Alun Lewis Structural Massage Therapist

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I recently came across a social media post defending the use of a trademarked model of anatomy.
The argument was familiar: all models are imperfect, but they don't have to be perfect, they just have to be useful.

And in one sense, perhaps that's true.
Every model is wrong.

The problem is that some models are more wrong than others, and some limitations matter more than others.
As educators, clinicians, and therapists, our responsibility is not simply to give students a model that is easy to remember. Our responsibility is to help them understand reality as accurately as possible, while equipping them with the tools to adapt when new evidence emerges.

A model can be useful.
A model can organise information.
A model can create a shared language within a community.

But what happens when the model becomes more important than the reality it is supposed to describe?

What happens when learners are encouraged to fit what they see into the model, rather than allowing their observations to challenge the model?
What happens when the language of the model replaces the language of anatomy?
This is where the ethical question begins.

Education should expand a student's ability to think, not narrow it.
It should increase curiosity, not reduce it.
It should encourage exploration, not allegiance.

When we know a model oversimplifies the complexity of the human body, ignores contradictory evidence, or encourages "parts thinking" where systems thinking is needed, we have a responsibility to be honest about those limitations.
The goal of anatomy education should never be to create followers of a model.
The goal should be to create practitioners who can think critically, observe carefully, and adapt their understanding as knowledge evolves.

Models are tools.
They are not truths.

And the moment we forget that distinction, we stop teaching anatomy and start teaching belief systems.

Our Friend, the Nervous System

When someone is in constant pain, say in an area like the shoulder, from a rotator cuff injury or tendon degeneration, the whole nervous system can become overly sensitive.
A car alarm, when at a normal level of sensitivity, would go off if someone bumped heavily against it or broke a window. However, if the alarm system becomes too sensitive, it only takes a leaf landing on the car to set it off.
Our bodies are like that. The longer the pain signals keep bombarding the central nervous system from a persistent injury, the more sensitive it becomes until a normal level of pain is perceived as excruciating, or a non-threatening touch on an undamaged part of the body becomes pain provoking. This level of over sensitivity is known as Central Sensitisation.
As massage therapists, we have to remember that we’re not only stimulating a change in tissue response and healing, we are also creating a nervous system response. Now, that response could be restorative and supportive, or it could exacerbate an already painful condition.
It’s important we reassure the nervous system that our touch is safe and beneficial to the body, which is why we introduce our touch gradually, working slowly, only going deeper when the client's nervous system softens the tissues enough to let us in. In this way we down-regulate the sensitivity level and avoid sensitisation.
Pressure introduced too quickly, applying excessive pressure, and using too small a contact surface, like the point of the elbow, on a sensitive area, will cause excessive pain, leading to a heightened nervous system response, and undesirable effects.
It’s normal for the client to feel some pain or discomfort during treatment but it must be tolerable. For example, some people might describe it as a “nice pain” or a “relaxing pain”. This means we’ve been successful in persuading the nervous system that our touch is safe and that the level of pain/discomfort doesn’t equate to tissue damage.
Over the 40 years I’ve been a massage therapist, I’ve come to realise that, although we do create chemical and fluid dynamic changes in the tissue, our most important ally is the nervous system, and it's important that it considers us its friend, and we must always take great care to keep it our friend.

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A massage therapists hands are input for the nervous system not "wrenches" for the skeleton. We are quieting the nervous system to help our clients move better.
Certain techniques stimulate the production of Hyaluronan which is the "oil" between fascial layers. This helps the slide and glide of these layers, reducing the stuck feeling of "locked" muscles.

Alun Lewis Structural Massage Therapist Remedial Massage, Anatomy Trains Structural Bodywork and Myofascial Therapy for the treatment of ba

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Subacromial Bursitis – Shoulder Impingement Syndrome

The subacromial bursa is a small fluid-filled sac located between the acromion and the rotator cuff tendons. Its primary function is to reduce friction during shoulder movement. In subacromial bursitis, this bursa becomes inflamed, leading to narrowing of the subacromial space and painful compression of the surrounding soft tissues.
Patients commonly experience shoulder pain during overhead activities, tenderness, restricted range of motion, weakness, and night pain while lying on the affected side. Chronic irritation may also inflame the rotator cuff tendons and contribute to impingement syndrome. Factors such as repetitive overhead motion, poor posture, trauma, rotator cuff injury, and acromial bone spurs can worsen the condition.
Early treatment with rest, physiotherapy, posture correction, anti-inflammatory measures, and strengthening exercises helps restore shoulder mobility and prevent long-term rotator cuff degeneration.



Meta tags: subacromial bursitis, shoulder impingement syndrome, inflamed subacromial bursa, rotator cuff tendinitis, shoulder joint anatomy, shoulder pain causes, orthopedic anatomy, bursitis pathology, shoulder inflammation, acromion bone spurs, physiotherapy rehabilitation, clinical orthopedics, musculoskeletal disorders, anatomy illustration, shoulder impingement anatomy