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The Case For Consistency

There are about as many categories of soft tissue dysfunctions that we might see in our careers as there are types of nut butters in the grocery store these days. We cannot expect to know them all when we walk out the door of massage school in into our first years of practice. Or, perhaps ever for that matter. It can get a tad overwhelming, of course. There is the sports injury, the car accident injury, the work injury, the over doing it injury, the under doing it injury, the poor nutrition injury, the under hydrated injury, the no sleep injury, the yelling at kids injury, and, most recently, the quarantine injury. (This last one includes grey hair and wrinkles which I only wish could be treated with massage.) Thankfully, though, we can narrow this down a little and talk about a subcategory that falls under all of these headings - the persistent injury.

As bodyworkers, we know that our work is not a one-visit and done type situation. The work we do involves changing the way tissues operate and this is no quick fix. Receiving bodywork is like going to the gym - you are not going to get buff after one visit. You are also not going to be a good artist or writer or musician or ostrich farmer after one attempt, either. These things take practice. And so does healing.

Let’s take a hard look at Plantar Fasciitis. It is something we see quite often in our clinics and on our tables. It is a soft tissue injury that typically comes from overuse or improper footwear. And it is theoretically treatable with the right techniques. Why, then, does is persist? Like the skin from a clove of garlic that insists on sticking to the garlic, and then the knife, and then to your finger, Plantar Fasciitis stays clinging to your client’s foot like its on a mission. It has the tenacity of a child on Christmas morning. And when we are dealing with a tenacious tormentor, it takes an equal amount of tenacity to confront it.

If you think about it, Plantar Fasciitis is the combination of muscle tissue that is pulling in one direction and connective tissue that is straining to give us some sort of stability. It’s kind of like a magician trying to yank a table cloth out from under some dishes, except we are the dishes and the tablecloth is glued to our feet. There are a lot of things happening here that are screaming dysfunction. The main focus, though, is that the muscles won’t stop yanking and the connective tissue won’t stop sticking. Which is a good thing in the end. They are doing what they are supposed to do. But how do we deal with them when they just don’t know when to stop.

The answer lies in the simple truth that, to be good at anything in life, consistency is everything. In healing, this is especially true. We commonly talk about the importance of practice when learning a new skill. But we don’t often experience this in how we heal. We are very used to the quick fixes of modern medicine - the shots and pills that numb the pain. This makes learning how to move through pain a little like trying to speak Russian only after watching a few Russian TV shows. If we are given the tools but not taught how to use them, giving up becomes awfully appealing.

A massage therapist might be technically gifted and utilizing incredible skills to work through Plantar Fascia with a client. There might be intricate detail in the muscles of the calf and steadfast patience when manipulating the various elements of the foot. There might even be fancy tools or soothing oils handled like a chef at a Japanese Steak House. But unless we teach that client how to incorporate these magic tricks into their lives, they will just end up where they started: in pain and unhappy.

Giving a client homework has never been a strong suit for bodyworkers. The idea of telling someone what to do seems to go against the very grain of everything wholistic. The reality is, though, that we are responsible for teaching self care. Walking them through the details that will keep their tension at bay is more beneficial than any extravagant technique. Assuming they know what to do and that they will actually do it is on par with feeding your 8-year-old Mac and cheese and then believing he can make it for himself next time.

Try this: Allot time at the end of every session to sit with your client and walk them through exactly how to work on their own calf and stretch their own foot. Offer them options of how to stretch, like hanging their heel off of a step, and choices of how to self massage, like using their knuckles if it is too difficult with their thumbs. Be sure, though, to not allow much leeway when it comes to how often and how long these take place. This need to be set in stone. Lay out a regimen that they can follow. Include how often, how long, times of day, and frequency that they will be utilizing your suggestions. Emphasize, in each of these layers, the importance of consistency. And then, be sure to schedule a follow up session. Make sure they feel that you are in this journey with them - that you are as invested in their health as they are.

Once they have left your office, set a couple of reminders for yourself to check in with them before they return. Exemplify what constancy means. This will reinforce all the work you have ignited. Their practice and energy will be the missing element towards what it truly takes to heal.

Dr. Strange: “How do I get from here to there?

Ancient One: “How did you get to reattach severed nerves and put a human spine back together bone by bone?”

Dr. Strange: “Study and practice. Years of it.”

-Marvel’s Dr. Strange


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