Amy Bradley Radford (00:02.68)
Welcome to Massage Business Success. I'm Amy Bradley Radford, and this is the podcast for massage therapists who want to grow their business, strengthen their skills, and create a career they love. Let's get started. Well, hello my friends, and welcome back to the podcast. If you're new here today, today's podcast is about a massage process I developed called Pain Patterns and Solutions or PPS.
And every month I want to take one week and talk about some of the things I've learned over the last 33 years of practice that have made a difference for clients who struggle to find relief from pain no matter what we do or what we learn to do. So PPS has these governing concepts that I call universal principles that really have more to do with how you think than what your hands do. And what you do with your hands is actually pretty straightforward in this particular style of bodywork, but how you think about what you're doing changes everything.
So, if you want to learn a little more about this approach to pain management, I think these podcast conversations could offer some solutions for you and for the people you work with, and maybe even for yourself. So, because I'm building a structured foundation with these conversations, the PPS episodes are listed in order. So there's PPS episode one, episode two, and so on. If you jump in someday at PPS episode 27,
Some of the terminology we use may be a little confusing to you because I'm building on what came before. But either way, there will always be something here that I simply want to share with you and hopefully get you thinking about the body just a little bit differently. So as the time of this recording, I am currently building and testing the full PPS training program locally in my own area to make sure that the training process is really solid for the therapists who eventually want to learn it.
I'm also refilming all the hands-on segments. So there's a lot of groundwork being laid down right now. There is actually a form attached to the description of this podcast where you can put your name down if you're interested and I will send you information along as it becomes available. But however, like most things in my life, it's really not ready until it's really done. Because being a part-time caregiver, I have learned that my goals have to have a serious level of flexibility built into them, whether I want it that way or not.
Amy Bradley Radford (02:17.942)
So let's go ahead and talk a little bit about this PPS stuff. One thing I've learned over the last decade is that this type of approach to the body doesn't fit very well into a typical weekend workshop. I have learned this by failure and success, honestly. So it took me a while to realize that while I wanted it to fit into a weekend workshop, it fits much better into a mentorship model.
Where you have time to work with the principals, use them with real clients, review client profiles and progress, ask questions about what you're seeing and working with and things that are not working, and learn how to think your way through the patterns and problems that we learn about. And the foundation for this type of training must be really solid before a therapist starts using these concepts. Because of this, PPS is not simply another hands-on skill. It is a mental skill that teaches you how to read the body differently.
Think differently, and because of that, you work differently. And in the end, I believe it to be a very powerful tool for pain management. But it also requires a deep grasp of clinical thought processing. It takes so much more than here, I'll show you a technique and now you go copy the move on your clients. So before we go any further, I want to tell you very clearly what PPS is and what it isn't, because I don't want you to have to listen to this entire podcast episode waiting for me to tell you what it is.
So PPS is a very specific massage tool. It is a tool I bring out when a client is in pain and their body is not responding to the traditional massage approaches that I would normally expect it to respond to. These are the clients where you work on them and they feel better for a little while, but the pain comes back exactly the same, or they become incredibly sore after a treatment, or even when you didn't work the tissues deeply, they're sore after a treatment.
Or maybe you seem to help one area and then another area starts hurting. Or maybe everything you do just stirs the body up instead of settling it down. Those were the clients I couldn't make sense of for a really long time. And I went looking for a way to help them. And I took a lot of classes. I did a lot of continuing education. And in the end, what I found that works for me is what I call pain patterns and solutions.
Amy Bradley Radford (04:32.578)
So the entire PPS process developed around working with bodies that I felt were experiencing high levels of inflammation. What I am trying to do in those situations is not create another therapeutic inflammatory response that the body has to manage and at the same time shift their pain levels down enough for that treatment to be valid to them. They have to notice the difference and it has to be real.
And I want to align my work to assist with what the body is already doing. And that involves reorganizing some of the relationships that the muscular system is working within and to calm things down and give the body a better opportunity to do what I believe it's been trying to do all along, and that's heal itself. And here's the part that's gonna sound strange. If you've ever heard me talk about PPS before, the primary tissue I work with in this process is not muscle, it's not fascia, it's scar tissue.
All over the body, even when there isn't an injury where it exists. And I know that sounds a little weird, especially because when most of us hear the words scar tissue, we immediately think of an injury or a surgery. We think of that visible scar on a C section or a knee replacement or an old accident or like stitches in your chin. And yes, those are absolutely places where scar tissue forms, but my experience has taught me to look for scar tissue for many other reasons besides that.
Obvious surgery or injury. And that became one of the keys for me in understanding how to work with inflammation. Scar tissue is part of repairing an injury, but it also forms in places where the body appears to be creating stability and balance around something that has changed. Sometimes I find thickened tissue along surfaces that are continually being stressed through things like repetitive motion, almost as if the body has built an additional support system.
or structure where it has been asked to do the same thing over and over and over again. And you know, us little massage therapists are actually a really good example of this. So think about what you do with your hands every day. Think about the number of hours you have spent pushing and pulling and gripping and leaning and applying pressure with your hands and your forearms and the pressure that goes inside your shoulders. And then think about what most massage therapists eventually or start off right in the
Amy Bradley Radford (06:48.984)
First part of their practice complaining of, and that is upper neck and shoulder pain and upper back pain, or that constant levator scapula trigger point that just never goes away in your neck. So when I work with massage therapists, I research or work through areas where I commonly find this kind of thickening from repetitive motion. And the places I like to work are over the tendons on the top of the hands, or thickening that has occurred in along that inner osseous membrane.
Deep into those forearms. And I work along the ulna bone by the elbow where the bicipital apineurosis attaches. If you don't know what it is, go ahead and look it up. And I look at the shared attachments of the pec major, the latissimus dorsi, and the subscapularis on the humerus, right where you find that little knot that doesn't seem to want to go away. It's those muscles have bound together and they're stuck together with scar tissue. All of these things happen.
Because the body is trying to hold those structures in order to continue to do the movement for the work we do. So I want to test this theory just a little bit. If you're a massage therapist listening to this and you have neck and shoulder pain that never completely goes away, I want you to experiment with this on yourself. I want you to start working over the tendons of your hands, and that's right on the top and all the way down your fingers. I want you to press deeply into the bones of your forearm. I actually want you to.
Get there, get into the forearm and kind of stretch those bones apart. And if you have a massage gun, you can let that vibration go deep into the forearm and start changing some of that inner osseo membrane. And then I want you to explore along the ulna bone where right near the elbow, where you're gonna find these little crunchy spots if you pay attention. And I want you to work those over and flatten them out and break them down. And then I want you to find that thickened detachment area.
Right on that humerus, kind of where the deltoid almost attaches, where those three muscles share an attachment site. And I want you to just kind of break things up. And then I want you to stop. And I want you to turn your head and move your shoulders around and check your schneck, which is my terminology for that place between your shoulder and your neck. It's the schneck. And I want you to see what you notice. Did that tension ease?
Amy Bradley Radford (09:06.37)
Did those muscles kind of automatically let go and you can turn your head more and there's not as much tension? And you know, here's the interesting thing, and I wish some of you could sit side by side next to each other just to see the difference. Some of you are going to notice a very profound change. Some of you may notice only a little bit of change, or maybe nothing that's really obvious at all. All of that matters because I want you to remember PPS is a tool I developed around a particular type of presentation.
The person whose body is struggling with higher levels of pain and inflammation and isn't responding to the way you normally expect it to respond. If you are experiencing high levels of inflammation or moderate to high levels of inflammation, you're going to feel change by working those structures. If you don't have a lot of inflammation, you're not going to change. But regardless of how much you personally changed, I want you to notice something about what I just asked you to do. I didn't
Ask you to work on the muscles. In fact, if anything, we kind of went around everything. I sent you to tendons, bones, attachment, the space between the bones, and I asked you to touch everything around muscles that you probably would have expected me to tell you to work. And this is where a lot of people have told me that PPS is a little backwards from our typical education. And I didn't mean to make it backwards. It's just that's how it actually came to be. And
You and I both, we spent our entire education learning muscles. And now in order to change pain that's involved in high levels of inflammation, my clients' bodies were taking me to places where I wasn't working primarily muscles. I was working on top of bones. That's where I found the scar tissue. And I was taught not to work on top of bones. I think most of us were, and I was almost paranoid about it. Like it was a taboo to touch the spine of the scapula or work directly on top of the ligament attached to the spinous processes.
Or work directly on top of the sacrum in that ligament structure. And I think that is part of why it took me so long to understand what I was finding. I refused to go where the solution was until it was practically the only place left on the body I could touch. And I still wanted that answer for that inflammation. And when I finally gave myself permission to explore these areas, things really started shifting for my clients. Because scar tissue does not behave like muscle. Muscles move, scar tissue holds.
Amy Bradley Radford (11:29.368)
That's its job. And understanding that is really important. If scar tissue is helping repair, anchor or support something, then I need to look for it in places where that holding can occur. The job of a muscle is motion. That's a terrible place to use as an anchor, and that's why so much PPS work takes me onto surfaces and structures we don't normally think of as a primary focus for regular massage work. And some of the places that you'll find scar tissue are
along the spine of the scapula, or on top of the clavicle, or thickened tissue on ligaments of the spine, or you find it on the tendons of the hand and feet, or you find it through cranial fascia, which we kind of expect to, or planar fascia, or areas of the IT band, which we're going to talk about today. And you can also find areas that PPS defines as platforms, such as on top of the cheekbones, the zygomatic arch, the bottom of the chin, the jaw.
And between the eyes on the nasal sutures and sometimes even around or inside the eye socket. And one of my all-time favorites is the sacrum and the sacrotuberous ligaments, where this tissue can become so thickened with scar tissue that it shortens all of the area it forms in, and the muscles sharing and responding to those attachments of the pelvis have to shift their lengths to deal with what has changed. So much can get stuck there that needs to go back into the back.
And the legs and the thighs. There's just so much that sacrum and those sacrotuberous ligaments can offer. And this is what I want you to picture. I just want you to kind of start envisioning some of these areas and what potential they might hold. So scar tissue forms and holds, but the person still has to move. But once scar tissue is formed, the body has to compensate and learn to work around it. The muscles still have to contract, the body has to still stand up and walk.
Person has to turn their head, lift their arms, oppose gravity, and somehow continue living inside of a body that's now holding in a place where it didn't hold that way before. And this is where PPS became so interesting to me because I stopped looking at scar tissue simply as something hard that needed to be broken down. And I started asking what that holding was making everything else have to do. And that
Amy Bradley Radford (13:49.24)
Question eventually became the answer for a lot of other questions I had. But for right now, I just want you to understand that basic difference. When I use PPS, I'm not primarily trying to make that painful muscle let go. I'm looking for the scar tissue and binding that the muscular system is having to organize itself around and then compensate for. And my job is to create movement in these holding areas, and then I watch what the muscles do with the change.
And the change is usually fairly automatic. I don't necessarily need to go in afterward and really work those muscles to create a change. Sometimes, many times that shift simply happens. And I'm there more to touch where the pain was and tell it it's okay than actually create the change in the muscle that hurts. So when that shift happens, those muscles now have an opportunity to rest.
move and rehab inside that new reorganized muscle length because the muscles are relieved of the tension and pull it has been constantly fighting against. And for some clients, especially those whose bodies continue to fight higher levels of inflammation, PPS might remain part of how I work on them for a very long time, for the life of the client. And for other clients there comes a point where their pain has diminished and their body is holding on to the changes and inflammation has gone down and it's no longer the primary thing
that I need to address. And I have found that when pain goes down, inflammation goes down. And when those two things happen at the same time, healing, and I mean the real stuff, happens automatically. And once someone is on that path to healing, a lot of times that PPS tool goes back in my toolbox. And I can return to regular muscle work and use all of those other wonderful things massage therapy knows how to do. So that's why I call it a tool.
A lot of continuing education that I went to, it was the technique that you learned and that is what you went back and used. But in this situation, we're pulling out the right tool for the correct job. You don't want to do PPS on somebody that isn't in inflammation because you can put them into inflammation. And when someone's in a high level of inflammation, we use PPS, and this is the way I like to explain it, we use the tissue that inflammation builds to help itself.
Amy Bradley Radford (16:08.768)
So we use scar tissue to calm inflammation. It simply helps to get the body to a place where the muscular system can go back to where it needs to be so it's able to do something different again. So I wanted to give you this picture at the beginning because I don't want PPS to feel like it's this mysterious thing. It's not. And I don't want to spend this entire conversation with you dropping all these little clues and finally tell you where you are at the end of what I actually do. Because I want, I really want to help.
Therapists and clients change pain. Like really change it. So a lot of this started with a question. And that question was why do some people get better and some people don't? No matter what you do. And that was the question that PPS answered for me. So before we go any further, I actually want to clarify something because I know what some of you are probably thinking as you're listening to me talk about binding and creating changes somewhere other than where the pain is.
And I've had a lot of people say, well, isn't that just myofascial work? No. And I understand why you want to think that, because myofascial work can absolutely create bodywide changes by working with fascial restrictions and relationships throughout the body. I know that work. I've used that work. I still use some of that work. It's incredibly effective. But that wasn't the problem I was trying to solve when PPS was developed. I had clients with such high levels of pain and inflammation that they weren't responding well to myofascial work either.
I could work the muscle and I could create more inflammation. I could go to the antagonist and create more inflammation. I could work fascia. And there were still clients whose bodies would overreact with inflammation. It's almost like their bodies were already trying to manage so much that sometimes almost anything I did seemed to give their body just one more thing it had to recover from. So I wasn't looking for another way to create this body-wide change. I was looking for a way.
To work with inflammation that was already there without continually asking the body to create another inflammatory response as a way to heal itself. I wanted to figure out how to reduce inflammation without creating more inflammation and at the same time have the client feel the difference in a reduction in pain. So that's the distinction I want you to understand about PPS. PPS addresses inflammation. Now
Amy Bradley Radford (18:26.188)
When I say that, I know inflammation can sound like something we can't really put our hands on. We can typically see, you know, swelling and heat and pain, but how exactly do you do body work on inflammation? For me, the answer became scar tissue. If you wanted to change or decrease inflammation, then I needed to work with the tissue inflammation builds. This is the only tissue I know of that the body actually builds on demand.
as part of its healing process. And that's not fascia. And this is another place where I think it would be easy to hear what I'm describing and call it fascial binding because some of it certainly feels like binding underneath your hands and fascia is absolutely involved in this work. There's a lot of fascial surfaces the body likes to build scar tissue on. So yeah, I can see how some of it might be confusing, but fascial binding and scar tissue are not the same thing. I've spent a lot of time really working through this.
And this distinction became important to me because I wasn't simply trying to create movement in a restricted tissue. I was doing that, but I was also trying to understand why the body had built that tissue there in the first place if there was no injury and why it continued to maintain it. And probably the bigger question is when the person came back, why did the tissue come back? Because it did. There was times that it did.
And I could find this thickened tissue, work it, create movement in it, and feel a change happen somewhere else in the body. And then they would come back and there it would be again. And sometimes it was even thicker than it had been before. I don't think that's binding. That's the body laying down something. So, you know, then that changed a question for me. And it wasn't just how do I release this restricted area to create the change? My question became, why does the body keep rebuilding something I keep taking down?
You know what I knew at at that point was much simpler. If I worked this tissue and the body continually rebuilt it, then there was something about its purpose that I still needed to understand. And that distinction became really important to me because now I wasn't just looking, I wasn't just finding a restriction, creating movement in it and waiting to see what changed. I was working with a tissue the body had actually built. And if I broke it down and the body built it again.
Amy Bradley Radford (20:44.856)
Then I needed to start asking why the body believed it still needed it. I just didn't understand the answer to that yet. As I was learning all of this, you know, but as I continued working with this tissue, I learned that there were relationships between areas of scar tissue, the area of injury and its equal and opposite reaction to that injury. There was an order to how they needed to be worked, and there's some basic
physics principles behind why the body was building these areas. And this is where PPS eventually ended up. And it gave me a way to work with the tissue created through the inflammatory and healing process, manage that tissue in a very specific way, reduce some of what the body was having to manage, and give the body an opportunity to continue the healing process. So now that you understand that distinction, let's go back to something every massage therapist understands and kind of use it as a
Example. So let's talk about rhomboid pain. There's another universal principle underneath PPS that changed the way I started thinking about pain as well. And I think rhomboid pain is probably one of the easiest places to actually see it. Because what you feel under your hands and what you see when you look at the body can almost seem like two completely different things. And the principle is that pain is typically felt in muscle tissue that's being lengthened, not shortened.
And want you to think about the client who comes in complaining about that spot between the scapula and the spine. Maybe they call it a knot, maybe they call it a trigger point. Maybe they tell you it feels tight all the time. And when you put your hands there, it does feel tight. There's pressure in that rhomboid, and it may feel hard or dense underneath your fingers. And the client is telling you, yeah, right there, that's the spot. That's what feels tight. So because it feels tight, we naturally think short.
But before you do anything with your hands, I want you to back up a minute and I want you to actually look at that person standing in front of you because they usually aren't standing there with their chest puffed out and their scapulas almost touching each other in the back. Because if they were, then yes, the rhomboids would be shortened and tight. Usually they're doing exactly the opposite. Their shoulders are rounded forward, the scapulas have moved away from the spine, their upper back is rounded, and that entire group of muscles in the back.
Amy Bradley Radford (23:02.922)
Is sitting in a long position. So picture the rhomboid. One side of that muscle is attached toward the spine, and the other side is attached to the scapula. And if you take the scapula and move it further away from the spine, there's really only one thing that can happen to that muscle sitting between those two points. It gets longer and it screams. And the client says that's where they hurt. And yet when you put your hands on it, it can feel so tight. And that distinction is important because tight and short are not the same.
Sometimes what we are feeling is tightness is tension inside a muscle that's being held in this state of length. It wants relief, it wants the pressure taken off of it. It is being pulled while at the same time it's trying to contract and do its job from that longer position. You know, and if it stays there long enough, it gets tired, it fatigues. And as it gives up a little more length, it has to continue to do its job from that newer lengthened position until.
Eventually you have this muscle sitting in a state of length and it's absolutely screaming about it. And then we go in and do the only thing that massage therapy does, and that is lengthen. When we apply massage strokes, we lengthen everything we touch. So we try and make it longer. And we find that trigger point and we strip through those rhomboids and we dig around that medial border of the scapula and we try to get that tissue to let go because underneath our hands it feels so tight.
But visually we can see that the scapula is already sitting further away from the spine and the rhomboid is already being held in a lengthened position. So if I go in and keep trying to loosen and lengthen that tissue even more, I might actually be asking an already lengthened muscle to give me more length. Now, I'm not saying working the rhomboids is wrong because for a lot of people, working that area feels really good. Their body responds, perhaps with inflammation in the way it's supposed to help.
The trigger point changes, the pain decreases, and that's exactly what we want. Or we may take it a little further. If it's not responding, we try going to the front of the body. We look at where the pecs are tight, or the anterior deltoid, or the biceps, or the structures that may be holding that shoulder forward, because if the scapula is sitting laterally and the rhomboid is long, then it makes sense that there may be something on the other side of that relationship that is short.
Amy Bradley Radford (25:24.47)
So we work those shortened tissues in the front so that the lengthened tissues in the back don't have to fight so hard. And you are correct. This is a completely reasonable way to think about pain. And for a lot of clients, it works beautifully. But then you get that one client. And they can have almost the exact same rhomboid pain and even look similar standing in front of you. But when you go to work those pecs or that anterior delt or the biceps, their body responds completely differently. Everything hurts.
They tell you it burns. You lighten your pressure and slow down and take your time and maybe move somewhere else and try to work around it, but everything you touch seems irritated. And by the end of the treatment, they are now sore in the back and the front. And you really haven't changed anything. So what do you do now? These were the clients that I kept getting that I was asking questions about.
And I had one of those clients years ago. I've talked about her on this podcast before, and she had one of the worst rhomboid trigger points I had ever felt. She was in so much pain that I couldn't even hardly touch that spot in her rhomboids without bringing tears to her eyes. It was visibly lifted off her body. And so I did exactly what I had been taught to do. I worked the pecs, I worked around the scapula, I thought about all of the agonist and antagonist relationships. I went to the opposite side. I tried everything that made sense.
Based on what I understood at the time, but everything I did made it hurt. Everywhere I touched hurt or burned. And everything around that shoulder made her pain more angry. So this is when I thought, I obviously need to get further away from it. It's not here for no reason. She's in a lot of pain. What is causing this? So I started moving away from the shoulder, trying to follow what her body would, you know, kind of actually allow me to do, like touching an area.
That didn't hurt and trying to work those areas that didn't hurt. So I eventually went further down her body, working around the hip. That didn't work. And then I found myself trying to go all the way down to her foot. And as I was working down her IT band and her hamstring and everything, that seemed to help a little. So I followed it and I started working my way back up on the outside of the leg. And when I reached her IT band, she reached her arm back and said, Stop. Stop right there. And I actually thought I'd hurt her more.
Amy Bradley Radford (27:42.456)
But what she told me was that whatever I was touching on the outside of her leg, she could feel it taking the pressure off her back. And I remember stopping because I'm standing by her leg. I'm nowhere near her rhomboid. And yet she can feel something changing in the exact place she came in asking me for help. So I went back and kind of touched that rhomboid. I could feel it had softened. So I went back to the IT band and I worked it again.
Then I went back to the rhomboid and I checked it and I went back to the IT band and I checked it again. And at that point, you know, I didn't really have an explanation for why that was happening, but I knew I was going to pay attention to it because I could feel and see that something was changing. And what I learned from her, I started applying to other people who were presenting with the same kind of unresolved rhomboid pain. And my question was, is would it repeat from person to person? And it did.
And I could work the IT band and go back to the rhomboid and feel a change underneath my hands. And that became one of those moments in the development of PPS where I had to decide whether I was going to kind of dismiss something because it didn't fit into the training that I had already been given, or whether I was going to trust what my hands were repeatedly showing me and figure it out later. So I just decided to follow it. And what made it even more interesting was how different the tissues felt in those two places around this client's shoulder.
Everything was incredibly painful. It burned. It was reactive. She could barely tolerate me touching some of it. But that thickened tissue I found along the IT band was numb. And I could spend a lot of time working there and break some of that thickened tissue down and then go back up to the rhomboid and feel that muscle change. And for a while I thought I had found a really great answer, but I didn't I still didn't understand why. I didn't understand why working the IT band along the outside of someone's leg
could change a painful rhomboid muscle between their scapula and their spine. If I only looked at those two places, it made absolutely no sense. I mean the hip bones connected to the knee bone and the hip bones connected to, you know, the back, and I understand all that. I understand there's chain reactions, but I had no point of reference for that. So I stopped looking at them as unrelated places and I started looking at everything in between. And this is where this is where I'm going to give you a little anatomy lesson about that chain reaction.
Amy Bradley Radford (30:06.156)
Because remember, the universal principle we already talked about is scar tissue shortens anywhere it is found and it holds. So imagine scar tissue along the IT band and actually follow what the shortening can do. As that tissue shortens, it begins pulling through its attachments. So the IT band attachments get tugged on just a little bit. And those attachments are the iliac crest and the lower attachment on the tibia. So tibial tuberosity. The iliac crest can be pulled downward.
Ever so slightly, while the lower attachment on the tibia can be pulled upwards. So you're kind of coming towards the middle. And this will cause the knee to slightly medial rotate, and the arch will flatten just a hair, and the foot can fall inward just a little bit. And that position of the leg changes everything just a little bit. None of these changes have to be big. And this is important because we can miss what is happening when we are looking for something big.
These are very small changes, but small doesn't mean that nothing is happening. One of my favorite sayings is that millimeters of scar tissue can create inches of change in the muscles. So I want you to follow that shortening up. So our leg has kind of dropped just a little bit and our pelvis has dropped just a little bit. And if you follow that shortening from the iliac crest up, there's muscular relationships along that iliac crest. That's where the QL attaches, but that's also where the lat attaches.
The lattissimus dorsi. So if the iliac crest is being pulled downward even slightly, that lat has to go down with it. So it moves, it tugs on its insertion point. And when you follow the lat upward, it travels all the way to the humerus. And as you get up to the humerus, it pulls just a little bit and medially rotates that arm, which then affects the subscapularis and it pulls that scapula out laterally just a little bit.
And now we have worked our way all the way to the rhomboid. One side of the rhomboid is attached to the spine, and the other is attached to the scapula. And if the scapula has drifted laterally, the spine is not going to follow it. It's going to stay straight. So the tissue between those two points, between the scapula and the spine, has to lengthen. And now that tight rhomboid we felt underneath our hands at the beginning starts looking just a little bit different.
Amy Bradley Radford (32:30.54)
That IT band doesn't shorten and suddenly yank that rhomboid across the body because that's not really what I'm talking about. These are little tiny changes being distributed as evenly as possible throughout the body so the body can maintain some balance. The foot changes a little bit, which changes the leg a little bit, and the pelvis changes a little bit, and you fall to one side a little bit. And then the lat has to respond what happened to the iliac crest. And as you follow that relationship upward.
The humerus changes just a little and the scapula drifts lateral just a little. Quick pause. If you want to stay connected, you can find classes and resources at amybradleyradford.com. Let's continue. None of those changes by themselves look dramatic, but when you follow them all together, eventually all of that redistributed length has to land somewhere. And in this particular relationship, it lands in the rhombus.
And then the rhomboid has no choice. It doesn't go anywhere from there. So it has to work in this lengthened position. It fatigues. It gives up a little more length. It has to work from that new position. And it continues trying to hold against this tug until eventually it can't keep doing it efficiently anymore. And we know this because we start to feel pain. And this is where this universal principle really began making sense to me. Pain is typically felt in tissue being lengthened.
Not necessarily in the tissue doing the shortening and the pains in the rhomboid. But the shortening that I needed to understand and what I was seeing with my clients with high levels of inflammation was that shortening was somewhere else and somewhere different than I had been trained to work. And eventually that became something bigger to PPS. And pain began to teach me about direction.
This is when I learned some concepts about the behavior of scar tissue that a couple of physics principles helped me explain. Now, mind you, I played around with scar tissue and muscles until something changed in a positive way, and then I would have to go out and find something to explain what I felt or what was changing and why. And I didn't start with physics and then try and apply it to the body. Physics just gave me some language that helped me make sense of what I was already seeing and feeling. And
Amy Bradley Radford (34:49.474)
There are two physics principles that described what the body and scar tissue were doing the most. The very first one was for every action, there's an equal and opposite reaction. And the second was, and I know this one sounds funny, it took me a little bit of time to understand it, but it's completely valid. The second was that an object will continue along the same path unless an unbalanced force acts upon it. And when that happens, its speed or direction changes.
And the second principle just took me time to understand what speed and direction really meant when you applied it to muscles and a living body. And we'll come back to that, you know, towards the end of the podcast. Because we need to talk about equal and opposite reactions first in a couple of different ways, so that that speed and direction and unbalanced force makes a little more sense. So scar tissue obviously forms to heel injury, but what I was finding underneath my hands was that it also appeared in places
Where there necessarily hadn't been an injury to that area. And I was finding it in patterns that seemed to help the body balance, maintain posture, offset repetitive motion, like we talked about earlier. And eventually what I began to see was that one of the most common places I found scar tissue was in relationship to other scar tissue. And that's where that first physics principle started to make sense to me.
Because scar tissue shortens anywhere it is found, it automatically means something else has to lengthen inside the muscular system, inside your body. Your muscular system is a closed system. If you shorten somewhere, you can't automatically put more muscle contraction ability into the system to offset it. What shortens creates an automatic lengthening. That's what I mean by a closed system.
So the body doesn't simply lose length in one place and have nothing else change. It still has to stand up and move and function. So if something shortens, that lost length has to be accommodated somewhere else. And there are a lot of things happening all at the same time as that occurs. Scar tissue can pull other tissue and move it towards itself into its center. And it will create this small chain reaction through muscles and
Amy Bradley Radford (37:05.492)
And then this light tension through the fascia, and then it slightly shifts, you know, a joint placement, and all of those little changes will continue moving through the body until it reaches the end of this chain reaction. And now we have a couple different things happening. We have a place where the shortening is occurring, and we have another area of the body that's having to accommodate that shortening by taking on additional length. And if enough length and strain are redistributed into that second area.
And enough irritation and inflammation that occurs over time, then the body is going to begin building scar tissue there too at the end. So now I want you to think what happens. That second area forms scar tissue and that chain reaction starts back in the opposite direction. Somewhere between the middle of those two areas of equal and opposite reaction of scar tissue paired forces, you will have a point of maximum length and typically pain in a muscle, not scar tissue.
Two balanced and anchored points with length in the middle. The muscle is living between these two changes and it's adapting to them and it's lengthening or shortening around them, contracting inside of them and trying to continue doing its job in the physical environment those scar tissue relationships have created and changed. And I'm here to tell you the muscle is not the equal and opposite piece. The only thing that equals scar tissue is scar tissue.
Scar tissue will never pair with muscle. They are not equal. And once I understood that, I had to go back and look at that IT band completely differently because now I had another question. If the scar tissue on the IT band was one side of an equal and opposite relationship, what was the other side? My brain automatically went to the other IT band. That was not the answer.
So up until this point, I had treated the IT band like it was the beginning of the relationship and the rhomboid was the end of it. And I could work it and change the rhomboid. So naturally I thought I had found the piece, the starting point that was the creating the problem. But if scar tissue forms in equal and opposite relationships as I started to learn, then the IT band couldn't just be sitting there all by itself. It had to be responding to something. And once I started looking at it this way, and after some testing, I realized I had been starting in the middle.
Amy Bradley Radford (39:24.46)
of some opposing forces. The IT band wasn't necessarily the beginning of the pattern. It was one of the places the body had built scar tissue as it was trying to manage something that had happened somewhere else. And this is what I learned. It was one of three pieces. And since we are a three-dimensional muscle machine, equal and opposite reactions doesn't necessarily mean just two. It can mean whatever it takes to create equality in all of the motion that is occurring. So
Let's say someone had an injury involving their head. It doesn't have to be something dramatic. Maybe they hit their head. Maybe they had a concussion. Maybe there was an injury that created inflammation and scar tissue somewhere in the upper part of the body. Whatever happened, scar tissue formed and it shortened that area. And if that shortening creates a change at the top of the body, that chain reaction of adaptation will occur until it finds a place to oppose it.
And what I began finding was scar tissue at the feet in equal and opposite proportions to the head. That was the end of the chain reaction. It makes sense, equal and opposite reactions. But if I have scar tissue at the head pulling from one direction and scar tissue at the feet opposing it from another direction, there is still a tremendous amount of force moving between those two areas. So the body needs something in the middle to help manage that force and stabilize the relationships.
And one of the places I repeatedly found that middle holding point was along the IT band. And the reason I would work the IT band is when a client complained of high levels of inflammation and had unresolvable pain in the rhomboids. So there could be a relationship between the head and the feet. But then there can be a relationship between the head and the middle holding point, and another relationship between the middle and the holding point and the feet. And each relationship still has an opposing force. But together they create something.
lot more three-dimensional. So now I go back to the IT band I had been working over and over again. I would find that thickened scar tissue, I would work it down, I'd go back to the rhomboid and feel it changed, the client would feel better and I felt like I had done my job. But I had changed something in the middle of the pattern. I hadn't actually changed the whole pattern. And I had loosened something in the middle of this larger relationship and for a little while that gave the body more movement.
Amy Bradley Radford (41:43.17)
But the forces on either end were still there. The body still had the same problem it had been trying to solve before I touched the IT band. So to create balance, the scar tissue on the IT band would rebuild. And that's why it would keep coming back. The body wasn't being stubborn. I wasn't doing something wrong. I had only changed one part of a relationship without changing enough of the relationship for the body to stop needing that piece. And that's where I kind of got this image of a knot.
Finally started to make sense to me like looking at a a tied knot and a piece of string. For people who are in high levels of inflammation, their body has almost become gridlocked in an attempt to find balance. Every time something changed, it created another response. That response created another response. And eventually all of those relationships were holding against one another in a way that allowed the body to keep functioning, but it didn't necessarily allow it to move.
out of that pattern and it stayed in pain. And it was almost like the body had tied itself in a knot trying to find balance and the inflammation just kept growing. Because this is the answer the body has to pain, inflammation, and healing. It forms scar tissue and it uses it over and over and over again until balance is found. And if it's not found, it becomes more aggressive at it, which means the person has a higher level of inflammation.
But when I only worked the IT band, I hadn't untied that knot. I had just loosened one of the pieces in the middle that created some slack, but because I hadn't changed what was happening on the ends of that relationship, one or both ends would pick up that slack and begin pulling everything tight again. And over time the place I had loosened actually became tighter and more reactive because the body was continually trying to restore the balance that I had disrupted.
And this explained to me why the IT band trick, as I called it, over time quit working. I could use the IT band for three to four sessions and create so much relief, but then something changed and the IT band wouldn't let me work on it as much. It would start to burn. And because I had repeatedly worked it without changing that larger relationship, it became painful to try to use it for a change. The relationship became more reactive. The ends started winning and the middle started losing.
Amy Bradley Radford (44:05.91)
And that taught me something incredibly important. And that is there is an order to releasing scar tissue. It is not haphazard. There's a lot of rules to it. Where the pattern began matters. Where the body counterbalanced that original change matters. And the pieces that developed between those areas, it matters. If something started in their head and then was balanced in their feet, you have to start in the head because the scar tissue in the feet would never exist.
without the beginning force of what was in the head. If you start in their feet, then you do something I call feed dysfunction. You basically take the pressure off the foot and everything slides up towards where the shortening originated. And so there is order to changing those relationships and having a permanent change. And if you don't change that, and I call it communication, because it's a type of communication. If you don't change it enough, it rebuilds because for every action
There's an equal and opposite reaction. And actually you could take another physics principle and apply it here. And it states that there are no truly unbalanced forces in nature. And we'll talk about that one another time because as we get into force and talk about force, I almost sound like I should be in Star Wars. But as you start learning about force in the body a little differently and you learn how inflammation and pain are rooted in force and gravity, there's some pretty deep concepts.
To talk about. So all of this changed the way I worked completely. Because now I wasn't simply looking for scar tissue and trying to get rid of it. I was trying to understand and eliminate the relationship between the pieces. I was trying to get them to stop talking so they would stop forming and they would stop existing. And eventually I learned that the goal wasn't to make every piece of scar tissue disappear. You can't erase the fact that somebody had an injury.
You aren't going to make a surgical scar disappear or return an injured body to some imaginary state where nothing ever happened to it. The body still needs some of that scar tissue. Scar tissue is correct. Too much scar tissue creates a lot of havoc. So the question then became, how much does it actually need? And I'll tell you what teaches you that. It's when your client's pain drops down to a manageable area where they no longer need you. That's how much scar tissue needs to be there.
Amy Bradley Radford (46:31.094)
Because in the body that heals well, scar tissue forms, does its job, and then the body will gradually reduce it and remodel it down until it's down to the littlest amount it needs for the structure. So the body has maximum movement and little bit of healing. And what I was seeing in chronic inflammatory patterns was completely the opposite. There was too much tissue holding against too much tissue, creating enough force.
That the body was set up for more injury, which then created more scar tissue, which then created more scar tissue, which then set it up for more injury, and it just continually irritated and damaged itself. And then the healing would build more tissue and create more force and just continue this cycle. So the goal in PPS became finding that the least amount of resistance those scar tissue relationships needed to continue doing their job without maintaining all of that unnecessary force.
And at the same time, reducing pain and increasing healing. So that's what I mean when I talk about working scar tissue in pairs. It isn't about attacking both ends and making them disappear. It's about changing the connection between them enough that they don't have to keep pulling it against each other with the same amount of force. And it's so interesting because you will know you have reduced the scar tissue enough because the pain goes away. So it has its own set of.
responses that guide you to do your work. And you know, so that brings me to a point where talking about what PPS looks like as a massage flow, I've had people tell me that PPS isn't real massage. Well, it probably isn't. It has a very specific tool that does a very specific job. So when you observe someone doing PPS on a body, it doesn't necessarily flow from one end of the body to the other like we might work it in a traditional massage. You are following
And breaking relationships. So you may work on the head, move to the foot, come back to the middle, go back to the head, go back to the foot, because those pieces are all talking to one another inside a particular pattern. And the order is based on what happened, what responded to it, what the body built between those things as it tried to balance, and you're breaking those communications in the order they occurred.
Amy Bradley Radford (48:48.374)
And when I can begin changing those relationships together, instead of continually taking down just one piece the body still believes it needs, something very different can happen. The body doesn't have to keep fighting me to rebuild what I just removed. It can begin letting go of what it no longer needs. And when the scar tissue is no longer creating this huge area of shortening, the muscles that are being forced to lengthen in that equal and opposite reaction.
They automatically pick up the slack. This is biology and nature at the most funnest part of watching at work. They automatically pick up that slack and all of those muscles redistribute that ability to contract right again, and they all find a more comfortable length to move in. So they're getting closer to their state of neutral or optimal. And then they heal in those states. And that is when I realized that is how you untie that knot.
You know, and this brings me back to that second physics principle I mentioned a little earlier, because once I began understanding these equal and opposite relationships and learning how to work the scar tissue in an order that actually created change and held change, something else became easier for me to see. And that is the muscles changed all by themselves. Not because I went back and forced them into a different position, but because I had changed some of the forces they had to respond to. So
Remember that rhomboid we started with, it felt tight under your hands, but when we actually looked at the body, it wasn't short, it was long. Something else was pulling on that scapula and pulling it away from the spine, and that rhomboid had been adapting to that position for however long that pattern had been there. And when I changed enough of the scar tissue relationships, creating that pole, those rhomboids didn't have to live at that same length anymore, and they could pick up the slack. And that was so fascinating to me because.
Now I wasn't only seeing changes in pain or tissue or scar tissue textures. I was watching the muscular system reorganize itself all by its little self right in front of my eyes. And that's where that other physics principle came into play and helped me understand what I was seeing. You're basically moving contractionability around. So that physics principle was an
Amy Bradley Radford (51:10.442)
Object in motion will continue along the same path unless an unbalanced force acts upon it. And when that happens, something changes in its speed or direction. And I remember seeing speed and direction and having absolutely, I mean, I was seeing a car moving or somebody walking, you know. I had absolutely no idea what that had to do with what I was feeling under my hands, and I obviously wasn't measuring how fast somebody's rhomboid was contracting.
But this was the law that explained what I was observing happen when the scar tissue would lengthen out and the muscles would automatically shorten back up. I'll buy them little cells. So it took me a long time to understand that muscles are a movement machine. Even when a muscle is contracting to hold us in place, there is activity occurring. It's producing and controlling movement, it's resisting movement, it's shortening and lengthening and continually adjusting on all.
Types of micro levels to all the forces acting on the body. So I started thinking about speed, and it really was explaining the ability of the muscular system to move and contract. A muscle contracting harder is behaving differently than a muscle that is giving up length. A muscle holding efficiently is behaving differently than one that's struggling against a force that's continually pulling it longer.
There's differences in what those muscles are doing and how much they are doing and the direction they are doing it in. And I don't want to take us too far into that today. This is just to open your mind because this gets much deeper when we start talking about contraction and direction. But I do want you to understand what I mean when I use the words speed and direction. The physics works. And I'm not standing there with some instrument measuring how fast muscles contract. I'm just looking at movement. I'm looking at contraction.
I'm looking at what the muscular system is able to do under the forces acting upon it. And once I began looking at it this way, speed and direction started making so much more sense to me. A muscle has an origin and an insertion. It shortens to create movement, and that contraction produces motion in a particular direction. So when I began looking at what scar tissue is doing in the muscular system, I began seeing changes in both the ability to move and the direction.
Amy Bradley Radford (53:33.688)
The movement was occurring. I was looking at changes in contraction. So since scar tissue shortens anywhere it is found, as we've already talked about, that shortening doesn't stay isolated to one tiny spot. It changes all of the relationships around it. Something moves, something lengthens, something rotates, another area has to compensate. And eventually muscles that were designed to contract efficiently from one position are being asked.
To contract from a completely different one and it's painful. And if there's enough force introduced into that system, the direction of contraction itself can change. And this is where some of the terminology I use in PPS eventually came for. I actually started calling these directional changes what I call them before I ever found the physics principles to explain them. So I started calling these changes reversals and transfers because they explained to me.
what I observed was going on in the body between two areas of scar tissue or between paired forces. Something had changed the direction the muscular system was trying to move in. Instead of the muscles working off of one another, the muscles were opposing the holding areas of scar tissue and it changed their ability. And I also don't want to take this too far into reversals and transfers today because those are entire conversations by themselves. That's actually what we're going to talk about next time.
But I do want you to begin seeing what I was describing. So let's put it this way: think about the body standing upright against gravity. In a body that is functioning efficiently, there's this beautiful amount of suspension happening all the time. We don't think about it because we don't have to. The body is holding itself upright. We are taller, our chest is up, our ears are over our shoulders, over our hips, over our knees, over our ankles. We are opposing gravity efficiently. The muscular system is.
contracting and supporting all movement. And all of those relationships are continually adjusting. So we can stand and walk and reach and turn and move and all of those things. So suspension and compression, you know, they're typical terms in massage therapy. And if you studied posture or postural deviations, then you probably already thought about the body this way. So what PPS added for me was another question. What changed the direction? Because what I began seeing was that as these scar tissue forces started activating
Amy Bradley Radford (55:57.208)
Building their relationships through the body, suspension reversed and became compression. The person went from opposing gravity efficiently to beginning to bend towards gravity inefficiently. And I know you can see that. We see it in the head begins to move forward and the shoulders round and the pelvis tilts backwards or forwards, and the body starts folding inward in different places and trying to accommodate this.
motion going downward by pushing different things forward or backwards or lateral in order to accommodate the fact that we've gone down. And we recognize those things as postural deviations. But I became interested in what was happening underneath those deviations and more specifically, what had changed that direction of force. Why would people come in and say, I keep trying to like put my shoulders back and I just immediately slump forward. It's like I can't
I get so tired to push back and it's easier for me to round. Why is that? What changed? Because now you're not simply looking at a body that has poor posture. You're looking at a body where the muscular system has adapted to these scar tissue forces, and somewhere along the way the direction changed. The suspension that had been helping the body oppose gravity was beginning to reverse towards compression. And the body was gradually moving.
With gravity instead of opposing it efficiently. And that brings us back to that physics principle about speed and direction. What forces changed? Where was the scar tissue? What was shortening? What was being forced to lengthen because of that shortening? What was fatiguing? What was failing? What was no longer supporting and holding? And what happened to the direction of muscular contraction as the body continued adapting to all of it? And this whole concept became a
Much bigger part of PPS than I ever expected because now I started looking at posture and not simply seeing that something was out of alignment. I could begin asking what direction the body was moving in and then what scar tissue relationships were contributing to that direction. And this is where understanding pain for me changed and became different and important. Because remember, in PPS I don't use pain simply to tell me where to rub.
Amy Bradley Radford (58:22.45)
I use pain to tell me where to go. So over the years, as I kept playing around with these principles, I kept mapping out these patterns. And pain sorted itself. Muscular pain didn't necessarily belong to the same level of forces as joint pain. Tendon pain was different. And more complicated structural pain showed up differently as well. And these weren't just
differences I saw within one person's body, I kept seeing the same kinds of pain presentations lead me towards scar tissue relationships in different places on different people for different things. And that repeatability is what eventually allowed me to build these PPS maps. So when a client tells me where they hurt, I'm listening very differently now than I did earlier in my career. I'm listening to where the pain is, but I'm listening to what it's in, what kind of pain it is, and how much they're experiencing.
Because those things begin giving me clues about the direction and the level of force I may be looking at. And the pain always gives me a starting place. I just simply have to investigate with my hands whether the scar tissue patterns are where I expect them to be. And that's where a lot of these PPS pieces started coming together for me. I'm addressing inflammation. The physical tissue I'm working with is scar tissue. The scar tissue has relationships. Those relationships have an order. One started it.
Physics gave me a way to begin understanding why those relationships existed, how they affect one another, why they're acting the way they are, why scar tissue forms and behaves the way it does, and then how I could work with that. So pain gives me the clue that tells me where to start looking. And I know that sounds simple when I put it into a few sentences like that. It was not simple getting there. It was 30 years of frustration, really.
And it took me years of working with people, finding something that changed their pain, watching it come back, trying again, getting it wrong, finding another piece, and then slowly realizing that all of these things I thought were separate were actually part of the same process. And I think that's probably the piece I I really want to leave you with today is PPS didn't develop because I went looking for a more complicated way to do massage. It actually became more simple as I understood it better.
Amy Bradley Radford (01:00:38.752)
Instead of having all of these if this then maybe that kind of answers, I began finding principles that stayed true no matter whose body was on my table. Scar tissue shortens anywhere it is found, automatically lengthens something somewhere else. Scar tissue doesn't necessarily exist by itself. It develops relationships as the body tries to find balance. Those relationships have an order. And when those relationships begin changing the direction of force through the body,
The muscular system has to adapt its contraction around them and it becomes less efficient and set up for more problems. And that's where we're going next. Because in the next PPS conversation, I want to spend some time specifically talking about direction. And what I mean by direction of force, that's what happens when contraction changes direction and how those changes eventually became the reversals and transfers I use in PPS today, and the pain patterns that showed up specifically for reversals and transfers.
But for now, I think that's enough to begin to understand the pain somebody points to isn't necessarily telling you where the problem began. It may be telling you where the force landed. And once I began to understand that, I stopped looking at pain the same way. You know, when I look back on all of this, I think that's why those very basics physics principles became so important to me. And I'll be honest with you, I actually went to a fifth grade teacher's website that taught you how to understand physics at a fifth grade level, and that was the perfect level for me.
That's how they were so simple that I was able to understand them. And they helped form the principles of PPS and started making sense of what the body was doing in inflammation. I understood that what I was doing was helping people in a way that I hadn't known before. I knew I could work somewhere that didn't seem to have anything to do with where they hurt, go back to the painful area and it had changed all by itself.
The pain was less. Their body moved differently. And I think one of the most fascinating things was I watched the body heal itself when given the opportunity. I merely assisted by kind of putting it back on the right track and then stepping back and watching it do what it was meant to do. And that was heal itself. And I think one of the most important things I did was I did not dismiss that simply because I didn't understand. It frustrated me for a long time, but I couldn't deny what I saw.
Amy Bradley Radford (01:02:58.08)
And I knew if I could change one area of pain, that rhomboid, then I could change so many other areas of pain just the same way. If I created a positive change, I wanted to know why. And I think there was one more piece to this. And it's something that I've mentioned in my podcast. And that was when I was younger, I had broken my leg when I was six. And by the time I was eight, I had chronic migraines, really bad headaches. I'm not sure they were migraines, but they were bad enough that I had to lay down, get in a dark room.
My mom would give me that really nasty orange aspirin to try and help my head. But I just remember their I just remember all of the pain that I was in. And my grandma learned reflexology. It's one of the reasons I went into massage therapy was her desire to learn more natural healing. And she came to take care of us one day while my mom had some doctor's appointments and I had one of these headaches. And she said, Missy, she's called me Missy Tame Tame. She said, Can I work on your feet? And
Course I said yes, you know, it was my head that was hurting, but she worked on my feet for almost two hours. Broke down all of those crunchies, you know, those crystals, whatever, whatever they were calling them at the time. And she went clear up onto my ankles and my legs, then all the way down. I mean, she just was very thorough. And I never had another headache after that. And that left such an impression on me that between the experience I had with the rhomboid and the experience I had with myself, I knew that there was a
different level of healing that could be achieved if you could find it. So I kept working on these things until I could repeat the change with another client and then I would start mapping those things out. And my goal was to find that solution for every pain pattern. And that's why I call it pain patterns and solutions. And that's how PPS grew over over about 30 years. I kept looking because I had people in front of me who needed help. And I I didn't know how to help them yet.
And at some level, I was actually trying to help myself after my car accident. But I was willing to think outside the box. I was willing to follow kind of some unconventional methods when I was looking for answers. And basically that was starting to work on top of bone and looking in into other things that, you know, the answer was there. I just had to find it. So today we've talked about scar tissue and paired forces and a little bit about speed and direction and how those patterns eventually became what I call reversals and transfers.
Amy Bradley Radford (01:05:23.756)
And we're gonna take this idea of force we've been building and start looking at what happens when that force changes direction, when suspension begins reversing towards compression, when muscles start responding differently, and when pain is giving us clues about where those forces are inside the body. And that's where we're gonna go next. Thank you for staying and listening to this story. And I hope this PPS stuff is interesting to you. It's my passion project next to business success. And I am excited to tell you about how it came to be.
And hopefully with what I share, it can make a difference for you if you are seeking some different answers too. Thanks for listening, and we'll see you next week. Thanks for spending part of your day with me. If today's episode helped you, please subscribe, leave a review, and share it with another massage therapist. To learn more about today's topic, explore continuing education, coaching, and free resources, visit Amy Bradleyradford.com. And until next time.
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