As massage therapists, we ask our clients about their areas of concern, what hurts, what movements make it hurt, what is your range of motion? And, usually when asked these questions, clients respond with “it hurts right here”, and point to a specific spot, or, “in my shoulder”, which is a pretty general area, or when I do this, or, “my range of motion is pretty good”, as they tend to demonstrate movement of the wrong joint because the correct joint, well, hurts. But we don’t expect them to be able to explain a 100% accurate assessment of their situation. We just need to understand how to interpret it and what to do with our interpretation.
Typically, the goal of the session, or series of sessions is going to be increase functionality of the muscle and joint while decreasing pain. Doing so is going to increase the range of motion.
But what is range of motion, or ROM? It can be described as the full movement potential of a joint. That is, if the bone, muscles, tendons, ligaments, etc. are working correctly, the joint will move properly. If these things are not working correctly, the joint will not function correctly, and will then lose ROM.
There are three types of ROM, passive, active, and active assist. Passive is when the therapist performs all the movement action for the client, active, the client does the all the movement, and active assist, the client, with the help of the therapist does the movement. As therapists, we should be using all of these techniques, as they will all have different results when initially applied to your client.
Passive movement typically will have more range than the other two, as in many cases there is decreased pain without the activation of the muscle, and the clients own strength is not needed during this movement. This also helps to show the client how much more the joint can move than what they are actually doing, giving them a tangible goal beyond just, “I don’t want it to hurt.”
Active and active assisted techniques can be applied to help the client work through painful movements, as it helps to activate and strengthen the specific muscles used for the movement, which will help to educate the client on the correct way to perform the movement and give them exercises to keep strengthening the muscles.
As we work with our client, we also need to remember that just because they may be feeling pain in a specific spot, area, or during a specific movement, there are multiple muscles involved in this process. Remember to work with the antagonistic and synergistic muscles as well, because those muscles are playing just as big of a part to the whole movement as the protagonist.
Thus, if we can understand what the full potential is versus the actual potential, we can increase the actual potential, eventually working it back to full, creating the goal of increasing range while decreasing pain.
Lance Thompson, LMT