Deep Tissue & Neuromuscular Therapy: The Torso, What is Deep Tissue Massage? (01:28)
Sean Riehl explains that deep tissue massage is specific, efficient, penetrating, and effective. It uses elbows, fists, and knuckles as tools.
Neuromuscular Therapy (01:05)
Neuromuscular therapy is a specific form of massage that focuses on release. Trigger points are irritated tissue that has begun to overwhelm the spinal cord with pain.
How to Perform Trigger Point Massage (01:12)
Trigger point therapy is the same as a normal massage. The first step is to search for sensitive tissue.
How Long to Apply Pressure (00:55)
Riehl believes that every client is different and that no therapist should rigidly stick to one rule. Body work should be semi-intuitive.
Appropriate Pressure (01:46)
With appropriate pressure, the initial soreness will start to dissipate after ten to thirty seconds. If the pain does not ease, you may be pushing too hard or pushing on a nerve.
More on Pressure (01:55)
Ask the client questions and listen for clues about how deep to work. Getting sore from a massage is a caution sign.
Working With Injuries (02:00)
The desire to work with injured people is one of the main reasons that massage therapists undergo training. There are many contraindications to massage.
Static Pressure (00:23)
Ischemic compression is useful in releasing trigger points and is one of the most potent ways to release the tissue.
Three Secrets to Correct Application of Static Pressure (01:31)
Our body is made up of cylinder shapes. When massaging the torso, it is important to line up the joints and apply pressure at a ninety degree angle.
Stripping Strokes (03:35)
These strokes are the application of slow and deep gliding pressure along the length of the muscle fibers. Performing these strokes on the body can elongate tight muscles.
Stripping Strokes With a Loose Fist (00:23)
The fist and the knuckles are excellent tools to apply deep pressure. When applying force with the fist, keep the fingers relaxed.
Stroke Speed: Mechanical Component (00:41)
The intention of stripping strokes is to elongate tight muscles and fascia. It is important to perform these strokes slowly. Faster strokes are more superficial.
Stroke Speed: Emotional Component (00:28)
Slow rhythmic strokes demand an attitude of patience on the part of the practitioner. Slow work brings you into the moment and makes you feel connected.
Evaluation Techniques (04:38)
When people go to Riehl with injuries, he first assesses what structures are involved. Most injuries involve muscles and tendons. Range of motion assesses the integrity of the joint capsule.
Hip: Assessments Internal & External Rotation (02:50)
How someone holds their hips influences the kinds of pain they will experience. It is important to evaluate the tension pattern in the hips.
Hips: External Rotators (00:53)
To assess the external rotators, bend the knee ninety degrees, while stabilizing the pelvis and pulling the clients leg toward you. Be cautious if the client experiences pain during the test.
External Rotator Technique (03:22)
To work on the external rotators, start the skin rolls on the gluteal fascia by picking up the tissue and slowly rolling it between your fingers. Grabbing a larger area will loosen the tissue.
Piriformis Muscle Syndrome (00:50)
Spasms in the piriformis muscle can cause compression on the sciatic nerve. The sciatic nerve can be compressed at the sacral nerve roots and lumbar nerve roots.
Internal Rotators & Abductors (01:26)
Muscles internally rotate and abduct the leg. Trigger points refer pain into the sacrum. The tensor fasciae latae internally rotates the femur.
Internal Rotator Technique (02:34)
To work the gluteus medius and minimus, use the elbow to strip anteriorly between the crest of the ileum and the greater trochanter. The trigger points in the gluteus medius refer into the sacrum and SI joint.
Hip Adductors (01:39)
The adductors are the opposing muscle group to the abductors located on the outside of the hip. When testing the adductor muscles, flex the hip and let the knee fall out.
Adductor Technique (03:23)
Stand on the opposite side of the table and use your forearm to glide up the adductors. Then move to the same side of the table and place your thigh under the client’s knee and externally rotate the leg.
High/Low Hip (01:19)
It is common for clients in pain to have one hip higher or lower than the other. To evaluate the hips, find the ileum with your finger pads.
Anterior Posterior Rotation (01:43)
The hips can rotate forward and back. To measure the amount of rotation in the hips, compare the bottom of the ASIS with the bottom of the PSIS.
Hip Flexors (02:54)
To test for a restricted psoas muscle, have the client bring both knees to the chest, then bring one leg down. This muscle can refer pain into the anterior thigh and lower back.
Hip Extensors (02:43)
A trigger point in the hip muscles refers pain into the posterior hip. Trigger points in the gluteus maximus refers pain into the SI joint.
The back is one of the most complicated areas of the body. The back is intimately connected to the hips. The positioning of the hips will directly affect the curve of the spine.
The Spring Test (00:56)
One of the major contributions to back pain is lack of mobility. To test for spine mobility, perform the spring test.
Muscles of the Lower Back (01:41)
There are six muscles to focus on when working with people who have back pain. Trigger points in the psoas can refer pain into the anterior leg.
Back Technique (05:40)
First release the longissimus by using your forearm to glide up the back, just lateral to the spine. Next release the multifidi. For tight muscles use static pressure.
Riehl demonstrates how to stretch the QL and the gluteus medius. He lets the leg drop off the table, while stabilizing the rib cage with his hand.
Anterior Torso (01:40)
Riehl demonstrates how to release the rectus abdominus friction located across the lower ribs. He braces one area with his thumb and uses the fingers of the other hand to pull down toward the pubic bone.
Side Posture (02:48)
Position the client on his or her side. Use your forearm to glide up the adductors and use your thumbs to search for sensitive tissues. Friction the upper part of the adductor attachments.
The Scapula Movers (00:15)
The shoulder is separated into two different muscle systems. The glenohumeral joint is covered in the extremities video. Riehl demonstrates the scapula's movement on the torso.
Scapula Retractors & Elevators (04:13)
Evaluate the client's posture. Notice if the shoulders are forward in relationship to the hips. Do not perform stripping strokes or stretches on muscles that are already too lengthened.
Scapula Protractors (02:45)
The main muscles of scapula protraction are the pectoralis major and the serratus anterior. Use your fingers and palm to glide out from the sternum toward the humerus.
The Neck (00:15)
The neck is divided into extensors and rotators, lateral flexors, and flexors in anterior neck.
Extensors & Rotators (04:06)
The deepest neck extensor and rotators are the suboccipital muscles. The splenius capitis is over the semispinalis muscles.
Neck Lateral Flexors (03:16)
The muscles that laterally flex the neck are the scalene medius, scalene anterior, and scalene posterior. The brachial plexus emerge between the scalene anterior and the medius.
Neck Flexors: Anterior Neck (03:08)
Victims of whiplash syndrome will have strained and tight anterior neck muscles. There is a gentle way to test for neck extension.
Credit: The Torso: Deep Tissue and Neuromuscular Therapy (00:04)
Credit: The Torso: Deep Tissue and Neuromuscular Therapy
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