At the Soft Tissue Pain Clinic, we use orthopedic massage as a modality for addressing issues of pain associated with soft tissue.
If you are unfamiliar with exactly what orthopedic massage is or what is so special and amazing about the therapy, I encourage you to spend some time here checking out our website. Inside you will find answers to your questions.
"I am in Pain"
Skeletal muscle is the most abundant tissue in the body, making up 40-45% of total body weight.
With such a large amount of muscle tissue in the body, it's no wonder there are so many muscle-related pain complaints.
What is Orthopedic Massage?
Orthopedic massage is a type of massage therapy that is focused on treating painful conditions which affect the soft tissues of the body.
Why the name Orthopedic?
Although It stems from "ortho" (straight) and "pedic' (child), in conventional medicine the term "orthopedic" is used to refer to the locomotor system, as it describes a conceptual approach to medical practice more than just one particular treatment method. Orthopedic massage in turn is also concerned with the locomotor system (specifically the soft tissue), and a broad spectrum of techniques and approaches to treat soft tissue dysfunction - allowing it to be a more comprehensive and effective approach.
Simply put, orthopedic massage is a hands-on, pain free, multi-disciplinary approach utilizing deep tissue, connective tissue, & stretching techniques - providing a comprehensive system of expertise for the most effective treatment of soft tissue pain and injury, to find a more lasting relief of chronic/continuing pain & restricted range of motion.
Back to top
Who is it for?
Orthopedic massage may be recommended for anyone with previous injuries or chronic/continuing pain.
Orthopedic massage may be recommended by a physician who wants a patient to pursue multiple treatment modalities, or people can see an orthopedic massage therapist independently. In addition, many athletes and dancers receive orthopedic massage regularly to enhance and optimize performance, which reduces injuries and restores balance to the entire body for pain-free movement and optimal performance.
The Path to Pain Relief
With chronic pain conditions, many people start with the standard drugs or surgery. In my opinion, a better place to start would involve less side effects and be a less invasive route. Orthopedic massage is a much more appropriate place to start when we are treating musculoskeletal pain conditions or sports injuries. I also believe that conditions like joint pain/arthritis are symptoms that can result from tight muscles around a joint; thus, thoracic outlet and carpal tunnel syndrome are actually conditions that can be treated with orthopedic massage.
Back to top
How Does Orthopedic Massage work?
Recovering from an injury
Orthopedic massage helps people recover from soft tissue injuries in several ways. Massage can decrease excess neurological activity, decreasing spasm and restoring proper muscle tone and length in the area of injury. Reducing muscle spasm will increase the flow of blood and nutrients to the area, which supports healing.
"...but I never had an injury."
Muscle groups shorten, due to prolonged poor posture or repetitive motions, and shortened muscle groups need to be stretched out or they will pull bones onto nerves and blood vessels, and cause or contribute to all sorts of chronic/ continuing painful orthopedic conditions. Orthopedic Massage can address compensations in posture and movement, as well as treat myofascial trigger points that may be contributing to pain and movement limitations.
"So what's the point?"
The objectives are to restore structural balance (normal resting length of muscles and tissue) throughout the body, dissolve adhesions, normalize the position of the soft tissue and release its torsion, lengthen the connective tissue, hydrate the joints, facilitate normal neurological function, release entrapment of the peripheral nerves, and decompress arthritic or painful joints.
This is done by addressing issues of hypertonis (most commonly, it is an increased state of contraction stimulus to the entire muscle causing it to hold a higher degree of resting tonus than it normally would - muscle memory), scar tissue (disfunctional soft tissue) and the compensitory issues that occur with both of the previous. This allows a focus on the preventing & rehabilitating of soft tissue dysfunctions & chronic pain. In short, to provide an extremely efficient and effective method of therapy.
The Break-down
The work involves thorough functional assessment, myofascial release, structural integration, neuromuscular therapy, positional release, neuromuscular re-education, scar tissue mobilization techniques, joint capsule work, myoskeletal alignment techniques, active isolated stretching, and p.n.f. stretching.
- We use active isolated stretching techniques to increase range of motion.
- We use myofascial, trigger point, pin and stretch, post-isometic relaxation, reciprocal inhibition, and neuro-muscular techniques to reset normal muscle-resting length.
By the very nature of the work, all of these techniques are done pain-free.
Back to top
The Difference:
Training
If you have ever looked for a massage therapist in the phone book, you would note page after page of listings, but only a very few have certification in orthopedic massage therapy as it requires considerably more training.
Knowledge
The orthopedic massage practitioner is knowledgeable and skilled in their understanding of the body and its mechanics, the musculoskeletal system, of pain and injury conditions, and of many different massage therapy treatment techniques.
Understanding
They also must be skillful critical thinkers to understand the condition present, discern which anatomical structures are involved, and what protocols are required to create functional and measureable improvements. In orthopedic massage, we strive to find not just relief of a symptom, but also using different assessment to determine the exact underlying cause of the symptom.
This combination of expertise provides for the most effective treatment of soft tissue pain and injury conditions using massage therapy.
Understanding that everyone is different:
- Muscle/soft tissue testing determines the source of pain patterns and takes into account your overall health history.
- Treatment should be according to your needs, indications, and contra-indications. The orthopedic massage therapist integrates a wide range of techniques to treat a single situation, ideally adapting his/her style for each client, as every person's body is slightly different.
- Treatment will not be the same for each client, nor will each session for the same client be the same. As the body responds, so the techniques, protocols, and treatments will adapt.
- Your treatment plan will be designed to suit your unique needs, but the goal for everyone is the same: to return the individual to a permanent state without discomfort and with full pain-free range of movement.
Four elements are used regardless of the injury or medical treatment involved:
- Assessing the injury/discomfort
- Matching the treatment to the issue
- Adapting the treatment as needed for best results
- Educating you (the client) in ways to prevent future discomfort.
These four points are very important in orthopedic massage, because unlike other forms of massage therapy, the most emphasis is placed on understanding the injury as well as what it will take to address/treat it and create a permanency of pain relief.
Back to top
The Effects of Orthopedic Massage:
Orthopedic massage has many benefits to offer patients, including the following:
- Increased blood circulation—this can help to heal an injury.
- Decreased pain—the massage itself, as well as the side effects caused by the massage, can help to relieve pain. In many cases the pain relief is just a side effect of restoring normal muscle resting length or creating functional scar tissue from dysfunctional scar tissue.
- Relaxation—not only can this reduce pain in the injured area, but it can also help to promote healing by relaxing the muscles near the injured area.
- Reduces tension—this is a great benefit whether it is preventative or used as a pain relief (such as for sprains, etc.).
- Enhanced performance—orthopedic massage is used by many athletes regularly to enhance their performance (the relaxation, tension relief, and realignment help to accomplish this).
- Realigns tissues - Orthopedic massage can take dysfunctional, uncomfortable scar tissues and realign it . This can help relieve pain, promote healing in injuries, as well as prevent injuries.his can help relieve pain, promote healing in injuries, as well as prevent injuries.
- You are taking the restrictions of that scar tissue and moving them with the muscle rather than allowing them to hinder the muscle.
- Managing scar tissue - Massage therapy is very effective in managing the development of scar tissue. In fact, doctors often instruct patients to massage their scar tissue after surgery. There are specific techniques that help your body create the most functional scar tissue possible (tissue that offers both mobility and flexibility in the injured area). Scar tissue (collagen fibers) is very rigid, and will never have the elasticity of normal tissue. but, if you can realign the collagen fibers to the point that they allign with the muscle tissue, you are in essense creating fuctional scar tissue. The body is very good at protecting itself by putting down scar tissue, but it does a very poor job of getting rid of it when you are done healing. These fibers can remain and hinder normal functioning. It's like a lazy contractor. He puts up the scaffolding to fix a building, but leaves the scaffolding up long after he's finished. Scar tissue is the scaffolding that your body puts up to hold everything together as it is healing. The severity of scar tissue is never constant - it can change given a number of different factors, including severity of the injury, and activity levels before and after the injury.
- A low-level amount of scar tissue leaves one somewhat functional, but still restricted.
- Moderate to severe amounts of scar tissue leaves one very disfunctional, creating adhesions in the surrounding tissue, which in turn creates more compensation, pain, and less mobility.
- Dissolve adhesions—Adhesions and excess scarring after injury can limit movement and functioning. This can cause muscle tightness and compensations that, in turn, cause further pain and dysfunction. This scar tissue glues itself to nearby muscles, tendons, ligaments, and other tissues - greatly limiting one's range of motion. Once these adhesions are released, the range of motion returns to a healthy normal, and movement becomes much more natural and free. The process is rather surprisingly pain-free, and the effectiveness often catches clients by surprise!
- Strengthening—this can be helpful with enhancing performance, but it is most helpful to patients who have had an injury and have been unable to use certain muscles in their body due to the injury. When this happens, the muscle will begin to deteriorate over time and orthopedic massage can help strengthen those muscles again.
As you can see, there are many benefits to receiving an orthopedic massage. Whether you are looking for enhanced performance or are seeking to recover from a soft-tissue injury, you can achieve this with orthopedic massage. Start enjoying these benefits by finding an orthopedic massage therapist near you and scheduling an appointment today! If you are not within driving distance of our office, you can find a certified orthopedic massage therapist here.
Back to top
Your First Session
A typical session includes the following:
- Evaluation:
- Client history
- Postural Analysis
- Assess Active Range of Motion
- Assess Passive Range of Motion
- Assess Resisted Range of Motion
- Treatment
- Area Preparation
- Myofacial Release
- Trigger Point Therapy
- Cross Fiber or Multidirectional Friction
- Eccentric Scar Tissue Alignment
- Pain Free Movement
- Stretching (pain free)
- Strengthening (pain free)
- Continuing Home Care Recommendations
The Personalized Evaluation:
First, the therapist will ask you to fill out a brief, confidential health history form. Whether you are hoping massage will help you find relief from pain or support your recovery from an injury or surgery, time will be spent discussing your reasons for seeking bodywork, your expectations, and your history.
Postural analysis follows. Then, the therapist will perform a thorough assessment of your condition. This normally involves range of motion & muscle tests to further identify the soft-tissue structures needing attention. As well as functional assessment tests that can determine most orthopedic conditions and outline a treatment plan using multiple modalities.
After the personal evaluation, the therapist will have a clear understanding of your situation. If the therapist is partnering with your physician, chiropractor, or physical therapist, then the notes from that (those) medical professionals will also be consulted. A treatment plan will then be created.
Back to Your First Session
Your Treatment:
Expectations
While you are in a session, Orthopedic Massage is not anything that you would probably recognize as "massage therapy". That is to say, you don't immediately go into a room by yourself, get under a sheet, and wait for the massage therapist to come in - that much you have realized after reading about the evaluation procedures. The session that follows is not usually passive, but instead active and engaged. It focuses less on relaxation and stress relief, more focused on finding the root cause of a particular pain and relieving it.
Deep Tissue = Pain
Orthopedic Massage is a very deep therapy, but also pain-free. For many people who have experienced deep tissue massage, that may seem like an oxymoron. One of the main ideas behind Orthopedic Massage is that any kind of discomfort/pain that would create a "guarding" response in the muscle group being affected would make any therapy much less (if at all) effective. We try to work with the muscles, rather than against them. If the muscles tense against the discomfort of the work, it defeats the effectiveness of the techniques.
The therapist works with the client on the table. You may be asked to bring shorts or a bathing suit for a postural analysis and/or to make it easier to do stretching or other treatments.
By using various soft tissue manipulation techniques, the massage therapist can alleviate an assortment of painful conditions caused by soft tissue strain. The therapist may release tight muscles, help to stretch shortened muscles and tendons, and decompress joints. The goal is to normalize the soft tissues of the body, both to treat specific conditions and non-specific pain issues.
Depending on your issue(s), multiple sessions may be recommended to treat the problem - to ensure that the problem is eliminated and to build up strength and resistance in the affected area so that the condition does not reoccur.
Back to Your First Session
Home Care:
Your treatment is followed by a teaching session and homework. You will be taught techniques that you can do at home/work to assist in the prevention and elimination of soft tissue injury & pain. These techniques may include problem-specific stretches, tonis building exercises, and tips to improve your posture during daily activities. The suggested homework you receive (stretching exercises) will help maintain what we achieved in session. This gives you control over how good you feel. Back to Your First Session
Back to top
The Pain Cycle
Breaking the Cycle of Chronic Pain
Chronic pain is exhausting. It's stressful. Massage helps to interrupt the patterns that make your pain worse.
You hurt, so your muscles tense up, which makes you hurt more, which makes you anxious, which makes you more tense, which makes you hurt more...
Orthopedic Massage is a non-invasive therapy for persistent, painful problems. Using proven practices the therapist can help you release the affected muscle(s) which will increase blood flow and facilitate healing (reducing the tension and discomfort, breaking the cycle).
Back to top
Credit where credit is due.
The ideas and text expressed herein are not mine, but a culmination of theories, techniques, and protocols learned from the current big names in the field of massage theropy and orthopedic massage - such names as author Whitney Lowe, Dr. Erik Dalton, Dr. Janet Traveli (myofacial trigger points), James Waslaski , Aaron Mattes and many others. I tell all who ask, it’s not just me – it’s the therapy. The therapy is just that effective, and for those practitioners with the will to learn and not get too proud to accept the learning transitions happening in the field of massage therapy, the results that can be achieved for people in pain are just astounding.
Back to top
