A funny thing happens when you use a modality long enough; technique seems less important. In the beginning, the techniques were everything. How many classes could I take and how many new techniques could I learn? Of course there were plenty of new seminars to fill my needs, each promising more and more. But after a point I realized that the techniques were the easy part of myofascial release. What was the essence of this work was the development of the feel. I’ve written about this feel in the past, as it is the basis of what I do on a daily basis, as well as what I try to give to each therapist that takes one of my seminars.
The feel is making a complete feedback loop. Touching into your patient, sensing an area of tightness that feels like the cause of pain. You then make your patient aware of the area you located and seek their feedback. Confirmation completes the loop. This sounds simple, it sounds like what we all do daily, and for some of us it is. But I believe that there s a deeper awareness that therapists need to hone in themselves before they can fully sense and connect to this feel.
Techniques are easy, we make them up each day, based on situation and need. Moving your hand, direction, or intent ever so slightly can drastically change the effect. Knowing the anatomy is helpful, but not essential. Whether you are a believer of the fascia’s influence on pain or not, the interconnectedness of the body blurs the line between one structure and another. We develop hundreds of variations on what we already know every time we touch and treat a patient. See if you can deepen technique, by honing your feel.
For now,
Walt Fritz, PT
Thanks Walt ~ Love to “feel” the connection while working MFR therapy.
Share an experience to illustrate. Dr. went to a very good therapist that he has used for many years. Goal was to increase femur extension. Made good measurable progress decided to go for more with out stopping to “listen”. They should have stopped when the Dr. jumped off the table with cramps in the quadrecepts but instead continued when the cramps subsided. D. spent the afternoon with patents and then went to the track to make use of his new range of motion. Instead developed severe pain in right knee and later pain spreading down calf and up the adductors. MRI showed torn meniscus and burst bakers cyst. Dr. & therapist came to agreement that the Knee injury resulted from restrictions in the hip socket that caused adverse knee tracking. They both had the capacity and experience to “feel” but but failed to do so because they put the goal first.
Now I am working with the Dr. to do movements on the ball using his skill to “feel” to honor both the protection of the new injury and the scar tissue in the right hip from seat belt compression during a violent car accident some years ago.
Thanks, Hans. Lucky the Dr. did not sue the therapist…maybe he should have. The aggressiveness that therapists approach injuries such as this baffles me. I was schooled/trained in the same way, I just do not get it.
Intuition and feel are coming along for me but only after having practiced those techniques and gaining the self-confidence to trust the work! Anatomy has been essential for me in describing notes for insurance mostly. Anatomy also gives common ground to discuss where the “pull” goes to or comes from. I often discuss the transverse diaphragms with clients (pelvic, respiratory, thoracic inlet and occipital) and let them know how tension there can strain other vertical areas (spine, muscles). The more I learn anatomy, the more intentional I can be with a release – it’s still a matter of “following” but I’m able to be with it through the whole ride visualizing “what’s happening where”.
Hi Becky,
I think therapists can come at this from many different directions. I do feel like I have a fairly good grasp on anatomy, but I understand that patterns of tightness and pain often do not follow along anatomical lines. The interplay and interconnectedness that patterns can follow transcend the origins and insertions of muscles, etc. Hence my statements.
Technique might gives us a starting point, but many times when doing a cross hand release the hands went in an unexpected direction and the client feedback was “how good it felt and she/he felt much better”. The initial assessment is key to to the required work and I do not rush to start until the initial connection led me to the area in need.
Well said, David. Assessment is key to me as well, though not all assessment pulls out anatomical information. The felt sense of the pain, to me, is even more important.