Thanks Whitney

Geoffrey-
I think you may have misinterpreted what I (and many others) are advocating. I don’t think anyone is suggesting that techniques shouldn’t be taught. Techniques are like tools. You can’t do good work without them. But just having a good tool does not make you a good craftsman. You have to know how and why you use it. The “how and why” are the critical thinking and clinical reasoning skills that others advocate.

The problem I see is that most educational programs emphasize only the tools (techniques) themselves as the answer to all clinical problems. Without the clinical reasoning process (knowing and understanding why you do what you do), your techniques will not be as effective as they could be.

It is like the craftsman who has a chisel, saw, and router. They are all great tools, but if you don’t understand when to use each one to their most appropriate use, you certainly won’t do the best work you could be doing.

This concept is an important aspect of what you and Erik teach in your assessment methods as well. Determining the nature of the client’s pathology is critical thinking and clinical reasoning. From that point you choose an appropriate treatment strategy. You then apply the appropriate techniques that are most likely to produce effective results. I would assume you don’t just start doing a random series of techniques you have learned for that region of the body.

My argument has been that we need to teach much more clinical reasoning to balance the content that leans toward to tools (techniques).

What is Myoskeletal Alignment Techniques?

From Erik Dalton, PhD, founder of Freedom From Pain Institute, creator of Myoskeletal Alignment Techniques.

What makes MAT Special?

Well-documented theories explain how joints become fixated from myofascial stressors; yet relatively unknown in the massage therapy community is how joint dysfunction creates protective muscle spasm and dysfunctional strain patterns, such as forward head postures, slumped shoulders and scoliosis. This reflexogenic relationship between muscles and joints is the foundation of the Myoskeletal Alignment Technique and is considered not only uniquely different from traditional thinking, but possibly an important next step in addressing abnormal strain patterns caused by muscle/joint imbalances.

Massage therapists can now safely address all soft tissues, including ligaments, nerve dura, fasciae, discs and joint capsules, responsible for much of the pain previously blamed on muscles alone. Osteopathic methods, such as muscle energy, strain-counter strain and mechanical link, are also designed to relieve muscle/joint dysfunctions, but the MAT method complements today’s bodywork practices as it was specifically designed to fit a massage-therapy format.

One distinguishing goal that establishes the MAT method apart from other techniques is its dependence on identification and correction of joint fixations. This is accomplished by systematically releasing deep spinal muscles, ligaments and fibrotic joint capsules that torsion and compress spinal joints. In some cases, a bodyworker may apply direct pressure to bones to release fibrotic muscles that create joint blockages, but the intent is always soft-tissue work.

Posture’s Roll

Most manual therapists today agree that no therapeutic approach to neck/back pain is complete unless body posture is generally improved. Whatever the root of the client’s condition, special attention must be dedicated to posture-especially the correct positioning of the pelvis. Many therapists complain that postural assessments are often too complex, too time-consuming, too clumsy-in a typical massage setting with the client draped.

The MAT method lessens assessment anxiety with an efficient five-minute hands-on evaluation that quickly identifies gross body asymmetries, such as pelvic tilts, short legs, sacroiliac dysfunctions, scoliosis, facet restrictions and hip-capsule adhesions. MAT also incorporates Vladimir Janda, M.D.’s upper-and-lower crossed visual assessment method for easy recognition of muscle-imbalance patterns that cause neck and low-back pain. Combining these hands-on and visual assessment techniques allows the therapist to immediately tell which muscles are tight and pulling unevenly on the body’s bony framework, and which weak muscles are permitting the asymmetry. Janda’s muscle-imbalance research has gifted bodywork practitioners with a remarkably useful model for explaining how predictable muscle imbalances cause predictable faulty postural patterns, such as slumped shoulders, forward heads, swaybacks and dowager’s hump. (Hands on procedures using Janda’s formula are detailed in Part II of this series.)

Ultimately, for long-lasting relief of chronic neck/back pain, the MAT system works to achieve these goals:

balancing the head on the neck

balancing the neck on the shoulders

balancing the shoulder girdle on the rib cage

balancing the pelvis on the femurs

restoring pain-free movement

Recent studies have confirmed a noticeable reduction in noxious neural input entering the spinal cord and brain when the postural goals listed above are met. In 1979, biomechanical researcher J. Gordon Zink, D.O., coined the term “common compensatory patterns” to describe routinely found postural patterns in the neuromyofascial-skeletal system. His studies were the first to validate how structure and function play a dual role in posturally initiated pain syndromes. Eventually, he concluded that postural muscle stress leads to chronic, recurrent central nervous system irritation initiated by sensory receptors, such as mechanoreceptors, nociceptors and chemoreceptors.

Postural muscles are structurally designed to resist fatigue and function in the presence of prolonged gravitational exposure. If their capacity to resist stress is lost, the postural muscles become irritable, tight and shortened. Fortunately, as balance and function are re-established in distorted myofascial structures, hyperactivity in agitated joint and muscle receptors rapidly dissipates. Zink’s conclusion leads to the underpinnings of the client’s outcome: less sympathetic muscle spasm, less limbic system activation, less stress-and less pain.