How Remedial Massage actually helps.

Guru's sell "fixes" - Professionals facilitate change. Massage doesn’t “fix alignment” — it changes signals. Here’s what that actually means.

If you’ve ever been told any of the following…

• “Your pelvis is out.”

• “Your shoulder is stuck.”

• “I’m breaking down adhesions.”

• “We need to release the fascia.”

• “I’ve put that vertebra back in.”

…you’ve been handed a simple story that sounds satisfying.

The problem is: a lot of those explanations don’t match basic tissue mechanics or modern pain science.

And here’s the important bit: calling out a bad explanation isn’t the same as saying manual therapy doesn’t work.

Manual therapy can be extremely useful — just not in the way people were taught to describe it 20 years ago.

The newer story is less magical… but more accurate, more empowering, and (ironically) more effective.

The quick reframe

Manual therapy is not a magic eraser for tissue damage. It’s a mechanical + sensory input into a complex system (you) that decides what to do next.

That decision involves:

• your nervous system (pain, tone, motor control)

• your autonomic system (stress state, arousal, recovery mode)

• your immune/endocrine chemistry (inflammatory signalling, stress hormones)

• your brain’s expectations and meaning-making (placebo/nocebo, confidence, safety)

  
  

In other words:

You’re not a sculptor chiselling tissue into a new shape.

You’re sending information into a system that updates how it behaves.

That’s why you can see meaningful changes in 5–20 minutes without needing “alignment” stories.

Why the old story falls apart (without being dismissive)

1) Collagen is tough. It doesn’t remodel on demand.

A lot of the “breaking adhesions” story assumes connective tissue changes easily. It doesn’t.

Collagen (tendons, fascia, scar tissue) is designed to tolerate big forces over long timeframes. Real structural remodelling generally requires:

• repeated loading

• recovery time

• and biological turnover (which takes days to months, not minutes)

So if someone says they “reorganised your fascia” in a single session… that’s probably not what happened.

2) Joints don’t casually go “out of place” and back in

If your joint was truly out of place, you’d be having a very bad day and probably meeting an emergency department.

What people often mean when they say “out” is something like:

• stiff

• guarded

• sensitive

• unpredictable

• or “my brain doesn’t like that range right now”

That’s a state problem, not a “bones are wrong” problem.

3) If thumbs could permanently change structure quickly, we’d injure people constantly

If a therapist could permanently lengthen muscle, remodel fascia, and shift joints with ease… the risk profile of manual therapy would be terrifying.

Instead, most people feel better, move easier, and walk out more confident.

That outcome fits far better with systems modulation than structural renovation.

So what is happening? The “5 bucket” mechanism map

You don’t need a PhD to understand this, but you do need more than “I released a knot.”

Most of what manual therapy does can be grouped into five overlapping buckets:

1. Mechanical

2. Neurophysiological

3. Autonomic

4. Immune / Endocrine

5. Cognitive / Contextual

   
   

You rarely get just one. A session is more like a cascade:

Mechanical input (pressure/stretch/shear)→ sensory signals to the nervous system→ changes in tone/pain/motor output→ shifts in autonomic state→ immune/endocrine nudges→ all wrapped inside context, expectation, safety, meaning

Let’s break those down.

1) Mechanical: the “front door” signal

Yes — manual therapy is physical. When pressure is applied:

• tissues deform (skin, muscle, fascia, joint capsule)

• fluid shifts (interstitial fluid moves)

• local circulation can change

• layers can glide differently in the short term

That matters.

But here’s the clinical reality:

Mechanical effects are often the start of the story, not the end.

Think of mechanical input as a message:

“Hey brain — pay attention to this area. Something is happening here.”

The more useful question isn’t “did we physically change the tissue forever?”

It’s:

“What did your system do with that signal?”

2) Neurophysiology: why you can change pain and ROM quickly

This is where the outdated explanations really struggle.

Pain isn’t a direct measure of tissue damage.

Pain is an output of the nervous system — a protective alarm based on:

• sensory input (nociception)

• context

• past experience

• stress state

• perceived safety

• and what the brain predicts will happen next

Manual therapy feeds the system a lot of high-quality sensory input:

• touch receptors in the skin

• muscle spindles (position/length feedback)

• joint receptors

• fascial mechanoreceptors (yes, there are receptors in fascia)

• and general “this area is being explored safely” signals

That input can influence:

a) Spinal cord processing (the “volume knob”)

At the spinal level, incoming signals can be modulated — some are amplified, some dampened. You can think of it as changing the “gain” on the system.

This is one reason sensitivity can drop quickly.

b) Motor output (guarding, tone, recruitment)

Guarding is often not a “tight muscle problem.” It’s a protective strategy.

When threat reduces, tone often reduces.

So you can see:

• smoother movement

• less co-contraction

• improved “ease” of motion

• better tolerance of stretch or load

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c) Brain-level updates (predictive processing)

Your brain is constantly predicting: “If I move like that, will it hurt?”

Manual therapy can help update that prediction:

“Maybe that range is safer than we thought.”

That’s why someone can go from “my shoulder catches at 90°” to “that feels freer at 140°” after a thoughtful session.

You didn’t reshape their joint in ten minutes.

You changed the nervous system’s decision to protect.

3) Autonomic: state changes are not “woo” — they’re physiology

The autonomic nervous system is your background operating system:

• sympathetic: alert, stressed, “fight/flight”

• parasympathetic: recovery, “rest/digest”

Manual therapy can shift state through:

• touch and pressure input

• breathing changes

• perceived safety

• and downregulation of threat

You’ll see it as:

• slower, deeper breathing

• feeling “heavier” or calmer

• reduced jaw/shoulder tension

• improved sleep that night

• less “wired but tired” energy

Important nuance: more relaxed isn’t always the goal.

For a competitor pre-event, you don’t want “parasympathetic puddle.”

You want calm-but-alert.

The smarter question becomes:

“What state do you need for what’s next?”

4) Immune / endocrine: small nudges, not miracles

Manual therapy isn’t an anti-inflammatory injection.

But it can influence the environment in ways that help, especially alongside good recovery.

Potential effects (generally modest and variable):

• changes in local blood flow/perfusion (warmth)

• shifts in inflammatory signalling (cytokines, mediators)

• changes in stress chemistry (cortisol dynamics)

• neuroimmune cross-talk (nervous system and immune system are deeply linked)

If your body is running “threat chemistry” all week — poor sleep, high stress, low recovery, constant guarding — your tissues often stay more reactive.

Manual therapy can be one helpful nudge toward:

• better recovery signalling

• improved sleep quality

• calmer baseline arousal

But it works best when it rides alongside the basics:sleep, load management, nutrition, movement, and time.

5) Cognitive / contextual: not “just placebo” — a real mechanism

“Placebo” gets used like an insult. But the better phrase is:

“Expectation and meaning shape physiology.”

Everything in a session sends signals:

• the words you use

• the explanation you give

• the confidence you project

• the ritual of care

• the time you take

• whether the person feels listened to

Those signals influence threat vs safety.

And safety changes what the nervous system allows.

Here’s the key point:

Context doesn’t mean “fake.”

It means the brain is part of the mechanism — because it literally is.

A fragile story (“you’re out of alignment”) can create dependency and fear.

A capability story (“your system can adapt”) builds confidence and movement.

The “window” concept: why a session helps… and why it sometimes doesn’t last

This is where people either get great results or get stuck in the cycle.

Manual therapy often creates a window where you have:

• less pain

• less guarding

• better movement options

• better confidence to load

That window might last:

• minutes

• hours

• days

If you do nothing with it, it closes.

If you use it well — the right movement, the right loading, the right habit change — you turn a temporary state shift into longer-term adaptation.

Manual therapy isn’t the whole solution.

It’s the opening of the door. What you do next is walking through it.

What this means at Rebound Remedial Massage (Ipswich)

When you book in, the aim isn’t to “fix your alignment.”

It’s to:

1. reduce unnecessary protection (pain/guarding/threat)

2. improve movement options and tolerance

3. get you into the right state for your next step

4. help you use the window with a practical plan

Sometimes that plan is:

• return-to-training load progression

• mobility that actually sticks because you can tolerate it

• strength work that stops flaring you up

• recovery changes that reduce reactivity

And if you’re already working with a physio, GP, chiro, or coach — great. This approach plays nicely with others because it’s based on systems, not superhero stories.

A simple takeaway you can hold onto

If you remember nothing else, remember this:

Good manual therapy changes state, not structure.

It shifts sensitivity, tone, control, and confidence — so you can handle the forces that matter to you.

And that’s a far better story than “you’re broken and I fixed you.”