Palpate – Hidden Language
A TABLETOP FOUNTAIN flows. MUSIC “Drake Meditation Spirit” by Lobo Loco begins.
CECILLE moans. Again. And grunts.
CECILLE: Mmm. That feels so good. [PAUSE.] Can you do right here?
BECCA: Mmhmm, yeah. [PAUSE.] My fourteen-year-old son, one day asked me, he said, “Why do you just want to rub on people all day?” LAUGHTER.] And I said, “Ah, son, you have a lot to learn.” My name is Rebecca McKinney, and I am a licensed massage therapist.
INTRO MUSIC begins.
SCOTT: You’re listening to Hidden Language — a podcast about tuning into place, bodies, and time and discovering the unexpected ways their stories can be told. I’m Scott Lunsford.
JAY: And I’m Jay Varner. Today, Scott begins a two-part series on the body language of massage.
INTRO MUSIC fades.
CECILLE: Aye aye aye.
SCOTT: That’s my partner, Cecille, who is on the table, being worked on.
MASSAGE MUSIC begins and continues throughout the episode.
SCOTT: She introduced me to Becca maybe nine years ago — in fact, this past summer of 2021, Becca celebrated her tenth year as a massage therapist. And over the years, I’ve become interested in the connection, the relationship, between the massage client’s body and the massage therapist’s body. Because when I’m on the table, I’ve noticed that Becca — and other massage therapists I’ve had over the years — they tune in to what the client’s body is telling them. Cecille’s grunts reflect points of pain, Becca running her hands over a knot reveals a stress point in that client — and it may be a stress point the client isn’t even aware of. The body — with its connections of tissues and muscles and joints and all that stuff act as a kind of roadmap, a kind of book that tells your story. And your story told through your own body is indeed yours, different from other clients perhaps, because your body has experienced the world differently. And it postures and aches and grunts in its own way.
Becca was working on me recently, and she noticed that one of my legs wasn’t even with the other, one was a little lower than the other. And it had something to do with my back being out of whack. It was a marker that had something to say about me — that maybe I’m not holding my posture right, maybe I’m not sitting on the couch the way I should, watching the news in the evening. And it’s not unlike other markers that we actually consciously adorn ourselves with — like tattoos and clothes and hairstyles and jewelry — these things that we make a conscious effort to express something about ourselves. This is of course not to deny those unconscionable efforts when people have been marked by force, with no choice. It is not to deny anyone their own stories told through their own bodies, no matter how they are born, or how they become, how they identify themselves, how they reclaim control of the ways others try to control them.
So, our bodies tell us things that we may not even be aware of until others, such as a massage therapist, lay their touch on us and feel the contours of our bodies — the text, if you will — reading the narratives of past childhood traumas, or of old sports injuries, of new stresses at work, of new stresses of sitting at home during a pandemic, doing the work differently. And so I simply asked Becca to speak to these ideas: What can the body tell us through touch? How does that work? And then, how does the physical space enhance the therapy — the design of the room, the lighting, the sounds and the silence, the intentional mood of the space? How do these all contribute to the therapeutic communication between one body and another?
But let’s start at the beginning.
A client goes into the room while the therapist waits outside. It’s dimly lit, there’s some ambient music, and a general hum around the room: the air conditioning, a slight ticking of a wall clock. There’s the trickle of a small tabletop fountain. The client gets undressed if they’re comfortable doing so and climbs onto the table, face down, underneath a blanket.
The massage therapist then comes into the room and positions herself beside the client, making sure the client is comfortable.
BECCA: At the beginning of most people’s massages the back is generally what’s the tightest on all of my clients. So I use oil during the massage, but at the beginning I do a dry massage because it really helps the friction with my hands against the skin, really helps to loosen the fascia, which is directly underneath the skin and it wraps around every muscle. And if the faccia loosens up then the muscles are able to relax a little bit better and then to really enhance it I add heat. I do like a wet heat on the back while I work down on the hips and the lower legs or the whole back of the leg and then I come back to the back and it feels totally different, like it really does make such a difference doing a myofascial release and using the heat pads as well. And it helps me be able to feel, you know, just where there’s knots and trigger points and tension.
SCOTT: This initial dry massage gets Becca in tune with how the client’s body is doing. It’s called palpation.
BECCA: So palpation, as a massage therapist, is used primarily by our hands and our fingers to feel the condition or the state of someone’s muscles or soft tissue, fascia, what be it, that we need to know if there’s a problem in a specific area. So it really helps us decipher if there’s an issue. So somebody complains of a specific issue on the back, that’s automatically, as a massage therapist, our only way of knowing is by palpating that area and we’re trained and our fingers becomes super sensitive to feeling underneath the skin’s surface, whether it be superficial or deep layers, we’re able to feel and navigate to see if there is an issue there and the surrounding area too. Or if the client doesn’t complain about it and we feel it ourselves, I’ll go, you know, “It feels like you may have a spot here. Does this hurt?” So, you know, so we can even tell by palpating without the client having to let us know that as well. So it’s our main way of navigating the body and finding out where the issues may lie. I will never forget in school, in training in massage school, one of the instructors said, “Can’t you feel this? This is what faccia that’s adhered feels like. There’s an adhesion here” — you know, and I was like, “I have no clue what you’re talking about.” I could not feel it, and she said, “Well, it kind of feels like crinkly paper.” And I tried to feel it, and I kind of felt it a little bit, and now if there’s even the slightest bit of adhesion in the faccia or if there’s the slightest little knot that’s the size of a pea, my hands over 10 years of doing this had become so sensitive that it’s amazing that in my brain immediately like, you know, there’s a problem here, and I used to not be able to feel that at all so it definitely built up sensitivity over the years.
SCOTT: Okay, let’s get a definition here. She keeps talking about fascia. The only fascia I know is those boards around the roof of my house.
BECCA: Underneath the surface of the skin, directly under the skin, there is a connective tissue and it’s called fascia. And the cool thing about it is that it is not wrapped around each individual muscle. There is one sheet of fascia wrapped in our entire body. It binds all the muscles together in our entire body. So that’s why it’s super important for us to feel that initially because . . . another analogy is that if you put a rubber band around a t-shirt, it pulls all the fabric in towards the rubber band. That’s the exact same scenario as fascia. So, if there’s an injury and there’s an adhesion, it’s gonna pull the muscles around that in towards the injury and cause more inflammation and more damage. It’s like a domino effect. So by going in and kind of pushing that out and getting the wrinkles, for lack of a better term, out it helps free up the muscles and it doesn’t make it all so congested in that specific area of injury.
SCOTT: So, I like this idea about the hands having this way of navigating the body to determine what’s going on — this palpation — like a roadmap. And do you hear her describe the fascia sometimes as crinkly, as crinkled paper? There’s a British osteopath, Leon Chaitow, who says that “We need to unleash a torrent of descriptive words for what we feel when we palpate” and “to obtain a thesaurus and to look up as many words as possible to describe accurately the subtle variations in what is being palpated.” So, what he’s describing here is a palpatory literacy — actual ways of knowing and talking about the body and its therapy that help therapists and their clients understand the problems of the body. And sometimes in very mundane ways, like crinkled paper. Crinkled paper is a great way to describe to laypeople how muscles feel.
But it is in the hands where the narration begins to be read, where everybody’s body — every body — presents a text, tells a story about itself. Where the hands are listening, just as much, if not more, than the ears, interpreting a story as we would with other senses.
BECCA: And if I find a spot like this, it feels tight to me, and then she made a noise to confirm the tightness. I just hold it and generally she was, she breathed on her own, and most people actually do that. It’s just maybe a natural response and if they don’t I remind them to take a deep breath and it calms everything and just helps the muscle let go.
Basically a knot is muscle fibers that are tight for one reason or another and I manually go in and break up where the muscle fibers are spasmed and then once they’re broken up it really helps bring fresh oxygenated blood to it to heal it more so, because when there’s a knot no fresh blood can really get into the area to heal it so manual manipulation is key.
It’s amazing the connection with our muscles and our brains. If I were just to go in and dig in with my elbow and go in really intensely the message to the brain will say, or rather, the message from the brain to the muscle will tell it to tighten up ‘cause it defends itself that way. So I have to be really careful to go in gently and work superficially until their body trusts me and until the person trusts me too, and they’re able to relax because a relaxed muscle is what I need to work on to make it better.
I do find that if somebody comes in here for the first time and this is almost always, you know, we’re strangers, we don’t know each other, and they’re very vulnerable. I mean, they come in and lay on the table and have me work on their body. So generally the first massage is just an introduction massage and I kind of get a feel, literally a feel, for the person’s body, but I’m really careful with what I do until I kind of understand the person a little bit better and sometimes that’s without words and sometimes it’s with words too — without words meaning if their muscles are all really tense and tight and maybe they’re stressed or maybe there have, you know, they have a lot going on in their lives or they feel uncomfortable laying here, so I have to kind of navigate that and figure out how to help them relax. And then once they gain that trust and their minds are relaxed and their central nervous systems are relaxed then I can get into the muscles a lot better. And it can take some people a while and a lot of that can be due to, you know, some kind of trauma, they were touched inappropriately, had some kind of abuse, and it can take a while to break through to be able to gain the trust of that person but once they do they are so grateful for it ‘cause it’s what they’ve needed for a long time.
Often times, I could almost, I can almost always tell maybe what someone’s job is or how stressed the person gets or, you know, if there’s an injury in an area because there are parts of the body that are really tight and then the rest of the body feels great and so if I would say for example, you know, I have somebody here that sits at a desk all day and it’s their upper back and their neck, I will actually say, “You must have a desk job.” And they’ll say, “How did you know that?” And I’ll say, “Because of where your muscles are tight.” You know, so it really does, every — and I think I had told you this before — every body, every physical body has a story for me and I try, I really try to assess it — that’s what that first session is really important for — sorry, I dropped a little bit of lotion, I’ll get it up, there we go — and it really, it really is cool, because my hands has become so sensitive, I mean, so sensitive to where when I even go to open up like a peanut butter jar lid, just the little ridges on it, I never would have noticed that before. But my fingertips are so sensitive from feeling people’s muscles and what’s under the skin that, I mean, I can tell, I can pinpoint the areas and I’ll have people go, “How did you know to work there?” or “How did you find that spot?” or “I didn’t even know that spot existed or that it hurt.” And so it’s kind of cool that it’s just feeling that can correlate that message to my brain that I need to work on that spot longer or focus on it or pinpoint that particular muscle.
[TO CECILLE]: Is it okay?
CECILLE yells in pain.
CECILLE: Oh my gosh!
CECILLE: Oh, that hurt.
BECCA: Just that?
CECILLE: Oh, my gosh.
BECCA: It was that tight?
CECILLE: That was weird.
BECCA: That was, because I barely even palpated it.
SCOTT: You’ve been listening to Hidden Language. Music for this episode was written by Lobo Loco, Blear Moon, and Edoy. Our theme music by Jay Varner. For a list of episodes, transcripts, and show notes, be sure to visit hiddenlanguagepodcast.com. And if you enjoy this podcast, please spread the word using whatever language you see fit. Stay tuned for the second part of this episode when I’ll be on the table, talking to Becca about music, sound, and silence of the massage room. See you then.
OUTRO MUSIC ends.
Chaitow discusses his idea of palpatory literacy in Palpation Skills: Assessment and Diagnosis Through Touch, published by Churchill Livingston.
Music was provided by the following artists through Freemusicarchive.org, with the respective Creative Commons licenses.
“Drake Meditation Spirit” by Lobo Loco, CC BY-SA 4.0
“Jaeger’s Cape” by Blear Moon, CC BY-SA 4.0
“Waiting” by Edoy, CC-BY 4.0
“Gone” by Blear Moon, CC BY-NC 4.0
“Chod” By Blear Moon, CC BY-NC 4.0
“Arctic Fog” by Blear Moon, CC BY-NC 4.0