Massage Journal-JanuaryFebruar

nurturing body, mind & spirit
january/february 2009
Massage & Bodywork

Survive & Thrive
Fortify Your Practice

Financing
Your Vision
survive & thrive
Attuning to Clients
with Stephanie Mines
Abuse Survivors speak out

Judith Astons
Dimensions
of Alignment
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22
Financing Your Vision
Dont let a credit crunch dent your dreams. This

Business Side column includes tips on securing
a loan even in todays challenging climate.
By William J. Lynott
46
Attunement and Bodywork
The ability to sense and read your clients

creates a superior experience for you both.
Intention and focus are crucial to the equation.
By Stephanie Mines
56
Advice from Abuse Victims
Learn from the insights gleaned as survivors of

abuse tell this researcher and bodyworker why
they sought out healing massage therapy.
By Audra Hixson
64
74
Craniosacral Primer
Dimensions of Alignment
Gravity is an opportunity, not an obstacle, for

movement pioneer Judith Aston. Read how she
refines structure and enables movement.
By Laura Servid
Looking to diversify your skills? The following

primer offers a synopsis of some of the leaders in
this specialty and the training programs they offer.
By Aureal Williams
84
Treating Knee Injuries, Part 2

Have you visited the digital edition of
Massage & Bodywork magazine? Check it out
at www.massageandbodywork.com.
001-027_MNB_JF_09.indd 4
Here are strategies to improve knee extension,

a discussion of the complexities of gait, and
techniques to deal with compensatory reactions.
By Art Riggs
11/14/08 12:10:22 PM
whats inside?
January/february 2009
38
surViVe & THriVe
Uncertain economic times call for cunning

and creativity. Bolster your appointment
book with these action items. Brainstorm,
trim, and triumph to come out ahead of
the game.
By roBert Chute
Columns
28
TalK aBouT TouCH

AmBiAnCe
With Mary Kathleen Rose

and Mary Ann Foster
98 TaBle lessons new
moBility And stABility
By Douglas Nelson
102 essenTial sKills
humAn touCh
By Ben E. Benjamin, Ruth

Werner, Daphne Chellos
110 PaTHologY PersPeCTiVes
polyCystiC ovAriAn syndrome
By Ruth Werner
116 HearT oF BodYworK
hoW muCh is too muCh?
By Nina McIntosh
120 mYoFasCial TeCHniQues new
neCk And shoulders
By Til Luchau
126 somaTiC researCH
ChArts And grAphs
By Ravensara S. Travillian
144 PraCTiTioner ParaBles
forWArd in your Journey
By Robert Chute
deParTmenTs
8
editors note
10
ContriButors
14
reAder forum
16
neWs notes
20
hAppenings
30
round the tABle
36
fingertips for the Client
94
ten for todAy: linens
100 neW produCts

132 spotlight on eduCAtion:
lorettA young
134 eduCAtionAl resourCe listings
140 ClAssifieds
140 displAy shoWCAse
143 Ad index
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Massage & Bodywork promotes professionalism among practitioners,

stimulates healthy dialogue, and expands the knowledge of those in
the eld to advance their successwhile remaining mindful of the
breadth of bodywork backgrounds, beliefs, and modalities.
sTaFF
leslie A. young, editor in Chief
leslie@abmp.com
dArren Buford, mAnAging editor
darren@abmp.com
Jenny good, AssoCiAte editor
jenny@abmp.com
lArA evAns BrACCiAnte,

online properties direCtor
lara@abmp.com
kArrie osBorn, ContriButing editor
karrie@abmp.com
adVerTising
Jodi miller, mAnAger
jodi@abmp.com
Angie pArris-rAney, CoordinAtor
angie@abmp.com
ProduCTion and design

Amy klein, mAnAger
Printed in the U.S.A. on

recycled stock containing at
least 10% postconsumer fiber.
amy@abmp.com
JAmes sutherlin, AssoCiAte
james@abmp.com
Massage & Bodywork (ISSN 1544-8827; USPS 005-245) is a bimonthly magazine published by
Associated Bodywork & Massage Professionals Inc., 25188 Genesse Trail Road, Golden CO
80401. Periodicals rate postage paid at Evergreen, Colorado, and additional offices.
POSTMASTER: Send address changes to ABMP, 25188 Genesse Trail Road, Golden, CO 80401.
Vol. #XXIV, Issue #I January/February 2009. All rights reserved 2008.
suBsCriPTions
Annual subscription rate in the U. S. and Canada is $26 for one year, $45 for two
years (U.S. funds). Subscription rate in all other countries is $75 per year (U.S. funds).
To subscribe, write to the address shown above or call 800-458-2267.
websites: www.massageandbodywork.com, www.abmp.com, www.massagetherapy.com
No part of this publication may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, recording, or by any information storage and retrieval
system, without specific written permission from ABMP. The views expressed herein are those of
the authors, and not necessarily of the publisher or its advertisers. Publisher cannot be responsible
for any unsolicited articles or materials, or the return of such items. The editorial and advertising
content in Massage & Bodywork is for educational purposes only and is not intended as comprehensive
modality training or medical advice. Massage & Bodywork encourages practitioners and massage
therapy clients to consult a qualified professional for individual diagnostic and healthcare needs.
massage & bodywork
001-027_MNB_JF_09.indd 6
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editors note
from me to you
the Merry-Go-Round
Like kids headed to the carousel, were filled with excitement
as we look to the year ahead. OK, yes, were also nervous
as we pick our mount. After the ups and downs of 2008,
we figure 2009 has to be an improvement. As I write
this, postelection, Im steeped in reader, advertiser, and
educator feedback, most of which reflects apprehension
about the economy and its influence on the profession.
Leslie takes a spin on a historic carousel at the

Democratic National Convention media party.
Rick Giase photo.
In Memorium
You may recall Massage &

Bodyworks Energy Medicine
column by Kondaa (Barry
Kapke). He was diagnosed with
colon cancer in 2005 and his last
feature appeared in the December/
January 2006 issue. He spent his
final years in San Francisco and
Thailand. Kondaa died at press
time on Tuesday, November 18,
surrounded by friends. He was
a loving, eclectic individual who
embraced life, work, and the
dharma. His friends are updating
his site, www.bodhiwork.org.
massage & bodywork
001-027_MNB_JF_09.indd 8
In unsteady economic times it takes varying doses of business savvy, intuition,

and dumb luck in order to thrive. In fact, just surviving may be tricky for
the balance of massage therapists. Many of you tell me youd rather heal than
handle money. But in order to heal, you must be able to balance the books.
Last summer, we at Associated Bodywork & Massage Professionals (ABMP)
did a survey as part of our strategic planning for future communications with
professionals like you. We asked licensed MTs what theyd like to learn from their
professional publications and the answer was clear: you want more information
on how to become a better bodyworker and, no thanks, you dont want businessoriented information. We also asked you if you had enough clients. You said, no.
If fact, you wish your schedule was more full. And, in a heartwarming vote of
confidence, you said you expected to have more clients in 2009 than in 2008.
Clearly theres a disparity here. Narrowing this gap between expectation
and realityand subsequently filling your appointment bookcan help
you better weather 2009. Challenge yourself to learn what you need to
learn, not only what you want to learn. Grow your skills by stepping out of
your comfort zone and raising your level of business expertise. Well help
you do it, issue by issue, through our website, and through every vehicle
we have. Youll also benefit from the ABMP BizFit program, designed to
help members and Massage & Bodywork readers survive and thrive.
My best advice is to do what therapists in this profession do so very
well: stay centered. Focus on what you love to do and practice to your
fullest potential. Your clients will be the benefactors and theyll calculate
your sessions into their budgets. Help them understand massage is
essential as they manage stress and ride todays merry-go-round.
And if you still feel like youre on a carousel, at least pick a colorful horse.
Leslie A. Young, Editor in Chief
leslie@abmp.com
11/20/08 11:16:03 AM
I am ABMP.
Roberta Geier, Steamboat Springs, Colorado.
Member since 1999.
BACKGROUND: My life encircled theater and education, but

training in Healing Touch, neuromuscular therapy, Muscle Release Technique, and Ashiatsu revealed my true soul. I began by
working with a chiropractor and a physical therapist, developing
contacts that led to my thriving private practice.
PERSPECTIVE: I listen carefully with my ears, eyes, hands, and
heart, striving to create a healing session thats physical, emotional, and spiritual. To guide others to heal themselves is truly
rewarding.
BUSINESS GROWTH: My client return base is excellent. I offer
discounted packages that can also be used by family members
and office staff. Its incentive for them to continue the therapy
year after year.
ABMP AND ME: ABMPs rate for liability insurance, along with
their publications and all the other services, is the bargain of the
century. I also appreciate how hard the association works for
legislation and positive media coverage.
LAST WORD: With broader communication about our profession and higher standards for training, well gain our rightful
place in the world of healing.
Comprehensive liability insurance and

practice support for massage and bodywork
professionals and students.
Associated Bodywork & Massage Professionals
800-458-2267 www.abmp.com
001-027_MNB_JF_09.indd 9
11/14/08 12:11:45 PM
contributors
in this issue
Audra Hixson
Audra is frequently cycling or hiking trails around her

hometown of State College, Pennsylvania. She also enjoys her
three cats and dog, Zoe, who is her most frequent massage
client. Aside from providing bodywork, Audra works at
Penn State University advocating for victims of crime.
Til Luchau
Check out new

columns by
Doug Nelson
and Til Luchau
on pages 98 and 120.
Til is on the faculty of Advanced-Trainings.com and the Rolf

Institute. His mother named him after Till Eulenspeigel, a 15th
century vagabond prankster, whose pranks showed people
the foolishness of their everyday assumptions and ways.
Til hopes to someday be the brunt of such a joke himself.
Stephanie Mines
A poet and dancer at heart, Stephanie feels life chose her

to become a healing artist and educator, transmitting
messages of empowered, sustainable healthcare. She is an
adoring mother and grandmother, and an advocate for
children everywhere. She is happily partnered with her
husband, environmental attorney Robert E. Yuhnke.
Douglas Nelson
Douglas loves learning, cycling, great wine, and the

company of his wife. He thrives on diving deeply into any
question, approaching the worlds of massage therapy and
neuroscience with curiosity, wonder, and a keen intellect.
Aureal Williams
A good cup of tea, a mystery, saunas, craniosacral touch,

heavy rains, nature walks, deep friendships, heart-opening
community, and surprises support Aureal in her increasingly
intuitive-led life in Cincinnati, Ohio, where she gives
talks and provides craniosacral work for wee ones.
10
massage & bodywork
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11/14/08 12:11:59 PM
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Massage Therapy Journal
Clinical Massage Therapy:

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11/14/08 12:12:46 PM
whats on the web
NOW CLICK ON
ABMP Launches Redesigned Website

Its your site
We invite ABMP members to submit photos
of themselves and testimonials about the
profession and/or their relationship with ABMP.
Learn more
Discover the many benefits included

with ABMP membership and join or renew
online to gain immediate access.
Find it fast
Keyword search functions in the
public and Members sections, as well as a
comprehensive site map, help you quickly
locate your many membership benefits.
Schools and students
Find a long list of new resources for massage

school administrators, instructors, and students
ABMPs commitment to the profession.
State rules and regulations
Every state has different criteria for massage practitioners.

Simply click a state on the map for all you need to know.
Get your practice in shape

Access the new ABMP BizFit series, located within the Business
Management section, to help
navigate a challenging economy.
And more, at your fingertips

A marketing center with customizable
brochures and newsletters, a career
development section with an interactive
continuing education calendar, a client
treatment tab loaded with downloadable
forms, and more.
visit massageandbodywork.com to access your digital magazine 13
001-027_MNB_JF_09.indd 13
11/20/08 10:31:12 AM
reader forum
What you are sayinG
Postgraduate
Training
november/december 2008
Keep Active
Clients Going
SportS mASSAGe
IS It tIme for
A mASterS In
SomAtICS?
Integrating Intake
procedures
mASSAGe muSIC:
ChooSInG WISely
Bonnie Browns
million-Dollar Giigle
Verbal Bouquet
Just letting you know what a huge

impact your magazine and Web
offerings have made in the practitioner
community here in Kern County.
This magazine has become a mainstay
and required support resource. We
see nothing but the latest and greatest
information cross section affecting the
full spectrum of the wellness industries.
dAvid doWdy
BAkersfield, CAliforniA
Thank you for your excellent magazine.

While some bodyworkers/alternative
healers explain what they are doing
very clearly, others leave clients totally
mystified. Your magazine, with its
fi ne articles and ongoing discussions,
helps clients know what to expect from
practitioners and also helps clients
know what practitioners expect. As a
client myself, I appreciate this, and am
more willing to investigate unfamiliar
therapies and/or talk about them
with others after reading Massage
& Bodywork. Yours is a magazine
with defi nite healing powers.
I fi nd the notion of creating a graduate

degree in somatics to be very exciting
[Foundations of Somatic Practice,
Part 2, November/December 2008,
page 78, by Thomas Myers]. Not
only do we accumulate more effective
approaches as we continue our
practice, but we also accumulate more
questions. Ideas for areas of research
come to us every day as a result of our
immersion in the practice of bodywork.
Academia would lend itself to the
support of this kind of research.
As a student of John Barnes
technique of myofascial release, I am
quite familiar with the adage pain is
our teacher. As healthy living practices
are increasing our life span, we are
faced with the realization that theres
more to quality of life than longevity.
Who wants to tack on an extra 20 years
to a body that is experiencing joint
pain and immobility, poor digestion,
deteriorating vision, and hearing and
stress? I would think that a great deal
of support could be generated for
this kind of education and research at
this time when all the baby boomers
are reaching their senior years. In
the current economic climate, we
are going to want more education
and awareness for how to keep your
instrument tuned upan updated
owners manual for the human body.
My own search led me from
the practice of speech pathology to
bodywork, to myofascial release, and
then to body mechanics. I was lucky
enough to stumble into the studio of
Katy Santiago, innovator of Restorative
Exercise Institute in Ventura,
California. Her practical approach
to corrective exercises through body
Not only do
we accumulate
more effective
approaches
as we continue
our practice,
but also more
questions.
ronelle Wood
mechanics helped me recover from

a rotator cuff tear that I thought
would end my career. I discovered
that patients were coming there after
exhausting all their insurance coverage
through physical therapy, doctors
visits, and prescriptions, but were still
experiencing pain and limited mobility.
I just completed her six-month
training program and am thrilled to
have the tools of instruction for my
clients who are looking for more than
just a temporary solution to their
body pain. A program like this would
be a great addition to the graduate
curriculum described in the article.
ronelle Wood
oJAi, CAliforniA
kC omAlley
minneApolis, minnesotA
14
massage & bodywork
001-027_MNB_JF_09.indd 14
11/14/08 12:13:13 PM
The Human Voice
I must preface what I am going to say

with this caveat: (1) I read the articles
in Massage & Bodywork from a male
therapists perspective, and (2) I have
been in private practice for four years
and have been rated in the Houston
Citysearch program 9.0 or higher for all
those years. My practice is 60 percent
female and 40 percent male and is made
up of type-A personalities, such as
attorneys, doctors, sports people, etc.
But, in reading Rebecca Joness
article on music I was somewhat
bewildered [Music and Massage,
November/December 2008, page 94] by
No. 8Avoid Lyrics and Sing-Alongs.
Let me think here: avoid the human
voice. Is this the same voice that soothes
us in times of trouble or pain? The
same voice that sings a baby or a child
to sleep after he has had a nightmare?
The same voice that a friend uses
to console us in times of need?
That same voice that softens our
hearts and brings a smile to our faces
when we hear a song that reminds
us of a special time or place?
Sorry. I very quickly learned, at least
in my practice, that babbling brooks,
storms and oceans, waves breaking on
the beach, and birds chirping never
appealed to my clientsespecially
my pregnant moms. But a soft
voice, in a well structured melody
(for example, Diana Krall or Julie
London), brought rapid relaxation.
It is the human voice that we
so often turn to for comfort, for
reassurance. It makes no sense that in
an atmosphere created for relaxation
and de-stressing you would want
to shut out this wonderful asset.
Your clients are tremendous
testing boards. In my waiting room,
I have a CD player and headphones.
A card on the table lets the client
know I am putting together a new
CD to use and invites them to listen

to the CDs and make comments. In
no time at all your clients have put
together your CD for you and then it
is simply a matter of creating the CD.
Trust me, when they hear the songs
or selections that they commented
on, there is huge positive feedback.
Personally, I create two-hour CDs.
When I take the client back to the
workroom, I turn the CD on. The
CD is on while clients are getting
ready for their massage, during
their massage, and while they are
dressing to leave their massage, giving
them a continuation of the massage
even after I have left the room.
Avoid the human voice? In
general most attempts to bring lyrics
into the music for massage have not
been very successful. Sorry. I have a
couple of hundred clients who would
adamantly disagree. In fact, I am
now exploring with my clients the
idea of creating their very own CDs
that go into their fi le and which I
pull out when they come in for their
appointment. Lots of voices on those
CDs. Lots of smiles. Lots of relaxation.

Tremendous positive feedback.
DICK JUBY
HOUSTON, TEXAS
Children and Spa
I have recently received press releases

on the newest profit center: spa
treatments for children between the
ages of 6 and 18 years old. One such
service was for an Aroma Chocolate
Massage for $75/45 minutes. Another
in Palm Springs got on the bandwagon
with body treatments as well. I hope
that these are isolated situations.
I feel this type of marketing is
inappropriate. Sharing an adultstyle spa with children can be an
uncomfortable and confusing situation
for the children and the adults. I
also question the legality of this and
ask if the local health departments
would question spa services for
children as young as 6 years old.
PAMELA PRICE
CATHEDRAL CITY, CALIFORNIA
Foundations
of Somatic
Practice, Part 2
The Questions We Need Answered
BY THOMAS MYERS
his is the second part of an exploratory article on what a

higher education program in somatics might give us as a
profession. Primarily, it would give us a well-maintained
pipeline from the pure biological/biomechanical research
that supports our work to the day-to-day practitioner doing
sessions and making connections with clients. It would
open many avenues of development for us as a group.
001-027_MNB_JF_09.indd 15
11/20/08 9:05:07 AM
news notes
Instructors
will be able to
pass along new
research skills
to incoming
massage
students in
support of
evidencebased
education and
performance.
Compiled by Sean Eads
Acupressure
Before Surgery
A study published in the
September 2008 issue of
Anesthesia & Analgesia suggests
acupressure helps children shed
tension before surgery. The report
examined 52 children between
the ages of 8 and 17 who were
all scheduled to undergo a
gastrointestinal procedure. The
patients were divided into two
groups: one receiving acupressure
and the other receiving sham
acupressure, which followed
New Officers
at FSMTB
Delegates to the Federation of State
Massage Therapy Boards (FSMTB)
elected a new president and several
new officers. Kevin Snedden, chair of
the Missouri Board of Therapeutic
Massage, was elected FSMTB president
for 2009. Other new officers include
Kathy Jensen as vice president and
Susan Beam as treasurer. In 2007,
the FSMTB created the Massage &
Bodywork Licensing Examination
(MBLEx), which has been increasingly
adopted by states that regulate
massage therapists. For more
information, visit www.fsmtb.org
acupressure procedures without

actually applying them to known
pressure points. The children who
received genuine acupressure
reported a 9 percent drop in
presurgery anxiety levels while
those receiving the placebo
experienced a 2 percent drop.
16
massage & bodywork
001-027_MNB_JF_09.indd 16
Massage Therapy
Foundation
Launches New
Education Program
The Massage Therapy Foundation
announced an education program
designed to promote research skills.
The program, Teaching Research
Literacy: Teach Your Teachers, is a
continuing education class to help
practitioners develop awareness about
ongoing research in the field. The
program will be provided to massage
school instructors in the form of an
eight-hour workshop that qualifies
for NCBTMB continuing education
credits. After the workshop, instructors
will be able to pass along new
research skills to incoming massage
students in support of evidencebased education and performance.
For more information, visit www.
massagetherapyfoundation.org.
11/14/08 12:13:31 PM
Pine Tree
Extract for
Knee Pain
Researchers from Slovakias

Comenius University School
of Medicine reported the
results of a study confirming
pycnogenol as a pain reliever
for knee osteoarthritis.
Pycnogenol, a pine tree
extract, was found to
reduce symptoms of knee
osteoarthritis by nearly
21 percent and lowered
pain by about 40 percent,
with the positive effects
lingering up to two weeks
after discontinued use. The
results suggest pycnogenol
could serve as a natural
alternative to cortisone
shots, analgesics, and
surgical intervention. The
Centers for Disease Control
estimates that 34 percent
of the U.S. adult population
over 65 in the suffers from
knee osteoarthritis. The
reports were published in the
August 2008 issue of Journal
of Phytotherapy Research.
American Ginseng
Cancer Study
The National Center for
Complementary and Alternative
Medicine (NCCAM) is committing
$6 million to a five-year study of the
cancer-fighting properties of American
ginseng. The grant money was awarded
to the University of Chicago Medical
Center and will be used to create
the Center for Herbal Research on
Colorectal Cancer, a facility dedicated
to the scientific analysis of herbal
medicine. The centers first three
studies will examine ginsengs ability to
kill cancer cells, alter gene expression
in tumor cells, and manipulate
the internal signals that regulate
cell growth and death. For more
information, visit www.nccam.nih.gov.
Alternative
Medicine for the
Troops
The Pentagon is pursuing alternative

medicine to treat combat injuries and
posttraumatic stress disorder (PTSD)
in our troops. According to Dr. S.
Ward Casscells, the Pentagons assistant
secretary for health affairs, this decision
represents a major departure from the
militarys traditional treatment options.
Acupuncture, yoga, and meditation are
among the alternative therapies being
explored. The Pentagon committed
$5 million to fund research in 2008,
compared to no spending in this area
previously. The army has accepted
10 proposals for 2009. The Pentagon
estimates 300,000 veterans are now
suffering from PTSD or depression.
001-027_MNB_JF_09.indd 17
11/14/08 12:13:36 PM
Professional Massage Therapy & Spa Products
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more sizes.
more savings!
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001-027_MNB_JF_09.indd 18
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11/14/08 12:14:10 PM
news notes
Career, Community
Website for MTs
Health Shoppr, Inc. has launched a
website for massage therapists called
Healthprovidr.com (http://massage.
healthprovidr.com). The site includes
career resources for those in the
massage industry and is intended
to foster community participation
among professionals with a job board,
discussion forum, and Q&A sessions
with experts and peers. The website
plans to expand its services to other
healthcare fields as well. Health Shoppr,
is a new consumer-oriented company
that seeks to assist the public in making
informed decisions regarding their
healthcare and increase the visibility of
healthcare providers across the nation.
new nccam
leadership
Dr. John Killen, Jr., is the new
deputy director of the National
Center for Complementary and
Alternative Medicine (NCCAM).
Killen was directing NCCAMs
Office of International Health
Research, where he was
responsible for international
collaborations in the study of
traditional and nontraditional
medicine. Killen joins Dr. Josephine
P. Briggs, the recently installed
NCCAM director. NCCAM was
established in 1998 as part of
the National Institutes of Health
Acupuncture
for Hot Flashes
Acupuncture has proven itself to be the
equal of prescription drug venlafaxine
when it comes to controlling hot
flashes in breast cancer patients. A test
conducted at the Henry Ford Hospital
in Detroit, Michigan, studied 47
patients over three months to compare
the efficacy of acupuncture against
the drug, an antidepressant that is
marketed under the name Effexor.
Half the patients were given regular
acupuncture sessions during the 12week study, while the control group
received only the drug. Both groups
reported the same decrease in hot
flashes, but the drug group experienced
some adverse side effects. The
acupuncture-only group meanwhile
reported enhanced sex drive and longerlasting relief from their symptoms.
(NIH) and funds rigorous scientific

investigations into the efficacy
of alternative healing practices.
001-027_MNB_JF_09.indd 19
11/14/08 12:14:25 PM
happenings
see you there
American Organization for

Bodywork Therapies of Asia
National Convention
Day Spa Expo &

Business Forum
May 1517
Las Vegas, Nevada
800-859-9247
www.dayspaexpo.com
January 812, 2009

San Diego, California
856-782-1616
www.aobta.org
A focus on vendor and product

selection, as well as a business
education program. Attendees include
spa owners, operators, directors,
managers, as well as estheticians,
technicians, or practitioners who
have management and/or purchasing
responsibilities for their facilities.
Presenters include Pam Ferguson,

Joanna Flores, Michael Gaeta, Rick
Gold, DoAnn Kaneko, Debra Persinger,
Michael Spatuzzi, and Iona Teeguarden.
Spa & Resort/Medical

Aesthetics Expo &
Conference
Australian Association
of Massage Therapists
National Conference
February 2122
Los Angeles, California
877-271-6789
www.spaandresortexpo.com
May 2224
Hobart, Tasmania
61-7-3854-1611 (international)
www.aamt.com.au
Workshops, procedures, technologies,

and networking for spa professionals
to enhance patient and client care.
Body Mind Life Expo
World Massage Festival

and Massage Therapy
Hall of Fame
March 78
Minneapolis, Minnesota
612-798-7256
www.101expos.com/bml
Now in its ninth year, this

health and natural products expo
addresses aromatherapy, skin care,
healthy solutions for your home,
and unique vacation ideas.
Portals to the Self: A

Womens Circle by the Sea
March 29April 5
Isla Mujeres, Mexico
440-779-6727
www.islawomensretreat.com
Explore this island in the

Caribbean, sacred to Ixchel,
the Mayan Moon Goddess, and
historically a place for healing
rituals among the Mayan people.
April 2426
New Braunfels, Texas
830-214-0827
www.worldmassagefestival.
com/2009
This years festival theme is The

Retreat. Instructors include
Nathalie Cecilia, Margie Meshew,
Margie Schaeffer, Anita Shannon,
Ralph Stephens, and James
Waslaski (also keynote speaker).
North American
Research Conference
on Complementary &
Integrative Medicine
May 1215
Minneapolis, Minnesota
612-767-7984
www.imconsortium-conference.org
Sponsored by the Consortium

of Academic Health Centers for
Integrative Medicine, the conference
will showcase CAM research through
presentations and scientific sessions.
20
massage & bodywork
001-027_MNB_JF_09.indd 20
In 2009, the Bowen Therapists

Federation of Australia partner
with the AAMT for this annual
bodyworker gathering.
International Society
for the Study of Subtle
Energies and Energy
Medicine
June 26July 1
Westminster, Colorado
303-425-4625
www.issseem.org
This years theme is Sacred Synthesis:

Science with Heart. Presenters include
Puran and Susanna Bair, Mae Wan
Ho, Steve Levin, and Rustum Roy.
Second Fascia Research

Congress
October 2730
Amsterdam, The Netherlands
www.fasciacongress.org
This conference focuses on the

latest and best scientific research
findings on the human fasciae in
all its forms and functions.
11/14/08 12:14:33 PM
FSTMB_
THE
MASSAGE
PROFESSION
FINALLY
HAS A
LICENSING
EXAM OF
ITS OWN.
MBLEx
massage & bodywork
licensing examination
Now accepted
for licensing in:
Arkansas
Georgia
Iowa
Louisiana
Maine
Mississippi
North Carolina
Oregon
South Carolina
Tennessee
Texas
Utah
Washington
West Virginia
With more on the way.
DEVELOPED FOR THE PROFESSION BY THE PROFESSION

AND THE FEDERATION OF STATE MASSAGE THERAPY BOARDS (FSMTB).
TO LEARN MORE ABOUT THE MBLEx,
PLEASE VISIT WWW.FSMTB.ORG OR CALL 866-962-3926
001-027_MNB_JF_09.indd
FSTMB_MJ_08.indd 1
21
11/14/08
11/11/08 12:14:34
10:33:05PM
AM
business side
By William J. Lynott
Editors note: in 2009, the editors of Massage & Bodywork are offering a variety of business
strategies to help leverage your practice against a weakened U.S. economy. this article, and
future Business Side features, will help you make sound financial decisions.
in upcoming ABMP media (ABMP.com, Different Strokes, etc.), members will notice a new logo.
ABMP BizFit spotlights business resources dedicated to helping practitioners understand and
overcome a challenging economic climate.
22
massage & bodywork
001-027_MNB_JF_09.indd 22
11/14/08 12:14:35 PM
Financing Your Vision

Securing a Loan During a Credit Crunch
Credit is the oil that lubricates
the machinery of most
businesses and professional
practices. Whether its a
loan to buy inventory or
supplies, support renovation
or expansion, a capital
purchase, or as a means to
meet operating expenses,
almost every business depends
on credit at some point.
The upheaval in todays economy has
resulted in a credit crunch that has
made it tougher than ever for small
business owners and professional
practitioners to swing a loan. Im
not so sure thats a bad thing, says
Eileen Laird, massage practitioner
and author of 101 Things Every New
Massage Therapist Should Know (FYB
Publishing House, 2006). Its so easy
to get in over your head with credit
that great caution should be used
before taking out a business loan.
Still, there are legitimate and often
urgent reasons why an MT may need
to apply for a business loan. For those
in the know, there are enough options
available to make the task a little easier.
Money may be tight, but business loans
are being made every day to those who

know how to ask. If youre planning
to look for a business loan, here are
some choices, along with hints on how
to greatly improve your chances of
coming away with the money you need.
Banks
The first place that many therapists

turn to when they need a business
loan is their local bank. Thats why
its essential to build a solid business
relationship with your bank well
before you need to ask them for
money. Allowing your bank to become
familiar with your practice and how
its progressing sets the stage for the
time when you need to ask for a loan.
For relatively new businesses,
most experts like the time-honored
system for establishing good credit.
Take out a relatively small loan,
even when you dont need itsay
$4,000 or $5,000, says certified
public accountant Tom Normoyle of
Huntingdon Valley, Pennsylvania.
Put that money in the bank where it
will draw a little interest. Then, a few
months later, pay off the loan in full,
plus interest. Now the bank knows you,
and you have a solid credit history.
Even after establishing a
relationship, some credit seekers meet
with frustration when the bank turns
down their loan application. Most
bankers agree that this is usually
because the applicant has failed to come
prepared with the information a lender
needs to make a positive decision.
How to find the money to

finance an expansion or acquisition
is the last thing that many business
owners think about when they plan a
project, says James G. Marshall, vicepresident, Fulton Bank of Lancaster,
Pennsylvania. Its best to have a team
lined up behind you when you begin to
plan a major financial moveand your
bank should be a member of that team.
How should you prepare
for a meeting with a bank loan
officer? Marshall suggests
you come armed with:
Accountant-prepared financial
projections and cash flow analysis.
Financial statements for
your existing practice.
Information on the background
and experience of owner(s).
Marketing feasibility study
for the project.
Copies of leases, bills, or other financial
commitments the bank needs.
With this information, Marshall
says, the bank can give proper
consideration to your loan application.
If youre thinking about acquiring
a competitor, its important to have
a clear understanding of the value of
every asset in your acquisition target.
Banks or commercial lenders are more
likely to look favorably on a deal that
has already been inventoried and valued
by individual asset. Before going to a
lender, you should count, confirm, and
value every single hard asset you are
able to identify, including all operating
equipment, furniture, and fixtures.
001-027_MNB_JF_09.indd 23
11/14/08 12:14:36 PM
set your
sights higher.
National certification:
an achievement you can
be proud of.
If you aspire to greatness, only one exam* program puts
both state licensure and national certification within reach.
The NCBTMB exam program.
National certification represents the highest standard in the
field of massage and bodywork. And practitioners who earn
the NCB credential experience the many rewards such an
achievement brings:
Professionalism: enhances reputation
Portability: provides employment opportunities
because 32 states and the District of Columbia
accept the NCBTMB exam
Credibility: increases marketability and opportunities
for career advancement
Legitimacy: meets governmental and/or employer
requirements
National
Career growth: promotes learning through continuing

education
Certification
Board for
Therapeutic
Massage &
Bodywork
Pride: promotes feeling of accomplishment

and personal satisfaction
National certification adds a
level of professionalism to my
practice that was unavailable
solely through my diploma
and state license. It inspires
me to do and be my best in my
practice. I like constantly being
challenged to add to my skills
through continuing education.
Janet O.
West Jordan, UT
Put yourself at the pinnacle

of the profession take your
first steps toward becoming
nationally certified today.
Ask your instructor, call
1-800-296-0664 or visit
www.ncbtmb.org to
learn more.
* In the 32 states that use NCBTMB exams
1901 South Meyers Road

Suite 240
Oakbrook Terrace, IL 60181-5243
www.ncbtmb.org
11.04.08 2008 National Certification Board for Therapeutic Massage & Bodywork.
24
massage & bodywork january/february 2009
001-027_MNB_JF_09.indd 24
11/14/08 12:14:39 PM
business side
Business Glossary
Collateral. Specific asset (such as land or building)
pledged as a secondary (and subordinate) security by a
borrower or guarantor.
Fixed Asset. Land, buildings, equipment, machinery,
vehicles, leasehold improvements, and other such items.
Fixed assets are not consumed or sold during the normal
course of a business, but their owner uses them to carry
on its operations.
Home Equity Loan. Typically, a second mortgage loan
secured by the home equity of the borrower. In case of a
default, the first (senior) mortgagee is paid before the
second (junior) mortgagee can get anything. Also called
home equity debt.
Lender. Entity that advances cash to a borrower for a
stated period and for a fixed or variable rate of interest,
with or without a security other than the borrowers
signatures.
Principal. Capital as distinct from the income (interest)
derived from it.
Source: BusinessDictionary.com
Attention to details will emphasize

your knowledge of what the assets of
the target business are worth in the
market and why someone should lend
you the money to buy those assets.
What Happens When

Banks Say No?
When your best efforts fall on deaf

ears at your local banks, all is not
lost. Following are some alternate
sources of business financing
that may meet your needs.
State Programs
Most states have loan programs
designed to provide small business
financing. Some of these programs
provide loans at lower than market
interest rates provided the business will
create jobs in the state, says Donna A.
Holmes, director of the Small Business
Development Center, Pennsylvania
State University. Some state programs
will take a subordinate position to the
bank, giving the bank a better collateral
position and an incentive to make a loan
that they may have otherwise rejected.
For information on small business
financing programs in your state,
contact the office of your state
representative or state senator.
Federal Programs
The federal government also has
loan programs available to assist
small business owners. The most
popular of these is the Small Business
Administrations (SBA) guaranteed
loan program that guarantees as much
as 80 percent of the loan principal.
This program gives your bank an
incentive to lend to a borrower who
does not otherwise meet the banks
lending guidelines, Holmes says.
Among other SBA loan programs
available to small business owners
is the 504 loan. Established in 1980,
the 504 Loan Program provides
long-term, fixed-rate financing for
real estate, facilities construction or
expansion, or other fixed-asset needs.
001-027_MNB_JF_09.indd 25
11/20/08 9:01:34 AM
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massage & bodywork
Mass&Bdywk.FULL.1108.indd 1
001-027_MNB_JF_09.indd 26
Easy to Learn Home Study

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11/14/08 1:05:14 PM
11/14/08 12:32:51 PM
s.
OW
business side
If you decide to seek an SBA loan,

your best bet is to work through a
certified or preferred lender. The
SBAs guaranteed loan process is
rather complex, so you want a lender
who has experience working with
them. To find certified or preferred
lenders, visit the SBA website or call
your local SBA office for guidance.
The SBA has local and regional
offices in every state. Youll find
their phone number in the federal
government section of your local phone
directory. Or, for detailed information
on all SBA programs, visit www.sba.gov.
Small Business investors

Small business investment companies
(SBICs) are private investment firms
licensed by the SBA to provide
investment financing and long-term
loans to small businesses. Some SBICs
make only equity loans, others provide
debt loans, and some provide both. As a
rule, SBICs will require the same level
of collateral and credit ratings as banks.
For information on how to contact
an SBIC, check with your local SBA
office or go to www.sba.gov/inv.
Local Organizations
Your local chamber of commerce
or other business group may
have some revolving loan funds
available to businesses specific to
your community, Holmes says.
Generally, these funds come from
a variety of local resources and have
specific guidelines for their use.
Holmes recommends you begin
by contacting the director of your
local chamber of commerce to see
what help might be available for the
specific purpose you have in mind.
Angel Investors
When conventional financing options
seem out of reach, many small
business owners have had success
seeking out individuals or commercial
lenders willing to invest in a business
expansion, either with debt financing
or by taking an equity position in the
both your business and personal life,

especially if you arent aware of the
pitfalls. If you do take a loan from
a friend or family member, make
sure that all details are carefully
spelled out in a written contract.
Home Equity Financing

If you have enough equity in your
home, a second mortgage may provide
all the money you need. While the
interest rate on this type of loan may be
among the most favorable, keep in mind
that it also puts you at risk of losing
your home if your business falters.
business. When you find an angel
investor, youll probably find that
this option is more flexible than a
bank loan or government program.
If you dont know anyone with
the economic firepower to fund your
financing needs, dont give up. There
is an entire industry of professional
investors looking for opportunities
to invest in growing small businesses.
For more information on how to
match up with an investor who might
be interested in your situation, or go
to www.entrepreneur.com/money/
howtoguide/article52742.html.
Be advised, though, that unless
youre willing to give up an equity
position in your practice, working with
a professional investor is not for you.
When All Else Fails
Depending on the size and

economic health of your practice,
the only source of expansion money
available to you may be what you
can dig up on your own. Be advised,
though, that each of these money
sources carries special risks.
Friends and Family Members

If you have a friend or family
member able to help with financing,
you may find this to be the
easiest type of loan to obtain.
Use caution, however. Most
financial experts agree that mixing
business and personal relationships
can lead to destructive problems in
Credit Card Financing

You may have credit cards with lines
of credit substantial enough to fund
all or part of your expansion plans.
While it can be tempting to simply
charge everything, this is arguably
the riskiest and least desirable of all
financing methods, especially in todays
volatile economy. The burdensome
interest rates charged by credit card
issuers can become impossible to meet
if your practice hits even a minor
bump in the road. The result could be
a severely damaged credit ratingor
even the loss of your business.
When you need to raise money
for your business, say most experts,
a thorough and detailed business
plan is the key to the safest and most
desirable types of financing. While
other conventional sources of money
may seem the easiest to find, they
are seldom the wisest choice.
William J. Lynott is a former management
consultant and corporate executive who writes
on business and financial topics for a number of
consumer and trade publications. His latest
book, Money: How to Make the Most of
What Youve Got (AuthorHouse, 2000), is
available through bookstores. You can reach
Lynott at wlynott@cs.com or through his
website www.blynott.com.
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talk about touch
With Mary Kathleen Rose and Mary Ann Foster
Ambiance: The Healing Environment
A good way to check the ambiance of your

own room is to receive a massage in your
space from a colleague.
28
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Mary Ann Foster: One of the basics

of a successful massage practice is
creating a welcoming environment
that makes clients feel comfortable
in anticipation of their massage.
Mary Kathleen Rose: While traveling
last year, I stopped by a recommended
massage clinic. A friendly therapist
greeted me at the door, showed me
into a dimly lit massage room, and
left me to undress and get on the
massage table. As my eyes adjusted
to the light, I noticed that the image
on the wall was a larger-than-life
painting of a reclining nude female.
MAF: A client once told me he got
MAF: Even though its important that we
a massage in a dimly lit basement

room filled with icons of a religious
nature and strongly scented candles.
Although he enjoyed the massage, he
was uncomfortable in that setting, so
he didnt go back. I wonder how many
clients who seem to respond well to a
massage dont return because something
in the surroundings put them off.
are comfortable in our own work spaces,

first and foremost, the setting must
accommodate the needs of the client.
For example, a small step stool would
help a short client get on a tall table.
MKR: Water features can be annoying
uncomfortable. What kind

of place was this?
for some people. Personally, I

have endured too many plumbing
disasters in my homes over the
years to relax to the sounds of
trickling water inside a building,
coupled with the hum of a motor.
My sister tells me these fountains
make her feel like she has to pee.
MKR: It seemed reputable. The
MAF: And yet, someone else might
therapists were licensed, and it was

part of a chiropractic clinic. I do
appreciate good art, including figure
drawing and painting, but it just
seemed like an odd choice for dcor
in a therapeutic massage clinic.
enjoy the feature. So the therapist just

needs to be sensitive to that and ask the
client before the session begins. A few
of my pet peeves are ticking-tocking
clocks, headache-inducing scents,
and animals begging for attention.
MAF: First impressions are so
MKR: There are many elements
important in a successful massage

and bodywork practice. I always
gauge recommendations by asking,
Would I refer my Aunt Betty here?
that you encounter when you walk into

a massage clinic create the ambiance
and affect clients expectations.
that do contribute to a healing

environment. The visual impression
we create also says something about
the work we do. A painting or image
on the wall that evokes a feeling of
calmness supports the practice of
relaxation massage. Informative
anatomical charts can set the tone
for an orthopedic massage practice.
MAF: Certain things are a must. The
MAF: Its also important that we, as
room itself should be clean, warm,

and well-lit, with easy access to a
bathroom. Clients need a comfortable
place to sit, as well as a place to put
their clothes and personal items.
practitioners, enjoy our own work

spaces. I like to have colors and artwork
I enjoy looking at while I work.
MAF: That would make me
MKR: The sights, sounds, and smells
MKR: It is important to have adequate
indirect lighting to ensure physical

and psychological safety, but best to
avoid using overhead lighting, in order
to create a relaxing environment.
MKR: Yes, there is room for individual
creative expression. Choices in

office dcor can be pleasing to
us, as well as appeal to people of
different backgrounds and tastes.
MKR: A good way to check the ambiance
of your own room is to receive a

massage in your space from a colleague.
This can help any practitioner become
aware of what might need some
attention and what is working well.
MAF: I never noticed how
distracting a small unpainted spot

on my ceiling was until I received
a massage on my own table.
MKR: And I realized how much
I enjoy the warm coziness of

my own massage room.
MAF: With this attention to detail,
we invite our clients to step into

a world where they can immerse
themselves in a therapeutic and
rejuvenating experience.
Mary Kathleen Rose, BA, CMT, has been
practicing shiatsu and integrative massage
since 1985. She is the developer of Comfort
Touch, consulting to hospices and other
medical organizations nationwide. She
produced the video Comfort Touch
Massage for the Elderly and the Ill and is
the author of a textbook of the same title.
www.comforttouch.com.
Mary Ann Foster, BA, CMT, has been
practicing and teaching massage and
movement in the Boulder/Denver area since
1981. She has diverse trainings in movement
and structurally integrating therapies, teaches
at the Boulder College of Massage, and wrote
Somatic Patterning: How to Improve Posture
and Movement and Ease Pain (EMS Press,
2004). www.emspress.com.
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round the table

go ahead, speak up
Tell us about
a specific
person who
has influenced
your bodywork
career and why.
Coming in March/April: How do you bridge the gap between holistic therapist and entrepreneur?
See page 32 for upcoming topics, deadlines, and submission information.
30
massage & bodywork
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11/14/08 12:34:39 PM
When I was 9 years old, my

grandmother passed away.
She and my grandfather had
been married for 50 years,
and he took her passing
really hard. For a week,
he could not sleep or eat.
My aunt, who at the time
was a practicing massage
therapist, gave him a onehour massage. That was when
his body relaxed enough for
him to start sleeping. From
that point on, I realized what
the power of touch can do
to help someone heal. That
is what made me want to
be a massage therapist.
Fran Johnson
Statesboro, Georgia
Robert King. He is an enthusiastic,

personable, and wonderful motivator
for massage therapists. I took one of his
workshops and was very impressed. His
knowledge and humility are outstanding
and he is an excellent teacher.
Jody Hutchinson
Pacific Grove, California
One of the most influential people in

my bodywork career was my first boss,
Joel Tull. My initial interview with him
almost 15 years ago occurred while
I was still in school. And, as I have
told him, it was not the most pleasant
experience of my career ... in fact, at the
time it seemed like a complete disaster.
However, that experience totally
shaped my work for the better. Why?
Because he gave me honest (although
somewhat critical) feedback about
my techniques and skills. He let me
know what I needed to work on and
where I could make improvements.
Then after he hired me, he tutored
me on those same areas and
techniques until I perfected them.
At the time of the interview, I was
crushed and thought I had entered the
wrong profession. Later, looking back
on it, I realize that Joel actually gave
me a gift and helped me to always want
to make my work, my business, and
the massage profession the best they
could and can be. He is still a colleague,
mentor, and friend to this day.
Felicia Brown
Greensboro, North Carolina
My bodywork career has been

profoundly influenced by Suzanne
P. Reese. She has unequivocal care
and concern for all: for the youngest,
the least understood, the unwanted.
She has passion and conviction that
all have the inalienable right to
nurturing touch, to feel safe, and to
be honored and respected. Her level
of compassion and her gift for always
speaking positively is awe-inspiring.
However, I dont want to be like
Suzanne, I want to be me! We all
have our talents and we all have
a mark to make on the world. I
appreciate and value her influence
on my life and my work.
Jessica Shenefield
Snow Camp, North Carolina
I grew up seeing my grandmother and

grandfather performing their style
of massage when someone was sick.
They utilized herbal medicine as well
as massage to heal the people who
came to them. As I got older, these
practices were considered the old way
of natural medicine. My grandparents
were of Native-American decent from
Arizona. I married, had children, and
quickly became disillusioned with the
practices of modern medicine, which,
in my opinion, do not get to the root of
the illness and create more imbalances
within the body. I decided I would
learn massage therapy and carry on
a natural tradition for the health of
my family and my clients. I was very
fortunate to find a massage therapy
school in Joplin, Missouri, that fit my
needs. Now, I have a thriving massage
therapy business and wonderful clients
who are now on the road to better
health. I will take the old way any
day. Thanks, Grandma and Grandpa.
Dianne Overton
Carthage, Missouri
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11/14/08 12:34:40 PM
round the table
Please e-mail your Round the Table submissions (200 words or less)
to darren@abmp.com. Submission does not guarantee inclusion.
Also, due to space constraints, your material may be edited.
His holistic
approach to me
as a person,
and especially
his healing,
caring touch
was just what I
needed.
Laura Sutherland
Paradise, California
32
massage & bodywork
28-55_MNB_JF_09_.indd 32
Upcoming Topics
Deadline
Publication Date
Why did you become a bodyworker?
February 15
May/June 2009
Bodywork can be a demanding

profession. How do you mentally
and physically care for yourself?
April 15
July/August 2009
What strategies have been the

most successful in getting clients
to rebook after a session?
June 15
September/
October 2009
I would have to say that there are a

lot of people who have influenced
my bodywork career. But the one
person who I can always count on and
is always the first person to come to
mind is Laura Charlton. She was the
one who I felt really took me under
her wing from the first day I walked
through the doors of my school.
She has a way of really seeing people
and leading them to be the exceptional
[people] she knows we are. She takes
her career seriously, not only in the
classroom, but at home, and in the field
as well. Having such an appreciation
for life and the human experience
itself, she has had numerous jobs that
can be linked to helping and caring for
someone else. I took an intro to infant
massage [class] with her before my first
quarter of school was even over and, at
the time, I had no idea what an impact
that class would have on my personal
life and my career. Thanks to the brief
knowledge she bestowed on me, I am
on my way to being an advocate and
teacher for parents and their premature
and newborn babies. She is the one
person I know I can call if ever I need
anything. I am privileged to have the
opportunity to have come to know

this awe-inspiring woman and the
chance to be her student once again.
Michelle Rhodes
Corrales, New Mexico
Five years ago, I was a physically

burned-out critical care nurse. My
massage therapist referred me to
a chiropractor for additional care.
Meeting Dr. B. was a life-changing
experience for me. His holistic approach
to me as a person, and especially his
healing, caring touch was just what
I needed. It didnt take me long to
realize that what I wanted to do with
the rest of my working life was to touch
people in this way. So I have been on
a journey of learning to take better
care of myself and moving from the
high-tech world of critical care nursing
to the high-touch world of massage
therapy. Along the way, Dr. B. has been
available as a mentor and a role model
in ways that have made me a better
therapist and a better businesswoman.
Thanks so much, Dr. B.!
Laura Sutherland
Paradise, California
11/14/08 12:34:48 PM
My clients
comfort is
of utmost
importance
to me ...
I absolutely LOVE the bodyCushions! Before I even graduated from massage
school I knew that the cushions were something that I would integrate into my
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heat and the lushness of the cushions; my clients enjoy not just a massage, but an
EXPERIENCE. They appreciate the extra touch during their massage sessions. I share
the knowledge that the cushions allow their spine to rest in its natural S-curve,
allowing each area of their spine to decompress slowly, and allows all of their
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practice, EVERYONE LOVES THEM! The bodyCushions are addicting...
Thank you!
My only request is that you make mattresses. They are perfect to sleep upon!
Jenni Jo @ Mana Massage
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28-55_MNB_JF_09_.indd 33
11/14/08 12:34:48 PM
Y OU LO V E WHAT YO U DO.
N O W L OVE YOU R C A R EER.

When youre happy, you improve the well-being of everyone around you. Thats why
at Massage Envy, our friendly environment is designed specifically with you in mind.
From spacious therapy rooms to enjoyable coworkers, we know its your soothing
touch that keeps our clients coming back.
As a Massage Envy therapist, youll enjoy:

Flexible Schedules
Continuing Education Programs
Competitive Compensation
Supplied Linens and Lotions
Advancement Opportunities
Visit MassageEnvyCareers.com today and discover how

satisfying a career with Massage Envy can truly be.
2008 Massage Envy Limited, LLC.
28-55_MNB_JF_09_.indd 34
11/14/08 12:58:28 PM
C.
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11/14/08 2:15:13 PM
fingertips for the client

By Laurie Chance Smith
Note to massage therapists: each issue of Massage & Bodywork contains the column Fingertips for the Client, which is
targeted to clients. This column is available online at www.massageandbodywork.com as a printable file. print the facing
page, attach your business Card, and send it home with clients, courtesy of Associated Bodywork & Massage Professionals.
36
massage & bodywork
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11/14/08 12:34:55 PM
Massage: Your Key to Health
Massage
reminds
your body of
the pleasure
of taking
time out.
Esme Floyd and Paul Wills,
authors of Body Massage
The notion of healing has always

fascinated humans. And the healing
power of touch, for both body and
mind, has been recognized for
millennia. Ancient Egyptian artwork
depicts doctors utilizing a relaxing
hand massage, and the Greek healer
Hippocrates, often touted as the father
of modern medicine, suggested that
physicians become adept at rubbing
their patients to increase health. Among
the countless ways to maintain strength
and vitality, massage is the most basic
healing tool, writes Kristine Kaoverii
Weber, author of Healing Self Massage.
Therapeutic touch is an instinctive
and eloquent form of communication
that has been molded into a healing art.
Larry Costa, author of Massage: Mind
and Body, writes that massage has many
physical and mental benefits, including
... relieving muscle soreness, increasing
flexibility, easing chronic pain, reducing
tension headaches, boosting the
immune system, promoting restful
sleep, and improving concentration.
Massage positively affects the bodys
circulatory, nervous, and immune
systems. By encouraging blood flow
through the veins, massage benefits
the entire body. The calming effects of
massage on the nervous system often
produce a sense of serenity and wellbeing. Regular massage also stimulates
the lymphatic system, which enhances
the function of the immune system.
From easing arthritis and asthma
to improving digestion, the benefits
of massage therapy run the gamut.
Massage helps relieve daily stressors
and eases recovery from many serious
illnesses. In The Complete Book of
Relaxation Techniques, Jenny Sutcliffe
points out that massage can relieve
pain by stimulating the production
of endorphinsthe bodys own
painkillersand, by increasing the
sensory input to the brain, thereby
blocking out the pain messages.
The positive physiological and

psychological effects of massage
were demonstrated in a recent study
of patients undergoing care for
cancer. When given massage, study
participants at the University of Texas
MD Anderson Cancer Center in
Houston exhibited increased relaxation,
better sleep, and improved immune
function, along with relief from
fatigue, pain, anxiety, and nausea.
In Ayurvedic Herbal Massage,
author Gita Ramesh says regular
massages can relieve stress and help
to promote a long and healthy life. In
the Indian healing system of ayurveda,
massage is considered a form of whole
body exercise that increases stamina
and energy, while simultaneously
delivering an inexpressible quality
of stillness and joya time to be
present. Massage realigns the entire
body, promotes deeper and more
natural breathing patterns, and helps
restore individual resources of vital
energy. The moments spent in massage
are an opportunity to experience
oneself as completely accepted.
Regular massage is a gift to yourself.
Through the power of structured,
healing touch, massage helps the
body run smoothly, like keeping a
musical instrument in perfect tune.
Massage rejuvenates the body from
the outside in, with side benefits
that include improved complexion,
better posture, and a relaxed
disposition on life. For additional
information about the numerous
benefits and types of massage, visit
www.massagetherapy.com.
Laurie Chance Smith is a Texas-based
writer and photographer who works for national
and international markets on a plethora of
topics. She can be reached at
lauriechancesmith@yahoo.com.
For more information, visit massagetherapy.com 37
28-55_MNB_JF_09_.indd 37
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W
38
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11/14/08 12:35:08 PM
survive
& thrive
fortify your practice
by robert Chute
hen times are tough, you may be the first expense your clients
cut. While its important to teach them about the long-lasting
health benefits of massage and bodywork, you can also bolster
your appointment book with some tried and true business
practices. Each bullet in the 10 categories that follow is an
action item to stop loss and make gains. Apply what you can
today and youll be able to help people for years to come.
28-55_MNB_JF_09_.indd 39
11/14/08 12:35:13 PM
survive and thrive
1. Perfect the Fundamentals

When evaluating the health of your
practice, its important to start with the
fundamentals. First, get the basics right
so people feel good about purchasing
your services. Dont groan that this is
going to be a lot of work, because this
is stuff you should be doing anyway.
Talk less, listen to your clients more,
handle with care, dump excuses at
the door, and consider these steps.
Stay on schedule. When you give
clients extra time in their session,
you arent being generous with
your time. Youre being generous
with their time. Stay on track, and
you might have another slot to fill
in a day. One slot a day makes a
big difference to your bottom line.
Time is money. Dont waste it.
Go through your files and update your
mailing list. Youre going to boost
your retention rate by reactivating
clients youve let slip away. When
clients dont come back, its not
necessarily a dire judgment of your
clinical skills. They just havent
gotten around to it and a simple
reminder is all they need to return.
Remind clients they are overdue for
a massage. Phone calls are going to
feel pushy for them and awkward for
you. Depending on how long your
mailing list is and how much time
and money you want to spend, send
them a postcard or a note. No one
gets letters anymore so a personalized
note from you is very effective. If
youre determined to spend no money
at all on this project, e-mail. (You
do collect e-mails on your health
history, dont you? If not, its time to
develop your mailing list further.)
40
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28-55_MNB_JF_09_.indd 40
Without measurement, you cant

demonstrate how youve helped
them when they start thinking
massage is a frill they should
delete from their family budget.
In order to spend more time working

on clients, spend more time marketing.
Therapists who devote one work day
a week arent losing a day of work.
Theyre growing their practices
because they know that if its not
growing, its dying. Heres a key
roadblock to your success youre going
to have to get over: even brilliant
therapists need to market their skills.
There are plenty of less-than-brilliant
therapists who are very successful.
Depending on where you feel you
fall on that continuum, this is either
depressing or sensational news.
When those reactivated clients start
coming in, they should have an
improved experience. If youve got
an oil-dotted wall, its past time to
repaint. If your sheets are see-through,
replace them. Clean the algae out
of the aquarium. Dust and sweep
and vacuum and get rid of that spot
in the carpet. You need to evaluate
your clients massage experience
as if you are the client. Go a step
beyond your clients expectations.
Tighten up your paperwork. Are
you in a rush to just get clients on
the table? Cant remember the last
postural analysis or treatment plan
you did? If you dont keep your
files up to date, youre sending a
dangerous signal. Youre telling them

this isnt important. Record pain,
stress, and energy levels. Without
measurement, you cant demonstrate
how youve helped them when they
start thinking massage is a frill they
should delete from their family budget.
Therapists who approach client
treatment with a lax approach (and
Ive been guilty of this, too) often
think they are showing they care
more. Wrong. Treatment plans
show you care about their health
and that we are caring and careful
practitioners. Demonstrate that and
theyll be back on a regular basis.
At the end of each appointment,
ask when they want to schedule
the next session. It is staggering
how many therapists fail to ask
even the keenest clients about
rescheduling. The client goes home,
means to make an appointment,
and never gets around to it.
When you do schedule them, dont
just think in terms of the next session.
Lots of appointments are coming
your way. For clients to get the times
they want, suggest they schedule
several appointments at a time. Even
better, establish a regular appointment
time. Now youre making progress.
11/14/08 12:35:13 PM
Reevaluate your policy on dealing

with insurance. Many therapists avoid
taking insurance cases. However,
many therapists build successful
practices by billing third-party
payers. Is there more time, energy,
and stress involved? Sure. Therapists
who choose to be stress resistant are
snapping up work other therapists
are turning away from. They are also
often satisfying a need for folks in
pain who might otherwise not receive
treatment. If you have philosophical
objections to doing insurance work,
fine. If youre uncomfortable filling
out some paperwork, however, you
need to reconsider. Is remaining
aloof to that income stream a luxury
you can still afford? People who are
willing to do what others wont will
always succeed, no matter what the
economy is doing. For example, if you
think plumbers are overpaid, how
much money would it take for you
to go fix a strangers toilet?
Youre wondering by now why I

havent mentioned upgrading your
dazzling therapeutic skills. I wont.
Most therapists feel their technical
training was excellent. They cant
remember what mitochondria do,
but their hands-on skills are solid.
There is a common denominator
I have noticed among successful
therapiststhey are confident, solid
communicators dedicated to problem
solving. Their clinical skills arent
necessarily any better than those
of less successful practitioners.
2. Better Your
Business Practices
Many practitioners, especially those

working solo, often dont follow good
rules of business, yet this is a critical
component of your economic health.
If youre working out of your wallet
instead of a cashbox, at least fold
up the money you take in. Deposit
the folded money at the bank,
or it will be spent on pizza.
Every lost or ignored receipt is money
thrown away. Keep better track of your
receipts. Get 12 envelopes, label them
from January to December and put
every receipt related to your business
in the envelope. (That includes your
laundry expenses, toilet paper for the
spa, and your subscription to Massage
& Bodywork!) Track your businessrelated mileage, too. It adds up.
Bonus: if you do all the recording and
organizing as you go, your accountant
should be charging you less at tax time.
3. Find New Income Streams

Dont sit waiting for something to
happen. Get out and make it happen.
Cross-promote your practice
with on-site work. I started out
as a new graduate in a new city
with no contacts. I didnt have a
mailing list, and my clinic wasnt
in the best location, either. I had

to get the word out to people
to get them to come to me.
Find some target markets. I reserved
one day a week for on-site massage
in a group home for people with
cerebral palsy and I did house calls for
clients with multiple sclerosis (MS).
This paid the rent when my clinical
practice wasnt yet up to speed. It
was very rewarding work, but it was
also marketing for my clinic. Soon
staff members from the group home
and the MS Society were coming
to me and it grew from there.
Think about how you could leverage
your experience to market your
individual skills further. Most spas
sell products to complement their
services. Many therapists teach to
supplement their income. What other
income stream could you develop?
4. Beware False Economies
Work within your field to develop

your clientele. On an hourly
basis, its hard to find part-time
jobs that outperform our fees.
Dont take an unrelated, low-paying,
part-time job without strict analysis
of the reward. Working behind a
retail counter wont pay if youre
going up into the next tax bracket
and you splurge with your low hourly
wage on an employee discount.
That kind of pay costs you.
Evaluate value over cost. One $300
pair of glasses lasted me years. My
$60 frames fell apart in a month. Poor
quality items cost more when they
have to be replaced quicklyespecially
when you skimp on the quality of your
professional supplies. Sheets with low
thread counts cost you less but will
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survive and thrive
devalue your clients experience. Is

the table Uncle Jack pounded together
really as comfortable and reliable as a
professionally-made massage table?
When clients say they have to cut
massage because they cant afford an
hour of treatment, dont automatically
rush to discount your services. How
will you get out of that discount
hole when things improve? You
dont want to communicate to your
clients that you arent worth your
hourly rate. Instead, try offering
them less time and charge that rate,
or stay with the hour and cut down
on frequency if thats appropriate.
Now you have time freed up in
your schedule for more clients.
Dont be afraid to think outside
the hourly-rate box. In fact, some
therapists make this approach the
strength of their practices. They
work in shorter blocks andcharging
more than half their hourly
ratemake more in one hour than
most therapists charge by the hour.
The pace is faster. The case focus
tends to be weighted toward more
therapeutic than relaxation goals
(though not necessarily) and makes
for a varied, dynamic practice.
5. Control the Outgo
Look around to see where you can

cut back. When you control the
outgo, you may be surprised to find
you dont need more income.
Leave your credit card at home, locked
up, preferably with your spouse
holding the key (and pay down that
expensive interest-spawning debt!).
When you go grocery shopping,
leave the kids at home. Youll
save 35 percent on the bill.
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When youre shopping, evaluate

if you really need something
more to dust and consider online
services like Kijiji.com for buying
locally at flea market prices.
There are many books to help you
simplify your life. Borrow them from
the library, dont buy them.
7. Free Up Energy
If all economists were piled end to end,

theyd still never reach a conclusion.
Many of the so-called experts you
see on TV are the same people who
scolded us for not spending, except for
when they were scolding us for not
saving. People are panic-selling stocks
and, ironically, the people buying up
Dont be afraid to think outside

the hourly-rate box.
6. Reevaluate Your
Relationship to Stuff
Find other ways to save your

hard-earned dollars and enjoy the
experience more than the stuff.
Theres no shame in choosing to work
from home to slash overhead. If you
have a grand clinic, good for you,
but dont look down on spa therapists
paid on an hourly rate. Chances
are excellent youre both working
for the same money and each client
base values the services provided.
Our lives dont have to be shrines
to conspicuous consumption.
Entitlement and overspending got
us into this global economic crisis.
If your clients are evaluating your
success based on what kind of car
you drive, that says nothing about
you and more about them. Dont
get sucked into that mind-set.
Some of us are going to have a lean
Christmas. Youll choose presents
more carefully this year. The kids will
actually play with all the stuff you
do give them and there will be more
time for tobogganing Christmas day.
the stocks think they are making an

equally sound economic decision.
Turn off the TV and focus on
being better and doing better.
Otherwise, you might catch fearinduced paralysis by analysis and
that doesnt help you move forward.
Dont feed anxiety. When you
stoke those fires, youre fueling the
recession rather than the recovery.
Keep in mind that, despite the panic
in the air, many people will not be
affected at all by this downturn in the
economy. People still need care and
treatment, so you are in an excellent
position to weather this storm.
8. Downsize
Amanda Harper, owner of Living

Well LLC in Mobile, Alabama, is a
real-world example. She loved her big
clinic space with three other therapists,
a psychologist, and a homeopath for
pets. However, when the stock market
dropped precipitously, Harper knew
she had to move into a smaller space
11/14/08 12:35:21 PM
28-55_MNB_JF_09_.indd 43
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massage & bodywork
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11/14/08 12:35:34 PM
survive and thrive
Success that is
not measured
cant be
repeated easily.
Unmeasured
failure
will be
repeated.
with just one other therapist. The

easiest thing for me to do would have
been to close up, she says. For a
while, I thought moving back into the
smaller suite was failure but it took a
lot of strength. All around us there are
spas closing. I get calls every day from
therapists who are looking to work. I
personally wasnt feeling the crunch but
I spent a lot of my own money on
marketing [the clinic]. I realized I had to
act quickly and resolve the situation.
Harper arranged with her landlord
to move back into a 580-square-foot
spacedown from 1,600 square feet.
She dumped an expensive website,
opting for a cheaper one, and she cut
down to one phone line from three.
The new website gets more traffic
than the expensive one. Sometimes
people think they can just go with the
flow. Im a more go out and get it and
make it type of person. I do something
as soon as my mind is made up.
Most people will feel uncomfortable

with this downsizing strategy and lay
down until the urge to take action
passes. Do what you know you must.
9. Measure and Track
Success that is not measured cant

be repeated easily. Unmeasured
failure will be repeated.
Watch where the money goes. I lost
four regular clients when a local
industrial plant closed. They will
continue to see me, but far less
frequently. I bartered a massage for
a tutorial on spreadsheets. It was an
eye-opener as to where the money is
going. The math came to an annual
loss of $3,000. Thats when I opened
my schedule to new clients again.
Watch where the money goes at home.
This is a family project, too.
10. Ask for Help
This is the hardest one. Nobody

wants to admit they need help, but
everybody needs it sometime.
Prepare an envelope with three
business cards. When your clients
are on their way out, ask. You know
three people whove been thinking
about coming in for at least a year. I
need your help. Would you give them
my business card and ask them to give
me a call so I can help them? That
would really help me. Thank you.
Few clients will refuse to help you.
Your clients want you to succeed so
youll be able to continue to help them.
Insulate yourself from financial
heat. Stay cool. You could earn even
more income than before the subprimed bottom fell out.
Robert Chute, RMT, is a regular
contributor to Massage & Bodywork
magazine. Contact him at
consciousbodywork@hotmail.com.
28-55_MNB_JF_09_.indd 45
11/14/08 12:35:40 PM
Whose hand
is this?
attunement and bodywork
by stephanie mines
46
massage & bodywork
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11/14/08 12:35:48 PM
odyworks effectiveness is exponentially increased when you

attune to your client. This means that sensing and reading
who the recipient is, beyond the physical complaints, creates
a superior experience. Through alignment with an individual
you stimulate the potent neurochemistry that brings profound
relaxation. You even lasso endorphins that heighten immune
function, speeding recovery from injury and inflammation.
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whose hand is this?
You can be a masterful therapist if

you establish an attuned, focused, and
optimistic state of being even before
you engage your hands. This is not
just a good idea. It is science. Intention
and touch alter psychic activity with
or without the recipients awareness.
Modulating stimuli in response to
who your client is evokes a cascade
of physiological change, including:
Balancing hyper- and hypotonicity.
Hydrating tissues.
Increasing circulation.
Interrupting patterns of habitual
clenching and holding.
Lubricating joints.
Releasing muscle tension.
Softening the psoas.
Connective tissue is not just a
sheath of body fabric. It is actually a
multi-layered memory scroll with an
extensive database. Connective tissue
is an intimate and precise record of
the life, including the prenatal life and
birth, of the person who has entrusted
this body to you. The more you let
yourself read this book of connective
tissue and listen with confidence to
the stories being articulated into
your hands, the more accurately you
attune. People will then come to
you not only to heal from injuries
and to relax, but also to reconnect
with the power of life in the body.
Your attitude always shapes the
quality of treatment you provide. If
you dislike your work environment,
if you had a fight with a coworker
that morning, or with your partner
or your child and you are still
mulling it over, your client will
know you are not fully present. It is
impossible to mask your true feelings
in the intimacy of somatic therapy.
Distraction prohibits attunement.
What would happen if before you
begin your day of treatment, you prayed
or meditated for all the people you
were about to see and touch? What
if you were to also pray or meditate
C.
to allow your hands and every cell of

your body to attune to each of your
clients, no matter what the issues in
your life, so you could serve their
highest purpose? Such a practice,
or anything similar to it, enhances
compassion, uplifting both therapist
and recipient. The magnitude of your
compassion creates the level of safety in
the healthcare (or any) environment.
The Neurobiology
of Touch
The experiences we are having each

moment actually change the structure
of our brains. Dawson Church, PhD
Miraculous things happen when
experience-dependent neurological
patterns shift to allow new neural
pathways to be stimulated in the brain.
Through the psychosomatic network,
so named by Candace Pert, PhD,
(author of Molecules of Emotion, Simon
& Schuster, 1999), the loop between
experience and physiology is quickly

translated into neurological growth.
The recipient of massage or bodywork
acknowledges this with the felt sense
of deep relaxation humans crave.
It is common for massage therapists
to see their clients spontaneously
remember trauma in response to touch.
It is equally possible for numinous or
otherworldly experiences to occur. This
is because the hypothalamus transforms
the activity of the frontal lobes
(awareness) into hormonal messenger
molecules. These then communicate
with the endocrine glands, including
the immune system, digestive system,
and muscular-skeletal system. More
messenger molecules are then released.
When clients experience attunement
coupled with compassion and educated
touch they are poised for a numinous
experience that could substantially
enhance their immune function, as well
You can be told what materials

make a hand: the skin, the fine
bones, the nails, the persnickety
thumbsbut then all the
ingredients fuse and explode.
Whose hand is this?
Excerpt from Natalie Goldbergs Old Friend from Far Away:
The Practice of Writing Memoir (Free Press, 2008)
28-55_MNB_JF_09_.indd 49
11/14/08 12:35:56 PM
whose hand is this?
as change structure and movement. If

this happens sequentially, lives change.
Eric Kandel, winner of the
Nobel Prize in Medicine in 2000
for his research on memory and
brain function, reported that new
synaptic growth and subsequent brain
change is only long-term when the
new experience is repeated. If we
reinforce our novel experiences, we
strengthen the neural net that supports
them. If we do not, the new neural
circuitry decays within a month.
Memory is not static. It changes if
recollections of historical traumas are
repeatedly attached to new outcomes.
Positive experiences that provide
novel options for conditions related to
previous nervous system overload plant
the seeds for neurogenesis. This is the
mechanism of opening new synaptic
pathways to counteract habituated
tendencies and dissolve obsessive
neuronal consolidation. I call this
restorying and use it as a structure
for resolving shock and trauma.
Bodyworkers are positioned
perfectly to make these kinds of
revolutionary differences in their
clients lives. To do so, they must
cultivate awareness, heighten their
skill set, and attune to their clients
by asking, Whose hand is this?
Just as osteopath John Upledger
created a system whereby craniosacral
therapists could support neurogenesis
(SomatoEmotional Release or SER), so
can massage therapists and bodyworkers
use the signals from connective tissue
and human structure to enhance
consciousness. Perhaps we must design
our own therapeutic structure, inspired
by SER, specifically for our profession.
The quality of ones attention
when providing somatic treatment
is transmitted directly through the
therapists hands to the client. This
is, of course, a two-way street. The
therapist is continually receiving
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28-55_MNB_JF_09_.indd 50
bioelectrical messages from the

clients body even if, and perhaps
particularly if, the client is asleep. Just
below the level of discursive thought
bioelectrical channels chatter away,
disclosing confidences and divulging
secrets. This is what makes bodywork
and somatic therapy so evocative.
The release of tension can never
be solely a muscular event. In order
for muscles to come out of contraction
the mind must also let go; with this
letting go, memories are unleashed,
along with the fear, anger, or horror
that initiated the contraction.
Our bodies are storehouses,
veritable libraries containing volumes
of life experiences. Optimally, the
bodys inhabitant will read these books
and fully understand their language.
The therapist reports on the state of
the bodys depository. By feeling what
is tense or stressed in the body, what
is not balanced, what can and cannot
be tolerated, where touch is welcome
and where it is forbidden, the therapist
provides the client with an accounting
of the activities in this personal library.
Throughout treatment there is
a constant, invisible bioelectrical
call and response between therapist
and client. The dialogue includes
information about the therapists
skill and the clients receptivity and
the particular somatic relationship
between these two people.
Body Talk
It is possible to attune to your client

without uttering a word or by saying
very little. Your conversation can be
replete when you dialogue directly
with the body and understand its
mother tongue: sensation. The
attuned therapist listens intently
and responds appropriately.
11/14/08 12:35:57 PM
Here is a report from one therapist

who conducts this kind of body talk as
a regular practice. After you read this
you will see why her schedule is always
fully booked, months in advance:
My client complained of pain along
the left anterior tibialis (shin splints). He
had dif culty walking and could no longer
keep up with his wife on hikes. Other
than a severe ankle sprain 13 years ago,
there were no other injuries relevant to
this restriction. His movement limitation
was causing him signi cant distress. It
signaled aging and incapacity that was
inappropriate and unnecessary. He was an
active and vigorous man, and loved the
outdoors. He wanted to regain his capacity
to walk at a good stride with endurance.
I found unilateral tightness along

the left lumbar vertebral border and
the end feel of this palpation was mushy.
I asked the tissue if this was a problem
with bone. There was no response which
meant the answer was no. I then asked
the tissue at this location if the problem
was in the fascia and the response was
active sensation pouring into my hands.
This meant the answer was yes.
I proceeded to treat the fascia
surrounding the lumbar region until
it became resilient and vibrant. When
my client stood up after his session was
over, I asked him to walk around the
room so I could observe his gait. There
was no restriction. Since this session
he has walked vigorously and hiked
extensively, with no problem. The
session happened one month ago.
In another session of mine with a

woman who complained of chronic hip
tension, profound personal evolution
occurred, as well as the thorough and
fi nal release of the hip restriction.
Her history included the Caesarean
delivery of her fi rst child and a radical
episiotomy in the delivery of her second.
My palpation of her tissue revealed
constriction on the left side of her
respiratory diaphragm along with some
tightness over her left adrenal gland. As
I felt this constriction I asked wordlessly
if the issue was rooted emotionally or
structurally. The tissue articulated
its response into my awareness with
the repetition of the word emotional.
This encouraged me to address the
areas of her tension with subtle energy
medicine so that the intervention could
assage
raps
28-55_MNB_JF_09_.indd 51
11/14/08 12:36:04 PM
whose hand is this?
be primarily at the etheric level where

emotions reside. Later, this woman told
me that numerous manual interventions
had failed to release her hip pain.
Using my intention, I invited my
client to take the space she needed
to free herself of any grief she felt
regarding her femininity. As the session
proceeded she shed tears, but said
nothing. I noticed that her breathing
deepened and her color changed. A
rosy glow began to spread over her
face. In addition, the tonicity of her
tissue shifted from flaccidity to alert
presence, as if her skin was coming
alive. I then asked her how she felt.
She answered by saying that
somehow during the last 15 minutes
of the session she was able to resolve
a feeling of being blamed by her
mother for not being good enough.
This was a feeling that had haunted
her after both the Caesarean and
the episiotomy. She had harbored a
secret disappointment in herself that
insisted she should have been able to
avoid both. Now she knew this was not
true and she had done her best. She
expressed gratitude for the space and
the opportunity to reflect so deeply.
She left without hip pain and called
me two weeks later to say that it had
not returned. She felt she had learned
a great deal about the relationship
between her body and her history and
about how feelings shape structure.
She felt quite liberated. Indeed she
commented that she had never felt
freer to move forward into the world.
I felt awed by the power of both
somatic therapy and intention. Without
saying very much, but by being both
conscious and confident about what
I perceived, expansion and healing
had occurred that would benefit this
woman and her entire family. I was
grateful to have been an instrument
in this. It was truly a blessing.
52
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28-55_MNB_JF_09_.indd 52
Defining Awareness
What does it mean to know who your

clients are? It means that through your
awareness you can assess their patterns
of absorbing physical impacts in their
bodies, how they compensate for
physiological stress, how they respond
to touch, and what their potential
is for movement and recovery. You
can also know how they respond to
you, the therapist. Does your energy
welcome them, make them retreat, or
both? What makes the difference?
As the somatic therapist prepares
herself to benefit her client she always,
consciously or unconsciously, makes
a choice about how much she listens
to her clients body. She can either
listen deeply or eavesdrop. The choice

to listen deeply and believe what you
hear is the path to mastery. I suggest
that this choice becomes conscious,
and that the commitment be clear.
The touch of hand to skin is the
touch of memory to memory. This
dance is quite refined, like a Straus
waltz in which deep intimacy is masked
within a structure for movement with
precise contact. Prepared movements
hide a surprising and confiding
partnership. The structure for
treatment creates a container. Intention
and awareness evoke the profound
content that fills that container.
11/14/08 12:36:06 PM
e
Sp a$ v 0
u
to
What turns a somatic therapy

experience into a turning point is
the realization of potential in the
form of regaining movement or
awakening awareness. When this
happens the therapist has helped to
answer the question, Whose hand
is this? for herself and her client.
CooL SAviNgS!
Take your test online EASiLy, and get

your CE Certificate iNSTANTLy.
CE Hours
the level of mastery
The ankle recovery and hip release

reports are not random, isolated
incidents of miraculous healing. They
are illustrations of how a combination
of skilled treatment and attentive
presence honors the intelligence of the
body and its innate capacity to fi nd its
own tensegrity (homeostasis). Perhaps
at some point a research design will
track the consistency of these responses.
The choice to listen

deeply and believe
what you hear is the
path to mastery.
For this moment, it is my hope that
readers will courageously experiment
with this dynamic themselves. You are
encouraged to venture into the realm
of body talk. I encourage you to record
your experiences and share them with
me. A collection of phenomenological
reports could suggest a protocol.
One of my purposes in writing
for massage publications and working
for and with massage therapists and
bodyworkers is to enhance the status of
the profession, to bring to it the level
of skill and respect it deserves. I want
to encourage therapists to heighten
their use of capacities that fully
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whose hand is this?
The human body has its own

internal pharmacy and it is fully
capable of producing what it
needs for optimum health when it
is encouraged to do so.
embrace the inseparability of body and

mind and the bioelectrical resonance
between clients and therapists.
This resonance, we now know,
has always pervaded the healthcare
environment, but it is only now
being acknowledged more broadly.
Who the therapist is and what she
intends, play a key role in the recovery
process. This is as true for physicians
as it is for psychotherapists, massage
therapists, or any caregiver.
Healthcare, in all its forms, has
always required the integration
of awareness, intuition (a form of
awareness), and technical expertise. The
somatic therapist must embody what
she knows through her confidence in
reading the body and responding to it.
The truth is that all changes
in consciousness are healthcare
interventions. The human body has
its own internal pharmacy and it
is fully capable of producing what
it needs for optimum health when
it is encouraged to do so. The role
of the therapist/healer/healthcare
professional is to allow this to happen.
When this is the primary goal of the
therapist, changes in consciousness
inevitably occur. Physiology and
consciousness are inseparable.
authors note: this article grew out of a
presentation I gave for the students and staff
at lotus blooms Massage Institute in kapaau,
on the big Island of Hawaii in april 2008.
Stephanie Mines, PhD, is the founder

and director of the TARA Approach for
the Resolution of Shock and Trauma. Her
design represents the new paradigm in
somatic therapy that combines Eastern
meridian-based therapies and western
neuropsychology to bring balance to the
nervous system and enhance human
potential. The TARA Approach is
taught worldwide. For more information,
please visit www.tara-approach.org.
22
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Victims
Speak Out
Insights on Sexual Abuse and Domestic Violence

AUDRA HIXSON
hrough my years offering massage therapy to survivors of sexual

and domestic violence, Ive seen the tremendous emotional,
physical, and spiritual impact of these interventions. Could
this be an avenue of healing for others? Could the therapeutic
experiences of these once bruised and battered women offer
comfort or, better yet, a healing path to todays victims?
To answer those questions, I designed a research project to
evaluate the role of massage therapy in the well-being of sexual
abuse and domestic violence survivors. My hope was that this
information could be shared to empower other survivors to
make a more informed decision about receiving massage.
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victims speak out
I started the project by spreading

the word. Posters about the project
were hung in the local community
and a letter was also mailed to local
massage therapists with a request for
them to post information in their
offices. Then it was time to wait
and see if anyone would volunteer
to be interviewed about his or her
personal experiences. During the next
few weeks, a few calls came in and
while some women were comfortable
meeting at a local coffee shop, others
only wanted to talk over the phone.
Based on the research guidelines, 10
women agreed to be interviewed.
Although they were not going
to be interviewed about the specific
experiences of abuse they endured,
these women were courageous in
volunteering to talk about the effects
these experiences had on their lives.
I was amazed at the resiliency they
displayed in trying to survive and heal
from the violence. What came out of
these interviews was not only important
for other survivors, but helpful for the
practice of massage therapy in general.
Results in Narrative
As consumers of bodywork, the women

interviewed for this research provided
information about their personal
experiences with massage therapy and
therapists. The resulting information
included subjective reports regarding
the effects of sexual and domestic
violence on the survivor, the methods
used for healing from these effects,
and the reasons that led each woman
interviewed to turn to massage therapy
as part of her healing journey. With
regard to their personal experiences
with massage therapy, the women
provided information about the benefits
of massage they had received, their
emotional experiences during massage,
and their feelings of safety during their
interactions with the massage therapist.
The
knowledge that
psychological
trauma and
emotional
issues connect
profoundly
to the body
may give
all massage
clients a new
perspective on
wellness.
Based on the responses, it is obvious
that although the specific effects differ
among individuals, the experience of
being traumatized through sexual or
domestic violence is a life-altering
event. The multidimensional nature
of traumatic experience produced
emotional, physical, and spiritual
challenges for the women interviewed.
Issues reported by survivors range from
self-esteem struggles and difficulty
in trusting ones perceptions, to
an inability to feel safe when alone
and with others. Interactions with
other people are a source of stress
for women who have been abused
and this is not limited to their

intimate or personal relationships.
The difficulties mentioned affect
the ability of a survivor to reach out for
assistance to any helping professional.
This is especially true about the
decision to contact a massage therapist.
Despite these challenges, the women
interviewed showed resilience in
trying to heal from the experience of
abuse and in taking calculated risks in
reaching out for help in various ways.
Survivors have significant
apprehension about initially contacting
a massage therapist. A survivor
of abuse is less likely to call a new
therapist using the phone book, due
to issues of hypervigilance about
safety. Information from the subjects
suggests that a face-to-face meeting
would be helpful to establish a basic
level of interpersonal comfort prior
to the first massage session. It may be
helpful for massage therapists who are
interested in serving this population
to volunteer their time at domestic
violence shelters and rape crisis centers
in order to connect with potential
clients who might not otherwise seek
the services of a massage therapist.
Connections with psychologists,
social workers, and other professional
counselors or advocates who commonly
work with survivors are valuable
resources with regard to client referrals.
Because community support groups
have been identified as a common part
of the healing process from sexual and
domestic violence, getting permission
to provide a short presentation at a
meeting would be another valuable way
to connect with this population. The
need to build trust with a client and
network with other professionals is not
unusual, but the level of hypervigilance
or difficulty experienced by a survivor
of abuse has implications for the level
of outreach massage therapists use to
advertise their practice.
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victims speak out
Holistic Self-Care
Education about holistic self-care

that benefits the body, mind, and
spirit is another resource for the
healing process of many individuals.
The knowledge that psychological
trauma and emotional issues connect
profoundly to the body may give all
massage clients a new perspective on
wellness. The option of using healing
modalities such as massage or bodywork
as an adjunct to psychotherapy may
also become more popular. When
issues of healing the body through
touch are considered to be important
connections to trauma, just as
intellectual-based aides such as books
and support groups are, a more holistic
approach may be applied to helping
survivors of abuse. For survivors, this
awareness may close the gap between
understanding the emotional and
physical nature of trauma recovery.
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Chronic physical symptoms such

as muscle tension and pain, digestive
disorders, and migraine headaches
are reported during the healing
process from abuse, yet these physical
symptoms are not necessarily attributed
to the abuse unless the violence has
been physical in nature. Most of the
women interviewed reported receiving
massage for relief from day-to-day
stresses or chronic pain rather than as a
specific part of trauma recovery; it is not
uncommon for a survivor of abuse to be
unfamiliar with the fact that receiving
massage may tap into deeper emotional
issues or that the treatment of her
chronic physical issues may connect
her with the aftermath of abuse.
Because a new massage client may
not realize trauma can cause physical
symptoms and that massage for the
physical symptoms may bring up
emotional reactions, it is essential for
a professional massage therapist to
not only be aware of this connection,
but be able to explain this to clients. A
client presenting for massage therapy
who is carrying the trauma of abuse
may look the same as any other client
who comes in for a stiff neck caused
by work stress. The survivor may not
disclose that she has been abused,
as she may not feel this is relevant.
Massage therapists might consider
a standard practice of explaining
to all new massage clients this link
between body and mind and how
issues may come up during treatment.
Having empathy for the person who
feels she is taking a risk by trusting a
massage therapist and remembering
that the experience of safe touch and
a caring presence by the therapist,
can be a powerful healing force.
Gender Implications
While it might be challenging for

a survivor of abuse to make initial
contact with a massage therapist, it
appears that the massage therapists
gender is another serious concern.

This topic, with regard to study
participants willingness to receive
massage therapy and their perceptions
of safety during massage sessions, was
discussed frequently. This bias toward
employing female massage therapists
clearly has implications for male
massage therapists in the field. This is
one example of the way that violence
against women has implications for
men as well. If, as a result, of her
abuse experiences, the survivor has an
inability to trust men or their ability
to provide safe or caring touch, this
is a major roadblock for a professional
male massage therapist to overcome.
Because of the increased vigilance
and safety concerns that survivors of
abuse have with regard to receiving
massage by a male therapist, sensitivity
regarding client interactions,
professional boundaries, and draping
are heightened. It might be even more
critical for a male therapist to educate
himself about the issues surrounding
sexual and domestic violence and about
working with traumatized clients, than
it is for women. Male therapists might
also have to make a more concerted
effort to engage with survivors
of sexual and domestic violence
through the resources that serve this
population, if they are indeed interested
in working with this clientele.
Heightened Awareness
Many of the women in the study

reported a greater awareness after
receiving massage. This may be due
to the experience of touch providing
deeper mind-body connections than the
client initially expected. Some of the
feedback from survivors who received
massage included positive feedback
about the benefits of experiencing
safe touch, the positive experience of
11/14/08 1:00:22 PM
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victims speak out
feeling connected with the body, and

a decrease in the emotional numbing
that survivors sometimes endure.
These all aided the individuals healing
journey. It is important to note that
these experiences were sometimes
reported only after several bodywork
experiences, never after the first
massage session. Many survivors
reported feeling ambivalent about
continuing with massage when it began
to touch on their emotional scars. This
participants imply that it is important

for massage therapists to ask clients
about any areas of the body that they
might not want to have worked on
during treatment. If a survivor is
uncomfortable with having her neck
massaged for example, this would give
her the opportunity to ask the therapist
to avoid the neck during the session,
rather than endure the discomfort
or dissociate during that part of
the session. The client may not feel
client and improve the connection

between client and therapist.
Crucial Communication
Comments by the women who

participated in this study suggest that
it is important to continue checking
in with clients periodically as the
massage session progresses. They
reported feeling vulnerable in certain
body positions and also mentioned that
oftentimes pressure is too deep and the
It is important for massage therapists to ask clients

about any areas of the body they might not want to
have worked on during treatment.
implies that benefiting from massage
is a process for many individuals.
Some of the negative experiences
that were mentioned included: being
triggered during the massage; an
inability to relax the body due to fear;
and dissociating while being touched
during treatment. Its important
for a massage therapist to provide
standard pretreatment education
for all clients about the effects of
massage. For survivors, this is a crucial
part of therapy, so they can reduce
the fear and discomfort they may
experience when their abuse issues
unexpectedly come to the surface
during treatment. The retraumatization
of experiencing triggers on the
massage table can detract from the
overall massage experience, especially
if the survivor is caught by surprise.
Setting Boundaries
In addition to highlighting the potential

for emotional issues to be triggered
during massage therapy sessions,
the suggestions provided by study
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056-083_MNB_JF_09.indd 62
confident enough to make this request

on her own. Asking the question
gives her the healing opportunity
to be assertive about her wishes.
Besides asking about preference
regarding body regions, letting the
client know she can disrobe to her
comfort level is another aspect of
allowing the client to set limits.
While many clients are nude or only
wearing underwear under the drape, a
massage therapist should not require
this nor instruct the client to disrobe
to this level without giving options.
Survivors of abuse have reported
difficulty in setting boundaries in a
variety of situations. Although she
may take off her clothes if requested,
the perceived pressure to disrobe
completely may feel unsafe. Without
empathy for the potential struggles
experienced by a survivor of abuse, it
may not be apparent that this request
would generate fear. Communication
about these issues prior to the
massage session is a powerful way
to establish a comfort level for the
massage strokes are too fast. While

these factors may decrease the ability
of any massage client to fully relax
during a session, the implications are
more serious for a survivor of abuse,
as she may be frightened or otherwise
reminded of her victimization by this
experience. When a survivor of abuse
feels vulnerable on the table, she may
not feel safe speaking up on her own
about personal boundaries. This may
result in an internal struggle that
clearly detracts from the benefits of
the massage. Only half of the women
surveyed reported they felt safe and
comfortable with the massage therapist
at all times. Asking about clients
comfort level gives them another
opportunity to participate in the
structure of the massage session and
provides evidence that the massage
therapist cares about their experience.
Instituting these ways of
communicating with clients may
make a massage therapists work more
successful with all clients. If a client
11/14/08 1:00:56 PM
feels she has some control over what

is happening to her body, she will feel
safer and better able to experience the
benefits of the treatment. On another
level, the experience of setting limits
with the help of a massage therapist
is therapeutic. Although a survivor of
abuse may not be able to state her needs
on her own, being asked about them is
a valuable opportunity in her healing.
Participants also said that, should
a client become visibly uncomfortable
not the massage therapists role to ask

for details of the abuse experiences.
Listening to her if she wants to talk,
and providing validation about her
reactions, are appropriate and helpful
responses. Recognize her courage in
trying to heal from the experience.
If a client has experienced distress
due to emotional issues during a
massage, it is helpful for the therapist
to have referral information available
for community resources. Providing
seems to be the best way survivors of

abuse can clearly connect the benefits
of massage with their healing process.
The women interviewed for
this study have offered many
recommendations for professional
massage therapists who work with
trauma survivors. It is apparent that
knowledge of the dynamics of the
aftermath of abuse can facilitate
massage therapists ability to effectively
work with clients who have experienced
or emotional during a massage session,

appropriate support by the therapist
is important. Giving the client
the option of stopping the session
temporarily or permanently may be
helpful. Do not decide for the client
that the session has ended because she
is upset. Asking the client if she needs
anything, such as a glass of water or
tissues, may also be helpful. Beyond
these gestures, it is important that the
massage therapist stay professional
and normalize the event as much as
possible for the client. Practitioner
education about the reactions of the
body to touch and trauma, as well as
the connections between the emotional
and physical, is beneficial here.
It is not wise for the massage
therapist to assume that the distressed
client wants to be hugged or touched
in any way, as this might feel unsafe to
her during a time of emotional release.
Validating the persons experience and
providing a caring presence are key
roles for the massage therapist. Unless
the client volunteers information, it is
these options for the client and

offering to support her as she makes
those connections is a positive step.
Ultimately, it is the clients decision
to utilize resources that are offered.
The therapist should not apply any
pressure to get the client to take action
or reach out to a particular resource.
sexual or domestic violence.

Practitioners who work carefully to
establish a caring and professional
relationship with their clients have
a unique opportunity to reduce the
impact of sexual and domestic violence
in our society. If massage therapists can
in anyway reduce the effects of trauma,
they will provide a great service to the
many individuals affected by abuse,
and their loved ones as well.
The Untold Trauma
Without an increased effort among

massage professionals to modify their
services for the survivors of abuse
who are on the massage table, untold
numbers of clients may be silently
feeling traumatized during massage
therapy sessions. This discomfort was
frequent among the women surveyed
for this research and in most cases it was
not detected or acknowledged by the
massage therapist. Clearly the benefits
of massage cannot be maximized under
these circumstances. Attention to the
clients emotional state, breathing,
and relaxation positively affects the
massage experience. A positive or safe
experience with therapeutic touch
Audra Hixson has a doctorate in natural

health and received training in massage at the
Central Pennsylvania School of Massage. She
works at Pennsylvania State University as a
program coordinator, providing education,
advocacy, and support on issues affecting the
wellness of female students. Shes a certified
massage therapist and speaks publicly on
wellness issues such as stress reduction and
self-care topics. Contact her at ALH145@sa.
psu.edu.
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T
he directive to stand
up straight is a familiar
instruction to properly present
oneself in the world. The
progression to an upright
posture, in terms of both
human evolution and individual
development, ultimately
demands a delicate balance
of a complex structure. The
question of what is the most
correct and credible upright
alignment can be debated,
depending on perspective
and particular school of
thought. The subject of
this article discusses the
Aston-Patterning model of
alignment, which is based on
Judith Astons many years of
teaching and observation.
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Dimensions
of Alignment
An Aston-Patterning Perspective
BY LAURA SERVID
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11/14/08 1:01:53 PM
dimensions of alignment
Three-Dimensional Concept
An early observation from Judith
Aston, a pioneer in the field of human
movement and body mechanics, was
that regardless of how well people were
trained into a correct alignment, they
would only hold that posture when
they were consciously on their best
behavior. The correct posture seemed
to be a forced position, involving
appreciable tension, which often made
people look stiff, uncomfortable, and
less like themselves. Astons question,
then, was why, if a posture is supposed
to be correct and good for us, is it so
difficult to maintain? Why dont we see
people naturally assuming this pattern?
Astons investigations followed her keen
sense of dimension and proportion
and were based on her knowledge of
both functional and expressive forms
of movement. What has evolved
today is an empirical understanding
of human alignment that achieves
delicate balance of the body structure
and allows for easy and less effortful
movement assisted by the forces of
gravity and ground reaction force.
Looking at the familiar anatomical
charts that describe the three planes
of the body, the coronal plane is seen
to bisect the body in halves: front
and back. Using this as a reference,
correct alignment seen from a side
view may be described as a straight
line, perpendicular to the earth,
running through the ear, shoulder,
mid-trunk, hip, knee, and lateral
maleous. This representation of the
body fits the model that describes the
body structure in terms of straight
lines and perpendicular planes.
Key in Astons view of alignment
is the departure from the idea of a
single line through points on the body
to a three-dimensional concept of the
body. The concept describes shapes
rather than perpendicular planes. Her
paradigm visualizes the body as a series
of three-dimensional segments that
are supported from the ground up.
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056-083_MNB_JF_09.indd 66
Each body segment has an inherent

optimal shape, differing somewhat
from person to person, depending on
their genetic makeup and personal
history. The optimal placement of
these parts is determined by first
imagining the center of the mass of
each segment, then considering how
it would be best positioned over the
segment below for its support and to
support the segment above. When
the structure is at its best, no single
part borrows space from another,
beer belly, the dimension of depth

may be greater than the dimension of
width, and the depth to the front can
be described as being greater than the
depth to the back. Each individual
segment can also be described in
terms of these three dimensions.
This is helpful in understanding
the relationship of the segments to
each other and to the whole body.
In Aston-Patterning, the external
three dimensions describe the shape
of the being, creating the boundaries
When the structure is at its

best, no one part borrows
space from another, nor does it
compromise the movement of
another segment.
nor does it compromise the movement
of another segment. The goal of this
three-dimensional alignment is to
balance the body over the feet in
such a way that the whole structure
can move together cooperatively.
Aston uses the three aspects of
dimension to describe body segments.
Those aspects are: length (the space
from head to foot), width (the space
through the body from side to side),
and depth (the space through the
body anterior to posterior). A person
who is tall and thin can be described
as having greater length, less width,
and perhaps even less depth. A
person who is short and heavy may
be described as having less length
and greater overall width and depth.
If the heaviness takes the form of a
for the internal dimension. It is

the inner space created by these
parameters that is vitally important
to consider. This space is referred
to as internal volume. The internal
volume contains all the body structures
and organs and can be thought of
as the space in which they operate.
Where the space is compromised,
function is also compromised.
The analogy of a balloon can be
used to better understand internal
volume. The outside of the balloon
shapes the space inside. If the balloon
is pressed on one side, the space inside
is changedflattened or indented on
the side under pressure. The pressure
pushes into the space and increases
the dimension of the opposite side. If
11/14/08 1:02:11 PM
the top and bottom of the balloon are

compressed, the shape gains width and
depth and loses length. If it is squeezed
side to side, the length and the depth
may be seen to increase. Pressure
front to back will lessen the depth,
making the shape wider and longer.
Of course, the body is not hollow on
the inside like a balloon and contains
relatively rigid skeletal structure
mobilized by joints. The fascial system,
the muscles and organs, however, are
quite malleable and elastic. Individual
segments and the whole body can
take on varying shapes depending on
the application of different forces.
This is obvious when one observes
that human beings, while having
the same basic structure, come in an
endless variety of shapes and sizes,
The man pictured above demonstrates an alignment in which the

pelvis is held in a posterior tilt placed back on the femur, and the center
of the chest is held behind the center of the pelvis. The exaggerated
motion of his arms assists in the forward motion, overcoming the
weight of the upper body held behind the center of gravity.
056-083_MNB_JF_09.indd 67
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Over time,
the patterns
can create
strain or stress
on a part,
uneven wear
and tear on
joint surfaces,
and cause
pain and
discomfort.
68
massage & bodywork
056-083_MNB_JF_09.indd 68
each one an individual being. The

integral tensions of the fascial and
musculoskeletal systems organize and
provide support for the whole structure,
manifesting the whole person.
The resulting form, each person
in their own shape, volume, and size,
characterizes the individual physical
body and offers indications as to the
attitudes, emotions, and belief systems,
all of which make up that person. Our
shape, dimension, and alignment truly
express the very essence of who we
are. It was this individuality, Aston
noticed, that was missing from a class of
students all modeling correct posture.
Formula for Alignment
An unfolding of observations and

discoveries shaped Astons formula for
alignment. She first noticed that when
one stands with the feet parallel to
each other, a certain amount of tension
occurs, wrapping the tissue around the
hip joints into medial rotation. This
also produces medial rotation of the
tissue around the tibias. However, when
the feet are in a slightly open stance
the heels directly under the ischial
tuberosities and the forefoot turned
out about 515 degrees, this tension is
reduced. Studying the way the femoral
head fits into the acetabulum, Aston
notes that the slightly open stance
matches the natural structure of the
body. From the open stance, without
excess tension either at the back or
the front of the hip joint, the pelvis is
allowed to come on top of the femoral
heads. With the pelvis in a slight
anterior tilt and sitting directly over the
heads of the femurs, the spine becomes
well supported. The thorax, then,
moves forward slightly to relax over
the pelvis, directly supporting the neck
and head. With support from below,
tension is not necessary to hold the
chest up and the depth of the chest is
supported by the depth of the forefoot.
Finally, in this alignment, the shoulders
rest on the rib cage, the arms hang

easily, and tension is not required to
hold the shoulders back. Building the
structure from the ground up is logical
when we consider that our bodies are
structures on the earth. Each part rests
on the one below and supports the
part above. In this model, the standing
body balancing over the feet can be
set in motion easily by the transfer
of weight hinging across the ankle.
The posture Aston describes is a
dynamic resting point in relatively
stationary balance with weight
distributed over the whole foot. The
shape of the body divided on the
coronal plane is deeper anteriorlythat
is, the rib cage is deeper to the front
than the back and the head also has
more depth to the front. When the
body is slightly angled forward, this
depth to the front is supported by the
forefoot. Aston believes that in neutral
alignment, the body is angled forward
about 24 degrees, hinged across the
ankle. This places the center of gravity
over the arch of the foot, accessing
a spring off the ground to support
the body above. There is a subtle
motion through the whole system that
maintains our standing posture and
keeps us ready for movement through
space. If the body is aligned at 90
degrees, perpendicular to the earth,
with the ear, shoulder, hip, knee, and
ankle directly one over the other, the
weight falls on the posterior third of the
foot. Here, balance is achieved through
tension rather than a subtly dynamic
motion with capability for relaxation
of the parts, each supported by and
supporting the adjacent segments. This
can be felt in the following exercise.
Step 1.
Stand comfortably straight with your
weight about even right to left and
the feet parallel. Align yourself in
the familiar suggestion with your ear
centered over your shoulder, shoulder
11/14/08 1:02:37 PM
over hip, hip over knee, and knee

over ankle bone. Notice any tension
necessary to maintain your alignment?
Step 2.
Now, allow a slightly open stance as
described above. Let all segments of the
body move slightly forward, hinging
across the ankle, to bring the weight
evenly over the balls and the heels of
the feet. Is this a more relaxed posture?
Base of Support
Our foundation, or base of support

(BOS), is an essential concept in the
Aston system. Rather than thinking
of the structure as hanging from an
imaginary sky hook, which truly is
imaginary, the focus is on the ground
as support, both on which to rest and
from which it is possible to push off.

The BOS is described as the surface
on which the weight of the body is
resting. In standing, the BOS is the
feet on the ground or the floor. In
sitting, the primary BOS becomes
ischial tuberosities on the chair as
most of the body weight is on the seat.
The secondary BOS is the feet on the
floor, supporting a lesser amount of
weight through the legs. The BOS
can also be described in terms of one
segment in relationship to the segment
above. For example, the pelvis acts as
a BOS for the abdominal segment,
and the neck is the BOS for the head.
When each segment of the body
can occupy its own space and rest on
the one below, there is minimal tension
required to maintain the alignment.
However, compromises to the shape

and placement of the segments are part
of lifes impression on the body. Forces
acting on the body can change the
shape or dimension of a segment or alter
the relationship of one segment to the
adjacent segment. With displacement of
one part relative to another, the nervous
system supplies the necessary tension
needed to keep the structure upright.
The body can then be seen to take
on compensating patterns of balance
and counterbalance as the structure
maintains itself moving through
space and time. These compensatory
patterns can be genetic or due to
injuries, surgeries, postural habits, the
result of attitudes, conformation to
organizational rules, or fashion trends.
056-083_MNB_JF_09.indd 69
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Over time, the patterns can create

strain or stress on a part, uneven
wear and tear on joint surfaces,
and cause pain and discomfort.
Gravitys Pull
Forces acting on the body and shaping

its segments have a variety of sources.
One of the most obvious and pervasive
forces is gravity. The pull on physical
mass toward the center of the earth is a
constant force on the human structure
affecting its dimensional shape. This
downward pull tends to decrease
length and cause compression of body
segments on one another. Depending
on the shape of a segment or the tension
around that segment, the downward
force may result in direct compression
of two segments or a combination
of compression with displacement.
For example, if a pelvis is held in a
posterior tilt, the tendency is for the
pelvic segment to be placed back on
the femurs and pulled down by gravity,
resulting in a reduction of space at
the back of the upper leg segment. In
three-dimensional terms, the length
at the back of the hip is reduced by
compression, while the length at the
front of the hip is increased. There
is less depth between the lesser
trochanter and the ischial tuberosity.
In another example with excess
thoracic flexion, the neck segment tends
to be pulled down and forward on the
upper chest. Loss of dimension can
be seen both in the front of the chest
and in the back of the neck. The front
of the chest can be described as losing
both length and depth. Rounding of
the shoulders forward results in loss of
width as well. The internal space of the
anterior chest is then compromised,
putting pressure on the lungs and
limiting mobility of the anterior ribs
for respiration. At the back of the
neck, the pull of gravity on the head
creates compression on the posterior
spine, creating the circumstance
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056-083_MNB_JF_09.indd 70
that is consistent with anterior disc

protrusion, stenosis, or bone spurs.
Fortunately, gravity does not act
alone. As with all actions, according
to Newtons law, there is an opposite
reaction. Gravity has a counter force
called ground reaction force (GRF).
This counterbalance to gravity can
be exaggerated by pushing against
the earth which helps to increase
length and lift the body structure
away from the ground. The interplay
between these forces and the human
structure is at the heart of all AstonPatterning movement, and is called
Aston-Mechanics. Often, where
gravity compresses and reduces the
shape and space of a segment, the
use of GRF can suspend and fill
the space, reclaiming dimension.
The displacement of segments
in anterior-posterior or left-right
relationship, creates other forces in the
body. These forces are tensile force,
sheer force, and rotational force. In
the above example of the posteriorly
tilted pelvis, the force at the back
of the hip joint may be described as
compressive. However, at the front of
the joint there may be a tensile force
as the placement of the femur forward
and the pelvis back creates a stretch
across the Y-ligament. In the example
of the neck being pulled forward on
the upper chest due to thoracic flexion,
the force between the segment of the
upper chest and the neck segment,
could be described as a sheer force,
the neck sliding forward and down
across the surface of the upper ribs.
The twist that occurs when one
segment turns forward in one direction
and the next turns forward in the
opposite direction, creates a rotational
force between the two segments.
In the Aston three-dimensional
view of alignment, the interface
between two segments or a twodimensional cross section through
any part of the body is described as
an aperture. An aperture is regarded
The picture above shows consistent alignment

through the body, with weight over the
forward foot as the back foot pushes off the
ground to propel forward motion. Photo
and illustrations courtesy of Laura Servid.
11/14/08 1:03:11 PM
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Bob King National CE Tour
Cortiva Institute is excited to present Bob Kings Clinical

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Approaches for Low Back Pain.
as a space through which movement

can occur, a plane across which weight
and force can be transferred, or an
open channel for communication
between parts. When two segments
are optimally aligned, the aperture
is fully open, the segment above has
a full BOS, and the communication
between the segments in terms of
blood flow, nerve conduction, and
muscular work can occur without
hindrance. Displacement and tension, as
described in the forces above, squeeze
the aperture, obstructing portions
These exclusive 2-day workshops are designed for

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massage & bodywork
056-083_MNB_JF_09.indd 72
NCBTMB approved
The image on the left shows direct alignment of the segments, with
each segment claiming its full dimension. The dotted lines indicate the
field of support provided by the BOS, the feet. Where the alignment is
indirect, as in the image on the right, the dimension of the segments is
compromised, and the field of support does not match the body. Seen
from above, the apertures between the segments are evident, with shaded
areas indicating direct support. With indirect alignment, notice the area
of direct support through the structure is limited to a small pie shaped
space. When the alignment is direct, the full area of the lower legs is an
open aperture for weight bearing and support of the segments above.
11/14/08 1:03:39 PM
of it. When this happens, movement

through the space is restricted and the
BOS reduced. Take, for example, the
tension created in a stance with the
feet parallel. The tension created by
the wrapping of the tissue into slight
internal rotation makes movement
though the anterior medial dimension
of the hip joints more difficult. Tension
through that section of the aperture
restricts movement through it. That
tension may hold weight bearing onto
that medial aspect of the hip joint and
limiting the base of support to that
one area, rather than engaging the
full dimension of the hip for support.
The ability of the nervous system to
sustain upright balance of the human
structure is truly amazing. Comfort and
ease are often lost as the body works
to balance and counterbalance all the
segments and their specific tensions.
Problems with tension or discomfort of
one part are often due to an appropriate
compensation for a shift in alignment
of another part; until the overall shape
of the body is brought into balance, the
struggle will continue. Recognizing
this relationship changes the clinical
approach to solving a problem.
For instance, there is the common
determination in posture that the
head is held too far forward. Often,
this is true of the neck and head in
relationship to the upper chest. But if,
as in a previous example, the thoracic
spine is in flexion and the chest is
centered behind the center of the pelvis,
the forward neck and head may be
appropriately held forward in balance to
the parts below. In fact, the neck may be
forward on the upper ribs, and the head
may actually be held back on the neck.
Moving the head back, then, is not
indicated, and that effort can force too
much weight to the back. The solution
may be that the chest segment should
be positioned forward, reclaiming
dimension and providing the necessary
BOS for the neck and allowing the
head to find a more neutral position
on the neck. With the chest forward

in relationship to the pelvis and head,
the position of the head is no longer
an issue, strain on the neck is reduced,
and the aperture through the corridor
of the chest, neck, and head is open.
Relationships between segments
and the balance of the whole are
essential to our alignment. Each part
acts as the BOS for the part above and,
depending on the relationship, can
create ease or tension. The part above
has weight-bearing influence on the
part below, and can, depending on its
mobility and tone, allow or restrict
movement of the segment below.
When the alignment of the body
segments is accurate, each segment
holds its own shape and supports the
segment above, so the downward
pull of gravity need not displace the
structure. Holding good posture does
not mean stiffness and muscular effort
against the pull of gravity. Instead it
lets the structure rest into the pull of
gravity and readies the body for GRF
to spring up through the segments,
affording length and decompression.
Whole-Person Assessment
Aston-Patterning, as a form of
treatment, is careful to assess the whole
person with regard to their alignment
and dimension in order to understand
the problem of a particular part. The
initial assessment is done in terms of
seeing the segments of the body: their
position in space both in relationship
to the feet on the ground and in
relationship to the other segments.
Watching common movement patterns
such as casual stance and walking can
show where there is available space
for movement and weight bearing and
where those elements are not readily
accessible. A specific form of palpation
determines the areas of tension or
lack of muscle tone that may need to
be addressed in order to allow the
structure an easier and more fluid
access to balance and movement. Aston

sessions are specifically designed to
bring out the best three-dimensional
shape available. Movement coaching
helps the person feel the support of
the structure on the ground or on
the chair, allowing the body to yield
to gravity, land, and push off the
ground to facilitate motion. With
balanced cooperation of the whole,
the strain on specific parts is reduced,
and often symptoms disappear.
Awareness of the full three-dimensional
shape of ones structure and
movement through its spatial design
can be enlightening and rewarding.
Exploration into spaces that have been
inaccessible, and movement along
pathways that allow greater ease,
give a sense of renewal and expand
the possibility of expression. The
understanding made possible through
inquiring into and exploring the
bodys truth contacts an inner wisdom
in which the client is empowered
to shape personal evolution. In the
Aston paradigm, correct posture and
good alignment are indicative of far
more than the physical structure.
They represent the place where the
body rests comfortably and is well
supported, allowing for the individual
manifestation of dynamic balance
and expression on many levels, and
movement in any direction.
Laura Servid is an occupational therapist
and Aston-Patterning practitioner. She has
been working with movement and alignment of
the body for 32 years. She maintains a busy
private practice, is a member of the AstonPatterning faculty and has written numerous
articles about the Aston work. She finds her
years of experience in physical and neurological
rehabilitation, woven together with the Aston
principles, make for a richly satisfying
exploration into the manifestation of the
individual in human form.
056-083_MNB_JF_09.indd 73
11/14/08 1:08:17 PM
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The Breath
of Life
A Craniosacral Primer
BY AUREAL WILLIAMS
raniosacral touch is a light contact modality that invites the body

to self-correct through skilled touch, conscious presence, deep
stillness, and a working knowledge of anatomy, physiology, and
embryological development. This modality is known by a variety
of names, such as craniosacral therapy, Visionary Craniosacral
Work, biodynamic craniosacral therapy, craniosacral biodynamics,
and dynamic stillness. The spectrum of approaches to craniosacral
touch extends from direct manipulation, as in inducing a stillpoint,
to a non-action presence that holds neutral. Whatever the name
or the approach, the client, practitioner, and the field around
them seems to sink into deep stillness where the body can selfcorrect. A universal client experience of craniosacral touch
seems to be one of renewal, well-being, and deep contentment.
056-083_MNB_JF_09.indd 75
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The Breath of life
Ridley believes
the Breath of
Life is in charge
and intention
and regard for
function get in
the way.
Charles Ridley
relationship between the cells and the

tissues with the Breath of Life, and
that this is possible even in the most
acute processes or pathologies.
Training through the BCTA/NA
involves a 700-hour certification course
spread over 10 segments. Completion
of the course spans a minimum of two
years to a maximum of three years.
In addition to course training, each
student gives 150 one-hour practice
sessions, receives 10 sessions, and
completes 150 hours of independent
home study. An exam and a class
project complete the requirements,
allowing one to apply for certification
as a registered craniosacral therapist.
Breath of Life
Cranial Touch
While there are various approaches,
the core root is deep and singular.
We find these roots in the works of
Andrew Taylor Still and his most
famous student, William Sutherland,
doctor of osteopathy (DO). In 1892,
Still established the first school
of osteopathy and following that
development, Sutherland created
cranial osteopathy. Doctors of
osteopathy practice cranial osteopathy,
and massage therapists and other
bodyworkers train and practice in the
various programs of craniosacral touch.
If you are interested in exploring
craniosacral touch as a modality for
your practice, the following primer
offers a summary of leaders in this field
and the training programs they offer.
The Biodynamic
Craniosacral Therapy
Association of
North America
Based on the work of Franklyn Sills

and his Karuna Institute, located
in Devon, England, biodynamic
craniosacral therapy works to help
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056-083_MNB_JF_09.indd 76
resolve the trapped forces that underlie

and govern patterns of disease and
fragmentation in both body and mind.
Peggy Risch, a registered
practitioner of this approach, is also a
teaching assistant with the Biodynamic
Craniosacral Therapy Association
of North America (BCTA/NA)
training programs. She says toward
the later years of Sutherlands life, he
recognized that there was an Intelligence,
an Innate Wisdom in the body that
was expressed through what he called
the Breath of Life, or the bodys life
force. The Breath of Life manifests
itself through palpable rhythms, like
the craniosacral rhythmic pulse.
Risch says biodynamic craniosacral
therapy looks for the downregulation
in the nervous system when these
deeper tides become dominant, hold
potency, and allow the clients Innate
Intelligence to self-regulate. The
human system will tend to want to go
to a level of higher order, she says.
The biodynamic craniosacral therapy
work is an acknowledgement of the
Breath of Life and its manifestations
within the human system. It is the
recognition that health is never lost
and the intention is to reestablish this
Charles Ridley, founder of dynamic

stillness, says in his school of thought,
the practitioner does not treat. Instead,
the practitioner senses and cooperates
with the movement of health as it
is directed by the clients primary
respiration. One of Charles Ridleys
valued contributions to the craniosacral
and biodynamic community is a
clear delineation of three distinct
approaches to the work: biomechanical,
functional, and biodynamic. In
his book, Stillness: Biodynamic
Cranial Practice and the Evolution of
Consciousness, Ridley presents each
cranial enfoldment, or tide, as a level
of human consciousness, as accessed
by resting in heart perception.
Ridleys biodynamic approach
represents a total non-doing. He believes
the Breath of Life is in charge and
intention and regard for function get
in the way. Sensing the relationship
between body and the Breath of
Life requires deepening ones heart
perception to the psychic level of
consciousness (fluid tide), where the
self knows itself as one with nature.
Deepening further, one evolves with
the unfolding of the Breath of Life into
11/20/08 2:55:10 PM
subtle consciousness. Direct contact

with cosmic breathing, of long tide, is
sensed as a 50-second excursion one
way out to infinity and a 50-second
cosmic infusion back to the body.
Finally, one touches dynamic stillness,
that point of intersection where the
invisible meets the manifest world.
Causal consciousness is where utter
relaxation of ego begins and awareness
can realize itself as non-dualboth a
separate individual and one with the
whole simultaneously, Ridley says.
Sutherland, Ridley shares, evolved
all three approaches. He didnt finish
[the process], yet he did teach that in
the science of osteopathy you no longer
have to motion test; you wait for tide
to show up. You follow the unerring
guidance of the tide and wait. After
Sutherland, Ridley credits the work of
Rollin Becker, DO, and James Jealous,
DO, for delineating the harmonics
of the longer tides and furthering
along the biodynamic evolution.
Ridleys training program involves
a bridging class of four days and
a yearlong mentorship that meets
four times a year. Student access to
Ridley is available to refine skills,
as needed. Upon completion of the
mentor course, one can become a
certified practitioner of this work.
Michael Shea Teaching
What interests me most is that

embryology is the new anatomy in
biodynamic craniosacral therapy,
says Michael Shea, PhD, of the
Shea Educational Group. The
word biodynamic comes from the
study of human embryology. It
refers to the slow movements in the
fluids of the embryo and adult that
maintain and repair the body.
Michael Shea
Roy Desjarlais
Sheas work is based on Sutherlands

last teaching, where a practitioner
senses and synchronizes her attention
with the slow embryonic rhythms
within the client. This process involves
sustained skin contact (SSC) because
the practitioner frequently has her
hands in one location for 1015
minutes. Shea says that SSC actually
goes into the attention centers of
the brain and can heal disorganized
patterns from infancy and childhood.
For SSC to have a lasting effect,
the therapist has to self-regulate her
own emotions and autonomic nervous
system. Utilizing his focus on pre- and
perinatal psychology, Sheas training
teaches practitioners how to do this
with slowness and stillness. I call it
therapist-centered therapy because
the infant research shows that positive
resonance between the child and
caregiver builds inner regulation, he
says. It is the same when treating a
client, according to researchers. Positive
resonance does most of the work.
I have stated in my book,
Biodynamic Craniosacral Therapy, Vol.
I, the evolution of the work is about
healing the heart by establishing a
heart-to-heart circulation between
a client and therapist, Shea says.

The focus in the cranial world has
been the brain and I feel it has to be
deeper down and into the middle of
the heart. This is what the embryo has
taught methe brain is subservient
to the heart throughout life.
Prospective students with no
craniosacral experience can pursue
Sheas introductory courses and
foundation certification training of
700 hours to become a biodynamic
craniosacral therapist (BCST).
His trainings are approved by the
International Affiliation of Biodynamic
Trainings. Those with experience
can pursue a bridging program for
BCST or training to become an
advanced biodynamic practitioner.
Primary Respiration
The foundation of the work taught by

James Jealous, DO, is set upon the
therapeutic powers of the dynamic
stillness, the Breath of Life, the tidal
potency, fluids, and other natural laws
at work supporting and generating
life. According to his website, Jealous
says, Its not about bones, or levers,
056-083_MNB_JF_09.indd 77
11/20/08 8:59:48 AM
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The Breath of life
or palpation. It is not about balanced

membranous or ligamentous articular
tension; these approaches are a
different composite. It is about the
Tide at work as the primary source
of diagnosis and treatment with no
application of force to osteopathic
lesions or psycho-emotional systems.
Primary Respiration is the focus
for Jealous as a therapeutic tool, and
he calls it uniquely complete in its
wholeness. Even with his deep roots
in the field, Jealous says osteopathy has
shamefully hidden its great mystery
and resources. On his website, he
says, I believe that to acknowledge a
higher wisdom at work and to sense
rather than palpate is at the soul
of osteopathy. With his BioBasics
course and his postgraduate offerings
in pediatrics, Jealous continues to
bring great depth to the field.
The Upledger Institute
One of the most recognized training

programs of craniosacral therapy is
The Upledger Institute. Roy Desjarlais,
LMT, CST-D, vice president of clinical
services for The Upledger Institute
says that the training is based on three
principles defined by Andrew Taylor
Still: the body is a unit; structure
and function are interrelated; and
the body is self-correcting. Our
curriculum is steeped in research
and comes from an osteopath [ John
Upledger, DO, OMM] who has
dedicated the majority of his career
to a single-minded focus of looking
at how we can engage the body with
natural, self-corrective mechanisms.
The work, Desjarlais adds, is
very gentle in nature. It tends to be
indirect. Yet, Desjarlais says, What
I like about our way of teaching and
working is that we have a choice based
on the signals that we get from the
body There might be times when
the body wants to recreate a little bit of
pressure in order to engage the tissue
memory more fully so it can release

and get to the depth of tissue we are
dealing with. That is not dictated by the
therapist; that happens naturally from
the patient/client and then we follow.
Desjarlais says that The Upledger
Institute trainings incorporate a holistic
view, encompassing work with tissue,
energy, emotion, and belief systems.
Ultimately, we are trying to help
people become empowered in their own
health, to be able to become tuned into
their bodies in a way that they can live a
much less dependent life on medicines.
There are two levels of certification
training at Upledger. The first is a
technical certification that includes
anatomical techniques from the 10 Step
Protocol, hard palate work, advanced
dural tube and spinal cord evaluation,
and release techniques. The diplomate
level of certification occurs after
technical certification and includes
somatoemotional release techniques,
dialoguing techniques within the
scope of practice, and training on
the energetic system, including
arching phenomena that Desjarlais
describes as active lesion patterns.
Visionary
Craniosacral Work
The genesis of Hugh Milnes, DO,

Visionary Craniosacral (VCSW)
program dates to 1967 when, as an
osteopathic student, he had experiences
of inner-eye perception. What most
touched me as I read Sutherlands work
was when he wrote of his own teacher,
Andrew Taylor Still: He could look
right through you and see things, and
tell you things, without even putting
a hand upon the body. I have seen
him do that! Time and time again.
Hugh Milne
Books
Hugh Milne, The Heart of Listening: A

Visionary Approach to Craniosacral Work,
Volumes 1 and 2 (North Atlantic Books,
1998).
Charles Ridley, Stillness: Biodynamic Cranial
Practice and the Evolution of Consciousness
(North Atlantic Books, 2006).
Michael Shea, PhD, Biodynamic
Craniosacral Therapy: Volume One (North
Atlantic Books, 2007) and Volume Two
(North Atlantic Books, 2008).
Franklyn Sills, MA, RPT, RCST,
Craniosacral Biodynamics, Volume 2 (North
Atlantic Books, 2001).
John E. Upledger, DO, OMM, Your Inner
Physician and You (North Atlantic Books,
1997).
John E. Upledger, DO, OMM, and Jon D.
Vredevoogd, MFA, CranioSacral Therapy
(Eastland Press, 1983).
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The Breath of life
Milne says those words spoke to

him. It touched me because things
like that had happened to me, and
it took me years to find teachers to
help me understand it. I think that
this aspect of the work can and must
be taught. Of course, we must also
understand the Breath of Life, the
biodynamics of craniosacral work,
the anatomy, develop skill in sensitive
touch, become more present, and
work on interpersonal skills.
On perception and touch, Milne
says, The harnessing of perception
is part of the reason that craniosacral
work exists and is in demand.
Human beings want and need to be
seen and touched at their deepest
levels. When you can see where they
need to be touched, it helps your
touch be effective. Such visionary
touch can be transformative.
The visionary approach does its
best to honor what [Carl] Jung called
dreambody, what Carlos Castaneda
called the Nagual: the complete
human being. When we can be open
and vulnerable in a session, we allow
energy to come into the room.
VCSW certification involves seven
core classes requiring a minimum
of two years and allowing flexible
scheduling and completion time to
support the students personal process.
Requirements include review classes,
140 client sessions, student exchanges,
and receiving professional sessions.
There are also three postgraduate
classes. Auxiliary classes include VCSW
anatomy and Beyond the Stillpoint
with Giorgia Milne, an embryology
class based on Erich Blechschmidts
work with Konrad J. Obermeier, and
two pediatric craniosacral classes
and two visceral manipulation classes
with Benjamin Shield, PhD.
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Rebecca Flowers
Pediatric Craniosacral
As a result of worldwide acceptance

of biodynamic, craniosacral, and
visionary work for adults, and the
growing rates of autism, sensory
processing disorders and learning
disabilities, and youth violence, massage
therapists and bodyworkers look to
pediatric craniosacral therapy for
effective help for these stressing issues.
Shea addresses pediatric biodynamic
craniosacral therapy, and the following
two programs also offer trainings
in pediatric craniosacral therapy.

Rebecca Flowers, OTR, CSP, CST-D,
is the ombudsman for the pediatric
curriculum at The Upledger Institute.
In this capacity, she develops the
pediatrics curriculum and supervises
the institutes pediatric instructors
around the world. Her background is
in occupational therapy and sensory
integration. Craniosacral therapy has
the ability to facilitate the body selfcorrecting in that the system is able
to come back into more balance and
the central nervous system (CNS) is
able to function in a more efficient and
effective way, so that when you apply
other therapies like physical therapy,
occupational therapy, speech therapy,
sensory integrating therapy, aquatic

therapy, you actually see great gains
and you see them occurring more
quickly, because you have just facilitated
correction of the foundational
pieces of the CNS, Flowers says.
We recognize that we need to meet
the child where he is and not expect
him to do what we want and meet us
where we are. We recognize that the
work of the child is play and we allow
her to move in and out of positions
as she needs to, recognizing that the
behaviors that we see from her tell us a
great deal, even if they are nonverbal.
Pediatric health conditions that
can benefit from craniosacral therapy
for pediatrics (CSP) include sensory
processing disorders like autism,
learning disabilities, visual deficits
or visual motor incoordination and
dyspraxia, brain damage disorders like
cerebral palsy or genetic disorders,
traumas including posttraumatic
stress disorder, and reaction
attachment disorder with children
who are adopted. Treating seizure
disorder is The Upledger Institutes
next focus of pediatric research,
based on the positive effects of CSP
treatments for this condition to date.
The path to training with The
Upledger Institute for CSP is to
complete the core curriculum, Cranial
Levels I and II, and somatoemotional
release. Once the basic CSP class is
taken, the student may take Clinical
Applications for Pediatrics, a class
of four students working in The
Upledger Institute clinic with Flowers.
Here, students receive direct handson feedback and coaching as they
develop their skills. There is also an
advanced Clinical Applications for
Pediatrics and Flowers is currently
working on a certification track for The
Upledger Institutes CSP training.
11/14/08 1:05:54 PM
Cranio Glossary
Cranial osteopathy. A practice of craniosacral touch that is
practiced by physicians and doctors of osteopathy. James
Jealous, DO, is a leading practitioner of cranial osteopathy.
Craniosacral therapy. The most familiar identifier of
craniosacral touch. Dr. John Upledger, DO, his training
programs, and his extensive research have contributed
greatly to the growing recognition of this modality.
Benjamin Shield
Breath of life. A term first used by Dr. William Sutherland,

and continued to today, that speaks to the core essence
healing nature of craniosacral touch. Accessing the breath
Visionary Craniosacral Work

Benjamin Shield, PhD, teaches the
pediatric craniosacral classes for the
Visionary Craniosacral Work of the
Milne Institute. The nature of the
course, Shield says, is to bring the
practice of craniosacral therapy and
manual therapy into the hands of
practitioners who want to work with
infants and children. The principle of
the work is to honor the consciousness
of the infant. The courses that I teach
involve infant-centered therapy and
they incorporate a caring, common
sense approach utilizing craniosacral
therapy, manual therapy, prenatal
and perinatal psychology, and
principles of infant development.
One component of Shields
pediatric craniosacral class includes
information on the polyvagal theory
of Stephen Porges, PhD. In addition to
the sympathetic and parasympathetic
branches of the autonomic nervous
system, Porgess research posits a
third part: the social nervous system.
Polyvagal theory relates to five of the 12
cranial nerves involved with newborn
acclimation. Specifically, these nerves
relate to sucking, crying, hearing,
facial expression, and head turning to
orient to surroundings. Shield teaches
that upregulating one of these cranial
nerves upregulates them all, allowing
of lifea seemingly germinal state that reflects unconditional

lovewithin a session may be a reason for the nearly
universal client experience of contentment and well-being.
Embryology. The study of in utero development is central
to craniosacral touch, because the modality addresses
and helps to release traumatic imprints, some of which are
held from womb time. Many clients report release of stored
memory experience of in utero development and the birthing
process through craniosacral touch. Craniosacral training
programs typically include curriculum in embryology.
Biodynamic therapy. Variation on the terms for craniosacral
touch as taught and practiced by leaders like Michael Shea,
PhD, Charles Ridley, and Franklyn Sills, RCST, among others.
Visionary craniosacral work. A term for craniosacral
touch as taught and practiced by Hugh Milne.
Polyvagal theory. A theory developed by Stephen Porges,
PhD, which says the nexus of five cranial nerves, V, VII, IX,
X and XI are crucial to infant/mother bonding and as such,
lay the foundation for relationships throughout the life
span. Porges also introduces a third part of the autonomic
nervous systemthe social nervous systemin addition
to the sympathetic and parasympathetic branches.
056-083_MNB_JF_09.indd 81
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The Breath of life
Contact Information
Biodynamic Craniosacral Therapy

Association of North America
734-904-0546
www.craniosacraltherapy.
org/CSTA_home.html
Peggy Risch, RPT, RCST
530-926-5614
http://dynamicwholeness.
com/contact.html
Dynamic Stillness
Charles Ridley
415-342-1149
www.dynamicstillness.com
Stephen Porges
312-355-1557
www.stephenporges.info
Primary Respiration
James Jealous, DO
Longtide Management, Inc.
813-649-0708
www.jamesjealous.com
Shea Educational Group, Inc.
Michael Shea, PhD
561-493-8080
www.michaelsheateaching.com
561-622-4334
Hugh Milne
Milne Institute, Inc.
831-667-2323
www.milneinstitute.com
Milne Institute, Inc, Pediatrics
Benjamin Shield PhD
323-932-1112
http://milneinstitute.com/
teachers_benjaminshield.html
for optimal functioning of the nervous

system, beyond stuck points of fightor-flight sympathetic response or
parasympathetic freeze and withdrawal
response. Another component of
Shields classes includes learning
how to establish safety, trust, and
possibility of choice for the pediatric
client, even a newborn, to help resolve
experiences of physical or emotional
birth trauma. In addition, the classes
include information on the birth and
development process, newborn and
child cranial anatomy, craniosacral
evaluation of newborns, and maternal
care. Broad spectrums of pediatric
a student: how did the biodynamic,

Upledger, and visionary approaches
differ? It is hard to avoid personal
bias, that my approach is the best. I
answered the question as openly as
I could, but I knew I hadnt found
big mind and felt dissatisfied.
I hand the class over to Giorgia,
and go to have a nap. A dream comes.
I am in a big room, and Sutherland
walks in. He is dapper, bright, and
grandfatherly. He looks at me and
says, You shouldnt try to name it.
None of the names are right.
I wake up from the dream feeling
as if he poked me in my hara, like a
I felt corrected in the big

mind way. I think that is
the best that can be said
about all the schools.
Hugh Milne
health conditions, in relation to the
applications of craniosacral therapy,
are taught in the classes. This program
includes two, four-day classes. The
first class covers pediatric craniosacral
work for infants and babies, newborn
to 2 years. The second class addresses
craniosacral treatment for children age
2 to 14 years. There is a master class for
pediatrics in the works, where students
will have the opportunity to work
directly with pediatric clients under the
teaching and supervision of. Shield.
Big Mind
There are many lines of thought in

the world of craniosacral touch. Milne
offers this anecdote to give perspective:
I was teaching in Hamburg, Germany,
and I was exhausted from the jet lag and
the traveling. A question came from
Zen master. I felt corrected in the

big mind way. I think that is the best
that can be said about all the schools.
This is something, the perception
of where to touch, then the laying
on of hands, that has existed since
prehistory: You shouldnt try to name
it. None of the names are right.
Aureal Williams, BSN, RN, LMT, is a
public speaker, writer, and craniosacral
bodyworker specializing in craniosacral work for
prenatal and postpartum women, newborns,
infants, and toddlers. In addition to individual
sessions in Cincinnati, Ohio, Williams offers
experiential classes for schools, parenting
groups, corporations, and nonprofit
organizations. She is certified in Visionary
Craniosacral Work and an advocate of all types
of craniosacral touch. To learn more about
Williams work and to contact her, visit www.
aurealwilliams.com.
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connections
an integrated approach
to Treating Knee injuries, Part 2
by arT riggs
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a
fter introducing the
importance of a holistic view

of knee rehabilitation in order
to restore proper gait, the
previous article (November/
December 2008, page 52)
ended with our fingers deep
in the iliotibial (IT) band.
The demonstrated techniques
(Treatments 14) began with
more superficial work that is
appropriate soon after injury or
surgery, and progressed to tools
for returning flexion mobility.
We now turn our attention
to treatment strategies to
improve full extension to the
knee and to a more detailed
explanation of the complexities
of gait, including techniques
to deal with the compensatory
reactions in the feet and hips
that occur after injury.
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I am ABMP.
Maggie Brunner, Centralia, Missouri.
Member since 2005.
BACKGROUND: Growing up on a cattle farm, Ive long wanted

to pursue the holistic health field. I studied spa management,
then massage therapy, and Im also an esthetician. I believe the
training never ends.
PERSPECTIVE: I already see a huge rise in the awareness
of alternative health options, but its our job to keep educating
people. I believe in and love what I do; clients can see that
through my work.
BUSINESS GROWTH: Referrals and persistence are the keys
to success. I foresee my business branching out to surrounding
communities as I add more amenities to my practice.
ABMP AND ME: I joined ABMP as a student member. After
school, I started my own business, building a solid foundation
with ABMP resources. ABMP saved me from a lot of headache,
protects my business and me, and keeps me in tune with issues
in the industry.
LAST WORD: Massage therapy doesnt have to be just an
alternative career. Often, as with me, its your calling.
Comprehensive liability insurance and

practice support for massage and bodywork
professionals and students.
Associated Bodywork & Massage Professionals
800-458-2267 www.abmp.com
84-109_MNB_JF_09.indd 86
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connections
Treatment 5: Returning
Normal Extension
Because of the impossibility of normal

gait without full knee extension, I
feel that this is the primary goal for
proper rehabilitation after injury or
surgery. Of course, tight fascia and
muscles, particularly the hamstrings,
will prevent full extension, but the
therapist should also be skilled in
working with the deeper restrictions
in the joint itself by using mobilization
techniques (shown later) to work
with the knee joint. Lets begin
with some of the major muscles that
contract after trauma and prevent
the knee from straightening.
Working with Popliteus

and Plantaris
Cautionary note: you may feel a fairly
strong pulse from the popliteal artery,
but dont let this deter you. Just be sure
to use the usual precautionary techniques
to distinguish the muscle tissue from the
artery and be precise in your work.
Since these are relatively weak
flexors of the knee compared to the
hamstrings, popliteus and plantaris
are often neglected in conventional
therapy. Their role in preventing full
knee extension is less one of strong
muscular resistance than of being
agitators delegating responsibility to
stronger muscles that do the dirty work
of preventing knee extension. The body
always reacts to pain as a strong dictate
of movement, and both these muscles
can be sensitive or painful when
stretched if they shorten after injury.
At the first sign of pain in popliteus
and plantaris, they send inhibitory
reflexes to the quadriceps to prevent
them from contracting to straighten the
knee. They also recruit their allies, the
hamstrings, to strongly contract and
prevent the knee from straightening.
Reducing irritation to these small
muscles and lengthening them is
a first step in proper functioning
of the larger muscle groups.
Although most of the examples

in this article recommend working
with muscles in a stretched position to
effect a release, working in a sensitive
area like the posterior knee is best
done with enough flexion to allow
easy entry through superficial layers
and have popliteus and plantaris
relaxed so they are not irritable. As
you relax and lengthen them with
your work, slowly extend the knee by
using a small bolster to retrain their
stretch receptors to feel safe with more
extension. Once these muscles relax,
the primary flexors and extensors of
the knee can begin to work properly
without neurological interference
from popliteus and plantaris.
Usually popliteus and plantaris are
shortened as a protective mechanism
rather than from adhesions. Therefore,
strokes in a distal direction are most
effective to train them to relax and
lengthen. Use very soft fingers to sink
through superficial tissue to find the
tight muscles and very slowly stroke
distally, with an intention of simply
relaxing and stretching an irritable
muscle. The texture and depth of
popliteus and plantaris are similar
to what it feels like to work on the
scalenes in the anterior neck, so use
the same principles. While working
on these muscles, it is also a good
time to begin stretching the more
superficial fascia in the posterior knee.
Working with the Hamstrings

These are the most important muscles
to relax and stretch to allow extension.
The hamstrings will have learned to
contract anytime the knee approaches
the painful angle of straightening.
Not only must you release any fibrous
restrictions, but you must also train
these muscles (and to a much lesser
extent, the gastrocnemius, which
also crosses the joint and is a minor
flexor) to relax into a lengthened
position. In the prone position,
refrain from using a bolster under
the ankle so the leg can straighten.
Hamstring work is almost always
beneficial for injured knees, but
remember that if the knee is still
inflamed and extension is painful in
the joint, then it is a natural reflex for
these muscles to be short and tight. If
the joint is painful in movement, or
structural barriers such as adhesions
are present, then the hamstrings
will naturally contract to protect
the knee. Extensive work with the
hamstrings will always be helpful,
but permanent lengthening will only
take place after the joint heals. This
will sometimes take several weeks
or even months, so follow-up visits
over an extended period of time are
helpful to incrementally lengthen the
muscles. Joint mobilization techniques
(shown later) will be very helpful in
freeing the joint so the hamstrings
will not contract for protection.
Photos and illustrations courtesy of Art Riggs,

with thanks to model Joanne King.
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connections
Although this may be the most

important muscular work you do to
return normal function to the knee,
it is relatively simple work without
fancy tricks. Have your client slide
down so that both feet are hanging off
the table; compare the injured knee
with the healthy knee to determine
normal extension. In this case, the
right knee doesnt allow full extension,
so the right heel is about an inch
higher than the left. Use your fingers,
knuckles, or forearms to slowly stroke
distally while visualizing grabbing
and stretching the hamstrings.
You should continue your
intention of lengthening the
posterior compartment below the
knee to the gastrocnemius and
soleus. Note the dorsiflexion of
the ankle to provide stretch.
Not all your work with the

hamstrings will be to educate them
to lengthen. There may be significant
thickening and adhesions in different
depths of the muscles or surrounding
fascia that need detailed release. Anchor
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and stretch using precise pressure at

fibrosed areas. Visualize that you are
placing all of your intention on a knot
in a rubber band. Anchor with proximal
oblique pressure at adhesions when
the knee is flexed, and then slowly
lower the ankle to extend the knee
and focus the stretch at your anchor.
Cautionary note: if your client is
recovering from anterior cruciate repair,
the surgeon may prefer that the knee does
not reach full extension. It is advisable to
check with the doctor for guidelines about
the limits of extension. This caution should
also apply to the use of joint mobilization
techniques shown in the next section.
Treatment 6: Knee Joint

Mobilization Techniques
The largest paradigm shift in my

bodywork protocol occurred after
I had been practicing for almost
10 years. I took a spinal mechanics
class and began working with joints,
not only in the spine, but virtually
anywhere on the body. I hope new
therapists wont wait as long as I did.
With the knee, we are primarily
working to improve extension, flexion,
and a bit of rotation between the femur
and the tibia. Anatomists agree that
the knee joint is the most complicated
in the body, but some relatively simple
joint mobilization techniques can be
practiced safely and effectively even if
you are new to this concept. Although
it is tempting to look at the joint as a
simple hinge, in reality, when moving
from extension to flexion and back, the
tibia must slide anterior and posterior
and rotate relative to the femur. After
knee injury or surgery, tightening
muscles that surround the knee can
contract and compress the joint from
all sides, impeding the articulation
of the bones. If normal movement
between the tibia and femur is not
returned within a reasonable period
of time, then adhesions form deep
in the joint and can permanently
restrict joint mobility. Since most
therapists are apprised of ways to
stretch the knee into flexion, we will

concentrate on extension and rotation.
Cautionary note: if there is any
possibility of torn ligaments or meniscus,
these techniques are not appropriate unless
you have permission from an orthopedist.
However, these are very beneficial after
surgery, when inflammation has subsided.
Anterior and Posterior

Shear of the Tibia and Femur
Straightening the knee to full extension
requires that there is freedom for
the tibia to glide back and forth on
the femur (shear) rather than just
straightening like a simple hinge. Soon
after injury, adhesions begin to form,
and even the slightest limitation can
impact gait. Most therapists are trained
to work on the knee when its supported
by a bolster, but this practice prevents
extending the joint into its structural
barriers to release them. Early in the
recovery process, you may work in
supine position with the extended leg
just resting on the table as you gain
your clients confidence. But as you
begin making progress, place a bolster
under the ankle or calf so the knee
is suspended in space (bridging) as
demonstrated in the photo below.
11/14/08 12:54:03 PM
Remember to place your intention

deep in the joint, and that unlike
simply stretching the knee into
extension as you would if the client
was prone, you are applying posterior
pressure directly down toward the
table and visualizing sliding the tibia
and femur in opposite directions.
Mobilization can be applied in
two ways. First, you can use relatively
quick pulsations of pressure with about
two pounds of force, repeating the
pulsations for a minute or more. It is
crucial to move the joint all the way
until end-range resistance is felt. This
is helpful in overriding conscious soft
tissue holding patterns and begins to
free up the joint as the bones slide back
and forth. Secondly, you can apply a
bit more steady pressure downward,
being careful that your client is not
uncomfortable. Sustain the pressure for
a minute or two, waiting for a feeling of
softening in the joint and a sense that
the bones are sliding past each other.
In the first photo, I am putting
pressure on the femur so that it is
sliding posterior relative to the tibia.
Conversely, by placing your hands
below the knee on the tibia, you are
now sliding the tibia posterior relative
to the femur. As you become adept
at these procedures, you can expand
your effectiveness by experimenting
to either compress or traction the
joint as you apply anterior/posterior
shearing pressure. The key to the
success with this and most joint
mobilization techniques is to apply
enough force to mobilize the joint,
but not so much force that your client
has pain or is fighting against you.
Mobilizing Rotation of
the Tibia and the Femur
When the knee moves, the tibia
actually rotates upon the femur,
rotating externally as the knee extends
and internally as the knee flexes. If
rotation is impaired, then flexion and
extension are impaired. The rotation
is subtle, but important to work with.
As you flex the knee by helping

your client bring her knee to her chest,
place steady pressure to rotate the
tibia internally. When you reach the
end range of comfortable flexion, stay
in this position and continue to exert
gentle internal rotational force while
waiting for softening of resistance.
Reverse the process as you pull the
leg back into full extension by rotating
the tibia externally through the range of
motion. Of course it can even be more
helpful to perform this technique while
also stretching tight fascia or muscles,
but your primary intention is to be
rotating the tibia around the femur.
This technique works well if your

client has large or heavy legs or you
feel unstable on the table. It has
the added advantages of stabilizing
the femur during movement and of
the natural gravity of the lower leg
placing traction on the joint while you
work. As you have your client flex her
knee, rotate the tibia medially, and
then reverse the rotational direction
to external as the knee is extended.
Remember that the most release will
happen at the end range of movement,
so hold a sustained pressure at this
range of motion for up to a minute.
Understanding
Movement Patterns
The treatment suggestions that we

have covered so far should provide
considerable benefit for your clients
who have knee problems and anyone
looking for better movement and
freedom of the entire leg. As mentioned
earlier, a great many people have
sustained injuries that persist in
compensatory patterns of movement
that have been ingrained for decades. A
holistic treatment plan that deals with
the complicated relationship between
the feet, ankles, knees, and hips will be
a great boon to your practice and will
provide better movement for all your
clients, not just with those injuries.
In the previous article we provided
a chart of the muscular and joint
compensations when the knee isnt
able to extend. Now, lets revisit the
chart in more detail to discuss the
basic kinesiology of walking gait at
84-109_MNB_JF_09.indd 89
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connections
GAIT ANALYSIS
TOE OFF
SHORT PSOAS
LIMITED HIP
EXTENSION
SHORT RECTUS
FEMORIS
INHIBITED PROXIMAL
HAMSTRINGS &
GLUTEALS
SHORT DISTAL
HAMSTRINGS
SHORT PLANTARIS
AND POPLITEUS
INHIBITED GASTROC
AND SOLEUS
LIMITED
PLANTAR FLEXION
PROPULSION
SHORT TIBIALIS
ANTERIOR
PROPULSION
NORMAL GAIT
LIMPING GAIT
HEEL STRIKE
INHIBITED
HIP FLEXORS
SHORT
HAMSTRINGS
INHIBITED
QUADRICEPS
SHORT PLANTARIS
AND POPLITEUS
INHIBITED
GASTROC
& SOLEUS
IMPACT
IMPACT
LIMITED
DORSIFLEXION
NORMAL GAIT
LIMPING GAIT
toe off and heel strike with more

attention to the feet, ankle, and hips.
by my older clients.) If the foot is not

far enough behind the body, it loses
its power to propel the body forward
and energy is expended in lifting the
body up, instead of forward. The
foot ceases to flex at the toe joints
(transverse arch) and become immobile,
causing the plantar fascia to shorten.
The ankle remains in a neutral
position rather than plantar flexing
Toe Off
This is the important stage of walking
that propels the body forward. With
limited knee extension, the stride
is shortened, approximating the
mincing steps of very elderly people.
(I find that working for better knee
extension is always greatly appreciated
to push off, so the tibialis anterior

becomes short and the gastrocnemius
and soleus become weakened.
As previously mentioned, since the
knee wont extend, the hamstrings,
upper gastrocnemius, plantaris, and
popliteus become shortened and will all
need lengthening work. But dont forget
to work with the superficial fascia,
especially behind the knee, to stretch
this tissue. Perform joint mobilization
to return normal flexion, extension,
and rotation of the joint itself.
Many therapists neglect the hip
in rehabilitation of the leg. If the leg
cannot extend freely to the rear, then
rectus femoris and psoas will become
short because they dont need to
release to allow the hip to extend for
a long stride. They also will become
fibrous from overwork. Since the leg
is not propelled by the foot and ankle
to swing forward, rectus femoris and
psoas will have to use more energy
to lift the leg to overcome inertia.
Instead of swinging freely forward, the
knee will be lifted at a more vertical
angle by the pull of these muscles.
Heel Strike
If the knee cannot straighten, then
the leg is unable to swing forward in
front of the body with ease. Instead
of landing on the rear of the heel
with the ankle slightly dorsiflexed,
the foot lands flat at a more vertical
angle, preventing the normal
rolling motion from heel to toe that
dissipates shock. Gastrocnemius and
soleus remain short and will need
lengthening so the foot can dorsiflex.
The ankle will need to be mobilized
in both plantar and dorsiflexion to
begin working like a smooth hinge.
In addition to being short in
the distal portion to prevent knee
extension, the hamstrings will also
remain tight near the ischeal tuberosity
as they prevent a full leg swing forward.
It is easy to see how working with the
hamstrings is the key to rehabilitation.
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connections
Be sure to become skilled

in joint mobilization techniques
on the joint itself to help
restore proper mechanics.
All of these complex feedback loops

occur from the simple restriction to
knee extension. Remember the chickenegg relationship with the joint and
the muscles. The lack of proper joint
movement will cause the muscles to
shorten, but these shortened muscles
will solidify improper joint movement
if the walking pattern becomes
ingrained. Be sure to become skilled
in joint mobilization techniques on
the joint itself to help restore proper
mechanics. The best news is that
these techniques work equally well for
restoring proper movement patterns
after injury to the feet, ankles, and hips.
Although one can understand
these kinesiological principles at a
cerebral level, by far the best way to
understand what is happening in your
clients body is to feel the sensations
in your own experience by mimicking
the limping pattern. What joints
arent moving? What muscles are
contracting improperly? If you simply
concentrate to prevent your knee from
straightening, you will experience the
profound compensations from the
toes up through the hips as you walk.
In classes, I actually have students
tape their knees to prevent full knee
extension. I also have them experiment
with placing a pebble in the forefoot or
heel of their shoes. This is an excellent
way to feel both the joint and muscular
adaptations to pain or discomfort, and
will enable a strategy for treatment.
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Working in the end range of

motion is the key to this technique.
With soft fingers, bend the toes
as far as possible into an upward
dorsiflexed extension. With knuckles
or fingers patiently work the area of
the metatarsal heads with both crossfiber strokes and in the direction of
lengthening of tissue. Broaden your
goals to soften the entire planar fascia.
Treatment 7: Balancing
Secondary Compensations
Now we can move to some techniques

to return proper function to secondary
areas that respond to knee dysfunction.
Work to satellite areas is extremely
important because of their tendency
to reinforce limping patterns. Until
proper function is returned to the
primary site of injury, the secondary
compensatory patterns will persist.
It is perfectly appropriate to work on
secondary compensations throughout
your treatments because they often
cause discomfort as they adapt.
However, your primary goal should
be to return the primary injury site
to health as soon as possible, and
then focus on the feet and hips.
Freeing the Toes, Transverse

Arch, and Plantar Fascia
With a limping gait, the feet become
stiff and inflexible as they land similar
to wearing a very stiff-soled shoe
that prevents the toes from flexing
and providing power on toe off.
The biomechanics of stretching

the foot into dorsiflexion in either the
prone or supine position can be difficult
when the leg is straight. This technique
offers the advantages of using your
body weight, being able to exert strong
pressure to dorsiflex the ankle, and
the use of the broad and comfortable
tool of your forearm. This technique
is also useful to treat plantar fasciitis.
Improving Ankle Movement
The front of the ankle is surrounded by

a fibrous retinaculum that can stiffen
the ankle joint like an Ace bandage,
limiting both plantar flexion and
11/14/08 12:54:29 PM
dorsiflexion and causing torsion on the

ankle. Use your knuckles or the ulnar
surface of your forearm to soften and
free this tissue. Anchor in one direction
and then mobilize the ankle in any
opposing direction to improve freedom.
This is an excellent technique after
ankle sprains or on virtually anyone
who wishes easier ankle movement.
Improving Hip Mobility
By flexing the leg with the knee

relatively straight, you can place the
hamstrings on a nice stretch while
releasing any areas, both anchoring and
stretching against the stretch. Dont
strain yourself by holding the leg with
your arm if your client is large. You can
have your client help you by pulling
her leg toward her chest or even have
your client apply the stretch by using
a strap over the bottom of her foot.
The rectus femoris and front of

the pelvis will become short and tight
if your client has been walking with a
limp that prevents the leg from freely
swinging back into extension. Working
in the neutral supine position will
soften tissue but not stretch enough
to open the area. This position allows
you to work easily using your own
body weight as you stretch the leg
into extension. Support your clients
head and neck, and possibly low back,
with pillows and have your client pull
her opposite leg to her chest to keep
the pelvis in a neutral position.
Apply pressure with your other
hand to extend the hip and work
in the direction of the stretch,
using your fingers for superficial
tissue and your forearm for deep
muscular work on the quadriceps.
This technique is also useful for
working with the psoas in a stretch, but
do not overextend the hip. If the hip
is too extended, it becomes difficult to
sink through the superficial tissue in
the anterior pelvis to contact the psoas.
Holistic Connections
I hope these articles have given

you insight into the interesting
interrelationship of the joints of the
legs, as well as some specific tools to
successfully treat problems, not only
to the knees, but to the other joints of
the lower extremity. All joints of the
leg are inextricably linked together
in a complex feedback loop that must
be treated in a holistic manner for
the best results. Remember, each
client will present unique adaptive

mechanisms to injury and the solutions
to solving limping problems rarely are
simple or lie in only one area. These
considerations are what make our
work so interesting and rewarding.
A holistic treatment not only
includes a broad view of distant joints
and compensations, but should consider
the whole person you are working
with, including the causative factors
of an injury (especially with overuse
injuries), a clients approach to self-help
though home programs of stretching
and strengthening, and the associated
emotional feelings. Fear, anger,
depression, and self-judgment are often
associated with injuries. We always treat
more than muscle, tendon, and bone.
The best therapists skills are more of
an art than a craft, as they provide a
hopeful healing environment for their
clients with their humanity and contact
with the person behind the injury.
Art Riggs is a certified advanced Rolfer
who has been practicing and teaching in the
San Francisco Bay area and internationally for
over more than 20 years. His graduate studies
were in exercise physiology at the University of
California in Berkeley. He is the author of
Deep Tissue Massage: A Visual Guide to
Techniques (North Atlantic Books, 2002),
now in a second edition and translated into five
languages, and the seven-volume companion
DVD set. Visit his website at
www.deeptissuemassagemanual.com.
Editors note: Massage & Bodywork magazine is
dedicated to educating readers within the scope of
practice for massage therapy. This feature was written
based on author Art Riggs years of experience and
education. It is meant to add to readers knowledge,
not to dictate their treatment protocols.
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ten for today

By Rebecca Jones
Choosing and Caring for Linens
Michigan massage therapist Patrice

Wisner thought shed figured out
her linen laundry dilemma when
her husband started washing smaller
loads and using more detergent.
The result was cleaner sheets, fewer
impossible-to-get-out oil stains, and
no more lingering smell of oil.
Then, some of her clients started
sneezing when they got on her table.
Too much detergent? she
wonders. Currently, we use detergent
and bleach, but were on a septic system
and I cant say that its all that great for
my septic system to use so much bleach
to get these sheets clean. But if I dont,
they start to smell when they come out
of the dryer, and at some point later
on they start to smell like French fries!
Theres just got to be an answer.
Table linens are one of the most
important accessories massage
therapists will purchase, since those
linens are so visible to clients. And
caring properly for the linens is
one of the most important steps in
maintaining a hygienic practice.
The experts all agree: dont
short sheet your massage practice
by choosing anything less than the
best-quality linens you can afford
and keep them in tip-top shape. Here
are some pointers for selecting the
right linens for your practice, and
how to care for them so they always
send a positive message to clients.
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1.
Pure or blended
Some people avoid 100 percent

cotton sheets, preferring the wrinkleresistance and greater durability that
comes from cotton/polyester blends.
But theres much to be said for the
comfort and soft feel of 100 percent
cotton. They also tend to release oil
more readily than blends. Likewise,
those who appreciate earth-friendly
sheets may even look into hemp
sheetsmore expensive initially, but
extremely long lastingor certifiedorganic cotton sheets. Remember
that you get what you pay for in
most instances and quality sheets
will not pill as easily as cheaper ones.
Theres no one best answer. Its just
a matter of personal preference.
2.
Flannels appeal
Its the most comfortable sheet there

is, says Steve Gern, owner of Sew
& Sew, a maker of massage sheets in
Glide, Oregon. And while the quality
of other kinds of sheets is measured
in thread countthe higher the
better, as a rulethats not true with
flannel sheets. Flannel is measured
in weight. Sew & Sew, for instance,
carries 3.8-ounce and 5-ounce flannel
sheets, with the heavier-weight flannel
costing a bit more. The heavier the
weight, the more plush the feel and

the more washings it can endure. And
while flannel is mostly associated
with chilly climates, its actually a
good product for warm weather,
too, since it wicks away perspiration
more readily than other materials.
3.
Your linen closet
John Sise, owner of Innerpeace, a

Walpole, New Hampshire, massage
linen company, suggests keeping a
minimum of two days worth of linens.
So, if youre going to do five massages
a day, you need to have at least 10 sets
of standard-width (46-inch) sheets on
hand. We recognize that some people
may need a wider top sheet, so we
recommend that the therapist has a few
wide top flat sheets to accommodate
the people who may have extra modesty
issues or are larger than the average
client, Sise says. Its also a good idea
to keep plenty of hand towels nearby.
Theyre really good for wiping a client
off, so you dont have to use a sheet or
a drape to wipe them off, says Diana
Dapkins, president of Pure Pro Massage
Products, of Greenfield, Massachusetts.
And if you spill a product, theyre
just a nice tool to have around.
11/14/08 12:54:40 PM
4.
to sterilize all table surfaces between

clients. Select quality, ecofriendly
cleaning products that are considerate
of clients allergies and void of artificial
scents. And, of course, thoroughly
wash your hands between clients.
Solids versus prints
Again, this is a matter of personal

preference. There are lots of beautiful
prints on the market, including batiks
and themed designs, but Gern says he
sold so few printed sheets he stopped
carrying them. Solidsespecially
whiteslook clean and hygienic, but
prints carry one big advantage over
solids: they can help camouflage stains.
5.
Sanitation rules
Of course, dont reuse any towel or

sheet that has come in contact with
a client before laundering it. Sheets
should be changed after every client.
Same for face-rest covers. Find a
hamper for dirty linens that is well
away from the clean ones. Make sure
6.
Laundry tips
Experts disagree about the ideal

temperature at which to launder your
linens. Norma Keyes, director of
product standards for Cotton Inc.,
a trade group to promote cotton
products, advises using the hottest
water possible to remove stains and
odor. Gern and Sise say hot water
only sets in stains. They recommend
warm water. Dapkins insists warm to
lukewarm is fine, and that even washing
in cold water is acceptable. But heres
something they all agree on: get them
washed as soon as possiblewithin
24 hours of use. If you must wait to
wash them, store them in black plastic
bags, Dapkins says. Tie the bags shut
to keep out air and light, as these are
the two things that turn oil rancid.
For badly stained linens, allow them

to soak in a degreaser, then launder
them twice to completely remove
oily residue. For stubborn stains, add
bleach to the second wash so the bleach
can penetrate after some of the oily
buildup is gone, Dapkins suggests.
7.
Special supplies
Unlike bed linens, which are only

for sleeping, massage table linens get
regularly doused with oil. Simply
tossing them into the wash with other
linens wont be adequate. Some sort of
degreaser must be used, experts say.
One possibility is dish soap, which
wont harm linens, or the spray product
called Zout. Dapkins created Pure
Pro Linen Degreaser, a citrus-based
product, specifically with the demands
84-109_MNB_JF_09.indd 95
11/14/08 12:54:43 PM
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massage & bodywork
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ten for today
of massage therapists in mind. I got

tired of hearing massage therapists
talk about stained linens, she says.
Its a citrus-based solvent, which is
very different from other products on
the market that are petroleum-based.
Anyone will tell you that vegetable oil is
tough. It doesnt mix with water and it
doesnt come out very easily. The citrus
solvents are just phenomenal at eating
vegetable oil. She says degreasers
do not remove stains. Thats what
bleach is for. But before the bleach
can work, massage linens may require
an initial washing with a degreaser.
8.
Dryer safety
If a sheet comes out of the washer

still smelling of oil, do not put it in
the dryer. Drying it will only worsen
the problem, because it will bake in
the oil residue, making removal even
harder. Whats more, theres a safety
issue involved. Weve had a number
of people with dryer fires, because
they put the stuff in the dryer and it
combusted. There was simply too much
residue on the linens, Dapkins says.
9.
sheet. Fold the smooth end over the top

of the bulky end, then fold lengthwise
into thirds yet again. If youre having
trouble picturing this, a number of
online reference sites have step-bystep picture guides. Just type fold a
fitted sheet into your Web browser,
and youll find lots of online help.
10.
Letting go
Finally, if you see any sign of holes,

broken elastic, fraying, or anything
that looks unserviceable, its time to
find a different use for that sheet than
putting it under a massage client. And
if youve tried every trick you know and
you still cant get a stain out, surrender
to the inevitable and ditch the sheet.
If you get a years worth of service
out of a sheet, and you do 25 clients
a week, remember thats just pennies
per use. Youve gotten your money out
of that sheet, Dapkins says.
Rebecca Jones is a Denver-based freelancer
who has a new appreciation for the intricacies of
massage linens. Contact her at killarneyrose@
comcast.net.

Folding technique
Yes, there really is a secret to folding a

fitted sheet, and if you master it, your
linen cabinets will be forever neater.
Start by pulling the sheet out of the
dryer immediately, not letting it sit
around unfolded for hours. Youll need
to spread the sheet out on a table or bed.
Fold it in half horizontally, then tuck
the top gathered end into the pocket
formed by the bottom gathered end.
Fold everything horizontally in half
again. Then fold the bulky gathered
ends horizontally into the middle of the
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table lessons
By Douglas Nelson
Editors note: in massage sessions, there are often embedded lessons that can teach us much about the body and the
importance of a deep model of physiological understanding. In this column, Douglas Nelson shares some of his
insights into somatic principles that affect soft-tissue therapy.
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Mobilit y and Stabilit y

That is very strange. I dont
understand why I cant do that.
From across the room, I could hear
the concern in her voice. I was teaching
a seminar about the upper extremity
and everyone was working in pairs.
As I walked toward her, I could see
the confusion in her face. Her partner
therapist also looked perplexed.
The instructions I had given
were very simple. I asked the class
to measure the capability for each
person to perform humeral abduction,
which should be about 165. What
these two therapists had noticed was
striking. If the young lady who was the
client (call her M) lifted one arm
in abduction, her maximum ability
was 90. This was also true on the
other arm. While quite limited, this
may not be that unusual. What was
remarkable was that for some reason,
she thought to try raising both arms
at once, which resulted in flawless
abduction on both sides to about 165.
I must admit that I hope my
face did not belie my initial lack of
a plausible explanation. At first, this
made no sense. Her arms clearly were
capable of full abduction, so no intrajoint pathology could be present.
How could it be a muscular issue if
the muscles were capable of creating
and allowing the motion, albeit only
when both sides contracted at once?
What was it about bilateral contraction
that made this work properly?
It is at these moments when all
the time spent studying anatomy
pays off. Watching her abduct her
arms, the reality of the situation
hit me. I tried a little experiment

to confirm my hypothesis.
Before you abduct your left
arm, I want you to push your right
arm against me as though you
were trying to abduct it, I said.
As I held her right arm tightly to
her body while she pushed against
me, she easily lifted her left arm up to
165. She lifted her left arm again and
again into full abduction. To make
the point, I did the same thing to her
other side. If I resisted her abduction
on the left, she could easily raise
her right arm into full abduction.
The Mystery Unravels
There is a very satisfying point in any

mystery when the picture begins to
form and previously unrelated details
suddenly make sense. Let me show you
something that explains your dilemma,
but will also teach you a very important
lesson about functional anatomy, I said.
I asked her partner therapist to hold
her own right arm at 90 of abduction.
Firmly, I pressed into her arm
downward, challenging her abductors.
I placed Ms hand on the midscapular
area and asked her to palpate where she
felt contraction. M said she felt very
strong contraction on the left side of her
friends back along the spinal erectors
and scapular stabilizers. This makes
perfect sense; when you place weight
out on the lever arm, something must
contract to stabilize that weight. When
you pick up a suitcase with your right
arm, the left spinal erectors massively
contract to stabilize the action. In M,
this was not happening. The stabilizers,
for whatever reason, were not firing.
Raising both arms together created
its own stabilization, activating both
sides at once, fixing the problem.
To demonstrate a correction, I
treated Ms left scapular and spinal
stabilizers with a rather vigorous upregulation technique. Immediately
following, she was able to raise her
right arm into full abduction. Doing
the same treatment on the right
side allowed her to raise her left
arm into full abduction. She smiled
and shook her head in disbelief.
A Stable Base
The lesson here is that any muscle

contraction can do its job only if there is
a stable base from which to operate. We
have been trained to think of agonist
and antagonist relationships only. For
agonists to contract and antagonists
to lengthen, all this must happen in a
stable environment. If that base is not
stable, the brain will shut down the
muscle contraction to prevent injury.
Muscle shortness/tightness is not
the only reason for lack of range of
motion. The agonist can be inhibited/
weak, the antagonist can be too short,
or a stabilizer can be inhibited. All
of these will lead to improper range
of motion. Mobility and stability are
forever linked. Probably, the memory
of humeral abduction and stability will
also be forever linked in Ms mind!
Douglas Nelson is the founder and
principle instructor for Precision
Neuromuscular Therapy Seminars and
president of the 16-therapist clinic BodyWork
Associates in Champaign, Illinois. His clinic,
seminars, and research endeavors explore the
science behind this work. Visit www.
nmtmidwest.com or e-mail him
at doug@nmtmidwest.com.
84-109_MNB_JF_09.indd 99
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new products
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Comfort Touch:
Massage for the
Elderly and the Ill
The textbook from Mary Kathleen

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11/20/08 8:53:33 AM
Align for Life:

Journey to
Structural
Integration
This 216-page paperback by Dan
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essential skills
By Ben E. Benjamin, Ruth Werner, and Daphne Chellos
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Human Touch in Our Lives

Attitudes toward touch affect
us all. The way a culture
understands the role of touch
in human lives has a profound
impact on the way its people
grow, develop, and engage
with their physical and social
environments. Is touch a
necessity or an indulgence?
What impact does it have on
our physical and psychological
health? Is the desire for tactile
contact healthy, dysfunctional,
or even dangerous?
At various points in time, different

societies have come up with very
different answers to those questions.
For those of us trained as massage
therapists and bodyworkers, popular
perspectives on touch have a powerful
impact on both our personal and
professional lives. In this article,
well take a close look at human touch
from a historical and physiological
perspective, exploring a range of views
that have held sway in the past and
the facts we now know about the role
of touch in the human life cycle.
American Attitudes
Toward Touch
A critical milestone in this countrys

perspective on touch was the 1894
publication of The Care And Feeding
Of Children: A Catechism for the Use
of Mothers and Childrens Nurses
(Appleton and Company). In this book,
pediatrician Luther Emmett Holt
decried old-fashioned, hands-on
methods of caring for babies. As Holts
theories became popular, doctors began
to discourage mothers from spoiling
their infants with too much handling
and cuddling. Babies were put on strict
feeding schedules; they skipped sleeping
in the mothers bed or even a cradle
and went right to their own enormous
cribs; they spent most of their days
alone; and they were touched only as
often as necessary to keep them clean
and fed. At most, parents might bestow
a kiss on the forehead at bedtime and
shake hands in the morning. In the
common perception, this was the only
way to raise children who would be
strong and independent enough to
cope with a hard, cruel world. These
basic principles remained popular,
especially among the upper classes,

until around the mid-1950s.
We know now that this approach to
child rearing did far more harm than
good. As a result of this long-lived
fad, generations of people have grown
up in this country deprived of loving
human touch. Those hardest hit by
such misunderstandings were the most
vulnerable of human beings: infants.
At the end of the 19th century,
orphanages were an everyday part of the
American social landscape. Unwanted
babies were deposited in these
institutions, where modern antiseptic
procedures and adequate food seemed
to guarantee them a fighting chance
for a healthy life. However, about 99
percent of those babies died before
they were seven months old.1 The large
majority of them ended up wasting
away, but not from infectious diseases
or malnutrition. Sterile surroundings
didnt cure them, and having enough
food made no difference. These babies
died from a completely different kind
of deprivation: lack of touch. When
babies were removed from these large,
impersonal institutions and placed
in environments where they received
physical nurturing along with formula,
the condition reversed. They gained
weight and finally began to thrive.
Today, medical authorities
recognize that touch is vital for
survival in the very young.
We know now that it is not
only OK, but actually important to
pick up and comfort a crying baby.
Nonetheless, were still dealing with
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essential skills
the repercussions of years and years of

hands-off training, and our culture
continues to struggle with the meaning
of touch and the contexts in which
touch can be appropriate. As a start,
it is helpful to understand how our
sense of touch develops, as well as the
various ways that healthy touch can
influence our early development.
The Role of Touch in

Human Development
The sensation of touch actually begins

in the womb. The skin, derived from
the same cells as the nervous system,
is a perfect instrument for collecting
information about our surrounding
environment long before birth. A
fetus will withdraw from the touch
of a probe at less than eight weeks
of gestation, showing that the link
between touch and survival is one
of the first and most important
protective mechanisms to develop.
In contrast to most other mammals,
human babies are born before they are
developmentally and physiologically
readynot only are they unable to
move around in their environment, they
also cannot see clearly or differentiate
sounds. As a result, human infants must
communicate with the world almost
entirely through the skin. Even older
babies, who are not yet crawling, use
their skin as a way to get information
about the world. Watch a baby explore
a new toy: the first place it goes is
into the babys mouth. The baby is
not really interested in how the rattle
tastes. It happens that a huge number
of sensory neurons are in the skin of
the lips and tongue, and this is where
a baby gets his or her information.
Babies put toys in their mouths to
find out what they feel like.
Some of the most important
messages conveyed by the skin have to
do with safety and well-being. Studies
show that all babiesperfectly healthy
ones and others who suffer from colic,
104
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84-109_MNB_JF_09.indd 104
Some of the
most important
messages
conveyed by
the skin have to
do with safety
and well-being.
Studies show
that babies
benefit from
regular touch.
cocaine exposure, AIDS, or abuse

benefit from regular touch. Changes in
blood chemistry indicate a reduction
in stress, and the babies end up crying
less, sleeping more, and being generally
easier to soothe. In some hospitals, sick
and premature infants who are isolated
in sterile environments are given
gentle massage therapy for 15 minutes,
three times a day. Sometimes they are
simply held and rocked by hospital
volunteers. Although these babies are
given exactly the same amount of food
as others, they grow faster, gain more
weight, and leave the hospital sooner
than their untouched counterparts.
Cross-species studies demonstrate
that its not just humans who require
touch for proper development. For
instance, rodents and other lower
mammals must be licked by their
mothers after birth to stimulate their
first bowel excretions; without this
stimulation, the babies die. Research
also shows that separating baby rats
from their mothers causes measurable
brain damage: cells in the central
nervous system actually degenerate
and fall apart without their mothers
touch. Furthermore, baby rats that are
removed from their mothers will in
turn not mother their own offspring:
early nurturing through touch is
vital to the survival of the species.
Consistent nurturing touch in
infancy seems to influence later
coping skills as well. When placed
in a novel situation, young monkeys
who have been nurtured tend to
show curiosity and a kind of tentative
courage. When introduced to a new
enclosure, for instance, they will
explore it by degrees, frequently
retreating to hug the mothers leg for
reassurance. Then they will venture
forth again and again until they feel
comfortable in their new surroundings.
In contrast, baby monkeys that are
raised without comforting, nurturing
touch are easily overwhelmed by new
11/14/08 12:55:43 PM
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massage & bodywork
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essential skills
experiences. Placed in an unfamiliar

environment without a sense of safety,
they simply collapse in hysterical
screams. They cant cope with
challenging or threatening situations
in the same way that their touched
and comforted counterparts can.
Although we cant conduct studies
on touch deprivation with human
babies, we can look at the differences
in cultural attitudes toward infants
and how those attitudes are reflected
in patterns of adult behavior. Cultural
statistics show that children who
are welcomed with lots of physical
touch and tactile stimulation tend
to grow into well-adjusted, capable,
and loving adults, while children who
are touch-deprived in infancy show
tendencies toward aggressiveness and
violent behavior. Naturally, there
are countless other variables that
influence human behavior besides
how we are touched as babies. But
it does make sense that during this
most vulnerable time of our lives, we
would form strong expectations about
how the world worksspecifically,
about how safe and valued we are
in the worldthrough our skins.
How Touch Affects

Adult Physiology
Of course, the importance of touch

does not end in infancy or childhood.
Human touch has a powerful effect
on the way the body functions
throughout the lifespan. From heart
rate to blood pressure to the efficiency
of the digestive system, healthy touch
can make the body work better.
When our skin comes into contact
with other human skinor with
any other tactile stimulussensory
information races to the brain. The
brain interprets that information and
creates a corresponding response in the
body. If the stimulus is soothing and
welcome, the effect will be relaxing
and pleasurable (a parasympathetic
nervous system response); if it is

perceived as threatening, the effect will
be anxiety-provoking and upsetting (a
sympathetic nervous system response).
A parasympathetic response from
being touched will lower our blood
pressure, increase digestion, deepen
our breathing, and generally make us
feel more at ease, while a sympathetic
response will have the opposite effect.
So, typically, a persons body will tense
up when slapped and relax when given
a foot rub. However, there is often wide
variation in individual responses to
particular sorts of contact. It all comes
down to how the stimulus is interpreted.
Interpreting a tactile stimulus
is a complex matter. When we
receive touch, we go through largely
unconscious processes to determine
the meaning of that specific contact.
According to research done by Heslin
and Alper, a variety of different

factors influence our response:2
What part of the body touched me.
What part of my body is touched.
How long the touch lasts.
How much pressure is used.
Whether there is movement
after contact is made.
If anyone else is present to witness
the touch, and if so, who.
The relationship between myself
and the person who touched me.
The situation we are in.
There are several other components
that Heslin and Alper didnt mention
that are probably important as well:
The verbal exchange that
accompanied the touch.
Any other nonverbal behaviors.
My prior experiences with touch or
with the person who has touched me.
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essential skills
From heart rate to blood pressure to the

efficiency of the digestive system, healthy
touch can make the body work better.
We all like to be touched by some

people but not by others. While
one persons touch makes us feel
warm, cared for, and safe, anothers
may make us feel cold, queasy, and
threatened. Most of us have had the
experience of unexpectedly feeling
violated by a persons touch. This
holds true for friends, coworkers,
acquaintances, healthcare providers,
and touch practitioners.
Thus, it is quite a complicated
process that we each go through simply
to determine if a touch is a positive
or negative experience. Add to this
equation the familial, ethnic, and
even regional differences in norms
regarding touch, and then combine
prevailing cultural and gender
differences, and it is easy to see how
touchy this experience is for us.
(In a future article, well look at how
confusion about intimacy and sexuality
creates even further complications.)
Finding the Right Touch
Though it may sometimes be

challenging for an individual to find the
right type of touch to bring support,
relaxation, and healing, the rewards
are worth the effort. Study after
study shows that receiving touch that
is pleasurable, safe, and appropriate
reduces sickness, depression, and
aggressive behaviors. In fact, as
time goes on, we may find that
therapeutic touch and massage hold
more answers than we ever imagined.
Dr. James Prescott, a developmental
neurophysiologist at the National
Institute of Child Health and Human

Development says, I am convinced
that deprivation of sensory pleasure
is the principal root cause of violence,
and, further, that there exists a
reciprocal relationship: the presence of
one inhibits the existence of another
... I believe that the deprivation of
body touch, contact, and movement
are the basic causes of a number of
emotional disturbances which include
depressive and autistic behaviors,
hyperactivity, sexual aberrations, drug
abuse, violence, and aggression.3
As bodyworkers and massage
therapists, we have a vital role to play in
communicating the value of therapeutic
touch and making it more widely
available to those who could benefit
from it. We can also use what we know
to help the people we care about most
making sure that nurturing touch is an
integral part of life for our infants, our
children, our teenagers, our elders, and
ourselves. With every step we take in
this direction, were advancing not just
individual physical and psychological
health, but the health and well-being
of our society as a whole.
Ben E. Benjamin, PhD, holds a doctorate in
education and sports medicine. He is founder
of the Muscular Therapy Institute. Benjamin
has been in private practice for more than 45
years and has taught communication skills as a
trainer and coach for more than 25 years. He
teaches extensively across the country on
topics including SAVI communications, ethics,
and orthopedic massage, and is the author of

Listen to Your Pain, Are You Tense? and
Exercise Without Injury and coauthor of The
Ethics of Touch. He can be contacted at
bbby@mtti.com.
Ruth Werner is a writer and educator who
teaches several courses at the Myotherapy
College of Utah and is approved by the
NCTMB as a provider of continuing education.
She wrote A Massage Therapists Guide to
Pathology (Lippincott Williams & Wilkins,
2009), now in its fourth edition, which is used
in massage schools worldwide. Werner is
available at www.ruthwerner.com or
wernerworkshops@ruthwerner.com.
Daphne Chellos, MA, LPC, was named a
pioneer in the field of sexual ethics by the
Bodywork Entrepreneur in 1991.She is a faculty
member atNaropaUniversityand has a
psychotherapy practice inBoulder,Colorado.
Notes
1. Deane Juhan, Jobs Body: A Handbook

for Bodyworkers (Barrytown, NY:
Station Hill Press, 1971), 43.
2. Richard Heslin and Tari Alper, Touch: A
Bonding Gesture, in J.M. Wiemann &
R.P. Harrison (eds.) Nonverbal Interaction
(Beverly Hills, CA: Sage, 1983), 4775.
3. Ashley Montagu,Touching: The Human
Significance of the Skin (New York:
Columbia University Press, 1971), 225.
massagetherapy.comfor you and your clients 109
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pathology perspectives
By Ruth Werner
Polycystic Ovarian Syndrome and

Metabolic Syndrome: A Hidden Link
Meet Ms. X1: she has a problem. She is 28
years old, secure in her career, and financially
stable. She and her partner agree that this
would be an ideal time to start a family, but
her body has other ideas: after two years of
trying, shes still not pregnant. Because of
a complex sequence of events, her ovaries
dont release mature ova for the possibility of
fertilization on any predictable schedule. In
addition, Ms. X struggles with being overweight,
constantly fights unwanted body and facial
hair, and even in her 20s is still battling acne.
These problems (overweight, hirsutism,

acne, ovarian cysts, and infertility)
indicate a condition called polycystic
ovarian syndrome (PCOS). In this
condition, folliclesthe site of egg
release on the ovariesdont develop
normally. The ovaries develop multiple
cysts where follicles are incomplete,
and the connective tissue scaffolding of
the organs becomes thick and enlarged.
Infertility is a frequent and frustrating
complication. But thats not all: PCOS
is linked to several other issues that may
put Ms. X at risk for type 2 diabetes,
atherosclerosis, heart attack, and stroke.
Ms. X, in her attempts to get pregnant,
may discover that she is dealing with
an unexpected but potentially serious
problem: metabolic syndrome.2
Metabolic syndrome is a reliable
predictor for risks relating to heart
disease (the number one killer of
women in the United States) and
type 2 diabetes, and the incidence of
metabolic syndrome among women
with PCOS is, according to at least
one study, about 11 times higher
than for the rest of the population.3
In this article we will examine
aspects of both PCOS and metabolic
syndrome, with special emphasis
on how hormonal imbalances tie
one to the other. This will allow
us to discuss health issues with
our women clients who live with
one or both of these conditions
with much more fully formed ideas
about how these challenges affect
function and predict possible risks.
110-131_MNB_JF_09.indd 111
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my
al
"
o,
whaT iS PCOS?
Here is an amazing thought: every baby

girl is born with ovaries that are already
equipped with a lifetime supply of cells
that will eventually mature into ova
when she reaches puberty. In addition
to being the site of egg maturation,
normal ovaries also produce several
hormones, including testosterone, and
a variety of subtypes of estrogen and
progesterone. These chemicals work
with pituitary secretions (especially
follicle-stimulating hormone and
luteinizing hormone) to establish
a menstrual cycle. If a woman has
PCOS, then her testosterone and
luteinizing hormone levels are high,
but follicle-stimulating hormone
levels are low. Consequently, ovulation
becomes irregular and infrequent,
and menstruation is disrupted.
While not all experts agree on
the diagnostic criteria for PCOS, a
recent consensus of opinion suggests
that at least two out of these three
features be present in the postadolescent female: oligo-ovulation
(ovulation is irregular and reduced);
hyperandrogenism (excessive levels
of free testosterone are found in
blood tests); and cysts form on the
ovaries.4 Other causative factors must
be ruled out for a credible diagnosis:
these include Cushing syndrome and
congenital adrenal hyperplasia, which
can affect testosterone secretion.
Signs and symptoms of PCOS are
directly linked to hormonal disruption.
Menstruation is irregular and infertility
is typical. Excessive testosterone leads
to two irritating symptoms: acne
and changes in hair growth patterns.
Male-pattern baldness (androgenetic
alopecia), along with excessive facial
or body hair (hirsutism) is a common
indicator of PCOS. (Interestingly, the
brothers of women with PCOS often
report premature balding: another
sign of testosterone predominance.)
whaT iS MeTaBOLiC
SyndrOMe?
Signs and
symptoms
of PCOS are
directly linked
to hormonal
disruption.
Further, changes in how hormones
manage blood sugar leads to a high
incidence of obesity among women
with PCOS, although this phenomenon
is more frequent in the United
States than in other countries.5
PCOS is treated mainly by
managing symptoms. Because it leads
to irregular periods, women who dont
wish to become pregnant are frequently
prescribed oral contraceptives to
smooth out hormone secretion. This
can be problematic, because oral
contraceptives can have an adverse
effect on other hormonal issues.6
Women who want to get pregnant
may be prescribed fertility drugs.
Medication to limit the growth of
body hair and interventions to control
acne may also be recommended. If a
woman with PCOS is overweight, she is
encouraged to fi nd strategies to control
this issue; for some, this is a particularly
difficult challenge. If no other options
are satisfactory, a woman with PCOS
may undergo surgical ovary drilling:
a laparascopic procedure that is thought
to destroy testosterone-producing
cells and thereby reduce symptoms.
Metabolic syndrome is a collection

of features that, when they occur
individually, are not cause for
excessive worry, but when they
occur in combinations with each
other, they statistically boost the
risk of developing some potentially
life-threatening conditions.
Several diagnostic criteria for
metabolic syndrome have been
developed, but a widely accepted
one proposes that metabolic
syndrome can be identified when at
least three of these five risk factors
are simultaneously present:
High fasting blood glucose (over 100
mg/dL after nine hours of fasting).
Abdominal obesity (a waist
measurement exceeding 35 for
women or 40 for men); this
is somewhat flexible to allow
for individual variations.
Elevated triglyceride levels
(over 150 mg/dL).
Low levels of high-density
lipoproteins (under 40 mg/dL for
men; under 50 mg/dL for women).
Hypertension (systolic over
130; diastolic over 85).7
Other possible features in metabolic
syndrome include a high risk of blood
clotting and high levels of C-reactive
protein (an indicator of inflammation).
When these factors appear in
combinations of three or more, they set
the stage for an extremely elevated risk
of type 2 diabetes, atherosclerosis, heart
attack, heart failure, aneurysm, and
stroke. Studies show that people with
metabolic syndrome have a twofold
risk of atherosclerotic cardiovascular
disease, and a fivefold risk of type
2 diabetes (which itself raises the
risk for cardiovascular disease).8
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Treatment for metabolic syndrome

is often divided into short-term and
long-term goals. Short-term goals
include lowering blood glucose and
correcting cholesterol levels with
medical intervention. Long-term goals
include increasing physical activity and
losing weight. Reducing body weight
by 57 percent (1014 pounds for a
200-pound person) significantly reduces
the risk of complications due to insulin
resistance. Exercise improves insulin
action and decreases blood glucose.
Limiting alcohol use and quitting
smoking are other important steps.
insulin are normal or above normal,

but targeted cells fail to receive it. The
precise causes of insulin resistance
are not fully understood. A genetic
component seems clear, but this
condition may also be promoted or
triggered by eating habits that tax
the pancreas and by lack of exercise,
which allows blood sugar to elevate.
If cells become resistant to
insulin, then three bad things
happen: insulin accumulates in the
bloodstream (hyperinsulinemia);
glucose accumulates in the bloodstream
(hyperglycemia) and cells have to
burn other fuel sources to make
Our role with a client caught in

this tangle is to be a source of
compassion and peace in a world
of frustration.
The Link Between PCOS and
Metabolic Syndrome
Curious readers will now be wondering

why these two conditions, which
dont seem obviously linked, appear
together so frequently. The connection
between these two problems is a
silent but potentially dangerous
risk factor: insulin resistance.9
Insulin, you will recall, is a
hormone produced by the pancreas that
transports blood glucose into hungry
cells: especially skeletal muscle and
fat cells. Insulin requires receptors
on target cells to allow it access; a
series of reactions inside the cell allow
glucose to be burned in a very clean
and efficient way that creates the
potential for energy. Insulin resistance
is identified when circulating levels of
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energya process that generates a

lot of metabolic wastes. In the long
run, this sequence is a setup for type
2 diabetes and cardiovascular disease
(i.e., metabolic syndrome). But for
many women, hyperinsulinemia
is also a setup for PCOS.
The relationships between
hyperinsulinemia and both
metabolic syndrome and PCOS
are complicated and often circular.
A very abbreviated explanation
includes the following factors:
Insulin resistance requires that
cells burn non-glucose sources of
fuel, namely proteins and fats; this
produces a variety of metabolic byproducts that are potentially toxic.
Because a person who is insulin

resistant must derive energy
from fats and proteins instead of
carbohydrates, the potential to
gain weight is much greater than
for the rest of the population.
Being overweight increases the
risk of losing insulin receptors and
promoting insulin resistance.
Elevated insulin acts on the
pituitary to increase the secretion
of luteinizing hormone.
Elevated insulin acts with luteinizing
hormone in the ovaries to promote
the production of various forms
of testosterone. This suppresses
the maturation of follicles and
interferes with ovulation.
Elevated insulin also acts on the liver
to reduce testosterone-neutralizing
enzymes, allowing free testosterone
to influence cell functions.
Excessive testosterone makes sebaceous
glands more active, leading to acne.
Excessive testosterone promotes
secondary male sexual characteristics,
especially the loss of head hair
(alopecia) and the growth of facial
and body hair (hirsutism).
Having a large omentum (apple
shape) may promote excessive
testosterone production through
insulin resistance and its effects
on the ovaries; having excessive
testosterone may in turn promote
having a large omentum.10
Elevated insulin acts on the liver
to promote the production of
triglycerides: these are a form of
cholesterol carriers associated with
an increased risk of atherosclerosis.
The good news in all this tangle
is that insulin resistance and its
consequences are treatable. Muscular
activity increases insulin sensitivity and
burns blood sugar. Weight reduction
can reverse several processes seen
with insulin resistance,11 as well as
reducing blood pressureanother
factor in metabolic syndrome. And a
variety of drugs can increase both the
number of insulin receptors and their
11/14/08 1:10:24 PM
efficiency; these are often prescribed

to help control type 2 diabetes. In fact,
this strategy has been shown to be
so effective that women with PCOS
who want to become pregnant may
be counseled to treat their condition
with diabetes drugs: an indirect route
to improved ovarian function.
Where Does Massage Fit?
Any therapist who works with females

in their childbearing years may have
clients who are living with PCOS
and/or metabolic syndrome. And
while it is probably false to claim
that massage will fix this problem,
we can, with sensitivity and good
information, at least try to contribute
to an environment that has the best
possible outcomes for our clients.
If we have a client who has PCOS,
it is important to bear in mind that
her ovaries may be enlarged and in a
location that is vulnerable to bruising
or crushing. A healthy, non-pregnant
womans ovaries are typically located
down low in the pelvis (more or less
behind where the pubic hair begins to
grow). This keeps them out of reach of
most types of deep abdominal work.
But a woman with PCOS may have
ovaries that are located higher and
more lateral than we anticipate. If this
condition is identified, these clients
need to receive bodywork that does
not risk impinging or bruising these
delicate structures. In other words, deep
abdominal work must be conducted
extremely conservatively. Some experts
suggest addressing abdominal issues
indirectly through reflexive techniques,
and/or approaching abdominal work
for women clients with PCOS by
improving the quality of the muscles
and fascia of the abdominal wall,
working obliquely rather than deeply.
The appropriateness of massage
in the context of metabolic syndrome
depends entirely on the health and
resilience of the client. If this person
successfully controls his or her
condition through diet and exercise
adjustments, massage is probably

safe and appropriate. If this person
has developed any of the serious
complications associated with these
conditions, judgments must be made to
accommodate possible weaknesses of
the circulatory and urinary systems.
Perhaps the most dependable role
for a massage therapist or bodywork
practitioner with a client caught in the
PCOS/metabolic syndrome tangle is
to be a source of compassion and peace
in a world of frustration, conflicting
and contradictory information, and
unanswered questions. We can,
through the creation of a welcomed
relaxation response, promote and
support the self-care that must be
at the center of any choices our
clients make on their own behalf.
What Happened to Ms. X?
Ms. X. went on birth control pills to

try to regulate her cycle; this was a
mixed success. Then, on her doctors
advice, she stopped taking them and
began treatment with fertility drugs, to
no avail. Her next strategy was to lose
weight (she lost 50 pounds through diet
and exercise) along with using insulin
uptake drugs. She found that this
regimen did not regulate her cycle, so
she also started acupuncture treatments.
With this strategy she had more
success: her first child was conceived
very shortly thereafter, and her second
was born just last summer.
Authors note: many thanks to all the women
who contributed to the profile of Ms. X.
Ruth Werner is a writer and educator who

teaches several courses at the Myotherapy
College of Utah and is approved by the
NCTMB as a provider of continuing education.
She wrote A Massage Therapists Guide to
Pathology (Lippincott Williams & Wilkins,
2009), now in its fourth edition, which is used
in massage schools worldwide. Werner is
available at www.ruthwerner.com or
wernerworkshops@ruthwerner.com.
Notes
1. Ms. X. is a fictional character: an amalgam

of several generous women who allowed
themselves to be interviewed for this article.
2. D. Douglas, Primary Amenorrhea and PCOS
Tied to Metabolic Syndrome, Archives of
Pediatric & Adolescent Medicine 162 (2008):
5215. Available at www.medscape.com/
viewarticle/577389 (accessed December 2008).
3. R. Azziz, How Prevalent is Metabolic Syndrome in
Women with Polycystic Ovary Syndrome? Nature
Clinical Practice Endocrinology & Metabolism
2, no. 3 (2006). Available at www.medscape.com/
4. Ibid.
5. Z. Hopkinson, Polycystic Ovarian Syndrome: The
Metabolic Syndrome Comes to Gynaecology,
1998. Available at www.bmj.com/cgi/content/
full/317/7154/329 and www.medscape.com/
6. P. Kovacs, Metabolic Syndrome and PCOS. Ask
the Experts About Gynecology and Reproductive
Endocrinology, Medscape Ob/Gyn & Womens
Health 8, no. 2 (2003). Available at www.medscape.
com/viewarticle/456221 (accessed December 2008).
7. Metabolic SyndromeStatistics, 2006 American
Heart Association, Inc. www.americanheart.org/
downloadable/heart/1136819875357META06.
pdf (accessed December 2008).
8. R. Werner, A Massage Therapists Guide
to Pathology, 4th edition, (Baltimore:
Lippincott Williams & Wilkins, 2009).
9. T. Cascella, Visceral Fat is Associated with
Cardiovascular Risk and Polycystic Ovary
Syndrome, Human Reproduction 23, no. 1
(2008): 153159. Available at www.medscape.com/
10. J. Brunzell, Dyslipidemia of Central Obesity and
Insulin Resistance, American Diabetes Association
(1999). Available at http://journal.diabetes.org/
diabetescare/FullText/Supplements/DiabetesCare/
Supplement399/C10.htm (accessed December 2008).
11. Obesity and Polycystic Ovary Syndrome,
Clinical Endocrinology 65, no. 2 (2006),
137145. Available at www.medscape.com/
110-131_MNB_JF_09.indd 115
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heart of bodywork
By Nina McIntosh
Let the client take the lead in talking

and respond as little as you can.
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How Much is Too Much?

Because we want to create a relaxing
atmosphere for clients, Ive often cautioned
against talking too much while working. But
how much is too much? Two recent letters
from readers challenge the idea of needing
total quiet and offer examples of times when
being more verbal can be helpful.
Although I agree with you in general

about not conversing with clients while
we work, my current work setting has,
more or less, made chatting a necessity. I
work with a chiropractor who is warm,
friendly, and very informal with his
patients (whom he often refers to me).
He has known many of these people for a
very long time, and during his treatments
he talks with these patients as you or I
might talk with a coworkersharing
stories, information, or opinions about
family, vacations, politics, etc.
When I began working in his office,
I tried to maintain a firmer professional
and personal boundary, keeping my
conversation with clients focused strictly
on the work. This confused and baffled
many of them, as they were accustomed
to a more chatty level of interaction, and
some of them misinterpreted my behavior as
emotional distance, personal coldness, or a
rejection of their desire to get to know me.
In the end, I have chosen to adapt my
style so that it more closely matches the
doctors. I still maintain a professional
demeanor, honor patient confidentiality,
and uphold ethics and standards of practice.
At the same time, I have come to realize
that every clinic or group practice has
its own distinct dynamic, and there are
myriad ways to express professionalism
and maintain good boundaries.
Carl K., Boise, Idaho
Dear Carl,
Thank you for your thoughtful
comments. This is a great example
of adjusting your style for the sake of
your clients comfort. The key here
is that you havent lost sight of your
professional role and your focus on
clients well-being. Youre choosing
to chat in order to gain clients trust,
not because of your own social needs.
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heart of body work
Although it sounds as though youve

worked out an appropriate and useful
way to engage your clients, there are
still some things to watch out for. For
instance, you say the chiropractor has
known many of these people for a very
long time. In that time, hes probably
learned what topics work and dont work
with particular clients. Unless we know
a client, its best to stay away from hot
button or controversial issues such as
politics or religion. Even if your views
seem to be the same as the clients,
some topics just arent relaxing. If the
No matter what the

situation, let the client
take the lead.
client brings up a controversial subject
and your views are in fact different, its
best to keep them to yourself, keeping
in mind that the client isnt paying you
for your opinions on public matters.
Nor is it appropriateat any
timeto share your personal problems
with clients or anything more than
light-hearted comments or complaints
about your family life. Saying that
your husband (or wife) snores also isnt
the same as burdening a client with
details of your latest marital spat.
No matter what the situation,
let the client take the lead in talking
and respond as little as you can
(without being rude). Some clients
may appreciate a little small talk and
others may be yearning for quiet.
The lesson your letter teaches
us is to be flexible about rules and
bend them when they interfere
with our clients sense of security.
Dont forget your professional role.
Even though we may act friendly
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Questions about professional boundaries and ethics? Contact

Nina McIntosh at 877-327-0600 or visit www.educatedheart.com.
with clients, its not like hanging

out with friendsas you remind us.
Our professional responsibilities
should still be uppermost.
I know youve said, Dont ask questions
or talk in such a way that clients have to
think to respond to you. I think thats
appropriate if a client is there to receive
a relaxation massage. However, for those
massage therapists who provide clinical
or medical massage (neuromuscular
massage, muscle therapy, or deeptissue work), it is imperative that they
communicate often with the client
regarding trigger-point locations, pain
levels, sensations, and tissue responses.
As part of my treatments, I ask clients
to rate their pain, describe it, and provide
immediate feedback as I am working in
their problem areas. I tell them, Although
I can feel the shape and consistency of
your muscles, I cannot feel what you feel
inside. I suggest, On a scale of 1 to 10,
with 10 being excruciating pain, what
number am I on when I press here?
Im not trying to interfere with their
relaxation, but in order to address the
tissues without causing damage (or making
the muscle tighten or guard), I need them
to share that information with me.
Bob L., Austin, Texas
Dear Bob,
Thank you for your comments. I agree
that techniques with specific pain relief
in mind require more communication
with some clients than with others.
Even with a massage that has pure
relaxation as the goal, we may want to
check in occasionally with clients.
One issue that I need to clarify is
what thinking meanswhen we say
that a client shouldnt have to think to
respond to our questions. The concepts
of right brain and left brain are useful
here. The left brain is the side that deals
with the logical, analytical, and rational
aspects of our lives; the right brain is
more intuitive, creative, and subjective.
Left brain is what we want less

of when clients are on the tablewe
dont want them planning what to
have for dinner or worrying about
how to solve their work problems.
That will not help them be in a
relaxed state. And even for the more
technical kinds of work, we want the

client relaxed, open, and receptive.
During a session, we dont want to
engage clients left brain, for instance,
to make them focus on a complicated
explanation of how the body works or
to answer a detailed question. Harmless
as it seems, asking, How many times
have you hurt this foot? requires a
client to go too much into his thinking
and analyzing left brain, as he tries to
remember and count all the times the
foot had been hurt. However, clients
can easily answer questions about
how they feel or describe a pain level
without revving up the left brain.
One way to help clients stay calm
and peaceful is to be conscious of
how you use your voice. Rather than
talking in your everyday speaking
voice while youre working, use a
lighter tone and softer volume than
you would in normal conversation.
Also keep instructions simple. For
example, some people have trouble
distinguishing between right and
left, and even people who dont, when
they are deeply relaxed, may have to

think to remember which is which.
It can be helpful just to tap lightly on
the appropriate side and say, Would
you turn over on this side, please?
Ive collected a variety of feedback
from other bodyworkers on useful
ways to get information about how
the client is doing. Some find the 1 to
10 pain scale effective, others think
that even that much calculating can be
confusing. They prefer making sure
that the client knows to tell them to
ease up with painful touch. Still others
say they mostly gauge a clients pain
by noticing physical cues from the
clienttensing up, frowning, and so
forth. And some suggest varying what
you say in accordance with how much
body awareness a client has, checking
in more with those who arent as
tuned into their physical sensations.
No matter how and what we decide
to communicate with our clientsand
ask that they communicate with us
the bottom line is always client comfort
and satisfaction. Keeping professional
boundaries in mind, whatever the
form of communication with clients
whether a little bit of contact-making
chatting or inquiries into physical
responseour goal is always to attend
to their health and well-being.
Authors note: special thanks to my online
forum for their contributions.
Nina McIntosh combines more than 20

years of experience as a bodyworker with her
previous years as a psychiatric social worker.
She is the author of The Educated Heart:
Professional Boundaries for Massage
Therapists, Bodyworkers, and Movement
Teachers (Lippincott Williams & Wilkins,
2005). To learn more about professional
boundaries and ethics, visit www.
educatedheart.com.
To learn more about illustrator Mari
Gayatri Stein, visit www.gypsydogpress.com.
110-131_MNB_JF_09.indd 119
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myofascial techniques
by Til Luchau
The superficial fascia of the neck, in green,

surrounds the deeper structures like a sleeve or cowl.
Illustration courtesy and copyright of Primal Pictures Ltd.
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Preparing the Neck and

Shoulders for Deep Work
Welcome to Massage &
Bodyworks new Myofascial
Techniques column. In the
coming issues, Ill describe
techniques that work with some
of the most common client
issues. Ill draw on the work
taught in Advanced-Trainings.
coms Advanced Myofascial
Techniques workshop series.
Although the faculty are
Certified Advanced Rolfers
and many teach at the Rolf
Institute, my emphasis in these
articles will be on specific,
practical techniques useful
to any hands-on practitioner.
Well start by looking at the
superficial layers of the neck.
(For video examples of techniques and

tests mentioned here, visit Massage
& Bodyworks digital edition, which
features a video clip from the 2009 DVD
Advanced Myofascial Techniques for
the Neck, Jaw, and Head from AdvancedTrainings.com. A link is available on
ABMP.com and Massageandbodywork.com)
What are the most common complaints
you see in your practice? Chances are
neck pain and discomfort are high on
the list. Although cervical issues can
have many causes, youll often see
better results if you begin by addressing
restrictions in the superficial layers
of the neck and shoulders. Whether
caused by deep articular fixations, poor
posture and misalignment, habits,
stress, injury, or other reasons, neck
issues respond quicker and stay away
longer when the outer wrappings
are released first. As with other
parts of the body, many seemingly
deeper neck issues resolve when the
external layers have been freed. In
this article, Ill describe how to work
with these superficial but important
layers in order to prepare the neck for
working with its deeper structures.
sternocleidomastoid (Image 2), and

the platysma. Together, these cowllike outer layers extend from their
upper attachments on the occipital
ridge and lower face, to their lower
connections with the outer layers
of the shoulders, chest, and upper
back. Like a sleeve, they encircle the
deeper musculoskeletal and visceral
structures of the necks core.
The superficial layers of the
neck have a surprising thickness
and resilience. When they have lost
pliability or are adhered to other layers
and structuresbecause of injury,
postural strain, or other reasonsthe
outside layers have the ability to restrict
The Importance of the

Superficial Layers
The necks superficial tissue layers

have a great deal of influence on its
alignment, mobility, and health. These
outer wrappings encircle the neck and
shoulders like an overlarge turtleneck
sweater, or a surgical collar (Image 1).
Anatomically, these layers include
the superficial and deep cervical fasciae,
as well as the muscles within those
fascial layers, such as the trapezius,
The superficial layers of the neck, in cross

section. Illustration courtesy estate of John Lodge.
110-131_MNB_JF_09.indd 121
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myofascial techNiQUes
Tips for Effective Work

Keep everyone comfortable. You and
your client should both be comfortable
and able to relax. The pressure, position,
or movements you use should never be
uncomfortable for either of you.
Stay supercial. Even though the tools
shown hereforearm, soft st, palm,
ngertipscan be used for deep work,
stay in the outer layers of the body at rst.
Youll be surprised at how much easier the
deeper work will go, and how much longer
its effects will last.
Make anatomy a breeze with
Primal 3D anatomy software.
Use your clients movement. Instead of

pushing tissue around, use your clients
slow, conscious movement to release and
reeducate habitual movement patterns.
Primal 3D anatomy software can help you learn, revise

and remember anatomy more effectively using clear
and accurate 3D images in an easy to use digital format.
Ideal for massage therapists, Interactive Functional
Anatomy 2nd Edition DVD-ROM includes a choice of
3D models of human anatomy that include bones,
attachments, insertions and muscles plus an overview
of the neurovascular system. Choose a view, rotate,
add/remove anatomy layers and identify any muscle.
Select a muscle for related text and links to muscle
function animations.
The software has enhanced my skills as a manual therapist because I am

able to identify muscles precisely and understand their functional synergy
with adjacent muscles. M.Rizk, CPT, IFS, NMT
Interactive Functional Anatomy 2nd Edition DVD-ROM RRP $275

Readers of Massage & Bodywork can save Order online at:
20% simply quote MB109 when ordering. www.primalpictures.com
(use offer code MB109 at the checkout).
Call TOLL FREE 800 716 2475
Take a preview online at www.anatomy.tv use login: MB109 and password:
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Primal Pictures Ltd, 4th Floor, Tennyson House, Great Portland Street,
London W1W 5PA UK Tel. +44 20 7637 1010
Fax: 1-415 366 1679 (secure e-fax number that comes to a PC in London)
www.primalpictures.com www.anatomy.tv
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110-131_MNB_JF_09.indd 122
Touch the person, not just the tissue.

Remember that you are asking for change
from a living, breathing being; not from
inanimate compounds like tissue or
myofascia.
Balance and integrate. Most clients will
feel more balanced if you end with work
in the front to counterbalance the back
length of the rst technique. Be sure to
incorporate your local work into an entirebody perspective, rather than just focusing
on parts.
30/10/08 08:17:41
11/14/08 1:10:40 PM
movement range, disrupt alignment,

and bind the structures they surround.
Imagine trying to move in a wet suit
that is a size too smallthe outer
layers of the neck can bind, distort, and
constrain movement in the same way.
Seeing Superficial
Restrictions
Try this: watch a friend turn his or her

head from side to side. Watch what
happens with the superficial layers of
the neck, shoulders, chest, and back.
Are there areas of the torsos fascia
that move along with the head and
neck? Or, do you see lines of tension
and pull appearing in the skin and
outer layers? Often, these signs of
fascial restriction will be most visible
at the extremes or end-range of the
movement. Look from both the front
and the back. Compare left and right
sides for any differences. Then, look
again as he or she gently looks up and
down (being careful, of course, to avoid
any posterior cervical compression
when looking up). Your friend might
feel different kinds of restrictions when
moving, including pulls in the deeper
musculature, or catches involving neck
articulations or the upper ribs. For
now, were going to leave these aside
and focus on the outer layers first.
Sometimes superficial fascial
tension will be visible as linear
patterns tug in the skin (Image 3).
In other cases, a whole sheet of fascia
will move or creep along with the
rotating or nodding head. Linear tug
patterns are more commonly seen
in the thinner layers of the anterior
neck and chest, while the creep of
whole fascial sheets is seen more often
when looking at the thicker posterior
layers of the back. If it is difficult
to see restrictions in the superficial
layers, you can use your hands to feel
for tugs and pulls in the outer layers
while your client rotates his or her
head. Whether watching or feeling,
note any areas that dont have smooth,
An example of fascial strain visible as

tugging of the outer layers when moving.
even lengthening of the dermis and

superficial fasciae when the head moves.
We are constructed like onions:
layered, from superficial to deep.
When testing for fascial tension with
movement, dont confuse movements of
deeper structures for movement in the
superficial fascia. For example, youll
sometimes see the rib cage turning
along with the head, or a shoulder roll
forward, etc. Some of this movement
is normal; if you see exaggerated or
asymmetrical movement of the rib cage
or shoulder, this might be because of
deeper restrictions. Make a note to
check for and address these patterns
later, but remember that since these
deeper movements might be caused
by restrictions in the outer layers,
releasing the superficial layers is the
logical first step. Unless youre working
with a scalpel and are cutting right
through, you need to gently peel away
the outer layers to get to the core.
The Over-the-Edge technique releases

the superficial layers of the upper back and
shoulders. Although relatively safe, head-down
positions are usually contraindicated for clients
with uncontrolled high blood pressure, a history
or risk of stokes, or vertigo, or acute sinus issues.
Releasing Superficial
Restrictions
Once youve seen or felt where your

client/friends outer layers are tugging
or creeping along with head and neck
movement, you can go to work. A
word about sequencing your superficial
work on the upper torso: in most
cases, youll begin by releasing the
posterior restrictions of the upper
back, and end by working the anterior
restrictions. This is the order were
using in this article. Why this backto-front progression? Since most of
us tend to have our heads forward of
the coronal midline and be narrower
across the front of our chest than across
our upper back, the anterior fascial
layers of the chest and shoulders tend
to be shorter than the posterior layers
of the shoulders and back. Ending
by lengthening the shorter anterior
restrictions balances the earlier work on
the posterior side and leaves the client
with a greater sense of anterior width,
length, and freedom, and therefore
helps with overall alignment. A possible
exception to this ordering: if your
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myofascial techNiQUes
client has a very flat upper thoracic

curve, you may want to reverse the
sequence and end with work on the
back to encourage more spinal flexion.
over-the-edGe teChNiQue
Ask your client to lie face down on
your table, arms at the sides, with his
or her head and neck just over the top
edge of the table. The edge of the table
should fall an inch or two below the
top of the sternum. Your client may
need to adjust upward or downward
a bit so that the edge is comfortable.
Dont leave your client like this too
long, but youll usually have at least
two or three minutes to work before
his or her head starts to feel too full.
Once your client is comfortable,
ask him or her to turn the head from
side to side as you again watch or feel
the outer tissue layers in order to

recheck your fi ndings. Look again at
the up and down movements too, using
care to avoid any neck compression
with extension. Often, this prone
position will make the superficial
restrictions even more obvious.
The tool well use to release
these restrictions is the flat of our
forearm; specifically, the fi rst few
inches of the ulna just distal to the
elbow (Image 4). Use this tool to
gently anchor the inferior margins of
the places you saw or felt superficial
restrictions. We dont use oil or cream,
as well be using friction more than
pressure to contact the layer we want
to release. Also, we wont be sliding
muchour client will provide the
movement needed for release.
Once you have the outer layers

gently anchored with your forearm,
ask your client to slowly turn his or
her head away from the side youre
working. Feel for a direction of your
pressure that gently lengthens the
superficial layers being pulled by the
head movement. Imagine that youre
helping your client lengthen and
free herself inside the wet suit-like
outer layers of superficial fascia.
Alternatively, you can ask your
client to lift and lower the head
(extend and flex the spine) as you
lengthen the layers of the back
inferiorly. Youll fi nd that most release
will happen on the eccentric phase
of the motion, that is, while your
client is lowering his or her head.
Remember, your client will get
uncomfortable if you leave them in this
position for more than a few minutes.
Although relatively safe, head-down
positions are usually contraindicated
for clients with uncontrolled high blood
pressure, a history or risk of stokes,
or vertigo, or acute sinus issues.
aNterior NeCK/shoulder
differeNtiatioN teChNiQue
After releasing the posterior restrictions
of the back and shoulders superficial
layers, youll want to broaden and
continue this release by addressing
any surface restrictions in the upper
chest and anterior shoulders.
To release these anterior
restrictions, well use either our palms
or fi ngertips to anchor the superficial
fascia of the shoulders, chest, and
anterior neck (Image 5). Then well
use our clients movement to release
the restrictions we saw or felt earlier.
The palm is especially useful where
you saw fascial layer creep with head
movement. When using your palm,
dont be tempted yet to rub, slide, or
massage the deeper layers of pectoralis,
etc. Instead, use the broad surface of
the palm to catch and gently anchor
the outer layers of the chest while
your client moves his or her head.
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11/14/08 1:10:56 PM
In contrast to the broad tool of

the palm, your fingertips will allow
you to work specific areas, and are
useful for the local tugs in the outer
layers visible when your client was
moving. The fingers are slightly
curved rather than straight, and are
sensitively hooking in to the outer
layer you saw or felt moving with the
head. Push with your fingertips, as if
straightening out your curled fingers,
to encourage superficial release away
from the direction of movement.
Whether youre using palm
or fingertips, dont slide along the
surface and dont dig down to the
ribs or intercostals. Feel a tug in the
outer layersthe layers of dermis and
superficial fasciae that lie between
the surface of the skin and muscles or
bones beneath. As in the over-the-edge
technique, ask your client to slowly
turn his or her head away from the side
youre anchoring. Find a direction for
your pressure that gently releases the
superficial layers being pulled by the
head movement. Imagine that youre
helping your client lengthen and free
him or herself inside the wet suit-like
outer layers of superficial fascia.An
option is to have your client tighten his
platysma muscle, which lies within the
superficial fasciae that youre working.
Try it yourself: turn your head, then
grimace or snarl until you feel a tug
from your lower lip into the pectoral
fascia of your chest. By anchoring
the lower end of this tug in the chest,
you can snarl and relax repeatedly to
release constriction in the anterior
fascia. Having your client tighten and
relax the platysma in this way while
you anchor its inferior attachments
can help your client focus the release
into the tightest areas (Image 6).
Finishing
Once youve released the outer layers

of the neck and torso from the back,
and front, look again as your friend
turns his or her head from side to
side. If youve been both patient and
thorough, youll see fewer pulls and
Active contraction of the platysma, as in grimacing, can aid in releasing the superficial fascia
of the anterior thorax.
An open palm or the tips of curled fingers may be used for the Anterior Neck/Shoulder
Differentiation technique.
tugs in the outer layers, and more than

likely, smoother and greater range
of motion. Clients report that their
movement feels easier, freer, or that
their head is lighter and more upright.
The next step could be deeper work
with the neck, rib cage, or spine, either
in the same session as these techniques,
or the next one. The deeper work will
now be easier, more effective, and
longer lasting. Or, instead of working
deeper right away, you might want to
continue the theme of superficial release
by adapting the techniques weve done
here to other complementary regions
of the body, such as the lumbars, limbs,
or hips. Ill write more about these
possibilities in other articles. In the
meantime, keep investigating what
happens when you take time to release

the outer layers of the body.
Til Luchau is the director and a lead
instructor at Advanced-Trainings.com Inc.,
which offers continuing education seminars
and support services for practitioners and
schools throughout the United States and
abroad. The originator of Skillful Touch
Bodywork (the Rolf Institutes own training and
practice modality), he is a Certified Advanced
Rolfer and a Rolf Institute faculty member. He
welcomes your comments or questions at
info@advanced-trainings.com.
110-131_MNB_JF_09.indd 125
11/14/08 1:11:11 PM
somatic research
By Ravensara S. Travillian
126
massage & bodywork
110-131_MNB_JF_09.indd 126
11/14/08 1:11:14 PM
reading charts and Graphs

There is a
section of
many research
articles where
a real effort
is made
to present
information in
a concise way
that makes
it easy to
visualize.
Research articles, by nature

of their traditional format,
are not particularly friendly
to visual learners. However,
charts, graphs, tables, and
other non-expository methods
of presenting information are a
compact way of communicating
a great deal of information.
They provide a high-level
overview and show trends
or patterns, usually among a
group of participants, rather
than focusing on results for
any particular individual.
In this column, well
examine some representative
examples in detail.
The results in this article are from

a hypothetical study on massage for
back pain in manual laborers, which
well refer to as Huffman 2007. In this
fictional study, the research team makes
use of several charts to indicate the
results, or outcomes of their study, in
addition to the narrative description in
the text. In general, good charts should
be straightforward, andeven without
a great deal of statistical background
on the part of the readereasy to
understand at a very general level.
You should be able to see whether
a trend is increasing, decreasing, or
staying the same, and if some values
are very different from other values.
Representing Text
In this first example, notice how the

researchers tie their text description to
the information shown in their charts.
Image 1 represents the mean (average)
number of backaches experienced over
the period before and during the study.
Analysis of the data indicated a reliable
change over time for number of backaches
per week and confirmed that the frequency
of backaches experienced was significantly
lower during the four months of the
treatment period than it was during the
four months of the pretreatment period
(p < 0.001). All of the study participants
reported a reduction in the number of
backaches per month in the first month
of the massage treatment period. As well,
the mean number of backaches per month
decreased from 6.5 before treatment to
1.56 during the treatment period.
110-131_MNB_JF_09.indd 127
11/14/08 1:11:14 PM
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110-131_MNB_JF_09.indd 128
11/14/08 1:11:16 PM
SOMATIC RESEARCH
min
n:
in
at
s
om
dy
mens
m
!
BEGINNING OF TREATMENT
10
9
8
7
6
5
4
3
2
1
0
1
Image 1. Average number of backaches per month for each study participant before the massage
treatment period (1-4) and during the massage treatment period (5-8).
The results reported by Huffmans

team in this hypothetical study are
shown in Image 1, where the height
of the bar increases with the number
of backaches. The fi rst four months
of the study were the baseline period,
during which measurements were made
to establish the background against
which the team hoped to see a change
as a result of the massage. The last
four months of the study were the
treatment periodand, as the bars
show, all of the numbers in months
five through eight are lower than their
corresponding number in the fi rst
baseline months of the study. Image
1, therefore, is a visual presentation of
how all of the participants in the study
experienced fewer backaches in the
treatment months of the study than
they did in the baseline months before
the treatment began. This reinforces
and visually presents the information
from the previous text paragraph.
ne
STANDARD ERROR OF MEASURE
The little lines in the shape of a T

on top of the bars in Image 1 are called
error bars and represent standard error
of measure (SEM), a very useful and
widely-used statistic. You can think
of it as visually indicating an estimate
of how much measurement error may
be influencing the data, which in
turn tells you how much confidence
the researcher has in the data.
For example, the SEM bar on top
of the fi rst column has a height of
approximately 1; the column represents
a mean of just less than 5 backaches a
month, as the vertical scale indicates,
and the top of the error bar is at 6. So
the researcher understands the mean
for column 1 as 5, but it may be as much
as 6, due to measurement errora
difference of one backache per month
on average. By contrast, the error bar
for column 3 is taller: column 3 is about
7.5, while the top of the error bar is
almost 9, or an estimate that the mean
for column 3 could possibly be off by
1.5 backaches per month as a result

of measurement error. That is a lot
more potential error than for column
1, and so the researchers have a lot
more confidence in the measurement
in 1 than they do for the larger error
in column 3. The error bar for column
7 is very short; column 7 indicates a
mean of about 1 backache per month,
and the error bar indicates that the
estimated error may be as much as
around 0.25, showing more confidence
in this measure than in either of
the others previously mentioned.
INDIVIDUAL AND
GROUP RESULTS
While Image 1 describes the results of

frequency of backaches (how often they
occurred over the course of a month),
the team also looked at the duration of
the backacheshow long they lasted
over the period of the study. Image 1
illustrates the results for individual
participants and the group mean. Image
2 shows those results, which Huffmans
team also reported in narrative form.
110-131_MNB_JF_09.indd 129
11/14/08 1:52:50 PM
somatic research
The mean duration of backaches was

compared between the pretreatment period
and the treatment period, as shown in
Image 2. The group showed a decrease
in mean backache duration from 5.88
days to 2.88 days during the treatment
period; each study participant also
experienced a decrease in mean backache
duration. However, the p-value of this
measurement did not achieve statistical
significance (p = 0.089), due to the small
number of participants in the study.
In this hypothetical study, all of the
participants individually experienced
shorter backaches during the treatment
period. In addition, the group average
length of backache duration decreased
as well. However, the study had a small
sample size, and therefore insufficient
power to reliably detect a treatment
effect. So, even though the researchers
observed a trend, with a p-value of
.089 or 8.9% chance of this being a
false positive resultgreater than
the 5%, in other wordsthat trend
was not statistically significant.
For each participant in the study,
and for the group mean, there are
two geometrical shapes connected by
a line. The first shape indicates the
average baseline value of backache
duration before the treatment phase
of the study began. The second shape
indicates the average duration of
backaches during the treatment phase
of the study for that participant.
All of the lines move downward
as we read the graph from left to
right, indicating thateven though
it turned out not to be statistically
significantthere was a definite trend
for all individuals, and for the group
as a whole, to experience shorter
backaches in the treatment phase.
Sometimes, such trends in the data,
even if not statistically significant
in themselves, can serve as the basis
for deciding whether it makes sense
to study the question again with a
larger sample size, to see whether
it is a real effect on outcomes.
130
massage & bodywork
110-131_MNB_JF_09.indd 130
Participant 1
Participant 2
Participant 3
Participant 4
Group mean
3
2
1
0
Pre-treatment period
treatment period
Image 2. Duration of backaches, in days.
Finally, the team examined the

effects of their massage protocol
(procedure) on the intensity of
backaches (how much pain) the
study participants experienced.
Study participants were asked to fill out
questionnaires about the pain they
experienced, including a visual analog
scale ranging from 0 to 10, where 10
indicated the most severe pain. Image 3
presents the results of those questionnaires
on reported pain intensity. A wide range of
variation in treatment effect was reported
by participants, with two participants
reporting major reduction in pain, one
participant reporting some reduction in
pain, and one participant indicating that
pain had actually increased during the
treatment period. The group average
intensity declined, but not significantly
(p = 0.23 [23%, or slightly more than
1 time out of 5 that you would see this
result by chance as a false positive]).
Participants 1 and 2 showed a
steep drop in the line as you read
the graph from left to rightthose
are the two who showed the major
reduction in pain described in the
preceding paragraph. Participant 3
also showed an improvementthe line
dropped, but not as much as the other

twoand shows the participant who
showed some reduction in pain.
Interestingly, Image 3 shows that
Participant 4 had backaches that got
more intense over the course of the
study. The Results section is not where
you expect the researcher to address
what something like this means, only
that it happened. If interpretation of
why this person experienced more
intense backaches is addressed, it would
fall under the Discussion section.
As you would expect for a group
average, the results lie somewhere in
the middleas a group, the backache
intensity decreased, but the mild
improvement and the increase averaged
out with the two marked improvements
to make a group average between
marked and mild. The effect of
small sample size is also demonstrated
dramatically herewhen 1 participant
out of 4 has an increase in backache
intensity, that represents 25% of this
study population. One participant out
of 100 in a different study, however,
would only represent 1%, and the
implications of those percentages for
the larger population of massage clients
11/14/08 1:11:18 PM
Look for trends

or patterns in
the data that the
charts reveal,
and see if you
can connect
the visuals in
the graph to
explanations in
the text.
in general would be very different

for the interpretation of each study.
Useful Tools for

Massage and More
Try applying this technique to

understand graphs you come across
every daynot only in research
articles, but in discussions of the
economy, environment and climate,
and other important topics. Look for
trends or patterns in the data that
the charts reveal, and see if you can
connect the visuals in the graph to
explanations in the text. See if you can
tie those visual indicators to results
described by the researchers. When
we meet again next time, we will take
the specific things we did here and
discuss how to turn them into general
techniques for approaching visuals,
such as charts and graphs, in research
articles. Well review topics including:
What different types of charts
are commonly used and why.
What information is often
represented on charts.
10
Why different types of charts would

be selected by researchers to present
information about their studies.
Common errors in interpreting
graphs and how to avoid them.
Other information that will
assist you in developing a clear
understanding of charts, graphs, and
other illustrative materials.
Ravensara S. Travillian is a massage

practitioner and biomedical informatician in
Seattle, Washington. She has practiced
massage at the former Refugee Clinic at
Harborview Medical Center and in private
practice. In addition to teaching research
methods in massage since 1996, she is the
author of an upcoming book on research
literacy in massage. Contact her at
researching.massage@gmail.com with
questions and comments.
Participant 1
Participant 2
8
7
Participant 3
Participant 4
Group mean
4
3
2
1
0
Pretreatment period
treatment period
Image 3. Intensity of backaches, on a scale from 1 to 10.
110-131_MNB_JF_09.indd 131
11/20/08 8:52:34 AM
spotlight on educationloretta young

By Karrie Osborn
From the Heart to the Core

Classrooms come in all shapes and
sizes. Loretta Young found the most
transformative educational experience
of her career at the foot of her
teacher in the Belizean rainforest.
After five years of working as a
licensed massage therapist in New
York, Young became a certified pre/
perinatal massage therapist under
Carole Osborne, and an infant
massage instructor with Diana Moore,
in 2002. But when a client asked if
there was any type of bodywork she
could do to help with fertility, Young
decided to add a few more skills to her
repertoire. She remembered a note
shed seen about Maya abdominal
massagea core technique used
to support womens healthand
decided to pursue it further.
After inquiring about the work,
Young realized that first she would
have to enroll in a Maya abdominal
massage self-care course being
offered by the Arvigo Institute.
I was intrigued that regardless
of being a licensed practitioner, a
prerequisite self-care class needed
to be completed prior to studying
on a professional level, she says.
In trying the technique on her own
body, Young quickly realized its value.
I had always had a lower-back pain
with my menstrual cycle and I learned
that even a slightly retro-tilted uterus
can have that effect from the extra
ounces of pressure against the nerves in
that region causing discomfort. And I
learned that the falls I had taken on the
sacrum during years in gymnastics, as
well as running on hard surfaces, had
an impact on my internal dynamics,
132
massage & bodywork
132-144_M&B_JF09.indd 132
restricting blood and lymph flow

in the pelvis. I walked away feeling
empowered by a deeper relationship
and understanding of my own body.
This inspired a new focus
with massage therapy and a goal
to share this information with as
many people as possible. I decided
if this self-care class and technique
can make a difference with my
own body, then I would absolutely
want to share this with others.
Transforming the Work
Inspired for more, Young was eager to

learn the Arvigo techniques of Maya
abdominal massage from its founder,
Rosita Arvigo, a naprapathic doctor.
Five months later, Young was walking
through the Belizean rainforest with
Arvigo, her mentor and teacher. She

calls the experience magical. She
remembers hiking to and from Arvigos
home via the Rainforest Medicine Trail,
which was carved out by Don Elijio
Panti, the Mayan shaman with whom
Arvigo had apprenticed years ago.
There was a strong energetic presence
being on the land where this technique
was developed, Young remembers.
It was nothing if not life-changing.
Now both a certified Maya
abdominal massage practitioner
and self-care teacher, Young says
the technique has transformed the
way she works with clients and how
she approaches the body, while also
creating a specialization for her
bodywork practice. She says the
basis of the technique is massage
therapy, but Arvigo also teaches her
students to work with the emotional
and spiritual aspects to treat each
person in a holistic manner.
Maya abdominal massage changed
the way I approach the body on so many
levels, Young says. Learning the
abdomen and pelvis in full detail was
fascinating. Understanding how it can
have an effect on everything from head
to toeinternally (emotionally and
mentally) and externally (physically)
was phenomenal. Most importantly,
it showed how our bodies tell our
stories, how we need to listen to them,
and how we can take care of them
with this simple, self-care massage.
Young finds that her professional
athlete clients love the abdominal
work and request it a majority of the
time. It is not often that a massage
11/14/08 1:17:55 PM
For more information, visit www.arvigomassage.

com and www.theartofbodywork.com.
My clients
love when
I study new
modalities,
because they
know they will
benefit from it.
Loretta Young, Maya abdominal
massage practitioner
therapist will address the abdomen

in this manner and focus on a critical
area for the athletetheir core, she
says. Football players, basketball
players, tennis players, martial
artistsIve worked with them all.
Every athlete understands the concept
of working from their corethis is
where all movement should originate
from. This technique addresses the
diaphragm for deeper breathing and
alignment of the pelvis, in addition
to improving blood and lymph flow.
Being able to release restrictions
in the abdomen will also result in
great benefits for the lower back.
The Therapeutic Edge
According to her teacher, Young is

typical of the massage therapist looking
for an edge on business by offering
a specific therapeutic modality, such
as the Arvigo techniques of Maya
abdominal massage. These techniques
add a holistic approach, including
emotional healing, to a practice,
Arvigo says. Most therapists avoid
the vulnerable area in and around the
abdomen, however, our techniques train
practitioners to massage the abdomen,
Loretta Young, pictured here with Rosita Arvigo (left), says her experience learning Maya
abdominal massage in Belize was life changing.
releasing stored emotions, realigning

misplaced organs to improve overall
health and wellness of digestive and
reproductive systems, and improving
musculo-skeletal alignment.
Today, at least 90 percent of
Youngs new clients are seeing her
specifically for Maya abdominal
massage. And noting its therapeutic
value, Young says she makes sure to
offer some core work to all her clients.
All clients receive some abdominal
work, because in my opinion, there
is a connection with whatever else
may be going on in their body.
While Maya abdominal massage

has changed how Young practices,
she credits continuing education, as a
whole, with helping her be a viable and
successful practitioner. Continuing
education has been my key to keeping
ahead in this field and the more I
learn, the more I can bring to the
table, she says. My clients love when
I study new modalities, because they
know they will benefit from it. And
therein lies the true bottom line.
Karrie Osborn is contributing editor for
Massage & Bodywork magazine. Contact her
at karrie@abmp.com.
visit abmp.com for a calendar of ceu listings 133
132-144_M&B_JF09.indd 133
11/14/08 1:17:57 PM
education resource listing
Schools, Seminars, and workshops

Contact Angie Parris-Raney at 800-458-2267, ext. 641, or angie@abmp.com for more information.
Visit ABMP.com for a calendar of CEU listings.
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INTERNATIONAL SCHOOL
OF SHIATSU
Landmark Building, 10 S. Clinton St., Suite 300
Doylestown, PA 18901
Toll-Free:800-875-9918; Tel:215-340-9918
Fax:215-340-9181
E-mail:learnshiatsu@verizon.net
Website:www.shiatsubo.com
Shiatsu, transforming the world, one touch at a time ... Touch is essential to healthy human life. Without
nurturing touch, babies fail to thrive.What happens to adults? Look all around at the pain, illness, lack
of connection with society.What about your own life? Experience quality touch and feel whats in your
body. Try a shiatsu course at the International School of Shiatsu and decide if this new career in energy
work is the right one for you. Learn to feel and balance chi flow, creating space for integration. Help
your clients to live richer, more fulfilling lives. Are you ready to improve your life while learning to help
others? Free guide to stress relief!
Shiatsu Practitioner Training: 640 hours. Student Loans Available. CE Hours.
The Spirit of Learning

Teacher Training Program
Created and led by Carey Elizabeth Smith, this is the nations foremost teacher certification program
for massage, bodywork and spa educators!
Offered at the Body Therapy Institute

300 Southwind Road
Siler City, NC 27344
Toll-Free:888-500-4500
E-mail:info@massage.net
Website:www.massage.net
Gain the knowledge, awareness and practical skills to be an excellent teacherwhile you learn to
integrate body, mind, spirit and emotions in the classroom.
Youll develop a confident and embodied teaching presence that will sustain and enrich you, and that
will result in more successful learning outcomes for your students.
Ideal for both new and experienced faculty, as well as those who want to become a teacher
Study at our spectacular country campus in the North Carolina Piedmont
Transformational 100-hour curriculumbegins each September
Ignite Your Passion for Teaching!
Explore teacher training in this 1-day Introductory Workshop with Carey.
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national
Bodywork for the
Childbearing Year
Bodywork for the Childbearing Year

34 Hour Certification Training in Medical Massage for Pregnancy
8950 Villa La Jolla Dr. #A217

La Jolla, CA 92037
Toll-Free:888-287-6860; Tel:760-436-0418
Fax:760-436-6998
E-mail:pregnancymassage@aol.com
Website:www.KateJordanSeminars.com
This most comprehensive approach to pregnancy, labor preparation, labor support and postpartum
body therapy includes training in the use of Strain CounterStrain, Myofascial Release, Muscle Energy
Technique, joint mobilizations and reflex methodologies including connective tissue massage,
acupressure and reflexology.Participants learn application of the Alexander Technique to pregnant
and post-partum posture, as well as appropriate therapist biomechanics.Training in hands-on labor
induction and labor support modalities is included. Post-partum abdominal and pelvic restoration
techniques are taught.
The seminar is led by nationally recognized expert Kate Jordan.
2008/2009 Schedule: San Francisco, CA; Bloomington, MN; Austin, TX; San Diego, CA;
Tampa, FL; Chicago, IL; Seattle, WA; Washington, DC; Santa Monica, CA.
CERTIFIED BODYTALK
PRACTITIONER TRAINING W/
BODYMIND MECHANICS
NCBTMB CEs and NCCAOM PDA Points available for courses taken with Bodymind Mechanics.
Check national schedule online.

Based out of Houston, TX 77006
Tel:713-523-4429
E-mail:jennifer@bodymindmechanics.com
Website:www.bodymindmechanics.com
BodyTalk is an astonishingly simple and effective form of therapy that allows the bodys energy
systems to be re-synchronized so that they can operate as nature intended. Each system, cell and
atom is in constant communication with each other at all times. Exposure to stress will compromise
these communication lines, which leads to a decline in physical, emotional and/or mental health.
Reconnecting these lines of communication enables the body to function at optimal levels, thus
preventing disease and rapidly accelerating the healing process. BodyTalk can be used as a standalone system to treat many health problems, or seamlessly integrated into any healthcare system to
increase its effectiveness and promote faster healing.
FREEDOM FROM PAIN INSTITUTE
Americas #1 Selling Myoskeletal Home-Study Courses and Live CE Seminars
5801 N Ann Arbor Ave

Oklahoma, OK 73122
Toll Free:800-709-5054
E-mail:erikdalton@aol.com
Website:www.erikdalton.com
Designed for the passionate/dedicated therapist, Dalton draws on a wide range of disciplines which
focus on unusual, interesting and fresh approaches that expand technique repertoire and inspire
creativity and innovation. These easily incorporated deep tissue, muscle energy, and joint-stretching
routines offer the pain-management, sports therapist and structural integrator with Certified
Myoskeletal Therapist credentials that sets them apart in the eyes of clients and referral sources.
Your increased earning power will pay for your investment many times over.
Visit our site to view video clips, upcoming workshops andpublished articles. Sign up for our Free
monthly Technique e-Newsletter.
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Green River Dance for

Global Somatics
10700 Lindo Trail
Lindstrom, MN 55045
Tel: 651-257-8697; Fax: 651-257-9697
E-mail: dance@globalsomatics.com
Website: www.globalsomatics.com

Both
Green River Dance for Global Somatics (GRDGS) is a health resource center recognized for
professional trainings, innovative continuing education, somatic research, therapeutic services and
performance since 1982. We are the only Midwest somatic school that provides a comprehensive
curriculum in experiential anatomy, developmental movement and embodiment of the energy field.
The Global Somatics Process, developed by Suzanne River, empowers individuals to activate channels
between the physical body and energy field for self-realization, authentic healing and conscious evolution.
Professional Trainings:
Global Somatics Practitioner Training (GSPT) 17 mo. 1,400 hour
Approved by ISMETA, ABMP, BMCA, MOHE
Financial Aid available
Continuing Education:
Conscious Embodiment Intros
Body Systems: Fluids, Skeletal, Organ, Ligament, Endocrine, Muscle, Nervous, Cellular, Energy
Body Processes: Senses, Breath, Voice
Developmental Movement: Embryonic Dances, Vertebrate, Reflexes
SACRED JOURNEY INSTITUTE

16345 S. Harlem Ave., Tinley Park, IL 60477
Tel:708-614-6860
E-mail:beyondwellness@aol.com
Website:www.sacredjourneyinstitute.com
The Sacred Journey Institute offers a shamanic approach to Cranial Sacral Therapy that lays the
foundation to advanced studies in Sacred Journey Therapy and Miasm Release Therapy for the
lightworker. This unique approach to Cranial Sacral Therapy explores the physical, emotional, spiritual
and astral body by intertwining perception and intention with meditative use of inner eye, inner ear and
empathic heart. This high art of healing can successfully treat nervous disorders, physical and mental
health problems.
Don Massat, founder of the Sacred Journey Institute, has developed seven levels of higher-learning for
the lightworker by combining the principles of Cranial Sacral Therapy with the advanced modalities of
energy work.
Visit our website for course descriptions, class dates and times.
Continuing Education Provider, NCBTMB Approved Provider.
THAI INSTITUTE OF HEALING ARTS
The Thai Institute of Healing Arts was founded by Thais to advance Thai healing arts in the USA.
3900 Fairfax Drive, Suite 1718

Arlington, VA 22203
Toll-Free:888-842-4929; Tel:571-344-3333
E-mail:david@thai-institute.com
Website:www.thai-institute.com
We focus on creating an authentic learning environment for students interested in exploring the
traditional healing practices of Thailand. Those interested in a career change or those looking to add
new techniques to their current healing practice will be equally challenged and inspired.
Each of our courses is enriched with theoretical discussions and cultural experiences to allow the
western student the opportunity to gain the deepest knowledge in Thailands ancient healing arts.
This knowledge comes directly from the source, Thailand.
Learn from the Source, Learn the THAI WAY!!!
For more information visit our website, www.Thai-Institute.comor call 888-THAI-WAY today.
California
MCKINNON BODY
THERAPY CENTER
2940 Webster St, Oakland, CA 94609
Tel:510-465-3488; Fax:510-465-1533
E-mail:info@mckinnonmassage.com
Website:www.mckinnonmassage.com
Massage and Bodywork Training in the SF Bay Area. Two locations in Oakland and Palo Alto. We
offer Professional Certificate Programs as well as Continuing Education and Community Workshops.
Programs include: Swedish, Esalen, Acupressure, Shiatsu, Craniosacral, Deep Tissue, Sports, Touch
for Diverse Populations and more. Continuing Education in: Chair Massage, Reflexology, Pregnancy,
Hot Stone Therapy, Thai Massage, Reiki, Oncology Massage and more. Classes are offered weekdays,
weekends and evenings. Over 2000 hours of training available. All hours approved by the National
Certification Board. Visit one of our Orientation Evenings. See website for details, or call our office for
more information.
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SCHOOL OF SHIATSU & MASSAGE

Box 889, Middletown, CA 95461
Toll-Free:800-693-3296; Tel:707-987-3801
E-mail:info@waba.edu
Website:www.watsucenter.com
Recognized as one of the worlds premier learning institutes for aquatic and land-based healing arts,
the School of Shiatsu & Massage offers programs designed to integrate personal growth and a strong
foundation in technique. Choose from weekend classes, week long intensives, certification, and
residential programs. We offer aquatic certifications in Watsu, Waterdance, and Healing Dance. Land
programs include Shiatsu, Therapeutic Massage, Deep Tissue, Craniosacral, Reflexology, Lymphatic,
Thai, and more. Licensed by California BPPVE; approved Continuing Education Provider by NCBTMB
and Board of Registered Nursing.
Whether you are just beginning massage training or wish to enhance your existing practice, youll be
impressed with our comprehensive curriculum, professional staff, and breathtaking campus north of the
Napa wine region. Visit us online or call for a free catalog.
illinois
The New School for Massage,
Bodywork & Healing
The New School for Massage, Bodywork & Healing is the leading Chicago-based educational
institution for massage, bodywork, and the healing arts.
800 N. Wells St, Suite 300

Chicago, IL 60610
Toll-Free:888-461-0114; Tel:312-654-0900
Website:www.newschoolmassage.com
We offer: a comprehensive, state-approved Massage & Bodywork Diploma Program for individuals
seeking licensing and a successful career as a massage therapist; Continuing Education classes for licensed
professionals seeking to enhance their skills; and Introductory Workshops and a Clinic for the general public.
Our educational approach is one that emphasizes the connection of the mind, body, and spirit and
fosters internal growth and self mastery along with skill acquisition.
Small class size, innovative curriculum, superior faculty, student-friendly administration.Conveniently
located in downtown Chicagos Rivernorth neighborhood.
Check our website at www.newschoolmassage.com for additional information.
missouri
SCHOOL OF MASSAGE ARTS
729 W. Mt. Vernon
Nixa, MO 65714
Toll-Free:800-508-5124; Tel:417-725-0800
Fax:417-725-1461
E-mail:zzkirb@sbcglobal.net
Website:www.somawellnesscenter.com
Are you ready to change your life, and not just your career?As the oldest programin the state under
original ownership andthrough all the changes in the massage industry we have maintained our high
standard of excellence and have never compromised ourmission. The success rate of our graduates
speaks for itself.For non-smokers with a professional and mature attitude we offer the highest standard
of training to prepare you for a rewarding career in the massage and bodywork field. Because of our
strong clinical program, we are able to keep tuition affordable and our students get many hours of
real world experience working on real clients.Log on, give us a call or stop by anytime.
Wed love to meet you.
new mexico
SCHERER INSTITUTE OF
NATURAL HEALING
It is an honor to touch another human being.
Box 5737, Santa Fe, NM 87502-5737

Toll-Free:866-505-2006; Tel:505-982-8398
Fax:505-982-1825
E-mail:info@schererinstitute.com
Website:www.schererinstitute.com
The Scherer Institute has been a leader in bodywork education since 1979. People from all over the
world come to learn the sacred art and science of massage therapy. Students gain skills to work in more
traditional Western settings while maintaining the integrity and principles of holistic bodywork traditions.
Full-time, 6-month, 780-hour Massage Certification programs begin in March and September.
A Part-time, 10-month, 680-hour program also begins in September.Contact us for dynamic
Continuing Education courses as well.Financial assistance available for students who qualify.
We invite you to join us in the beautiful high desert of Santa Fe, a center of the healing arts.
The Scherer Institute is well-known and loved. Find out why!
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Both
new york
New York College of
Health Professions
6801 Jericho Turnpike, Syosset, NY 11791
Toll-Free: 800-9-CAREER (800-922-7337)
Ext. 351; Fax: 516-364-0989
E-mail: admissions@nycollege.edu
Website: www.nycollege.edu
NEW YORK OPEN CENTER

83 Spring Street, New York, NY 10012
Tel:212-219-2527
E-mail:info@opencenter.org
Website:www.opencenter.org
Help Others While Helping Yourself

New York College of Health Professions has been a Leader in Holistic Education and Care for over 25
years. Approved as the first Massage school in New York State to offer college degrees in Massage
Therapy, the College has both an Associate degree program, and a Bachelors program in Advanced
Asian Bodyworkfor those who wish to continue their studies. The new 60 credit fast track AOS
program allows students to complete their degree quickly! New York College has national institutional
accreditation;agraduateschool offeringcombined Bachelor/Masters degrees in Acupuncture and
Oriental Medicine;as well as an extensive Continuing Education program for bothprofessionals and
the Community. The campus is convenientlylocated on Long Island.
The New York Open Center is a non-profit holistic learning center offering evening events, full-day workshops,
ongoing classes and advanced trainings in the arts, psychology, spirituality, health and bodywork/yoga.
The Open Center continues to expand in scope through the creation of long-term professional training
programs.Currently trainings are available in the following areas: Reiki, Reflexology, Prana Yoga Teacher
Training, Life& Integrative Health Coaching, Green Medicine: Herbalism Training, Sound, Color & Music
Therapy,A Foundation Year in Classical Homeopathy, Feng Shui and more.
CEU credits are available at the completion of a number of these programs.
**Wellness/Massage Services, Onsite Bookstore and Meditation Room are also available at this location.**
north carolina
BODY THERAPY INSTITUTE
300 Southwind Road, Siler City, NC 27344
Toll-Free:888-500-4500
E-mail:info@massage.net
Website:www.massage.net
Learning that Changes Lives

Located in the heart of the North Carolina Piedmont, BTI offers educational programs of extraordinary
quality. Our beautiful 150-acre campus at South Wind Farm is the place where you can realize your
goals and dreams!
BTIs 650-hour Massage Therapy Diploma Program features an integrative approach which supports
healing of the whole person. Student loans are available.
We offer a comprehensive schedule of continuing education workshops and advanced training
programs with many of the top professionals in our field.
BTI is accredited by the Commission on Massage Therapy Accreditation, state approved by the North
Carolina and Florida boards, and is an NCBTMB Approved Continuing Education Provider.
Visit the BTI Website for complete information.
Celebrating 25 Years of Educational Excellence | 1983-2008
oregon
OREGON SCHOOL OF MASSAGE
9500 SW Barbur Boulevard #100
Portland, OR 97219
Toll Free: 800-844-3420; Tel: 503-244-3420
E-mail: osm@oregonschoolofmassage.com
Website: www.oregonschoolofmassage.com
Our 555-hour Western and Eastern certificate programs prepare students for Oregon, Washington,
and National licensure, integrating personal as well as professional growth. Our highly competent,
professional instructors support and challenge students. Training includes a learning retreat at
Breitenbush Hot Springs. Classes begin quarterly in both Portland and Salem. Daytime or evening
classes and payment options are available. OSM offers a wide variety of Continuing Education
classes. Please check out www.abmp.com CE corner for a complete listing of workshops. Or visit
www.oregonschoolofmassage.com for a complete list of classes.
Portland Campus: 9500 SW Barbur Blvd. #100, Portland, OR 97219; Toll-free: 1-800-844-3420
Salem Campus: 2111 Front St NE, Salem, OR 97301; Toll-free: 1-877-588-8912.
132-144_M&B_JF09.indd 139
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classifieds
A LISTING OF PROFESSIONAL PRODUCTS AND SERVICES

Contact Angie Parris-Raney at 800-458-2267, ext. 641, or angie@abmp.com for more information.
AROMATHERAPY
CONTINUING EDUCATION &

EDUCATIONAL OPPORTUNITIES
Aromatherapeutic Hot/Cold Products

www.shopbodysense.com
Send E-mail to sales@
shopbodysense.com
Toll Free: 877-816-3615
Ph/Fax: 702-878-9168
COMPUTER SOFTWARE
SOFTWARE: APPOINTMENT
CALENDAR, SOAP NOTES, Online
Appointment Scheduler, useful features, best
price. Free Demo www.BookingCalendar.com.
Call 866-342-0461.
Biodynamic Cranial Touch We kindly invite

you to view our web site for a list of NCBTMB
approved classes with CEUs, or to order Charles
Ridleys book: STILLNESS: Biodynamic
Cranial Practice and the Evolution of
Consciousness by Charles Ridley
(2006 North Atlantic Books).
http://www.DynamicStillness.com
E-mail: Info@DynamicStillness.com
THREE BREAKTHROUGH HOME STUDY
COURSES Real mind/body healing with
TRANCE MASSAGE; TMJ MASSAGE; and a
great spa massage, the TRANCE ACUFACIAL.
12 hours each course plus the FREE STRESS
RELIEF MASSAGE! Approved NCBTMB.
Call toll-free 888-458-0721 or visit
www.massageceus.net.
Tuning Fork Therapy Certification

NCBTMB approved. Fun. Affordable.
www.TuningForkTherapy.com.
REIKI
REIKI BOOKS. Certifications. NCBTMB. Free
Distant Healing. www.ReikiCenterofVenice.com.
THAI MASSAGE
Authentic Thai Massage
Training, taught just like
in Thailand. Thai Yoga,
Thai Foot, Thai Herbal
Massage courses taught
by Thais. Learn from
the Source, Learn the
Thai Way! Visit us online
www.thai-institute.com
or call 888-THAI-WAY.
display showcase
MASSAGE MBLEx,
STATE EXAMS & ALL
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EXAMS STUDY GUIDE
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includes s/h
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Order on web sites:

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Major Credit Cards Accepted
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New Study Guide for MBLEx and all MT Certification Exams
ADVERTISEMENTS FOR PROFESSIONAL PRODUCTS AND SERVICES
11/14/08 1:52:16 PM
Innerpeace
"The Sheet People"
TM
Massage Table Linens
Hand crafted in the USA, 100% cotton flannel

Manufacturing excellence since 1989
www.innerpeace.com
Call for free flyer, fabric samples, & SALES!
1-800-949-7650
P.O. Box 940, Walpole, NH 03608- 0940
(Mon - Thurs 8:00 am - 4:00 pm EST)
Accepting Visa and MasterCard

Special Rates for Schools and Stores
Learn Chiropractic
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massage and bodywork_2.1875x4.5625.qxp
11/10/2008
3:40 PM
Page 1
Aviana
Certification Courses
Breathing New Life Into Your Business
With Creator,
Nancy Schmitt
Whole person bodywork
influenced by the
worlds oldest holistic
health and healing
systems practiced for
thousands of years.
An approved provider of the National Certification
Board of Therapeutic Massage and Bodywork
(NCBTMB #393827-00). Approved for continuing
nursing education by the American Holistic
Nurses Association (AHNA #518), an accredited
provider approved by the American Nurses
Credentialing Centers Commission on
Accreditation.
Aviana (Mindful)
Touch Therapy
25 contact hours
Energy Medicine
10 contact hours
Cost $365.00
Cost $195.00
Contact us for dates and locations
Aviana Inc
Toll Free: 866-4AVIANA

www.AvianaBody.com
e-mail: info@AvianaBody.com
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ad index
need it? find it here

ABMP . . . . . . . . . . . . . . . . . . . . . . . . . . 9, 86
Academy of Lymphatic Studies. . . . . . . 44
Advanced Training. . . . . . . . . . . . . 122, 124
Aesthetic Video Source . . . . . . . . . . . . 141
Americas Expo. . . . . . . . . . . . . . . . . . . . 108
Ashiatsu Bar Therapy. . . . . . . . . . . . . . 106
Aviana CE Courses . . . . . . . . . . . . . 134, 142
Beautiful Image, LLC
. . . . . . . . . . . . . 69
Bellanina Institute. . . . . . . . . . . . . . . . . . 96
Benjamin Institute. . . . . . . . . . . . . . . . . 128
Bindi Skincare. . . . . . . . . . . . . . . . . . . . . . 48
Biofreeze. . . . . . . . . . . . . . . . . . . . . . . . . .58
Biotone . . . . . . . . . . . . . . . . . . . . . . . .IFC-1
Body Mind Mechanics
. . . . . . . . . . . . . . . 136
Body Support Systems . . . . . . . . . . . . . . 33

Body Therapy Institute
. . . . . . . 135, 139
Bodywork for the

Childbearing Year . . . . . . . . . . . . . 136, 142
Bon Vital. . . . . . . . . . . . . . . . . . . . . . . . . . 18
CellCharge . . . . . . . . . . . . . . . . . . . . . . . 142
Center For Massage &
Natural Health . . . . . . . . . . . . . . . . . . . . . 134
Ceu Compass. . . . . . . . . . . . . . . . . . . . . . 96
Claire Marie Miller
Integrative Reflexology. . . . . . . . . . . . . 6
Cortiva Institute . . . . . . . . . . . . . . . . . . . 72
Deep Tissue Massage. . . . . . . . . . . . . . . 44
Earthlite Massage Tables. . . . . . . . . 7, BC
Federation of State Massage Therapy
Boards ( FSMTB). . . . . . . . . . . . . . . . . 21
Institute of Integrative
Aromatherapy . . . . . . . . . . . . . . . . . . . . . 134
International School of Shiatsu . . . . . . . . 135
Jeana Naluai. . . . . . . . . . . . . . . . . . . . . . . 67
Kinesis/Anatomy Trains . . . . . . . . . . . . . 71
Know Your Source. . . . . . . . . . . . . . . . IBC
Loomis Institute. . . . . . . . . . . . . . . . . . . 106
Massage Envy. . . . . . . . . . . . . . . . . . . . . . 34
Massage Publications. . . . . . . . . . . . . . . 51
Massage Review
Publications. . . . . . . . . . . . 6, 43, 140, 142
MassageSupplies.com. . . . . . . . . . . . . . . 35
Massage Therapy Foundation. . . . . . . . 90
Massage Wraps, LLC . . . . . . . . . . . . . . . 51
McKinnon Body Therapy Center . . . . . 137
Mitchell Deep Tissue . . . . . . . . . . . . . . . 78
Myofascial Release Seminars. . . . . . . . . 61
. . . . . . . . . . . . . . . . . . 78
Stronglite. . . . . . . . . . . . . . . . . . . . . . . . . 105
Talus Corp. . . . . . . . . . . . . . . . . . . . . . . . . 12
Tao Trading. . . . . . . . . . . . . . . . . . . . . . . . 90
Thai Bodywork. . . . . . . . . . . . . . . . . . . . 118
Thai Institute of Healing Arts . . . . . . . . . 137
Universal Companies . . . . . . . . . . . . . . . 11
Watercolors. . . . . . . . . . . . . . . . . . . . . . . . 12
Educational Resource Section
Both
Continuing Ed Program
tate-Approved Massage
S
Therapy Program
Digital Video
Myokinesthetic System. . . . . . . . . . . . . . 26
My Receptionist. . . . . . . . . . . . . . . . . . . . 44
NCBTMB . . . . . . . . . . . . . . . . . . . . . . . . . 24
New Harbinger Publications . . . . . . . . . 78
New School for Massage,
Bodywork & Healing . . . . . . . . . . . . . . . 138
New York College of
Health Professions . . . . . . . . . . . . . . . . . 139
New York Open Center . . . . . . . . . . . . . . 139
Oakworks . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Ohashi Institute. . . . . . . . . . . . . . . . . . . 142
One 8 Publishing. . . . . . . . . . . . . . . . . . 141
Oregon School of Massage
. . . . . . . . . . 139
. . . 54, 136
Primal Pictures. . . . . . . . . . . . . . . . . . . . 122
Green River Dance for

Global Somatics . . . . . . . . . . . . . . . . . . . 137
Reflexology Online . . . . . . . . . . . . . . . . 141

Sacred Journey Institute . . . . . . . . . . . . . . 137
Hawaiian Temple Bodywork. . . . . . . . . . 12
Scherer Institute
Health Positive! . . . . . . . . . . . . . . . . . . . . . . 135
School of Massage Arts . . . . . . . . . . . . . . 138
Hughes Henshaw. . . . . . . . . . . . . . . . . . 140
School of Shiatsu & Massage
Innerpeace. . . . . . . . . . . . . . . . . . . . . . . . 141
Sew & Sew. . . . . . . . . . . . . . . . . . . . . . . . . 96
Institute for Integrative
SKS Bottle. . . . . . . . . . . . . . . . . . . . . . . . 141
Healthcare . . . . . . . . . . . . . . . . . . . . . . . 53
Sombra Cosmetics. . . . . . . . . . . . . . . . . . 82
Freedom from Pain Institute
Steamy Wonder
. . . . . . . . . . . . . . . . . . . . . 138
. . . . . . . . . 138
Institute of Somatic Therapy. . . . . . . . 112
132-144_M&B_JF09.indd 143
11/20/08 8:52:01 AM
practitioner parables
By Robert Chute
Forward in Your Journey
What
distinguishes
a wish from
a goal is
your plan.
144
massage & bodywork
132-144_M&B_JF09.indd 144
Youre thinking about 2009. Its rich

with possibility because this is the year
youll fire up your practice, get things
organized, and become the massage
therapist you were meant to be. Its a
fresh start except chances are it isnt
a fresh start and you wont make those
dreams come true without a plan and
some effort. The resolutions you make
for 2009 are probably the same ones
you made for 2008, 2007, and so on. So
how do you change your track record?
Our challenge is the misconception
that New Years resolutions are
one-time events, as if we can set
a course and not pay attention to
the wind and currents of our lives.
For instance, diet resolutions arent
made on an empty stomach. You
decide to lose the excess weight once
youre stuffed with a holiday feast.
Hungry, tired, and without a plan for
dinner, those resolutions evaporate
and you order pizza. Again.
To make change happen
youre going to need to do some
research and prepare a plan thats
achievable. What distinguishes a
wish from a goal is your plan.
One New Years Day I found a
stray note that had blown on to my
deck. It read: Toby will win the
lottery this year and live happily
ever after. Besides buying a ticket,
someone didnt have much of an action
plan. His scrawl looked kind of sad
in the morning light of January 1.
First, dream a little. Think about
what you want to change. More clients?
Hiring help? Choosing a new location
or redecorating your space? Are you
going to save up for a bodywork
course in Bali this year? What do you
really want? Go ahead. Ill wait.
Got them? Write your goals down.

(Stick with me. This wont take long
and its your life were talking about
here.) Prioritize them. If you have 10
things you want to change you can save
the bottom seven for later. No one gets
to the bottom of a to-do list and the top
three goals will take your energy and
attention if theyre at all challenging.
Change is difficult. If it wasnt,
you wouldnt have read this far.
Draw up a plan for number one.
Pick a completion date. Remember:
plan the work, work your plan.
Theres nothing to it but to do it.
Post your goals in a visible spot.
Announce your lofty intentions to
your loved ones. Tell someone whos
going to help keep you on track.
No lame excuses. Put yourself out
there. Consider enlisting a buddy
who shares your goals and set up a
friendly competition with money,
massages, or whatever on the line.
Now the key youve been looking
for: dont set sail for your destination
without any expectation of rough
weather or course corrections along
the way. All that enthusiasm youve got
right now for your resolutions must
be revisited daily, sometimes hourly.
Dont wait until next January 1, or
next Monday, or for your birthday.
The process is now and it is ongoing.
Each small choice you make carries
you forward in your journey.
Robert Chute continues to make the small
choices along the way of his journey. Contact
him at consciousbodywork@hotmail.com.
11/14/08 1:18:35 PM
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