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Massage Today
September, 2012, Vol. 12, Issue 09

The Significance of Tissue Density Measurement

By Linda LePelley, RN, NMT

Massage therapists often struggle with the perceptions and beliefs expressed by others about the validity of massage therapy. Some massage therapists end up questioning the benefits of massage as well.

It saddens me when I hear a therapist state that massage is just a "feel-good" experience. While there is nothing wrong with basing one's personal practice on providing relaxation massage, there are many therapists who dedicate their work to the relief of pain. Those of us who strive, and are able, to relieve our client's pain are often told that our results are subjective, therefore, "anecdotal."

It's been suggested to me a few times that the reason I'm successful at relieving pain is that I'm so kind and my clients like me. Supposedly my, "therapeutic presence" makes people feel better. Therapeutic presence is very comforting and beneficial, but it alone will not change a physical problem. I've also been told I possess "innate healing abilities." Some of us may have been seduced by the heady notion that we are magical healers, an idea that finds room for consideration when one cannot otherwise explain good results where others have failed. However, we do the profession a great disservice by cloaking our positive outcomes in ambiguity. Such is the stuff that quackery surrounds itself with, "mysterious ancient secrets" and the like. Better to acknowledge that while we may not know why a treatment works, we use it because it causes improvement. By studying and refining such treatments, perhaps the improvements can be increased and eventually understood.

Tissue Density - Copyright – Stock Photo / Register Mark It was during a devastating period of time when a medical condition caused me to lose the ability to walk that I became aware that palpable changes in tissue density (TD) are a reliable gauge of musculoskeletal pain. I was not willing to give up my massage practice, so I made adjustments to my clinic, such as removing the legs from my massage table to lower it and working from a seated position in a rolling task chair. I looked at what I was doing from a different perspective, and started trying new things that I would never have considered had I still been able to stand correctly and utilize proper body mechanics. I can laugh now, looking back at the dark days when I feared I would no longer be able to make a real difference in medical conditions such as arthritis, back pain, sciatica and other painful conditions. I believed I would have to relegate myself to doing relaxation massage, that I could only do, "feel-good" work. I resolved, however, to give it my all and deliver the most relaxing, best feeling massage each client had ever gotten. It was at this point in time that my work became most effective. Seated, and spending more concentrated time on a focused area, I came to recognize the subtle changes in the density and texture of tissues.

Painful, elevated TD can absolutely be felt by the therapist. Once a therapist has developed the skill of TD palpation, they can recognize problem areas before the client is even aware of them. It is not a psychic or intuitive knowledge; it is a universally assessable, measurable and documentable state of being which can be determined, recorded, and understood by any skilled clinician. Most importantly, elevated TD is restorable, and, once restored to normal density, pain is relieved and function often returned. This is what successful massage therapists have been doing all along. By narrowing the focus of whichever method we use that effectively restores TD; one can increase positive outcomes dramatically.

I think of the existence of elevated TD as a sort of, "Rosetta Stone." You may recall that it was the discovery of the Rosetta Stone that led researchers to understand the meaning of ancient Egyptian hieroglyphics. Upon it is recorded the same message in two languages using three different scripts, some understood at that time of discovery, the other, hieroglyphic, unknown. To over-simplify it, they were able to plug in what they knew about some of the writing and decipher that which was unknown. The association of elevated TD to a Rosetta Stone comes to mind when I think about conditions we don't understand, for example, the affect weather has on people with arthritis and old injuries. Science tells us that the complaints of pain that occur with changes in weather are subjective, therefore, are simple folklore and can't be proven. But "plug in" elevated TD as a factor, and there is an assessable, measurable, and treatable explanation. And, once recognized, it is undeniable.

Elevated TD results in tissue hardening and contraction, which can form various secondary compartments within the body. Our nerves become caught up in these formations and are subject to the stresses applied to the makeshift walls of these compartments by weather related changes in barometric pressure - similar to the discomfort we experience in our ears with changes in elevation. The severity will depend on the grade of TD involved.

Through the measurement of TD we can now provide consistent, corroborative, objective data about the condition of tissues before and after treatment. Combine that with a client's subjective statements, and the efficacy and benefits of therapeutic massage are provable. There is no longer justification for the benefits of massage to be questioned by doctors, clients or massage therapists. There is no reason left to deny the effectiveness of therapeutic massage, nor is there any acceptable excuse to decline payment for treatments.

Click here for previous articles by Linda LePelley, RN, NMT.


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