resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
March, 2004, Vol. 04, Issue 03
Discovering the Mastery in the Art of Connective Tissue Massage, Part One
By John Latz
Shifting paradigms is hard work for most people, especially when our egos are involved and our paradigms are reinforced by cultural norms. I encountered my own misinformed paradigm when I experienced Dr.Ida P. Rolf's structural integration work for the first time. Before that, I had only one perspective about my body, but structural integration changed that. It shifted my paradigm.
I started competitive swimming at a young age; by the time I entered college I was training three hours a day. The years of conditioning had left my extrinsic musculature overdeveloped. I believed this condition was ideal until I studied massage therapy in 1980, when I realized how much muscular effort I used in everything I did. I enjoyed giving massage, but it wore me out. I did not know how to relax and access my own power while giving massages. When I received a massage, it was difficult for me to feel "inside" myself. My body was incapable of proprioceptive feeling. Years of tension had created thick, dense patterns of physical and emotional armoring; this is what led me to receive the 10 session series of structural integration.
tructural integration reorganizes the body into a balanced vertical alignment within the gravity field. During these sessions, I was taught how to relax and let go of tension. It was freeing when constricted layers of connective tissue let go of adhesions and "knots." I experienced a new, inner awareness of my body, and I became more in touch with my emotions and how they affected my body and structure. I felt stronger when I swam, and I had more energy when I gave a massage. I was so happy with this "new" me that, in 1985, I decided to learn structural integration at the Rolf Institute.
The Body has a "Sleeve" and a "Core"
Ida Rolf's theories about human structure radically changed my concepts about my body. She described the body as having a "core" and a "sleeve." Think of a tree with a core. In each year of growth, a new layer of tissue wraps itself around the core. Human bodies are a lot like trees. We are made of layers of fascia, wrapping around our center. Our outermost layer of connective tissue is like tree bark; most of us live and work in this tough outer layer, protecting our soft inner selves. This deeper core space - symbolically and experientially our center - is our place of inner peace, contentment and deep feeling. Dr. Rolf described the core and sleeve as having a functional aspect, using the words "intrinsic" and "extrinsic." In general, the musculature closer to the bone is intrinsic; tissue nearer the surface is extrinsic.
In movement, intrinsics initiate a movement, and extrinsics take it further. According to Dr. Rolf, there needs to be balance between intrinsic and extrinsic function to achieve what she called "balanced movement." She often said, "If you can see the muscle that's doing the movement, it's not a balanced movement."1 Dr. Rolf extolled Fred Astaire as a model of balanced - intrinsically and extrinsically - powerful movement. She said that his knees had a life of their own, and asked us to watch his effortless movements as an example of natural intrinsic capability. According to Dr. Rolf, this intrinsic movement initiated from the core of the body with minimum expended energy. She often said: "Strength that has effort in it is not what you need. You need the strength that is the result of ease. To me, strength is balance."2 Strength comes when we integrate our core and sleeve; then we have the potential for graceful and balanced movement.
The opposite of balanced movement is movement from the "sleeve." Kramer, the character from the TV sitcom, Seinfeld, models fast, jerky, uncoordinated movement, tension, and a high-stress lifestyle. His unbalanced emotional behavior is part of his sleeve-dominated body image. Kramer, like all of us, has a core, but he cannot access it. Ida Rolf would have said that Kramer is "stuck in his sleeve."
As a beginning massage therapist, I also felt "stuck in my sleeve." I wasn't quite like Kramer, but I felt restricted in my somatic growth, nevertheless. In the paradigm we absorb from our culture, we overemphasize extrinsic movement, giving us a power produced by gross motor actions. This is the paradigm I had as a competitive swimmer. I was absorbed by esthetics: a body image that included six-pack abs, buns of steel and bulging biceps. Balanced movements, however, are rarely promoted in the media.
Our desire to match images of fashion models and actors has created a belief that the external body is what counts. This notion sends people to the gym, where they - like me in my youth - unconsciously create tension, contraction, compression and restriction in their structures. Our cultural paradigm is eroding our ability to connect with our place of inner peace, contentment and deep feeling - it is eroding our ability to move freely.
Over the years, I learned to access my intrinsic movement. I went through a process of evolution to find the best way to use my body. I wanted to transfer the intrinsic healing energy to my client without extrinsic blocks, and I found that the positioning of every aspect of my body affected the power factor. I use the term "body mechanics" to describe my relationship in space to a client's body. I show massage therapists this system of body mechanics as the foundation of connective tissue massage (CTM).
Once I accessed my core, I found more power in my work and could utilize that power to reach deeper layers in the bodies of the client with little effort. I was able to stay present in a session and was no longer distracted or disconnected. I recognized these changes as personal somatic growth and maturation. I finally understood, in my own body, the words that Ida Rolf had spoken years before: "This business of living in extrinsics is characteristic of the very young; it is characteristic of the immature...it may be that as long as you pre-eminently use the extrinsic muscles, you are immature. Perhaps maturity occurs as you begin to get intrinsics into the picture and bring both to balance. That is what it looks like as you work on kids."3
Learning to connect with our core is easier when the CTM body mechanics become part of our working posture.
Connective Tissue Is an "Organ of Posture"
It is helpful to have a three-dimensional understanding of connective tissue. No textbook, picture, or cadaver can adequately represent life-filled fascia. The supporting nature of fascia and its relationship to the structure of the body requires a new way of seeing and feeling the body in action. Our body's connective-tissue system is structured like a honeycomb and designed to keep our internal "honey" in the right compartments. Our connective-tissue structure is intimately integrated with our skeletal system and keeps our structural integrity intact.
Without three-dimensional connective tissue, our bones would fall into a heap; therefore, connective tissue is an organ of posture. Many people are surprised when they first experience fascial manipulation. The experience helps shift our point of reference from fixed landmarks (like frozen shoulder or tennis elbow) to relational webs. We experience our fascia like strands of spherical spider webs. We sense how our fascia connects to some part of our body that we previously thought was unrelated to our "sore spot."
This relational web of fascia in our bodies can also create problems. Connective tissue is capable of shrinking, twisting and sticking to itself and to other structures, especially our bones and organs. Connective tissue can dehydrate and shrivel like a wool sweater that is put into a hot dryer; in essence, the entire body is pulled out of alignment. Since fascial sheaths surround all muscles, bones and organs, dehydrated fascia compresses these structures, compacting the body, restricting movement, and often creating pain.
Typically, clients believe their pain is caused by muscle imbalance, skeletal displacement and nerve compression. They strengthen their muscles using extrinsic methods, such as weightlifting and power stretching. In reality, this cultural paradigm of extrinsics - while it may enable us to function in basic ways - reduces our freedom in movement, and disconnects us from our core. By practicing CTM, we can re hydrate, re-energize and lengthen the connective tissue quickly and easily. Tight, congested muscles release, increasing flexibility, and reducing strain and discomfort.
Editor's note: Part two of this article will appear in the April issue of Massage Today.
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