QuestionI just recently graduated school to become a massage therapist. I currently work in a chiropractic office doing some massages. I have noticed on several people (mainly the older population, that have degenerative/herniated disks in the lumbar region) lots of stiffness and build up of some sort. Their IT Band will be tight as concrete and very tender. I will feel some trpts around the area as well. Their glutes will be stiff and will complain of tightness and stiffness. This stiffness that is superior to the pelvis on the posterior side expanding frome the lumbar spine to the lateral hip. What is this stuff, and how can I help to clear up the build up. Is it arthritis?
AnswerGreetings Melinda. Some of this could be due to arthritis, or the muscule "fear" that comes from it. When there is a persistant pain in the body, the muscles around the affected area/joint begin to tighten, to limit movement and any chance of pain.
Part of the problem is the location. This is the platform that supports the entire upper body. The muscles are already under a lot of strain, so any additional problems are going to affect a lot of muscles. These can develope trigger points that then cause more pain and tension around their referal zones. Then it becomes a fun game of hide and seek; find and relax the secondary, or satelite, trigger points, and then find and relax the primary ones.
One thing important to do is to "remind" the muscle that is can move without fearing pain. A lot of gentle range of movement (ROM) exercises will help restore some flexibility. Stretches will help lengthen the muscles and set that shape.
I personally would start from the muscles around the pelvis, from the center outwards and forwarwd toward the back. Since the pelvis is the level where everything else comes from, that would be the best place to start. I would also focus on the pelvic and leg area for several sessions, ignoring the back in favor of stretches and more work.
Also realize that this is a problem that has spent a lot of time developing. It will take some time of both treatment and them working at home. Give them stretches that they can do that would help; the low back, the glutes, and the legs are areas to focus on.
I hope this was of some help, Melinda. Please feel free to write again with any other questions.
Sincerely,
Christopher Hall
