Let’s discuss one of the biggest mistakes that I often see people making in the soft tissue world. And I can say that because I did it for many, many years because my training. was very much based on fascial work, deep tissue work, joint mobilization, joint manipulation. Now, what I will tell you is that as my experience with people increased and more importantly, as my understanding of neurology increased, what I realized is that many of us who do soft tissue to others or on ourselves, right? I’ve got a tennis elbow. Oh, my neck’s killing me. I’m going to do a little bit of massage. We often bypass the most important system, the skin, in order to get to the stuff that we think is more important, which is the muscles, the tendons, ligaments, and the fascia.
So, I want to talk to you a little bit about skin work, give you a couple techniques that you can focus on and explain to you neurologically why skin is such an incredible tool for helping people get out of pain.
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Let’s get back to the skin. There are some neurologic phenomenon that occur in the body. So very simply, if I have my arm out and I take my finger or let’s say even more precisely a pencil or pen and I push it into my skin, not through my arm, but into the skin, something will happen that is called lateral inhibition or It will also sometimes be referred to as surround inhibition.
But what that basically means is that my nervous system is designed in such a way that when that pen tip touches my arm, the nerve endings directly under the tip will become more active and everything around it will be inhibited. Now, most of this is happening at the spinal cord level, and then as that information goes up to the brain.
Now, why that is really, really important is this. Let’s say I have pain somewhere in my arm. And let’s say I have maybe some tennis elbow. So, you know, I’m feeling through my arm, and I have pain right here. What you have to understand is that if that pain is coming from a deeper structure, like a muscle or a tendon, I may be able to decrease the sensation, the nociception, by not working on the muscles and tendons, but instead working above it.
Because as I work just at the skin level, I may create inhibition of the noxious or threat signals that are coming from the other tissues. I know that may be a little complicated, but that’s how it works and it is incredibly cool. So we do a lot of work on the skin. In fact, I tell people after 30 plus years of doing this, they’re like, probably 90 percent of the work that I do on a human body is more skin mediated or skin related now as opposed to working on deeper tissues.
It’s not that the deeper tissues aren’t important, but particularly for pain, I have found skin work to be incredibly valuable. And this is probably also why a lot of people respond great to things like kinesiotaping, very, very light cupping interventions, scraping, right? All of it will teach you, if you really pay attention to it, That the skin’s incredibly powerful.
It’s our, it’s a huge organ. It’s the number one thing that we use to interact with the environment. And so our brain is very, very, very focused on threat coming from anywhere on the skin. So if we can take it easy, tell the skin, everything’s okay. Good stuff can happen in relationship to pain. So how do you work on it?
Couple different ways that you can start. Number one, if you have an area of pain, you need to check the mobility of the skin. What I mean by that is don’t press through the skin. Just rest your fingers on top of the skin and check the compass directions, right? North, south, east, west. And you’re basically trying to identify Are there areas of the skin or direction specifically feel abnormally tight?
Probably going to have to compare it side to side to get some ideas. There were some cool studies done back in the nineties, looking at chronic headaches and skin tension in the upper trapezius muscle, and they found about an 80 percent correlation with increased skin tension on the side where people had their chronic headache.
So we will see this over and over and over again. So you begin by identifying the direction of tension, and then we typically will tell people to do some kind of test and retest while holding tension on the skin. So as, as an example, let’s say I was having a elbow pain, right? I’m gripping down. I’ve got some tendonitis or maybe I’m picking up my coffee cup or I’m doing a wrist extension.
What I would have you do is test it. Right? And let’s say, okay, right now that’s a three out of 10 pain. I would then find the area of the skin. Again, probably overlying the area that’s painful. I would test each direction, looking for areas that are a little sticky in my elbow. I feel some tension to the skin downward toward my hand and medially toward the midline of my body. So I would then pull some directional specificity on the skin in that direction and just simply hold it at that point. After 10, 15 seconds, I’m going to grip again. I’m going to give the same kind of testing and I’m going to notice does that decrease any tension or pain?
And actually, although my elbow is fine, that actually made my elbow feel better. Just that little bit of motion. Now, if that works for you, you’re going to spend some time on this. It’s about every. hour or so. You’re going to spend two to three minutes working on that skin. If you understand kinesiotaping, you can also use some tape, in that, area as well.
Once you’ve done the directional work and the skin has begun loosening up, you can also then go to what is called skin rolling. Skin rolling is a very, very simple technique where I’m going to not pinch the skin, but I’m going to place my thumb and I’m going to use my fingers to pull the skin toward it.
So that I’m actually rolling the skin. What a lot of people will find when you do this on yourself or you do it to somebody else, skin rolling can show you some exquisitely tender spots in the body. Those are going to be areas where the skin has lost elasticity, poor elasticity, poor mobility will generally set you up to have pain issues occur in that area.
So you can do skin rolling throughout the body. You’ll often find issues in the back, the neck, hamstrings calves. And if people have arm and wrist issues, you’ll often find problems around the joints of the elbow. the wrist and even down in the fingers. Main takeaway here, don’t forget the skin. It’s easy to forget and think, Oh, I need to go harder.
I need to go deeper because we get a lot of sensation from that. But if you’re really looking to solve pain and movement problems, don’t forget to work on the skin. A couple of different possibilities. You do directional work and you do some skin rolling. Those are great places to start. Hope you found this enjoyable and useful.
Good luck. And we will see you soon.
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