Two services are offered at Soarbody Therapeutics: Dynamic Muscular Therapy and Sports Massage. The goal of sports massage is maintenance of the client’s tissues for optimal performance. The treatment plan is short, simple, and completed within each session. The goal of Dynamic Muscular Therapy is to resolve chronic athletic musculoskeletal conditions. The treatment plan may be quite complex and take several weeks to complete. There is often some doubt among new clients about the need for the frequency and the duration of the treatments. A clear and simple explanation is provided below.
Chronicity: practice makes permanent; history is everything
The old saw practice makes perfect may be true, but with respect to how the body is wired, a more appropriate expression may be practice makes permanent. When you practice the piano, for example, the nervous system is programming specific pathways to fire in certain patterns, specific muscles are developing characteristics (strength, speed, local endurance) based on what the nervous system is demanding, and the fascial system adjusts itself to support the needs of the muscular system. The earlier you learn to play and the more often you practice, the more ingrained these patterns become. This is a good thing! If basic patterns were not executed thoughtlessly and effortlessly, we couldn’t so much as walk never mind play the piano. However, if one learns in their mid thirties that they have been playing the piano incorrectly since they were eight years old, it’s going to be more difficult to reroute the nervous system and create the changes in the soft tissues needed to form new patterns.
So it is with chronic injuries. There may indeed be a specific lesion that needs to be directly addressed (hamstring strain, lateral epicondylitis, etc), but the lesion may well be only the head of the dandelion – eliminating only the flower leaves the root cause of the injury intact to come back with even more devastating effects. Additionally, the body is smart! Once you’ve incurred an injury to one part of the body, the rest of the body will compensate around the injury to continue to meet the demands placed upon it. This compensation can allow movement and eliminate pain for some time – sometimes many years. But these compensational patterns are always inefficient and will eventually fail. For a great many clients, they don’t seek help until these compensational patterns fail, more damage is done and they cannot continue their activities effectively.
Duration: How long will treatment take?
Obviously, the sooner we can stop the body from practicing these compensational patterns, the easier it will be to heal the lesion and learn efficient movement patterns. This is why you have to fill out such an extensive history of activities, injuries, and surgeries, from childhood to present day, for your initial assessment. It provides us with clues as to the root cause of the pain as well as providing a rough idea as to how long it will take to resolve the root cause to best state possible. The older the inefficient patterns, the longer the duration of the treatment plan is likely to be.
Frequency: How many times per week will I need to have treatment?
The appropriate frequency of treatment in a treatment plan is crucial to success. After the first the first manual treatment the client will experience a decrease in pain and an increase in freedom of movement – for a little while. After that short relief, their condition will return back to it’s about its initial state. This makes sense – we can’t expect our piano performance to improve much if we practice once a week. But if we practice several times per week we can capitalize on the success of each subsequent practice, starting at a slightly higher performance level each time. There will be diminishing returns of course as we meet our potential, at which point we have the option of moving on to practicing different, more challenging pieces, which incorporate maintenance of our older skills.
So it is with treatment for chronic injuries. Without the proper frequency to improve at steady rate, the condition is not going to change significantly. We have to catch the improvement after each treatment to start at a higher level than the previous session in order to make steady improvement. See the graphs below.
Graph A illustrates little progress with a frequency of one treatment per week. This may be effective for optimal maintenance of the tissue’s condition once the lesion is healed and the patterns have been changed, but this frequency will probably not be effective for creating the change necessary to heal the lesion and change compensational patterns.
Graph B illustrates effective progress when the frequency of treatment is great enough to capitalize on the improvements made in each prior treatment. Progress is made more quickly and optimal tissue condition is achieved sooner.
Extensive patterns, conditions: Why must I see other practitioners?
Dysfunctional patterns often extend beyond the musculoskeletal system. Such patterns fall outside my scope of practice, which is why I have an extensive referral list of nutritionists, psychologists, physical therapists, structural integration practitioners, chiropractors and physicians. We are multidimensional beings and sometimes require a multidimensional approach to healing.
References utilized:
Joseph E. Muscolino, DC (2011) Treatment Planning and Client Education Massage Therapy Journal, Winter 2010, 4(4) 91-95
Hammer, Warren I. “Functional Soft Tissue Examination and Treatment by Manual Methods, 3rd Edition” Sudbury, MA Jones and Bartlett Publishers, 2007
Joseph E. Muscolino, DC (2011) Treatment Planning and Client Education Massage Therapy Journal, Winter 2010, 4(4) 91-95
Hammer, Warren I. “Functional Soft Tissue Examination and Treatment by Manual Methods, 3rd Edition” Sudbury, MA Jones and Bartlett Publishers, 2007
