I was recently asked what type of massage I practiced by a client looking for relief from chronic pain. In business and politics they estimate for every letter received there are 500 who share the same opinion, but didn't take the time to write. If that logic holds, if one person asks, there must be more of you out there wondering what types of massage are available.

Trigger Points are dysfunctional areas in the muscle where the nerve attaches to the muscle. It can feel like a big knot or just be tender to the touch, but the defining characteristic of Trigger Points is that applying pressure to the area reproduces the pain pattern that the client is experiencing. If pressure on the tender spot doesn't refer pain along the path of the nerve, then it isn't a Trigger Point.

What do I mean by referring pain along the path of the nerve? Well, nerves are not independent, finite entities. They are all connected either via the way we develop in the womb (e.g. dermatomes) or by the fact that more than one muscle can be innervated by one nerve. For example, the Sciatic nerve famous for Sciatica, starts in the pelvis and actually extends all the way to the foot innervating muscles throughout the leg. So what?-you think. The key concept here is that dysfunction at any point in a nerve can cause problems anywhere that nerve goes. Sciatica occurs primarily at the pelvic location of the nerve but pain is felt all the way through the path it takes in the leg. So treating a Trigger Point that is causing Sciatic pain can mean a client would feel a referral throughout the entire nerve path.

If this sounds like this might be uncomfortable, in the wrong hands it can be. Trigger Points are pretty sensitive. Dr. Travell, who did the definitive work on this therapy, described Trigger Point pain as "exquisite", an adjective that describes the sensation of both pain and relief felt all at the same time when pressure is applied. Trigger Point work can be intense but pressure on the area does not have to be painful to be effective. Neuromuscular treatment is done to the clients tolerance. The client will be asked, "Is this pressure OK, do you want lighter pressure?" The goal is to apply enough pressure so that the nerve is overwhelmed thereby allowing the muscle to return to a normal resting state. The goal is not to cause more pain! It is unnecessary to press so hard that "exquisite" pain is ever felt.

Orthobionomy has it's roots in Osteopathic medicine and is the gentle effective use of positional release to treat muscle tension and tender spots found in the body. It is particularly effective for neck and back pain. Practitioners of Orthobionomy feel that therapy should move with the body, not against. For example, in Neruomuscular Therapy stretches are sometimes used to try and help muscles relax. In Orthobiomy, a tight muscle would never be stretched as the idea is that tight muscles want to be tighter. So instead of trying to work against tension with stretches, Orthobionomy would prefer to move into the tension in order to find release The key concept here is contracted, shortened muscles want to be tight and helping them achieve that will allow them to relax.

For neck pain, a Massage Therapist using Orthobionomy would first assess muscles by each cervical vertebrae asking for client feedback as to which areas are most tender or tight. Once an area of tension is identified the Therapist moves the head into the tension, looking for the position of comfort. For a Massage Therapist, this is the position that allows the muscle to palpably soften. For the client, this is the position where pain is greatly reduced or no longer felt. This position is held for 30-90 seconds and the head is then returned to center where the client confirms that there is no longer any pain when the area is gently pressed.

Again, there are occasions when the body will respond better to Orthobionomy than Neuromuscular and vice versa. The challenge for the client in Orthobionomy is allowing the Massage Therapist to manipulate their body to find a positional release. Some people have great difficulty in giving up control. Regardless, any Therapeutic Massage technique has to be tailored to meet the client's individual needs. There is no single correct solution and sometimes a combination of modalities is more effective than either one alone.

If you have any questions about Neuromuscular Therapy or Orthobionomy or would like to schedule an appointment please contact us directly at 440-888-1902.

Below is a comparison of each of the therapies discussed here and their respective approaches and benefits.