Gentle manual therapy

Leading thought

I give gentle manual therapy, which means that I use my hands to improve the mobility of your body and to reduce or remove pain. I treat gently, do not force movements and try not to cause pain. I intend to help muscles instead of punishing them with a hard massage. If a muscle is tight or painful, the cause is almost always somewhere else in the body than in the muscle itself. If a gentle treatment of a muscle does not make it relax, the muscle generally reacts to a problem elsewhere in the body. Forcefully rubbing out muscle tension causes the symptoms to return or worsen later and can even result in new complaints. Therefore, I always try to form a picture of what is behind the symptoms. I try in the first place to act on the causes that I suspect behind the complaints. Often the cause is that some part of your body has lost its normal mobility. As a consequence, the rest of the body has to adapt to this and is therefore put under greater strain. Over the years, I have learned many manual methods to mobilize different structures in the body: from bones, muscles and fascia (membranes) to nerves and internal organs. The techniques I use stem from various kinds of massage, Kalevala bonesetting and osteopathy.

Why are muscles tensed and painful?

‘Travell & Simons’, Volume 1, Figure 6.2.

There are many possible reasons why muscles can be tense of painful. The following ones are the most common:

• The conditions for the functioning of the muscles have become less favourable. If there is for instance a pinched nerve, all muscles and ligaments supplied by that nerve weaken and easily get painful. If the circulation of the tissue fluid is impeded, the muscles get painful and tired. If the fascia that encloses the muscle (the muscle sheath) cannot move freely from adjacent tissues, the muscle cannot function normally. Stress, diseases and diet affect the well-being of the muscles too.
• The muscles try to protect something. If a movement causes pain, the muscles will tighten, so that the movement becomes difficult or impossible. If a movement can cause danger to an anatomical structure (e.g. a nerve), the muscles will stop that movement before it can cause (more) damage. The muscles do this so proficiently that you do not even notice the problem in the structure to be protected.
• The muscles react on a postural deviation. If the body or a part of it tilts to one side, the muscles at the other side must resist this tilt. A poor posture usually develops over a long time and can have causes of which the massage therapist is not aware or which he or she cannot easily influence. One of those is bad ergonomics, meaning that the work environment has been inadequately adapted to an individual or the individual has not adapted him- or herself as well as possible to the work environment. Therefore, a full correction of postural faults seldom succeeds, but generally it is possible to reduce the strain on the musculature caused by the incorrect posture.
• The symptoms are a projection of a problem at another place in the body. Each organ has an influence via the nervous system on specific muscles and ligaments. For instance a frozen shoulder can be the result of a functional disturbance of the liver or the stomach. Problems in muscles reflect themselves in other muscles via the fascia and via trigger points. Trigger points can arise from all causes mentioned in this chapter.

All these examples make clear that it is important to understand the causes of muscle tension, to treat them if that is possible and otherwise at least pay attention to them in the treatment.