I was listening to an interview with Tom Myers of Anatomy Trains. He used an analogy that really hit home for me. One of relating muscles, and the fascia they are connected to, to onion bags.
Picture an onion bag, then picture it in the shape of a diamond:
The bag (muscle/fascia) can either be pushed or pulled by the left and right sides, or pushed/pulled by its top and bottom. Based on the initial action there will be a reciprocal action.
For example, if the left and right are pulled apart, the top and bottom are “pushed” together (or vice versa). Or say the left and right are pushed together, then the top and bottom are pulled apart (or vice versa).
Here are some high tech drawings to help with visualization:
Using the netting of a onion bag to help with visualization, you can see how doing this over and over again can cause the muscle to become either chronically stretched or chronically short. Based on the condition of the muscle, that is whether it is chronically long or short, we form a treatment.
If it’s long, get it to shorten. If it’s short, get it to lengthen.
For me, this typically meant exercising the long muscles and getting them stronger in order to hypertrophy them, thus tightening them up. This is then accompanied by some manual therapy on the short muscles to loosen them up, as well as various exercises that emphasize stretching the short tissue.
However, what hit home for me was Myer’s comments regarding manual therapy work on the long muscle. Something I never considered as I’ve always thought of manual therapy primarily as moving with the grain of the muscle to help lengthen it.
Going back to our bag analogy, here’s how manual therapy can be used:
Let’s use the bicep as an example:
So, picturing the bicep as an already stretched out diamond shaped onion bag, if we flex the bicep the top and bottom of the muscle/fascia come closer together. Thus, the top and bottom of the onion bag come together, which means the left and right sides of the onion bag (biceps) move apart from one another. The muscle bulges laterally as it contracts.
Therefore, if we have someone with a chronically tight bicep, manual therapy along the grain of the muscle, that is, going up and down the muscle in this case, will help push the top and bottom away from each other. Again, when the top and bottom move away from each other, the left and right will come closer together. Voila, we lengthen the muscle.
However, what if the bicep is chronically lengthened? Again, using our bag analogy, the top and bottom of the bicep will be pulled away from each other. Therefore, the left and right will be pushed closer together. So, using manual therapy against the grain of the bicep (in a left and right motion) will widen the bicep.
Push the left and right sides away from one another and the top and bottom will be pulled closer together. Voila, the bicep is shortened.
–
Why is this important?
One of the mistakes I see people make when it comes to using foam rollers or getting a massage is blindly rolling or massaging the hell out of EVERYTHING.
When one muscle becomes shortened often times another becomes lengthened. But often times it seems when people get a massage or use a foam roller they assume everything is tight. (Just because something is tender when rolling it does not mean it’s tight!)
CRITICAL POINT: Trying to lengthen muscles that are already lengthened can and likely will make whatever you’re trying to make feel better…feel worse. Something can be too stretched.
Back to our beloved bag analogy and bicep example: If the bicep is lengthened, the top and bottom are pulled apart and the left and right move closer together. If some form of manual therapy is implemented which worked with the grain of the muscle, that is, if we pushed the top and bottom further apart from one another, the left and right would come even closer together. Thus, we would lengthen the bicep even further! Not helpful.
Note: This isn’t a common issue with the bicep but I use it because it made for an easy example.
Next time you perform some form of massage on yourself or you receive one, ask yourself what you’re trying to accomplish by working the specific muscle you’re working. AND if the direction you are working the muscle/fascia is the proper one.
–
***
For more on Tom Myers check out the Anatomy Trains book.
***
Matt
November 20, 2013
Interesting ideas here, but I wonder how useful they are in practice. Osteopaths have long assessed for fascial movement by tugging in four directions and then choosing to release in the direction of the least movement, but they’re usually using very little force. When people are using foam rollers or a therapist is using a lot of force, I think the effect on the golgi tendon organs and muscle spindles would likely be far more noticeable an effect…the little tugging you’d get on the fascia would be pretty unlikely to make much difference in muscle length. Have you noticed much difference when doing fascial work with these vectors in mind?
reddyb
November 23, 2013
Hey Matt,
Manual therapy by itself is never something I employ. When I’ve used it it’s only been an extremely small part of the process. A great deal of corrective exercise and activity of daily living modifications are always a (much more) significant part of what I do. At the end of the day, manual therapy just doesn’t fit into my philosophy and what I think is the best approach. So, I don’t really have a controlled subset of people I could speak on. A group where I only performed manual therapy and could assess the results.
Bit of a tangent:
When it comes to manual therapy I feel Myers is really on top of things, and this approach -the “onion bag” approach- very much makes sense to me. That said, I still don’t use it. So why bother writing this?
My primary purpose in this post was illustrating how flopping around on a foam roller, or going for a massage at Massage Envy, is really quite insufficient when it comes to alleviating chronic musculoskeletal problems. I have a good amount of clients who’ve said to me, “I just need to get a massage.” This post helped show many of them, and hopefully others, how you can’t simply have someone rub your body around and expect your chronic whatever pain to be corrected.
Joe Danna
January 23, 2014
The ironic part is that Massage Envy and Elements Massage franchises, which opened recently around here, have put a significant dent in my business. My response is to not put any negativity about it into my business but to focus on promoting the therapeutic side of the work as opposed to spa-type back-rub massage. I am learning truckloads from you. Strengthening and stretching techniques (self-care) are a crucial part of my work, but I must admit I get a little dyslexic sometimes when you say muscles can be tight at one end and loose at the other (hamstrings) when deducing if there’s APT/PPT, etc… I always thought muscles like hamstrings were either tight or not and that one end being tight would affect the other end. What you teach is often presented in a beautifully logical way, but I have to go over and over it for it to sink in after learning some possibly incorrect things before. Evaluating musculo/skeletal imbalances the right way is an amazing skill that requires a passion for the profession. Thank you for having so much to offer.
reddyb
January 24, 2014
Hey Joe,
This is why the easiest thing to do is assess people’s movement rather than how long / short something is. The former is much more clear than the latter. And changing the former will change the latter, where the opposite is not guaranteed.