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Seeing Inside

Many times in the past I’ve marveled at a blind person’s ability to read Braille. I’ve passed my fingers over the raised characters many times while waiting for an elevator, etc., and wondered how a person can develop the sensitivity to distinguish those small dots to create meaning.

Then, this morning, I was working with a therapist who was in town for my Myofascial Mentoring Program. We were talking about the process of being able to feel deeply into a person’s body; taking huge amounts of information that is present when one places their hand on a patient and bringing meaning from that. A novice may not be able to discern any differences; all tissue may feel identical. But with training and practice, the therapist will begin to feel differences in the quality of the tissue. Taking this a step further, those differences, once pointed out to the patient, often are validated as meaningful places of pain, or ones that create pain elsewhere. The loop is closed when the therapist is able to connect their felt sense and their patient’s subjective experience of that felt sense into a validated treatment experience.

While I would never equate learning Braille with mastering the “Feel” in a therapy such as myofascial release, it does call upon the therapist to deepen their senses to a point where previously unnoticed tactile clues begin to be felt. This is the first step to being able to make changes with touch. I call it “seeing inside”. Do you have words for this experience?

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Comment by Walt Fritz, PT on February 7, 2012 at 8:36am: Daniel,

Thanks for the feedback. I find similar issues as well. Rib issues often translate all around the length of the rib/thorax, resulting in a variety of conditions.

Comment by Daniel Cohen on February 5, 2012 at 9:36am: Walt I often find problems with the ribs. Trouble breathing, shoulder pain, and arm mobility all get effected and more. Not always from the back, sometimes the sternocostal joints are the source. When there is arthritis flares in these joints pain can be extreme (personal experience teaches a lot about the body). My rib work brings in singers before performances to loosen the rib cage.

Comment by Walt Fritz, PT on February 5, 2012 at 7:58am: I find the ribs to be one of the more common issues, especially with scapular pain syndromes. If all is well, the landscape of the posterior rib cage is one of a relatively smooth transition, creating a gradual cuve over which the scapula must glide. But with injury, the inevitable rib changes with scoliosis, etc, this landscape is changed. Many times ribs are forced up, lung proud of their neighbors. As the scapula attempts to glide over this area as the arm moves, irritation is inevitable. Repetition creates spams, chronic holding patterns and .....( fill in the blank, trigger points, knots). In my opinion, unless one involves this landscape in treatment, results are typically short lived.

Comment by Gordon J. Wallis on February 5, 2012 at 3:04am: Uhm, how often are ribs raised do to injury? How important are ribs in your overall approach to bodywork? What can the ribs tell you as far as removing pain from someones body? Only reason I ask is because I dont really focus or think about the ribs in specific unless someone complains of pain there on as a presenting symptom or on movement or palpation... You dont have to go into detail.... I guess Im asking why is it your favorite subject?

Comment by Walt Fritz, PT on January 31, 2012 at 8:27pm: Understanding both the anatomy of dysfunction as well as the cause of same is essential. I think the biggest problem is that the language that is spoke is very different to many. One may learn/teach knots, while another asks to look and feel deeper. Gordon, you've picked one of my favorite topics; ribs. If a rib is raised due to injury, normal variations in spine/rib symmetry, it is bound to create friction between itself and the scapula, as it "glides" over the ribs. Irritation, inflammation, and "knots are almost inevitable. Treat the cause, not the symptom.

Comment by Gordon J. Wallis on January 31, 2012 at 3:53pm: Hi Walt...Well working in a spa, many people come in on gift certificates..So I get to see a lot of people that are being treated by other massage therapists and health care providers... And I get to hear what they have been told by those other therapists and providers.....At times I'm shocked as to what I hear.. And its often enough.. I remember working on one women between her shoulders...the rhomboid area.. And she said." Can you feel my knots?". I said..." Oh Im sorry, are you sore there?". She said. " No but I have a lot of knots there." I said. " Let me get this straight.. You have no pain or discomfort between your shoulders, but you have a lot of knots there?" She said. " Yes , my regular massage therapist can feel them, cant you?" I said. " No I dont feel anything?" Then she said. "Whats that then?" I said "those are your muscles flipping under my thumbs as I move over them..Its like strumming a guitar string." She said."Oh?" .. Then she said." Whats that real hard one then.. He has been working on that one for weeks. And cant get rid of it." I said. "You me this?" She said "Yea." I said, " Thats your rib." Her other therapist is nationally certified (I know of him).... I hear similar stories often. A lot actually. It always comes back to my main theme...They have to stop teaching for tests.

Comment by Walt Fritz, PT on January 31, 2012 at 2:51pm: Gordon, Would you care to elaborate?

Comment by Gordon J. Wallis on January 31, 2012 at 2:03pm: At the same time.. There are many therapists that think they feel things...But its only their imagination, and they mislead their clients.

Comment by Daniel Cohen on January 31, 2012 at 9:36am: I think this is the most important part of being a good Massage Therapist. Thank you Walt for describing it so well. I refer to it as "seeing through contact". It is what quickly brings you to the source of a client's problem. For the general public it is surprising that we can feel so much.