Towards the heart vs IO/OI

[GUERA33]

The conflicting ideas of working towards the heart vs origin insertion to lengthen and insertion origin to tone came up in a class I'm currently taking.

If anyone has any insight, I would love to hear it. Specifically any documented research discussing why to work in a given direction.

 

[Krista]

Towards the heart vs IO/OI

The conflicting ideas of working towards the heart vs origin insertion to lengthen and insertion origin to tone came up in a class I'm currently taking.

If anyone has any insight, I would love to hear it. Specifically any documented research discussing why to work in a given direction.

I don't think it's necessarily conflicting as it is working for different results. I am of the "Energy Follows Intention" train of thought. Sorry no documentation.

 

[Ashleigh]

I realize my first post wasn't clear, so let me flesh out the ideas more fully. During massage school I was taught to work from origin to insertion to lengthen a muscle. This was a treatment for strong hypertonic muscles. I was also taught to work insertion to origin to tone a muscle. This being a treatment for hypertonic weak muscles (overstretched) or hypotonic muscles.

Several structural integration teachers that I've worked with, who are viewing the body from a more fascial perspective, have taught me deep strokes working towards balancing planes around joints (without regard to whether it was centripetal).

Working towards the heart is considered an important caution traditionally in massage in order to prevent venous backflow which could potentially dislodge a clot and cause an ischemic event.

Now, I'm trying to wrap my head around these seemingly contradictory methods and form a cohesive methodology to bring to my table. Any thoughts?

 

[Rizwan]

Working towards the heart is considered an important caution traditionally in massage in order to prevent venous backflow which could potentially dislodge a clot and cause an ischemic event.

When I went to school this was considered a myth. Is there any documentation anywhere of this happening? Has anyone ever died from a massage?

If there is a clot, we don't touch, period.

 

[Pompal 09.]

I was taught that any techniques that would potentially be moving fluids (engaged gliding strokes, deep draining etc) should all be done distal to proximal, to avoid stressing or damaging venous valves.

As far as specific treatment of muscles, I don't recall any particular protocol for addressing O/I's other than possibly the generic "warm, strip, friction/ address the attachments, and lengthen." Stripping or lengthening was suggested to do from origin to insertion based on the insertion being movable - if you want to lengthen a muscle it makes sense to work it in a direction that'll allow for lengthening (as opposed to working towards a fixed point.) I hope that makes sense. lol

 

[m_iqbal_hussain]

My understanding is that swedish strokes which are flushing and blood moving, have an effect on the circulatory system. While deep tissue (Structural) strokes which are deep, compressive and SLOW are of course effecting the blood, but not in the same systemic way that swedish or flowing strokes are. Therefore, the reasons to do either don't apply to each other.

 

[crunchy momma]

origins and insertions do not exist. A muscle simply attempts to shorten. Which end moves (and the direction it moves - if it does) is determined by the joints relationship to gravity and what other muscles are acting on that joint.

 

[12345]

*bump*--i like this discussion !

(i personally vote for deep fascia strokes in whatever direction the fascia needs to be moved to open or reorganize the joint, and semi-vigorous Swedish "toward the heart" for final "flushing". That 'towards the heart' feels at times superstitious and at times intuitively right, especially if you've been working vigorously proximal to distal. I'd love to know more about that. I'd never heard of working "toward the origin" to tone a muscle or toward insertion to lengthen it, though as Palpateit notes, how do you pick the origin?

 

[SLEEP IS FOR SISSIES]

origins and insertions do not exist. A muscle simply attempts to shorten. Which end moves (and the direction it moves - if it does) is determined by the joints relationship to gravity and what other muscles are acting on that joint.

Well stated! The old O/I concept assumes anatomical position and simple single-plane movement. It falls apart in the real world of multi-joint, multi-axial, multi-planar movement.

I work according to what I perceive needs doing while observing all due cautions regarding the person's health status.

 

[Pompal 09.]

Home with the flu so catching up on reading that I never can seem to make time for. Been reading about that tensegrity model of viewing the muscular and the fascia today...basically what palpateit and JasonE are talking about.

Reading 'Anatomy Trains' by Tom Myers and viewing the musculature as one big muscle contained by the fascia but insertions and origins are basically just a formality from this point of view to learn how to contact but in reality origins and insertions are just the connective tissue that is more plastic in nature still contained in the fascial sock of the "fasical net".

So funny that I would find your comments today because this thinking kind of turned some of my previous learning on its head and I love it when books and new knowledge does this! 8)

At least something good is coming of this wicked flu! Hope you all are well!

 

[Antiman]

Now I see niemand's clarification of his/her question and realize that there still is not been a succinct answer as to whether direction of the work should be considered in respect to the circulation in regards to myofascial or deep tissue work.

 

[2DIGNI5]

Just wanted to bump this thread back up because this question has come up for me in my own work. In school, I was taught that always do longitudinal stripping and deep tissue worktowards heart for protection of the valves in the veins. Now I'm working with a LMT who says going Origin to Insertion to really stretch the hypercontracted muscle out properly.

Can anyone give links to articles or books that discuss this matter more fully?
I'd greatly appreciate it!

 

[aglael l]

What I've ascertained quite recently is that the concept of massage strokes towards the heart originated in traditional ayurvedic medicine. Harish Johari has written several books.

Regarding the "distal to proximal" post, this is not exactly the case when lymphedema protocol is required - in those cases, we work in small sections, starting proximally and working distal to proximal from that point, then moving down a few inches and working distal to proximal, etc, until you reach the most distal point and then integrate one long distal to proximal stroke.

I was also taught in school that deep "draining" strokes ought to be towards the heart.

O/I work has been taught to me within the realm of therapeutic deep tissue techniques...in which we were taught to always warm properly before with swedish strokes and flush properly after, ie effleurage.

Does this answer any questions? Probably not, sorry!

 

[strongjoey21]

I think the problem with the original question is that it is asking for a single answer to many possible situations. In other words, the question is too broad to be succintly answered.

In considering the movement of fluids, we should first ask, "Which fluids are we focusing on?" as circulation of lymph and blood have different considerations.

In discussion of lengthening/stripping muscles, we need to consider what else is going on in the area. Is the tissue contracted, or sore due to overuse, or tight due to underuse, or because of fascial adhesions, or something else? What is the pattern of the discomfort and/or dysfunction? What functional restrictions are present and/or perceived? What other health issues are present? All of this will play into determining what type(s) of techniques may be best suited for the job. The technique used will in turn determine what options are available for applying it. Then we can choose the best one of the available options.

If we also consider stretching protocols, the issue becomes even more complex, but that's another discussion altogether.

If a poster asked a more specific question regarding applications of a particular technique or working with a specific type of situation, it would be easier to give a meaningful answer.

 

[confused.]

What Jason said. You have to identify the physiology of the problem IMHO. There is no discussion here of joint capsules, bursa, synovial sheaths, neural compression bla bla. Those statements are too general but maybe appropriate for a base program. Muscles can get stuck neurally long or short. Be bound in collogen. Be neurally shut off. Starved of nutrient. Being every "body" is different it changes case to case. That and there are almost always multiple systems involved in most every fascial complaint.

As far as working towards the heart.....exchange the word heart for lymphatic collection areas and your closer. Blood circulates around the body in a few seconds.... we are not pushing blood anywhere outside of the immediate area. Increasing circulation is like saying your gonna take a boat paddle and speed up a roaring river. Increasing metobolic exchange/migration maybe? We are making the membranes more permiable and hydrated to enhance waste and nutrient exchange.

Pick up a basic course on lymph drainage and that will tell you which way to work for flushing. Just keep in mind we are working a bunch of hydrolic myofascial bags (tensegrity if you will). This is why when you press on the distal quads the proximal quads "pump up". It's not like we're squeezing a tube of tooth paste.

Your real question is "what is the physiology of myofascial complaints"? Study that and body work becomes easier and not so ambiguos.

Hope that helps. ~peter

 

[AV (Avinash J Welinkar)]

Good thread!

The conflicting ideas of working towards the heart vs origin insertion to lengthen and insertion origin to tone came up in a class I'm currently taking.

When these two are in conflict, the "toward the heart" method DEFINITELY wins out. Pushing against venous flow can weaken or outright damage the valves, if they have them (some ppl don't) and increase dyastolic pressure (which is bad). I don't have any links to any studies, unfortunately (I'm sort of a research junkie myself) but I did hear this from reliable classes. (These were actual separate Anatomy classes and Physiology classes....complete with human cadavers...FUN! ...but I digress LOL) I also have personal experience with this. When I had eczema for over 2 years all over my hands and forearms, massage helped with the itching and the rash wounds but ONLY ONLY ONLY if it was done towards the heart. If not, even one single massage would actually make it much worse (both the itching and the rash) for DAYS. (With the itching I couldn't even tolerate the nerve stroke...Distal to proximal ONLY.)

(Lymphatic practitioners, you probably already know this stuff; what follows will be redundant for you, but might be helpful for those who are unfamiliar with MLD and may have a tough time picturing it--as was the case with me before I learned it myself): With Lymphatic, yep, it's true that you start working proximally and gradually go distal, but each individual stroke is toward the heart. (This is because each stroke eventually pushes the lymphatic fluid toward the thoracic duct where it can be shunted to the kidneys for processing.) But it's important that each stroke goes toward the heart, otherwise, lymph fluid backs up and you have a bigger problem than you started with. What happens is, each toward-the-heart stroke simply gets longer and longer, eventually covering the whole region (such as a limb)--thus, the reference to proximal-to-distal.

Hope that made sense! If not, just ask
Corrections welcome for anything that's inaccurate.
OK, I'm done rambling

Hugs,
~Jyoti

 

[London lady!]

Of course, we might not be discussing blood or lymph. In fascial work, strokes may proceed in almost any direction, and will often change vector during the stroke.

With cross-fiber friction work, the primary goal is to work perpendicular to the fibers, which can lie in almost any direction. In limbs, this often means working across, not towards or away from the hear.

There are other exceptions too, the point being that determining the physiology of the problem dictates how you need to work. There is no one best way for all situations.