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Massage for Adhesions

June 22nd, 2014

Adhesions are fibrous bands of scar tissue that form between two different muscles. Because adhesions physically bind two muscles together, they can impair the ability of those muscles to function independently. This frequently results in decreased functionality of both muscles involved, as well as decreased flexibility in any movement that requires those muscles to separate, as well as potential postural misalignments.

The most common place that we encounter adhesions is between the deltoid and pecs, between the rotator muscles of the butt, in the plantar fascia (bottom of the foot), and between the subscapularis and the serratus anterior. However, adhesions may exist anywhere, even between muscles and bones.

The most common causes of adhesions are:

  • Injury (from car accidents, falls, contact sports, etc)
  • Surgery
  • Working out until you "feel the burn" and not really stretching out afterwards, especially on an intense, habitual basis, such as in bodybuilding, weightlifting, or intense sports training.

When an adhesion exists between the deltoids and the pecs, the ability to lift the affected arm freely and open the shoulder can become impaired. Over time, this can cause postural problems such as shoulders that are permanently pulled/rounded forward. As the head naturally attempts to maintain its normal upright position, the muscles of the neck and upper back, including the trapezius, must constantly strain to keep it upright, which can lead to "boulders in the shoulders": chronic pain and tension in the neck, shoulders, and upper back.

When adhesions exist in the rotator muscles of the butt, decreased flexibility is seen in the client's ability to bend their knees to their chest or rotate their legs freely. This can cause other muscles to compensate during walking, which can cause general tightness in the legs and - potentially - lower back pain. If adhesions exist between the largest rotator muscle (the Piriformis) and the one immediately beneath it, the sciatic nerve may get pinched, causing Sciatica.

When adhesions exist in the plantar fascia (the muscles at the bottom of the foot), healthy foot flexion while walking becomes impossible. The feet are the foundation of the entire physical structure, so depending on the nature and location of any such adhesion, various muscle groups throughout the body will attempt to compensate for the lack of normal motion in the foot. This can manifest as chronic tension anywhere, and - over time - can lead to postural issues and joint wear.

When adhesions exist between the subscapularis and the serratus anterior or lattisimus dorsi ("lats"), the ability to open the arm freely overhead becomes impaired. Chronic pain and tightness in the upper back and shoulders is common.

The good news about adhesions is that expert Deep Tissue Massage, particularly Structural Integration and Rolfing, have techniques designed specifically to deal with them. Rapid resolution may result in noticeably increased mobility within just 1-3 sessions.

A highly skilled Deep Tissue massage therapist should be readily able to detect adhesions by touch - the fibrous bands that run between two adhered muscles do not exist on most clients, so feel like an anomaly that is readily detected by sensitive fingertips. The more severe the adhesion, the more obvious it is to such skilled massage therapists and the thickness can range from "thready" to "ropy", typically with an obvious direction of primary binding.

There are several techniques that may be used to sever adhesions. One is to apply intense, focused, directed pressure between the muscles that have adhered together, along the line where they would normally be separated. For best affect, it is usually desirable to get one of the muscles to activate (while the other stays flaccid) so the edge of that muscle can be clearly detected. Therapists trained in Rolfing and Structural Integration have a bevy of tools they can use for that, many of which involve coached client participation.

Another effective technique for severing adhesions is to isolate (pin down) one affected muscle while manipulating the body in such a way that the adjacent muscle is moved, thereby "shearing" the two muscles apart. This is the most common technique for dealing with adhesions in the rotator muscles of the butt.

A combination of these techniques would be to pin down one of the affected muscles and then have the client move their body part in a way that activates the surrounding muscles to the pinned one. This also breaks through scar tissue, releasing adhesions, and is commonly used by rolfers for issues in the feet.

As adhesions are severed, it is common for the client to feel a focused momentary burn or experience a series of light pops - almost like bubbles bursting between the adhered muscles.

Light adhesions may be resolved within a single session. Heavy, ropey adhesions may take several sessions to resolve. It is not uncommon for long-term adhesions (ones that were around long enough to cause postural issues) to regrow, so follow-up visits are advisable - the regrowth is typically a lot lighter than the original adhesion, and the underlying postural deformation caused by such a severe adhesion may be complex and should also be addressed by your massage therapist.

For more information, please see Deep Tissue Massage, Structural Integration, Sports Massage, Deep Lomi Lomi, or Thai Massage.

To reserve an appointment with Aloha Massage Kauai, please call (808) 635-2789(808) 635-2789. If you think you may have adhesions, please let us know so we can send one of our many expert Deep Tissue Massage therapists who have training in Structural Integration or Rolfing to your massage.