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Good morning my sunflower followers! Today we’re going to talk about positional release therapy. So, what in the world is that, you ask? Well, positional release therapy is an excellent adjunct to the practice of massage therapy, because it allows me (the massage therapist) to unwind tissue prior to manipulating it, making massage less painful and more effective, and its therapeutic effects longer-lasting. Instead of forcefully compressing or stretching the knot or tissue, which may only engender short acting pain relief, tissue is unknotted and then realigned with massage therapy, further facilitating tissue perfusion and structural alignment. This is a lot like removing a kink or knot in a garden hose – it allows regular blood flow to be returned, and prompts proper alignment.  

I have found positional release therapy is best applied prior to massage, or as tender trigger points are found during the course of a massage. My clients will often report decreased pain, increased warmth and tissue relaxation, as well as a sense of overall relaxation during or after the application of positional release therapy. When practicing positional release, my strategy is to remain SLOW and rhythmic. A great example of clients who benefit from this kind of therapy, are my clients with misaligned hips. Hips that are uneven can cause weight bearing discomfort on one side of the body and sometimes causes uneven muscular development on the client’s body. It can also cause uneven gait patterns. Human gait refers to locomotion achieved through the movement of human limbs. Gait is defined as bipedal, biphasic forward propulsion of the human body’s center of gravity, in which there are alternate sinuous movements of different segments of the body with least expenditure of energy: translated into layman’s terms, it basically just means walking.

When an individual experiences a sudden and unexpected strain, the antagonist to the strained tissue resists, or counter strains, against the force in order to stabilize the associated joint or appendage. This produces discrete areas of tissue tenderness. That is what positional release targets. During a hip alignment, I begin with evaluating my client’s gait pattern, and then I will start with the client side lying positions on my table. I will then stand behind my client, placing my hands on the anterior flexor muscle, and pull their pelvic region towards myself. I will also place my bent knee as a proper stabilizer in their sacroiliac region. I will then pull into the knee on their lower back and hold that position for a minute or two. I rock the hip and allow the pressure of the tight pelvic region to release. Then I will instruct the client to bend their knee and abduct (outward extending the hip to open pelvic girdle). I also hold their abducted hip out for a minute, then adduct (push hip back into resting place inwardly), then repeat this cycle about 2 times. After all that is done, I’ll place my hands onto the client’s ankle and pull their foot. This causes the pressure of daily wear and tear to release in the ankle and there will be a little cracking sound – the immense pressure release causes a pleasant sigh in my clients and they comment wow, that felt heavenly.

After I work on the side thats most uneven, I will say to my client, “Okay, now lets work on the opposite side,” you can’t do one without the other! So they will roll over to their other side and again we go through the process. Sometimes I like to add cupping on their erector spinal muscle grouping to work on releasing their spinal pressure. I also will manually massage their knots along the spine, then continue the positional release for their hip and sacroiliac joint. This therapy, as you’ve probably figured out, is pretty time-consuming. For most patients, it adds 20 more minutes to allow the full release to happen. Of course, this isn’t a therapy that can be rushed, slow and steady wins the race.

Positional release therapy, is a great method to reduce pain, and for those with misaligned joints it can cause lasting relief, since the root cause of the pain was addressed, not just the resulting muscle knots. If you have any questions, or would like to be evaluated for positional release at your next session, please feel free to call or message!


Alina Maury, L.M.T.