Massage Techniques – Distraction and Approximation

Overview This post briefly discusses the concepts behind distraction, approximation, decompression, and unwinding. This discussion is primarily about reestablishing joint play but also applies to techniques like diaphragm releases. It may be useful to read the post on Joint Play and Mobilizations. As well, it may be helpful to review this post on direct and indirect techniques. Distraction of the Acromioclavicular Joint Distraction Distraction occurs when structures separate so that soft tissue lengthens. For example, distraction is common in techniques that stretch tissues across a joint by pulling the adjoining bones away from each other. As a result, it lengthens the surrounding tissues. Most massage and bodywork regulations prohibit high-velocity distraction. However, some Muscle-Energy-Techniques have abrupt end-movements. On the other hand, brief releases of less than 20 seconds are standard, for instance, in sutural work. As well, practitioners implement long releases. These extended releases may lead to unwinding. The distraction of joints is a staple of this approach to free joints that are binding. Proprioceptive input detects binding joints and perpetuates trigger points in muscles that cross that joint. Consequently, this is a quick, easy, safe, and effective tool. Approximation of the Mandible Approximation Approximation brings structures together so that soft tissue shortens. It seats the articular surfaces while reducing tension in the surrounding soft tissues. An example of this in craniosacral techniques is the compression of the mandible before decompression. It seats the joint and allows tension to dissipate around the joint through indirect technique. Seating the joint creates better neurological organization so that reflex arcs that perpetuate spasms reset. This process helps to break the pathological reflex arc. Indirect technique uses approximation to release neurologically shortened tissues by holding them in a more shortened state. The nervous system perceives the shortening or spasm as no longer needed for protection and changes neurological control. Decompression Decompression is a particular form of distraction that loosens the entire structure by separating the attachments of soft tissues. Decompression techniques have indications that are more general and have a larger scope of impact. Although they are simple and part of fundamental skills, they are easy to underestimate. Decompression is a forgiving technique for the practitioner. Gentle decompression releases the shortest fibers when many soft tissue components cross a joint. When that releases, the following shortest fibers release, and so on. This approach helps balance structures without singling out and directly releasing the most restricted soft tissue. It is also useful when the practitioner is unable to work soft tissues directly. For instance, temporal decompression (ear pull) allows the practitioner to release the falx and tent with decompression. Decompression often leads to unwinding. Unwinding the Glenohumeral Joint Unwinding Unwinding is a sustained technique that allows the fascia to release in its novel pattern. This approach can be a part of distraction, approximation, and decompression. Unwinding is particularly interesting to the practitioner that prefers indirect techniques. Often, Diaphragm releases involve following the direction of ease. Then, when that release finishes, the practitioner follows the next direction of ease. Unwinding often involves the subtle perception of tension in the tissue. Often, unwinding occurs when the practitioner decompresses a complex structure, like the atlantooccipital joint or the lumbosacral joint. For example, instructors and practitioners often perceive the movement of the fascia around a vertebra distal to the point of contact. Once the vertebra settles, the practitioner may find another vertebral complex that unwinds. Sutural distractions can be more effective and complete with unwinding. In addition, changes in the craniosacral cycle often aid in unwinding structures that restrict a specific suture. By the way, this is part of biomechanical craniosacral. On the other hand, in biodynamic craniosacral, it is the cycle that changes the suture. Other components of mobilzation It is notable that joints may be released by other lines of a drive. In the picture above, the humeral head is released by mobilizing it posteriorly in the socket. This mobilizes the joint, lengthens soft tissue, and releases restrictions. However, this movement is not approximation, distraction, unwinding, or decompression. At times, it may be best to spin, rotate or glide the joint, based on assessment and objectives. See Joint Play and Mobilizations. It is worth noting that these motions are independent of voluntary movements such as the flexing of the elbow. It is also worth noting that approaches often have a strong position about unwinding, direct and indirect techniques.

Massage Techniques – Distraction and Approximation

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