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I had a client come in and his chief complaint was pain just below the outside of his right knee. After a brief assessment, him answering a few questions and showing me his pain pattern. I determined that the pain is most likely coming from the Vastus Lateralis muscle. I explained to him exactly why I determined the Vastus Lateralis was the culprit and gave him a brief plan of action for the massage session and the most likely outcomes.
Once getting him on the able and making sure he was comfortable in the side lying position I began a technique called myofascial therapy (MFT). This is a dry work technique that does not use oil in order to really work the fascia. I decided to use MFT for a few reasons. One, I love MFT! Two, MFT really allows you to warm up the tissue. Three, MFT allows me to locate the exact area the pain is coming from and assess what is causing the pain. Now in this instance I palpated the area the client was originally describing as the source of the pain, just below the right knee on the out side. Once I found it I began following the lateral fascial line up from the lateral tibial condyle to the Iliotibial tract or IT Band.
Based off of what my client had told me in the intake and assessment I decided to work the vastus lateralis first and just about the middle of the muscle belly I found a bundle of tight fibers also know as a "Trigger Point" or "Knot". I performed a little deep transverse friction but not too much since the client also made me aware that they had just began an exercise program and had his weekly workouts coming up. I also decided to with go any deep tissue or Trigger Point Therapy. So I decided to take an invasive approach in todays session. After I felt the area was warmed up enough and the fascia in and around the trigger point had been worked to my liking I then then spent the nest few minutes warming up all of the soft tissue around the IT Band like the TFL, Gluteus Medius, Gluteus Maximus, short and long head of the bicep femoris, as well as below the knee on fibularis longus. Looking for any other latent trigger points. Once satisfied with MFT, I began applying oil and firmly massaging the full length of each of the above muscles. Working from tendon to tendon in an extremely detailed manor, utilizing my Gua Sha tools and some dynamic low vacuum cupping to identify any areas of tension and adhesions. I then began to finish up the session with a complete lower legs and foot massage that borders somewhere between Swedish and deep tissue. Ended my session with a hot towel to remove any excess oil and a glass of water and asked the client if he would update me the next afternoon on the condition of pain.
I knew from the clients feed back that the pain was gone from the work in my session but as I explained to him that doesn't mean we are in the clear. Sometimes the pain can go away for a couple of days and then begin to come back so we decided to book another session for the following week just incase and I would wait to hear from him the next afternoon. The next day he contacts me and is pain free. He said "I don't know what you did yesterday but what ever you did worked!", lol and so at the moment I had me a happy customer, but, after I told him how happy I was I still reminded him that the pain may come back in a few days. It's common. He said "Okay, if it does then we will work on it again next week and if it doesn't I'll just get a nice relaxing massage."
The next week came around and he was pain free, which made me extremely happy. I did spend a little extra time on the previously troubled area but I also got to relief some chronic stress in his shoulders and neck. So a win-win overall. And another happy Customer!
If you have never had a massage before and are not sure whether massage is appropriate for you or your conditions feel free to email me michaelhale@gmf.one.
Michael Hale is a Neuromuscular Therapist, Personal Trainer, and Health Educator from Jurupa Valley, Ca, who graduated from National Holistic Institute (NHI) and International Sports Science Association (ISSA). He wholeheartedly believes that strengthening the body is equally as important as relaxing the body in order to reach homeostasis.
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