When Torey Ebding first visited local massage therapist Deborah Riley, she was experiencing three to four migraine headaches a week. Ebding had been rear-ended in a car crash in 2013 and thought her migraines were connected to the crash.
“Torey told me her pain started in her shoulder, and it felt as if something was wedged in her shoulder area,” Riley said. “The pain crept up into her neck and into the back of her head. She said she knew she was going to have a migraine if she couldn’t get on top of the shoulder pain.”
Ebding tried different prescription medications and physical therapy for three months post-crash, as well as other treatments, then saw Dr. Justin Olswagner with the Walla Walla Clinic.
Olswagner has been a client of Riley’s and had found her myofascial-release techniques — wherein connective tissues are pressed and manipulated — to be helpful. He referred Ebding to Riley, and the patient said she had finally found relief: Her three to four migraines a week have diminished to one a week. Sometimes she can go two weeks without a headache.
What Riley does is address the fascia, a system of the body that looks like a densely woven spider’s web that covers and penetrates every part of the body, including the spinal cord, muscles, bones, arteries, veins and internal organs. Treating a patient with migraine headaches — or any kind of pain — involves treating larger parts of the body. Riley said she follows the advice of her mentor and teacher, John Barnes, creator of the John Barnes Method of Myofascial Release: “Find the pain; look elsewhere for the cause.”
Riley explained that, as this kind of modality is so different, patients need to become educated about the technique before they begin treatment.
“Often, people come in expecting a deep-tissue massage type of experience — lots of digging into the muscles and forcing them to release. Myofascial work is almost the opposite of that approach.”
After taking a medical history, Riley said, she spends time observing the patient’s posture, areas of asymmetry and the way he or she moves and breathes.
“I generally have the person lie down and assess their body alignment — whether the head tilts to one side or the other, if one arm or leg is longer than the other.
“The patient could be complaining of headache-like pain, when it might be originating in the shoulder, or even the hip,” Riley said.
With trauma or surgery, or even postural habits, the fascia covering those areas can become inhibited and create a lot of pain.
To the therapist, injured tissues can feel thicker, tighter, almost glued together, Riley said. Healthy tissues feel supple and mobile.
For migraine headaches, techniques such as scalp manipulation (moving the fascia that covers the skull with slight pressure through the fingertips) and trigger-point massage (pressing carefully on the tight muscles of the jaw and neck) can give great relief. Trigger points are toxins that are built up in muscles and can cause widespread nerve irritation. Riley also uses ear pulls — literally pulling the ear in several directions; intraoral work — working inside the mouth to release the major muscles of the jaw; and cranial-sacral techniques around the face, neck, shoulders and pelvis.
“Practitioners who focus solely on the head are making a mistake,” she said.
To get the muscles, tendons and ligaments to return to a more fluid state takes time. With myofascial release, the therapist holds a body part that is painful, and instead of pushing, pulling or digging into the tissues, he or she just lets the muscle release in their hands.
Riley doesn’t generally use oils or lubricants because they cause her hands to slide over the skin.
“I like to sink my hands into the tissues, feel where the catch is and hold that area for several minutes.”
An oft-quoted law supports this theory of manual therapy. Known as the Arndt-Schultz Law, it basically states that to improve function, techniques must be applied slowly and gently.
The therapist said she is a fan of five-minute holds for optimal relief.
Riley believes that, in addition to myofascial release, there are several methods that help release pain, especially working with the mind-body connection.
“Change the mind and you change the body,” she said.
“I don’t think I get people better; I think they get themselves better.”