The feel-good movie, Love Actually ends with the uplifting song, ‘Love is all around us’, which has the wonderful lyrics, ‘I feel it in my fingers. I feel it in my toes … and so the feeling grows’. Unfortunately, today it is more like pain that is all around us! Back pain, sore necks and shoulders, herniated discs, carpal tunnel syndrome, RSI, sporting injuries, frozen shoulders, rotator cuff injuries, headaches, migraines, plantar fasciitis, stress related conditions, fibromyalgia, IBS. Need I go on?
Chances are you either have one of these conditions yourself, or know several people who do, and you are just ‘putting up with it’. Think of the five people closest to you – are they experiencing some kind of pain? Does it affect the quality of their lives? Do you wish you could help them so that within the month their pain would be drastically reduced or maybe even gone forever?
The massage therapist’s dilemma
For massage therapists, the responsibility of helping our clients with these conditions can feel overwhelming; we long to help but often just don’t know how to do so. Our qualifying courses in the UK are often inadequate when it comes to preparing us to deal with chronic pain – qualifying courses in the UK are generally around 100 hours compared to the 1,000 hours required in many states in the USA or the whopping 3,000 hours that Canadian massage therapists invest in their education. Our qualifying course usually teaches us good relaxation massage (if we are lucky!) and gives us a long list of terrifying contraindications.
Treating anyone in pain seems difficult, if not impossible. Looking for massage CPD to increase our skills, we feel overwhelmed by the options in terms of training – so many techniques, so little time! And who to trust? So many massage courses claim to cure all – but are they the equivalent of the used car salesman – big on promise but low on results?
The bodywork blueprint
This was how I felt as a novice massage therapist – I longed for a bodywork blueprint or a massage ‘recipe book’ that would tell me exactly how I needed to treat each condition that came into my clinic. My desire to find the key to unlocking client pain took me all over the world seeking advanced massage training – from New York city to a hilltop village in Thailand to a remote farm in Bavaria! My list of further massage training reads like an A,B, C of bodywork – Amma, acupressure, body reading, cranial work, manual manipulation, meridians, myofascial release, stretching, soft tissue release, stomach manipulation, trigger point, Tuina, Thai massage….to name some of the techniques I have tried and tested.
Everything I learned I tried out in my clinic on real clients in real pain. Some of the massage techniques worked well and were easy to put into practice; others were much harder to perfect and took greater mastery. Frustratingly, some techniques worked for some people but not for others, even if the people seemingly had the same condition. I kept working, refining, trying new things, adding in different elements, removing others. Without a doubt, there was no single technique or bodywork approach that worked for all of the people all of the time. It seemed that a combination of massage skills was always more effective. But which massage techniques and in which order?
Slowly but surely, after treating literally thousands of massage clients, I started to find an approach that gave me the best, consistent results with the greatest number of clients. The combination of techniques used to enable me to reduce clients’ pain within six weekly sessions, with clients typically experiencing 80-100 percent pain relief at around session three. The results were consistent with many different types of musculoskeletal conditions, including those that had been persistent for many years and had been treated by orthodox medical approaches and by physiotherapists, chiropractors and osteopaths.
Of course, not everything worked all the time – but the results were significant. I was getting more and more people out of pain and my reputation and business was growing. The results were exciting.
The approach that I refined in my clinic all those years ago has become the cornerstone of the Jing method – treating musculoskeletal pain with advanced clinical massage techniques. We have been teaching this particular combination of techniques for ten years now and our students and teachers have consistently reported the same results – dramatic relief from common pain in one to six sessions. We have refined the approach to produce the ‘bodywork blueprint’ I longed for all those years ago – a tried and tested template for massage therapists.
There is a saying that, ‘the teacher’s job is to shorten the journey’ and I take that very seriously. No other massage therapist should have to spend the amount of time and money that I did knocking my head against brick walls to get a result. If you know the right techniques to use, you can get great results time after time and build the life and business you desire.
The X factor – the Jing method of Combined Advanced Clinical Massage techniques
In my A-Z search to find the most effective massage methods, I realised that the elusive ‘X factor’ lay in a creative combination of massage skills. Without a doubt, this is the best way to achieve effective results; for example, trigger point therapy is a fantastic technique, but the results are better if it is combined with fascial release and stretching. The concept of gestalt – ‘the whole is greater than the sum of its parts’– illustrates the Jing method philosophy; the combined effect of these skills is greater than the individual sum of these techniques alone.
So just what are the techniques I am talking about and how can we combine them in a treatment for maximum results?
Step one: take an effective case history and do a full assessment
Good assessment and evaluation tools enable you to be professional and you can plan effective treatments to achieve the outcomes that the client desires. If you achieve good outcomes, you will have satisfied customers, which leads to a thriving and interesting practice. You will be able to assess your treatment and have measurable benchmarks to determine progress.
Assessments can be divided into four components which you can remember with the acronym, ‘HOPS’:
[H – Health history questions (usually known as the case history or medical intake)
[O – Observations (of posture, for example)
[P – Palpation (of soft tissues including muscles and fascia)
[S – Special Orthopaedic Tests (specific tests that help us to identify problems more precisely)
Step two: correct application of heat or cold
Your treatment can be greatly enhanced with hydrotherapy. In general, chronic conditions respond best to heat whereas acute conditions should always be treated with cold (ice packs or the direct application of moving ice). Apply heat or cold to the painful area before starting your hands-on techniques to get better results. Your client can be taught to apply heat or cold between treatments.
Step three: fascial work
Myofascial work (MFR) is a powerful technique for addressing musculoskeletal problems. MFR techniques address the body’s fascia, that is, the fibrous connective tissue that holds the organs together. Most commonly taught massage techniques fail to address the fascia, thus denying practitioners a large piece of the puzzle when treating painful conditions. MFR techniques aim to restore mobility to the fascia and soften rigid connective tissue with highly effective results. As MFR should be performed without oil, it is often most effective to do it at the beginning of your treatment.
Step four: release all the muscles around the affected joint using trigger point therapy
It has become evident that a lot of pain may be caused by trigger points, or small contractions in the muscles. Studies suggest that trigger points contribute up to 93 per cent of the pain seen in pain clinics and are the sole cause of pain as often as 85 percent of the time. (Gershwin Fishbain quoted in Travell and Simons: Myofascial Pain and Dysfunction: The trigger point manual Volume 1)
Trigger points are known to cause or contribute to lower back pain, carpal tunnel syndrome, tennis elbow, neck pain, migraine, jaw pain, and joint pain attributed to arthritis. They can cause sinus pain and congestion, nausea, chronic dry cough and are thought to contribute to fibromyalgia.
To gain effective results with the trigger point technique, we recommend treating all the muscles around the joint. This is really important as most painful conditions will involve more than one muscle. For example, if you have a client with a shoulder problem, you will need to check the following muscles for trigger points: trapezius, rhomboids, supraspinatus, infraspinatus, teres minor, teres major, serratus anterior, subscapularis, latissimus dorsi, deltoid, pec major, pec minor, biceps, triceps and coracobrachialis.
Step five: use acupressure and meridian based techniques
In my own clinic I have found a knowledge of acupressure points and meridians to be an excellent tool for the treatment of pain. According to traditional Chinese medicine, meridians are the energy highways of the body and acupressure points are where this energy can be accessed and influenced. Recent research suggests strong connections between the meridians and the myofascia, with acupressure points being places where the fascia can be accessed at deep levels. So if you know relevant acupressure points, use them!
Step six: stretching techniques
Once trigger points and myofascial restrictions have been removed, stretching will lengthen shortened muscles, realign scar tissue to create a functional scar and promote energy flow in the meridians to optimise healing. Stretching will improve your sporting clients’ performance, prevent injury and treat it effectively when it occurs. You can enable your clients to take greater control over their own health by teaching them to stretch between sessions. PNF stretching, Muscle Energy Technique and Active Isolated Stretching are all incredibly useful in the effective treatment of pain.
Step seven: teach your client a self- help technique to use between sessions
Placing control of healing in your client’s hands is a powerful psychological tool. There are many safe self-help techniques that are within your remit as a massage therapist – for example instructing clients how to treat their own trigger points, showing self-stretching or teaching simple breathing and relaxation exercises to help deal with stress. But, only teach your client techniques for which you are insured and are knowledgeable.
Putting it all together
The above steps are like a tried-and-tested recipe – include all the ingredients in your treatments and you will see results. You should also use your own skill and creativity to determine which of the ingredients may be needed to a greater or lesser extent as the exact ‘recipe’ will vary from client to client. So each treatment will be different, challenging and exciting for both you and the client! Good luck! CHW
￼© Rachel Fairweather is co-founder and director of the Jing Institute of Advanced Massage. Based In Brighton, London and Edinburgh we run a variety of courses in advanced techniques to help you build the career you desire. Out short CPD courses include excellent hands-on learning in all the techniques described above, including trigger point therapy, myofascial release, stretching and orthopeedic assessment. For the therapist who wants to be the best he/she can possibly be, we offer a BTEC level 6 (degree level) in advanced clinical and sports massage – the highest level of massage training in the UK. You can also check out the approaches discussed in this article in our DVD in advanced clinical massage techniques, downloadable from the website. Please call or check our website for further information and course dates. www.jingmassage.com