A 5 step Myoskeletal Alignment Techniques Roadmap

Recently, another therapist interested in studying Myoskeletal Alignment Techniques and taking one of Erik Dalton's workshops, asked me how I integrate MAT into a normal, full body, deep tissue massage when the client doesn't have a particular complaint coming into the session. Like planning for a multi-destination trip with the areas of the body being the towns we want to visit and the techniques being the transportation methods to get there, we still need a planned map to visit everywhere we want to go.  Being trained in traditional, classical biomechanics, I believe that once you understand the basic patterns with which a body stabilizes and reinforces itself in response to the effects of physics, you can dissect individual pattern variations and treat them.  These aberrant, overuse stabilization strategies are predictable and very treatable.

This generalized template has 5 steps that can be cycled through or you can veer off from at any point and then moved back to.  Many times this is also the way I approach the first session with a new client or an existing one that need a "tune-up".  Again, this is my personal, professional process and it is entirely a subjective evaluation.

1.  The first initial step of full body springing and assessment is vital to understanding the interdependent biomechanical relationships of the joint systems and related tension of the body in an unloaded situation. Using myofascial release, joint decompression and other MAT techniques during initial "warm-up" of the body, the shoulder, spine, hip, arm and leg mobility are assessed.  The aim is to ease generalized tension in the myofascial tensegrity net that may affect further mobility evaluation as the joint systems are sprung for "joint play". This step, which can be done in several minutes, can be particularly helpful in giving the client a sense of the fascial tension in their body. It also helps prioritize the session and provides a benchmark for each body area that can be reevaluated at any point in the treatment session.

2. Begin specific soft tissue work to address areas that need attention in the muscle belly, MTJ, ligaments, and joint capsule. Any method you want can be implemented here. Thoroughly release any soft tissue adhesions that may be affecting the mobility and neural tone of the area.  If adding any pin and stretch technique, either passively or actively, steps 3 and 4 are already being included.  These techniques can decompress joint capsules and begin to affect positive change in the sensory feedback system.

3. Move to specific, single joint mobilization as needed based on your springing assessments.  Muscle energy techniques and MAT graded exposure stretching can apply here. You can also move back and forth between single joints and #4's multiple joint mobilizations at will.

4. Progress to multiple joint segment mobilizations as need based on springing assessments. This is where you link the individual mobilizations together. An example would be Don Tigney's SI joint technique, while mobilizes the lumbar spine, SI joint, and acetabular femoral joint. At this point, you can cycle back to step 1 to reassess and integrate your work.

5. Finish with full body integration using myofascial release, graded exposure stretching, MAT finishing stretches or whatever you want. I like to include bilateral arm and leg traction and rotational stretches with client breathing assistance. In general, I finish up with the head and neck to integrate the cervical spine and occiput with the rest of the body. Often, I will go back to the full-body springing assessment to check for progress. It also gives the clients a sense of what we have accomplished. 

This process gives me a standardized sequence that always gives me a place to start and somewhere to come back to if treatment gets diverted to another process. Again, whatever evaluation method you use should provide you with all the information you need to plug yourself into the 5 step process.