A few Sunday afternoon thoughts on how we may be treating ourselves each time we treat another…nothing too strenuous, it’s Sunday.
How many times have your patients/clients commented on the warmth of your hands? If you are like me, it happens daily. I’ve not spent time searching for clues as to why, and I am sure there are many reasons/explanations/beliefs, but I came to an interesting awareness today. Over the past few years I’ve allowed my myofascial release and manual therapy practice be guided more by principles of neuroscience, including how a simple feedback loop of light skin stretching (to) brain (to) descending output can influence pain/tone/perceived tightness. Buried in our patients skin are Ruffini mechanoreceptors, which are slow-adapting lateral skin stretch receptors which we cannot avoid stimulating when we hold a sustained MFR-style stretch. Robert Schleip describes these receptor’s known effect as having the ability to provide inhibition of sympathetic activity (1). Inhibition of sympathetic activity is an inevitable effect of Ruffini stimulation and includes an increase in peripheral circulation, decreased heart rate, and a slower breath rate. There are more, many more, and they can be fun to look at, especially my favorite, borborygmous. Ruffini stimulation alone may account for the relaxation that patients/clients feel during/after an MFR, or other manual therapy/massage session. But has anyone ever turned this around on the therapist? Are we not laterally stretching our own skin as we do the same to our patients/clients? It is the same long duration stretching happening through our own hands, so wouldn’t we be subjected to the same potential effects? This seems a plausible explanation for our warm hands/calm demeanor, doesn’t it? Our effects are plural; them and us!
Another aspect or our work, be it myofascial release or many of the other versions/brands/flavors of manual therapy, is the sense of melding and ideomotion/spontaneous movement that occurs with our hands-on interactions. When we place a light stretch into our patients/clients bodies, after a short time a softening seems to occur. I’ve learned many different “reasons” for said movement, though there is little credible proof as to why this occurs. It may simply be a palpatory pareidolic effect (2) under our hands, but the consistency in which is occurs/is reported makes it seem more than imagined. If we look again to the light skin stretch we apply to our patients/clients, with a hopeful outcome of a lessening of pain/tone/tightness, might not the same be happening to us? Combine the effect of the two of us and the potential for a crazy mixture of local softening and lessening of tone could easily give the feeling of movement in the interface between us and them. We often try to come up with (or simply accept) labored explanations for what happens under our hands, but maybe it is just a simple explanation that is needed.
Both of my points are ways we may be passively/inadvertently self treating while we treat others and both are ways to view our manual interactions and interchanges from a simplistic perspective. That is enough for today. It’s Sunday. I’m resting.
For Now,
Walt Fritz, PT
Foundations in Myofascial Release Seminars
Perhaps that is why I tend to attract clients with problems similar to my own. I believe my cerebellum reads their tissue as if it was my own. Therefore I can ask in my mind will this feel better if I move this way or that.
Then I teach the client to do the palpation and do the same.