As the benefits of massage therapy continue to be supported by research, consumers are taking advantage of what you have to offer—from stress relief to helping manage the symptoms of chronic conditions to alleviating pain. Helping clients deal with a variety of issues, from the simple to the complex, can require a variety of techniques and modalities. And that’s where learning new ways to address the myriad issues your clients may come to you for becomes invaluable.
Active movement and massage involves having the client perform a movement engaging either a concentric or eccentric contraction while the therapist performs a muscle broadening or lengthening technique throughout the course of movement. As passive movement is incorporated, the massage therapist moves the muscle through its shortening or lengthening phase as they either broaden or lengthen the muscle fibers. The choice to broaden or lengthen fibers is dependent on type of contraction or movement that is done.
According to Lee Stang, a massage therapist located in Southington, Connecticut, incorporating movement into a massage therapy session has a lot to offer both massage therapists and their clients. “If I think about what I am trying to do for a client with massage, it can almost be defined as simply as wanting to free up movement in the body and create an environment where a client can move without pain or restrictions,” she says. “What better way to accomplish this than to move the body during a massage session.”
The Benefits of Movement
The why. There are a variety of benefits to adding movement to a massage therapy session—for both the practitioner and client. First, movement helps with assessment. “Movement becomes a tool for the therapist to use to assess the condition of the client, determine the best approach and technique for that condition and track improvement,” explains Stang. “As part of the assessment process, movement can help distinguish those tissues that massage therapists can have a marked impact on, such as muscle and fascia, versus tissue that would be appropriate to refer out, such as a joint capsule.”
Massage therapists can also get a good idea of what is working and what isn’t. “We look for improvement in the range of movement, but also in the fluidity of that movement, strength of movement and level of pain with movement,” says Stang. “These can all indicate whether our choice of treatment is effective and where we might need to adjust and adapt.”
Because you can get really specific about both the technique you use and the tissue you target, practitioners might also start seeing better results when incorporating movement into their massage therapy sessions. “In general, these techniques will enhance the pliability of tissue, separate adhesions between damaged fibers and break up scar tissue,” Stang suggests. “Some movement techniques can encourage the elongation of the tissue while reducing hypertonicity. Movement techniques are also very helpful in locating fascial restrictions and facilitating their release.”
Movement can also increase a client’s awareness of their own movement patterns, which can help them better understand where restrictions in movement exist and encourage them to take a more active role in the treatment plan you develop. “Clients often come to us unaware of how their body is or is not moving,” Stang explains. “They have developed rigid patterns of holding because of real or potential pain, or have developed compensatory patterns that limit their ability to heal because of continued stresses to various tissues.”
The who. According to Stang, athletes are a natural fit for massage sessions that include movement because of how they use their bodies day in and day out. “They often push the limits, and come to us looking to relieve deep tissue aches and pains, or specific soft tissue injuries and problems,” she says. “They are also accustomed to being actively involved in all aspects of their health.”
But movement is tremendously beneficial to other consumer demographics, too, particularly those clients who have soft tissue injuries or restrictions that limit proper body mobility. “When clients present with either acute or chronic pain, limitations in range of motion and mobility of joints and muscles, or structural imbalances, the nature of active movement techniques allows massage therapists to really focus on a problem area and get quite specific,” Stang says. “This means clients who come to us with orthopedic conditions and soft tissue injuries will reap considerable benefits.” Stang also believes that passive movement can add a slightly new dimension to Swedish technique, and be incorporated into almost any massage session, including those focused on providing general relaxation.
Clients, however, aren’t the only ones who benefit from adding movement to a massage therapy session. Stang also sees some big benefits for practitioners, as well. One is the ability to work deeper without working harder. “If you apply pressure when a muscle is not contracting, the pressure applied is dispersed throughout the tissue,” she explains. “As a muscle contracts, the density increases. When you apply pressure to that denser tissue, the pressure is felt deeper into the tissue instead of being dispersed outward.” The result is that a massage therapist doesn’t have to increase their pressure in order to work deeper, which can be particularly useful if you have a client with thick muscle mass who continually asks for deep work.
What You Need to Know
Anatomy and palpation. For Stang, one of the biggest considerations when deciding to use a specific technique is understanding why you’re using the technique. In order to fully understand why a technique will be effective in helping particular conditions, you need a better-than-average knowledge of anatomy, palpation and injuries. “Massage therapists need to understand the nature of injuries,” Stang says. “Palpation skills are very important when incorporating movement into our work, as well as a very sound understanding of muscle anatomy. More specifically, fiber direction and direction of pull of a particular muscle is key.”
Stang offers this example to illustrate her point: If a massage therapist considers using movement techniques to broaden or lengthen a muscle, understanding the differences between types of muscle contractions is imperative. “We want to broaden when the body is naturally broadening the muscle during a concentric contraction,” Stang says. “Alternatively, we want to lengthen when the body is naturally lengthening during an eccentric contraction.”
Communication. The goals of these massage therapy sessions—particularly if you’re helping a client better handle an injury or chronic pain, for example—are going to be very specific and require that you are able to effectively communicate with your clients. You might spend the entire session focused on improving mobility or decreasing pain in a client’s shoulder, low back or hip, and it’s your job to help the client understand what you’re doing, most especially if you want them to be actively engaged in the session.
“Our ability to communicate effectively with a client during a movement session is very important,” Stang explains. “Helping them to understand initially why you are utilizing movement will set the stage for an interactive session, getting them to understand the type of movement, as well as the quality and speed needed, is key to a successful session.”
Set expectations for the client. Again, many massage therapy sessions that include movement are going to focus on alleviating a client’s pain, as well as helping to uncover the cause of the pain. Although causing the client excessive pain during a session would never be warranted, some discomfort can probably be expected when you’re using movement to help a client better understand what’s causing their pain and how they can better deal with the cause. “One of the beautiful things about active movement is that the client can control the level of discomfort,” Stang says. “They can move or be moved in and out of the pain zone and, as they are, they and the massage therapist can feel the tissue change.”
Stang emphasizes that clear communication around the amount, type and quality of pain is extremely important. “Working slowly and allowing the client control is key and allows you to work up to that therapeutic level that is necessary for optimal effect,” she says.
Massage therapists also need to prepare clients to participate in the session, as to be most effective, the client needs to be engaged in the process. “As a massage therapist, we can palpate and feel areas of tightness and restrictions in the fascia and muscles. We can feel the barriers to range of motion and see the limitations in the range of a joint,” Stang explains. “What we cannot do no matter how we try is feel what our client feels.”
And knowing how the client is feeling does more than help a massage therapist find and alleviate the cause of pain—it also helps maintain a therapeutic environment. “In order to ‘do no harm,’ we must have clients stay engaged during the session,” Stang explains.
Without question, your main goal during any massage session is to help your client achieve the goals they’ve outlined. Learning different ways to work with the different issues you see in your practice gives you—and your clients—the ability to maximize the effectiveness of massage therapy. And that’s a win-win situation.