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ABSolutely Necessary

The importance of addressing the abdominal region

          If you have had me as a therapist, chances are fairly high that I have asked if you would allow me to perform abdominal work. This is a region of the body that does not receive the attention it often needs. It is a hugely important region. These are muscles that help us sit, stand, walk, breathe, eat, and basically live day to day. Despite the importance of the area a lot of people don't want therapists to go near it. Why are we so nervous about work in that area? The abdomen is a very vulnerable area. Almost all of our major organs are nestled safely within the abdominal cavity. When we are afraid or stressed out we tend to curl forward (fetal position). When under threat or attack it is our first instinct to protect the front of our neck and abs. We are very protective of this area and with good reason. So why do I want to go digging around in people's abdomens? 
           First things first. What do I mean by "abdominal region/cavity"? This area is essentially from the bottom of your ribs to your pubic bone (where the two parts of the pelvis meet) To find the pubis place your hand just above the groin and press in slightly.  You will feel a bone spanning across from one side to the other. This is the abdominal region. 
            The above picture shows the superficial and some of the deeper muscles of the abdomen. Most people know of the 6-pack muscle, rectus abdominus (you only see half of it here). They have cut away sections so you can see the different layers of the muscles. All these muscles work together to allow us to twist, bend, turn, and all combination thereof.
              (A side note on a few terms used in the photo - the linea alba is a fascial band inbetween the right and left side of the rectus abdominus. An aponeurosis is a large, thick fascial sheath that covers a wide area - these are the white areas you see). Behind these muscles are all of our major organs.    
              The picture below is of the deeper abdominal muscles. These are behind our organs.  
            When looking at these pictures look at where these muscles are. The abdominals (transverse, internal and external obliques, and rectus) span from the rib cage to the pelvis. They blend in with the muscles of the back and upper chest. The deeper muscles (the psoas in particular) blends in with the diaphragm and all the way down to the muscles of the upper thigh. 
            We have a bad habit of viewing the body as separate parts. While there are regions of the body, the fact of the matter is, it is all connected. You can begin to get a picture of how stress and tension in one muscle can create pull and tension in others. For example: Sit up straight with shoulders back. Pay attention to where you rib cage is (if you want place your hands on the bottom of the ribs). Then, go into what is your typical posture. Feel how the ribs sink into the abdomnial area, your pelvis rotates back, your shoulders round forward, and your head goes forward.
             So why does this make abdominal work important? Posture is a habit. When the body is used to being in incorrect posture/position it will create a whole host of compensations to keep us as upright as possible. When we have bad posture we do not use certain muscles they way they were meant to be used. Ever heard the phrase "Use it or lose it"? Well this applies to muscles. If we don't use them they become weak and cannot perform their intended function. This results in muscular imbalances that can cause a lot of chronic pain, stiffness, and general soreness. If you have areas that always seem stiff and tight, chances are it is because those muscles are being used too much and working to take up the slack of other muscles.  
              In my previous post I talked about how we tend not to use the diaphragm as we should. Well if the diaphragm is restricted from not being used, it can prevent the ribs from fully expanding, it can pull on the muscles of the back, the psoas, and abs. It is essentially a domino effect. If there is dysfunction in one muscle it will affect those around it. 
              By finding the areas of tension and restriction, a therapist can release that pull. Massage helps flush that ischemic (a lack of blood flow) tissue with fresh fluid/blood, bringing in oxygen and needed nutrients. For example, by working along and slightly under the edge of the ribs I can affect the attachment points of the transvers abdominus, the rectus abdominus, and the diaphragm. If there is tension and restriction that is released it allows the chest to move into better posture on it's own. 
            I had a client come in and only worked the abdominal region. No back or shoulder work at all. When the session ended they stood taller and straighter. Also, the shoulders were in a more neutral position. The client mentioned that the left shoulder had been causing pain and after the session the shoulder felt looser and lighter.   
           The posas and illiacus can be major participants in low back and hip pain. Have you ever had a massage that felt good, but like it didn't quite hit where the pain was coming from? It is very possible it was a deeper back muscle or the psoas causing that pain. A short, tight psoas wants to pull the spine forward (how it is when you bend forward or are in a sitting position). If is is stuck in this shortened position, it puts a great deal of strain on the low back. The muscles of the back tighten up in response so you don't stay bent at the waist. Our body is basically fighting against itself to keep us upright.
              Abdominal work address the tension and patterns of restriction that have a major impact on our posture. As with any bodywork there are some cases where this work is not recommended, but most people benefit greatly from it.   
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