By Barb Frye
Originally published in Massage Bodywork magazine, July/August 2010. Copyright 2010. Associated Bodywork and Massage Professionals. All rights reserved.
Think about how often you reach during the day. Without this function, your interaction with the world would be very limited. Reaching is such a common movement that we're hardly ever aware of how we reach, but only of what we reach.
As a manual therapist, you spend most of your time reaching to perform your work. In other words: you reach, you undrape. You reach, you lubricate. You reach, you apply pressure. You reach, you traction. You reach, you drape. Who knew there was so much reaching going on!
Your shoulder girdle, for the most part, initiates the movement of reaching. Although it is a highly mobile joint, it has little stability in certain positions. Consequently, overexertion and repetitive movement can lead to shoulder inflammation or injury.
As a manual therapist, if you principally reach from your shoulder, you risk developing a habitual pattern in which you continually overexert your shoulder's soft tissues (Image 1). This can lead to chronic tension and possibly thoracic outlet syndrome, a condition in which the brachial plexus nerves, C5-T1, in the thoracic outlet (the space between the first rib and clavicle) are compressed and/or impinged. Repetitive tension in the shoulder girdle can also lead to an overexertion of the muscles and other tissues of the arm and hand. With this kind of poor body mechanics, it is easy to understand why so many manual therapists suffer from shoulder, arm, and hand pain and injury.
The healthful alternative is to initiate reaching from the whole body, specifically from your pelvis, legs, and feet. Reaching with the whole body supports the action of the shoulder joint and improves reaching performance. When you include your lower body in the movement, you carry your center of weight forward and toward the focus of your reaching (Image 2). Your shoulder in this case is not generating the effort, but rather is transferring the effort generated by the lower body. This greatly reduces the chance of overexerting the soft tissues of the shoulder.
Reaching With The Whole Body Reduces Shoulder Stress and Effort
Action. Stand comfortably and reach your hands out in front of you.
Feel. Notice from where the movement is initiated.
Ask. Do you move first from your shoulders? Your elbows? Your hands? Do you move first from another part of your body? If so, where?
Rest for a moment.
Action. Begin again, reaching out with your hands. This time purposely initiate the movement from your shoulders (Image 3). Make slow movements so you can pay close attention to how this feels to you.
Feel. Notice how your shoulders respond.
Ask. Do you feel tension or effort in your shoulders? In your neck? In your upper back?
Action. Begin again, reaching out from your shoulders.
Feel. Notice how this feels in your chest.
Ask. Do you feel effort in the muscles of your chest? How does reaching from your shoulders affect your breathing? Are you able to breathe normally without restricting your breath?
Feel. Notice how reaching out from your shoulders affects the rest
of your body.
Ask. Do you sense how your lower body is "left behind" in the movement? Do you feel tension or effort in your low back? In your knees or your feet?
Action. Now, stand in a one-foot-forward stance. Begin again to reach your hands out, but this time initiate the movement with your entire body. Slightly bend your hips, knees, and ankles, moving your lower body forward as you reach out with your hands. Have the intention of supporting the movement of your shoulders, arms, and hands with your center--your pelvis (Image 4).
Continue reaching out in this manner, each time feeling how you can involve more and more of yourself in the movement. Try pushing your back foot into the ground as you move forward to reach. This can increase your overall support and strength throughout the reaching process. Many therapists feel this grounding.
Action. Continue again, reaching out with your whole body.
Feel. Notice how your shoulders, back, and chest respond to this way of reaching.
Ask. Do you feel less tension or effort than before? Do your shoulders feel more flexible, yet stable during the movement? Do you feel less tension or effort in your neck? In your upper back? In your chest? How does reaching from your entire body affect your breathing? Are you able to breathe normally without restricting your breath?
Feel. Notice how reaching in this way affects the rest of your body.
Ask. Do you sense how your lower body supports the movement forward? Do you feel less tension or effort in your low back? In your knees and feet? Do you feel how your back foot can help push you forward?
Reaching with awareness, by involving your entire body, will increase your effectiveness not only as a manual therapist, but in everyday activities as well. It will also protect your shoulder joint from chronic tension and prevent possible injury.
Give yourself some feedback. How did reaching with your entire body affect the quality of your movement?
Barbara Frye has been a massage educator and therapist since 1990. She coordinated IBM's body mechanics program and authored Body Mechanics for Manual Therapists: A Functional Approach to Self-Care, 3rd ed. (Lippincott Williams Wilkins, 2010). She has a massage and Feldenkrais practice at the Pluspunkt Center for Therapy and Advanced Studies near Zurich, Switzerland. Contact her at email@example.com.