neck painStructural Relief Therapy is based on Muscle Energy Technique, developed by Fred Mitchell, D.O.; and Strain/CounterStrain, which is now called Positional Release Therapy, developed by Lawrence Jones, D.O. This gentle technique has changed my approach to what the body needs.
Before reading further, I want you to hold a position that will make your hand feel better so you can experience how it works.

Structural Relief Therapy fig 1Try Your First Structural Relief Therapy Position

While sitting, use one hand to squeeze the base of your thumb and the outside of your hand together. Do this without causing pain to your thumb or hand. Next, relax your shoulders so the only part of you that is contracting is the hand that is squeezing.

This basic position will decrease the muscle tightness and tension of the thenar eminence between the thumb and index finger. You are going to hold this position for about two minutes.

How Do We Get Hurt Doing Massage?

Schools teach students to apply a lubricant when doing massage, because it allows for glide.

Traditional Swedish massage begins with effleurage, long strokes to apply the lubricant and warm the muscles. This continues with pressure from light to deep until most of the lubricant is absorbed. (Although oils used in massage have large molecules, and so will not be easily absorbed into the skin.)
In the 1980s, members of the massage profession began to believe deeper pressure was better. I started using deeper pressure too, even using my elbows and forearms for more leverage. Soon, I noticed my thumbs, wrists and shoulders were sore at the end of the day, and I was waking up with stiffness.

Finally, one day, my shoulder exploded in sharp pain. I was unable to work for almost a month, giving me time to think about this new type of massage. Talking with my clients, I found most did not feel long-term benefits from deep work.

A discussion with my osteopathy instructor made me understand that pressing deeply into the tissues with the slipperiness of oil had hyperextended my joints.

This caused my muscles to develop strands of involuntary muscle contraction.

The muscles were getting a signal to try to stabilize the joints, so both the primary and antagonist muscles were pulling against each other. This caused my joints to be unstable, especially at the AC joint. I experienced that when a joint is not moving with ease, nearby muscles develop involuntary muscle contraction, which causes pain.

I was not listening to my body when it got sore and stiff. It was trying to tell me I was not using my muscles and my body correctly. Are you experiencing these symptoms?

Principles of the Technique.

In this article, I will share some positions to help relieve symptoms most massage therapists present. But keep in mind, in class we use Structural Relief Therapy tender points to find the exact position the body needs. And when it comes to the shoulder, arm and hand, there are many more Structural Relief Therapy tender points that contribute to symptoms.

1. Gently assess range of motion and tight tissue.

2. Find the Structural Relief Therapy tender point usually found at the muscle/fascial attachment on the bone. (Not the same as myofascial trigger points.)

3. Position the body passively to eliminate the pain of the Structural Relief Therapy tender point.

4. Hold the position for 90 to 120 seconds.

5. Return the body to neutral slowly.

6. Reassess the tissue and range of motion.

It’s Probably Time to Switch Hands.

When you assess a tight muscle and massage releases it easily, I believe it usually means the tightness originated from emotional tension or emotional stress. When you apply deeper pressure to muscles that do not release easily or completely, this usually means there is involuntary muscle contraction present in the muscles.

Muscles with strands of involuntary contraction cause the antagonist muscle strands to be overstretched. The muscles are having a tug-of-war, with both sides trying to rebalance the joint.

This overstretching creates tightness and burning. Your client points to these overstretched areas and you use deep pressure to try to relieve the complaints. Applying more stretch creates discomfort and pain and signals the body to give up so it will stop receiving pressure.

Typically within an hour or so, the body will reset back to the original involuntary contraction and the complaints will return.

Here is an example: When working at a desk for several hours, say, your mid-back begins to feel tight. When you feel this tightness, notice how you have begun to slump forward. This reflects the anterior muscles involuntarily contracting.

The muscles of your mid-back are being overstretched, creating a burning sensation. When we feel this burning, we unconsciously lift our arms over our head and lean backward over the chair. This stretches the anterior muscles and creates relief, but it only lasts for a few minutes. Very soon, the burning symptoms in the mid-back return.

Movement or exercise overrides involuntary contraction, but at rest, muscle strands will once again involuntarily contract.

This is why clients feel tighter in the morning or after a period of inactivity. These muscles will also test weak, because the strands that are stuck in contraction cause the muscles to be fatigued. These muscles are not functioning correctly, which is why exercise does not always resolve muscle weakness.

I started teaching Structural Relief Therapy because I needed other therapists to use it on me—but I have also successfully used Structural Relief Therapy for self-treatment.

Structural Relief Therapy can be used for self-treatment by yourself, your client and sometimes with the assistance of a helper. You can use these positions daily if needed. Now it’s time to try more positions on yourself.

Structural Relief Therapy fig 2For Carpal Tunnel Syndrome, Try This Elbow Position

While sitting, bend your elbow and rest it on a table. Next, grip near your wrist on the ulna and radius and pronate outward (think “Do the Egyptian”) to the end of range. Remember, the position should not cause pain or other symptoms.

You may experience some numbness or tingling, but this will stop after you come out of the position.

Next, try to relax your shoulders so only the hand holding the position is contracting. This basic position will decrease the muscle tightness and tension of the forearm area and decrease the pressure on the occluded nerve of carpal tunnel syndrome.

Hold this position for about two minutes, then notice how the muscles of your forearm are less tight and movement feels easier.

Structural Relief Therapy fig 3For Limited Range of Motion and Shoulder Pain, Try This Anterior AC Position

While sitting, grip the wrist of your other hand and internally rotate your arm, then bring it obliquely across toward your opposite anterior superior iliac spine. This movement might be on the outside or inside of your leg, whichever position feels better. I would also try applying some slight traction to your arm.

Check in with your body and make sure this position feels comfortable, especially in your shoulder. This basic position will decrease the muscle tightness and tension of pectoralis minor and will decrease the pressure on the occluded nerve of thoracic outlet syndrome.

Hold this position for about two minutes, then notice how the muscles of your shoulder feel less tight and movement feels easier.

Structural Relief Therapy fig 4For Tightness in the Shoulder, Try This Subscapularis Position

Subscapularis tightness makes you want to roll your shoulder to try to release that deep tension. Lie on your side, making sure you are on your hip, and flex your knees so your side-lying position is stable.

Move your arm to your side, but don’t rotate your trunk or pelvis. Let your upper arm fall straight behind you into extension. You are trying to bring the subscapularis attachment on the upper humerus closer to the attachment on the anterior scapula.

The last part of this position is either internal or external rotation. If you have a very long clavicle, it usually likes external rotation, but most clients need internal rotation.

Take about 15 seconds to notice how this position feels, and adjust your body as needed. Remember, you are finding a position of ease, not stretch.

This basic position will decrease the muscle tightness and tension of the shoulder and will decrease the pressure on the occluded nerve of thoracic outlet syndrome.

Hold this position for about two minutes, then notice how the muscles of your shoulder feel less tight and movement feels easier.

fig 5Easy Position to Release The Levator scapulae.

Next, you need to release the functional antagonist to the subscapularis, the levator scapulae. Lie supine and place your arm as if you are going to cough into your elbow. Take about 15 seconds to notice how this position feels.

You may need to move your arm more toward your feet (inferior) or toward the top of your head (superior) to find a position of ease.
Notice if the tension in the upper attachment on the side of your neck feels more relaxed. Hold this position for about two minutes, then notice how the area of your levator scapulae feels less tight and movement feels easier.

Reprogram the Strands of Involuntary Muscle Contraction.

Bodies present the ultimate mystery—and we need many tools, techniques and perspectives to help our clients. My search to find techniques to decrease my clients’ pain led me to develop Structural Relief Therapy from two effective osteopathic techniques: Muscle Energy Technique and Strain/CounterStrain, which is now called Positional Release Therapy.

Almost everything we learn in massage techniques is based on some form of stretch or direct pressure. Structural Relief Therapy shortens muscles to gently reprogram the strands of involuntary muscle contraction.

About the Author

Taya Countryman, L.M.P., has practiced massage since 1977 and been an instructor since 1985. She specializes in clients experiencing complex, chronic medical conditions, and teaches continuing education classes in Structural Relief Therapy nationwide. She has received numerous honors and was inducted into the World Massage Hall of Fame in 2013.

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