themann_ca
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This thread is a tangent spun off from another thread. I've made it separate to prevent hijacking the original.
Okay, here goes:
While I was in school, most of our training focused on therapeutic work, particularly trigger point therapy. The instructors were all veterans of 16-20 years, so they also taught us advanced palpation and what they called "layering" when doing trigger point work. The essence of layering was to approach trigger points and tender points as foci of discomfort that were embedded in multiple layers of tissue. For example, we might find a tender point between the scapulae. Instead of just apply direct static pressure and push hard for a while, we were taught to apply pressure gradually, feeling for the subtle tissue response(s).
As the tissues started to release, we would follow the softening into deeper layers, waiting at each new layer of resistance until it released and allowed us to sink further in. With practice, we learned to adjust the angulation of our pressure and to use small stroking movements to enhance the effectiveness of our layering. Sometimes we would move through several tender points before finding a trigger point hiding further in, then move through that into more tender points. We NEVER forced the release by just using more pressure, at least, not if we were doing it correctly.
With practice, we learned to feel the releases, count them, and began to understand which layer of muscle we were working on. For example, for a tender point between the scapulae, we were expected to know if we were in the trapezius, rhomboid major or minor, iliocostalis, longissimus, semispinalis, multifidus, etc. It took a combination of anatomical knowledge and palpatory skill to determine this.
For me, the key to mastering layering was patience. I had to accept that the tissues would release when they were ready. So I began to practice layering using gentler pressures, concentrating my attention on feeling for the tissue response and the "sucking" sensation of the softening tissues pulling me in. It was a major challenge for me, but I stuck with it. A phrase uttered by one of our instructors stayed with me, "Move when the tissue permits you, but only so far as it allows."
As I became competent at layering, I started to really enjoy the process of sensing tissues release and following them to the next restriction. It became a bit of a game. Time-consuming, to be sure - it might take an hour to thoroughly work through the flexors and extensors of a forearm, especially if they were really hosed up. However, I was in school and it was all good practice. Eventually, I started to apply the layering concept to some of the other skills I learned, such as effleurage. With my body mechanics in place, I could apply firm/very firm pressure without much physical effort. The next step was using layering to enable deep, slow effleurage. I achieved the 20 minute strokes during a session with a practice client during my last term in school.
In a 90-minute session, I chose to focus on my practice client's erectors. They were so tense that I saw them as multiple raised ridges running along on either side of his spine. After a few minutes of easy warming strokes, I went to the upper attachments of his right iliocostalis. From the head of the table, I positioned a reinforced palm (one palm over the other, with elbows locked) and held a static position as I layered my way in for bit. Eventually I felt as if the tissues were ready for me to move, and I slowly shifted to a more oblique angle of pressure. My hands slowly slid a few millimeters before encountering another restriction. Rather than ease up to a more superficial depth, I simply waited until the tissues melted and permitted further movement. Sometimes I gained a lot of ground, other times it was millimeter by millimeter, all the way down to the top of his glutes. (Then I did light effleurage to glide back to more upper attachments and repeated the process.) When the bottom hand became fatigued, I would take the top hand and place the palm of it immediately behind my lead hand. Once it sank in (which didn't take long), I would use the other hand to reinforce it. In this way I never lost what I had painstakingly gained, and my body wasn't unduly stressed. On the first stroke I switched hands maybe 2-3 times. On the fourth stroke I switched hands maybe 5-6 times. After the four strokes, I switched back to lighter work and closed the session. The client LOVED it, and reported great pain relief (much more than I had expected).
Since then, I have continued to apply layering in most of my work. I have tried different combinations of speed and pressure, and so far slower is almost always more effective (for me) than faster. The patience and palpatory sensitivity I developed have proven to be great assets regardless of what type of work I am doing. I think my body mechanics are much better too, due to developing the ability to safely and comfortably sustain working positions/movements over a longer period of time.
Hope that's what you were wanting, Pueppi! Hope it helps your quest!
pueppi said:
Okay, here goes:
While I was in school, most of our training focused on therapeutic work, particularly trigger point therapy. The instructors were all veterans of 16-20 years, so they also taught us advanced palpation and what they called "layering" when doing trigger point work. The essence of layering was to approach trigger points and tender points as foci of discomfort that were embedded in multiple layers of tissue. For example, we might find a tender point between the scapulae. Instead of just apply direct static pressure and push hard for a while, we were taught to apply pressure gradually, feeling for the subtle tissue response(s).
As the tissues started to release, we would follow the softening into deeper layers, waiting at each new layer of resistance until it released and allowed us to sink further in. With practice, we learned to adjust the angulation of our pressure and to use small stroking movements to enhance the effectiveness of our layering. Sometimes we would move through several tender points before finding a trigger point hiding further in, then move through that into more tender points. We NEVER forced the release by just using more pressure, at least, not if we were doing it correctly.
With practice, we learned to feel the releases, count them, and began to understand which layer of muscle we were working on. For example, for a tender point between the scapulae, we were expected to know if we were in the trapezius, rhomboid major or minor, iliocostalis, longissimus, semispinalis, multifidus, etc. It took a combination of anatomical knowledge and palpatory skill to determine this.
For me, the key to mastering layering was patience. I had to accept that the tissues would release when they were ready. So I began to practice layering using gentler pressures, concentrating my attention on feeling for the tissue response and the "sucking" sensation of the softening tissues pulling me in. It was a major challenge for me, but I stuck with it. A phrase uttered by one of our instructors stayed with me, "Move when the tissue permits you, but only so far as it allows."
As I became competent at layering, I started to really enjoy the process of sensing tissues release and following them to the next restriction. It became a bit of a game. Time-consuming, to be sure - it might take an hour to thoroughly work through the flexors and extensors of a forearm, especially if they were really hosed up. However, I was in school and it was all good practice. Eventually, I started to apply the layering concept to some of the other skills I learned, such as effleurage. With my body mechanics in place, I could apply firm/very firm pressure without much physical effort. The next step was using layering to enable deep, slow effleurage. I achieved the 20 minute strokes during a session with a practice client during my last term in school.
In a 90-minute session, I chose to focus on my practice client's erectors. They were so tense that I saw them as multiple raised ridges running along on either side of his spine. After a few minutes of easy warming strokes, I went to the upper attachments of his right iliocostalis. From the head of the table, I positioned a reinforced palm (one palm over the other, with elbows locked) and held a static position as I layered my way in for bit. Eventually I felt as if the tissues were ready for me to move, and I slowly shifted to a more oblique angle of pressure. My hands slowly slid a few millimeters before encountering another restriction. Rather than ease up to a more superficial depth, I simply waited until the tissues melted and permitted further movement. Sometimes I gained a lot of ground, other times it was millimeter by millimeter, all the way down to the top of his glutes. (Then I did light effleurage to glide back to more upper attachments and repeated the process.) When the bottom hand became fatigued, I would take the top hand and place the palm of it immediately behind my lead hand. Once it sank in (which didn't take long), I would use the other hand to reinforce it. In this way I never lost what I had painstakingly gained, and my body wasn't unduly stressed. On the first stroke I switched hands maybe 2-3 times. On the fourth stroke I switched hands maybe 5-6 times. After the four strokes, I switched back to lighter work and closed the session. The client LOVED it, and reported great pain relief (much more than I had expected).
Since then, I have continued to apply layering in most of my work. I have tried different combinations of speed and pressure, and so far slower is almost always more effective (for me) than faster. The patience and palpatory sensitivity I developed have proven to be great assets regardless of what type of work I am doing. I think my body mechanics are much better too, due to developing the ability to safely and comfortably sustain working positions/movements over a longer period of time.
Hope that's what you were wanting, Pueppi! Hope it helps your quest!
Thanks, Jason!
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