A few days ago, one of my clients wondered why I didn't just "go after" a very tender and aggravated area of her leg. In her mind, if the problem is so focal, why not zero in and get it over with. 

Working Indirectly - (Using the Back Door)

In a way, muscles are like people. If someone is really angry with you, everything you do is another possible irritation (or worse). A gentle attempt at an apology can backfire, no matter how noble your intentions. When the threshold of tolerance has been crossed, every stimulus is a threat. 

In such cases, the best strategy is often an indirect approach. The situation must be diffused before any real intervention can happen. With muscles, one example of an indirect (or back door strategy) is treating other muscles that have the same function or nerve supply to reduce the activity and irritation at the primary site of pain. 

My client was astonished at how much better the original site of pain was after working related areas. To be honest, I am sure she thought that I was a bit lost when I moved away from the site of pain since none of the other muscles I addressed were where she felt her original symptoms.  But, returning to the original site that was previously so painful, the intensity had diminished by more than 50%. At that point, we were able to gently and thoroughly treat the epicenter of her pain without it being overwhelming. 

The Direct Approach  (The Front Door)

There are many other times, if not most, when it is absolutely essential to address sensitive areas with exact precision. In research at the National Institute for Health, the areas of injury we look for in a muscle are often about the size of a grain of rice. Feeling something that small is no easy task. We seek and need your feedback. The turn of a wrist or a slight change in the angle of pressure can be the difference between success and failure. If you feel that we are close, but not quite "on it", don't be afraid to tell us. 

Which is Appropriate: Direct or Indirect?

 The key is how your nervous system responds. If the focal area feels like a "good pain", then a direct approach is preferable. If you feel the need to recoil as we press on the site of discomfort, an indirect approach is probably a better choice.  This is part of the art and science of massage therapy. We appreciate your clear and honest feedback to navigate help us be as effective and efficient as possible.