resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Is the New Medicare Reporting Exemption Right for You?
What you've heard is not a rumor – there will be exemptions for providers of Medicare patients, with no penalties assessed for offices that do not do Quality Payment Program (EHR, PQRS, MACRA and MIPS) reporting.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
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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