Trademarked Massage

The road to fame and fortune—if that’s what it can be called in this line of work—seems to be to “invent” your own kind of massage. “Invent” in quotation marks because, by and large, new types of massage are actually more like songs using sampling—that is, taking a portion (or a sample) of an already recorded sound or song and using it in the creation of another song. So, for instance, Structural Energetic Therapy (SET) is a combination of deep tissue massage, myofascial release, and kinesiology, developed by massage therapist Don McCann in 1983, while polarity massage therapy, created by Randolph Stone, a doctor of osteopathy, chiropractic, and naturopathic medicine, blends energy-based bodywork, diet, exercises, and self-awareness techniques.

Many of these specialized therapies are referred to by a handy acronym/abbreviation: in addition to SET, there are also, for example, NMT (neuromuscular technique), PUSH (power under soft hands), ART (active release technique), and BART (bonding and relaxing technique). Even therapies that aren’t known by their abbreviation use acronyms to summarize their technique, a practice sometimes inelegantly applied as in SCRIBE, which describes the “six guiding principles” of Comfort Touch (created by Mary Kathleen Rose): Slow, Comforting, Respectful, Into the center, Broad, and Encompassing. I say inelegant in that “into the center,” for example, seems rather contrived, phrased in such a way merely to make the acronym come together. “Inward” might have worked equally well and wouldn’t rely on a preposition to make an intelligible acronym. I have other issues with this summary as well (shouldn’t all massage, for instance, be respectful?), but it’s the infelicity of the prepositional device that strikes the most strident chord with me.

Other therapies avoid the confusion of these helpful, easy to remember abbreviations by their creators’ dispensing with modesty and naming their modalities for themselves: the Arvigo Techniques of Maya Abdominal Massage (for Dr. Rosita Arvigo), Aston-Patterning (for Judith Aston), The Feldenkrais Method (for Dr. Moshé Feldenkrais), The Niel-Asher Technique (for Dr. Simeon Niel-Asher), and Bonnie Prudden Myotherapy (named for—guess who?), among others. Further, many of these are actually trademarked techniques, lest anyone think to borrow wholesale from them and call it their own.

So I’ve been thinking about jumping on the bandwagon and coining my own therapy. The only thing I can’t decide is whether to incorporate my name into the name of the technique: Zipter Catch and Release Technique or just Catch and Release Technique. CRT is nice and simple, but if it has a ring to it, it’s because it’s also the abbreviation for cathode ray tube. ZCRT avoids that but is rather clumsy. CRMT (for Catch and Release Massage Technique)? Maybe I should leave decisions about what to call it, for now, and work, instead, on describing this astonishing new modality.

An acronym summarizing the technique might be a reasonable place to start. And going with the catch-and-release metaphor, I’m thinking FISH might be a nifty mnemonic: Find, Isolate, Squish, Hold. In other words, Find the area of pain, Isolate the knot, Squish the knot, and Hold it until it releases. If that sounds a lot like trigger point therapy, well, in fact, it is. But I mix in a certain je ne sais quoi. It’s the je ne sais quoi part that troubles me, though, in terms of making this a viable technique that can be taught to others. This je ne sais quoi has something to do with intuition, which I’m pretty sure can’t be explicated in a step-by-step way, thereby making it something hard to pass on. Intuition can be developed, I’m convinced, in someone who is open to it and who has a good foundation from which they practice. I’m just not sure how to tell you how to go about acquiring it.

I have therefore reached the unavoidable conclusion that, sadly, my new and would-be patented form of massage is not quite ready for primetime. And to be honest, I just don’t have the chutzpah to claim that what I do is either unique or better than what’s already out there. This isn’t to say that I don’t think I’m a darn good therapist, with special skills and genuine ability. I’m just not ready to proclaim myself a new massage messiah.

Plus, there are already a lot of good modalities out there, with each having their appeal and benefit for different people for different situations in their lives. For instance, though I’ve made light of Comfort Touch’s SCRIBE mnemonic, that type of massage is actually quite beneficial for those who are frail and/or ill. And its creator has generously answered many of my questions, without knowing me from Adam. I think my point here is—and, to quote Ellen DeGeneres, I do have one—that it’s important to shop around not only for a massage therapist but also for modalities so you can find the one that’s right for you right now.

But with something like 160 modalities currently in use and with an estimated 278,000 massage therapists in the United States as of January 2008, the task of finding that right therapist seems daunting to say the least. That’s a stress producer right there! But for help finding a massage therapist, while nothing beats a recommendation from a trusted friend, a good place to start searching for someone that specializes in a particular modality are the registries of the two professional massage associations and the national certification board.

As for me, fame and fortune may not be in the cards but—and I apologize for sounding like a sap—the thought that I will have an opportunity to help make people feel better, every day, for years to come, is a reward in itself. And I’m sure that’s how the bank that holds my mortgage feels as well.

Sources:

On the number of modalities, see http://www.massage-therapy-benefits.net/types-of-massage-therapy.html.

For numbers of massage therapists: http://www.massagetherapy.com/media/metricsgrowth.php.

The registries for the professional associations and certification board can be found at http://www.amtamassage.org/findamassage/index.html, http://www.massagetherapy.com/find/., and http://www.ncbtmb.org/consumers_find_practitioner.php.

Contents under Pressure: Massage for Hypertension?

All manner of assertions are made about the benefits of massage. But are they all true? And how do we know?

It used to be that everything we knew about massage was based on anecdotal evidence and observation. As scientists have learned more about the how the human body functions, however, and as interest has grown in complementary and alternative therapies, researchers have started to examine some of the claims made for massage. It is frequently alleged, for instance, that massage can reduce blood pressure.

This claim is, of course, relatively easy to test. Blood pressure can be checked, using a blood pressure cuff, before a massage and then again afterward. If someone’s blood pressure is lower for the after measure and there were no other variables, it seems pretty clear that massage was responsible for the change—especially when these results are replicated numerous times with numerous subjects.

And, in fact, a variety of studies have shown that massage lowers both diastolic and systolic blood pressure. (Diastolic, as you may recall, refers to the pressure between beats, or when your heart is at rest, whereas systolic is the pressure during a heartbeat and is higher than the diastolic pressure.) A study that looked at the effects of a relaxing back massage on hospice patients found not only that blood pressure was lower following the massage but that it actually continued to decrease when they measured again, several minutes later. Even a five-minute hand massage has been shown to lower blood pressure significantly.

It appears, however, that not every kind of massage has this effect on blood pressure. For instance, researchers at the National University of Health Sciences in Lombard, IL, examined the effect of different types of massages on blood pressure and found that recipients of trigger point therapy (in which sustained pressure is applied to a knot to help it release) and sports massage (a vigorous massage using a variety of techniques) had, in fact, higher blood pressure just following treatment. This is not surprising when you consider that intensive therapies such as these can sometimes create temporary discomfort and, further, when you consider that acute pain has been shown to lead to a surge of adrenalin, which in turn increases heart rate and blood pressure. But as soon as adrenalin levels fall back to normal, so do heart rate and blood pressure. Assuredly, though, neither of these types of massage would be good choices if your goal was to lower blood pressure. Then again, relaxation and stress relief are not the intent of such massages.

For something like Swedish massage, though, which does lower blood pressure, how does it do so? Massage, as it turns out, causes a decrease of the hormone arginine vasopressin (AVP)—which constricts blood vessels and raises blood pressure. The test subjects for the research demonstrating this submitted to having blood drawn numerous times before and after the massage via catheters inserted into the arm for the duration. This fact makes the results even more impressive, given that getting a forty-five-minute massage with a needle poking into your arm is not an entirely stress-free circumstance.

While lowering blood pressure is, in and of itself, a good thing, when you take into consideration that high blood pressure is linked to elevated measures of stress, anxiety, the “flight-or-fight” hormones known collectively as catecholamines, depression, and hostility, reducing blood pressure levels takes on even greater importance. Massage may not be “just what the doctor ordered (yet)—but it should be! Massage: it does a body good!

Sources

Aourell, Moa, et al. 2005. “Effects of Swedish Massage on Blood Pressure.” Complementary Therapies in Clinical Practice 11:242–46.

Cambron, Jerrilyn A. 2006. “Changes in Blood Pressure after Various Forms of Therapeutic Massage: A Preliminary Study.” Journal of Alternative and Complementary Medicine 12:65–70.

Cloud, John. 2011. “The Lab Rat Gets Petted: How Massage Works.” Time.com, January 19.

Fraser, Joy, and Janet Ross Kerr. 1993. “Psychological Effects of Back Massage on Elderly Institutionalized Patients.” Journal of Advanced Nursing 18:238–45.

Hernandez-Reif, Maria, et al. 2000. “High Blood Pressure and Associated Symptoms Reduced by Massage Therapy.” Journal of Bodywork and Movement Therapies 4:31–38.

Kaye, David Alan, et al. 2008. “The Effect of Deep-Tissue Massage Therapy on Blood Pressure and Heart Rate.” Journal of Alternative and Complementary Medicine 14:125–28.

Kim, Man Soo, et al. 2001. “Effects of Hand Massage on Anxiety in Cataract Surgery Using Local Anesthesia.” Journal of Cataract and Refractive Surgery 27:884–90.

Meek, Sandra S. 2003. “Effects of Slow Stroke Back Massage on Relaxation in Hospice Clients.” IMAGE: Journal of Nursing Scholarship 25:17–21.

Taking a Tiny Tumble

Late evening massage gigs when traveling by cargo bike—a bakfiets, in my case—is not without its hazards.

I recently was hired to do chair massage at a cocktail party fundraiser for a local parochial school. The guests would be moms whose kids attended the school, and I, along with one of my massage therapist friends, would be providing short massages for the guests in between their eating, drinking, and socializing. The massage portion of the party was going to be offered from 7 pm until 10 pm, and though I was a little leery of traveling five miles on a bike with my massage chair in tow after 10 at night, not only were the brakes on my car beginning to fail but, also, one of the guests at the party was the host of the show 190 North, where I’d been featured as a massage therapist who delivered massage “on two wheels.” It therefore seemed wrong, somehow, to arrive on four wheels.

Getting there was no problem, since at this time of year there is plenty of daylight at 6 or 7 at night. My biggest problem was trying to ride slowly enough that I didn’t arrive sweaty. I am not the type of cyclist to just tool along, even when I’m not in a hurry. Actually, I’m not the type of walker, swimmer, etc. to go slowly. Sometimes I think doing massage—which generally requires a measured pace—is therapy for me. But I somehow managed to arrive not requiring a shower and change of clothing.

More challenging was the getting home. To begin with, I am usually in bed by 10. But here I was, at 10, not only upright but actually packing up my massage chair and readying myself to ride home. I was so tired by then—having earlier in the day gone for a short run with the dog and attended my two-year-old niece’s birthday party—that I could barely form coherent sentences. But after a tiny lemon tart for the road from one of the hosts, I trundled my massage chair to the end of the block where I’d locked up the bakfiets, loaded the chair into the box of the bike, zipped up my jacket, put on my helmet, and headed down the street toward home, sweet home.

I had gone hardly more than a block or two, though, when I realized that while it wasn’t really cold out, there was enough wind that, without the little hat I’d brought along, my ears were going to be unhappy with me. So I found a safe spot to stop on a side street, put down the kickstand, and rummaged through my bag for my hat. After I’d put on the hat and rebuckled my helmet, I climbed on the bike, ready to set off again, only then realizing that I’d forgotten to put up the kickstand.

Now the kickstand on the bakfiets is not some slender metal wand beside the pedal to which you can apply a simple kick backward with the heel to make disappear. In order to hold a hundred pounds of bike up in a steady fashion requires something more substantial, and the kickstand for the bakfiets has two rubber-tipped feet on either end of rod that runs beneath the box. Putting the kickstand up requires giving the bike a good push forward to take its weight off the stand and then looping your toes behind one side of the stand to slam the feet up into a locked position.

I blame it on the fact that I was tired, for I don’t know what else could have possessed me to think I could do all of that while straddling the bike frame. Pushing the bike forward went fine, but when I went to flip the kickstand up into the locked position, my pants leg got caught on one of the feet—just as the kickstand locked into place, of course. The only way to let the kickstand down again is to tap the coin-sized lever just to the right of where my leg was now fairly firmly trapped. And before it even happened, I knew the only way out was down. And that’s where I went: me, the massage chair, and my bag, all dumped on the ground as the bakfiets tumbled over.

Other than a slight scrape on the left palm and a rather savage nudge in the butt from my bike seat, I was unhurt. But wouldn’t you know it: just as I and my things spilled out into the road, a car came along. Off to the side, as I was, I was in no danger of being run over—just of being really embarrassed. I swiftly righted the bike, put the kickstand in place (which had come down in the fall), reloaded, and got back on. The car sped off without so much as an “are you ok?” Which was fine with me. I wasn’t keen on acknowledging my klutziness, thereby more firmly entrenching the embarrassment.

The rest of the ride was less eventful, but suffice it to say, there is a different feel to riding your bike down the street at 10:30 on a Saturday night than there is during the daylight. First there were the Saturday date-night folks, going to or from trendy bars and restaurants in the Lincoln Square area. Then, on Lawrence Ave., I saw a man standing on the sidewalk wrapping himself in a long white cloth, perhaps a dhoti. I’d never seen anyone in the process of doing that, much less on the sidewalk, so that was interesting. But the crowd in front of the Admiral Theater with its euphemistically named adult entertainment just made me sad, seeming to be, as the song says, “looking for love in all the wrong places.”

But then who knows: they might have thought I was the one to be pitied, a poor woman alone on a Saturday night on her weird bicycle! Little did they know that the next day I’d be out with my best gal at the garden center, buying some window-box plants and a bale of straw for the garden. Oh yeah, I’m a happenin’ gal. Don’t cry for me, Admiral Theater.

How'd I Get That Pain? Part 3, Limbs

As noted in part 1 of this article, there are times when there is little doubt about why you have a particular pain. But if you have a muscle pain that seems to come from nowhere, factors such as those listed in the article linked to below might be responsible—factors that could be avoided in the future. Of course, when you can’t dodge an ache, it’s time to see your massage therapist! Calf pain? An ache in your forearm? Hamstrings killing you? You might have gotten that soreness this way:

Muscle	Location	Stressors of That Muscle
Extensors	Top (or hairy side) of the forearm, from the outer edge of the elbow to the base of each finger	Repetitive forceful hand gripping and repetitive extension; weeding with a trowel, extensive handshaking, or Frisbee throwing; faulty mechanics (e.g., typing playing musical instruments)
Flexors	Inside (or nonhairy side) of the forearm, from the inner edge of the elbow to the base of each finger or the base of the palm	Prolonged gripping or grasping (e.g., working with hand tools, racquet sports); being in professions such as massage therapy, carpentry, weight lifting, waiting tables, chefs
Pronator teres	Around the inner side of the elbow	Gripping ski poles for long periods of time; holding small hand tools lightly
Supinator	Above and around the outer part of the elbow to the nearest third of the radius from there	Repetitive or sustained supination (rotation in which palm faces upward) of hand, especially with elbow straight as in “flipping” a briefcase onto a table, wrestling with a stiff doorknob, mis-hitting a ball off-center, twisting a racquet with elbow completely extended, wringing clothes; opening jars, working with a screwdriver
Triceps brachii	From the top, back of the shoulder joint to the back of the elbow	Strain from sports (e.g., “mis-hit” tennis ball or improper golf swing); overuse of forearm crutches or a cane that’s too long; prolonged extension lacking elbow support (e.g., holding down a sheet of paper while writing or doing needlepoint work); push-ups or overhead and bench presses
Brachioradialis	Top of the outer edge of the upper arm to the far outer edge of the radius	Combining gripping and twisting motions as in sports (tennis and other racquet sports)
Brachialis	From about midway down the inside of the upper arm to the front side of the top of the ulna	Heavy overload from lifting (e.g., holding a power tool or meticulous ironing)
Biceps brachii	From the inner side of the scapula to the inside of the elbow	Unaccustomed vigorous repeated supination (e.g., using a screwdriver); lifting heavy objects with the hand supinated; sustained elbow flexion (e.g., playing a violin or guitar, using electric hedge clippers)
Peroneals	Upper outer edge of the fibula to behind the outer edge of the ankle	A fall with twisting and turning inward of the ankle; weakness from prolonged underuse (e.g., being in a cast or mostly sitting day and night); lower leg length inequality; poor arches; pronated feet
Flexor digitorum longus and flexor hallucis longus	Down the back surface of the tibia to the sole of the foot and the base of the big toe, respectively	Hyperpronation or an unstable foot; a badly worn shoe (esp. with runners) that creates an unstable gait; an inflexible shoe sole that prevents normal extension of the foot and toe joints during walking or running; walking and running on sand, especially barefoot
Tibialis posterior	Underneath the soleus and gastrocnemius muscles	Running on uneven surfaces or being new to running; excessive pronation; footwear that is badly worn or encourages turning the foot outward or rocking
Extensor digitorum longus and extensor hallucis longus	Along the shin bone to the start of the toe bones on the top of the foot	Steep accelerator pedal in a car; sitting for long periods with the feet back under a chair; nervous twitching of the foot
Tibialis anterior	From the top of the outer edge of the tibia to the top of the foot	Catching the toe on an obstruction; overuse, such as during running (leading to shin splints)
Popliteus	From the outer surface of the lower end of the femur to the top of the back of the tibia	Excessive pronation; playing soccer or football, running, twists or slides, especially when running or skiing downhill; tearing of the posterior cruciate ligament
Soleus	Long flat muscle under gastrocnemius	Wearing high heels, slipping or losing balance; sitting in a chair that is too high; too tight and/or high stocking or elastic-band socks that may limit blood supply; ice skating, roller blading, or skiing without good ankle support; lower leg length inequalities
Gastrocnemius	From the inner and outer surfaces of the bottom of the femur to the back of the heel	Physical overload and/or bad positioning of the foot (e.g., climbing steep slopes, riding a bicycle with the seat too low, wearing a cast on the leg); wearing high heels, prolonged driving in a car, certain sleep positions
Pectineus	From the base of the pubic bone to the top of the inner side of the femur	Lower limb length inequality; horseback riding, gymnastics, soccer (running and kicking at the same time); sitting cross-legged; sitting with the hips in a jackknifed position
Adductor brevis and longus	From the lower edge of the pubic bone to the upper inside edge of the femur	Strenuous horseback riding, in-line skating, cross-country skiing; sitting in a fixed position with hips acutely flexed and on thigh or leg crossed over the other knee
Adductor magnus	The large triangular muscle that starts at the lower inside edge of the pubis and attaches the base of the butt and the inside of the femur	Sitting in chairs for long periods; chronic hamstring strain and fascial distortion; pelvic misalignment; lower leg length inequality
Sartorius	From the front of the outer edge of the hipbone to the upper inside part of the tibia	Prolonged sitting in a cross-legged “tailor’s” position; excessive pronation of the foot
Gracilis	From the lower part of the pubis to the inner side of the knee	Slipping and resisting spreading legs while trying to recover balance; overenthusiastic exercising; structural knee dysfunction; postural imbalance
Vastus muscles	From the top of the inner and outer edges of the femur to just below the knee cap	Pronated arch; structural misalignment in the pelvis; imbalance between vastus lateralis and vastus medialis
Rectus femoris	Top of the front of the thigh to top of the knee cap	Jumping, running downhill, skiing, weight lifting, deep knee bends; lordosis (when the spine curves outward at its base; a swaybacked posture)

My Bread and Barter

Bartering—the exchange of goods or services between two parties for mutual advantage—predates the use of currency and has probably been around since the dawn of humankind. It has even been argued that if symbiotic relationships are construed as a form of bartering, plants and animals engage in bartering as well.

According to “The History of Money,” a PBS online article from NOVA (www.pbs.org/wgbh/nova/moolah/history.html), “Cattle, which include anything from cows, to sheep, to camels are the first and oldest form of money”—though it’s hard to imagine the kind of purse you’d need to carry a cow or how you’d get change for a camel! But even when metal coins first appeared in China around 1000 bc and then elsewhere, such as Greece, Turkey (then known as Lydia), and Persia, around 500 bc, not everyone had access to coinage, and bartering continued to be a common way for people to get things they needed in exchange for things they had. We should all be glad, in any case, that tax misdeeds are punished, today, only with fines or jail time—unlike the Danes that lived in Ireland around ad 800–900 who, if they failed to pay the Danish poll tax, had their noses slit—hence the phrase “paying through the nose”!

The overlap of bartering and currency-based economies has never ceased entirely. However, despite former Nevada state GOP chair Sue Lowden’s recent suggestion that health care costs be lowered by having people barter with their doctors (which I’m sure would be ever-so-appealing to your HMO or PPO!), bartering has decidedly not been a primary means of obtaining goods and services for people in this country for quite some time. Our current economy, though, in which money can be as hard to come by as a pocketful of sheep, has caused a resurgence of bartering.

And given this climate, I have to say that having something like massage to trade has come in very handy. I am, I think I can safely say, the envy of all my friends in fields like academia, social work, and data processing. For the most part, I’ve traded massage for personal training sessions, but I have also traded for construction work on my home, design work for my business, and getting a handmade belt made for my kickass Monster Half-Marathon finisher’s belt buckle. Theoretically, I have editing and writing services to barter as well, but frankly, not only do people have much less need for those (or think they do!), but having your punctuation checked is far less alluring to most folks than getting your stress relieved.

There are limits, of course—it’s not like I can offer a massage to someone at AT&T in exchange for some phone service or at Jewel Foods for bread and milk. But small businesses of all manner, as well as individuals, seem open to the idea of doing trades. And for me it’s been a huge help with getting some of the things I need or want that I wouldn’t have been able otherwise to afford right now.

Making sure the trades are fair to both parties is potentially tricky, but so far, using my hourly massage rate as a gauge has made it relatively easy to ensure equity. It also bears considering whether something like massage can ethically be traded for certain kinds of services, especially when there is an ongoing relationship with those you hope to trade with. For instance, I think you’d have to question the professionalism of any psychotherapist who was willing to trade counseling for massage—boundary issues spring to mind. . . .

But in the main, having a spare massage in my wallet to use for “buying” certain goods and services has been great. It really is win-win. And right now I’ve got my eye on a birch sapling over at the local garden center. Not sure how many massages it would cost (or even if they’d be willing), but whatever the price, it would be worth it just to drive the sapling home in the box of my cargo bike!

The Wheels Roll Both Ways

The other day, my friend Brian Schab (schabpersonal@gmail.com) was coming to my house for the first time for a massage so I told him I’d pick him up at the el stop—in the bakfiets. I have been trading massages with Brian for boxing and personal training sessions, all of which had taken place at Fitness Formula Club where we both worked, until recently when Brian left there to strike out on his own. (I’ll have more to say on bartering in a future blog.)

Now, not many grown men—especially men who are martial arts experts—would be willing to sit in a wooden box on the front of a bike and let a woman pedal them down a major city street. But that’s what I like about Brian: he’s very open, not at all obsessed with showing how macho he is, and in possession of a good sense of humor. He climbed right in, sat down on the bench, and laughed about the fun of it all as I pushed the bike down off the kickstand and got ready to chauffeur him to my house.

Brian did refuse to put on the pink bicycle helmet I’d brought along for his safety. But to give full disclosure, I don’t believe it was the color that bothered him. Nor was it the possibility of messing up his hair, since he shaves his head. Rather, he was having trouble getting it to fit his head over his hat. So throwing caution—and my usually unwavering safety principles—to the wind (literally, as it turned out), we set off.

A little wobbly at first—Brian being my heaviest “cargo” to date—I gradually picked up speed as I gathered confidence. “This is awesome!” Brian shouted over the wind. “Hey,” said, “I not only pedal massage to you, I pedal you to massage.”

I only wish we'd gotten a picture. . . .

"Beyond That Which Is Known to Man"

Along with how amazing a massage feels, the thing that may surprise massage newbies the most is how science-based this practice is. Even after putting to rest any misconceptions about “happy endings,” far too many people seem to think that a massage is only a lot of rubbing and kneading. Though that may in fact be the case with a relaxation or stress-relieving sort of massage, every legitimate massage therapist who works in a state that requires massage practitioners to be licensed will have had to complete coursework that not only teaches them how to do basic massage techniques but also gives a fairly thorough understanding of the human body. At its most basic, this knowledge allows the therapist to make informed choices about what techniques might work best for which muscles or muscle conditions and to avoid endangerment sites: areas where nerves, arteries, or veins lie close to the surface, theoretically exposing them to possible damage during, say, deep tissue work. (The actual danger involved in massaging these so-called endangerment sites have recently been called into question, however; I plan to investigate further and post my findings here.)

Especially for therapists doing any kind of therapeutic work, though, such knowledge of the human body is particularly critical. There are probably innumerable examples of why this is so, but as an example, let me address the concept of referred pain. It is a fairly well established fact that, while you may perceive a pain to originate in a particular muscle, the source of the pain can actually be in another muscle entirely. Experience and/or advanced studies teach, for example, that a client pointing to pain in his or her neck might actually have tight muscles in the upper back that need to be treated as well. There are charts that can be consulted (and committed to memory) that show common referral patterns so that a therapist will know immediately that when heel pain is the issue, the soleus muscle should also be examined. But even if such charts have not been committed to memory, just the fact that a licensed therapist knows that where the pain seems to be isn’t necessarily where it comes from gives him or her the foresight to address more than a single muscle for any given complaint.

Some massage therapists rely especially heavily on the training they received and “go by the book” when working with a client. That is, continuing with the example of referred pain, they know where the sore spots in a muscle should be and where they should refer, and they simply go to those spots. And for the most part, this should work. It certainly makes sense for a therapist new to the field to take this approach.

But the longer I practice, the more I find that my own experience as a massage therapist along with a newly discovered sense of intuition have lead me beyond the guidance of my teachers and the textbooks. The word “intuition” doesn’t quite get at what I mean to convey, though, since intuition often originates, at least in healthcare fields, in a deep understanding of the human body. I have no doubt that intuition bears on the work I do, too, leading me to a knot in a muscle, say, without me even thinking about it.

There are times, though, when the process seems nearly mystical, as though I have been led to a muscle by some power or knowledge outside myself. Perhaps it is only intuition that guides me or only past experience. That would certainly seem reasonable. Or perhaps it is a sort of telepathy between myself and the client that evolves as I put my hands on him or her, maybe even subtle cues of some sort that I pick up from the client. But I can’t tell you how many times clients have commented on the fact that my hands go directly to a knot like metal to a magnet—ergo, the Knot Whisperer! It isn’t even only that, though.

It is also the way that when I am applying pressure to a knot with my elbow I feel a vibration as the knot begins to release. At first, I thought I must be imagining this vibration or confusing a shaking in my own body with what I took to be the client’s muscle loosening. There are a couple of pieces of evidence, however, that led me to conclude that I was neither imagining the pulsing nor confusing it with some tremor in my own body. To begin with, I noted that, before I applied pressure, the muscle had a distinct area of tightness—maybe a tight strand like a piano wire running through it or a flat piece of rock—whereas afterward, the muscle felt pliable, with no hard spot in the area where I had been working. In addition, when I would return to a muscle that I felt had released a little but not entirely, clients would often report that the pain was less than when I had pressed the first time, indicating that the muscle was indeed less tight. And finally, clients who are particularly in tune with their bodies will sometimes comment that they feel the muscle releasing simultaneous with the vibration I feel.

This might raise the question: What the heck are these vibrations? Am I feeling the actual movement of the muscle fibers as they let go of each other? Is it the energy created by the fibers being set in motion that I feel? Perhaps it’s some sort of transcendental force that I am sensing? In short, it is a very good question—for which I have no answer.

If this all sounds a little Twilight Zone to you, you’re not alone—it feels that way to me, too. Since it seems to be working, though, whatever it is, I have learned just to go with the flow. Of course, after my magical mystery tour of knots and adhesions and sore spots, I can talk science with the best of them, explaining, for instance, how Epsom salts help remove muscle-tightening chemicals produced by the body through osmosis or how a knot might have formed. But during the massage itself, there is not only science at work but also something deeper, more spiritual that connects me to clients in that moment. If this is true, that would explain why the client isn’t the only one who feels physically and mentally revived by the massage, why I, too, feel a sense of peace and improved health.