Aspects of Deep Tissue Bodywork Part I – Muscle: Anatomy, Function, Fatigue & Release

There are soothing and pampering, or ‘feel-good’ forms of bodywork with secondary therapeutic effects – and there are treatment modalities where the therapeutic effect is of primary concern.  Deep tissue sessions definitely fall into the latter category. 

Sometimes the literature also refers to them as orthopedic muscle sculpting a term, which in itself highlights the two important factors involved in these treatments: precision and structure.  The therapist takes on the role of a sculptor who with precision aims to help the client’s muscles regain their ideal shape (irrespective of size) and placement, by tracing them with deep strokes and pinpointing tense spots.  This process, when applied skillfully, and, again, with precision, can be so effective that it will have an orthopedic effect: In other words, it can restore the correct function of the skeletal system, its articulations and associated structures.  For the one receiving a series of such treatments, this is a deeply healing experience and most often in terms of the actual result, surpasses the effects of the prescriptions from an orthopedic physician, or the ministrations of mechanically oriented physiotherapist.

So, in case you are a therapist, you may ask yourself, what do I need to do in order to achieve such results?  What do I need to know?  What skills would I want to have at my command?  You require three things: Knowledge, experience and sensitivity, or awareness.  Knowledge is the basis, in this case sound anatomical knowledge of muscles, fascia, bone, nervous system, emotions – and their interplay.  Experience refers to technical precision in terms of strokes and point holding, learned from the ground up and refined over time.  Whereas the sensitivity required, is of a two-fold nature: you need to be aware enough to listen to and pick up on the signals given by the client’s body in reaction as the treatment progresses and by your own body, in order to not to tire and in order to let the treatment unfold naturally, like water flowing over rocks in a steady pace.

Yet again: knowledge is the basis.  Which is why the first two posts in this multi-part series on deep tissue treatments are dedicated to deepen the understanding of the anatomy, function as well as frequent malfunction of especially muscles and connective tissue, or fascia.  As a therapist you would not only want to know where and how each muscle is attached to one bone and inserted into another.  You also would want to understand how muscles work, what gives them energy,how they tire, as well as you would want to understand the results of muscle fatigue and its impact on fascia and bone structure.  Such knowledge will greatly help you in your practice, because it makes you get a grasp the physiological and psychological effects of your treatment.  On its foundation you are in a position to fine-tune your treatments, thus giving them greater precision for even better results.

A healthily sustained and exercised body is mostly muscle.  It is this most obvious bulk that we feel with various strokes, pressures and stretches during a deep tissue session.  And these muscles have more than only a motor function in the sense that they allow the body to move.  In them memories are stored, good and bad, including physiological and psychological traumas like accidents and moments of defeat, extreme inner pain and helplessness.  Most of the ailments associated with habitual posture, everyday stresses and emotional holdings are represented in the muscles as aches, stiffness, soreness, tension, spasms, cramps, tiredness etc.

For example, for more than 80% of the cases of low backache and cervical spondylosis (a very common diagnosis here in India), no radiological or biochemical abnormality is found. Such cases are also usually reluctant to effective cure with conventional medicine.  Although analgesics and muscle relaxants can provide temporary relief in a few cases, the effect usually lasts only as long as the drug is ingested on a regular basis.  If one searches for the cause outside the usually assumed culprits, that is bones and ligaments, the search would inevitably lead one to discover that the so called “unknown cause” for the pain and discomfort in back and neck can be found in the chronic muscle spasms in these very areas.

Muscles are by far the most metabolically active organ in the body.  They burn a tremendous amount of energy.  The working muscle’s need for replenished ATP (Adeno-Tri-Phosphate) is in fact so great that during any given day, the body will produce ATP in an amount equal to its weight.  As the cells’ main fuel produced in the mitochondria, Adeno-Tri-Phosphate or ATP is crucial to three separate phases of the contractile process inside the muscle cells.  Which is one of the reasons why, if you weigh 65 Kgs, your body will need to produce 65 Kgs of ATP every day for you to stay alive.  This need for ATP is fulfilled by aerobic glycolysis and Kreb’s cycle i.e. by burning of glucose in the presence of oxygen to produce ATP, as well as CO₂ and H₂O along with it. The whole ATP-production process thus needs a constant supply of sufficient amount of oxygen, the requirement of which is especially high during high levels of work in the muscle cells. 

Now you may ask, why go into all this science mumbo-jumbo?  Because roughly and very unscientifically speaking, deep tissue treatments increase the oxygen flow in the muscles, thus helping the body to produce more ATP.  Which, in turn, is why after a good deep tissue treatment a client feels more alive, more completely embodied.

When the work by the muscle cells exceeds the energy input and oxygen supply, muscle cells shift partly to anaerobic glycolysis, producing large amounts of lactic acid and other toxic metabolites as waste.  It is probably the irritation of the muscle tissues and nerve fibers that produces the typical soreness in muscles, which have exerted beyond their aerobic capabilities.

Within the general parameters of normal human activities, this is a natural phenomenon. When the lactic acid levels reach a certain threshold, normally the brain sends a signal to stop any further exertion. Once the workload on the muscles is decreased, accumulated lactic acid and other wastes are slowly washed away through blood stream and a fresh supply of oxygen is restored.

However, in today’s fast paced life, no one has the time to pause for a moment and listen to one’s own body’s needs.  There is not sufficient time for rest and relaxation.  Increasing responsibilities, the competitive spirit, the ‘always-in-a-hurry’ attitude all take their toll on the body.  The constant abuse gets stored in the body as chronic tension in muscles and fascia, especially around the knees and ankles, in the shoulders and in the neck, as well as in the lower back.  The continuous state of tension in these areas leads to an increasing build-up of lactic acid in the muscle cells.  Lactic acid over time gets crystallized forming “knots” in the muscles.  These knots keep on growing in size pulling muscle fibers and fascia along the long lines of tension.  Both crystals of lactic acid and muscle pull irritate the adjacent nerve fibers leading to backache, cervical spondylosis, arthritic pain of the knee join, and so forth.

The fact that in most such cases, no abnormality is found radiologically, in itself serves as proof that hardened muscles, not bones and ligaments, are a major cause most musculoskeletal problems.

Only a skillful manipulation of the soft tissues (muscles and fascia), by a knowledgeable therapist can, through deep tissue treatments, help release crystallized lactic acid and restore suppleness in the muscles.  Drugs cannot solve the problem.  Because drugs do not help the body produce the ATP the body needs.  Only gentle exercise and ample amount of moving the body, as well as deep tissue treatments on hardened muscles can achieve that. 

In other words, deep tissue treatments work because they fulfill a physiological need and correspond to the body’s own logic.