The Phenomenon Of Adaptation

Dear reader,

This part of our journal dedicated to the science of stress-reduction and therapeutic massage. Our authors will share with you the precious scientific information accumulated by the Western school of massage on the usage of its preventive and healing power. We see our goal in making our readers competitive on the market and successful in building up practice. Pay attention to this information because it will make great difference for you and your clients. This article is a part of the vast collection of articles and massage techniques to be found in Video Library of Therapeutic and Stress-Reduction Massage.

The Phenomenon Of Adaptation

We work hard as massage practitioners performing therapeutic and stress-reduction massages. Our goal, of course, is to serve the health and well-being of our clients, but we also want to build up our practice to the point where we have enough regular clients to provide us with both professional and financial satisfaction. This can prove to be a very real challenge for all of us, whether we are self-employed or employees at a spa or a medical office. A client is one thing. A loyal clientele is another. Once you get someone on your table, how do you keep them gladly coming back to you again and again? Let’s take a look at one common scenario. You were referred a new client, Mrs. C., whom you have been seeing on a weekly basis for two months now. She told you regularly how much she enjoyed the massage, how “gifted” your hands were, how much she looks forward to the next session. Then, suddenly, Mrs. C. stops visiting you (does it sound familiar?). It would be easy to simply label her as a “non-loyal client.” However, it is a common mistake to transfer the blame to the client when the real blame, in fact, lies much closer. The real blame lies right between our own hands. It is the massage practitioner who lost the opportunity to have – and to keep – this client as a regular and loyal client. “Nonsense!” you may argue. “How is it my fault if a client loses interest in my work?” A very common reason why a practitioner fails to retain their clients is because he or she is not fully mindful of The Phenomenon of Adaptation. Mrs. C. got bored. She would tell her friend who referred her to you, “I loved his or her massages at first, but after a while, they didn’t do anything for me anymore.” Or, “They all started to feel the same.”

What Mrs. C. and you, her massage therapist, may not be aware of is the degree to which the “boredom” Mrs. C. has come to experience during her massages is physiologically based, and is the result of a series of mechanisms whose workings can be scientifically explained. To discover these workings, and to better understand this phenomenon of adaptation, we need to look in some detail at certain nuts-and-bolts aspects of how the autonomic nervous system responds, in measurable ways, to massage.

What causes the phenomenon of adaptation? The majority of clients visit massage practitioners to maintain wellness and to reduce their level of stress. One’s stress level is under the control of the autonomic nervous system, which manages all body functions without our conscious participation (as, for example, our heart rate or the flow of blood through our muscles). The autonomic nervous system consists of two divisions: the sympathetic and the parasympathetic nervous systems. Both divisions control the body’s functions by constantly interacting with one another. The sympathetic nervous system is the stress system. It is activated during emotionally or physically stressful situations, as well as generally during the waking hours. The parasympathetic nervous system has the opposite effects. It is more active during periods of relaxation, as well as generally during the sleeping hours. In a healthy body, both divisions act upon the organs and tissues as a plus and minus, constantly balancing each other’s effects, with the overall result of their interaction equaling zero. For example, if the sympathetic nervous system increases the heart rate, the parasympathetic system then decreases it. If the parasympathetic nervous system triggers bronchoconstriction, the sympathetic nervous system then produces bronchodilation. When the relationship between the sympathetic and parasympathetic nervous systems becomes unbalanced, the sympathetic nervous system increases its activity, resulting in sensations of stress: physical tension, anxiety, morning stiffness, chronic mild pain, etc. This is the tipping point when a person under stress will decide to seek massage, or to practice yoga, meditation or aerobic exercise. These all result in a decrease in the activity of the sympathetic nervous system, and thus in one’s level of stress. Modern medicine has come to understand chronic stress as a primary trigger of chronic disorders in the human body. Thus, owing to its effective stress-reduction impact, massage is an important (and grossly underutilized!) tool of preventive medicine. The practitioner works with soft tissue, which contains millions of sensory receptors that are activated during the massage. The peripheral receptors – receptors of touch, pressure, vibration, and temperature, as well as muscle spindle receptors and Golgi tendon organ receptors – all send sensory information to the spinal cord. This sensory information is primarily processed in the posterior horns of the spinal cord by spinal neurons. The spinal neurons are responsible for the further conduction of sensory information to other parts of the spinal cord and to the brain. Massage impacts the central nervous system and restores the balance between the sympathetic and parasympathetic divisions through the activation of the peripheral receptors in the massaged area, and subsequently, activation of the spinal neurons located in the segment of the spinal cord responsible for the innervation of that area. Each type of peripheral receptor has its own threshold of adaptation. A perfect example of this is the continuous application of a particular massage stroke in the same area. The client experiences the first strokes as sharper and more distinct, as compared with the same strokes in the same area conducted for one minute or more. Adaptation of the peripheral receptors (in this case, touch and pressure receptors) is the result of their desensitization. The spinal neurons in the posterior horns of the spinal cord also have their own threshold of adaptation. After prolonged repetitive stimulation of peripheral receptors, the spinal neurons reach their own threshold of adaptation due to the consistent flow of (harmless) sensory information they receive from the peripheral receptors of the massaged area. Thus, the desensitization (that is, the attaining of the threshold of adaptation) of the spinal neurons occurs secondarily to the desensitization of the peripheral receptors brought about by the practitioner’s strokes.

How do peripheral receptors and spinal neurons overcome adaptation? Whereas peripheral receptors are able to shake off their adaptation and restore their full working potential very quickly after a repetitive stimulation has ceased (the moment you stopped the application of effleurage, for instance), spinal neurons, on the other hand, stay adapted for a while after sensory information has ceased to flow to them from the peripheral receptors. When spinal neurons reach their threshold of adaptation, they allow less sensory information to reach other parts of the spinal cord and the brain itself. As a result, the balancing impact of your massage strokes on the relation between the sympathetic and parasympathetic divisions of your client’s autonomic nervous system is now lessened. Returning, once again, to our (so unfairly labeled) “disloyal” Mrs. C., let’s consider that the practitioner has developed an hour-long massage routine that he or she (let’s pretend it was you) uses on all clients from session to session. For Mrs. C., as a new client, your personal style feels new and exciting, and she really enjoys the first few sessions. Mrs. C. has a regular weekly appointment with you for 8 weeks, and every week she comes into the same room, at the same time, and experiences the same massage routine. Her peripheral receptors, therefore, send a flow of the identical sensory information to the posterior horns of her spinal cord, and with each new session of the same massage routine her spinal neurons reach their threshold of adaptation sooner into the session, and remain adapted longer. Then Mrs. C. hears from her girlfriend about a new massage practitioner in the neighboring spa, decides to try her massage, and absolutely loves it! This new practitioner very likely conducted a massage routine generally along the same lines as yours, however the variations of her personal style kept Mrs. C.’s spinal neurons from quick adaptation. Boom! A new and exciting experience for Mrs. C., about which she will certainly tell all her friends! Unfortunately for you, it is too late. You just lost a regular client, as well as all the positive word-of-mouth that goes away with her. What’s sad is that Mrs. C. was your client to lose, and her nervous system’s adaptation – her “boredom” – yours to prevent!

How do we control, and thus prevent, the phenomenon of adaptation? It’s like a relationship. When we start dating, it all begins with an initial interest, followed by a liking of what we experience, reinforced by the excitement of what’s coming next, leading to a certain personal commitment. However, sooner or later the honeymoon (when everything is naturally exciting due to the newness of things) is over and we have to become conscious of using our intuition and creativity to keep our relationship interesting and lasting. The best solution to successfully building a practice that will keep your clients interested and coming back is a richer, more varied technical repertoire. There are more than 60 variations of 7 basic massage techniques, but when practitioners compose their massage routine, they often use only a very limited number of these variations, applied over and over again. A limited technical repertoire and a never-changing massage routine are two major factors which contribute to the adaptation of one’s clients’ spinal neurons and thus, their further lack of interest. It undermines the therapist’s practice. Conversely, by investing in a variety of techniques and routines, a massage therapist ensures that their clients will remain fascinated with their work and, just as importantly, that the therapist’s own level of interest in and excitement for what they do will continue to grow. Variety doesn’t mean that you need to visit all 60 variations upon your clients each time you work with them. That would be quite senseless. The solution, thankfully, is much simpler. So let’s discuss in practical terms how to control, and thus prevent, the unwelcome phenomenon of adaptation. Let’s say you have developed an hour-long (or 1.5 hour-long) massage routine that you enjoy executing and are proud of. Great! This is the foundation of your practice. To control the phenomenon of adaptation, you simply need to incorporate one or two new variations into each day’s massage routine, switching these around daily with other variations, or combinations of variations. For example, you decide that for all your clients today you will incorporate into your massage routine ridging friction and scrolling kneading. In such a case, you add both techniques to the massage of each segment of the body. Tomorrow, within your regular routine, all of your clients will receive two different variations from the previous day: for example, stretching friction and mobile kneading. If you have 5 to 7 such gourmet sets of massage techniques, you can incorporate them into your routine and constantly rotate their application on a daily basis. Alternatively, for clients who see you on a weekly basis, you can function along the lines of an added Special Combo of the Week. In this way, your regular clients will never reach the threshold of adaptation and feel bored; each time they see, you will be surprising their peripheral receptors and spinal neurons in some different way. Your ever fresh and original work will be the Talk of the Town. Your clients will remain captivated by your exciting, surprising massages, and you will retain the opportunity and privilege of exerting a positive influence on their lives. Heck, you may even get Mrs. C. back!

To learn more about science of therapeutic and stress reduction massage and review all variations of seven basic massage techniques developed by the Western School of Massage visit our Video Library where all techniques are presented in the video mode.

John Antonopoulos, LMT, has been practice massage therapy for 25 years. He has studied with the distinguished Paul Andres of Alsace, as well as at Montreal’s Kine-Concept Institute. He conducts a private practice in Montreal, Quebec, Canada. He can be reached by e-mail: ianosmammio@gmail.com

Tags: Journal of Massage Science 2009 #1, Science of Therapeutic and Stress Reducing Massage