For Better Client Outcomes, Just Add Water

By John Upledger, DO, OMM

If you have been following this column since I first began writing it back in 2001, you probably already know how passionate I am about working with dolphins. Since 1954, when I was in the Coast Guard and first had the opportunity to swim with wild dolphins, I have had a deep inner urge to do more with these wonderful creatures.

In an article called "The Magic of Dolphins" (from London's Sunday Express, April 2, 2000), Jane Phillimore said, "After swimming with dolphins, many people report not just a sense of well-being, but also improved learning and cognitive abilities, concentration, communication and social skills - which seems to last for weeks, even months." We explored this potential firsthand in 1996, when The Upledger Institute set up a pilot therapy program treating clients with CranioSacral Therapy at the Dolphin Research Center in Grassy Key, Fla.

Yet for those practitioners not near dolphins, we have found equally dramatic results when we simply work with clients in water. "The relative weightlessness of the body in water lets you tap into an environment that can boost the effects of CranioSacral Therapy," said Upledger Institute Vice President Roy Desjarlais, LMT, CST-D.

David Dolan, LMT, who developed Ocean Therapy, a four-day experiential UI workshop also held in the Bahamas, agrees. "What the ocean water adds to light-touch, subtle-energy techniques is multifaceted. Water in itself is a healing medium that reduces gravity and friction, making three-dimensional movement almost effortless. As joint range of motion increases, the nervous system is able to move into a parasympathetic response (relaxed state). Muscles lengthen, tensions release, and internal natural healing processes begin to work more effectively."

"Everything we do in the treatment room is multiplied when working in the water," said UI staff clinician Sheryl McGavin, MBA, OTR/L. "For clients who have hit a plateau in their progress or have particular body issues hampered by the confines of the massage table, the water adds that extra element that can gently urge them to their next stage of healing."

Sheryl said she was first attracted to this aspect of therapy when working with Bob, a client who had fallen 40 feet off the stack of a tugboat onto the deck below. He had multiple cranial fractures, a ruptured kidney that was later removed, and numerous extensive injuries. He also had been in a coma for quite a while. Sheryl found the treatment table simply wouldn't allow for the movements Bob's body seemed to want to make in an effort to release his tissue' restrictions. But in the water, all that changed. When his body had the freedom to move wherever it wanted, the results started coming much more quickly.

"Bob had a lot of back and neck pain and stiffness that severely affected his gait and sleep patterns," Sheryl said. "This area improved tremendously for him after our work in the water, making walking much more effortless." Secondary to his original injuries, Bob also had lost most of his vision and was considered legally blind. "Surprisingly, his eyes started to track together after each water session," Sheryl said. "Now we're seeing great improvements in his vision. That was something none of us expected."

If you feel inspired to add the benefits of water to your therapeutic repertoire, I offer you these tips:

• If possible, conduct the session in a gentle body of salt water. Its natural buoyancy helps support the client better. That said, any body of water will help, whether it's a pool, a lake or even a hot tub.
• Whether it's salt water or fresh water, make sure the temperature is warm enough and comfortable for the client. Sometimes it helps to wear a lightweight wetsuit for warmth.
• Try to have at least two therapists with each client at a water depth about waist-high or chest-high. Many therapists often work with five practitioners at one time.
• No special equipment is necessary unless you're working alone with a client. In that case, a flotation device like a "pool noodle" can help with support and body positioning. Clients sometimes use goggles, nose plugs or ear plugs for comfort. It's also helpful at times to use water shoes for stability.
• Once your hands are in position and the client is comfortable in the water, gently engage the tissues by applying about 5 grams of pressure (roughly the weight of a nickel). Because the client is floating, the body can move in an uninhibited manner that expresses the changes in tissue mobility and tensions. Simply follow and support this movement with your hands. As the tissues release restrictions, they will lengthen or soften, or come into greater functional alignment. More movement of tissues, fluids and structures will then be available for the client to use in a more functional way, facilitating the body's own self-corrective mechanisms.

Whether you choose to work alongside dolphins or simply to add the benefits of water to your therapeutic sessions, I encourage you to follow your instincts. The more we learn, the more our clients benefit in sometimes surprising yet always welcome ways.