What do we mean when we (therapists) say tight?
Words can be truly misleading and thanks to the internet the access of confusing and conflicting information is at our fingertips.
I haven’t been able to work for several weeks now and it has given me a usual amount of free time. I have done some study and must say, the information out there is so confusing. I think a major issue we have is the language therapists use. Some is just outdated and even I am in the process of adjusting my website and social media platforms to reflect the change.
We say words like “tight”, but do we mean tight?
I think tight is more of a feeling than a muscular description. It is a universal word that therapists and patients alike can refer to. I have felt plenty of ‘tight’ shoulders that have great ranges of movement so how can they be tight?
Tight for me is a word that means: Inhibited, painful, loss of power, overworked, underworked, tender to the touch, increased tissue tension and finally – listen to what your patient is saying. If they are describing something as tight, ask yourself why? The feeling of tightness is a symptom and not a cause.
The word tight also relates to you and your mental state. Are you emotional? Your shoulders feel like they are stuck to your ears, so you come in saying I feel tight.
I think that there will always be conflicting information regarding massage and other manual therapies. For years I have leaned towards finding what works for you. If cupping, needles, tape, manipulations, massage and much more works for you… isn’t that enough?
Sports Massage – “How can you feel what I feel?”
I would say around 80% of people who come in to see me are in some degree of pain. About 20% of these people are in a lot of pain. They struggle to sleep, walk or get out of a car. Now, if after some manual therapy and homework to do every day, they improve; I tend to class that as a win.
I am confident in my manual therapy and my general approach towards patients. I take pain seriously and understand only too well the physical and mental effects having an injury can have.
Following a history and physical assessment, we start to build a picture. Occasionally patients ask how I can feel where the issue is? My answer:
“I hope I can, but I do not rely on my palpation alone. You came in with a back problem. Indicating muscular and not neurological. We did a history and that told me you sit for long periods, have young children and are moderately active in the gym and run. When we did the assessment, I noted one side of your hip drops more than the other, you have poor flexibility at major joints, even with passive movements and you have terrible balance.”
Now the above statement has given me a few physical things I can assess further and aim to treat during the session through ‘sports massage’. It has also given me targets to set for you to change at home. All of this combine is hopefully what get the issue better and stops it from coming back in 6 months.
I strongly believe that you have to make multiple changes not only during a session but the other 166 hours of that week. I am not magic, and even though, jokingly some of my patients say my hands are, they are not.
Overall I think you have to build trust in your patients and let results speak for themselves. I have never shied away from referring patients on to different therapies. Simply one person can not treat it all. However, if you are a patient and the language we use is confusing then please do question us. Many of us have studied for a long time and can give explaining things further a chance.
As always, if you have any issues or questions please do be in touch.
JM Sports Massage