This is the UN-edited article published in the July 2002 issue of Massage Magazine.
Mid Back Tension
"Intention and Imagination"
by Taum Sayers
One of the keys to success within the art of bodywork appears to be utilizing intention and imagination. Rumor has it that we humans utilize only a small percentage of our potential abilities. I believe that we can increase that percentage when we exercise, and thus promote, our ability to imagine, intend and see outside the box. Portions of the following information serve to encourage the innate ability to listen to and utilize the clues your client's tissue is providing. My primary mentor, Lauren Berry Sr., RPT and Structural Engineer, often described a successful therapist as part detective and part mechanic. It would appear that intuition and imagination aid both of these roles.
A good foundation includes knowing your anatomy so that when a client points and says "It hurts here", you can 'see' the pertinent muscles in your minds eye and then tactilely follow along the length of the muscle attached near that point of tenderness and address the various tensions, adhesions and distortions that might be contributing factors. This approach recognizes, respects, and addresses this situation throughout the body, often reducing pain and restoring function with remarkable speed.
While this protective adaptation initially serves its purpose well, it is similar to applying duct tape to mend a tear. A useful yet transitory solution, rarely efficient for long-term healthy function. Problems often arise when the tension (duct tape) remains long past the body's need for that protective mode. Therapists asked to work on long standing concerns of their clients can often add to their successful rate of pain reduction by respecting that we are often not so much addressing the initial problem, as we are the body's historical adaptations and compensations.
The Rhomboids are not necessarily the culprits in Mid back tension.
Sure, we humans can adapt to the various insults to our upper back, but not without an accumulative cost. In this case, the price is often an ongoing tension between the shoulder blades.
This article will focus specifically on several of the muscles often associated with tension in the thoracic area, the Iliocostalis Thoracis and Iliocostalis Lumborum.
With thoracic tension, these two muscles, in addition to commonly being in a state of tension due to postural imbalances, appear to frequently distort in a lateral/inferior direction. The resultant tension is felt by the client most noticeably between the shoulder blades where these muscles attach. As part of any client's session, Lauren often suggested we massage the attachment points of a muscle before correcting its position. He explained this action would increase the blood flow to the muscle. After further anatomy investigation, it would appear to this author that massaging the attachments can also stimulate the properties within the Golgi Tendon Organ (GTO) (see GTO illustration) thus reducing the tension on the attachment points. Consider…within the neural/muscular mechanism, the stretch reflex regulates the length of skeletal muscle. The tendon reflex monitors the tension produced during a muscular contraction and prevents damage. The sensory receptors for this are the GTO's. They are located among the collagen fibers within the tendon near its muscular junction and serve to monitor the external tension on skeletal muscle. Their associated neuron is stimulated when the collagen fibers are under stress. They are more susceptible to activation during contraction than stretching, when the energy comes from within the muscle as opposed to an external force. Within the spinal cord, these neurons stimulate inhibitory interneurons that innervate motor neurons controlling the muscle. The greater the tension in the tendon, the greater the inhibitory effect on the motor neurons. Consequently, skeletal muscles are generally prevented from developing enough tension to damage their tendons. This serves as a built-in relief switch. (As an example of this protective mechanism, consider why you cannot hang onto a pull-up bar forever. At some point, the GT0 sends the message to your nervous system that the stress of holding on is reaching a point of muscular/tendinous damage. The brain responds by overriding your wish to continue hanging on and reprograms the muscle into a relaxed mode thus weakening your grip and you let go.)
It would appear that Lauren's technique also stimulates the mechanisms within the GTO to manually reduce a muscle's internal tension. This technique intends not so much to stretch the muscle as much as simulate a stress within a particular muscle. By applying a specific cross-fiber massage, similar to pulling the string on a bow and arrow, this approach stimulates the natural properties with-in the neural/muscular mechanism to set off the GT0's response and persuade the muscle to relax. This technique is most successful when your intention is focused thru the surface tissue layers to your target fibers. I personally have a lot of admiration for bodyworkers who are very specific with their intent and their capacity to "see" with their fingers. An ongoing study of anatomy followed with practice in the field is an excellent way to nurture and refine these abilities. For example, you might find and palpate the two muscles discussed here on each of your next day's clients. I highly recommend that you begin with a clear intention and a light touch. Initiate by palpating the insertions of the iliocostalis thoracis and iliocostalis lumborum, acknowledging your client's feedback as to levels of discomfort. (I recommend an agreement so that should your pressure cross the line from therapeutic discomfort into pain, your client notify you with the code word 'ouch' and you will stop to assess the information. This serves two purposes…assisting you in your assessment with their feed back and allowing your client to relax further knowing they have a say in this process.) This includes the attachments shared with the common tendon of the erector spinae. Though you probably will not be directly working on the GTO itself, the tendon is dense enough that your localized pressure can be transmitted to it to stimulate the desired response. This work is done without oil, allowing for a precise manipulation of the tissue.
A useful image is one of pushing or nudging dried strings of glue across glass with your fingertips. Consider that the attachment points of the tendon represent a concentration of force in one small area (the entire force of the muscle focuses tension on the bone through the tendon at its attachment). Because of this, the tension/force (pounds per square inch) at the attachment point is higher than at any point in the body of the muscle itself. There are pain receptors at the bone surface (periosteum), which in turn can make the insertion point very sensitive. It is thus helpful to expect these points to be tender and adjust your pressure accordingly. Consider that you are not so much repositioning the fibers to an exact position as much as you are introducing movement towards a balanced situation, thus reducing adhesions and removing distortion. The muscle tissue upon having the 'duct tape' removed will most often be able to nestle back to its optimal location. Note that one indication of a misplaced and distorted muscle is when the fibers tactily 'stand out' with that all too familiar stringy/ropey feeling. Additionally, when muscle fibers are in their most functional position, they usually blends back in with the surrounding fibers and 'tactily disappear'.
*Mirka Knaster, Discovering the Body's Wisdom (Bantam Books, 1996), p. 171
** The Institute of Integral Health, Inc.©, is a non-profit educational corporation located in Berkeley, CA, that continues to teach and certify practitioners in The Lauren Berry Method®.
Taum Sayers is a certified Lauren Berry Method® practitioner, instructor, President of The Institute of Integral Health, Inc.© and author who continues to practice and present workshops nationally and near his home in North Lake Tahoe, California. The foundation of his practice is primarily influenced by his apprenticeship with Lauren Berry Sr. RPT, and his ongoing association with his fellow board members, teachers and students within The Institute's ongoing educational programs.