“It Hurts When I Do This”

Working at the End Range of Motion

By Q & Art
[Art Riggs]

Dear Art,

You sometimes mention “working at the end range of motion.” Why do you suggest that, and how do I work this way?

—Expanding My Horizons

 

Dear Expanding,

In a nutshell, short and tight fascia, ligaments, and muscles can prevent full range of motion of the bones. If we work on these tissues in a shortened or even neutral length, we can soften them, but we lose the chance to educate them to release and lengthen, thereby reestablishing movement and protective neural patterns that allow more mobility. 

I rarely see someone complaining of a problem in the neutral range of motion; instead I hear, “It hurts [or is limited] when I do this”—with “this” being some limitation near the end range of motion where soft-tissue restriction prevents more movement. For this reason, I frequently work with joints extended comfortably very near the end range to challenge the restriction by asking for active movement as I work.

Most of us work this way in varying degrees when we rotate or side-bend the neck. Working this way is particularly helpful (and popular) with athletes, yoga practitioners, or anyone with an active lifestyle who wants more mobility. There really isn’t anything fancy or difficult about it; I just ask people to get into positions where they complain of limitations and work in these positions at the precise area where they feel the “rubber band” tightening. 

Rather than demonstrating many different postures, let’s examine a couple of yoga postures to illustrate the versatility of these techniques; you can then generalize from these to suit your needs. Once you begin working in this way, the positions are limitless. My students often mention how it transforms their practices, making their work more interesting and fun, and gets them rave reviews from clients.

Restriction will vary from person to person; just have your client assume the position and ask what areas are hampering the posture. As you free up the most obvious one, you will often find that another link in the chain is crying out for some caring attention.

Downward-Facing Dog

1. If tight calves or Achilles tendons are limiting factors, simply focus on those areas by either stretching a muscle or fascia away from an anchor, or by facilitating release by working in the direction of muscle lengthening. Notice if the restriction is superficial or deeper (Image 1).

2. Hamstrings, gastrocnemius, plantaris, popliteus, or tight superficial fascia can all restrict full extension of the knees. In addition to releasing short tissue, consider working with rotational patterns by rolling muscles or fascia to stretch in a straight line and improve tracking of the joint (Image 2).  

3. Of course the proximal hamstrings are often restricted, but some restriction is almost always located at the transition between the pelvis and the low back. Have your client rock her pelvis back and forth, freeing external fascia near the sacrum, the lumbar fascia, and deeper muscles near the spine, including gently mobilizing the lumbars to facilitate extension (Image 3).

4. To free the shoulder girdle and arms, work to mobilize the scapulae to slide over the ribs, focus on the transition to the arms for abduction and rotation, and gently mobilize the thoracic kyphosis to improve its ability to extend (Image 4).

The Lotus Pose

Either the full or half Lotus requires flexibility in many areas not demonstrated here (such as the ankle or rotation of the tibia on the femur), but let’s look at external rotation of the femur and freeing the low back and upper pelvis.

1. On a deep level, this is an excellent way to work with freeing the joint capsule by placing your intention on sinking through superficial tissue and rotating the actual femur in the acetabulum. Experiment with both compression or traction of the joint as you work the thigh through various ranges of motion. 

Move superficially, working with muscles and superficial fascia to freely rotate around the bone by grabbing large sections of the quads and iliotibial band. Remember to bring the tissue to its restrictions and then slowly wait for the tissue to melt (Image 5).

2. Pelvic mobility is very important. Work on the lumbar fascia, quadratus lumborum, and the upper attachments of the gluteals, asking your client to tilt her pelvis both anteriorly and posteriorly (Image 6).

You can work on the table, seated, or on the floor. Working this way necessitates a rewarding communication with your clients and a few minor changes, such as explaining what you have in mind and why, and having them wear proper clothing to enable the different postures. Working on flexibility, not only of our clients, but with our definitions of bodywork, will keep your work fresh, fun, and effective. 

  Art Riggs teaches at the San Francisco School of Massage and is the author of the textbook Deep Tissue Massage: A Visual Guide to Techniques (North Atlantic Books, 2007), which has been translated into seven languages, and the seven-volume DVD series Deep Tissue Massage and Myofascial Release: A Video Guide to Techniques. Visit his website at www.deeptissuemassagemanual.com.

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