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Massage Today
May, 2004, Vol. 04, Issue 05

The Art of Palpation

By Michael McGillicuddy, LMT, NCTMB

I remember learning 20 years ago in massage school that therapists could specialize in working with athletes. Since I lived in Florida and spent most of my high school years playing whatever sport was in season, becoming a sports massage therapist was a no-brainer for me.

Additionally, I learned that working with people who were active was a lot of fun.

It is a lot easier to discover where the body is most likely to develop aches and pains when you work with active people; however, you soon learn that applying Swedish massage strokes in the order you learned in school is not usually satisfying to most athletes. The great thing about being a massage therapist is that you get immediate "feedback" from your hands as to what tissue feels like; based on this feedback, you move from one massage stroke to another to get the greatest effect.

Years ago, I took a sports massage workshop with Jack Meagher. He had written a book, Sports Massage, in which he described the common sports massage techniques and the texture of healthy and injured muscle tissue. I read the book before attending the workshop, but it did not make much sense to me. Being in the workshop and watching Jack work made all the difference in the world. He would actually take your hand and position it so you could feel the texture of the tissue he was describing. All of the sudden, the light turned on for me! Sometimes I think one of the things missing in our profession is a universal vocabulary that describes the texture of tissue. We should be able to describe what healthy and unhealthy tissue feels like.

I usually describe healthy tissue as feeling smooth and consistent. Jack described unhealthy muscle tissue as muscle that felt like it had a piano string running through it. Sometimes, just a few strands of muscle fiber will remain in spasm giving the muscle a "piano-string" feeling. At other times, the whole muscle will become hypertonic and feel thick or ropelike. Some muscle tissues become inflamed, which causes them to feel spongy. Each of these muscle problems would require the application of a different sports massage technique to resolve the problem. The ability to palpate the texture of tissue is a skill a sports massage therapist must develop in order to achieve excellent results.

So, how do you get to the point where you can "feel" the texture of tissue? Having a highly skilled massage therapist as a teacher sure helps. Developing a skill usually takes a lot of practice, and it usually requires working on numerous people for experience in comparative assessment. Working slowly with your eyes closed while applying a specific technique on a specific muscle, also helps a therapist focus on what the tissue feels like. And asking for feedback from the athlete can help the therapist zero in on the specific texture of tissue. After practicing techniques this way for a while, I believe a sports massage therapist begins to "see" with the fingers.

A sports massage therapist that has developed very sensitive palpation literacy is often asked, "How do your hands know exactly where to go?" Most athletes sense this skill very quickly in a therapist, and this tells them that the therapist knows exactly what he or she is doing. Surely palpation literacy is not the only skill required for a sport massage therapist to provide effective treatment, but it is one I think should be high on the priority list. I hope this information has been helpful, and that you enjoy being a part of the massage therapy profession.

Click here for previous articles by Michael McGillicuddy, LMT, NCTMB.


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