As a massage therapist, you become conditioned to having clients lying on your table suffering from muscle tightness and pain.

The goal of massage is to help relieve this tightness and pain. Many times, through various massage techniques, this happens: Your client feels much better after they receive massage. There are times, however, when a client comes back complaining that their tightness and pain have not gone away.

Sometimes, in fact, the tightness and pain might even get worse. As a massage therapist, what do you do in this situation?

In cases like this, it is to your advantage as a therapist to have as many tools in your toolbox as possible. Muscle Activation Techniques (MAT) is a tool that can help massage therapists get to the root of clients’ muscle tightness and pain.

My Journey With Muscle Dysfunction

When I was 19 years old, I sustained a compression fracture of my L5 vertebrae in my lumbar spine. Due to this injury, I was forced to sacrifice my last year of eligibility in college football.

I graduated from college and moved on to work as an assistant strength and conditioning coach at Fresno State, in California. So I remained in the sports world, dealing with a variety of high-level athletes at the university.  During this time, I also worked to get my master’s degree in physical education, emphasizing exercise science.

As I worked as a strength coach, I continued to be challenged by issues that related to my fractured vertebrae.

By the time I was 25 years old, I had developed residual physical issues which included: patella-femoral syndrome, plantar fasciitis, and SI-joint disfunction. Through compensatory mechanisms, the pain had been shifting around in my body. Another issue that jumped out at me was that I was chronically tight. I could barely bend down to touch my knees, let alone my toes. I couldn’t help but think, If I’m this bad at 25, what am I going to be like at 50?

I needed to understand what was going on with my body. Therefore, I sought out the top specialists in every field, from physical therapy to chiropractic to massage therapy, you name it.

I wanted to learn from every specialist out there looking at the muscular system and how it related to pain and injury. What I learned through this process was that the common denominator with every specialist out there was that they focused on muscle tightness as being the primary cause of people’s injuries. Well this hit home with me because I was in chronic pain and I was chronically tight.

I proceeded down the path to learn an array of techniques from these specialists that were all designed to increase flexibility. I implemented these techniques into my practice and on myself. I had great success with many of the athletes that I applied these techniques to.

To the point that my ROM-based skillset enabled me to get hired by two professional organizations: The Utah Jazz and the Denver Broncos. All was going great for me professionally, however personally, I was still struggling with chronic pain.

I tried every modality imaginable to increase my ROM, but never achieved any long term affects. As a matter of fact, any time that I had a ROM focused modality applied to myself, my body would react negatively. There were times that following stretching or deep tissue work, I could barely get out of bed the next day. I would wake up the next morning with numbness and sciatica down into my big toe. This had me questioning “What is wrong with me?”

I developed MAT when I realized there was a missing link in the exercise and rehabilitation fields.

What is MAT?

Muscle Activation Techniques (MAT) is a muscle performance technique that I developed and began teaching to trainers and therapists in the late 1990s. Due to my own personal injuries, I was forced to take a different look at muscle tightness and how it relates to chronic pain and injury.

From my own personal experiences, I learned that physical and rehabilitative practitioners work within a paradigm that, at its core, primarily focuses on relieving muscle tightness. For many years, I worked within this same paradigm without giving it much thought. I had played high school and college sports, which evolved into a career as a collegiate-level strength-and-conditioning coach.

During this time, I was educated in various practices that focused on flexibility training. All of this training focused on the fact that by easing muscle tightness you would restore range of motion, which in turn would help relieve pain. It wasn’t until this paradigm failed to address my own pain and physical limitations that I began to question the paradigm.

While working as a consultant for the Utah Jazz, I worked alongside the team chiropractor, Craig Buhler, DC, who practiced clinical kinesiology. This involved the application of manual muscle testing, which I began to learn and implement into my practice.

Being a ROM specialist, I started to see a pattern emerging: Wherever I saw limitations in ROM, there were correlating muscle weaknesses. Because of some of the negative issues I was experiencing personally through my ROM-based treatments, I thought maybe this tightness that I’ve been taught to focus on is a symptom. Maybe the tightness relates to another underlying problem: muscle weakness.

My focus became addressing muscle weaknesses in order to resolve muscle tightness. In working with these principles, the first time I had one of my colleagues activate my hip flexors and abdominals, I bent down and touched my toes for the first time in over 10 years.

The tightness in my hamstrings and erector spinae muscles that I had focused on for years went away. It was these experiences that led me to develop MAT. Who would have thought that a fractured vertebra at the age of 19 would lay out the groundwork for a technique that I would eventually create?

An Assessment Tool

As massage therapists, how many times have you worked on a client who leaves the session feeling better but then comes back in pain and as tight as they were before? This can make you question what is really going on with your clients. What are they doing on a daily basis that is causing their muscles to tighten back up and their pain to return?

This is when you really want to understand muscle function. A primary goal of a massage is to improve muscle function. This can be done through techniques that relax tight muscles and improve circulation and energy to those muscles.

If you take a step back and think about the responsibility of the muscles, you recognize that muscles are what provide stability to our joints and protect us from injury. Through muscular contractions, muscles enable us to get through life and help us perform our daily activities. This is something you can’t see when your clients are lying on a massage table.

“How does your client move?” becomes the question. The answer to this question can provide important information to a massage therapist as it relates to your client’s health. The way your clients move can provide you with vital information regarding what’s going on with their muscular system.

MAT provides you with an assessment tool that enables you to evaluate how your clients move. Remember, muscles move bones, so if bones aren’t moving correctly it’s because the muscles that move them aren’t contracting efficiently. Through the MAT-based ROM assessment, a massage therapist can gain the ability to determine which movements a client is unable to perform efficiently.

Movement by movement, throughout the body, you will be able to identify which muscles have been overstressed and negatively affected by inflammation. Once you’ve identified which muscles are weak, through a hands-on activation technique, you can activate the muscle and improve your clients’ movement capabilities on the spot.

This process can also provide the massage therapist with important information that can direct them as they progress through their massage. The information relates to the levels of inflammation within your client’s body. Remember, it is inflammation that alters muscle function and causes protective muscle tightness. Therefore, the amount of muscle tightness that your client possesses can be an indicator of your client’s level of inflammation.

Also, it is important to note that pain is also a signal that represents inflammation in the body. Since weak muscles represent inflamed muscles, through the ROM assessment you are able to determine which muscles are irritated or injured. This provides a sign that these muscles need to heal. Therefore, these are the muscles that a massage therapist can choose not to dig into, as the applied force on the injured muscles could contribute to the inflammatory response and irritate inflamed tissues even more.

MAT in Practice: 3 Examples

MAT addresses muscle tightness. In order to apply these principles, there is much more assessment involved for the massage therapist. You could start by implementing the principles as they relate to the repeated issues that your clients demonstrate. Let’s look at three scenarios.

1. Let’s say your client comes in repeatedly with tightness in external rotation of the shoulder. Through continual application of massage techniques focused on releasing the internal rotators, the motion in external rotation does not seem to improve. At this point, you can perform manual muscle tests to the muscles that externally rotate the humerus at the shoulder. When muscles can’t contract efficiently, they can’t shorten effectively and then the opposite muscles tighten up.

Therefore, tightness would show up in the internal rotators, but potential weaknesses would be in the external rotators.

In this situation, the massage therapist would test the infraspinatus and the teres minor, which are the main muscles that externally rotate the humerus at the shoulder. As each weakness is identified, the massage therapist would then apply stimulatory palpation to the origin and insertion of the muscles in order to activate each muscle that tested weak.

2. Another way a massage therapist can implement MAT is to use it as a follow-up to a massage session. Many times, the focus of a massage is to release scar tissue or adhesions within muscles in order to get the muscles to relax. These areas of tightness may be a result of unresolved inflammation that therefore demonstrate pain when being massaged.

Since pain and inflammation are a sign of weakened muscles, a massage therapist can take note of the areas of the body that were the most tender during massage, then following massage they can test the associated muscles to see if weaknesses exist.

For example, if the client’s hamstrings demonstrated pain and tenderness upon massage, the massage therapist can test each of the hamstring muscles in order to determine if there is a weakness in those muscles. If weakness is demonstrated through manual muscle testing, then you can expect that, if not addressed, the body will tighten back up when the client returns to their daily activities.

Therefore, by activating these weak muscles before the client leaves, you can trust that your client will leave not only with increased mobility but also with a greater sense of strength and stability. This can prevent the client from experiencing the return of tightness and pain.

3. You can use MAT as an independent follow-up to your massage sessions. I tell my clients, “Life is going to beat you up!” Therefore, from a neuromuscular standpoint, someone has to be there to put you back together. That is what we do with MAT. We put the body back together so that it is more capable of handling the stresses that come with everyday activities.

Through learning MAT, you can offer MAT to your clients as an alternative to massage. In this manner, the clients can come back specifically for MAT sessions between their regularly scheduled massage sessions. This provides a benefit to both the massage therapist and client, as the massage therapist can provide more services that will enable them to maintain a busier schedule, and the client can benefit from the additional service that helps them maintain strength and mobility levels and stay out of pain.

About the Author:

Greg Roskopf is the creator of Muscle Activation Techniques (MAT). He has over 25 years of experience applying MAT principles to his clients and has worked as a consultant for the Denver Broncos, Utah Jazz and Denver Nuggets. Beyond this, Greg has worked with clients at all levels of physical disability. MAT training is available to massage therapists and other health professionals.