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Massage Today
March, 2002, Vol. 02, Issue 03

Putting the Pieces Together

By Keith Eric Grant, PhD, NCTMB

Puzzle pieces fit together in specific, "correct" ways. That is, although puzzle pieces look similar in many ways, every piece is very different from every other piece. One piece cannot be substituted for another piece unless you want the final picture to look really weird.

With a puzzle, there is always a single, overarching, "right" way to put the pieces together and each piece is unique. ... Rather than using a puzzle metaphor, I like to think of web application development in terms of Lego's. With Lego's, there is no overarching "right" way to solve a problem. There are just a whole bunch of block categories (6 hole, 4 hole, 2 hole) which can be put together in an infinite number of ways.

- Selena Sol5

Parenthood has pulled me into some unexpected byways of learning. One such journey came in reading about those who design imaginative constructions for LEGO®, the maker of the ubiquitous small, brightly-colored plastic bricks that fit together - the same sharp-edged bricks that I've stepped on too many times while walking barefoot through my house. While LEGO® makes many specialized pieces, those who design and make creations for LEGO® itself first have to demonstrate high proficiency with the simple basic brick. From the basic bricks spring forth the larger modules that eventually combine into thematic displays. In learning to skillfully practice the art and profession of massage, we can take lessons from LEGO® - the basic bricks are the starting points, to which we must add a larger context that guides us in joining the individual bricks into something greater.2

In teaching sports and deep-tissue massage classes, my basic bricks include evaluative skills, specific manipulation techniques, biomechanics, and knowledge of how to access and facilitate specific soft-tissue structures. Surrounding the individual kinesthetic skills and concepts is an ongoing context of client connection and communication motivated ultimately by the intent to create lasting benefit for our clients. It is this context of creating benefit that guides us consciously and unconsciously and allows each new session to evolve into something that is fresh and unique. As with the LEGO® bricks, there are countless "right" ways to create a massage from our store or conceptual and kinesthetic knowledge.

Like a good horticulturist, part of teaching the craft of massage comes in grafting the new learning onto a student's rootstock of experience, so that it will bear fruit rather than wither unused and unusable. I often start this process with exercises designed to build our kinesthetic vocabularies, initially backing off from the pressures of "doing massage" into the practice of coordination, movement and connection found in variations of tai ji push hands. This kinesthetic practice teaches us to match the movement and to become aware of the pressure and contact that we exert vis-a-vis our partner. We can maintain the contact on the physical level or loosen it into contact via a viscous visualized "energy taffy" - still maintaining the moment-by-moment connection of intent and awareness - in touch yet not physically touching. A primary effect of this practice is that we rapidly move from being a room of strangers to being a class of individuals who have moved together and laughed together into feelings of cohesion and commonality. We are practicing the nonverbal skills of perception that will allow our clients to teach us touch-by-touch what works for them.

This movement practice allows us to examine and relearn our own body usage. The exercises slow us down to practice the flow of one position into another, so that we can become aware of our proprioception of bearing our own weight and how that realization shifts as we move forward and back or side-to-side. We become aware of those places in which our movements are smooth and continuous and learn new neuromuscular patterns for those places that we previously sped or jerked through.

The movements integrate us, moving not just in our hands and wrists, but in our arms and shoulders; and not just in our arms and shoulders, but through our torsos and legs into our feet. Through our feet, we create contact with the floor. When we align our pelvis with the direction of performing our massage strokes and roll tissues using our entire body rather than just the intrinsic muscles of our hands, the strength and smoothness of our moves are palpable to our clients. Our work becomes a tai ji dance, rather than an injury inviting strain of our own muscles and tissues.

With our skills of movement and nonverbal contact accomplished, we are freer to sense and attend to our clients' needs, letting each session develop from their expressions and our own perceptions. We can glean background from our clients in words either written or verbal or by the visual means of having a client color in problem areas on a body image diagram. 3 Visually, we can look for areas of asymmetry and dislocation in the alignment of the different sections of a client's body. 1, 4 Via palpation and range-of-motion checks, we can seek areas of muscle hypertonicity and abnormal tissue texture. I've found Philip Greenman's mnemonic of ART to be useful - Asymmetry of related parts, Range of motion of joints, and abnormalities of tissue Texture. 4 Depending of the focus of a massage, we sometimes observe these implicitly within the context of an opening stretch or compressive effleurage, and sometimes explicitly in seeking the causes of pain or limitation. Our therapy also can be done implicitly by focusing on a tissue lesion within the flow of a general massage, or explicitly as part of a planned facilitation with considerable client interaction and participation. There are indeed nearly an infinite number of ways to put the pieces together to further our goal of creating long-term client benefit.

To begin is the thing. Begin anywhere, anyhow.

- Henry Miller


  1. Judith, Aston, 1999: Aston™ Postural Assessment Workbook -- Skills for Observing and Evaluating Body Patterns, Psychological Corp; ISBN 0-7616-1530-X.
  2. Keith Eric Grant, Learning at the McKinnon Institute: proficiency with the bricks, Open Exchange Magazine, summer, 2001.
  3. Keith Eric Grant, 1999: Body Image Symptom Chart, (an example chart as an Adobe Acrobat PDF file),
  4. Philip E. Greenman, 1989: Principles of Manual Medicine, Williams & Wilkins, ISBN 0-683-03556-8.
  5. Selena Sol, Of Lego Blocks and Puzzle Pieces, May 31, 1999,

Click here for previous articles by Keith Eric Grant, PhD, NCTMB.


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