A Good Back Rub and Training Recovery

I am currently working my way through the new text, Fascia: The Tensional Network of the Human Body. As I read through it I get various ideas for therapies, treatment options, and potential concepts to try and play with and apply.

A chapter I found particularly interesting is the one on interoception by Schleip and Jager as it is something we can maybe consider and potentially tap into when using soft tissue therapy for recovery/restoration purposes.

Exteroception, the ability to sense stimuli from the outside of the body, is familiar to most therapists as they often comment on the potential improvement in proprioception and awareness a client may gain with touch therapy. These are more ‘mechanical’ effects of treatment. However, the interoceptive response is a little bit different, is not a mechanical effect of treatment, and may be something to consider.

Interoception

Interoception can basically be defined as ones ability to sense their own physiological condition or sense stimuli originating inside of the body. This can encompass a number of different sensations such as:

• Hunger or thirst
• Warmth and temperature sensations
• Pain, ticklishness, or itch
• Sexual arousal
• Various visceral sensations (e.g., a distended stomach or bladder)

Much of these interoceptive sensations play a role in our sense of well-being, self-awareness, and emotions.

Influencing Interoception

A number of receptors are found in musculoskeletal tissue and while most are familiar with the mechanoreceptors that provide a role in proprioception (e.g., Golgi Receptors, Paccini Corpuscles, and Ruffini Endings) one should consider that a large majority of the receptors found in the fascia are interstitial receptors.

Ninety percent of these interstitial receptors are found to be unmyelinated C-fibers which, when stimulated, result in activation of the insular cortex making them ‘interoseptive receptors’ whose stimulation can produce a variety of interoceptive changes in the body such as autonomic changes (IE, changes in heart rate, blood pressure, and breathing rate) as well as changes in mood, self awareness, and well-being.

Interstitial receptors respond to light touch and gentle stretching of the skin and connective tissue. Thus, in a treatment setting where one is looking to achieve a specific result of recovery and regeneration it may be wise to tap into gentle therapies which influence the client’s interoceptive system to help push them into a greater state of ease, comfort, and pleasure, and enhance their therapeutic experience – rather than just “going deep” for the sake of pushing an elbow deep into their soft tissue.

Treatment Ideas and Practical Application

The reason for the title, “A Good Back Rub”, is because when we are looking to achieve a good therapeutic result with our treatment, in terms of influencing a greater state of well-being, getting someone to recover/relax, or looking to ‘push’ the person into a more parasympathetic state, I have found that allowing the client to be prone and working on the back and spine can have profound effects.

In my experience, working on the back and having the client prone seems to do a few things:

• When face down there is less visual stimulation coming in so the client can relax more.
• When face down there is less talking or chit-chat taking place.
• The back is probably the largest and most exposed area of connective tissue in the body for us to work on, thus we can influence a greater amount of receptors.
• There seems to be something about having your back rubbed that tends to relax you. I think this may go back to being babies and whenever your parents wanted you to go to sleep they would lie you over their shoulder or lie you on your stomach and rub your back. It seems to have a very calming and soothing effect.

So, some ideas to think about when looking to influence the recovery processes of the client:

• Use a prone position to allow access to the back and spine
• Work light to influence interstitial receptors
• Work slow and allow their body to adapt to the stimulation (typically the proprioceptive effects are felt immediately during the massage stroke, but interoceptive effects may be felt several seconds after the stroke is completed when the individuals body is able to adapt to the soft tissue manipulation you just applied to it)
• Be patient

Patrick

Reference

Schleip R, Findley TW, Chaitow L, Huijing PA. Fascia: The Tensional Network of the Human Body. Churchill Livingstone – Elsevier. 2012.