The ligaments are one of the most essential mechanisms to address when dealing with lower back pain. Those that run “horizontally” – from the levels of S5, 4, 3, 2, 1 and L5 to the ilium at each vertebral stage – are of special interest. In other words, the sacroiliac and iliolumbar ligaments run at 90 degrees to the erector spinae’s “vertically” organised fascia.
One suggestion and one word of warning:
When a person experiences a low back or sacral spasm, it is most likely that they are experiencing a ligamentous sprain. When a ligament is damaged, particularly in a weight-bearing area, nature organises us so that the muscles spasm in response, adding stability and limiting further movement. As a result, the spasm is a part of the solution. The problem is that the nervous system almost often over-reacts rather than under-reacts (“better safe than sorry”). As a result, judicious therapy will help to induce a more balanced neurological response – and therefore reduce the severity of the compensatory muscle spasm.
One word of caution: if the back pain is too intense or the area feels hot and inflamed to the touch, you should probably refrain from doing the work mentioned below until the person’s body has recovered from the acute inflammation.
Cross-Fiber for the Iliolumbar and Sacro-Iliac Ligaments:
Applying cross-fiber (also known as “deep transverse friction”) to these ligaments is a simple and efficient technique. This necessitates a detailed “collection” of the thickened fascia bands that may be present.
Shift the thumb or assisted first or middle finger up and down (inferior to superior) in the region just medial to the sacro-iliac joint, starting just lateral to the spinous process of S5. You can normally only palpate one finger’s width of ligament at this stage. You can spend up to 10 seconds moving through the grain of these fibres if you encounter a thickening or tightened band (again inferior to superior). To disperse the fibres and increase local circulation, use cross-fiber. You’re also helping to re-weave the fascia so that it’s less loosely organised – similar to how when you roll your hands over a random bunch of toothpicks, they’ll line up perpendicular to the direction you’re rolling your hand in.
Continue to investigate and work with any stress or thickenings you find in this area – at each vertebral stage.
The ilium’s shape and relationship to the sacrum change as you get higher. The more space between the sacral spinous processes and the ilium’s medial border, the better. So, by the time you get to the iliac crest, you might have found as many as six places to cross-fiber through the iliolumbar ligament (whereas, as we said, at the level of S5, you’ll probably only find one fingers-width amount of space).
I recommend taking a “homoeopathic” approach to cross-fibering. I’ve found that if you’re anatomically correct and detailed, you don’t need to apply a lot of pressure or spend a lot of time.
So, here are some essential to-dos and don't-dos to keep in mind
Study these ligaments as well as the low back, sacrum, and pelvic musculoskeletal anatomy.
Examine the ligaments thoroughly.
Don’t overdo it with the cross-fiber frictioning or the palpation.
Don’t apply too much force.
Collaborate on a reciprocal basis, even though the client’s concern is largely unilateral. My left side suffers from a recurring sacro-iliac sprain. I may easily finish the session worse off than I started if the therapist does not function judiciously and bilaterally.
By the way, here’s a funny ilio-lumbar ligament anecdote. I felt a thorn-like projection on the top of my left iliac crest about 2 inches lateral to the sacro-iliac joint as a result of my discomfort. I looked around and quickly found http://sinoemedicalassociation.org/usmle1/usmlemed/usmlemedecine/id22.htm, which explains “The Iliac Crest Syndrome” and a “rose-thorn” spike that is frequently apparent on an x-ray!
Ligaments, which are deeper structures than muscles, play an important role in the transmission of weight and energy through the bones and joints. It’s a relief to realise this and to know that by incorporating enlightened work with them, you’ll develop structural shape and energetic function – with their support!
Side Effects and Risks
Deep tissue massages are not for all, and finding a well-trained practitioner is important to minimise any possible risks.
If you’re recovering from surgery, have nerve damage or an underlying injury, are in a cast or brace, or are pregnant, consult your doctor before scheduling a deep tissue massage.
Although uncommon, deep tissue massage side effects can occur if the deep tissue massage is done incorrectly. In high-risk patients, this may result in increased discomfort, bruising, soreness, inflammation, and other complications.
Where to Look for a Massage Therapist
Are deep tissue massages available at places like Massage Envy? It is dependent on the place and the therapists who work there.
While some massage therapists have a basic understanding of deep tissue massage, it’s better to seek out an accredited, well-trained professional. This is particularly true if you want to use neuromuscular therapy (NMT), which entails deep strokes that target the fragile soft tissues surrounding nerves.
NMT is a form of deep tissue massage technique that focuses on applying manual therapy to soft tissue with “quasi-static pressure” in order to stimulate skeletal striated muscle, according to the Neuromuscular Therapy Center. In addition to deep tissue massaging a painful or inflamed muscle, the area around it that usually supports it is often deep tissue massaged to relieve stress.
Joint pathologies, postural orientation, destructive patterns of use, dietary elements, mental well-being, allergies, and neurotoxins are all variables that NMT therapists consider when treating muscle or tissue dysfunctions.
Several deep massage therapists have received further training in procedures that aid in the treatment of fractures, inflammation, tears, and limitations. While more than one deep tissue massage session is normally needed to provide relief and see changes in pain, well-trained practitioners will usually prescribe at-home practises or stretches to aid in recovery.
Deep tissue Massage therapist certification requirements and legislation vary from state to state (and country to country). Most licenced deep tissue massage therapists must complete an approved massage therapy programme and pass the MBLEx exam.
When it comes to advanced techniques like neuromuscular deep tissue massage, bear in mind that if performed poorly, they can be more dangerous than helpful, particularly if you’re already hurt and trying to recover.
Before the deep tissue massage starts, tell your therapist about your medical history, disabilities, and sensitive areas.
There are now many educational programmes available around the world that include a minimum of 500 hours of basic deep tissue massage therapy training, as well as continuing education credits of up to another 400–500 hours.
Always make sure you’re “in good hands” by double-checking a therapist’s credentials and expertise, explicitly asking about NMT, trigger point therapy, sports massage, pain management, myofascial release, and orthopaedic massage instruction.
Last Thoughts
What is the concept of a deep tissue massage? Firm, manipulative pressure and movement are used in this form of deep tissue massage to loosen deep layers of tissue, including tendons and fascia (the protective layer surrounding muscles, bones and joints).
As compared to Swedish or relaxation massage, deep tissue massage uses more pressure, is typically slower, and can last longer.
