Sponsored by Thai Bodywork.
Many people have become aware of my Coaching The Body® approach via our therapeutic vibration/percussion tool, the Muscle Liberator™. It gets peoples’ attention to see someone get treated with what looks like a power drill. While I’m very excited about the results we get using the tool within the CTB system, there is a lot of misunderstanding regarding the use of vibration/percussion tools in general. “Massage guns” have become a popular eCommerce item, however I find that these tools are being used with very little understanding of either their true effects on the body, or the degree of resolution that could be achieved if they’re used in an informed manner.
Both therapists and lay users tend to think of the percussion machines as pounding adhesions and scar tissue out of existence, treating at the site of the pain. While this can provide some temporary relief, it never lasts – because it’s based on a misunderstanding of the true origins of the pain as well as the mechanism of intervention. Most of these machines are sold with an array of hard, broad plastic heads that can be painful and potentially dangerous if they accidentally strike a delicate bony landmark.
Everyone wants a “magic bullet”, but in my view, tools and techniques aren’t magic, they can just make a good system easier to implement. In Coaching The Body®, the magic resides in knowledge. Based on an integration of trigger point therapy, neuroscience and selected Thai bodywork techniques, CTB finds a high degree of success by following certain key tenets:
- The neuroscience insights of V. S. Ramachandran, Lorimer Moseley and others have shown us that the experience of pain is an output generated by the central nervous system, rather than an outside force predictably produced by injury and disease. On the other hand, most of our medical and therapeutic systems follow an injury-centric mentality, always looking for the disease or injury at the site of where the pain is experienced. The abject failure of this approach is highlighted by the fact that chronic pain persists in 20-40% of our population, and over-dependence upon painkillers has resulted in hundreds of thousands of unnecessary deaths.
- Trigger point therapy showed convincingly that most pain is being supported by referral from soft tissue rather than injury. Trigger points are potent nociceptors that can keep the central nervous system upregulated and generating pain. Further, most pain is not experienced at the site of the problem (the trigger point) so “rubbing where it hurts” is rarely an effective strategy. This is true whether you’re using your hands or a vibration tool. Unless you treat at the true origin, the pain will return.
- The CNS monitors networks of muscles connected via function and satellite referral, and we must get to the root of and disrupt these often hidden networks to truly have lasting success. The extensive nature of these relationships means that the true origin is often far removed from where the pain is felt.
In our CTB system, we have traced these networks for all of the most common types of pain, and incorporated them into protocols. Each protocol suggests a preferred order of treatment, along with a set of decisions that must be made based on actual clinical experience with the client. Our protocols can be applied across a range of techniques and modalities, including bodywork, therapeutic vibration, corrective exercise, yoga and self-care, and have been refined over decades of clinical experience. We assume high rates of success when our protocols are diligently applied.
Trigger points produce taut fibers — fiber bundles that feel hard and ropy, due to an involuntary contracture produced by the local biochemistry of the trigger point. Most therapists are taught to interpret these contractures as scar tissue or adhesions, and they think of a percussion tool as a means of mechanically breaking up the hard tissue. However, properly administered trigger point techniques can soften these fibers in a matter of minutes or seconds, which could not happen if they were truly composed of scar tissue.
Dr. Janet Travell, the mother of trigger point therapy, experimented with using a soft rubber mallet to percuss taut fibers and found it helpful. She never fully explored it, but it showed that there is a value to the sudden micro stretch produced in the fiber. Our Muscle Liberator™ percussion tool is capable of generating these micro stretches at up to 2400 per minute. We designed a soft silicone head specifically for use in trigger point therapy, narrow enough to target specific fiber bundles, and usable over bone and delicate tissues without harm.
A recent study, by Botter, Vieira, Geri and Roatta showed that when muscle fiber is suddenly strummed or tapped, it produces an engagement that originates out immediately from the site of the tap, meaning that it isn’t a reflex involving a roundtrip to the spinal cord and back. This is the same phenomenon that is the basis of the “twitch response” observed in trigger point therapy. When you quickly strum across a taut fiber, it produces a sudden, involuntary contraction of the fiber — and this has been observed to have a beneficial effect clinically. Interestingly, the jap sen style of Thai massage that I studied with Lek Chaiya pursues the same phenomenon, from a completely different theoretical framework. The sudden engagement seems to act as kind of a micro contract/ relax, and produces faster release in the fibers.
The other major component that underpins our use of therapeutic vibration is the idea of neurological distraction. This is a key concept in trigger point therapy. Pain is produced by the brain based on a danger assessment of the nociceptive streams coming in from the periphery, along with whatever neuroplastic changes have occurred in the brain itself. Travell & Simons used Spray and Stretch, involving a fast evaporating fluid that caused intense sensation on the skin. This masks nociception and pain, and lowers the danger assessment on the part of the CNS, causing it to release its protective holding and let go. The compound used for Spray and Stretch is expensive, expendable and inconvenient. We have found the therapeutic vibration from the Muscle Liberator™ to be just as effective a distraction mechanism as the spray, and in some ways more so, because the vibration permeates the entire region.
The best tool or technique in the world is useless if applied in the wrong place. For this reason, we have chosen not to sell the tool separately without some aspect of our training programs. Most people use percussion tools as non-specific “meat tenderizers”, without the guiding principles of where to work that I have outlined here. We have found that our tool, including our fiber-specific head design, is incredibly effective when used with our CTB Treatment Cycle guided by our protocols. We offer an online CTB Membership training that goes into detail regarding our approach. For more information, please follow the QR code or visit coachingthebody.com/trainin
g. We also offer online self care programs trainings that show detailed self care protocols for upper or lower body pain, including use of the Muscle Liberator Lite therapeutic percussion tool.