So what is the onion analogy?

Often in our clinic, someone will come in and they’ll have a specific pain.

In my experience, most massage therapists will go oh, you have a pain here, let’s work on the tension that’s here. But usually where you have the pain is responding to something somewhere else.

If we just focus on where you have the pain we don’t address the reason that the pain is occurring.

You’re looking at a very short-lived improvement.

For example, if you have a pain in the top of the shoulder, this is usually because your head and shoulders are forward. This creates a lot of strain on the muscles because they’re trying to hold the head up and there’s a pull on the shoulders.

If we just released that tension, it wouldn’t help the imbalance and it might make it worse.

That’s because if you’re leaning forward, your tension is in the front of the chest, which might be pulling you forward.

You may have tension in the side of the body pulling you forward.

You may have tension in the front of the neck pulling you forward.

Therefore, releasing the pain in the shoulder would be the top layer of the metaphorical onion.

Then we open up the chest and release the neck.

But why is the chest tight and why is the front of the neck tight?

That’s the next layer of the onion.

Sometimes you just have poor posture at work and you need to activate the muscles in your back and stretch the muscles in your chest to address that.

Sometimes it can be linked to your breathing patterns:

If you’re not breathing into your diaphragm, the muscles at the front of the neck will end up working as an accessory muscle for breathing, to try and get more air.

That will pull your head forward and pull your shoulders forward which over time will make the chest tight.

That’s another layer of the onion.

Now you see – if we only work on the top layer of the onion we’re never going to get a long term improvement.

The other way that the onion analogy is useful is when it comes to self-care.

Keeping with our earlier example, breathing can create tension in the neck and forward position of the shoulders. We could give you a stretch for the back of the neck and maybe a stretch for the upper back if you’re suffering discomfort there also.

That’s not addressing the deeper layer of the onion.

I could give you a chest stretch to help your body be in a better position, which would help and that’s another layer down, so better.

If you’re stretching your chest regularly, your head and shoulders are in a better position, your head is over your shoulders, your shoulders are aligned in the centre so you get less tension here and therefore less pain.

But if your breathing is an issue and you’re using your neck muscles to breathe up into your rib cage, that’s the next layer.

We could give you breathing exercises.

We could release the diaphragm and we could work with you on starting to breathe with your diaphragm more so you’re not relying so much on the front of the neck muscles.

We’re getting to the centre of the onion – it might stop there, or there might be something else going on.

If the reason that you have poor posture is that you’re stressed, we might talk about ways that you could manage stress or recommend that you see a psychologist or a cognitive behavioural therapist to help you with those aspects.

We’re always looking for the centre of the onion so that you have less self-care to do and you get longer-lasting results.

I’ll give you another example related to runners who often have lower back pain.

That lower back pain may be because their piriformis or their hip flexor is tight.

We could release the lower back and temporarily you’d feel better, but if you walk out without us working on your piriformis or your hip flexors, you’re not going to have a very long-lasting result.

We could release your hip flexors and your piriformis which is a muscle deep in the back of the hip.

But why is your piriformis tight?

Why are your hip flexors tight?

Your piriformis might be tight because your glutes aren’t activating so they’re having to overwork to compensate – you need to do glute activation or glute strengthening.

Your hip flexors might be tight because of your head position when you’re running.

If we can get your head in a better position so that your hip flexors don’t have to work so hard and your glutes activate, your piriformis shouldn’t get as tight, your hip flexors shouldn’t get as tight and then, if that was the correct centre layer of the onion, you shouldn’t get lower back pain anymore, right?

Whenever you’re going for a session with a massage therapist or physio or osteo, try and understand what is the most central reason that these problems are happening?

Make sure that the self-care that you’re getting addresses the centre of the onion.

We have to remember that our body changes over time.

Every day or week or month or year that you have this imbalance, your body is responding to it, and those responses or compensations become more and more ingrained and making those changes to respond to it more and more ingrained.

That’s why you can’t expect to get 100 percent improvement in one session for something that you’ve had for months or years or even decades.

We do see people who’ve had problems for decades – it may not be that you’ve had pain for years and years, it may be that the imbalances have managed for so long that you’ve only recently felt that pain (like we talk about in our water bucket analogy post).

The pain might seem new, but the cause might be really old because it’s been building up over time.

That’s one of the reasons we recommend that if you feel a niggle or a pain that you try and see someone as soon as you can.

The longer you wait, the longer it’s going to take to get an improvement time-wise, and the more sessions it’s going to take to get an improvement – because we’re having address layer after layer after layer after layer to get to the centre.

Does this make sense to you?

Do you have a problem and you feel like you haven’t gotten to the centre of the onion for it yet?

Leave a comment below, or if you’re in London come see us for a session.

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