extreme muscle tension

[Calm-A-Llama-Down]

I had a client on my chair yesterday whose shoulders felt like marble. Her traps were completely immovable. Honestly, it felt as if I was palpating bone instead of muscle, and nothing I did (compression, kneading, stretching) softened them AT ALL.

The poor girl is suffering from constant neck pain (I wonder why?). She says it gets better when she does Yoga, but she hasn't been doing that lately. I was giving her pretty firm pressure, and she said she could barely feel it.

What do you do with muscle tissue like this? I was completely clueless and felt pretty much incompetent when she left, although she said she loved the massage and would be back. :/

Is there help for this rookie?

Emily

 

[BMT]

My suggestion would be to try very slow and thorough compressions throughout the area. Remember superficial to deep, and compress slowly, adding your weight over time, not all at once. Let the tissue melt under you, and don't even try to move it until it does a bit of softening.

Do you have access to heat of any kind? A microwave to put packs in? If you could have that on her neck and shoulders the first 5 minutes while you do arm pulls, stretch the pecs and help her to mentally relax will help you ease into her hypertonic muscles a bit easier and more quickly.

How long is her chair massage?

 

[None-of-ur-business]

Don't forget to work the pecs and subclavius as well. Often I've noticed tight traps and neck extenders can be interrelated.

 

[Pompal 09.]

Thanks for your replies. Sorry it took me so long to get back here. As you can imagine getting ready to go full time doing massage is quite time-consuming.

Her massage is 15 minutes.

You're right, Rose, I do need to slow down. I've noticed a disturbing trend in myself of late. I am tending to move from superficial to deep too quickly. I think that extra stress in my life is causing this, so I need to be extra-mindful.

I don't have a microwave yet, but I need to get SOMETHING. Crock pot, perhaps.

Thanks again.

Emily

 

[Pompal 09.]

I've had those people and they can be TOUGH. In fact, they're the ones who inspired me to use hot stones in every massage (at least to some extent, and minus those who are contraindicated, etc). Usually the tighter someone is, the less they can feel, though this isn't a hard & fast rule. Here's how I handle it, your mileage may vary

First, before applying any oil, I do myofascial release (the gentle sustained stretching kind). This at least releases what I call the "gatekeeper" layer (if you don't release this layer, you won't get through to the muscle properly). This is time-consuming, but worth it. Do explain what you're doing and why, or they will get a little impatient, because to them it doesn't SEEM like you're doing anything constructive. Next, use a little heat, unless they're contraindicated for heat (the injury is acute, there's evidence of inflammation, etc etc). Then, I'd do what others have suggested, working superficial to deep. As I progress through the layers and apply more pressure, I slow my speed accordingly. I might finish that segment with assisted/resisted stretching of that area, if possible.

I also find that without fail, most of the people who present to our studio this way usually have a combo of the following going on: 1) they drink diet soda. The artificial sweetener breaks down into formaldehyde in the body and it interferes with the neuromuscular loop. These people will feel tight all the time and be very hard to massage. 2) They're on a prescription drug or five. Many of these drugs ALSO interfere with the neuromuscular loop. These people will also have increased nociception (ability to feel pain), and be very hard to massage. 3) They're not drinking enough water. Lack of water will make muscles dehydrated, making them feel tight and ropy, and these people will also usually feel stiff and sore. I find that most ppl who are like this have at least 2, if not all 3, of these things.

I DO give them this information and, with careful wording, I tell them that they definitely want to start replacing the diet sodas with water (even if it's a slow transition--slow is better than temporary ) and that if possible, they might want to think about working with their MD to reduce the amount of meds they have to take, saying that there are many natural herbs and other methods out there that can often be used in conjunction with the meds and perhaps minimize their dosage, and that if their current MD isn't open to natural methods that they might want to find one whose education is more current and mind more open. And I offer them 3 referrals (should give them at least 3 names and have them pick).

Depending on their situation (how tight they are and what their symptoms are) I might insist they see a chiropractor because much of chronic muscle tightness is a neurological problem (especially if it involves the decreased ability to feel pressure) and chiros are best at restoring proper nerve function, whether it's to muscles or organs.

Of course, how far you can go with referring or recommending depends on your state laws, and proper wording and delivery is pretty paramount to staying out of trouble Never overstep the scope of practice!

Sorry this got so long, I really hope it helps
Above all, save your hands! Do NOT work any harder than is healthy for you; recognize your own limitations. Also, a gem of an instructor once told me, "only work as hard as your client is willing to work", meaning that if they're not going to do the things you recommend, schedule consistent and regular sessions, and whatnot, don't assume responsibility trying to "fix" them, because ultimately, their health is their own responsibility.

Hugs,
~Jyoti

 

[kithic_kithic_kithic]

I also find that without fail, most of the people who present to our studio this way usually have a combo of the following going on: 1) they drink diet soda. The artificial sweetener breaks down into formaldehyde in the body and it interferes with the neuromuscular loop. These people will feel tight all the time and be very hard to massage. 2) They're on a prescription drug or five. Many of these drugs ALSO interfere with the neuromuscular loop. These people will also have increased nociception (ability to feel pain), and be very hard to massage. 3) They're not drinking enough water. Lack of water will make muscles dehydrated, making them feel tight and ropy, and these people will also usually feel stiff and sore. I find that most ppl who are like this have at least 2, if not all 3, of these things.

Yes!! Another reason not to have artificial sweeteners! I'm going to (eventually when I'm not lazy) do some research on that to get something to support that statement and maybe include the information on my website. Of course, even knowing this kind of thing will NOT deter most diet beverage drinkers. My boyfriend's constantly chugging 'crystal light' or the generic equivalent, at least when he's out of diet Dr. Pepper. He doesn't care/believe it's that bad for him.

Question: do you know what kind of prescriptions in particular interfere with the neuromuscular loop? I'd imagine pain-killers and arthritis meds would...

Sorry to hijack thread!

 

[Roger Dodger]

Question: do you know what kind of prescriptions in particular interfere with the neuromuscular loop? I'd imagine pain-killers and arthritis meds would...

Sure!

Lipitor is one of them for sure, in my experience (I think it's a cholesterol med). I also think that some of the antidepressants do as well. I don't have very many people who present to our studio like that, so when I do, they really stand out. I think you're onto something about pain and arthritis meds, too. I think it depends on what they do. Some are muscle relaxers themselves, but others simply block the pain signals going to the brain (in essence, the brain becomes deaf to the screaming body). Steroids (VERY common anti-inflammatories, especially for GI issues and autoimmune disorders such as fibromyalgia/rheumatoid arthritis/lupus) increase edema and tissue congestion/stiffness, too. Whenever you get a client on the table who feels like that, do a little digging Ask questions about water intake, prescriptions, and diet soda, and see what patterns you start to notice.

As for artificial sweeteners, I've found the book "Sweet Poison" by Janet Starr Hull to be most helpful. I gave it to my mother and got both her AND my dad off the diet soda for good. It's a very easy read. It is either entertaining or informative (depending on the part) and most parts are both. The book is about the author's personal encounter with diet sodas, what they did to her, and then having the science background that she does, she started to dig for info. And dig. And dig. And the book details not only her experience, but also her factual findings and the outcome of her own research. Maybe you'll be able to recognize in your boyfriend the symptoms the author experienced, and maybe not. But, there's no free lunch ever, and diet is no exception (Dang--I really want to just eat chocolate all day!! : ) The email circulates every few years that many ppl think is a "hoax" about the people who manifest serious health problems after having diet soda is actually NOT a hoax at all.

Good luck, Seebs, I REALLY hope he comes to see the light!
Hugs,
~Jyoti

 

[rocker4ever18]

Emily,

When I get a client who is extremely tight in the neck & shoulders, I do a few minutes of lymhatic drainage therapy on the neck and clavicle area. This seems to soften the tissues so I can get into the muscles. The tightness might be caused by toxins trapped in the area

 

[have_a_go_mate]

extreme tension

I think it is a mistake to try to fix with techniques for this and that when what you really need to look at is perhaps the basic deep rooted cause of the problem. Technique oriented massage is like an aspro.

Have you ever heard for the upper cross/lower cross syndrome as written by Dr Vladimir Janda? Many times the answer lies in correcting the balance between the tight facilitated muscles and the weak inhibited muscles.

 

[forestgrovejerry]

Question: do you know what kind of prescriptions in particular interfere with the neuromuscular loop? I'd imagine pain-killers and arthritis meds would...

Sure!

Lipitor...

I agree on the Lipitor.

I have a client who was taking it and had to stop due to the extreme muscular spasms it was facilitating on top of the extreme spasms he already has. He is a very medicated patient and the Lipitor threw him over the top.

IHave you ever heard for the upper cross/lower cross syndrome as written by Dr Vladimir Janda? Many times the answer lies in correcting the balance between the tight facilitated muscles and the weak inhibited muscles.

kemilyna, we've got at least one reference regarding Janda in the the Research Section:

Jandas Upper and Lower Crossed Syndromes/CCP

Her massage is 15 minutes.

Uh.... *frown of frustration regarding my ability to get those to relax nicely in 15 minutes*. Now this, I can't help much with. Maybe someone with a very specialized technique knows how to knock out extremes in that amount of time... but not me!

If they are extreme, I'd think you'd need that whole hour to start making some lasting progress. Unless it chair work at a company, I don't work any less than 1 hour at a time.

But, that said, I want to add my two cents in for the heat and compressions. Using them together, I'd think they'd be a benefit for what you described.

 

[I FANCY YOU :)]

Old Dog, the suggestion to look into upper cross/lower cross syndrome is FANTASTIC; thanks for mentioning it! I think that while some techniques help more than others, I do agree that to get to the root cause of the problem is a MUST. That will be MOST effective indeed.

Another possibility of remedy, though it IS pretty expensive.... cold laser. (There are a few cheaper imitators out there and while they work for many things, they're just not The One...The One is FDA approved and has been studied to the hilt, with more studies coming all the time.) I had cold laser recommended to me for a surprising variety of different ailments and conditions. We finally bought one (took a while to save but it's here) and---OMG, is all I have to say. I already have some clients excited about it and I don't even have the additional cold laser services added to my menu yet. LOL Our CAT is already an addict! (That ain't no placebo, you can't fake that cat LOL) So, in case anyone wants more info, feel free to ask, either on board or in a pm. I love this thing.

Depending on the laws in your state, MTs may or may not be able to use cold laser on their clients. In TX you can. But, many chiropractors have them! So do some osteopaths, naturopaths, and MDs. If the person is THAT tight to the point where you've kinda given up a little or are experiencing frustration, you can always co-treat with someone who has one, if the funding for one is out of your reach (as was true for us for the longest time).

Just another idea

Hugs,
~Jyoti

 

[Nintendude]

My "old" favorite for muscles of stone is SRT (positional release). It works like nothing else, for my clients -- followed by fascia release/stretch. Do you know anyone doing that work, or have you learned some yourself?

I love these threads where we all bring out our tried-and-true favoriTES...

 

[Candy B]

hi emily,

i think this is a great thread and i have enjoyed reading everyone's input.

one thing i would like to add about extreme muscle tension. try basic isometrics with extreme muscle tension. of all the muscle energy techniques i learned in school, basic isometric seems to really work at relaxing tension. did you learn about the law of post-isometric relaxation? are you familiar with basic isometric? you can do this several times throughout the 15 min chair massage, but you have to allow time for the isometrics and the stretch. the stretch following the isometric is really important. i don't do a lot of chair massage, but the times i have, i never stretched the upper trapezius. so, you have to figure how to get the face cradle out of your way (maybe have the client lean back into you for the stretch). (phew, now i'll describe the basic isometric for upper trapzius...):

first active ROM. client elevates and depresses shoulders a few times.
passive ROM. you elevate and depress the clients shoulder a few times.

basic isometric for upper trapezius - the client will GENTLY elevate shoulder into your hand for minimal resistance. the client should only be using 10% of the strength. most people want to give you all they got, so make sure they reset to lower resistance. isometrics work better LONGER NOT STRONGER. the key is to hold this muscle in isometric for 15-20 seconds. (time it with a second hand).

client relaxes from isometric, then put the client in a good stretch (should not hurt) hold the stretch 15-20 seconds, time it with a second hand. (always hold the stretch for as long as you hold the isometric.) while the neck is in flexion, you can press out the traps with your free hand during the stretch. this feels really nice.

repeat up to 3x (isometric, stretch, isometric, stretch, isometric, stretch) if needed. of you repeat, you should notice the stretch going farther each time.

you can do this technique at the beginning, middle, and end of the session.

you can do this before you even touch the trapezius. i would be curious if you are comfortable doing it, if you try it first, if you notice the difference in her traps right away. isometrics on the pectoralis muscles would be really easy to do in the chair, and may be very helpful for desk bound workers. anyway let me know if you try it, like it, or don't understand me at all...


and for what jyoti said:

Another possibility of remedy, though it IS pretty expensive.... cold laser. (There are a few cheaper imitators out there and while they work for many things, they're just not The One...The One is FDA approved and has been studied to the hilt, with more studies coming all the time.) I had cold laser recommended to me for a surprising variety of different ailments and conditions. We finally bought one (took a while to save but it's here) and---OMG, is all I have to say. I already have some clients excited about it and I don't even have the additional cold laser services added to my menu yet. LOL Our CAT is already an addict! (That ain't no placebo, you can't fake that cat LOL) Smile

i have to totally agree. when i lived in houston i met someone who was selling them, through an mt friend of mine. i got to see some demonstrations he did on a lady who busted her shoulder in a motorcycle accident. her recovery time from the surgery was amazingly quick, with minimal scar tissue and good ROM.