Healing Power of Deep Self Massage

The Healing Power of Deep Self-Massage
by Richard Hoff (Originally printed in Massage Magazine 5/00)

Deep tissue massage and pressure-point work are gaining increasing recognition as powerful healing modalities. At the same time, the current focus on containing health care costs has combined with the rise of holistic awareness to create a growing movement toward patient education and self care.

Given these facts, one might expect that health professionals would be eagerly exploring the possibilities of patient self-massage. Most practitioners of soft tissue work, in particular, probably feel that many of their patients really need more than they can possibly give them in once or even twice a week sessions. Yet I have encountered a curious lack of awareness of the possibilities of self-massage among many bodyworkers, not to mention administrators of health education programs.

How can this be? One reason for this, I think, is a lingering feeling that deep tissue massage and the various forms of pressure-point work, such as trigger-point, acupressure, and shiatsu, are too technical for most patients to grasp and too difficult or bothersome to employ on a regular basis outside the professional’s office. And indeed there is some basis for this concern. Many people are very unaware of their bodies, and many may be disinclined to make much effort to help themselves at home.

But these obstacles do not prevent health professionals from educating their patients and encouraging them to make changes in areas such as diet, exercise, and stress reduction. It may take time and some extra attention, but most people will make some headway and some will make significant improvements in their lives. In this way self-massage is no different from other self-care modalities. Patients first experience the bodywork in their sessions with the practitioner; they feel the quality of touch and degree of pressure, and the way it is applied. If they are then shown even one or two points or strokes that they can practice at home, they are already that much better off. A second problem with self-massage is the sheer physical difficulty of it. How can a person do to their own body what a practitioner can do to them? In particular, how can they work on hard to reach areas like the back, how can they avoid straining their hands and arms, and how can they work on themselves and still relax—which after all is a major point of this work—as they would when being massaged by another? (Back to Top)

The solution to this problem is massage tools. With the aid of some simple, inexpensive, well-designed massage tools and a little training and experience almost anyone can learn to give themselves deep massage on any part of their body, in a relaxed manner with little or no strain.

Simple, non-electrical massage tools are particularly well suited to deep pressure massage, in which you are not moving around a lot over the skin but focusing on one area at a time. And since I believe this sort of work is of exceptional therapeutic value, self-massage turns out to have exciting possibilities as a vehicle for personal healing.

Before we go on to take a look at the variety of therapeutic massage tools, let’s consider the nature of deep pressure massage and why it can have such profound effects on our bodies and spirits. I will limit my discussion to deep tissue work, since I have nothing to contribute to an understanding of how pressure-point systems based on the mysterious acupuncture meridians work. Trigger-point work seems to be somewhere in between: it does focus on release of muscular tension, yet the trigger points often seem to coincide with acupuncture points.

In deep tissue massage we are dealing with muscle spasms, usually chronic ones, and the contracted muscle fibers are not usually distributed evenly throughout the muscle tissue but coalesced into nodules or ropey strands which may feel either especially numb or especially sore or irritable. It is often said that the beneficial effects of massage on these spasms results from stimulation of blood and lymphatic circulation which removes toxins and provides extra oxygen and healing nourishment. There is also talk about stretching fascia and separating adhesive areas. No doubt these are indeed important effects, but I think there is another part of the picture which I have never heard discussed. (Back to Top)

Muscles work by contracting, and in order to contract they must thicken. Try the following experiment: place your right forearm on a table, palm up, and with your left fist press down on the flexor muscles of that forearm while trying to make a fist. The effort is difficult, because the pressure of your left fist on the flexor muscles is preventing them from thickening, as they must do in order to contract and pull your fingers into a fist. Conversely, if you start with the right hand already drawn into a fist and press down hard on those flexor muscles, it is difficult to maintain the fist.But this is just what we are doing in any kind of deep tissue massage or pressure-point work: we are pressing down on an area of contracted, thickened muscle fibers, thus countering or contradicting the thickening tendency and inducing a letting go or giving in effect to the contraction. What is different in the case of these chronic spasms, though, is the persistent and involuntary nature of the contractions. You will often feel them let go to some extent as you maintain pressure, but they will not generally disappear completely and will tend to more or less reassert themselves later.

How is it possible for nerve impulses to keep originally voluntary muscle fibers in a state of chronic contraction that goes on year after year and persists even in sleep? I cannot answer this basically physiological question. Perhaps a more answerable question is: How do these contractive impulses arise in the first place and why do they persist? Causes often cited are postural imbalances, non-ergonomic furniture, workplace stress, emotional stress, and trauma due to accident or injury. Such factors are clearly important, but I believe there is a deeper root cause that underlies our present-day problems and can make us more vulnerable to stress and injuries while inhibiting healing. With Wilhelm Reich, the early 20th century psychoanalyst who invented bodywork-assisted psychotherapy, I believe that the muscular tensions originate in early childhood, forming a system of "muscular armor." Like the foundation of a house, this pattern of emotional/muscular tension forms a substrate upon which all the later structure is built.

Whenever I have massaged the neck and shoulders of children, even very young children, I have been amazed to encounter many of the same little lumps and strands I find in myself and other adults, only less pronounced. I have not massaged babies, but I doubt very much that we are born with these spasms. (Back to Top)

I have a more immediate and personal reason, however, for believing in the theory of muscular armor. Many years ago, in the course of therapy with a Reichian therapist, after several months of intensive bodywork which included a lot of deep tissue massage during which I was encouraged to yell out the pain, I had a sudden and totally unexpected upwelling of deep sobbing and grief over an episode in my early childhood—an episode I had not even thought about for years. As this happened I could feel how all those stiff and sore places in my shoulders, abdomen, and face were participating in the convulsions of sobbing. And the bodywork had clearly done it! No amount of talking, thinking, or even psychedelic experience had ever unlocked that place within me. Since then I have continued to dissolve armor and release my inner child, and deep self-massage has played a vital role in this process.

The muscular armor is a pattern of muscle spasms which gradually develop in the course of the child’s continual effort largely unconscious—to master their urges and emotions in the face of societal pressures and personal suffering. It is a monument to self-restraint, to holding back. But what may have been necessary in childhood often becomes stifling or crippling in adulthood. Posture and physical structure become distorted, leading to further problems. Current emotional stress is piled on top of the unrecognized emotional burdens, unresolved conflicts, and character patterns of the inner child. New layers of tension collect around the core muscle spasms of the past. Accidents traumatize already tense and fragile tissues; injuries are exaggerated and healing is retarded.

I’m presenting these ideas here because I think it is good for people to hear them, but more particularly because it underscores my conviction that deep tissue massage is a healing technique of major importance. Few people may want to go so far as to deal with the muscular armor of the inner child, where I believe the ultimate release from tension is to be found, but at the very least regular deep massage keeps a body from ossifying and can play a very significant role in relieving stress, healing and even preventing injuries, and promoting a more vital well-being. When you give your patients deep massage and then show them how to give it to themselves, you are giving them a fine gift indeed, a lifelong gift that will make your work go much farther. (Back to Top)

I tell people that the basic principle of any sort of deep pressure massage is to hold the pressure steady at a level you can accept, then gradually increase the pressure as the tense tissues get used to it and begin to give in. Never force it, let the tissues call out for more. If a particular spot just continues to feel unpleasant, hang out with it at a level you can accept. Just be there with the feeling. Try a little slow movement of that part of your body as you maintain the pressure. Breathe into it. Try giving your muscles a voice; complain or make whatever sounds express the feeling in that muscle. More often than not spots that start out feeling unpleasant become more pleasurable as they begin to accept the pressure. Numb spots begin to come to life. There may be little tremors or sensations of warmth or energy—all signs of release. The hard knot may perceptibly soften, or may seem to shift. You can follow it, letting the pressed skin slide over the underlying muscles; it may lead you along a whole path you had not anticipated. Sliding can be facilitated by use of lubrication or cloth over the skin. When you’ve finished with one area, release the pressure and move on. (Back to Top)

After an area has been well worked out, I suggest moving it around and stretching it; see how it feels now. Massage of the torso may open up your breathing; let your breathing expand, and enjoy it. If people say they don’t know where to massage or how long to do it, I encourage them to explore around and follow their feelings, find their own "Aha!" spots. Self-massage helps you learn to listen to your body. You don't always need an expert to tell you A, B, C.

This is what I tell people. But of course you as the expert can tell them whatever fits your particular healing discipline, whether it involves sliding strokes, cross-fiber work, or specific pressure points. In any case the actual experience of your treatment, your touch, will be the greatest teacher.

Let’s take a look now at the massage tools I would recommend for deep self-massage. Nowadays of course the stores are replete with massage gadgets that are little more than novelty items or toys. They may give some superficial pleasure at first, but will do little or nothing for the deep muscle spasms that really need attention. Among the serious massage tools, although some are very versatile, no single one is perfect for everything. Each has its sphere of excellence, its reason for being. Let’s start by considering the small, hand-held massage tools, beginning with one of my own:

The Knobble®, which looks somewhat like a wooden doorknob with a rounded wooden shaft, is a dual-use massage tool. You can use it manually on yourself or others—it is very comfortable in your hand and can be used with a variety of grips—and you can lie on it or place it behind you in a chair to do your back, buttocks, hamstrings, and other hard-to-reach areas. The Knobble, then, is an ultra-portable all-purpose massage tool. It has been around since 1981 and I’m delighted at the wide acceptance it has received among bodyworkers of all kinds. (Back to Top)

The Indexknobber®, is molded in plastic and feels very good in your hand. It is basically a "pistol grip" tool, in which the massage knob-tipped "barrel" slants down along your pointed index finger and thumb. The knob and the butt of the handle can be employed in a variety of other grips also, and you can turn the tool around and get a sort of "brass knuckle" effect over your fingers. Like the Knobble, the Indexknobber is often used by bodyworkers to save their hands when working on tough spots, and can likewise be used for self-massage. The Indexknobber puts your hand and wrist in different alignments than the Knobble, and changing back and forth from one to the other in long massage sessions could be restful. Unlike the Knobble, you cannot do your own back with the Indexknobber.

The Jacknobber® looks like a large jack (as in the game of "jacks") with four knobby ends of two different sizes. Like the Knobble, the Jacknobber can be used hand-held or as a lie-down massage tool. The new plastic version is smoothly curved and comfortable to hold, and comes in some beautiful translucent jewel-like colors. The Jacknobber’s appeal seems to be more popular than professional, but it is never the less an ingenious tool capable of serious work.
The Hand-L® looks rather like a wavy stick, with a comfortable hand-grip in the middle and two slightly different rounded massage tips projecting out from your hand at either end. Like the preceding tools, the Hand-L can be employed with a variety of grips which use your hand and wrist muscles in different ways, and the massage tips hook around at an angle, which can give you a good "angle of attack" for certain applications. The Hand-L is made of stoneware clay, and is strictly for manual use. (Back to Top)

Another useful class of massage tools is the cane-style massagers, such as
The Backnobber® and The Theracane®, and the Body Back Buddy™. These are like large-curved walking canes you can hook over your shoulder or around under your armpit to work on your trapezius, rhomboids, and other hard-to-reach trouble spots. The current version of the Backnobber – produced like the other two "knobbers" by The Pressure Positive Company – is S-shaped and detachable into two sections for traveling or storage; while the Theracane is cane-shaped with a couple of projecting handles and two extra massage "nubs" for extra grip and technical possibilities. The Body Back Buddy is sort of a hybrid, S-shaped like a huge Backknobber but with two projecting handles and seven extra massage knobs and nubs like a burgeoning Theracane. All three tools are plastic. (Back to Top)