Movement restriction summary
Symptoms
- Stiffness
- Restricted joint motion
- Pain and discomfort
- Instability and balance issues
Conditions
How massage helps
- Reduce pain signals
- Introduce healthy movement
- Retrain nervous system and muscle patterns
- Loosen and release soft tissue
Techniques I use for this
Understanding massage therapy for movement restriction
Why does movement get restricted and how can massage help?
Causes of movement restriction
Some common reasons that people experience restrictions in range of motion are: injury, surgery, poor posture and movement patterns, and disease processes like arthritis and metabolic disease.
Loss of movement can happen just about anywhere in the body. It is very common to show up in the large, complex joints that carry a lot of load such as the shoulder, hip, and sacroiliac (SI) joint. Restricted range of motion can also occur in the smaller joints, possibly affecting any of the spinal segments, elbow and knee joints, or finger joints too.
Movement restriction following injuries can usually be traced back to tissue damage that resulted in scar tissue and other non-ideal changes during the injury and healing process. It is also possible to lose movement over time - either from over-use or under-use. Both may lead to tissue changes such as muscle hypotrophy or stiffening of joint capsules that reduces mobility in that area.
When it comes to restrictions caused by systemic processes, it is usually more difficult to reverse. Massage can be an important adjunct to treatment targeting the underlying disease, but it is very important to focus on reducing the impact of the disease in the first place.
Injuries, surgery, and tissue changes over time
Most movement in the human body relies on joints and their surrounding structures working in harmony. The required balance of stability and mobility requires many things to work together: Bones that are shaped just right; joint surfaces that are well lubricated and low friction; joint capsules made of very tough but elastic tissue; muscles that provide the right amount of tension at the right time; and a central nervous system that can coordinate everything. With so much going on its no surprise that restrictions in movement can develop over time.
The human body is incredible at adapting to many different situations and challenges to keep things moving. However, sometimes the adaptations made by our bodies become dysfunctional and ill-suited to our lives over time. This is especially true when the adaptations are extreme, such as after a serious injury or invasive surgery. When our tissue is damaged, the body will try to strengthen and stabilize the area at all costs - sometimes sacrificing movement in the process. Scar tissue can build up and create stiff areas or your nervous system can begin to restrict your movement to avoid a painful area. These changes can last even after the pain and damage goes away.
These adaptations can also occur from overuse and underuse - usually over a longer time period. With overuse your body may stiffen up to meet the demand you are placing on it or inflammation and injury may make movement painful. If you are sedentary and rarely move certain parts of your body through the full range of motion, you might find things stiffening up or muscles losing their strength and coordination. This too ultimately leads to less mobility.
Systemic and disease based changes
There are a number of systemic diseases the cause mobility challenges. Diabetes can cause neuropathy that makes movement difficult; autoimmune disorders can increase arthritic changes as in rheumatoid arthritis; and genetic disorders can cause connective tissue in your body to grow incorrectly. These are just a few examples. There are many ways that a disease might directly or indirectly cause changes that inhibit movement.
So, exactly what kind of movement problems can massage help with?
Everyday millions of people in the US receive massage to help increase their range and comfort of movement. I personally see dozens of people every month to help with their mobility. While not everyone will be helped by massage therapy, it tends to be a good fit for the most common types of movement difficulties that people experience.
If you're not sure if massage will help your condition, keep reading to find out when massage is likely to help and what to do if you are unsure. The best way to tell if a massage will help of course is simply to have one and see how your body responds. I will give you some information from my own experience so that hopefully you will feel empowered to make your own decision.
Massage can usually help with specific movement restrictions
Specific movement restrictions are those that have a local, physical cause like injuries, repetitive use, underuse, surgeries, etc.
The good news is that in all of these cases it is possible to ask the body to adapt back to a state of increased movement. Consistent, focused stimulus in the form of manual treatment such as massage therapy along with exercises and movement are often enough to trigger the adaptation process and create more ideal movement capabilities. We can encourage the tissue in the body to become more supple and mobile, and we can re-train the nervous system to allow more movement and move in more stable patterns.
Massage works so well for these kinds of restrictions because so many of the affected systems are stimulated by massage. In many massage techniques the following affects can happen simultaneously: temporary increase in blood perfusion and lymphatic flow, physical stretching or decompressing of tissue, relaxation of the nervous system, provide new information to the new nervous system. All of this helps to facilitate and encourage the healing process.
Massage can't directly help many systemic causes of movement restrictions
Since these kinds of movement restrictions are caused by diseases affecting the body internally, it is very important to seek the appropriate medical care to treat the underlying disease. Massage isn't really meant to do this, although it can be a helpful addition in many cases. Massage might be able to help reduce pain and encourage healthy movement, even though it won't cure the overall condition. I have many clients with systemic diseases that get massage therapy regularly to help manage their pain and preserve as much of their movement ability as possible.
Massage tailored to your needs
The most effective tools I have as a massage therapist to help with movement restriction are: soft tissue release/pin & stretch techniques, positional release, neuromuscular facilitation, and corrective exercise recommendations. There are many more techniques that I may use depending on how your body responds. Most of them are related or fit in the same category as the ones I mentioned. Basically, these are techniques that combine physically affecting the body to release restriction, and stimulating the nervous system to interrupt patterns of movement dysfunction and re-train healthy movement.
I always start with the approach that I think will be most effective based on consideration of your history and my past experience. However, once I start I will be carefully listening to you and your body's automatic response throughout the session to continually adjust my approach until we find something that really works for you.
Assessment
Assessment plays an important role in figuring out what to focus on to improve movement capabilities. I will often start by observing your posture and movement and looking for obvious signs of compensation and restriction. I will often explore this further with specific muscle or range of motion tests to identify specific alignment issues and unideal muscle activation. Most importantly I will listen to your experience of whats going on so I understand the full context of what you're dealing with and what your goals are. Assessment continues to take place, and most of it does take place, during the massage as I re-evaluate to determine what is having a positive effect for you.
How I approach movement restrictions with medical massage
Increase range of motion and more comfortable movement
Warm up and loosen tissue
The first thing we want to do is get blood flowing to the area, warm it up, and get the muscles and connective tissue loosened up. This begins to deal with tissue based restrictions and ensures that the area will be receptive to further work.
Release restrictions and reduce pain
Once the area is warmed up we can begin to deal with releasing deeper held restrictions. I like to use pin and stretch techniques to really increase the functional range of a muscle. Beyond just dealing with physical restrictions we have to reduce pain signals and get the nervous system to let go and stop blocking movement as well. I do this using positional release and related techniques.
Re-train healthy movement
Once we have achieved whatever amount of improvement your body allows during that session, it is time to make sure that the improvement sticks around. To do this we need to make use of the new range of motion. I like to combine passively moving you through this range with having you actively move yourself. I also like to apply compression, stretch, or resistance to target muscles while you continue to move around.