To complement the MASSAGE Magazine article, “Connective Tissue Massage,” by Chris Kagen, in the June 2011 issue. Article summary: There are many positive results from connective tissue massage, and several types of connective tissue techniques can be built into a massage practice in order to expand your skills and client base.

by Chris Kagen

Connective tissue-based injuries, dysfunctions, distortions and diseases include:

  • Adhesion: Adjacent structures can adhere to each other. Immobility, microtrauma and hypoxia can all cause formation of fiber that restricts movement and can cause pain through distortion or impingement of nerve tissue.
  • Scar tissue: Where any tissue has been damaged, the body responds by laying down fiber to splint and support the area. Ideally, this scar tissue resolves over time, replaced with functional tissue. But scarring in connective tissue often endures, causing restricted movement and pain.
  • Strain and sprain: Traumatic damage to dense connective tissue, in the form of tendons and ligaments, compromises the strength of the structure. Localized inflammation creates pain through chemical stimulation of nerve endings.
  • Tendinopathy: This is a family of tendon injuries, including tendinitis (damage with inflammation), tendinosis (damage without inflammation) and tenosynovitis (wear of the synovial sheath around a tendon).
  • Postural distortion: There are many causes of postural distortion, ranging from heredity to overuse to injury. Fascia shrinks to fit and maintains distorted positions. Bone, cartilage and other connective tissue also remodel to perpetuate distortions.
  • Arthritis: Joints are a complicated convergence of connective tissues, some designed to bind, such as cartilage to bone, and some designed to slip, such as synovial membranes. Infection, trauma or degeneration interferes with either function to cause inflammation, limitation and pain.
  • Spinal degeneration: Spinal articulation involves facet joints (synovial joints) and fibrous discs. Age, distortion and injury lead to degeneration of these structures. Eventually, pressure on nerve roots causes pain that refers to the lower body.
  • Auto-immune disorders: Some autoimmune disorders involve the immune system attacking connective tissue. Examples are systemic lupus erythematosus, rheumatoid arthritis and scleroderma.
  • Fibromyalgia: Fibromyalgia is a rheumatoid disorder, meaning that it affects joints and soft tissues. While the causes are unclear and may have more to do with the nervous system, therapy often focuses on pain that manifests in connective tissue.
  • Cancer: Cancer can form in dense connective tissue, such as bone cancer; soft connective tissue, such as glioma, a form of brain cancer; and liquid connective tissue, such as lymphoma.

Chris Kagen, L.M.P., left his computer technology career years ago, graduating from the Brian Utting School of Massage in Seattle, Washington, in 2000. He now teaches anatomy and physiology, pathology, clinical technique and business classes at Cortiva Institute—Seattle School of Massage. 

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