My Most Important Client

Years ago I was working at a famous health and fitness resort in Tucson, Arizona. This was a true destination spa, the kind of place where you had to stay for a minimum of 3 or 4 nights, where you had to eat their healthful food, where you weren’t supposed to drink alcohol on the premises. At that time, they had about 20 different gyms on property, and more than 100 fitness classes or wellness presentations throughout the day.  This was the kind of place where type-A’s would go to work on their lifestyle issues, there was also a kind of exclusive “country club” attitude to the place as well.

The client who had the single greatest effect on my massage therapy career was a regular here, and he came a few times every year for a healthful vacation.  During his visits he would frequent the spa, and was famous among us therapists for demanding unbelievably deep pressure massage.

This guy wanted pressure so deep that a couple of my coworkers were telling me that they were actually trying to hurt this guy.  One said “when I get that guy I put my foot up on the wall, I make my elbow as pointy as possible, and I push with all of my strength, and he loves it!”

Soon enough it was my turn. During the pre-session interview he told me that he wanted me to work only on his back, and that he could take whatever pressure I could give him.  So we started the session, and almost right away he wanted more pressure. Then more.  It wasn’t too long before my elbow was as pointy as I could get it and I was pushing off the wall with my back foot giving him everything I had, and this guy still wanted more. I did my best, and at the appropriate time I said to him that “according to my training, it was time to turn over so that we could approach some of these issues form the anterior side.  He said “No, not me. I know my body, and I know what makes it feel better, and so you will work on my back, only my back, and deeper, please.”

At the end of that massage I think we were both disappointed in his level of satisfaction. and although he continued to return to the resort a few times a year I never worked on him again.

Over the next few years I watched that guy go from what I thought was a “normal” middle-aged posture to that of a stooped old man. He seemed to lose inches in height as the curves in his neck and back became even more exaggerated. His chin seemed to rest on his chest, and it appeared that he didn’t have and easy time turning his head from side to side.

“What’s going on with this?” I wondered. “If massage is supposed to help your back, and this guy gets so much of it (and from such talented pros like my coworkers!) how can this be happening?” I really started to regret choosing massage as a career–I wanted to do something with my life that actually helped people, something more substantial than giving rich people sensual pleasure at luxury spas.

But soon after I learned about fascia,  tensegrity and fascial balance, and realized that so many of the postural problems I was chasing in my clients were actually emerging from issues in the front. This single case shaped the rest of my massage career, even to this day, here in Honolulu, every day.

He was sure that he knew what his body wanted, and what helped him, but with the treatments that he demanded of us I believe he set himself on a path that could be difficult to recover from. We did what he wanted, and we were ruining him.

I believe that what happened with this guest from so many years ago was that we, the staff, were gradually stretching and spreading his tissues beyond their capacity to usefully support his structure.

In massage, we’re often moving in two directions at once (like *in* and *sideways*, for example).  This shearing force helps to spread and separate the tissues and their fibers.  Moving along the fibers of the tissues helps to free them along their length, moving across the fibers helps to free them from what’s next to them.

And so enter the ideas of balance and tensegrity, that the forces exerted on the skeleton must not only be balanced between front and back, but also from side to side, top to bottom, and relative to local imbalances as well.  Individual bones may be rigid, but the skeletal system is essentially floating; cushioned and spaced, but also rigged with pulleys, hinges and guy wires.  Tensegrity is the sum of all forces, and is the governing distribution of that constant.

Now, if in your body the balls of your shoulders have become more prominent or your chin seems to point forward or you exhibit other symptoms of forward head posture, then to me that is an indication that your back muscles may have become over-stretched and therefore relatively weak (muscles are not equally powerful throughout their range of motion, too short or too long and they fire less efficiently and are functionally weaker–over a prolonged period time, chronically so).  In terms of tensegrity, it means that the tensional forces in the front are greater than those balancing them in the back.

So with my client, and at his request, we were unknowingly stretching and spreading his tissues beyond their already weakened state, weakening them even further.  Our efforts we were forcibly pumping fresh blood and nutrition into his muscles, so to his subjective perception he would get some temporary relief.

But as those muscles returned to their regrettably “normal” state (of being chronically tight and oxygen-starved), the relief would evaporate. So he needed more–more massage and more pressure, always chasing that relief.  All the while those of us who were working on him were actually worsening his condition by hammering his symptoms, at his request (and great expense).

Today I think I understand better how our shapes influence or pain (and vice versa), and have developed some tools to help those clients who are ready for change in their patterns of chronic pain. Ultimately I think the best tool is variety of movement, but if I had to sum it all up in one catch-phrase, it would be:
“When your back hurts, Stretch your front!”

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