resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
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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