by Kathleen Gramzay, LMT, NCTMB

Kinesiology, the study of human motion, is a vast and fascinating subject. In healthy individuals movement is effortless, and largely unconscious. We wake, sleepily make our way to the bathroom, brush our teeth, shower and move through our days with little thought given to our vehicle that is the body. The body is designed for movement; and the health of each system and the body as a whole, is predicated upon it.

Movement in the body occurs through the kinetic chain comprised of the nervous, skeletal and muscular systems. For fluid movement to take place, each component must perform its role seamlessly interacting with its counterparts to perform the multiplicity of actions required to comb our hair, reach cereal in the cupboard overhead, or place an item in the back seat of our car. Each segment of the chain is independent, interdependent and highly adaptive.

In essence, the nervous system serves as the relay system of the kinetic chain. The Central Nervous (“CNS”) system acts as general processor of neural information. The Peripheral Nervous system (“PNS”) acts as a two-way carrier of impulses from sensory (afferent) nerves in skin, muscles, tendons and joints to the CNS, and motor (efferent) nerves conduct impulses from the CNS to the skeletal muscle fibers (Floyd and Thomson, 2007).

The skeletal system with its bones, ligaments and joints acts as the scaffolding of the kinetic chain. Its role is to provide attachment sites for muscle tendons, and serve as levers in the kinetic chain equation. Joints are the fulcrums across which movement occurs, in three cardinal planes around an axis.

The muscular system is the force that moves bones (levers) across joints (fulcrums). Muscles apply force via insertions to their bones to cause, control or prevent movement in the joints they cross. Typically, it is only when movement is restricted, impeded or painful that it comes to conscious awareness. It is then clients seek our services.

In massage, a common use of kinesiology is for Range of Motion (“ROM”) assessment. This yields information such as which muscles or muscle groups are involved, which muscles may be locked short or long, which fascial lines may be restricted, where pain is felt on the movement spectrum, etc. After application of massage techniques, ROM assessment is used again for comparison purposes and as a tool for client awareness and validation of the efficacy of the techniques applied.

Another exciting opportunity for the application of kinesiology is to make use of the body’s design for movement as the treatment/method of massage itself. I began exploring this as a beginning therapist when I found myself challenged to work with large, heavily muscled clients with only Swedish and Deep Tissue as my only tools. I realized if I didn’t find a smarter way to work, either I wasn’t going to be effective or my body would not be able to bear the brunt of the work to produce the results I wanted for my clients.

Kinessage® Massage Through Movement is a new and unique method developed and applied over 12 years in my massage therapy practice. Kinessage® incorporates movement, myofascial release, on-body anatomy shorthand and stretching to do the work so you can save your body and energy while being more gentle and effective with your clients. These principles are also applied very effectively for self-care for therapists. In fact, the initial movements of Kinessage® came about through my resolving how to relieve my own pain from working in that first year of practice. Kinessage® Self Care is also easily taught to clients, and is an excellent aid particularly for clients with chronic muscle tension, to help retain their gains between appointments.

Traditionally, it has been common to use force or more pressure to work deep. Using an elbow to work deeper layers may achieve a result in the tissue, but at what cost to the therapist? Instead of using force, Kinessage® uses physics, the extraordinary communication system of the kinetic chain, as well as its individual components, to effect change in the tissue rather than the therapist’s physical effort.

The body already has everything it needs for perfect movement. By understanding how each component of the kinetic chain works independently and in co-operation with the other components, simple movements can be used to effectively and kindly clear excess tension patterns and reset muscular balance. What’s even more fun is that in Kinessage® these same concepts are extended to include the therapist’s body in the work. HOW the therapist moves then becomes an integral component of the treatment yielding greater ease, better body mechanics, more energy, and less opportunity for therapist injury!

To understand how this works, let’s start by looking at the communication exchange between the Central and Peripheral nervous systems where individual afferent receptors each have their own jobs.

Mechanoreceptors such as Meissner’s corpuscles, Merkel discs, Type II Cutaneous and Pacinian corpuscles monitor touch and vibration in the skin and just deep to it. Type II Cutaneous and End Organs of Ruffini monitor pressure in the subcutaneous tissue and around joints, tendons and muscles.

Proprioceptors are my favorite because they relay information about their structures relative to body position, muscle tension, position and activity of joints. Together they serve as a system of coordinates used by the brain to plan and execute movement (Floyd and Thomson, 2007).

* Muscle Spindles monitor muscle fiber length 
* Golgi Tendon Organs monitor amount of muscle tension 
* Articular (joint) receptors monitor pressure, acceleration/deceleration and joint strain. They provide continual feedback about position of body and limbs, joint angle and rate of movement. The brain integrates this feedback to automatically adjust motor units to provide appropriate muscle tension to perform the desired joint movement (Smith et al., 1996). 
* Nociceptors – pain receptors, are free nerve endings which are main peripheral receptors of the pain analyzing system (Turchaninov, 2000). They are activated by noxious stimuli, that which may cause tissue damage. 

In Kinessage® the idea is to stay under the radar of the nociceptors and not activate them so that guarding during, or soreness after treatment is, mitigated. This makes for a massage that feels great and is extremely effective because without contrary signals and effects from nociceptors, the tissue releases and the therapist easily works deeper as the tissue allows.

Next let’s look at the skeletal system. The skeletal system’s gift to easier work is its lever system. Levers are used for one of three things and are numbered by class (Floyd and Thomson, 2007).

Class 1: To balance multiple forces – like a see-saw. 
Class 2: To enhance force in order to use less total force to overcome a greater resistance – like using a wheelbarrow in your garden. The amount/weight of mulch moved is far greater than the muscle force used to push it. A Class 2 lever in the body is plantar flexion of the ankle to stand on your toes. Class 2 levers are designed for force/strength and offer the greatest mechanical advantage – definitely my favorite lever! 
Class 3: To enhance speed and range of motion to move a resistance farther or faster – like hitting a ball with a golf club. It goes farther with the club than if you threw it by hand. In the body, most levers are Class 3. Designed for power, Class 3 levers are used in throwing, catching and running. They come in pretty handy in feeding ourselves too. 

Leverage is the mechanical advantage gained by a lever. To a great degree, a muscle’s force/strength and range of motion/power is determined by its leverage. There is also an inverted relationship; in exchange for range of motion/power, force/strength is sacrificed. In exchange for force/strength, range of motion/power is sacrificed.

So even though the body is primarily Class 3 levers perfectly designed for speed and range of motion in daily activities (not to mention a full day of clients), its cost is muscle energy. In doing massage, using (or becoming) a Class 2 lever saves energy and allows more work to be done with less effort.

Kinessage® not only takes advantage of Class 2 levers at every opportunity, it combines use of both the client and therapist’s levers to create more mechanical advantage. Movement generated from the therapist’s feet through their body, hands and through the client also reduces mechanical loads which helps reduce impacts that often cause therapist injury.

Currently, levers are used commonly in Thai massage, Shiatsu and different stretching techniques. However, by combining them with specific use of the nervous system, their application becomes exponential in Kinessage®. Lengthening of the tissue is achieved in an easier, quicker and more holistic way.

Let’s take a look at these concepts in action for a common problem of limited elevation range of motion (abduction and flexion) in the shoulder complex.

The glenohumeral joint is responsible for more than 50% of total abduction or flexion, with the remaining provided by the scapulothoracic articulation, and sternoclavicular, and acromioclavicular joints. Upward rotation is the largest scapulothoracic motion, occurring simultaneously with flexion and abduction of the humerus in shoulder elevation known as scapulohumeral rhythm (Oatis, 2009). Without full upward rotation and scapulothoracic movement, full flexion and abduction of the shoulder complex is not possible.

To review, the muscles involved in producing upward rotation are upper and lower Trapezius and Serratus Anterior muscles. Muscles involved in producing scapular elevation and downward rotation are Levator Scapulae, Rhomboideus Major and Minor muscles. Pectoralis Minor muscle produces downward rotation as it abducts and depresses from upward rotation.

The following video clip demonstrates the Kinessage® Scap/Trap Flipper and Roll. It is an effective means to increase rotation of the scapula and function of the scapulothoracic articulation.

The scapula (here as a Class 1 lever) and proprioceptors are used to effect the tension within and balance between the agonists and antagonists of scapular movement. Joint movement elicits constant feedback to and from the CNS which is used to recalibrate appropriate motor unit tension.

Remember when I stated earlier that the fun increases when we combine use of the therapist’s levers and body to do the work? For seated work, Kinessage® is done on an exercise ball. Viewer, please note that the movement you see in my hands rolling across the scapula is translated from the movement generated through my feet and rolling on the ball. Also, the anatomy shorthand referred to is taught in the Kinessage® Basics courses and gives you a new, easy way to remember and apply your anatomy.

An example of Kinessage® in application is a new client who after recent shoulder surgery presented with only 90 degrees each of abduction and flexion, and a pain level of 8 out of 10. After one Kinessage® session, abduction increased to 125 degrees and flexion to 115 degrees with no pain. After the second session, client demonstrated 135 degrees of abduction and 130 degrees of flexion with no pain. Here is her account:

“Scared, worried and anxious would best describe my state of mind when I first met Kathleen Gramzay. I didn’t know what to expect but was referred by a trusted friend who had experienced great results from therapy sessions with her. Six weeks post shoulder surgery after a fall and three weeks into physical therapy, I was being told by my orthopedist that I would probably only ever reach 85 percent recovery. I was worried, I was in pain, this was my dominant arm and I was 59 years old. I had seen friends post shoulder injuries with limited mobility and range of motion struggle with routine activities. I was definitely not progressing as well as I had hoped. And then there was Kathleen and Kinessage®. I was in Arizona for a short visit and she was able to fit me in for a session. I could not believe the results! Nothing was forced, I was not uncomfortable and I was so relaxed. Not only did my pain decrease significantly, but my range of motion increased by at least 25% after only 2 visits! When I returned to CA, I shared my experience and results with my physical therapist. He visited her website and adjusted my program to work more from her concepts. I have had tremendous results and can happily report that I am currently at 95% recovery. My sessions with Kathleen got me through the roughest part of my recovery. I was no longer afraid that every move would be accompanied by pain, and gained the confidence that I could and would recover. My state of mind today is relaxed, confident and positive thanks to Kathleen and Kinessage®.” Brenda C. Le Selva, CA

It is the author’s experience that application of the principles of kinesiology and the body’s incredible design for movement makes massage easier for the therapist and kinder and more effective for the client. Kinessage® can help you get better results with less effort by teaching you how to view and use the body and what you already may know, in a whole new way. It also incorporates easily with other modalities to sustain smooth flow in your work. It will definitely increase your skill level and it’s fun!

Kinesiology comes alive for massage therapists when they learn Kinessage®. Students are excited to learn how the kinesiology studies they took in school suddenly become more useful in helping make sense of what is going on in their clients’ bodies in a fun and practical way. You too can understand the body more deeply and dynamically and use it to your advantage and your clients’. Visitwww.kinessage.com to hear from Kinessage® students, and sign up for a Kinessage® class today.

 

REFERENCES
Behnke, R.S. Kinetic Anatomy (2nd ed.). Champaign, IL: Human Kinetics, Inc. (2006).
Floyd, R.T. Thomson, C. Manual of Structural Kinesiology (16th ed.). New York City: McGraw-Hill. (2007)
Golding, L.A., Golding, S. Fitness Professional’s Guide to Musculoskeletal Anatomy and Human Movement. Monterey, CA: Healthy Learning. (2003) 
Latash, Mark L. Neurophysiological Basis of Movement. Champaign, IL: Human Kinetics, Inc. (1998) 
Oatis, Carol A. Kinesiology the Mechanics and Pathomechanics of Human Movement (2nd ed.). Baltimore Lippincott Williams & Wilkins, (2009) 
Smith, et al. Brunnstrom’s Clinical Kinesiology (5th ed.). Philadelphia: F.A. Davis Company, (1996) 
Tortora, G & Grabowski, R. Principles of Anatomy and Physiology (8th ed.).New York: Biological Sciences, Textbooks, Inc. (1996)
Turchaninov, R. Therapeutic Massage a Scientific Approach. Phoenix: Aesculapius Books, (2000) 
Yates PhD, John A. A Physician’s Guide to Therapeutic Massage (Third Edition). Toronto, ONT, Curties-Overzet Publications. (2004)


Kathleen Gramzay, LMT, BS
Kathleen Gramzay, LMT, BS is a certified Massage Therapist and Approved Provider for Continuing Education through the National Certification Board for Therapeutic Massage & Bodywork. The owner of Knead for Balance, Inc., Ms. Gramzay has run a highly successful practice in Scottsdale, AZ for more than a decade, and worked concurrently for a number of years at DC Ranch Country Club and the Ritz Carlton-Phoenix. In these settings, she worked with professional athletes in baseball, basketball, football, hockey, golf and boxing, contributing a wealth of knowledge in the area of sports massage. Her excellent reputation in treating athletes led to her opportunity as the therapist for a Minor League Baseball team, where she works with professional baseball players, coaches and team staff during Arizona Spring Training.
Ms. Gramzay built her business with a solid foundation. After earning her bachelor’s degree in Business Administration and 20 years in corporate and entrepreneurial business, she graduated from the Phoenix Therapeutic Massage College in 1999. Her passion to understand how the body moves and the need to find a smarter way to work laid the foundation for a new perspective in massage. Through nine years of application, documentation & evolution, she developed Kinessage® Massage Through Movement, a highly effective and efficient method that uses the body’s design for movement to care simultaneously for both therapist and client. Ms. Gramzay is an avid learner with a compelling desire to help others. She has taught Anatomical Kinesiology and Anatomy at the Southwest Institute for Healing Arts in Tempe, AZ, and is a member of the AMTA, ABMP and Alliance for Massage Therapy Educators. She teaches Kinessage® and Kinessage® Self Care for Therapists around the country, and conducts speaking engagements on Self Care for the general public. To learn more about Ms. Gramzay & Kinessage® please visit her website at www.kinessage.com


Category: Stress Reduction Massage

Tags: