Deep Tissue Massage Might Fix You

But How?

-this post was brought to you by McDonald's McCafé, and a double dose of NeuroVolt this morning

Many years ago when I was still training clients full time, I had a bodybuilder show up to the gym wanting to talk. He was an enhanced guy, had a great physique, but was having recurrent problems with bicep tendinitis, forearm and arm and shoulder tightness, and wasnt quite sure what to do.

He was quite muscular, and it was a classical case where outwardly looking at him, you’d never guess he was in pain or struggling with training.

But he reported numbness in his arms, the aforementioned bicep pain, and as he described, his mind muscle connection had declined, and it was very concerning to him.

He’d tried talking to his regular doctor, but muscular as he was, the doctor told him him he likely overtraining, and didnt offer much beyond that.

Myself, Ive never been a competitive bodybuilder obviously, but Ive have a talent for movement and was well known for being able to assess biomechanics to a deeper level than most trainers.

He described his symptoms, his training history, and asked me what I thought.

I did not have an immediate answer, and I asked him if I could feel his arms and shoulders and take him through some movement drills

Hands on Assessment, Touch, and palpation is a Real Skill

If I put my hand on your shoulder and ask you to raise your arm to the front, that will feel different to the touch versus you raising your arm out to the side. I can feel what your joint is doing by way of touch.

And that is just one example. Hands on cueing and movement direction is not popular in the coaching world so much, but is used much more in physical therapy.

For legal purposes, always ask peoples permission and be very clear where you are touching them

Its well established in hands on palpation (actively touching a working muscle) actually increases neural drive to the muscle. Touch is powerful.

In his case, I asked him to squeeze his hand into a fist, do some simple resisted bicep curls, and some deltoid raises

While he did this, I simply felt his muscles with my hands, going from the wrist to the shoulder

What I noticed immediately is that his muscle tonicity was extremely high. Meaning his muscles felt hard to the touch. This is not unusual in guys who are using steroids, but his muscle felt hypertonic. They were hard to the point of being stiff.

When he flexed and contracted his muscles, this contraction did not feel “smooth” to the touch, but rather cramped.

To understand what i mean, imagine trying to flex your muscles as hard as you can while walking; you cant do it. They are opposing actions. Muscles contract and relax in cycles. If they are overly contracted, movement becomes increasingly stiff to the point of immobility.

His forearms and biceps and shoulders all had this feeling, as did upper back.

My assessment was not a diagnosis (Im not a doctor), but it ended up being the correct one

I think you may be experiencing Compartment Syndrome

Specifically, Chronic Exertional Compartment Syndrome (CECS)

Compartment syndrome is when excess pressure builds up inside a muscle or group of muscles, with pressure the muscle tissue, nerves, blood vessels and fascia.

As the muscle contracts and expands during repetitive activity, the fascia may not expand enough, temporarily limiting blood flow and irritating the nerves.

Compartment syndrome is somewhat similar to when you have “pump” in the muscle. Normally this temporarily swelling and mild pain is enjoyable, except it doesn’t go away, and it becomes irritating and starts affecting muscle function.

Compartment Syndrome can potentially be life threatening, this is called Acute Compartment Syndrome, but this is typically from a serious injury where blood is pooling up.

That is a very different situation from what this gentlemen was experiencing. His was the chronic kind.

I offered two suggestions to him.

-See local sports orthopedist who I knew was skilled and could confirm (or contradict, maybe it was something else, like thoracic outlet syndrome)

-See a local Chinese Medicine doctor who was well known for massage and using acupuncture.

TCM (traditional chinese medicine) gets argued about in mainstream medical world, but there is some evidence for it working for certain conditions, and as I told him, the intervention he clearly needed was getting the muscles in his arms to RELAX and not be so stiff.

What was the Outcome?

About a month later he dropped in again in high spirits. My observation had been the correct diagnosis, and the TCM doctor had done multiple rounds of deep tissue massage and acupuncture on him and his pain had decreased immensely and his workouts were far better.

In particular, he highlighted how he had never been a guy that gets massages, but now he was a believer in their effects and they’d become a regular part of his recovery.

-the merits of acupuncture we can discuss in another newsletter

Why Can Massage Be So Powerful?

If you ask some clinicians about massage and its effects, they may be pessimistic

-You cant change fascia or muscle with your hands!

-Any effects are temporary

-its placebo+relaxation

-Its impossible for someone to accurately FEEL muscle tension and knots and tissue quality with their hands!! Its PREPOSTEROUS!!

I am sharing this first to frame the skepticism that people have towards massage. Some people are very turned off by the idea of another person touching them, while others are doubtful that massage will do anything at all. This doubt is sometimes shared among some in the medical world as well.

However, massage has a LONG history as being used as Medicine

The Egyptians, Greeks, and Chinese all treated soft tissue restriction with hands. This is depicted in artwork, and described in historical literature.

The power of TOUCH is undeniable.

Touch is one of the oldest regulatory systems humans have. The universe is TACTILE, its atoms interacting with one another on a physical level. Touching another person creates a dynamic interaction between two peoples nervous system. Touch is an ultra powerful phenomena.

The skin is packed with mechanoreceptors that feed directly into the spinal cord and brain. When another person’s hands apply pressure, shear, or sustained contact, those receptors fire in patterns that self-touch and foam rolling cannot fully replicate. The nervous system receives the novel sensory data and responds to it.

Massage treats the nervous system through the skin and muscles

Muscle tonicity drops. Blood flow and oxygenation improve from the improved fluid dynamics within the muscle. The bodily intuitive sense of where the limb is in space can increase. This effect may not be permanent, but it is happening.

The ancients knew this. They observed actions and outcomes. Massage was prescribed for athletes 3000 years ago because it helped them recover from hard training. It was prescribed to help the body improve its vital powers to heal. Nothing has changed.

This is why I am dismissive of Modern skepticism.

If it didnt work, it wouldnt have lasted across civilizations for millennia. Our lack of understanding as to how it works does not negate the outcomes it produces.

Massage can change emotional state

A common phenomenon among masseuses is people experiencing “emotional release” during massage. This can be tears, sobbing, and rush of shame/fear/sadness/regret/trauma and more that is characterized as emotional repression.

Again, this phenomenon is dismissed by some as more a peculiarity than anything substantial, but Im not of the mind to dismiss it.

That the body and mind keep a record or “score” over time is a valid concept. Motor development, mental development, and skill acquisition from the time we are born through adulthood are all predicated on exposure and repetition. Our mindbody is ALWAYS keeping a score and maintaining a dynamic record of inputs, and this memory is dispersed throughout the body itself. It does not exist only in the mind-brain.

Dr. John Sarno’s work on Tension Myositis Syndrome must be mentioned

Sarno argued that unconscious emotional tension, especially repressed anger and the constant drive to perform, this causes the autonomic nervous system to constrict blood flow to specific muscles, nerves, and tendons. The result is mild oxygen deprivation. The tissue stays slightly ischemic. It tightens, and it hurts. The more primitive parts of the brain then treats the pain as a structural problem and keeps the cycle running.

This is how high mental stress people can end up with non specific pain and tightness that has no identifiable origin.

This can also be the people where they want a deep tissue massage to feel like being put underneath a steamroller.

They might get temporary relief, but there bodily tightness is psycho emotional in origin, not physical.

If this resonates with you, I would encourage you to explore Dr. Sarno's work further

The Divided Mind, the Epidemic of Mindbody Disorders

Practical Recommendations

If you've never had massage before, where should you get started? And what types are most beneficial?

The world of massage is Broad, I've had about every kind, from the various styles of Asian massage to medical massage, and niche therapies like muscle activation technique, active release, and electrical stimulation of various types.

I don't have a favorite, but I do have contextual recommendations

-if you are simply looking for a relaxing experience, Swedish massage, and Thai massage are good places to start

The masseuse will always ask you how much pressure you’d like and the overall focus is relaxation.

-if you have specific issues around muscle tightness, muscle condition, and recurrent muscle strain

-for tight muscles or muscles you have trouble recruiting in training, I’d recommend Muscle Activation Technique (MAT). This modality specifically focuses on improving communication between the brain and neuromuscular innervation.

-if you have inhibition due to past injury and scar tissue, I would recommend active release technique (ART)

-if you have more challenging neurological issues where it seems MAT can’t fix it, try ARPwave. This uses electrical stimulation to rebuild motor coordination

Always keep in mind that the mind body journey is never perfectly linear

The body rebuilds itself through experience. You learn by doing, you heal by experiencing.