The System Treatments Target (Isn't The Muscular One)

Have you ever had to tenderize beef? It can take a good amount of work to actually get it to soften enough the way you want it. And this is dead meat. It has no bloodflow, muscle tone, outer wrapping (skin) or reflexes to resist the deformity.

That being said, how can we expect to be creating actual mechanical changes to our own muscular tissue using only a foam roller or our hands?  Look at this picture of a cadaver and see how tightly-packed all of that "soft" tissue is! It's not thin and compartmentalized like anatomy textbooks make it look. It's a giant mass of hard, stiff, muscle. Ain't no cylindrical piece of foam changing the structural makeup of that.

So why do we pay clinicians money to massage us? Why do we foam roll? What's with those trigger point balls? Well, if we can't directly affect the muscular system, there's another system that is extremely responsive to these methods...

The nervous system.

The brain: The strongest muscle.

The nervous system is what controls muscle tone, tightness, spasm, cramps, and essentially every other muscle thing that muscles do. We won't go overboard with the exact neuroscience and types of receptors within the tissue, but here we go. When you go in for a massage for a muscle that's seized up or too tense, what the therapist is essentially doing is overriding the stimuli that cause the nervous system to believe that it needs to be tight and contracted, initiating a relaxation effect. It's sometimes quicker, sometimes a more gradual process, but at the end of the day, the nerves are the only true structure affected by mechanical pressure; that is, unless you run over the person's leg with a steamroller. (The above link cites another study demonstrating the absurd amount of force actually required to deform human tissue.) This is the reason why contract-relax techniques and modalities such as electrical stim are able to exist with the same end-goal as massage of muscle relaxation and decreased tone.

Even when it comes to scar tissue built up in a muscle, the treatments that any therapist does is simply promoting the healthy tissue to mobilize better around the scarring. (Long-term changes from exercises-induced bloodflow and tissue stress might have a different effect, however.)

For this reason, I don't subscribe to the belief that massage has to be excruciatingly painful to be effective. In fact, I see it as counterproductive if you're triggering enough pain to create a new spasm response. Also, this is the benefit of exercise rehab in conjuncture with treatments such as massage, mobilizations, or muscle stim. Once we remove the (allegedly) dysfunctional situation of a muscle when it's hypertonic, in spasm, or in too much pain from an oversensitive nervous system, we can then go in to retrain the body's mechanics to work around the physical structures that exist in an optimally-functional manner.

End of the story, the treatments you receive at the clinic, whether it's massage, stim, mobilizations, or contract-relax stretching, are still incredibly useful; just not for the reasons that you thought. The peripheral nervous system reigns with much more power than we're often inclined to think, and I think that by switching gears to focus on the effects of that system as opposed to having tunnel-vision on the muscles and ligaments themselves that we'll be able to advance our abilities in the healthcare and fitness fields.

Bonus Trivia!

We're talking about the nervous system, so take a look at this Michaelangelo comparison and mull it over.

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