Chiropractic Massage & Deep Tissue Work in Walnut Creek

Muscles attach to bones and cross over joints. When a joint is irritated or not moving properly, the nervous system may increase tension in the surrounding muscles in an effort to protect the area. Although this response may initially be helpful, persistent muscle guarding can eventually become part of the problem.

The reverse can also occur. Tight, shortened, or restricted muscles and fascia can continually pull on the spine, ribs, pelvis, shoulders, and extremities. Even after a joint has been adjusted, the surrounding soft tissues may continue directing the body toward the same restricted position or movement pattern.

Chiropractic adjustments are used to improve motion in joints that are not moving properly. Deep tissue and other soft-tissue techniques address the muscles, fascia, and connective tissues surrounding those joints. When appropriate, combining the two may help reduce protective muscle guarding, improve comfortable movement, and support better mechanics.

Not every patient needs deep tissue work, and not every tight muscle should be worked aggressively. Treatment should be based on the individual examination rather than a standardized routine.

Unfortunately, “deep tissue” has increasingly come to mean simply a massage performed with very strong pressure. Traditionally, deep tissue work referred more broadly to techniques intended to address adhesions and restrictions in the muscles, fascia, and other soft tissues.

Deep tissue work is a generic, nonproprietary term. Rolfing and Active Release Techniques are named systems with their own specific methods, training, and certification requirements. Dr. Rehl’s teacher at his massage school incorporated techniques used in Rolfing but taught them under the broader name of deep tissue work. Because Dr. Rehl was not trained or certified as a Rolfer or Active Release Techniques provider, he accurately describes the work he performs as deep tissue work.

In short, Dr. Rehl does not aim to simply press as hard as possible. Rather, the goal is to identify restricted tissue and apply pressure, movement, or stretching in a precise direction to help improve its mobility. This approach is more targeted than general massage and is designed to address specific areas of restriction.

Treatment may include sustained pressure, slow movement through tight muscle fibers, focused work around muscular attachment points, myofascial techniques, stretching, or trigger-point work. The depth, direction, and duration of the technique are adjusted according to the tissue involved and the patient’s response.

The place that hurts is important, but it is not always the only area involved.

Persistent neck and upper-shoulder tension, for example, may be influenced by restricted movement in the neck, upper back, ribs, shoulders, chest, or jaw. Low-back discomfort may involve the lumbar joints, pelvis, hips, gluteal muscles, abdominal wall, hip flexors, or other tissues that affect how the spine moves.

A muscle may also be working excessively because another muscle is not contributing appropriately. In these situations, repeatedly working on the tight muscle without addressing the underlying imbalance may provide only temporary relief.

Dr. Rehl begins by asking how the problem started, where it is felt, which movements aggravate it, and what has or has not helped in the past. He may examine posture, range of motion, joint movement, muscle tone, strength, tenderness, and movement patterns.

He also uses applied kinesiology and muscle testing as part of his broader evaluation. The purpose is to identify functional relationships that may be missed when attention is limited to the painful area. Muscle testing is used alongside the patient’s history and physical examination. It does not replace appropriate imaging, medical testing, or referral when those are needed.

Chiropractic care combined with deep tissue work may be helpful when muscle tension, restricted soft tissues, and joint dysfunction appear to be contributing to:

• Back pain or recurring low-back tightness
• [Neck pain] and restricted neck movement
• Shoulder and upper-back tension
• Muscle knots, spasms, or protective guarding
• Postural strain from desk work or repetitive positions
• Hip, gluteal, or pelvic tension
• Rib and chest-wall restriction
• Sports injuries and repetitive-use problems
• Tension-related headaches
• [Pinched nerve or nerve-like symptoms] when muscular or fascial restriction is part of the pattern

These symptoms can have many different causes. Deep tissue work is not appropriate for every condition, and it is not a substitute for medical evaluation when symptoms suggest a fracture, infection, blood clot, progressive neurological problem, or another condition requiring medical care.

Many patients with back pain experience both joint restriction and muscular tightness. The muscles may tighten following lifting, prolonged sitting, repetitive activity, an old injury, or an acute episode of pain.

Sometimes muscle or fascial restriction is a primary contributor. In other cases, the muscular tension is the body’s response to irritation in the lumbar spine, pelvis, sacroiliac joints, ribs, or hips.

Dr. Rehl evaluates how these structures are functioning together. Treatment might include a chiropractic adjustment to improve restricted spinal or pelvic movement, followed by focused work on muscles that remain tight or inhibited.

In other cases, soft-tissue work may be performed first to decrease guarding and make an adjustment more comfortable. Some appointments may consist mostly of deep tissue work when that is what the examination indicates.

The order is not predetermined. It depends on what Dr. Rehl finds and how the patient responds during the visit.

For some people, deep tissue work may provide improvement in pain, muscular tension, and movement. It is often most useful as part of a broader plan that may also include chiropractic care, movement correction, exercise, and changes to activities that are continually aggravating the problem.

Neck and shoulder pain frequently involve more than one structure. Muscles such as the upper trapezius, levator scapulae, scalenes, pectorals, suboccipitals, and the muscles surrounding the shoulder blade may become tense, shortened, or sensitive.

Restrictions in the cervical spine, upper back, ribs, shoulders, or chest can contribute to the same pattern. For example, a muscle in the neck may continually tighten because the upper back or ribs are not moving properly. Conversely, chronically tight chest or shoulder muscles may affect the position and movement of the neck and upper back.

Dr. Rehl looks at how these areas move together. When appropriate, he may combine gentle or traditional chiropractic adjustments with focused deep tissue work to help reduce muscle guarding and restore more comfortable movement.

Some patients benefit from firmer pressure. Others respond better to a slower and more gradual approach. Dr. Rehl adjusts the treatment according to the sensitivity of the tissue and the patient’s comfort rather than assuming that deeper pressure is always better.

A muscle can be tight and weak at the same time. In some cases, one muscle works excessively because another muscle is inhibited or not coordinating properly. Simply loosening the tight muscle may not correct the imbalance.

Dr. Rehl may use neuromuscular re-education to improve how muscles activate and coordinate with one another. This can include muscle testing, resisted movements, sensory stimulation, stretching, movement retraining, and home exercises.

The objective is not merely to make a tight area feel looser for a few hours. It is also to address the movement pattern that may be causing the same tissue to become overloaded repeatedly.

Treatment depends on the examination and the nature of the problem. Dr. Rehl may use:

• Manual chiropractic adjustments
• Activator or drop-table techniques
• Gentle table-assisted movement
• Deep tissue work
• Myofascial techniques
• Trigger-point work
• Muscle testing
• Neuromuscular re-education
• Stretching
• Corrective exercises

Some appointments emphasize chiropractic adjustments. Others involve considerably more soft-tissue work. Many combine both.

Dr. Rehl has more than 27 years of experience in chiropractic care and bodywork. He trained and became certified in massage therapy, practicing for seven years before becoming a chiropractor. His approach is hands-on and individualized rather than based on a predetermined sequence of adjustments or massage techniques.

Deep tissue work can sometimes feel intense, particularly in an area that is already sensitive, but it should not feel uncontrolled or unnecessarily painful.

Pressure should remain within a tolerable range. Patients are encouraged to tell Dr. Rehl when something feels too strong, sharp, electrical, burning, or otherwise wrong. He can modify the pressure, angle, technique, or area being addressed.

The goal is to create a useful therapeutic response, not to determine how much discomfort a patient can tolerate.

Some temporary tenderness may occur after focused soft-tissue work, particularly when an area has been chronically tight or restricted. Significant bruising or prolonged aggravation is not the objective.

Your first visit begins with a discussion of your symptoms, health history, previous injuries, daily activities, and treatments you have already tried.

Dr. Rehl will evaluate the painful area as well as other joints and muscles that may be influencing it. Depending on the condition, this may include evaluating posture, range of motion, joint mobility, muscle strength, muscle tone, tenderness, and specific movement patterns.

He will explain what he finds and whether chiropractic care, deep tissue work, neuromuscular re-education, or a combination appears appropriate. Treatment is adjusted according to your condition, comfort, and response.

If the examination suggests that imaging, medical testing, or evaluation by another healthcare provider is needed, Dr. Rehl will discuss the appropriate next step.

If chiropractic adjustments alone have not fully addressed your muscle tension, or if massage has provided only short-term relief, it may be helpful to evaluate both the joints and the surrounding soft tissues together.

Schedule an appointment with Dr. Michael Rehl at Rehl Chiropractic in Walnut Creek. He will assess your condition, identify what may be contributing to your symptoms, and determine whether chiropractic care, deep tissue work, or a combination is appropriate for you.

You can book a new patient appointment online or call the office to get started.