Pain Relief and Bodywork

As consumers, you literally have hundreds of modalities to choose from to get a variety of releases with bodywork. But…have you ever stopped to pay attention to what your therapist is actually doing with these modalities? Most of the time, they do these modalities because some expert told them this is how it’s done. You go out feeling good and can get good results, but we never ask ‘why?’ If you take the time to ask “what are doing to me” and “how does it work to help me, you can find some very effective modalities that actually make sense. I will mention a few of them along the way.

When it comes to manual therapies, there are some commonalities in them that, although effective, when looked at individually, do not make sense to do.

We must start with pain. Pain has one purpose in the body, only one: that is, to tell you that something is going wrong, a sign to warn you of danger, whether it is going on inside of the body or an external trauma.

The motto “no pain, no gain” was popularized by body builders to describe the muscle burn you feel when you work your muscles to fatigue--NOT ACTUAL PAIN! If your therapist is causing you pain when you are getting worked on, they are causing trauma to your bodies…period! They are putting you into a defensive mode which makes it very difficult for your body to relax and start the healing process.

If I am a client coming for pain relief, and I have a pain level of 6-7, and the therapist is causing me a pain level of 6-8, why would I want to come in to get hurt more than I am already hurting? Does that make sense? If I want to get beat up, I could get into a street fight and have it be free! Why pay someone to do it?

Some will say “because it feels so good when it’s over.” Duh! When pain, or other sources of stress, becomes significant and threatening, groups of cells in the brain release chemicals commonly known as endorphins. The endorphins bind to receptors on nearby brain cells and regulate how the brain interprets and regulates the pain-related signals that those cells are sending to one another. The effect is called anti-nociception, because the neurotransmitters typically suppress the pain response, as opposed to nociception, which is the actual perception of pain. So, in reality, all they have done with you is temporarily suppressed the pain response, not get rid of the pain.

Also, if you are feeling sore or achy for several days after your massage, you had too much release at one time, or, you were worked too hard. Your body can only handle a limited amount of muscular release at one time. It can only eliminate a certain amount of toxins efficiently without the soreness or achiness. “Nature does not hurry, yet everything is accomplished." --Lao Tzu

Common therapies and common sense?

Chiropractic is adjusting bones to open up restrictions in nerve pathways. Bones can only go where muscles make them go, so why not correct the muscle tension so the bones can stay in the correct position in the first place? As you can see, this very popular form of therapy, although it can be very effective, is not very efficient. This is also why most chiropractors have learned how to do muscle releases or have a massage therapist working for them.
Deep tissue massage includes most common types of massage that are considered “therapeutic,” modalities like trigger point work, ART, sports massage, shiatsu, etc., which use ischemic compression. The primary concept behind ischemic compression is to stop blood flow to the body part for several seconds so that when you release it, blood rushes into the area flushing away toxins.

Using this concept is like going in with a headache and then getting choked for several seconds, because when they let you go, the blood will rush back into your head making you feel better. Think about this, why would you ever want to stop blood flow to a body part unless there was an external bleed? Myofascial Pain and Dysfunction: The Trigger Point Manual, 2nd edition, by Janet G. Travell, (a book that ALL therapists should have read) clearly discourages the use of ischemic compression and recommends the use of a gentle stretch, stopping at the point of mild tension then a mild pressure that is held when the barrier is felt--not enough pressure to cause ischemia or pain.

Stretching is also common in many massage modalities, such as Thai massage, myofascial release, sports massage, etc. The first question asked is “Why do we need to stretch?” The most common answer is “because the muscle is tight,” and that is good enough for most people. What we should be asking is “Why is the muscle tight?” We don’t ask that question, because we would then need to think and figure out why the muscle is tight. If your therapist does not know how the human body works, they will never know the answer to this, so I am going to give you the general answer.

In general, for whatever reason, the body has to over use the tight muscle to get the movement or stability necessary on a daily basis. This is usually a postural issue, meaning that the antagonistic (opposite) muscle is not working properly to keep balance in the body: the tight muscle has to do most of the work.

When we stretch a muscle too far [and by too far, I mean beyond the feeling of mild tension], we are actually cutting off blood supply and squeezing the nerves in the muscle. As the muscle elongates, it decreases the space in the muscle that these other structures have to move. It is like the muscle is a Chinese finger trap, and the nerves and blood vessels are your fingers. The more you stretch the trap, the tighter it squeezes on your fingers.

The next issue with stretching is how we stretch. Since stretching can cut off circulation to the muscle, it should be done very gently and only held for a few seconds, ideally released before the stretch reflex is activated. We also want to use the body’s inhibition reflexes to our advantage; gently contracting the opposing muscle will cause reciprocal inhibition (relaxation response) in the muscle we are stretching, making for a more effective, mild stretch. As far as stretching goes, Active Isolated Stretching and mild PNF Stretching are very effective and safe ways to stretch when applied properly.

Conventional massage has been shown to be very effective in reducing stress as well as relieving tension and pain. I am not saying don’t get your massage, just be aware of what your therapist is doing to you, what methods they have chosen to learn and why. If you find a knowledgeable therapist they will know how to safely and effectively work with you without causing pain, and may even offer some of the more effective methods below.

Energy work, in general, seems to be fairly safe and can be very effective. Modalities like Reiki, cranial sacral, etc., fall into this category. I am not currently aware of any effective ways to clinically test ‘energy work,’ but I have had the chance to experience some of this type of work and have felt physiological releases as well as what I would call ‘energy flow.’ This work is very relaxing, but you generally will not feel the therapist do a lot of moving since they are more a conduit allowing the energy to flow through them and focus on you.

In addition to energy work, some modalities are very effective. They make sense to do and they will not cause you any harm. Trager work, Feldenkrais Method and Alexander Technique are effective, gentle movement therapies which is a great way to release muscle tension. Positional release techniques like Ortho-bionomy and strain-counter strain are safe and very effective.
These modalities stimulate the body's self-correcting and self-balancing reflexes by way of the proprioceptive reflexes located in our joints and muscles. The practitioner uses movements and gentle compression to find positions of comfort which allow the body to change the stress and pain patterns which are causing the discomfort.

Bowenwork is extremely effective and probably the most efficient of the manual therapies. It uses a gentle rolling motion over key structural points (many of which refer back to significant structures embryologically and developmentally) on the body to manually stimulate an inhibition effect in both slow- and fast-twitch muscle fibers which resets muscle tension. Studies have also shown that a Bowenwork move creates a piezo-electric current in the connective tissue which has been shown to have great healing properties. These methods allow for the body to self regulate tension.

It is my hope that this article will open your mind to think about what type of bodywork you choose to have done and find one that is safe and effective for you. Keep in mind that bodywork alone may not relieve your issues. Proper corrective exercise is absolutely necessary to keep you in balance and out of pain. Regardless of what kind of bodywork you choose to have, you must exercise!

REFERENCES:
Pain and the brain: Sex, hormones, & genetics affect brain's pain control system, shaping a person's pain perception, U-M
Active Isolated Stretching, The Mattes Method by Aaron Mattes
The Bowen Technique, the inside story by John Wilks
Myofascial Pain and Dysfunction: The Trigger Point Manual, 2nd edition, by Janet G. Travell
"No Pain, No Gain" by Ben Benjamin, PhD