Kinesiology For The Massage Therapist

Understanding human movement is crucial for massage therapists, especially those specializing in pain and injury. This scientific study of movement, known as kinesiology, forms the foundation of orthopedics, the medical field dedicated to addressing issues within the body’s movement system. In school, your kinesiology study may have focused on memorizing muscle actions. The value of learning about kinesiology extends far beyond that and will significantly enhance your clinical success.

Kinesiology can be split into three distinct disciplines:

• Musculoskeletal anatomy- the study of structure and form
• Neuromuscular physiology- the coordinated activities of the neurological and muscular systems that govern movement
• Biomechanics- principles of mechanical physics applied to the human body

Let’s look at these areas and how their study relates to practical clinical applications of massage.

Musculoskeletal Anatomy

Massage school training heavily emphasizes anatomy, often perceived as mere memorization without practical context. Yet, understanding the body’s structure and function is crucial for identifying the tissues involved in a client’s pain and determining the most effective treatment strategies. Kinesiology enriches this understanding by highlighting the interplay between tissues and physiological processes. While massage education prioritizes muscles, it often overlooks other pain-related structures like ligaments, tendons, and nerves. Applying kinesiology expands our perspective to consider numerous potential causes of movement-related pain. That keeps us from getting stuck in our muscle silo.

Clinical Applications of Anatomy

Applying sound anatomical knowledge offers numerous benefits. Understanding the underlying structures is essential when a client indicates a pain point. Similarly, suppose a client has experienced a biomechanical injury, like a forceful impact on their shoulder during a sports collision. In that case, it’s crucial to identify which structures absorbed the impact and are likely affected by the injury.

Neuromuscular Physiology

Anatomy explores structure, while physiology delves into function. Proper movement hinges on the seamless coordination between neurological and muscular systems. Motor activity is initiated by outgoing neurological signals, with incoming signals providing crucial movement feedback. In kinesiology, understanding neuromuscular physiology starts with recognizing three muscular contraction types essential for movement:

• Concentric contractions: Muscles shorten as they contract, typically during acceleration, to overcome forces like gravity.
• Eccentric contractions: Muscles lengthen under contraction, often during deceleration or resistance to gravity.
• Isometric contractions: Muscles contract without changing length, stabilizing limbs, or resisting force, such as maintaining an upright posture against gravity.

Proprioception, a critical aspect of neuromuscular physiology, informs the brain about the body’s position in space and the condition of tissues involved in movement. While primary senses like sight and hearing provide substantial sensory input, the central nervous system receives the most sensory information from myofascial tissues. (1) The effectiveness of manual therapy may primarily stem from neurological reactions to the pressure, movement, and tactile quality of treatment, as monitored by proprioceptors that provide feedback to the central nervous system.

Clinical Applications of Physiology

Regrettably, the recognition and understanding of various muscle contractions are frequently reduced to mere memorization, only to be later neglected. Understanding the contractions involved in different movements is crucial for identifying how muscle overload might lead to injuries. Familiarity and comprehension of these contractions are essential for effectively employing multiple treatment and assessment techniques that depend on them.

Biomechanics

Biomechanics is the application of mechanical physics to living organisms. It’s often confused with body mechanics, but the two differ. Biomechanics broadly applies mechanical physics principles, while body mechanics refers explicitly to how the body is utilized during massage treatments. Although biomechanics contributes to the study of body mechanics, they are distinct disciplines.

Biomechanics can be divided into two separate categories: kinematics and kinetics. Kinematics focuses on movement through space, involving velocity, direction, and the concepts of acceleration and deceleration. On the other hand, kinetics examines the forces and energy that create or constrain motion. Kinetic analysis involves the application of these key concepts:

• Inertia: The tendency of an object to maintain its state of rest or uniform motion unless acted upon by an external force, as per Newton’s first law.
• Mass: The matter within an object, where even small objects can have significant mass, e.g., a shotput versus a softball.
• Force: The effort needed to change an object’s motion, including acceleration or deceleration. Five types of forces are considered in the body, with compression and tension being the most common causes of soft tissue injuries:
  • Compression: When two objects press against each other, like vertebrae compressing a disc.
  • Tension: When forces pull on either end of an object. Tension forces on soft tissue can lead to strains or sprains.
  • Torsion: When an object is twisted, that is a torsion force. Because soft tissues are attached at each end within the body and under the skin, it is hard to apply a torsion or twisting force to them. However, you could also consider a torsion force applied to a larger structure, such as an entire joint.
  • Bending: A bending force applies to rigid structures when one side is exposed to compression and the other to tension. Bending force requires a rigid structure, so it only applies to bone.
  • Shear: Occurs when two structures slide against each other, such as tendons moving within synovial sheaths.

Understanding these concepts is crucial for analyzing and addressing movement and force-related injuries in clinical practice.

Clinical Applications of Biomechanics

It may not be immediately apparent, but all the physics involved with a kinetic analysis can be crucial in understanding what is involved in a particular injury. Kinetic analysis may also help you understand how the forces we apply to a client’s body affect the tissues under our fingers. It may seem a little daunting at first. Still, when you can begin to look at the body and how we work with it through a lens of kinetic analysis, you gain an appreciation for how this information can significantly enhance your clinical success.

Putting it Into Practice

As you can see, not only is kinesiology a much broader science than you may have realized, but it is an integral part of becoming a highly skilled soft-tissue therapist working with pain and injury complaints. An arsenal of techniques is essentially your bag of tools. However, even with a great bag of tools, your work will be so much less effective if you don’t understand when to use a wrench, when to use a screwdriver, and how much force to use when you apply it. This type of detailed analysis is super helpful in the detective work of identifying soft-tissue injuries. I have found it invaluable in addressing pain complaints with my clients.

Want to learn more about how to practically apply kinesiological principles in your practice for greater client outcomes? Check out our Orthopedic Medical Massage Courses to help guide you along the path!.

References

1. Schleip R. Fascial plasticity – a new neurobiological explanation. J Bodyw Mov Ther. 2003;7(1):11-19.