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3: Massage Mistruths
556 Plays3 years ago
Welcome to Episode 3 of the Movement Logic podcast! In this episode, Laurel and Sarah discuss massage and self-massage, common (accurate or otherwise) claims about their benefits, and what the research has to say (it’s not what you might think).
- What is massage, and how is it different than manual therapy in PT?
- Can massage increase proprioception?
- Does everyone benefit from massage, or do some people not need it?
- If there really is a problem with our fascia, is massage the answer?
- What therapeutic benefits does massage have?
- What role does massage play in helping trauma-affected populations?
Research Article: Affective Massage Therapy
Research Article: The effectiveness of massage therapy intervention on reducing anxiety in the work place.
Research Article: Massage therapy as a workplace intervention for reduction of stress.
Research Article: Failure of manual massage to alter limb blood flow: measures by Doppler ultrasound
Research Article: Evidence of the physiotherapeutic interventions used currently after exercise-induced muscle damage: systematic review and meta-analysis
Research Article: Adverse events and manual therapy: a systematic review
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Transcript
Introduction to Laurel and Sarah's Movement Concepts
00:00:06
Speaker
Welcome to the Movement Logic podcast with yoga teacher and strength coach Laurel Beaverstorff and physical therapist, Dr. Sarah Court. With over 30 years combined experience in the yoga, movement, and physical therapy worlds, we believe in strong opinions loosely held, which means we're not hyping outdated movement concepts. Instead, we're here with up-to-date and cutting-edge tools, evidence, and ideas to help you as a mover and a teacher.
Massage Techniques vs. Other Methods
00:00:44
Speaker
Welcome to episode three of the movement logic podcast. I'm Laurel Beaverstorff and I'm here with my co-host Dr. Sarah Court. Today we're talking about massage, including self-massage, using a ball, foam roller, massage gun, all the tools.
00:01:01
Speaker
When research around massage is so inconclusive, research shows, for example, there's no difference between massage interventions to achieve certain outcomes like relaxation flexibility versus other interventions like static stretching, why do we still do massage? What exactly does massage do?
Can Massage Fix Issues? Exploring Fascia and Change
00:01:22
Speaker
starting with what I think might be the most central question, which is that if we're massaging ourselves or getting a massage to fix something, what is it that we're trying to fix? Many, for example, claim that it's the fascia we're trying to fix because the fascia is stuck or sticky or dehydrated or there's knots in it. Is that those claims true? And if
00:01:52
Speaker
We are using massage to fix some specific problem. The second central question is, is massage actually going to create some meaningful change to that problem? There's been a lot of inconclusive research. I won't go into the details of some of the studies that I've encountered. And I certainly haven't pored over the research by any means.
00:02:21
Speaker
But it seems to be pretty universally accepted that massage is not outperforming. It's not remarkable in terms of its efficacy. So what's interesting, I think, about Sarah in my conversation
Evolving Understanding of Self-Massage
00:02:36
Speaker
in this moment is actually our history as friends. I met Sarah when I was actually learning to teach self massage. And she was currently training people to teach self massage. And here we are now several years later, neither of us to my knowledge are teaching people how to teach self massage. I still
00:03:00
Speaker
I offer self massage in my classes, Sarah will chime in about how she incorporates massage into her PT practice, but we've come a ways from where we were in terms of our understanding of things and why we're doing what we're doing. And we're here now partnering together on movement logic to have this
00:03:18
Speaker
conversation. So I like to share a little bit about that timeline and that history because I do think it is going to be relevant to what we talk about today. Before we get into it, Sarah and I, while we do have an extensive massage and self-massage background, we have not had this conversation before.
00:03:36
Speaker
We've not planned what we're going to say it's unscripted, and it's really just us bringing to the table our own ideas and opinions and understanding of some of these topics surrounding self massage to kind of think out loud together which is one of my favorite ways to learn. So, let's start with our first question which I think is a great question actually it's.
00:03:57
Speaker
It's my kind of question.
Defining Massage and Measuring Impact
00:03:59
Speaker
What is massage? It's so philosophical. What counts as massage, and what doesn't count as massage? So I'm going to ask you, Sarah, to start us off. That is a very laurel question. It is a less Sarah question, but I'm going to give it a stab. Interesting, because you came up with a question.
00:04:20
Speaker
Maybe I thought you were going to just jump right in. Maybe I'm rubbing off on you. No pun intended. I'm very tempted to start with Webster's dictionary defines massage as, you know, blah, blah, blah, but no. It's an interesting question. I mean, I think it depends on the lens with which you are looking at it that will give you whatever your working definition might be. If I'm very, very
00:04:49
Speaker
We're looking at it just from a biomechanical tissue standpoint. It is some sort of deformation of your tissue, whether it is a person or a ball or a foam roller or the corner of a wall up against your rhomboids or... Can I just jump in with a quick question? Yeah.
00:05:08
Speaker
What is deformation in the context you're using it? And are we talking about temporary or permanent deformation? Yes. Thank you. Thank you. Good questions. Deformation literally means like if you took your thumb and you stuck it in part of your muscle, you have deformed the tissue underneath it by pushing down on it. So that's literally all I mean. As the second I take my thumb away, I am no longer creating that force into the tissue. So I'm being very nitpicky around
00:05:37
Speaker
like not over defining it, meaning it's literally just, you're pushing, you're deforming tissue in that moment that it's happening. The lasting effect of it is what is really in question and the impact of it and what are we actually touching when we touch and what tissues can we actually try to change and what can't we?
00:06:03
Speaker
and what is the benefit of trying to create that change anyway. But I'm literally just saying like, I stick my finger in your leg and I make a dent. And then when I take my finger away, the dent goes away. Thank God. That's it. Right? I just keep poking you and leaving like dents in your body.
Challenges in Massage Research
00:06:21
Speaker
I would look really different if that were the case. Everything that touched me in my life created some permanent deformation. I mean, I would just be a series of, I would be covered in dents, I think we all would.
00:06:32
Speaker
be really stretched out. Yeah just a really strange kind of like liquidy person but I think you know one of the problems with research about the not problems but difficulties inherent difficulties in trying to research uh massage is that it's so to create must to create research that that is actually um
00:06:53
Speaker
quantifiable, you have to try to create a really homogenous group of people that you're studying and it's really hard to do that and especially with something that is so individual as people's perception of massage or how they feel afterwards or whether or not it improves their performance. So to my perspective, you know, it's kind of like I'm just a very like don't throw anything out person because you never know if it's going to be the thing that helps the person in front of you.
00:07:23
Speaker
Yeah. You know, I did do a little digging and I did find that there is actually pretty conclusive evidence, just going to toss this out there, that massage has been able to show positive outcomes for depression and anxiety.
Manual Therapy vs. Massage in PT Practice
00:07:40
Speaker
So anyway, I just wanted to toss that out there. Okay, so what is massage? What counts as massage and what doesn't?
00:07:48
Speaker
I don't know what doesn't count as massage. It doesn't put a dent, like deformation in your tissue. What, I don't know, what do you think doesn't count as massage? Well, I think that, you know, I have been teaching yoga for 15 years and I definitely employ touch as a tool. And I do it in a number of ways. I was never real big on administering hands-on adjustments.
00:08:16
Speaker
But I was taught to administer them and occasionally I would. And some hands-on adjustments were more about just touching the area of the body to bring more awareness to it. Some were about actually physically, manually using my body to move a student's body into a position. And others were actually massages, like the one that you probably have received in Shavasana, where the teacher comes up to you and massages your neck. And hopefully they're good at it because otherwise it's very awkward.
00:08:48
Speaker
And so that's actually like legitimate massage, but I think there's a lot of ways in which, for example, as a P, I wonder, do you use manual therapies in your practice? And are they all massage therapies? Yeah. And the answer to that is yes and no. Like when we're trained in manual therapy, manual therapy is a more sort of accurate
00:09:15
Speaker
umbrella term for any time that we're putting our hands on people because the goal of what we're doing may be different. It may be something like a soft tissue massage, which is what we tend to think of as like, you know, that general massage thing.
00:09:28
Speaker
there are hands-on techniques that are about impacting or influencing the joints and the position of certain bones. We're also totally trained in how to do chiropractic adjustments. It's not something that I do in my practice, but I'm trained in how to do it. When we're doing manual work on people, there's a lot of different things that we can do for a lot of different reasons.
00:09:53
Speaker
Quite often, people are disappointed that it doesn't feel more like a spa massage experience while I'm digging some part of my body into some part of their body. I have a joke with an old patient where he's like,
Massage Tools and Patient Expectations
00:10:08
Speaker
I'm going to write you a Yelp review. Sarah rubbed my leg and it hurt. One star.
00:10:15
Speaker
No, but you know what this actually so you're you're kind of hinting at patient expectations here. Yeah, I don't know that my students come to class expecting and that they ever have expected me to administer massage. I mean, I'm not a massage therapist. So student expectations.
00:10:36
Speaker
maybe not as relevant as patient expectations, especially in the context of PT. So I guess my question to you is like, so do you use massage tools in your PT practice? What are they? What guidelines do you follow around them? But then also, and I don't really know yet where you stand on this, but if there's kind of a, it seems as though there might be a lack of scientific justification for the administration of massage.
00:11:04
Speaker
How do you balance that. Yeah, if you believe that that's true. How do you balance that with your patients expectations that they receive it. Right. Well, and to clarify some people just think that physical therapy is massage so they show up expecting an hour long massage and they're sorely disappointed when I make them start using their body and efforting in some way but
00:11:23
Speaker
as far, you know, every, every PT practice is slightly differently. When I'm in the clinic with patients for the most part, I am using my hands or some other part of my body for whatever kind of manual therapy that I'm doing. If I'm giving them something that is for homework, that is when I'll pull out a tool like a ball or a foam roller or something so that we can, you know, do it together. And I show them what it is that I want them to do at home. Um, you know,
00:11:53
Speaker
It is.
00:11:57
Speaker
One of the things that I think is different about the rehab world usage versus strictly for performance, meaning like, oh, if I foam roll on this, will I be able to squat something heavier? Or will I get that last bit of end range dorsiflexion of my ankle that I've been missing or something like that? The use of it in a rehab setting
00:12:24
Speaker
You know, I have felt tissue change under my hands. I have felt tissue go from rock hard or something that felt lumpy to soft. Now, what is that that's actually happening? That's the part that's kind of
00:12:39
Speaker
up for debate and different people argue different things. There's a lot of people in the fascia world that say that trigger points are not a real thing, that does not exist. And then there are also entire people that learn trigger point release. I get the sense that there are also manual therapists within the realms of PTs who use manual therapy in their practices.
00:13:06
Speaker
claim to be able to assess really very specific patterns of coordination between muscles. What muscles are turned on and turned off if a disc is herniated and or to make very specific diagnosis just based on the way that the body feels underneath their hand. Yeah. I mean, I do not believe that you can manually assess if a disc is herniated. I think that is
00:13:36
Speaker
But I can palpate someone's vertebrae and I can tell how a vertebrae is positioned in relation to the one above and below it. I can palpate what feels like tightness or tension in soft tissue. What I was going to say about that changing with manual therapy is that
00:13:57
Speaker
I don't know the process of what's happening. It may be entirely impacting the sort of neuro muscular system in that the sensation of massage is relaxing to the person. The tension that they're holding in the muscle from their nervous system, talking to the muscle specifically starts to relax. So it's not that I'm impacting the tissue itself by like, if I stick my elbow in it harder, is it going to relax? In fact, sometimes the harder you stick your elbow,
00:14:26
Speaker
the tensor the tissue gets. And I've had that experience as well. And that leads me to believe more that it is that, you know, down regulating parasympathetic kind of response that is actually happening globally to the person for their whole body. And as a result, this place that they maybe are ordinarily carrying a hypertonicity, a greater tension in the muscle can relax. I agree. And
00:14:55
Speaker
A application of massage is much more limited than yours. I agree that massage is primarily a manipulation of perception and, or it's more of an, like a, it has more to do with the neurology of touch and less to do with actually making changes to tissue. But my, my, so my question is based on what you touch and feel.
Using Movement Assessments to Inform Touch Therapies
00:15:18
Speaker
and what you can determine about what is probably happening based on that. Say, for example, you feel that someone's T10 is positioned differently than their T11 or their T9, right? The thoracic vertebra 10 is different than nine or 11. Based on that assessment, are you then able to draw conclusions about why someone has certain symptoms? That's a good question. And that's a sort of practice
00:15:46
Speaker
technique slash preference question. My, and I remember a PT who was a mentor of mine for a long time. She used to say, you know, some people are very movement based and some people are really hands-on based as PTs. We sort of naturally gravitate towards one and the other. Because I came from a movement world, I had years of watching people move
00:16:10
Speaker
and then hearing about where their pain was in their body and kind of putting together their movement with what they're feeling. So my go-to assessment for people when I'm looking at what's going on is movement-based. Other people's go-to assessment is touch-based. I typically
00:16:28
Speaker
anything that I'm doing touch-wise is usually just to confirm what I believe is happening based on what their movement is. And sometimes it completely contradicts what I think is going on. And so that's why it's useful to do both because you don't want to only rely on one skill. If I'm only palpating your spine, I'm like, well, that's why you have back pain is right here. But I'm not addressing the fact that their pelvis is offset or I haven't even looked at their feet or something like that.
00:16:57
Speaker
uh for me it's it's movement first and then touch second as far as being able to tell what's going on with somebody um but that's there are pts who work exactly the opposite or who really only do manual therapy and so their assessment and their treatment is is manual but that's not my that's not my jam i'm a movement person right but do you think do you think that so i have
00:17:25
Speaker
also been listened to several PTs, you know, share their opinions about massage and it, there tends to be, and this is my bias of course, you know, by the way, I teach self massage and I love massage. And so this really is just trying to understand this from the perspective of therapeutic application and a problem solution approach, which is very different than I think how maybe a movement teacher would introduce massage, which
Is Massage Just a Passive Treatment?
00:17:54
Speaker
is,
00:17:54
Speaker
maybe primarily for enjoyment because it feels good, right? But it's a little bit different when we're looking at the clinical relevance of a treatment. Many describe massage as a weak treatment as an adjunct to movement because of how inconclusive
00:18:18
Speaker
It's been shown to be for creating changes, for solving the problem. Yeah. What do you think about that? Well, I agree because this is how I describe it to all of my patients. There's active treatment and there's passive treatment. Passive treatment is anything that's happening to you. So massage, chiropractic adjustment.
00:18:37
Speaker
using ice, using heat, using ultrasounds, like all of these modalities where you're lying there and something is happening to you. Somebody could like massage the knots out of my shoulders and I wish they would. But the second I stand up and I start moving, if I haven't then
00:18:56
Speaker
re educate brain about how I want my body to move in the upper quarter. Instead, if I haven't done what I what I would then call an active treatment, which is a movement based, then there's a reason for my brain to do anything other than recreate the situation that made me get the massage in the first place. And that's when we get people who say things like, you know, I have to get adjusted every week, or I have to get a massage every week. Otherwise, my body is blah, blah. And I'm like, well,
00:19:24
Speaker
or you could actually do some things and then maybe you wouldn't. But so that's how I think about it. I've never seen anybody really get, actually solve the problem because the massage component is usually dealing with the tissues that are irritated or in and around the area that's irritated or something like that. But I haven't learned anything.
00:19:49
Speaker
from that, the person being getting the massage, the patient, the student, I haven't learned anything from that about how I should change how I move. So until I learn a new movement pattern, I'm not going to change my movement pattern. There's no, you have to give the brain a really, really good reason to do it. And if it receives no input at all, if it gets no information, then it's just going to be like, well, that felt good. Now I'm going to stand, you know, within the hour, we're going to be hunched up shoulders and our ears again, because that's just where I know to be, you know,
00:20:19
Speaker
And to go a little further with this idea of changing movement patterns, my understanding, at least from my perspective of what I'm offering my students is I'm trying to provide them with a pleasurable and enjoyable experience so that they keep moving first and foremost. Massage might play a role there. But my understanding is that in trying to change someone's movement patterns, it's less about trying to solve a problem because that's not necessarily my job. I don't consider it to be my job. It might not even be a problem for them, for all I know.
00:20:48
Speaker
Right? My idea is that I'm trying to change their movement patterns so that they have a choice, or they have some more options, or they have actually some more variability in their movement. Diet? Yeah. Biology is so overplayed, but it's so overplayed because it's so good. And or that variability then would potentially also boost tissue capacity if loads are sufficient, for example, strength, right?
00:21:18
Speaker
I think that this might also be what you're helping people to do, but when you see your patients, they are in the problem stage where they're coming to you to solve it, right? And would you say that a pretty fast way? I don't know, fast is a good word. Why are you trying to change their movement patterns?
00:21:44
Speaker
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00:22:14
Speaker
We'll help you better understand how the foot and ankle integrates with the leg, hips, and even the neck. We'll teach you exercises that explore supination and pronation, arch support and development, balance and proprioception, and how they all contribute to the mechanics of walking. And we'll explain why old beliefs incorrectly emphasize position over function.
00:22:37
Speaker
Physical therapist, Dr. Sarah Court, yoga teacher and strength coach, Laura Beaversdorf, and Pilates teacher, Anula Myberg have created this foot and ankle tutorial to help you better understand and connect to your feet and ankles and improve your overall function and health. Click the link in the show notes to learn more and to purchase. Um, you know, to your point about creating variability. Hmm.
00:23:03
Speaker
That's often why the person is having pain in their body. If we can really dial it down to neuromuscular musculoskeletal issues, as long as there's not something else systemic going on that we don't know about, it is that they
00:23:21
Speaker
there's just such a narrow field of options for their movement and because of that, that has in some way caused whatever problem that has brought them in to see me. And so it is the same, it's the same idea, right? We should widen the field of movement options that they have so that
00:23:41
Speaker
And that's what I mean by changing movement patterns. So they're not stuck with only this one way that they've been doing this thing this whole time, but they have multiple ways to do it now. Yeah, that's so cool. I guess I never put that together. That actually we're kind of coming at it.
00:23:58
Speaker
from the same, taking kind of the same philosophical approach, the difference is that the person or the people we're working with are in a different situation. Yours have pain or have some problem that they need you to help them resolve. And mine, maybe they do, but I don't necessarily have the details on that, right? No, hopefully they're coming to you because they want to improve or they want to broaden their scope of movement options because they're not yet at the point
00:24:28
Speaker
where their limitation has actually injured them. Right, right. So there's like pre, they're pre-having because they realize like, okay, I need to get on this so that I don't actually injure myself. And I'm just catching the ones that aren't thorough enough to do that.
00:24:42
Speaker
Yeah. I mean, the way I identify, the way I think of myself and what I'm doing is that I am helping them learn and that that in and of itself might be an enjoyable experience for them.
Ethics of Teaching Massage
00:24:54
Speaker
And also I'm helping them feel better after class or feel better the next day or feel better kind of long-term. And so you're helping them feel better, but from that different starting point of them not feeling good, right? Right. Yeah.
00:25:09
Speaker
This is right up this discussion right now. It's right up my alley. I'm completely digging it. All right. So let me see here. We've talked about how you approach
00:25:22
Speaker
administering physical therapy to your patients. We talked a little bit about patient expectation, and we talked a little bit about how maybe changing movement patterns plays a really important role in both kind of immediate, like acute solutions to pain, but then also
00:25:44
Speaker
more long-term solutions to pain just by adding variability, having movement options. What I'd like to talk about now is how I noticed that people who are really massage therapists themselves or they really subscribe to teaching self-massage or offering self-massage, there's often a lot of problematizing
00:26:11
Speaker
of a particular tissue of the body in order to, what feels like in order to justify what it is that they're doing. In other words, that it's almost as though they are really in great detail describing a problem and then offering massage in its various forms as solutions for those problems. But I wonder if we could just talk a little bit about fascia. And some of the problems that I hear people
00:26:41
Speaker
describing around fascia. One is that there is maybe knots or trigger points in fashion. You kind of alluded to the fact that not everybody believes that's true. I've also heard people, of course, using the terms like breaking up the fascia, releasing the fascia. There's also claims made about improving circulation, which
00:27:09
Speaker
We could talk about the best way to improve circulation is exercise and maybe reducing inflammation and all of these things that might be wrong with fashion. This is why self-massage or massage is beneficial. Do you believe that any of those problems are actually happening to fascia?
00:27:36
Speaker
come across any types of disorders to fascia, apart from the widely accepted ones like hypermobility disorder and Ehlers-Danlos and Marfan syndrome. And what's your take on fascia and the problematization of fascia?
00:27:53
Speaker
Um, I will say I feel like you are trying to get me in trouble with one very specific person. No, no, no. No, no, no. I'm teasing. I'm teasing. We can cut this part. No, no, let's leave it in.
00:28:09
Speaker
I'm not, that's not what I'm trying to do. I do actually also want to say that you, you hit on my, you know, we all have phrases that are, that we hate because they're just so overused. And my personal hated phrase is release. I'm releasing this because I'm always like, is there like a flock of doves? Yes. Coming out behind me. Yeah. I mean, there, so.
00:28:36
Speaker
There's a lot to say. I know. There's a lot to say and I'm here for it. So conditions like Ehlers-Danlos, Marfan's, just basic hypermobility, are a body-wide issue of connective tissue. So not just fascia. Let's name the connective tissue, shall we? All of them? Yeah, fat, blood,
00:29:00
Speaker
blood vessels, the lining of certain organs.
00:29:07
Speaker
the tendons and ligaments. It's basically anything that is connecting things to other things. Here's what's kind of cool. If it's not muscle and it's not nerve tissue and it's not skin, epithelial tissue, it's connective tissue. That leaks a lot of tissue. It does. It does. But somehow we're fixated on fascia.
00:29:31
Speaker
You know, there was a period where everyone was obsessed with their so as people people like to get fixated on things. Remember fast food cookies. Currently, many people are very, very fixated on fashion. Yeah, yeah. I find it ironic. I'll tell you why but you go first. Yeah. So, so that that sort of.
00:29:49
Speaker
Pathology, for want of a better word, of the connective tissue of the body means not just your fascia, but things. These are people who have issues with things like they have cardiovascular issues because the blood vessels are not able to function properly. They have issues. They'll have like
00:30:08
Speaker
issues with getting lightheaded when they stand up too quickly for the same reason, they may have terrible headaches. So there's all these other things that can happen because of the condition of the connective tissue. There are other things like there's a compartment syndrome where the fascia can actually get too tight around certain muscles and things, and then that's surgical intervention, that's a real condition.
00:30:28
Speaker
Yeah. So compartment syndrome is where there's like a barrier. A barrier has been created by your fash. By the way, that barrier, that protective barrier is one of the main
00:30:40
Speaker
roles that fascia plays which is it prevents the spread of pathogens through your body but it can work in reverse where it prevents an area of your body from being able to like release those pathogens out of it so you know it can result in things like amputations it could be very severe but fascia is a protective barrier because it's so tough because it's so tough and and this idea i mean
00:31:05
Speaker
I think, to be completely honest, I think people who have trained in something like self massage are
00:31:15
Speaker
repeating what they were told in the training as far as the effects that it is having on the body. But I am not aware of any research that really truly backs that up. And part of that is, again, the issue around research generally with things like this. But if someone, anytime someone says, I'm doing this blank to your body, like I'm breaking up adhesions,
00:31:43
Speaker
use my specific claim yeah anytime there's a really like i am i am uh i am hydrating your fascia with my massage tool anything like that you know i i just get very leery around things like that because even the you know the people who study fascia
00:32:00
Speaker
and have done for decades still get together and argue with each other about what's actually happening. It's amazing. It's kind of hilarious to watch because they all firmly believe what they've seen and then they firmly do not believe what the other people have seen. And then they go away for a few years and they come back together and argue some more. So there is no consensus around even whether or not you can have something called a trigger point that is in the fascia.
00:32:27
Speaker
So it stands for reason that we cannot make these very specific claims around what it's doing, what massage may do to your fascia, to your body, as if we know exactly what's happening. We would have to be doing it with an MRI. And there actually have been studies where they've used ultrasound to show the width of a tissue has increased after massage of a tissue.
00:32:56
Speaker
But what does that mean? And do we assume that that means it's a positive outcome, or is that actually inflammation, which everyone also then says you want to get rid of? Well, some claim that massage reduces inflammation, and then there's also been
00:33:11
Speaker
studies showing that it actually increases inflammation. Some people say that it aids in the recovery from exercise. In other words, it maybe reduces delayed onset muscle soreness or the feeling of muscle soreness after exercise, but when in fact, massage actually creates muscle soreness. Yeah. This idea that massage improves circulation is flawed. It does maybe to some minor degree, but
00:33:40
Speaker
It's far inferior way to increase circulation to an area than even moderate exercise because it's ultimately your cardiovascular system, metabolic demand, right? Your tissues need for energy that determines the blood flow. The other part is, I'll see people come in all the time where they're like,
00:34:04
Speaker
My neck was hurting, so I rubbed it with a ball, but that made it worse. I'm like, yeah, sometimes tissue wants to be left alone. Sometimes it's already irritated, and the irritant of you deforming the tissue with a ball or putting your thumb in it or whatever you're doing is not the best solution in that moment. It doesn't need to be poked anymore. It needs you to just go away for a minute.
00:34:27
Speaker
Yeah. My favorite is that it removes toxins. I knew that one would get you going. Why don't you take it from here, Sarah? Oh, about your toxins? All I will say is that if you have a liver and at least one kidney, that is already being taken care of for you. That's good to know. The end. That's good to know. Yeah.
00:34:56
Speaker
The other thing that I find ironic about how people contextualize what it is that they're doing and why with respect to self-massage, and I will again remind you that I teach self-massage. But the problem that I have is when they talk about working on the fascia, we're going to work with the fascia today.
00:35:17
Speaker
This is a fascia practice or whatever. This idea I find so ironic because I noticed that one of the things that people really kind of jive on about fascia
00:35:29
Speaker
and wax poetical about is how fascia is body-wide. It's ubiquitous. It connects everything. But I think we can also go back to that list of connective tissues and go, well, so does blood. And so do tendons and ligaments. Quite literally, they are connecting bone to bone and muscle to bone. But also, so is fat potentially connecting everything and body-wide.
00:35:56
Speaker
But what I find kind of ironic about this idea that we're going to just focus on the fascia and talk about the fascia to the exclusion of all these other connective tissues, not even to mention the muscles, which are probably much more relevant, is that that is so reductionistic. While they are kind of playing up the holistic connectivity of their topic,
00:36:24
Speaker
They're talking about it as if you can even touch your fascia. I mean, you can't. You're touching your skin first, right? Yeah, as if you aren't also touching every single other structure that is in that space, including your nerves, including your blood vessels, including it's the old Celine Dion joke.
00:36:47
Speaker
Celine Dion during her performance, she comes to the edge of the stage and she sits down and she says, this next song is for all of the parents in the audience tonight and also all of the children. Isn't that just everybody?
00:37:06
Speaker
Right? So it's like this idea that, I mean, in some ways making a claim that a particular thing you're doing is targeting a tissue, maybe not incorrect, but it's not possible to, you know, it's not possible for me to roll a ball on my piriformis without also rolling it on my glute max. It's not incorrect, right? Well, it might, it might be incorrect, necessarily guaranteed to be incorrect.
00:37:36
Speaker
What I think it is, is it's not quite honest. Because how do you know? It lacks a kind of integrity that really, I think a lot of people shy away from because they want to sound smart, which is that you don't know.
00:38:01
Speaker
I think being able to admit that and skirting claims that suggest that you do in favor of claims that are maybe more general, right? We're doing massage for this really general outcome because generally this is a pretty safe claim to make, right? But it's not sexy, Laurel. It's not sexy to be general. It's not precise, right? It's not sexy.
00:38:27
Speaker
to not call your class, fashion release, because of those words that people have heard, and that's gonna drive people to your class. They've heard of fashion, they don't know what it is, but clearly if it needs releasing, they haven't been releasing theirs, so they better go. Exactly, and this is where we start to confuse therapy and teaching with marketing. Yes. This is where we accidentally become marketers, I think.
00:38:54
Speaker
Because okay, my goal as a teacher is to help people learn about their body. And I love using self massage to do that. Because your skin, I'm way more interested in touch as it affects the skin and therefore what we're able to perceive because the skin is fantastically sensory rich. I'm so interested in how touch using self massage
00:39:22
Speaker
can help students perceive their bodies better. And locate specific areas of their body because that really does help them learn about their body and how to move and get curious. It's also potentially really relaxing and enjoyable, especially when we don't take it too seriously, right? And so I love teaching so much for that reason. And if my aim, if my real like big goal as a teacher is to help people
00:39:47
Speaker
understand their body better. I better not say things that I couldn't possibly know or make claims that are not shown to be true, because that doesn't help students understand their body. It actually helps them misunderstand their body. Yeah. Well, you are actually better for me to say I don't know. Yeah. And it is to make something up. Well, you are an extremely ethical
00:40:12
Speaker
person and teacher. And I think that for some people, the, and this kind of goes back to our conversation last week about scope of practice, where, you know, are you ready to teach a certain population? Well, not when you start out, I think, especially when in the beginning, at least this was for me, I felt how acutely not good at it I was until I got a little bit better. But
00:40:39
Speaker
you want to embody the role of the teacher who knows things. And so it's very tempting to, when someone says, why does this hurt? To just answer like, oh, it's your IT band. Because somebody probably said, I mean, somebody said that to me at some point, and I probably said it to somebody else as well.
00:40:57
Speaker
And it's also much more satisfying. Whether it's ego based or not, you're in a role of service and help. You want to help the person. So it's not helpful in my mind. It's less helpful to say, I don't know than it is to say, it's your IT band, but it is actually more accurate to say, I don't know. And ultimately it is kinder to say, I don't know because otherwise the person goes home and they're like, well, my yoga teacher said it was my IT band. And then they roll their IT band for the next 10 years and wonder why nothing changed.
00:41:24
Speaker
But it is challenging to not occupy the space of the person who knows the answer. And I think also, consciously or not, we repeat the things that we learn. And it takes a very certain sort of personality not to just say back to a room what they heard their teacher say, even if they're like, is that a thing?
00:41:54
Speaker
I remember taking a bar class one time and the guy teaching the class said that today we were working on, we're going to be bringing the fat that's on the inside of our body. And I was like, I mean, isn't that where all of it? Not like not the fat that you brought with you in your purse, the fat that's on the inside of your body, you know, and and I think it's just it's easy to fall into.
00:42:21
Speaker
repeating things that you've heard without necessarily stopping to question if they're accurate or if they even make sense. Well, I think I've said this before. I'm a verbal processor. I learn through words and I practice by speaking. I practice by articulating writing. I learn by writing. And so my process as a teacher has largely been about imitation. And it's been,
00:42:51
Speaker
Interesting. It's been effective. I think it's been effective. I think I'm a pretty good teacher. It's been effective. Thank you. It's been effective in the sense that I acquired language quickly. And I was reasonably confident in what I was saying because some experienced, intelligent, talented individuals were saying it. And whether or not what I was saying was 100% accurate or not,
00:43:20
Speaker
Now, it doesn't really matter, honestly. What matters is that I think for all of us who are self-critical and are constantly looking to learn and evaluate what it is that we know and question it, what's most important is that when we're presented with new evidence that flies in the face of what we've learned, that we change, that we change. And it's painful. It's painful because
00:43:48
Speaker
it might feel like you're sort of, you know, throwing in the towel and conceding, right? Somehow that, oh, yeah, I wasn't right after all.
00:43:58
Speaker
And it doesn't have to be that way. It can literally just be this crazy process of trial and error that is all of learning, all of learning, by the way, which is like, I'm going to put my best foot forward. I'm going to try on this approach and this belief. And I'm going to make this case.
00:44:18
Speaker
And then down the road, you find ways to do that and you change, or you figure out that those ways weren't effective or true or accurate and you change. And there can be a lot of shame attached to it, but I don't think there really needs to be. Yeah, I don't think there should be, especially, yeah, I think, you know, there's so much new evidence and new learning and growth that's happening in the world of movement.
00:44:44
Speaker
just generally, like if we look back over the past 30 years in terms of our understanding of what different things do, you know, the one that I am currently
00:44:54
Speaker
reevaluating in my own work is around pain science. It used to be very much in pain science that the idea was you are trying to find movement for the person that does not create any pain because you were trying to reprogram their brain to see like, look, you did this movement, it didn't hurt. But a lot of the new research is actually showing in some circumstances, it's actually totally okay if you bring on some pain, not in every circumstance.
00:45:25
Speaker
which is kind of wild because that's the opposite of what I have learned and what I have taught. But then it's on me to be like, hey, so here's what actually the new research is showing. It's not that I misinterpreted something, it's just there's new information. Right. Awesome. My last topic, which I'll maybe a couple of questions around this is,
00:45:50
Speaker
You know, I don't, I, I teach self massage. I know a lot of people probably listening to this podcast do as well. I know a lot of students who practice with me do teachers that practice with me do, and I don't want to be soul crushing. I got it. I didn't sign up to do this. Okay. I'll do that. I'll do that part to crush people's spirit and go.
00:46:11
Speaker
Big red X, wrong, wrong, wrong. And so I want to actually end on what I feel and what you feel are actually some really strong benefits massage.
Therapeutic Benefits of Massage
00:46:24
Speaker
Oh, yeah. I mean, yeah. And potentially the good reasons to introduce it to students in my case. And if you think patients in your case, you can share about that. So my question is,
00:46:41
Speaker
What are the benefits of massage in a therapeutic setting? Does everyone need to incorporate massage in some way? Are there certain people who don't need it? I'll start with those. Okay. Just those small questions. So what are the benefits? Well, and to be fair as well, some people don't like it.
00:47:06
Speaker
Some people really, really don't like being touched by other people. And being touched by other people is very different than self massage for sure. That's true. Or even just the sensation of massage. Sometimes people just don't like the way that it feels. Um, but you know, certainly I look at it as a way to help my patients regulate their nervous system. And when people have pain, especially if the pain is chronic or if it is
00:47:41
Speaker
I mean, I'm gonna curse and just apologize in advance, but it is a shit show for your nervous system. It's just, it's brutal. It's a tornado of mess. And if we discover that, you know, in our sort of exploration together of what feels good, if we discover something that helps to quiet down the craziness and helps that person actually relax, that they can get into these more parasympathetic states and they can,
00:47:57
Speaker
really, really high level acute. It is a
00:48:10
Speaker
uh not only have their pain reduced but in the case of self-massage reduce it themselves right that's huge that's huge in terms of getting amount of pain long term yeah so that's generally what i'm doing if there's something where it's like we're trying to improve range of motion i don't go to massage for that that's not what i use it for but if it's something where
00:48:33
Speaker
This is a high anxiety level person. They have a lot of tension that they're walking around with in their body. I'll give them some stuff to do and be like, okay, do this and then do your homework because I want their body to be in as relaxed a state as possible when they then go to do whatever the active movement things that I want them to do. Or sometimes, and it really depends person to person, there's been people that like,
00:48:57
Speaker
literally the only homework I give them is you're going to take this sponge ball and you're going to put it on your belly and you're just going to lie face down for 20 minutes and roll around and that's it because there is so much going on that I can't get to any of it until we sort of get through that. I have patients where I'm thinking about one person in particular where
00:49:19
Speaker
they've had so many people put their hands on them and either not get them better or make them feel worse. That part of it is either the sort of like the autonomy of doing it yourself, right? But also me using touch as a way to make myself a trusted clinician as opposed to one of the many that have proved themselves untrustworthy. And that's a very specific
00:49:48
Speaker
thing to do and that's less necessarily about changing tissue and it's more about you know showing you know confidence in your in your ability and your your ability to watch to to be aware of how the person's responding to what you're doing and not just be like I'm just gonna shove my elbow as hard as I can into this part of your body until it until it gives up. Yeah and I think that I think that it's it's a very powerful way I imagine I don't I don't I'm not a massage therapist but I've had is a very powerful way to establish trust.
00:50:16
Speaker
Yeah. Would you say? Yeah. Yeah. Absolutely. And you, and you sometimes, you know, see, you see people fight you, you know, consciously or not, you know, you see people fight you and then you see, hopefully the moment where they stop fighting you, or sometimes people are just like, they're ready to, to not fight you and they're just, you know, go full jellyfish or whatever. But a lot of the time you see that sort of internal battle where they're like, I don't know. I don't know. I don't know. And, and then, um, you know, hopefully you can make some change.
00:50:44
Speaker
And you had two other questions, but I don't remember what they are. It's okay. No, you kind of answered like are certain, are there certain people who don't need massage? I guess like certain people don't like it. And it sounds like it's more of a preference thing really. I find that massage for myself, I found that massage was a wonderful way to experience, experience touch in a way that felt safe.
00:51:11
Speaker
and to explore touch for its own sake after my mother passed away. And it was actually a very emotional experience. I would cry almost every single time. Sometimes I would sob. And I now recognize that it wasn't a massage. It wasn't the releasing of emotions, say. That was causing me
00:51:37
Speaker
to cry, it was the fact that I had returned home from helping my mother die after several months in hospice.
Emotional Impact of Massage and Self-Care
00:51:46
Speaker
And I had started taking care of myself. That's what caused me to cry. And so being cared for, being cared for, I think, is an emotional experience. I'm not sure that myofascial release is. And for me, that emotional experience
00:52:05
Speaker
emotional experience was incredibly cathartic and it ended up actually being in and of itself. It helped me to recognize, my own crying helped me to recognize that I was potentially in need of more help, more support, more care. So I sought out a therapist, a grief counselor,
00:52:27
Speaker
And so I think self massage actually occupies and and and massage as well, of course, who is touching you becomes very important then right when we're doing self massage. I don't even think it matters what you use to touch yourself with honestly you're the one touching yourself right it's just what you prefer, but.
00:52:47
Speaker
the interpersonal dynamic of the person administering the massage the person receiving is very, very important in that case. But I think that what massage does is it offers us potentially when I think when presented well an opportunity to explore touch for its own sake.
00:53:04
Speaker
And to express agency our own agency, specifically through self massage and to experience touch and agency and safety all together in the same experience, I think that this is this is where people who do teach self massage to.
00:53:23
Speaker
to trauma affected populations, see how it works, see how it helps, anecdotally, but there again, I think is some pretty good evidence to suggest that massage can reduce the symptoms of anxiety and depression as well. And I wonder, you know, because that's just, those are complex conditions. So I wonder, you know, we can't really probably name specific mechanisms for why, but I wonder if it might have something to do with this intersection between agency, touch,
00:53:52
Speaker
and safety.
00:53:54
Speaker
Yeah. Well, and I think as well, there is, again, if somebody likes massage or they enjoy it, there is that serotonin release. Potentially. There's a neurotransmitter. For sure. That might be a part of what, I mean, I'm a little bit spitballing, but that might be part of how it's impacting someone with depression or anxiety. Yeah. But it certainly is impacting their general tone
00:54:22
Speaker
from sympathetic to parasympathetic. Thank you for sharing that about your experience with your mom. It was really lovely. I think that is rather than, I think it's a more useful way to think about massage rather than trying to determine what tissue exactly am I impacting because it's basically not really possible. If we take a step back and we look at it as a tool of
00:54:52
Speaker
that's more holistic, that's addressing the whole person's needs, not necessarily the not in their upper trapezius setting.
00:55:00
Speaker
and how impactful it can be under those circumstances. I think that's really probably a more useful way for people to frame their work when they're using, if they themselves are massage therapists or if they're teaching people how to use self massage tools. I think that could be a more helpful framework. Yeah. Yeah. Well,
00:55:28
Speaker
I think I think we've covered a lot. We've covered a lot. I think this has been a really interesting conversation. I know I've just had lots of light bulbs go off and having it with you. So I really want to thank you for bringing in your perspective and really causing me to think differently in a new ways about this topic.
00:55:49
Speaker
A note to you listeners, you can check out our show notes for links to references we mentioned in the podcast. And you can also visit our website.
00:56:00
Speaker
movementlogictutorials.com where you can get on our mailing list to know about sales on our tutorials. You can also watch the uncut raw version of this episode. If you want to see what Sarah and my facial expressions and our body movements look like while we're doing this podcast, you might be shocked.
00:56:26
Speaker
And you can also check out Sarah's recording studio where she has basically a rainforest growing in her closet. I don't know how she did it, folks. So thanks so much for joining us on the Movement Logic podcast. Finally, it really, really helps us out. If you just hit the button on your phone to subscribe, and then if you want to go the extra mile, you can rate and review us and
00:56:55
Speaker
that would just be super cool. Join us again next week for more movement logic and more of our loosely held opinions that are strong. They're very strong. I lift weight.
00:57:12
Speaker
Thank you so much for listening. If you enjoyed today's episode and you want to support us, please subscribe, rate, and review on Apple, Spotify, Stitcher, or wherever you listen to podcasts. If you'd like to watch, head on over to our website at movementmagictutorials.com forward slash podcast, where you can watch the video version. We'll be back in your ears next week to nerd out about movement without taking ourselves too seriously in the process.