resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
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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