Every selfish man, strangely enough, becomes a self-slayer." – Sadhu Sundar Singh, Indian Christian missionary (1889-1929) "The first thing any coaching staff must do is weed out selfishness." – Johnny Majors, College Football Hall of Fame "One player’s selfish attitude can poison a locker room and make it hard, if not impossible, to establish teamwork." – Dean Smith, basketball coach, University of North Carolina "One man in a meeting, filled with unbelief, can make a place for the devil to have a seat." – Smith Wigglesworth, British evangelist (1859-1947) "Do not tolerate brilliant jerks. The cost to teamwork is too high." – Reed Hastings, founder of Netflix "The best teams play for each other, not with each other." – Jeff Van Gundy, NBA coach and commentator (Such teams are operating in alpha mode vs. beta.) Also, fear seems to be held in the diaphragm, which is inclined to tense up with little provocation (Namikoshi, 1981). It is the only muscle that bridges both the autonomic (autopilot) as well as the sympathetic nervous system, which includes the fight-or-flight response. When we’re tense, we contract the diaphragm. Conversely, releasing tightness in the diaphragm can help reduce this tension and put us more in touch with our intention. If you prefer, work the diaphragm line of the foot; it's less invasive and helps us better appreciate the umbrella shape of the actual diaphragm upstairs. "Strong intention can be felt in the chest." – new age maxim "A writer's mind seems to be situated partly in the solar plexus and partly in the head." – Ethel Wilson, Canadian novelist "Watch your thoughts. Every thought accepted as true is sent by your brain to your solar plexus – your abdominal brain – and is brought into your world as a reality." – Joseph Murphy, Irish-American ‘New Thought’ writer (1898-1981) "The solar plexus is the home of the ego or the spirit of men; it is the connecting link between man and the Infinite and is the meeting place of the divinely physical, and the physically divine men." – Julia Seton Sears, The Psychology Of The Solar Plexus, 1914 "In order to train the tiger, one must remain close to it." – Chinese proverb "Fear is not an unknown emotion to us." – astronaut Neil Armstrong "People who are shocked easily need to be shocked more often." – Mae West Note that fear, which can be expressed as choking in the clutch, can get lodged in the suboccipitals as well. They’re located just beneath the bony ridge where the skull meets the neck. It’s been suggested that their release can also lead to better visual acuity, so maybe we’re even seeing a physical link to “seeing the ball” better. The importance of the occipital region continues to gain traction in recent years, even in the field of reflexology. In 2007's Total Reflexology, author Martine Faure-Alderson pays particular attention to zones, both horizontal and vertical, found within the occipital region. Moshe Feldenkrais offers a similar train of thought when he says that releasing abdominal tension shifts our functioning away from patterns of anxiety. The result is better breathing and visceral function. When the sympathetic (hyper/fight-or-flight) branch of the autonomic nervous system is dominant, he says, our ability to perform at full capacity is diminished to a commensurate degree. Granted, some degree of anxiety can actually be beneficial. As leading sales trainer Zig Ziglar once said, if we feel no anxiety at all our chances of success are greatly compromised. The word "anxiety" comes from the Latin angustia, meaning "shortness of breath." Notice the similarity to the word "angst," a feeling of apprehension (agita) or insecurity, as if the proverbial hammer were to drop at any moment. Etymologically, it is said, the word "anxiety" comes from a Latin root meaning "twisted rope" (upon which one chokes?). “Stand still in the middle of the anxiety and enjoy it.” – performance/sport psychologist Joseph Parent “If we’re going to win the pennant, we’ve got to start thinking we’re not as good as we think we are.” – Casey Stengel, Yankee manager 1949-60 “Champions don’t smoke pipes. Pipes make you contented and champions aren’t contented.” – Joe McCarthy, Yankee manager 1931-46 “Show me a contented newspaper editor and I'll show you a bad newspaper.” – Arthur Christiansen, former editor of London's Daily Express “Fat hens lay few eggs.” – German proverb “Ballplayers who are first to the dining room are usually last in batting average.” – Jimmy Cannon, New York area sports journalist “You can’t win with three-car garage guys. With two-car garage guys you got a chance.” – Pete Carril, Princeton basketball coach “He who has a slight disadvantage plays more attentively.” – Emanuel Lasker (Germany), Manual of Chess, 1926 “Boldness becomes rarer, the higher the rank.” – Carl von Clausewitz, On War, 1832 “Some men are successful chiefly because they didn’t have the advantages others had.” – from the Columbia (South Carolina) Record “If a ballplayer is satisfied, he's going to slip.” – baseball hall-of-famer Nellie Fox “If you think you’re perfect already, then you never will be.” – Cristiano Ronaldo, Real Madrid Said Ziglar, "You can't get rid of the butterflies, but you can get them flying in formation." It's also interesting to note that boxing champ Jack Dempsey often got so nervous before a bout that he couldn't shave himself. Gillanders (2007) says that butterflies in the stomach are vibratory signals emanating from the solar plexus. “I went to a fight the other night and a hockey game broke out.” – comedian Rodney Dangerfield “Don’t be nervous, but don’t make any mistakes.” – Fred Astaire to dance partner Barrie Chase  “Any runner who denies having fears, nerves, or some kind of disposition is a bad athlete – or a liar.” – Olympic long-distance medalist Gordon Pirie of England “Learn to surf on the waves of nervousness.” – Joseph Parent, Zen Golf: Mastering the Mental Game, 2002 “You don’t win by making sensational plays. You win by not making mistakes.” – Bum Phillips, NFL coach “The expert in battle would first make himself invincible and then wait for his enemy to expose his vulnerability.” – Sun Tzu, The Art of War “If you regularly lose, you are not the unluckiest player at the table; it is your partner.” – Edward Meyer, bridge master When anxiety (and its cousin, self-invalidation) abounds, another muscle area to react quickly is the rectus (uptown) abdominis, part of our Tin Can Union Jack. Said Jack Meagher, author of SportsMassage, (he also notes the relationship between the rectus and pelvic floor): spasm here can lead to over-reliance on Tums and Rolaids, and Davies makes a similar suggestion. Publishing before the era of trigger-point awareness, Meagher’s frequent use of the word ‘spasm’ can probably in hindsight be also read as “trigger point,” though a TP is certainly not synonymous with spasm. (Chaitow also comments that the word 'spasm' is often applied without precision; Rolf calls it an "implosion" of muscle tissue.) As an additional side-benefit (aka precession), our indirect abdominal work has now improved circulatory efficiency through the pelvis (source: Chaitow). One more point here: we can actually activate additional and unwanted trigger points in the abdomen by overdoing traditional sit-ups. Problems here frequently occur near the attachment of the rectus abdominis/abdominus to the pubic bone. Instead of working close to the pubic area (and the squeamish-factor involved), we concentrate our work on the muscle’s lateral border (Cash). Now here’s the kicker: Earls & Myers in 2011 demonstrated how the fascia (which itself exerts contractile force) of the rectus abdominis is continuous with the SCM (sternocleidomastoid), which helps rotate the head and is said to resemble a beef jerky. We can now envision, and possibly begin to clear up, a line of force and energy (bus route) designed to travel from the adductors of the upper legs all the way up to the neck, which in most people is tilted to some degree. Here's one reason why we're advised not to lift overhead weights from a sitting position: we don't engage the power of our legs. The other noteworthy point here is that a tilted neck (perhaps starting with a tilted pelvis) sends an SOS to the SCM and scalenes to go out of their way and realign our eyes along a horizontal axis. This so-called "righting reflex" is hard-wired into our brains. While we're on the topic, Archer (2007) notes that a tilted pelvis can begin with trigger points located in the quadratus lumborum. Myers also encourages us to stop thinking of two separate SCMs. Functionally they operate more like one single sling (perhaps an arch?) looping around the back of the skull. By the way, if you or a client have a stiff neck, try loosening the feet first. Then search out trigger points in the trapezius. You might find the neck relaxing before you even touch it. If we can free up some energy blockages that get lodged in the abdomen, what’s the payoff? Let’s take an example. In Japanese swordsmanship (kendo), an amateur holds the sword with tensed fingertips. The master holds the sword with his hara – the seat of his abdomen. Like Darth Vader wielding his light saber, he even swings the sword not with his arms but from his hara, a source of significant ki energy. “The fact is that everyone has ki, which is really little more than a technique of visualization allowing one to utilize the internal energy that we all have and letting it flow through the body.” – Chuck Norris, actor and martial artist (A profound statement, expressed with a clarity beyond most any text on the topic, suggesting that ki – and the free flow thereof – is the 'missing link' between visualization and its translation into physical intent. Perhaps we can go so far as to equate ki with visualization/intention.) “His force is in the navel of his belly.” – Job 40:16 (In southeast Asian theory, sen kalathari lines criss-cross at the navel and are considered a psychic/mental junction.) “God, grant me the strength to swing easier.” – heard on the links Moving from a sports to a bodywork analogy: In order to distinguish an amateur practitioner from a professional, master Shizuto Masunaga would ask them to display their shiatsu technique. Unskilled practitioners would blindly concentrate on their fingertips. A master, however, channels ki energy from the hara, in a state of complete relaxation. Notice how we’re now moving beyond the limited realm of mere technique, emphasizing instead the habit of awareness free of dwelling and obsessing (from Masunaga's outstanding text Zen Shiatsu, 1977). Notice also how this mindset resembles the concept of playing tennis from the core rather than merely from the arms and shoulders and the mind. “Problems must be resolved at the level beneath the one at which they occur.” – John Whitmore, British racer and performance coach “Players who stand flat-footed and swing with their arms are golfers, not hitters.” – Rogers Hornsby, baseball hall-of-famer “I never had technique.” – Al Oerter, four-time gold medalist in the discus “Technique that does not facilitate expression is little more than showboating.” – Agrippina Vaganova (1879-1951), Russian ballerina and instructor “We can be eaten by techniques and forget what we have inside of us.” – Eric Cantona, Manchester United “Emphasize rhythm, not mechanics.” – sport psychologist Gio Valiante “Technique is noticed most markedly in the case of those who have not mastered it.” – Leon Trotsky, Russian revolutionary (1879-1940) “As far as swing and techniques are concerned, I don’t know diddly-squat. When I’m playing well I don’t even take aim.” – Fred Couples, member of the World Golf Hall of Fame “Technique without rationale = no retention.” – educational dictum To borrow the thinking of Feldenkrais one more time: The shizentai (a relaxed but alert stance, as in karate) is our optimal starting point. The graceful, precise and efficient movements executed effortlessly – and without delay – in any position and at any instant are made possible by maintaining the center of gravity in our core at the most potent energy level possible. Just picture a lizard lounging on a sunny rock, ready to pounce in any direction, and you get the idea. If Mr. Lizard had a name it would be Zanshin, the omnidirectional state of mind fostered by the shizentai. “He kept goal on his toes, like a coiled spring, always ready to pounce.” – Arsenal goalkeeper Bob Wilson regarding Vladimir Beara, legendary goalkeeper from Croatia “The true speed of war is not headlong precipitancy (eagerness), but the unremitting energy which wastes no time.” – American rear-admiral Alfred Thayer Mahan, Lessons of the War With Spain, 1899 “A sucker don't ever catch on. A smart man don't ever sleep. He's got to keep ducking the traps.” – Johnny Moss, professional poker player “The best strategy relies upon an unlimited set of responses.” – Morihei Ueshiba, founder of aikido “Versatile, volatile ... same thing.” – David Beckham, Manchester United & Real Madrid “Body inefficiency stems from self-doubt.” – John Whitmore, Coaching for Performance, 1992 “Waste in movement . . . will get you killed.” – martial-arts master Masaaki Hatsumi The ramifications for reducing fatigue, via increased muscular efficiency, as well as forestalling injury should be evident. Starlanyl (2013) also notes that a primary function of our core’s myofascial structures is to stabilize our center of gravity during movement, a role assigned in large part to the pendulum (metronome?) known as our psoas. Some place this center of gravity at or near the sacrum, where major stress lines cross. Other enlightened individuals suggest we stabilize our center of buoyancy, a nautical term generally found below the center of gravity of a ship. This latter concept does gain traction when we view the body as floating within a supportive gravitational field. "Keeping the head still is golf’s one universal, unarguable fundamental." – Jack Nicklaus “In order to see birds it is necessary to become part of the silence. One has to sit still like a mystic and wait. One soon learns that fussing, instead of achieving things, merely prevents things from happening.” – sociologist (Columbia University) Robert Staughton Lynd (1892-1970), on bird-watching as a hobby “The better I shoot, the less I have to maneuver.” – Eddie Rickenbacker, fighter pilot / auto racer / airline executive “Fast is fine, but accuracy is everything.” – Wyatt Earp (1848-1929), lawman/gambler “In football, as in watchmaking, talent and elegance mean nothing without rigor and precision.” – Lionel Messi, Barcelona forward “You don’t have enough talent to win on talent alone.” – Herb Brooks, coach of the American hockey team that beat the Soviets in the 1980 Olympics “It's not enough to have talent. You have to have a talent for your talent.” – Stella Adler, founder of the acting studio that bears her name Lastly, to be in touch with our ki energy, particularly in the martial arts, makes it more difficult for an opponent to move us. Football players and wrestlers also talk about this phenomenon. “In football everything is complicated by the presence of the opposite team.” – Jean-Paul Sartre Legs Moving along with our sub-theme of working indirectly when the situation calls for it, let’s suggest the following: that by the time we’ve addressed the abdomen and pelvis, we’re already halfway towards releasing the legs. To quote Dr. Jwing-Ming Yang from his excellent text Qigong Massage (2005 edition): the most important part of massaging the legs is actually to be found in massaging the hips, the gateway from the lower spine. More specifically, the key to effective leg massage is relaxing the larger muscles of the hips as well as stimulating and opening the ki gates located here, particularly through range-of-motion exercises. Notice how Yang’s assertion dovetails rather nicely with the fundamental principle of working and moving outwards from the core. The legs do not lead, they follow. “In massage, when you have loosened the joints (ki gates) you are already one-third of the way to your goal.” – Dr. Jwing-Ming Yang, Qigong Massage, 2005 (Could the good doctor have meant visualization/intention gates?) (Per Ida Rolf, joints house the "red flags" that indicate when things are out of kilter. Let's keep them well-oiled.) Next we revisit our matter of pre-existing imbalances, particularly in the relationship between the quadriceps on the front of our thighs and the hamstrings (ischio-crurals) on the back. Says sports-massage author Michael McGillicuddy, the quads are generally a stronger group than the hammies, sometimes by a ratio of 3:1. When the underworked hammies tighten up, the grip of the quads can overwhelm them, leading to a season-shortening pull. Says Phaigh (Athletic Massage), our hamstrings are generally not used to their fullest capacity until called upon during key moments of sport competition. Per Davies, that's when the 'semi' portion of the hammies (semitendinosis/semimembranosis) are at their most vulnerable, for instance at full extension the moment after one kicks a football. Once fatigue sets in, the hammie then loses its ability to relax after use. Since the opposing quad is naturally stronger, the overworked hammie is forced to extend further, causing or worsening the pull. Hamstrings also have a nasty habit of ‘gluing’ themselves to the posterior adductors. (Starlanyl, 2013, advocates working the hammies first.) The intervening septum (partition, as we see in a grapefruit) can feel like strapping tape. Ylinen/Cash (1988) are also adamant that we don't overtrain the quads at the expense of the hammies, lest we pay a serious price down the road. Septum: A Latin word meaning enclosure, wall, hedge or fence. We're also getting an insight here that's not normally mentioned in the sports-massage literature: fatigue in itself can hamper a muscle's return to a resting state after use. That's why it's important not to exercise when tired, a point well-taken by upper-tier weightlifters who should lift before cardio exercise, not after. To this end, boxing great Oscar de la Hoya once commented that at the height of his career he only worked out vigorously every other day, a strategy that elevated him to levels several rungs above his opponents. “In an exhausted field, only weeds grow.” – Henryk Sienkiewicz, Polish novelist, author of Quo Vadis “It is impossible to out-play an opponent you can’t out-think.” – pro golfer Lawson Little (1910-68) “Some boxers just go in there and just throw punches and hope to win.” – Lennox Lewis (of England), world heavyweight boxing champion “Hope is the raw material of losers.” – Fernando Flores, Chilean engineer and politician “It is possible to choose to encounter our world from beyond the standard reference points of hope and fear.” – sport psychologist Joe Parent, Zen Putting, 2007 “All forms of fear produce fatigue.” – Bertrand Russell, British mathematician/philosopher (1872-1970) Besides offering traditional massage techniques, particularly fascia-friendly compressions upon both muscle groups, let’s consider a “sideways” approach here. Specifically, one potentially overlooked shortcut to placing the quad/hammie dilemma on the back burner is to address the TFL/ITB (tensor fascia lata / iliotibial band) continuum on the outside of each thigh. (Myers says the TFL and ITB form one fascial sheet, and one wonders aloud if someone who studies fascia can be considered a fascist.) This unit runs down the leg just like the stripes on the gym pants of the Phys-Ed Teacher from Hell, the kind who looks like an overnight-shift assistant manager at a McDonald’s and is in charge of cleaning out the grease pit. According to Bernard Schatz in 2003’s Soft Tissue Massage for Pain Relief, this unit when tense exerts undue pressure on the knee, to the point where Schatz calls it “The Knee Destroyer.” Gibbons (2014) clarifies this point when he reminds us that the ITB has a direct effect on the tracking mechanism of the patello-femoral joint. Chaitow (1988) asserts that when the ITB is too tight it's often misdiagnosed as a sacro-iliac problem. Perhaps we can envision the ITB/TFL as an adjustable brake caliper on a bike. When the cable is too loose we lose braking power. But when adjusted too tightly, the brake pad rubs right against the wheel, turning us into the proverbial Slow Boat to China. We would also be remiss here to not mention, if only briefly, the role of sartorius, a muscle that often gets short shrift in the bodywork literature. The longest muscle in the body, sartorius is viewed by some as a weaker counter-balance to the ITB/TFL adjustable brake cable. It performs several functions, including adduction, all of which are revealed if we check the bottom of our shoe for gum. Sartorius takes its name from a Roman-times 'sartor' or tailor whose crossed leg activated this muscle and often enlarged it. In fact, the word 'sartorial' is still found in a modern dictionary, minus allusions to pesky trigger points and diminished tracking of the patella if we sit too long mending our trousers. “All tailors are cheats, and all men are tailors.” – Charles Lamb, English essayist (1773-1834) “Hold when you’re at home, and don’t when you’re on the road.” – John McKay, University of Southern California (USC) football coach with four national championships “If you ain't holding, you ain't trying.” – Lyle Alzado, NFL defensive end (and steroid aficionado) “I never threw an illegal pitch. The trouble is, once in a while I toss one that ain’t never been seen by this generation.” – Satchel Paige, perhaps the best pitcher in baseball history Ylinen/Cash also remind us that a tight gluteus maximus can wreak havoc in the thigh and diminish function of the knee as well. Gluteus maximus originates over the sacroiliac joint, so work the lateral borders of the sacrum and you’ll also help free up the hammies. Earls & Myers (2010) suggest that if hammies aren't freeing up to a satisfactory degree, check the mid-portion of adductor magnus (where presumably we'll find a trigger point hard at work). Note that attachments in the hip joint run very deep, so enhanced relaxation is called for first. In other words we don't dive in here a mere five minutes into the massage. "It’s not how deep you go, it’s how you go deep." – Ida Rolf It’s also here, potentially, where we address the pre-existing quad/hammie 3:1 imbalance. Or perhaps more accurately, we set the table for a spontaneous rebalancing to germinate. Schatz, by the way, asserts that when people are put on exercise programs to make muscles stronger, they actually get weaker. These programs only stimulate the production of more fibrotic (knotty) tissue and Gorilla Glue. Once this occurs, release will rarely happen on its own. Nor will release occur by force; it must be coaxed, minus any goading, as if we're gently leading elephants around the circus ring with a more benign goad. This element of nudging is another way of expressing the concept of “relaxing into length,” which is the physical counterpart of "letting go." "One cannot coax and rush at the same time." – Bernard Schatz (2002) “It does not seem reasonable to start with strengthening of the weakened muscles, as most exercise programs do. It has been clinically proved that it is better to stretch tight muscles first. It is not exceptional that, after stretching of the tight muscles, the strength of the weakened antagonists improves spontaneously, sometimes immediately, sometimes within a few days, without any additional treatment.” – Dr. Vladimir Janda (1928-2002), Czech expert in chronic musculoskeletal pain (Didn't Janda really mean to say 'address the trigger point of the tight muscle first'?) "Muscles tissues need time to readjust toward normality – need coaxing, so to speak." – David "trigger point" Simons, MD "When injured, most tissues heal. However, skeletal muscles readily develop habits of guarding that limit movement and impair circulation." – Janet "trigger point" Travell MD, 1976 "Some of us think holding on makes us strong, but sometimes it is letting go." – Herman Hesse, German-Swiss poet (1877-1962) "If you hold back in hurdles, you are going to fall over." – Sally Pearson, Australian Olympic medalist For now, we will also assume that the TFL/ITB continuum, when it dries up to the shape and consistency of a leather strap on the chair of an old-fashioned barber, cannot perform its partnership role with the adductors, handing us yet one more source of groin-pull predisposition. For the record, Ylinen & Cash assert that one can't release the quads properly without addressing the ITB. In his later work without Dr. Ylinen, Cash clarifies the picture even more by asserting that the ITB, in effect, is the tendon of the TFL. It connects the TFL to the tibia and controls lateral knee stability. Ebner (1985) noted that the ITB tends to shorten when its blood circulation is compromised. We address this situation by working ITB's fan-like origin at the ilium. Per Ebner, increasing blood supply anywhere in the pelvic region – particularly the sacrum – helps harmonize the interplay between the sympathetic and parasympathetic aspects of the nervous system. This improved pelvic circulation predictably generates a heightened sense of well-being. Ebner's assertion illustrates the key contribution of the German bindegewebsmassage, or connective tissue massage, first developed by one Elisabeth Dicke in the 1920s. Though she suffered from a paralyzed leg, Dicke emphasized working over the iliac crest and sacrum. In her self-treament, Dicke noticed her own ‘infiltrated’ tissue over these areas. Rather than producing force, the TFL is designed to control it, and TFL coordinates with adductor magnus to produce stability in our gait. Distortion of the TFL/ITB can also lead to ACL problems, whose tears can begin with imbalances in the hip. The infamous ACL (anterior cruciate ligament, located behind the patella, helping bind tibia and femur) is also thrown out of gear by tightness in the hammies (Starlanyl, 2013). To complete the loop, as it were, the hammies can be structurally "married" to adductor magnus (Myers). The adductors are intimately connected with the psoas, so working on them entails working on the other (from Spinal Manipulation Made Simple, 2001, by Jeffrey Maitland). As we can see, therefore, it doesn’t take a great leap of logic to discern that a glued psoas predisposes us to a groin pull as well as tightness in the quads to a degree that downgrades the function of not only the hammies but the barber strap as well. Shortened psoas fibers also keep continuous pressure on the intervertebral disks in the lumbar region and may be at the heart of many otherwise unexplained disk problems. Even in healthy spines we can find instances of vertebrae moving together as a unit rather than individually (per Myers), and psoas may be the main culprit. Lumbar tension may also lead to a twisting of the sacrum (bus depot), leading to yet one more pre-existing imbalance in our gait. "By her gait the goddess was known." – Virgil, Aeneid "Feet are tattletales. Every imbalance at higher levels shows unmistakably in the feet and ankles." – Ida Rolf "Good health in the lumbar plexus and its neighboring autonomic ganglia is basic to the well-being of a person." – Ida Rolf How do we pull these factors together into a workable sequence? As with the book Thai Bodywork (2002, Niclaire Mann & Eleanor McKenzie), instructor Ananda Apfelbaum (Thai Massage, 2004, a so-so text) illustrates the powerful technique of "walking" up the adductors. The client lies supine – face up – while the sports masseur (or whoever) sits on the massage table or floor near their feet and "walks" the adductors and inner thigh with their feet. This is definitely one move where photographic illustration trumps verbal description. (Moreover, at this point in the game I do challenge you to address trigger points with merely your toes.) We’re working now to unlock hip rotators, which also function as spine stabilizers, and we’re helping to further unglue the combination rotator/flexor known as our psoas/iliopsoas. One caveat: I consider this stretch appropriate only for those who work out on a fairly regular basis and are already strong, lest undue soreness overtake our partner the next day. Author Michael Gach (Acupressure’s Potent Points) describes this stretch as "juicing" the thigh. For additional precision of pressure, hold and tug your partner’s foot as you “walk.” While it’s not a guarantee, we’re seeing enormous potential, in a very brief time, for freeing unwanted and unneeded muscular tension in the pelvis and groin, the tollbooth that precedes leg function and speed. Says sports-massage “czar” Jack Meagher, a groin-pull is the granddaddy of all sports-related injuries. Don’t settle for someone taping you up (and consider paying the toll before you hit the road). For the record, sports massage educator Mel Cash says that what we call “groin strain” can actually result from tissue damage near the pubis attachment. During a sports massage session, this brief sequence known as walking the adductors is second in importance and effectiveness only to the benign PNF applied from the ankles toward the psoas/slow-ass. To insure that the body is prepped adequately, both movements should occur well into the timeframe of the massage sequence, if not near the end. Restricted range of motion within the adductors can go unnoticed for years. When released, the gluteus medius can start to kick up (Starlanyl, 2013). “We settle for so little! As long as we can get by, we let it go at that.” – Moshe Feldenkrais “Hit the shot you know you can hit, not the one you think you should.” – sport psychologist Bob Rotella Before we leave the legs, let’s make a couple brief observations about the calf, our "ground zero" for preventative maintenance: Even the soleus muscles located here can maintain a spasm-like grip on the lower back, says Davies. The soleus is sometimes called the body's "second heart" because of the role it plays in helping pump blood back up from the feet and legs. For this reason, he suggests, poorly functioning soleus muscles can lead to low blood pressure and/or weak spells that seem to arise out of thin air. Trigger points here can also lead to the development of varicose veins. One fine way to quickly wear out the soleus muscles, he adds, is through overly enthusiastic aerobics. “When legs are freed of spasm, varicose veins subside and the feet get warm." – exercise pioneer Bonnie Prudden Tightened calf muscles, by the way, are responsible for at least half the pain we feel on the bottoms of our feet, and they can also refer pain to the back of the knee (our 360 joints take an inordinate share of pain referral from TPs). When tightened, calves can also affect the fascial continuity around the heel/calcaneus, which functions in many ways like the sesamoid patella, a glorified pulley, so to speak. The heel in this case is drawn more into the ankle in what may be an unexpected and undiagnosed source of foot pain. Myers (2009) also points out a fascial continuity between the heads of the gastrocnemii and the distal hamstring tendons, providing us an additional hypothetical (and perhaps unexpected) gateway toward hammie treatment. Myers further notes that tight hamstrings often generate limitations within plantar fascia. In a similar vein, so to speak, Davies asserts that TPs in gastrocnemius produce most of the pain in the foot's arch. Lurking just beneath, TPs in the long toe flexors, particularly flexor digitorum longus, contribute to sore feet as we walk. Taken together, we now see how plantar pain can originate both in the hammy as well as the calf. Let's leave the calves for just a moment to point out a similar phenomena upstairs, namely when trigger points help pull the head of the humerus (upper arm bone) tightly into the glenoid (socket) fossa of the shoulder blade, or sometimes up against its acromion process (speedbump up top). This condition, sometimes labeled "impingement syndrome," also goes by the colloquial name of swimmer’s shoulder. Note that sports massage for a swimmer is mainly considered an affair of the shoulders. When this debilitating condition occurs, place trigger points in the rotator cuff muscles atop your list of probable culprits, remembering that trigger points can diminish performance even when no pain is felt (source: Davies). Fossa comes from the Latin for ditch (where the arm bone sits), where we find fossils. Acromion comes from the Greek akros, meaning "highest", and omos (shoulder), meaning we should hold the city of Akron, Ohio in the highest esteem. It's also been suggested, by the way, that the glenoid fossa is more of a dish than a ditch, meaning that the humerus snuggles in here more like a ball on a plate. Back to the calves and away from Akron, it may also be worth noting that muscles here, per Dr. Serizawa (1976) are controlled by the sciatic nerve. Serizawa then asserts that impingement of the sciatic, which can reach the width of our pinkie finger, can therefore lead to cramping in the calves. Whereas the sciatic is traditionally bullied by the piriformis, perhaps it's really the psoas acting up behind the scenes, leaving us with a cramp in the calf that arises apparently out of nowhere while the sciatic gets the blame, regardless of how many bananas we eat or Gatorades we drink for their purported potassium and electrolyte values. (It's been suggested that much of the "research" regarding Gatorade's value has been funded by Gatorade itself under the veil of the "Gatorade Sports Science Institute.") The physician/runner/author George Sheehan once observed that a high percentage of sciatic-pain patients display abnormal lumbo-sacral x-rays. – from (Running and Being, a rather pretentious work from 1978, suggesting the role of piriformis in distorting pelvic alignment) Regarding the debilitating effect of those Charley horses in the calves, especially the nocturnal variety, the popular literature tends to come up woefully short. While the sciatic nerve and psoas may play a role in cramping, the main culprit appears to be trigger points located in the lower leg, both front and rear. This holds especially true when the body is fatigued, which creates signal confusion resulting in muscular self-protection leading to temporary shut-down. Starlanyl & Sharkey, meanwhile (2013), implicate trigger points in the quadratus lumborum. Serizawa (1976) suggested we look for an impinged sciatic, which innervates calf muscle. Also, we shouldn't overlook the potential role of unresolved scar tissue, since scarring itself can produce similar effects as do trigger points. (Shiatsu exponent Namikoshi [1981] also implicates the role of fatigue.) Regarding alleviation, the point known as Gallbladder 34 is considered an effective spot for treating spasm and cramp of the calves. It's located at the proximal junction of the tibia and fibula. Ditto for Bladder 40, located in the middle of the crease behind the knees (Mercati '97). This backs up Starlanyl/Sharkey's assertion that if the calf fatigues or cramps easily, the popliteal artery may be entrapped. Curiously, the bladder meridian runs along the same pathway as the sciatic nerve (Dougans 2006). Notice also the general pattern that shiatsu points enjoy camping out at joints, creases, as well as the midpoints of muscle. Isn't it curious then that trigger points also enjoy pitching their tents at the midpoint? "I used to get tired in a game when I wasn’t mentally prepared." – Des Drummond, English professional rugby player (his body was choosing to go unconscious) "It is better to be tired from physical exertion than be fatigued from the poisons generated by nervousness while lying awake." – Joseph Pilates, whose professions included boxing, performing in a circus, and training British detectives in self-defense "Spasm can exhaust the sufferer even while the pain is alleviated by medication." – exercise pro Bonnie Prudden Simeon Niel-Asher (2005) implicates trigger points located in the gastrocnemius as well as the toe extensors of the shin, the latter of which can foster toe cramps, the kind that like to ambush us in the middle of the night. John Cross (2010) tries to make a case for acupoints located in the webbing of the feet and hand, but his argument does not hold up to a satisfactory degree. Starlanyl (2013) points toward TPs in the quadratus lumborum as well as impingement of the popliteal artery behind the knee. Meanwhile, you can spend an entire day looking for this discussion in a fitness book, with a couple extra hours trying to find any book whatsoever on the topic of cramping, and you'd still come up dry. However, an astute reader who pieces this puzzle together may someday, inadvertently, also come up with a reliable treatment for the mystery known as restless leg syndrome. (Cramping has also been attributed to electrolyte imbalance, dehydration, as well as hypothyroidism.) Regarding the achilles tendon, it's OK to apply deep pressure here to clear congestion and improve circulation (Cash). Per Phaigh, cross-fiber friction to tendons, achilles included, helps loosen their bindings to their surrounding sheaths. (It's said that the achilles doesn't have a full sheath but a softer paratenon, and achilles tendinitis accounts for about 10% of running injuries.) Cross-fiber should be avoided, of course, on newly injured areas, as should outright force when an achilles tightens up. Twisting the foot is a far-preferred method. If the so-called tendinitis is accompanied by a burning sensation in the achilles, explore the role of trigger points referring not just pain but nerve entrapment. The likely site of these TPs would be the soleus of the calf, the quadratus plantae on the sole, or tibialis posterior, which lies deep to soleus. For those keeping scorecards, quadratus plantae also goes by the moniker of flexor accessorius. Per Myers, in a customary burst of original thought, there is virtually no discontinuity between a tendon and its surrounding sheath. Polyhedral bubbles provide the lubrication necessary to maintain the balance between the need to move and the need to transmit force, which in the case of the achilles is substantial. Its array of fibers spiral by up to 90 degrees to achieve this capacity. Per Cash, for large tendons encased within a sheath, such as the achilles, we can sometimes feel a creaking sensation (termed crepitus) during movement. Crepitus is an indicator of scarring within the sheath itself. Crepitus/crepitation: – Where noises are produced by the rubbing of parts, one against the other. – From the Latin crepare, meaning rattling, creaking, or sometimes rustling, like leaves. – The subtle noise produced by bone rubbing against bone or cartilage, as can be found in arthritic conditions. – The sound that can be created when two rough surfaces in an organism's body come into contact. (Let's now get off this topic, lest we sound like a steamy romance novel.) On the opposite side of the calf, Phaigh reminds us that the sheath that encloses shin muscles needs to expand in conjunction with them. If not, blood circulation will be reduced and increased pressure will be placed upon nerves, leading to shin splints. Shin splints are usually caused by fatigue of the lower leg muscles where tendons attach to the tibia. The term refers to when an aggravated muscle shortens and stiffens, forming a type of splint to prevent further injury. If you have shin splints, your shins can feel sore when you walk and on fire when you run. Per Dr. Mally, however, the term shinsplint ('foreshortening,' if you will) falls under the category of what he calls "wastebasket diagnosis" – a catch-all term for when other explanations prove themselves bosh. The imprecise term often bedevils runners putting in over 30 miles per week on hard surfaces. With these runners, the tibialis anterior is probably "tacking onto" the tibia, to borrow an expression from Earls & Myers (2010). In this case, tibialis anterior needs to be "cleaned away" as they put it. Before we leave the calf, let's allow Myers to remind us that tibialis anterior extends deeper than we generally give it credit for, and that it's now the custom to call the peroneals of the calf the ‘fibularis’ muscles. Regarding the presence of trigger points (often referred to as TPs in the literature) in the tibialis, Davies asserts they can lead to falls and "presumed" balance problems. Trigger points here can weaken the tibialis, leading towards feet that drop when they shouldn’t (a cousin of restless leg syndrome?). Too many TPs here also diminish our desire for proper levels of training and exercise. Note that the peroneus longus (with brevis) acts like a stirrup for the foot (Ebner). The possible role of the peroneals in restless leg syndrome, not to mention cramping in the foot and leg, now becomes easier to envision. Myers also notes that peroneus/fibularis "locked short" can widen the gap (depth of bowstring) between tibia and fibula, which can help explain hitherto unresolved tracking abnormalities in the feet. Alternate definition of "locked short": More susceptible to new injuries and trigger points Says Phaigh, formerly of the fabled Athletics West Track Club in Oregon, ten minutes of deep-stroking and kneading the calf can double the blood flow here for up to 40 minutes. On the other hand, ten minutes of exercise can increase, though not double, the blood flow for but 10 minutes. Working with former Olympian Mary Decker Slaney, Phaigh noted how she had abused her legs by severe over-training as a teenager. By the time she hit her twenties, says Phaigh, Slaney's calves felt like "a sack of marbles" – loaded up with knots and scar tissue. A student of the Therese Pfrimmer method of deep tissue massage, Phaigh took it upon himself to massage Slaney's calves so deeply that her body's own fluids could permeate the scar tissue and soften it. As a result, the scar tissue gained pliability and was less likely to re-tear. At this point, said Phaigh, the scar tissue now felt less like a callus and more like skin, less irritating to the surrounding tissue, reducing the likelihood of fiber-tearing spasm. Through this method Phaigh may have also inadvertently given us one more tool in our ongoing battle against leg cramps. “The cell is immortal. It is merely the fluid in which it floats that degenerates. Renew this fluid at regular intervals, give the cells what they require for nutrition, and as far as we know, the pulsation of life can go on forever." – French surgeon Alexis Carrell, Nobel Prize winner for medicine, 1912 “Underused muscle fallen flaccid doesn’t provide enough pumping action to bathe nerve cells with intercellular fluids." – Dean Juhan, Job's Body “Over-training is, to my way of thinking, the biggest medical problem incurred by talented runners who lack the experience or discipline to cope with their own enthusiasm." – Marti Liquori, Olympic track competitor and commentator “I have a saying: 'train, don't strain.' The Americans have the saying 'no pain, no gain' and that's why they have no distance running champions." – Arthur Lydiard of New Zealand, ‘All-Time Best Running Coach’ per Runner’s World magazine “Most athletic injuries of the lower extremities are not due to trauma but to overuse." – Dr. George Sheehan, Running and Being, 1978 The first masseur at Athletics West was the Finn named Ilopo Nikkoli, whose deep pressure work was met with skepticism by some runners. That is until more than a few of them began to experience fewer injuries due to his work, possibly because resistant scar tissue required the deeper pressure that other masseurs hesitated to apply. Slaney also noted that her injury time increased when travelling took her away from Phaigh for extended periods. She may also have noticed, "inexplicably," better times in her performance, for Nikkoli's work certainly impacted another deep calf muscle of Slaney's: her flexor hallucis longus, which controls the big toe. Together with the achilles, a supple flexor hallucis (from the Latin hallux for "big toe") works synergistically not merely to move the foot forward but to actually propel it, placing an astute athlete at a competitive advantage over competitors whose personal trainers diddle on the sidelines looking for ice packs. Essentially a deep calf muscle, flexor hallucis (which sounds like the name of a bad guy from the Marvel Comics) can also refer pain to the big toe. Scar tissue It's rather unfortunate that 'Scar Tissue' is the title of the biography (really a hired-gun puff piece) of one of the least talented performers in so-called alternative music history, namely Anthony Kiedis of the supremely untalented but hyper-marketed Red Hot Chili Peppers. That said, it's rather safe to assume that Slaney's calves suffered more than their share of scar tissue that formed in response to tears, microscopic or otherwise, in her musculature. Whether it's a structural flaw or whether there's an intelligent design behind the situation, scar tissue has a nasty habit of forming in rather haphazard fashion in comparison with normal muscle fiber. While attempting to form a bridge to help reconnect tears, evolution has seemed determined to produce some overkill in the healing process, leaving us less limber than before the injury or insult occurred. A key point here, according to Phaigh, is that damaged muscle tissue does not regenerate itself. The bandaid that nature provides us, the healing scar tissue, is of a different cellular quality: strong and pliable (some sources disagree on the pliability) yet somehow irritating to the main tissue. In fact, when left as is, without physical intervention from a therapist, scar tissue can irritate a muscle as much as a grain of sand in the eye, a point not discussed in the sports massage literature as often as one may expect. Scar tissue presents other problems as well, including the fact that it contracts as it ages (Bill Foran, et al). And as with a trigger point, which we'll discuss next, the nervous system seems to overreact to even the tiniest of scars, firing away to keep the muscle in a shortened and often painful state, all in the name of self-protection. As a result we're faced with yet one more renegade signal to neutralize. Chaitow calls it "neurological mayhem," though "nerve kerfuffle" sounds a speck more charming and memorable. Says Phaigh, the prevailing theory for years among physiologists was that massage led to the reabsorption of scar tissue back into the body. In practicality, however, what we aim for is a better realignment of chaotically formed scar tissue with the original direction of the muscle fiber, parallel rather than perpendicular. We're sanding off the rough edges of the scar tissue, as it were, helping to reduce the pain and irritation that occurs when scar tissue contacts and perhaps offends the healthy muscle tissue. In his sports massage video of 1996, Dr. Mally of California, some 12 years after Phaigh, illustrated this point even more clearly: Irregular, thick and weak scarring, a source of adhesions between the original healthy tissue and its inferior bandaid, can also induce muscle spasm, often at inopportune (anti-kairos) moments, say at four in the morning when we're still fast asleep. “The time is out of joint." – Hamlet “Know the right moment." – Pittacus of Mytilene (640-568 BC) “Between too early and too late there is never more than a moment." – Austrian novelist Franz Werfel (1890-1945) “Months of preparation, one of those few opportunities, and the judgment of a split second are what makes some pilot an ace, while others think back on what they could have done." – Pappy Boyington, ace fighter pilot in World War II “If you saw it, you missed it." – saying among professional photographers "Nearly all trouble comes from mis-timing." –Freya Stark, Anglo-Italian explorer and travel writer (1893-1993) “Take your time in deciding, but when your mind is made up act swiftly." – Isocrates (436-338 BC) “Tempus fugitus et non come-ee-backibus." – heard in the seminary Massage to the scar area, particularly deep-and-slow cross-fiber friction, can help increase the fluid content of the scar tissue (shades of Pfrimmer theory), increasing its pliability and thus its performance-capacity during competition. The affected muscle may not be able to stretch to its full pre-injury length, but at least its contractile abilities are improved. This is the best option nature seems to offer us, given the prevailing assumption that scar tissue cannot be eliminated, nor can the hapless Chili Peppers at this moment in time. Says McGillicuddy, cross-fiber friction does have a track record of breaking up minor scar tissue (and the adhesions it forms between fibers of healthy muscle tissue), but wait at least three weeks before attempting this. By holding off this long we give the scar tissue time to solidify, a point also taken by Mally. Mally also seems to suggest that some scar tissue is reabsorbed this way, helping to bail out the physiologists of old. Top-tier sports masseur Mel Cash (cited earlier; see bibliography) leans toward the reabsorption theory, claiming that if we don't flush away particles that remain after deep friction, they can reform and recongest. We "flush" these particles away indirectly with superficial strokes, though it's the improved circulation that does the bulk of the work. Cash advises not to break up scar tissue for more than a minute lest we stimulate a local reflex contraction. Note however that the renowned Dr. James Cyriax (1904-85) advocated working for up to 15 minutes, though some practitioners may consider this excessive. (Cyriax spent much of his career at arms-length from the British medical establishment. His name lives on while the establishment of his day does little more than push up daisies in the boneyard.) Once the debris is cleared, says Cash, we stretch the affected tissue to help restore normal length. Another practitioner not embraced by the medical mainstream was one Dr. Oakley Smith, an early American chiropractor from Iowa. Smith noticed in the 1930s how scar tissue could account for some otherwise unexplained symptoms. Based upon his anatomical research, Smith discovered that when dense or fibrous connective tissue (muscles, tendon and ligaments) become damaged through overuse, they produce a scar-like condition in the body. This scar tissue can impede the performance of nearby nerves. Smith termed his treatment protocol ‘naprapathy', and he spent his life treating the soft-tissue component of the chiropractic patient. "Huge numbers of relievable disorders in otherwise healthy people are not relieved, not because nothing can be done, but because there's no one to apply knowledge already there for the asking." – Dr. James Cyriax (1906-1985), regarding the hesitance of medical professionals to embrace alternative methods of healing "Penicillin sat on a shelf for ten years while I was called a quack." – Sir Alexander Fleming of Scotland, developer of penicillin, winner of the Nobel Prize for medicine, 1945 "It takes fifty years to get a wrong idea out of medicine, and a hundred years to get a right one in." – English neurologist John Hughlings Jackson (1835-1911) Don't be afraid to penetrate areas of minor soreness, but go tenderly at first, feeling for areas of lumpiness, no more than twice a week. Be sure to warm up the area before and after the cross-fiber work, which is related to the Japanese practice called kenbiki. Kenbiki is essentially a variety of vibration/shaking/rocking movements designed to disperse and calm jitsu (hyperactive) areas as well as increase circulation. According to Masunaga, by the way, it is easier for a practitioner to find these jitsu areas (protrusions/active/grass-like) than to find the real source of the problem – the corresponding hollow areas of kyo, which are more passive and root-like. In a sense these kyo areas resemble the indentations on a golf ball, but deeper, and like a coy flirt they play 'hard to get' when the body is stiff. Masunaga says the temptation is to concentrate on the jitsu point where the stiffness can be felt. However, he says, skilled therapists don't travel this route. "A shot that goes in the cup is pure luck, but a shot to within two feet of the flag is skill." – Ben Hogan, World Golf Hall of Fame "One of the advantages bowling has over golf is that you seldom lose a bowling ball." – Don Carter, bowling Hall of Fame "It is skill, not strength, that governs a ship." – Thomas Fuller, English churchman and historian (1608-1661) "Managing is like holding a dove in your hand. Squeeze too hard and you kill it, not hard enough and it flies away." – Tommy Lasorda, Los Angeles Dodgers "An audience reflects an actor’s attitude as faithfully as a mirror. If he is relaxed and sure of himself, his audience gives him its heart. But if he feels fear or works too hard for his effects, there is thrown over the house the chill of discomfort." – Fanny Brice, stage and film actress (1891-1951) When we find the jitsu spot and then its corresponding kyo point, we just hold the jitsu point and tonify (increase the available energy of) the kyo. Only then will the stiffness and resistance in the muscle connected with the jitsu (grassy) point subside. It is palm pressure to the kyo that helps attract deficient ki, and we can assume this technique relies more upon intention than force or willpower. Masunaga says it takes more time to normalize (tonify/strengthen) kyo areas (jitsu areas call for sedation) because warmth (and intention) must reach deep inside them to nurture strength. The classic medical books of the Orient compare tonification with waiting for the arrival of a lover – affectionately, patiently, and without regard to time. “Kyo is the world of emptiness." (as in ‘hollow’ or ‘not ready’; it also suggests ‘broken concentration’, which of course carries ramifications for sports performance) . . . . Technically kyo means 'a state that is void of ki energy'. The symbolic character for kyo represents something that is sunken in the middle. Have we perhaps stumbled upon a physical counterpart of low intention? – Ryokyu Endo, Tao Shiatsu, 1995 Notice if you will the strong similarities between treating scar tissue and addressing trigger points. Alena Kobesova at Prague's Charles University reported on this connection in 2007, commenting that scar tissue, like trigger points, can alter proprioceptive input. Notice also that Masunaga's advice for finding kyo points parallels the ongoing search for trigger points. “Just be patient. Let the game come to you. Don’t rush. Be quick, but don’t hurry.” (Brilliant) – Earl 'The Pearl' Monroe, New York Knicks "Concentrate on hitting the green. The cup will come to you." – Cary Middlecoff, World Golf Hall of Fame "One man by delaying saved the state for us." – Quintus Ennius (239-169 BC), regarding Fabius Maximus "Don't play the saxophone. Let it play you." – Charlie Parker "Balard did not discover bromine, rather bromine discovered Balard." – German chemist Justus von Liebig (1808-73), regarding the French chemist Antoine Balard "The trick always, in taking a sucker, is to get him to suggest a bet." – Marty Reisman, The Money Player, 1974 "The finest trick of the devil is to persuade you that he does not exist." – Charles Baudelaire, French poet (1821-67) "Do not swallow bait offered by the enemy." – Sun Tzu "The Devil is easy to identify. He appears when you’re terribly tired and makes a very reasonable request which you know you shouldn’t grant." – Fiorello LaGuardia (1882-1947), former mayor of New York City Ylinen and Cash (1988) expressed Masunaga's point from a more clinical perspective, one that should encourage masseurs and physical therapists (who love to measure things) to step back a moment and not dive into a troublesome spot immediately. Say these authors, larger muscle ruptures can be felt as a hard bulk of contracted tissue (jitsu) which may be located a short distance from the site of the actual trauma. The muscle naturally goes into contraction when a break occurs between attachments. At the site of the actual trauma, however, a hollow area (kyo) will be felt if there is not excessive swelling. As practitioners, let's give this hollow area as much attention/intention as the more obvious spot. Myers in 2001 (Anatomy Trains), helps fill out our understanding of the matter when he says it's vital to distinguish between muscle that is tense because it is shortened vs. muscle that is tense because it is strained. If one myofascial unit is locked short (concentrically loaded), the antagonist is locked long (eccentrically loaded). Muscles "locked long" are often more painful, but it’s the short and plump "locked short" muscle that needs to be addressed before balance returns. Now one more time back to Rich Phaigh, who points out an often-overlooked area for small tears and resultant scarring here at the origin of the hamstring group. Random scarring here can easily cut down on the length of our running stride. This origin/attachment point can be difficult to find with a client resting on their stomach, so try the supine approach that's illustrated. Working here can help release butt muscles that nearly always tighten when the hammies are torn. The hammie gets a little protection by the tightening, but the healing process gets placed on the back burner. Trigger points / static charge There’s an uncanny similarity between a knot in human muscle and a knot in a plank of wood, and it’s a curiosity that in standard massage texts the analogy is not drawn more often, if it all. While a knot in a wooden piece of furniture or flooring can be visually attractive, it is nonetheless a source of structural dysfunction, for the wood is weaker at that point. In fact, in terms of structural integrity a knot is often worth little more than a hole of the same size. In the first illustration notice the direction of the knot’s fibers: they are generally at right angles or oblique to the grain of the board. At a minimum, they work at cross purposes to the general direction of the grain. If this piece of wood is ever called upon to bend, the knot offers little cooperation to this tensile stress and the wood may crack with minimal pressure. Notice also from the second illustration that a knot is not merely a single spot, it is a radial line of force that can stop a saw in its tracks. (Davies, therefore, wasn't far off the mark when he likened this radial line – a "palpable taut band" of tissue – to a knitting needle, which can give a saw fits.) Now just imagine what this knot, not to mention scarring, can do to hinder free movement in our legs when it shows up as a trigger point. Notice another obvious characteristic of the knot: the grain of the rest of the wood flows around it before it rejoins. The continuity of fibers has been disrupted; distributions of stress are no longer uniform; the bus-lines of force are shunted into unwanted detours. If we have any degree of imagination the discussion of knots in the human body can end here, but let’s of course continue, picturing the knot in wood every time we hear the term “trigger point.” Granted, the word 'knot' is not precisely synonymous with 'trigger point,' but our assumptions and conclusions still hold until the day arrives when better evidence and descriptive powers present themselves. (Per Davies, a knot may simply be a subset of a nearby trigger point; find and treat the TP and you begin to resolve the knot.) "The world is full of obvious things which nobody by any chance ever observes." – Arthur Conan Doyle, The Hound of the Baskervilles "When you hear hoofbeats, think horses, not zebras." – physicians’ adage "All obvious moves look dubious in analysis after the game." – Viktor Korchnoi, Russian chess grandmaster "Chess is the gymnasium of the mind." – Lenin "The strategies of offense and defense are very similar between chess and football." – middleweight boxer Rubin 'Hurricane' Carter When under the influence of a trigger point (or two or three or four), a muscle simply works harder than necessary to accomplish its tasks. This may indicate a source of lingering fatigue, the type described by the English neurologist Sir William Gowers in the early 1900s. (Gowers also dutifully noted these symptoms occur even in "ladies of blameless habits.") With muscle wrapping around a trigger point (road construction) as shown on the illustration, how can our execution of physical tasks be anything but sub-par? "All top international athletes wake up in the morning feeling tired and go to bed feeling very tired." – Brendan Foster, bronze medalist for England in the 10,000 meters, 1976 For example, if we can't bend over to touch our ankles, we've probably got tight gluteals caused by trigger points, which can feel like little dried raisins. And as any masseur has experienced, these raisins can be tough to find on clients whose saddlebag rear-ends are "well-upholstered." Stiffness in general is a clear sign of latent trigger points, which are far more common than active ones. The familiar "groin pull" even stems from trigger points in muscles of the inner thigh (source: Davies), as jockeys at the racetrack can attest. Alternate metaphor for raisin: "A BB (pellet about 0.2 inches in diameter) under a strip of raw bacon." – Dr. George Goodheart, developer of applied kinesiology For an athlete, the measuring rod to determine when trigger points have reached a critical mass of dysfunctionality is this: timing is thrown off considerably (Meagher 1980; Mally 1996). We simply feel out-of-sync, favoring certain muscles over others (without telling the coach). When we bend the wrong way we can “crack.” In and of itself, stretching cannot resolve this situation. "Scratch marathoners once, they tell you how wonderful they feel. Scratch them twice and they tell you about their latest injuries." – Arnold Cooper, professor of psychiatry, Cornell University, 1981 One study by Dutch researchers found that among 77 patients in apparent need of traditional stretching, most recovered sooner without any. Those patients were instead provided with “supervised neglect.” (Diercks/Stevens 2004; Journal of Shoulder and Elbow Surgery 13(5): 499-502) Look again at the wood with the knot fibers working at cross-purposes to the rest of the grain, fibers that can never resolve their misdirection on their own. Likewise, unless correctly treated, a knot or trigger point in muscle is like a government worker or agency; its sole purpose is self-perpetuation. Per Fabian Fernandez (Deep Tissue Massage Treatment, 2006), this knot is a combination of spastic (characterized by hypertonic muscles, as in "spastic cerebral palsy") and intertwined muscle fibers – somewhat resembling a golf ball when we rip off the hard cover. "A vicious cycle of self-perpetuating impulses." – German physiologist M. Bayer (1950) To help disengage the congestion, we stroke away from the center, avoiding the temptation to apply cross-fiber, circular friction or direct pressure. By no means can we muscle it. The trick, per Benjamin & Lamp, is to mimic erasing a mistake on a piece of paper: go too light and the mistake remains; rub too heavily and we do little more than tear up the paper. Let up a little bit after each stroke to allow the enhanced blood circulation to begin its work. Likewise, Ingham discovered that an alternating pressure on the foot is more powerful and effective than a continuous one. So in other words our thumbs walk the feet like a penguin rather than a bull in a china shoppe. Regarding thumb presses and preventing burnout: – Doctors Kolster and Waskowiak (Germany 2003) recommend using the pad; – Shiatsu often allows students to use the tips of their fingers before progressing to the elbows; – Thai masseurs are apt to use the crease of their thumb; – Eunice Ingham, the American ‘dean’ of reflexology, used the corner of her thumb "When you make a trigger point worse, it’s usually because you’re too intent on getting a result." – Clair ‘Trigger Point’ Davies Curiously, trigger points also display a remarkable 70% correlation with classic acupuncture points, says Chaitow. Melzack (Doctor Pain) bumps up the figure to 80%. (There are currently about 251 accepted m-TPs, or myofascial trigger points as compared with about 361 "classic" acupoints and/or tsubo.) Myers has also stated that myofascia can flow in body-length pathways that approximate the paths of traditional Oriental meridians. And the way Davies explains it, the flow of meridians tends to resemble myofascial referred-pain patterns. So, it doesn't take a great leap of logic to discern a connection between trigger-point deactivation and enhanced myofascial function. Further, there is growing evidence that chronic fatigue, lowered resistance to infection, as well as most aches and pains are caused by trigger points. Deactivating them is a crucial step toward breaking up the pain-spasm-pain cycle in a given location. However, says Davies, there continues to be great resistance to the whole concept. Trigger points, these areas of high resistance to current (as are adhesions), can also generate spasm in other muscles, leading to loss of coordination and decreased work capacity. The problem is, we often interpret these weaknesses as a need for increased exercise. But if we don’t deactivate the responsible trigger points, the exercise is likely to enlist other muscles to act as mediocre substitutes, further weakening and de-conditioning the involved muscle (Janet Travell & David Simons, Myofascial Pain and Dysfunction, 1983; a landmark text). "Learning to inhibit unwanted contractions of muscles that function without, or in spite of our will, is the main task in coordinated action." – Moshe Feldenkrais "Injury initiates a deteriorative biochemical cycle." – Janet Travell, re pain/spasm/pain In 1957 Dr. Travell, later a White House physician for Kennedy, discovered that trigger points (which may even be physical counterparts of anger) even generate tiny electrical currents. They generally form near the midpoint of a muscle, near where the motor nerve enters (though some recent research indicates the entry points can be more dispersed). While the cause is not completely understood, they can be a product of muscular exhaustion as pliancy (oscillation) at the microscopic level begins to break down. Muscular sarcomeres (miniscule muscle segments that function as tiny pumps) are overly compressed. Travell and Simons called this phenomena an “energy crisis.” Our good friend Dr. Chaitow has likewise described it as "physiological alarm" and "metabolic crisis." Any attempt to ameliorate the issue by mere pulling will meet with unflinching resistance. The body is now "bleeding energy," as Ida Rolf put it, like a hot air balloon damaged by a puncture hole. For the record, Drs. Travell & Simons also noted that around 75% of pain clinic patients have a trigger point as the sole source of their pain. Travell also believed that distorted perceptions caused by trigger points in the sternocleidomastoids were a hidden cause of falls and motor vehicle accidents. She even implicated trigger points as behind-the-scenes culprits in PMS. (Another physician who treated Kennedy's notorious back problems was one Hans Kraus, who some consider the 'father' of sports medicine in the U.S.) "Perception is strong and sight weak." – Miyamoto Musashi, The Book of Five Rings Per Ylinen and Cash, and also noted by Myers, the smallest division of a muscle that can exhibit contraction is a single motor unit, presumably the sarcomere. The word comes from the Greek sarx, meaning 'flesh' and meros or 'part.' Several motor units in contraction will feel like a small nodule or piece of string in line with the fibers surrounded by otherwise normal muscle. This description compares favorably with Davies' depiction of the "palpable taut band" of tissue that contains a trigger point. It can be so taut, he says, that in certain spots it can feel like a cord, cable, or even the aforementioned knitting needle. Let's go with a tightened rubber band which we'll now strum across the middle. A slack rubber band would not protest the strumming, but a tight one produces a quick snap-back, which clinicians call a "local twitch response." Regarding the compression, Thomas Myers in 2001's Anatomy Trains provides a brilliant analysis that builds upon Travell's observations: Stress passing through a material deforms that material, even if only slightly, thereby ‘stretching’ the bonds between the molecules. This creates a slight electric flow through the material known as a piezo-electric charge. The term piezo-electric basically means electricity resulting from pressure. Any mechanical force that creates structural deformation engenders such a piezo-electric effect, which then distributes itself around the structure, or in the case of the body, the connective tissue system. When chronic, mechanical stress through an area results in increased laying down of collagen fiber and decreased hydration of the local ground substance. Brief evolution of trigger point theory: 1600: Guillaume de Baillou of France coins the term 'muscular rheumatism' to describe myofascial pain 1816: Scottish physician George William Balfour describes “thickenings” and “nodular tumors” in painful muscle 1843: German anatomist Robert Froriep employs the term “muskelshwiele” (muscle calluses) to describe hardened nodes of connective tissue in patients with rheumatic disorders 1898: German physician H. Strauss described "pencil sized" nodules and "little-finger-sized" palpable bands 1904: Sir William Gowers, London neurologist, suggested that inflammation of fibrous tissue created the hard nodules. Gowers introduced the term fibrositis, which is no longer in fashion 1919: German researcher H. Schade described “myogeloses” (muscle gelling) of hardened nodules 1920s: English physician Jonas Kellgren described the phenomenon of "referred pain" 1940s: cardiologists Janet Travell and Seymour Rinzler coin the term "trigger point," possibly influenced by premier shiatsu proponent Tokujiro Namikoshi of Japan 1978: English doctor Benjamin Tivy coins the term myotherapy In 2013, Julian Baker published Bowen Unraveled, which attempted to explain the theories behind the relatively obscure Bowen Technique. Whereas Baker's editors failed to pull the book together into one cohesive argument, a crucial point broke through: Collagen, the primary component of fascia, is laid down in strong spiral units. Each collagen fibril is a triple helix. The more tension we experience (torquing), the more energy is present in these tightly wound, spring-like structures. Like a jack-in-the-box, little pressure or movement is required to release this energy (though it's doubtful that stretching by itself can do the trick). “Traditional stretching releases only about 20% of the fascial system. It doesn't release the other 80% ... the collagenous barrier of the fascial system." (This barrier forms the actual restriction itself as opposed to the elastic component of the fascia.) – national-level massage instructor and author John F. Barnes, who says that fascia is much more than mere 'packing material' For clarification, connective tissue contains both structural and fluid components. The structural component consists of collagen protein fibers. These lie within the fluid gel-like matrix also referred to as ground substance (Green, 2019, citing Myers in Anatomy Trains, 2001). Future research may back up a suggested optimal ratio of one part collagen to two parts ground substance (Jello). To date, too many texts emphasize the Jello and give short shrift to the collagen. Back to Myers, metabolites are less free to travel from blood to cell and back again. The cell suffers from lack of nourishment. In an active area of the body, the ground substance changes its state constantly to meet local needs. In a ‘held’ or ‘still’ area of the body, it tends to dehydrate to become more viscous, more gel-like, and to become a repository for metabolites and toxins. Translation: Pressure and stress lead to bio-electric malfunction. In similar fashion, Juhan noted how even a minimal pressure on nerve trunks diminishes their transmission efficiency, sometimes by a factor of 40 percent. Such pressure, he says, also reduces the flow of fluids within neural axons and therefore the propagation of action potentials. Aside: Juhan (1987) maintains that this ground substance, a transparent fluid similar to raw egg whites (some say Jello), appears in all connective tissue. Some 40+ years before Juhan, physiologist Walter B. Cannon coined the term "fight or flight response." Not to be outdone, Cannon referred to this Jello by the more professional sounding term "albumen," which is synonymous with egg white. Outdoing himself again, Cannon noticed a correspondence between stiff Jello and a diminished capacity to dissipate heat during activity, a point that most authors in the field of sports massage have curiously missed. "The heat produced in maximal muscular effort, continued for 20 minutes, would be so great that, if it were not promptly dissipated, it would cause some of the albuminous substances of the body to become stiff, like a hard-boiled egg." – top-tier physiologist Walter B. Cannon (1871-1945) "The more an organ is exercised, the more it is nourished." – George-Louis Duvernoy, French zoologist, 1771-1855 "Man is as old as his connective tissue." – Alexander Bogomolets, Ukrainian patho-physiologist (1881-1946) The muscle tension is now constant, overstressing muscle attachments, even in younger people. Remember what Meagher said: it’s in the realm of attachments (such as muscle/tendon) where the "action is" in terms of performance. It's also here where trigger points refer or send their pain, as if to mask their true location. The phenomena resembles the distortion of light rays in a swimming pool: once under clear water, our leg appears to be several inches away from its actual spot. Much is made of TPs referring pain, but our understanding of the matter is enhanced considerably when we get Davies' assertion that trigger points also refer weakness. For the record, they can also refer coldness/clamminess caused by constriction of superficial blood vessels. Such points on the skin often appear whiter (like a clam) and feel more rigid. To keep us on our toes, Ylinen & Cash (1988) report that trigger points can also refer warmth as well as the sensation of running water. “If you have a problem with the third act, the real problem is in the first act.” – Billy Wilder, Oscar-winning film director Aside (these are getting out of hand): It's a good time to help clear up a lingering source of confusion in the field of sports massage. Clearly, Meagher cemented the status of the muscle/tendon junction as ground-zero in our efforts to help restore an athlete's normal functioning. And yes, attachments can be the site of trigger points. The temptation therefore would be to dive right into the attachment trigger point and expect the healing gods to arrive without delay. But it was Davies (the "trigger point" guy) who reminded us that attachment trigger points are but subsets of the central trigger point in a muscle, taking operating orders from it without question. This is not only the case occasionally, says Mr. Trigger Point himself, it is always the case. Because of Davies' strict allegiance to the research of Travell & Simons, whose credibility sits on the top shelf along with the Glenlivet Scotch, let's save ourselves and our client some time and aggravation by forgetting the attachment trigger point and concentrating on the central point at the belly of the muscle. Trigger points can also tighten up surrounding fascia (which is composed of two-thirds liquid), making it inflexible. In addition, they can distort proprioception, our mechanism for orienting and positioning ourselves in space, not to mention the basketball court (Benjamin & Lamp). Coined by Nobel-Prize winner Charles Sherrington, the term 'proprioception' has been likened to our 'sixth-sense' and basically means "self-sensing." The word means not merely how we ascertain our position in space, but whether too much muscular effort is being employed in doing so (MacDonald). In this regard, some coaches define the word as "muscle sense." The proprioceptive process operates from within the medulla oblongata of the brain, which maintains, per Dubitsky, an "ongoing program" or operating system that determines the resting-length of every muscle fiber in the body. It is deep release to over-firing muscles, "screaming for attention," he says, that helps the brain to reset any aberrant instructions sent out by the medulla. Proprioceptors are also located in ligaments and joints. These are known as joint receptors, one function of which is to report on the angle of a joint and the degrees of tension within. Aside: One of the bigger mysteries in the canon of massage literature is the shortage of references and citations pointing toward the work of Nobel Prize winner Sir Charles Sherrington (1857-1952). A professor/researcher at Cambridge University, Sherrington greatly advanced our knowledge of body mechanics when in 1907 he published his "law" of reciprocal innervation/inhibition/stimulation. Simply stated, when one muscle is hyper-tense/compressed, its antagonist will generally be weaker and longer to a proportional degree, hindering smooth movement. For instance, a hypertonic bicep will be accompanied by a weak and long tricep. Stated another way, a muscle can relax when its opposite (or cooperating, depending on your point of view) muscle is stimulated. (René Descartes, periodically maligned in the literature of bodywork, had postulated a similar theory in 1626.) It was Sherrington's work that paved the way for some of the highly effective muscle energy techniques, introduced in the late 1940s, popular among physical therapists and sports masseurs today. At this point in our overly long discussion let's go out on a limb (preferably one without knots) and piece together an association that gets mentioned rarely if ever in the sports literature. First, Dubitsky calls the medulla oblongata a monitor for determining muscle activity. Next, it appears we have a second monitor, namely Golgi tendon organs located at tendon/muscle junctions ("where the action is," per Meagher). Cash says these GTOs named after the Italian physician Camillo Golgi are load detectors. They feed information to the central nervous system and help regulate muscle tone. Precise pressure here will inhibit neural messages – presumably dysfunctional ones – emanating from the organ, facilitating relaxation throughout the entire muscle and easing excessive tension in the tendon and its attachment. (Our old friend the “turn off to turn back on” technique.) “Neurons that fire together wire together.” – Donald O. Hebb, Canadian psychologist Says Cash, this method can also be effective for releasing tension in deeper, less accessible muscles, and possibly even more quickly than traditional methods. As Cash explains (1996), it takes time and effort to strengthen muscle fiber. But nerve conductivity, and we're presuming the Golgi/medulla pipeline falls into this category, improves quickly when stimulated. Elmer and Alyce Green (Beyond Biofeedback) have also noted that weak muscle does not always call for strengthening. What's needed, they say, is a return to consciousness and awareness, a point also suggested by Feldenkrais who calls for reestablishing a dysfunctional muscle's internal feedback loop. So, at the base of the skull we have a monitor receiving information from the muscle's reporting station, which gives us a physical explanation for a pathway that others have ascribed to intuition. This mechanism also appears closely related to the famous "gate control" theory proposed by Melzack & Wall (1965). The theory proposes that skin stimulation helps to reduce pain by limiting the amount of impulses that extend beyond the dorsal horn (‘gate’) of the spinal cord, which is closely related in location, and possibly function, to the medulla oblongata ("Oblongata Davida, honey," or so says Iron Butterfly?). Per Chaitow, the two researchers have also implicated trigger points as a causative factor for most any bout of chronic pain. “The spinal cord is the keyboard on which the brain plays.” – Dr. Irvin Korr (1904-2004), professor of osteopathy “We have in the spinal cord the prototype and the foundation for the entire structure of the brain.” – German anatomist Friedrich Arnold (1803-90) In terms of acupressure, the medulla at the center base of the occiput is known as point number 16 along the Governing Vessel, and it goes by the name feng fu or Wind Mansion. Backing up the claims of contemporary researchers and theorists, traditional Chinese medicine also considers this point and area a key spot for improving visual acuity, and thank goodness Wind Mansion is located far from the coccyx, lest it get activated more than is desirable among polite company. Similarly, the Thai word for vital energy is lom, which travels by and through traditional sen lines. Lom roughly translates as wind (aka feng), a term that takes center stage in Chinese healing. To wit, note the Chinese accupoints Wind Pool, Wind Palace and Wind Gate. Now substitute 'energy' for 'wind' to whatever extent you wish, noting how Pool, Palace, Gate and Mansion can describe various intensities of energy flow ranging from stagnation/torpidity to over-abundance. A momentary digression is required here (this page at times is one big digression) to mention that the medulla oblongata at the midpoint of the occipital ridge (base of skull) is one of those "special areas" popular with both serious students as well as new-age dabblers over the centuries. In Eastern terms it's been called the "Brain's Household" for it is an entry point of ki. Says Dubitsky in 1997's Bodywork Shiatsu, when we pull a muscle the spindles send signals to the brain long after the movement has ended. The oblongata portion of the brain eventually thinks the pull is normal. This results in chronic hyper-contraction and an attendant static charge or field around the area, as illustrated on the wood. The flow of qi is now disrupted, producing this wayward charge. Fibers, joints, balance and nearby muscle are now affected. It appears to be our evolutionary fate that the nervous system, closely related to the qi/ki system, lacks an inherent mechanism for resetting this dysfunction on its own. It’s at this point that some intervention, preferably manual, is called for, lest the condition remain indefinitely, even for life. From now on, unless the spot is deactivated, even minor insults to the muscle can reactivate stressors that would have ordinarily been shrugged off. Our manual intervention is aimed right at the offending trigger point, which is held long enough for the proprioceptive feedback mechanism to complete a loop from muscle to the medulla and then back again. This process can take three to five seconds. The movement itself comes not from finger power but from the wrist, as if we're a chef using a whisk. Per Elaine Liechti in 1998’s Complete Illustrated Guide to Shiatsu, the direction of our finger/thumb pressure/intervention should optimally be perpendicular (90 degrees) to the body to allow effective access to the body’s Ki. This Zen Shiatsu concept reflects Buckminster Fuller’s assertion that the real work of life occurs at 90-degree angles, contrary to our linear presuppositions. The brain (medulla oblongata) is now given permission to update its instructions, to reset the involved muscle's resting-length pattern, similar to a heart resetting itself after being jolted by a defibrillator.  While much is made of the "turning off" or neutralization mechanism when dealing with trigger points, the opposite side of the same coin says we're delivering an intentional and precisely placed "sensory overload" back to the brain, coaxing it to reset the instruction manual that informs the proper resting length of a muscle. Stretching in itself lacks this capacity. This intentional sensory overload helps to clear out "peripheral neural static," as Dubitsky puts it, much like the Roto Rooter man blowing out a clogged pipe or a book editor clearing annoying wordiness out of a passage, which is something we certainly need here. Our approach to treating trigger points is based on Travell’s theory that these points generate electrical currents, albeit tiny ones. Our assumption is that currents emanating from dysfunctional nodes of muscle tissue are themselves dysfunctional, as on the pictured plank of wood. When allowed to persist, chronic fibrotic changes may occur. Our best working analogy for the moment is that of the heart defibrillator for those in cardiac arrest. When used properly, the defibrillator for a moment actually stops dysrhythmic patterns in their tracks, reaching a null point as it were; the body then resets itself with normal rhythms. Osteopath Harold Hoover, cited by Chaitow, also developed methods to settle down muscle spindles from their state of exaggerated discharge, though his approach favored finding a muscle's most neutral position versus manipulating tissue directly. Around 1969 he coined the term "dynamic neutral," meaning that this particular null point of sorts is not a dead or static zone lacking activity, but rather a rest stop bursting with potential aliveness and efficacy. "The most important element of a massage is rhythm." – leading massage author/instructor Clare Maxwell-Hudson of London "Move at or below the rate of tissue melting." – Thomas Myers, Anatomy Trains, 2009 "The whole duty of a conductor is comprised in his ability to indicate the right tempo." – German composer Richard Wagner (1813-83) "Rhythm is 90% of the interpretation." – violinist Ruggiero Ricci "Tempo is the glue that sticks all the elements of the golf swing together." – Sir Nick Faldo, England, three-time winner of the Masters Tournament "A good base stealer should make the whole infield jumpy. Whether you steal or not, you're changing the rhythm of the game. If the pitcher is concerned about you, he isn't concentrating enough on the batter." – Joe Morgan, 10-time baseball all-star, commentator "Your rhythm should set the pace of the fight. If it does, then you penetrate your opponent’s rhythm. You make him fight your fight." – Sugar Ray Robinson "Rhythm and timing are the two things which we all must have, yet no one knows how to teach either." (Until now?) – Bobby Jones, World Golf Hall of Fame "Hit me with your rhythm stick." – Ian Dury Similarly, given the aberrant electrical patterns of trigger points, we aim to help disrupt a dysfunctional feedback loop that leads from the muscle to the brain and then back again (per Dr. Mally). We press, without "goading,” he says, to create a temporary ischemia (low oxygen condition so as to temper the fire), a form of null point, a point of nothingness. This may also be the real meaning of the Thai concept of “stopping the blood,” a point some Western practitioners have taken literally due to overly zealous translations and an unchecked skedaddling toward self-importance. A better translation may read 'damping the fire.' “You are denying the trigger point oxygen." – Dr. Janet Travell Mally's method of ischemic compression, however, has grown out of favor. Initially popularized by fitness guru Bonnie Prudden (a friend of Janet Travell), the accepted method is to now provide repeated swoops of the affected tissue, easing off the pressure after each fly-by, allowing ground forces time to regroup (per David Simons, the professional partner of Travell). The intent is to flush trigger points (not kill them) in order to reintroduce the blood circulation needed for self-healing. In fact, Travell & Simons themselves first advocated the comparatively static ischemic compression, which they later modified into the more dynamic Pressure Release. The enhanced circulation now helps reduce the ischemia – lack of oxygen – which is required for the synthesis of ATP (adenosine triphosphate), the catalyst for muscle contraction. Note that the word 'ischemia' comes from the Greek iskhaimos, which itself translates as the aforementioned "stopping the blood." (Why do so few massage texts mention the Latin and Greek origins of the words they use?) Without saying so directly, Earls and Myers update the expression "damping the fire" to "lowering the stimulation threshold" of motor nerves that are basically stuck in the "on" position, like a light bulb that never gets turned off. Without lowering the threshold, it takes little to set them off in dysfunctional ways and at inappropriate times (choking, referred to in some circles as performance anxiety, aka the yips). Note that in the popular literature (Sports Illustrated, for example), virtually no linkage is established between the yips and its physical origins. Only the mental aspect gets discussed, so the articles miss the mark, as usual, failing to empower the reader. Davies adds that muscle tissue not in a state of contraction is electrically silent. Conventional stretching, however, increases the electrical activity, another reason why stretching can make pain worse. (Because of the limitations they place upon stretching, these electrically charged trigger points may be a critical factor in both ligament as well as tendon injuries.) National-level massage instructor Peggy Lamb refers to this constant, never-resting lightbulb as "spindle bias." The nodule of muscle is constantly firing (crying wolf), signaling to a high degree, and to make matters worse it's probably been that way for years, despite many periods of rest, which in and of itself lacks the capacity to deactivate a trigger point. The best that rest can do is lull one into a latent state, ready to act up at the most inopportune time, say one mile before the finish line of a marathon. "Nearest the king, nearest the gallows." – Danish proverb "By reducing the capacity to stretch, persistent trigger points make new injuries almost inevitable." – Clair 'Trigger Point' Davies When working these points, which always hurt when pressed on, we can encourage the recipient to "breathe into" the tenderness, just as arthritis sufferers are sometimes encouraged to "ease into" the pain (source: Performance Massage [1993] by Robert King, a former national president of the American Massage Therapy Association). Notice how “breathing into” and “easing into” dovetail nicely with the concept of “relaxing into length,” a counterpart of "relaxing into results." Earls & Myers, by the way, made a noteworthy contribution to the issue of breathing when they started telling clients "breath into my hand." This in my opinion encourages just the right depth of breathing and offers a physical perspective for a matter that until now has been mainly conceptual; the client can picture the hand as an air sack or balloon ready to get pumped up. Unlike the knot, and owing a great deal to a body’s natural healing mechanisms (homeostasis), our temporary “turning off” is buying some time for the hypertense tissue to reset its sensorimotor pathway/arc in a functional direction or with a functional charge, or both, blowing out the static and its attendant unclear signalling back to the brain. Per Davies, we give these points “just the right” amount of attention – neither too much nor too little, preferably just enough to provoke the proverbial “good hurt” (aka "grateful pain", "comfortable pain" or "welcome pain"), which hastens recovery time. A 'good hurt' is one that is experienced as pain being released vs. pain being inflicted, though if you hit the bullseye your client may utter one or two words not found in the Bible. Another word not mentioned in The Good Book is "endorphin," which should kick in within a few moments to help counteract any excess pain we may have over-enthusiastically inflicted upon the hapless trigger point. For the last twenty years or so, conventional wisdom suggested eliciting a pain level of about 7 on a scale of 10, lest the bindings that suffocate the trigger point remain undisturbed. Perhaps my empathy has grown over the years, but a pain level of 6 seems more appropriate to current times, unless of course you're either a dedicated athlete or direct descendent of the Marquis de Sade. "It is only by way of pain one arrives at pleasure.” (A quote we will not take to the bank.) – Marquis de Sade (1740-1814), French nobleman and "adventurer" This good hurt, not to be confused with Toni Fisher's 1958 smash single "The Big Hurt," should also induce a subtle (or not-so-subtle in some cases) "take-away" from the client. In other words our achy friend on the table will instinctively pull away from our touch when the offending spot is bulls-eyed. This variant of the startle response is known as the jump-sign, akin to the barely discernable "up periscope" that shoplifters invariably betray themselves with at department stores while timing their heists. Here's a reason why experienced reflexologists (not to mention store detectives) don't look so much at their clients' feet as at their faces: to spot the tell-tale grimace indicating the right spot on the foot has been accessed. This pull-away/jump-sign has also been described as a wince, meaning a slight, involuntary distortion or shrinking movement of the body. The 'nervous start': that jolt or jump we make when we hear an unexpected noise, for instance a simple ring of the telephone when we're already wired up. You can bet an hour's pay that trigger points are on edge as well. "To go beyond is as wrong as to fall short.” – Confucius “Too much is the same as not enough.” – Miyamoto Musashi, The Book of Five Rings Aside: In various massage contexts and situations, particularly the application of finger pressure and PNFs, there is wide-ranging professional (though friendly, at least on the surface) disagreement regarding the proper amount of time to apply a particular stretch, pressure, or other technique. It seems the proper amount of time is either determined by "intuition" or the guidelines offered by the most influential scholarly paper at any given moment. Back in the 1930s and 40s, reflexology pioneer Eunice Ingham broke some ground on this matter when she discussed developing our self-concentration so we know when to leave one reflex point – when an application or movement is complete – and move onto the next. If we neglect this level of self-concentration, she said, we will fail (a very strong statement, if one thinks about it). “Nothing has been accomplished if there's anything still left to be done.” – Latin proverb “Do not plan for ventures before finishing what’s at hand.” – Euripides, master playwright of ancient Greece A man brings his torn trousers to a tailor in Athens. The tailor asks, "Euripides?" To which the man replies, "Yes, Eumenides?" "Never start on the ‘next’ until you have mastered the previous." – Nobel Prize winner Ivan Pavlov (1849-1936), Russian neurologist/psychologist/physiologist "Each movement is learned only after you’ve perfected the one before it." – Scott Hamilton, gold medalist in Olympic figure skating By 1995, another reflexologist from London, Pauline Wills (author of The Reflexology Manual) offered even greater clarity on the matter when she took the situation out of the realm of intuition and moved it over into the realm of tangible, palpable, measurable reality. Said Wills in one of the more under-appreciated moments in the history of massage literature, it is claimed by some that when our foot-work to a certain spot is complete, a certain “reaction pulse” registers and can be perceived by palpation. (To enhance your palpation skills, try performing a few massages blindfolded.) In the East, by the way, palpation can go by the term "setsu-shin," meaning literally to "touch the essence." Within this frame of reference we can more easily experience the reaction pulse than from the more clinical framework of mere palpation in its literal sense. “Massage is the study of anatomy in braille.” – Jack Meagher, sports trainer/masseur and author If we keep working beyond this point we can overdo matters and overwhelm the patient’s body. By focusing on the need for self-concentration in order to perceive this reaction pulse, Ingham got us halfway there; Wills simply put us over the top. The concept of reaction pulse has wide ramifications that can be discussed at length, including its tie-ins to the Renaissance concept of sprezzatura and its recognition for when a space is complete. “True eloquence consists of saying all that should be said . . . and that only.” – La Rochefoucauld (1613-1680), French litterateur “Too many pieces of music finish far long after the end.” – Igor Stravinsky (1882-1971), Russian composer/conductor “You never know what is enough until you know what is more than enough.” – William Blake, mystical poet/painter (1757-1827) “A speaker who does not strike oil in ten minutes should stop boring.” – Louis Nizer, Hollywood lawyer (1902-1994) “Too much effort and diligence sometimes saps the vitality and powers of those who never know when to leave off.” – Giorgio Vasari, Renaissance painter and historian “With maturity comes the wish to simplify. Maturity is the period when one finds the right measure.” – Béla Bartók, Hungarian composer (1881-1945) “A good pro referee will know when the player or coach has had his say, and will know when to walk away. An average one won’t.” – Sid Borgia, NBA referee, blacklisted by owners for his integrity “An angry player can’t argue with the back of an umpire who is walking away.” – umpire Bill Klem (1874-1951) “Umpires are most vigorous when defending their miscalls.” – baseball pitcher/author Jim Brosnon “Earl gave me his version of what happened and asked me not to suspend the umpires.” – baseball executive Lee MacPhail, regarding Oriole manager Earl Weaver “Always work the ref’s blind side.” – Fritzie Zivic, American boxer (1913-84) By 2004, author Ryokyu Endo (The New Shiatsu Method), clarified matters even more, saying that when the bottom of a tsubo is reached, it “echoes” back toward us. Endo was referring not to protrusions (jitsu points) but to depressions (kyo points) whose center will feel like the tip of a grain of rice. The proverbial tip of rice is the sha point where ki is most concentrated. Consider it not so much a physical spot, says Endo, but rather an expression of ki. As renewed energy travels to the point of pain or disturbance, sometimes this tip will "echo" as per the observations of Ingham and Wills, indicating the time to back off and move on. Whereas Ingham emphasized the role of self-concentration, Endo says we cannot feel the "rice tip" with our ordinary sense of touch. It must be experienced from a different part of our brain, the part that's developed by empathy, calling to mind Covey's emphasis on character as the precursor to technique. “By concentrating on precision, one arrives at technique. But by concentrating on technique one does not arrive at precision.” – Bruno Walter, German-born conductor and composer (1876-1962) “Ultimately you must forget about technique.” – Morihei Ueshiba, founder of aikido “Most warriors only perform tricks. The way of the warrior is filled with soul and feeling.” – Miyamoto Musashi, The Book of Five Rings “I don't have any tricky plays. I'd rather have tricky players.” – Abe Lemons, college basketball coach “Good players develop a tactical instinct, a sense of what is possible or likely, not what is worth 'figuring out'.” – Samuel Reshevsky, Polish-American chess master (1911-1992) “Men of genius are admired, men of wealth are envied, men of power are feared; but only men of character are trusted.” – Austrian psychotherapist Alfred Adler (1870-1937) “If you don’t live it, it won’t come out of your horn.” – jazz saxophonist Charlie Parker Aside regarding tsubo/acupoints: Tsubo is a Japanese word meaning 'vase'. A tsubo is a three-dimensional unit as opposed to a 'point'. They have been described as "spiraling whirlpools." Their depth can change from moment to moment. They are not perceived by the logical mind, but by empathy. Serizawa (1976) says we have 365 tsubo, often located at organic junctures. "Tsubo is more than point, more than location." – master Shizuto Masunaga “Leadership is a potent combination of strategy and character. But if you must be without one, be without the strategy.” – General Norman Schwarzkopf "There is only one tactic in a race and that is to be always in a position where you can win it." – Herb Elliott, Olympic gold in the 1500 meters for Australia, 1960 "Character is higher than intellect." – Ralph Waldo Emerson "Smartness is the cement, but not the bricks." – Sir B.H. Liddell Hart, Thoughts on War, 1944 "Talent is commonly developed at the expense of character, and the greater it grows, the more is the mischief." – Emerson "The best (work) I have done grew out of things deeply felt, the worst from a pride in mere talent." – Diego Rivera, Mexican painter (1886-1957) "On the whole, the psychological work of the last quarter of the nineteenth century emphasized the study of consciousness to the neglect of the total life of intellect and character." – psychologist Edward Thorndike (1874-1949) (Stephen Covey made a similar observation.) The integrity of this "turn off" theory has been boosted by the famed Dr. James Cyriax of Britain (1904-1985) who has sometimes been called the father of orthopedic medicine. It was Cyriax who championed the idea that deep transverse friction is the best way to break up adhesions between muscle fibers. According to Cyriax, when it comes to applying deep transverse friction, it is the friction itself that is paramount, not the pressure. Finger pressure that’s point-specific probably over-stimulates nerve receptors at any particular location, temporarily “turning them off,” though in discrete cases this course can prove beneficial. Working definitions of adhesion: 1) a fibrous band connecting tissue that is normally separate; 2) an abnormal union of membranous surfaces due to inflammation or injury. Once the point is relieved, now and only now must the muscle be gently stretched to its longest resting length (per Chaitow/Simons/Mally, among many others), just like we're pulling taffy. Per Gibbons, this null point of sorts – when the spindles are less hyper – lasts for some 20 to 25 seconds, which is the critical time frame for application of the stretch, though Gibbons was speaking from the reference point of isometric contraction. Without this stretch of the fibers housing the trigger point, it can reactivate at will. We don't simply apply this stretch "for" the client, either. She/he assists us fully, a line of defense against triggering the myototic stretch reflex in which the spindles doth protest too much. For the record, Chaitow says this null point can last up to 30 seconds, which he calls the "latency period." What's even more intriguing is that a good dictionary will define latency as the aforementioned interval between stimulation and response. Let's briefly restate Chaitow's protocol: Deactivate the trigger point Apply the strain/counter-strain (SCS) technique Apply the stretch. Don't stretch first, but don't leave the stretch out. (This is the essence of the Integrated Neuromuscular Inhibition Technique, or INIT. This procedure combines ischemic pressure, positional release, stretching and reciprocal inhibition. Source: Positional Release Techniques, 1997) "Any painful point found during soft tissue evaluation can be treated by positional release whether the strain that produced it is known or not, or whether the condition is acute or chronic." – Leon Chaitow, MD At this point we go on the “search and destroy” mission for secondary lesions, as Meagher called them before the term satellite trigger points came into vogue. Says Meagher, failure to relieve secondary lesions leaves us open to recurrence of the original problem. Awareness of this domino effect (how central/primary/matrix trigger points engender satellite points bouncing from muscle to muscle) can even help clear up the enduring mystery of some headaches (Davies). Compared to stretching alone, the end result can be enhanced muscular fluidity, an essential counterpart of true strength, bringing relief for longer durations of time. In fact, in 1957 the London physician Louis Moss, publishing in the prestigious Lancet, noted how the treatment of certain “trigger points” gave some patients permanent relief from arthritic pain. The location of these points, he noted, as does Chaitow, matched up well with traditional acupuncture points. (Chaitow also notes that relief from trigger point work can produce immediate results, sometimes in mere seconds. Lawrence Jones and Vladimir Janda suggest the same.) “When a joint enlarges from rheumatoid arthritis, the ligaments get stretched as the synovial lining thickens. This weakens the joint and interferes with function. Trigger points get laid down." – Bonnie Prudden, Pain Erasure, 1980 While resetting fibers in wood is a lost cause, muscle of course is living tissue and our actions can help jump-start the process of witnessing knotted fibers realign with the rest of the muscle, something we also aim for with haphazard scar tissue. We can now do more work, more precisely, with the same amount of effort – or less. It's vital to point out once more, if only for the sake of changing the text color to red, that rest in itself will not achieve the same results, or as Meagher puts it, "undo a full-blown lesion." Inflammations produce edema, which includes a thick fluid (Gorilla Glue) that acts as a healing agent, he says. Unfortunately, this fluid can act as a mild form of cement, binding tissue fibers together, and rest in itself lacks the capacity to unbind them. Muscle relaxants won’t get to the heart of the matter either, and if you go on playing you’ll develop ancillary spasms. “Rest, with nothing else, results in rust. It corrodes the mechanisms of the brain. The rhubarb that no one picks goes to seed.” – Wilder Penfield, American-Canadian neurosurgeon (1891-1976) “Rest leads to post-inertial dyskinesia (impairment of voluntary movement).” – exercise maven Bonnie Prudden Six quick notes for those of us who frequently work trigger points: 1) One of the basic theories of Dr. Lawrence “Counterstrain” Jones is this: give a muscle what it wants. If its pull is shortening up a region, then shorten the musculature in that area in order to work it. This also reduces the pain of application. Jones asserted that until muscular imbalances were dealt with across the board, complete healing and recovery would never occur. (Cash asserts that muscular imbalances can also lead to problems in bone structure itself. This point makes more sense if we envision bones as tent poles or spacers.) “Give the lady what she wants.” – department store magnate Marshall Field (1834-1906) 2) When working a hammy for trigger points (client face down), turn the lower leg into a “gear shift” on a car, possibly even a GTO. This enables us to find just the right degree of shortening before we address the tender spot(s). However, please don't inflict so much discomfort that the client needs to distract himself by wailing out "Moon Over My Hammy." If applying isometric contraction here, downgrade the level of force a little bit. Let's enlist no more than 25% of our client's effort, since hammy-land is so susceptible to cramping. “What is pain or discomfort to a relatively inexperienced runner is merely information to the elite.” – Marti Liquori, Olympic track competitor and commentator 3) Another variation worthy of investigation is an approach known as British Sports Therapy as developed by Stuart Taws. Also dubbed "soft tissue release," we press into an area affected with scar tissue and then stretch out the muscle while palpating for adhesions (clamminess), in theory rediscovering muscle memory. For the past several years, however, Taws has been revising this approach somewhat in order to minimize pain that may be inflicted during treatment. 4) For trigger points within the all-important psoas, bend the knee to a point where it sits over the medial portion of the ASIS. Several "competing" vectors of myofascial force emerge from here, as if the ASIS were a roundhouse or a clock (Myers). Rotate the leg over the inguinal ligament, remembering that the iliopsoas is also a rotator, not just a flexor or stabilizer/fixator. Probe for points just medial to the ASIS. Try adding a slight downward compression on the knee to help the points present themselves more easily. Earls & Myers remind us to politely refrain from telling any jokes at this time. “A rotator spelled backwards is still a rotator.” – a very perceptive soul 5) Of the four quads, the one that receives the most complaints regarding pain is the vastus lateralis. Per McGillicuddy, this quad muscle, a knee stabilizer, is highly susceptible to trigger point activity (in this regard, Travell and Simons called it a "hornet's nest"). Located on the outer portion of the thigh, vastus lateralis is often stronger than the vastus medialis toward the inner side, reducing optimal knee alignment in cyclists and runners. Now we can see why Travell also called vastus lateralis the "stuck patella muscle" in the same sense that Schatz called the TFL the "knee destroyer." Compressions of the thigh (front and rear), among other standard leg techniques, help reset this pre-existing medialis/lateralis imbalance. It is also said that trigger points in the quads are a primary source of knee pain (sometimes diagnosed as patellar tendonitis or "jumper's knee") and may also lead to restless leg syndrome. Per Neil-Asher (2005), TPs in the quads diminish "glide" in the knee and inhibit full leg extension. The knee can also unexpectedly give out or even lock up, sapping strength, though never of course at an opportune time. Likewise, trigger points in the vastus intermedius can lead to the hip giving out. As for that restless leg, a chief suspect is TPs in rectus femoris. 6) Trigger points at first palpation may exhibit no pain, even though our intuition suggests we've located a troublesome spot. If we persist, however, the underlying pain may present itself within 10 to 15 seconds. Aside: Chaitow cites studies indicating that competitive basketball and volleyball players are susceptible to patellar tendinitis (the more professional spelling of tendonitis) and other types of knee dysfunction. The ability to jump is often impaired by shortened psoas and quad muscles and the resulting weakness of the g-max (Gluteus Maximus, a good name for a Roman gladiator, especially if he's an ass). Once muscular balance is restored, says Chaitow, a more controlled jump is possible (Muscle Energy Techniques, 1996). The main "central" quad, by the way, namely the rectus femoris, the one we're most likely to squeeze a day after a hard run, is home to many hard knots in all types of athletes. Runners, for instance, often complain about weak glutes, when it's really the proximal attachment of the rectus (along with TFL) acting up. For the record, Cash says that "imbalances" within the quad group are the most common source of knee pain, though the trigger point approach appears to hold more potential. Cash also notes that such imbalances can affect the tracking of the pulley known as the patella, who also happens to be the daughter of the guy who runs a chain of 7-11 convenience stores. It's said that Patella is quite a dish, albeit a petite one, and isn't it intriguing that the Latin word for small dish just happens to be patella. As half-time approaches, let's clarify some of the differences between trigger points and knots, for there is a substantial degree of confusion on the topic: 1) A trigger point in itself may not be very sensitive to touch. Knots usually are. A trigger point often needs firm pressure and a little time, sometimes 10 to 15 seconds, to elicit pain. “Pain, will you return it, I won't say it again." – Depeche Mode, Strangelove 2) Trigger points can be much smaller in size, down to that of a pencil point. 3) The search for trigger points often begins at the site of the pain before it's deduced back to the actual spot. In this regard, it's helpful to remember that TPs generally refer pain outwards, from core to periphery, about 85% of the time (per Davies, based on Travell/Simons research). “The grand thing is to be able to reason backwards." – Arthur Conan Doyle “The defense tells you when to throw, where to throw and how to throw." – quarterback Sonny Jurgensen, NFL Hall of Fame 4) Knots often come in bunches; trigger points generally stand alone. 5) We work knots from the center toward the periphery. We work trigger points cross-fiber, in one direction only. Neil-Asher (2005) suggests finding the direction that most accurately reproduces the pain. 6) A knot produces local discomfort. A trigger point generally refers pain somewhere else, though not always at the moment we treat them. 7) A knot may simply be a subset, a derivative of a nearby trigger point; find the TP and you begin to resolve the knot (Davies). 8) What appears to be a knot can really be a glorified adhesion or else an excessive deposit of connective tissue (or both). Per Juhan these appear as cysts in muscle bellies. 9) Trigger points are protective devices, red flags, telling us to cool our jets and hold our horses until the muscle tension is resolved. "You translate everything – whether physical, mental or spiritual – into muscular tension." – F.M. Alexander "To get along with me, don't increase my tension." – Ty Cobb, baseball icon of a bygone era "Cobb is a prick." – Babe Ruth Page three Main page