Massage World Issue 103

EDITOR

Wendy Kavanagh

FEATURES

GRAPHIC DESIGN

Pauline Baxter Rachel Fairweather Susan Findlay Emma Gilmore Brenda Howard Yvette Jordan Meghan Mari Diane Matkowski Nana Mensah Dawn Morse Darien Pritchard Catherine Stone Michael Watson Madelaine Winzer Victoria Osborne

MEDIA COMMUNICATION

C J Newbury

PUBLISHERS

NK Publishing

ADVERTISING

Please call the Massage :RUOG RIĂ€FH T 020 7387 2308

FOUR QUARTERLY ISSUES UK: ÂŁ20 Rest of World: ÂŁ40

UK Student: ÂŁ15 ISSN 1474-4171

Massage World, The Crypt Centre St Mary Magdalene Church Munster Sq, London, NW1 3PL T/F 020 7387 2308 E info@massageworld.co.uk W www.massageworld.co.uk DISCLAIMERS The publisher has taken all reasonable measures to ensure the accuracy of the information in Massage World and cannot accept responsibility for errors in or omissions from any information given in this or previous editions or for any consequences arising thereof. The Editor may not always agree with opinions expressed in Massage World but allow publication as a matter of interest, nothing printed should be FRQVWUXHG DV 3ROLF\ RU DQ 2IĂ€FLDO $QQRXQFHPHQW XQOHVV VWDWHG No part of this publication may be reproduced in any form or by any means whether electronic, mechanical and/or optical without the express prior written permission of the publisher.

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he new year is upon us, giving you the opportunity to UHà HFW RQ WKH ODVW WZHOYH PRQWKV DQG SODQ \RXU JRDOV for 2019. The most obvious goals for most people LQYROYH JHWWLQJ ÀWWHU DQG ORVLQJ ZHLJKW EXW ZKDW DERXW professional aspirations? As a therapist, it is competitive when it comes to building a client base and there is no better time to set goals for your business than at the start of a new year.

This issue includes articles about the smaller steps you can take if you are simply looking to grow and accomplish more. Pauline Baxter discusses the different types of networking and WKH EHQHĂ€WV RI HDFK W\SH ZKLOH 'LDQH 0DWNRZVNL ZULWHV DERXW WKH SRZHU RI FRPPXQLFDWLQJ effectively to form solid relationships, both personally and professionally. Taking care of the bodywork side of things, Dawn Morse provides an introduction to iliopsoas tendonitis more commonly known as ‘snapping hip syndrome’.

We feel this issue is fresh and informative for working massage therapists, and also gives you a guide to events taking place during the course of the year. We love to hear your feedback, so if you have any comments or anything you would particularly like to read about in 2019, please get in touch via email or one of or social media platforms.

We shall be at the Yoga Show and the MTI Conference, along with many other exciting events throughout the year and we hope to see you there.

All the best for 2019 from all at Massage World!

Susan Findlay explains how less is more when providing a post event massage.

A runner’s needs are different from a swimmer’s needs, and here she highlights how massage therapists can use different massage techniques to adapt to individuals to optimise their post-event recovery

Dawn Morse provides an introduction to iliopsoas tendonitis, more commonly known as snapping hip syndrome. Listing the causes and effects of snapping hip syndrome, she lists the best massage techniques and stretches to help alleviate pain, while providing core stability exercises to help improve long-term stability.

Fascia is essential to stability and movement, and is central in recovery from injury and disability. Here, Emma Gilmore gives an insight to the importance of fascia in relation to everyday life.

With the heavy reliance on technology, the overall mental health of individuals in Western countries is rapidly declining. Here, Rachael Fairweather looks at how the power of touch therapy may be the answer to problems caused by the fast pace of the ever-changing modern world.

Many people talk about networking, but how many times do you plan to network and ÀQG LW WXUQLQJ LQWR D VRFLDO RFFDVLRQ" +HUH Pauline Baxter looks at different ways to build successful networks that will compliment your business and increase your client base.

Diane Matkowski looks at the power of effective communication in order to reach your goals and form solid relationships. She looks at different ways in which you can improve your communication skills, while learning and sharing \RXU RZQ LGHDV ZLWK FRQĂ€GHQFH DQG HORTXHQFH

$IWHU WKH ÀUVW HYHU 1DWLRQDO 0DVVDJH &KDPSLRQVKLS taking place at the Olympia Beauty Show this year, we are excited to announce that Massage World along with CityLux shall be hosting the championship again on Sunday 29th and 0RQGD\ WK 6HSWHPEHU %ULQJLQJ WRJHWKHU QRYLFH DQG PRUH TXDOLÀHG WKHUDSLVWV LW LV an event run by therapists for therapists and is judged by international judges with extensive professional massage therapy experience.

7KH ZLQQHU RI WKH HYHQW VKDOO UHFHLYH D FHUWLÀFDWH DQG D WURSK\ DORQJ ZLWK VRPH JLIWV IURP leading brands and recognition from your industry peers. As a participant, you shall receive a FHUWLÀFDWH RI SDUWLFLSDWLRQ DQG D JRRG\ EDJ RI OHDGLQJ LQGXVWU\ EUDQGV ZRUWK … It was inspiring to see so many people showcasing their techniques and skills over six different categories at this year’s event and we hope to see more participants in 2019!

We are excited to be a proud sponsor of the World Massage Championships over in Copenhagen on the weekend of 22nd and 23rd June 2019. The International Massage Association’s purpose is to promote a range of massage techniques used by experienced massage therapists worldwide, while giving therapists the ability to network with others and ÀQG SURIHVVLRQDO LQVSLUDWLRQ ,W LV D FRPSHWLWLRQ DQG LW JUDQWV SDUWLFLSDQWV WKH RSSRUWXQLW\ WR strengthen their skills and see who shall take the place of last year’s gold medallist Konstantina Makre from Greece. A diploma shall also be issued to each participant, enabling the massage therapists to brand their business in a new way.

Massage World would like to see a good turnout of therapists from the UK just visit the website below to enter.

The SMTO annual conference shall be taking place on the 23rd and 24th March 2019 at the Academy of Sport and Wellbeing in Perth. On both days the event will be presented by John Gibbons who is trained in Osteopathy, Sports Therapy, Exercise Rehabilitation, Spinal Manipulation, Acupuncture DQG 1XWULWLRQ ,W VKDOO EH -RKQ¡V ÀUVW WLPH SUHVHQWLQJ in Scotland and to make the most of his visit, he shall be presenting two days of workshops on Friday 22nd and Monday 25th March. Focusing on advanced soft tissue techniques, the vital gluten and psoas, the shoulder complex and neurological testing over the four days it gives people the opportunity to attend the workshops that shall EHQHÀW WKHP There shall also be The Trade Exhibition on the 23rd and 24th March which is open to everyone and is free of charge. Here, there will be Scottish Massage Schools with details of courses, Songbird Naturals selling their range of massage balms and waxes, Handspring Publishing selling a variety of books and many other exhibitors selling everything from chocolate through to sweatshirts.

The SMTO aims to promote the holistic approach to healthcare and the art and science of massage therapy in all forms.

3URPRWLQJ %UHDVW &DQFHU $IWHUFDUH <YHWWH -RUGDQ 8./& 7UDLQLQJ 'LUHFWRU LV ODXQFKLQJ LQ 0DUFK WKH Ă&#x20AC;UVW PRQWKO\ /\PSKRHGHPD Awareness Clinic at the Olive Tree Cancer Support Centre in Crawley, West Sussex. An essential education clinic for post breast cancer related issues regarding this terrible condition by addressing early sub-clinical intervention. UKLC has worked alongside The Olive Tree for two years with BCA/LPT therapists Juliette Cross and Anna Parsons helping women recover with Lymphatic Pressure Therapy and the results have exceeded all expectations, now they are very happy to promote this new method of aftercare therapy.

The Royal Society for Public Health (RSPH) Health & Wellbeing Awards is now open to register your interest. The Health & Wellbeing Awards is the UK’s premier awards scheme for promoting health and wellbeing and is widely regarded across the industry.

Kanye West certainly thinks so and so do many other celebrities including Simon Cowell and Katy Perry. Dr Dot specialises in celebrity massage and has over 1000 licensed massage therapists registered under her business name. To differentiate herself from other therapists, she uses a biting technique which she compares to cupping.

Dr.Dot believes it to help oxygen and blood to circulate and promote healing. Its new to us here at Massage World and we can’t help but wonder if we would get insured as therapists in the UK if we incorporated biting into our own routines.

What do you think?

It’s not every day you get the chance to see something you lovingly created with your whole heart and soul be transformed into something shared across the world. But that’s just what Rachel Fairweather and Meghan Mari, Directors of Jing Advanced Massage Training and authors of ‘Massage Fusion: The Jing Method for the treatment of chronic pain’, have been honoured to see.

7KLV .RUHDQ WUDQVODWHG GHOLYHU\ RI WKHLU SRSXODU ERRN DUULYHG LQ WKH RIÀFH WRGD\ DQG WKH Jing team couldn’t be prouder. To know that our massage methods and training is being adopted in Korea and China is a fantastic thought. It just proves that the language of touch can cross so many boundaries and that pain is universal – let’s continue to spread the healing word!

Try free classes, revisit old techniqu es and meet like-minded people at the world’s large st yoga show. With over 100 exhibitors ther e, you have access to the best products and serv ices on the market to ensure you are leading the ultimate yogic lifestyle.

Holding four shows under one roof, there shall be a range of inspiring seminars alon g with treatment demonstrations and 750 leading brands offering 1000s of exclusive offers. An event that can’t be missed!

Intouch shall be providing space for companies to interact with a large number of mas sage therapists and bodyworkers. With gues t speakers and workshops available thro ughout the day, it is a great place to learn about marketing strategies, massage in vario us work environments and etiquette with in the workplace. It is a great place to show case your brand as exhibitors can advertise their logo on the touch website.

RXU Ă&#x20AC;UVW FRQVLGHUDWLRQ LV ZKDW type of event it is, as there are VLJQLĂ&#x20AC;FDQW GLIIHUHQFHV EHWZHHQ a client who has just run a marathon and someone who has participated in a swimming competition. Energy expenditure is one consideration, marathon running is an endurance event whereas a swimming competition might only involve a few heats, so obviously, the physiological stress being greater in marathon running, when they come to you their energy stores have been depleted to differing degrees.

Soft tissue recovery for endurance sports UHTXLUHV PRGLĂ&#x20AC;FDWLRQV WKDW WDNH WKLV LQWR consideration, so you can understand why I worry when someone says to me that they have been taught to â&#x20AC;&#x2DC;strip the musclesâ&#x20AC;&#x2122;. In post event work, this is unkind and lacks sensitivity to the condition of the connective tissue and is probably not the best way to deliver an optimum recovery session.

Your techniques should always enhance the recovery, not put a further demand on the tissue that causes it to recover from

the massage. Post event work is obviously not an opportunity to employ deep strong techniques like friction or vigorous tapotement.

Instead your focus should be to calm the muscles and encourage them to return to the pre-event state. I get very excited when I hear therapists like Robert Schleip Ph.D., (Fascia in Sport and Movement, great book, worth having in your library) who is a respected researcher in WKH Ă&#x20AC;HOG RI IDVFLD VWDWH WKDW D VRIWHU PRUH mindful approach is more effective in any given situation. So, how exactly do we determine what techniques we should use DQG ZKDW DUH WKHLU PRGLĂ&#x20AC;FDWLRQV" Before you make any decisions about which techniques to use, start with your palpation skills, get a sense of the physiological condition of the soft tissue and trust your hands to give you the necessary feedback before deciding. If your client is a rosy cheeked novice marathon runner, probably KDYLQJ MXVW FRPSOHWHG WKHLU Ă&#x20AC;UVW HYHQW WR raise funds for charity, this whole experience could be totally new for them, so we would expect the condition of their tissue to be very different from that of a battle scarred and road worn elite athlete.

Also, have you considered whether this is WKHLU Ă&#x20AC;UVW HYHU PDVVDJH" , NQRZ \RX ZRXOG think that anyone who is running a marathon or performing high level sport would have included massage as part of their training, but this is not so, even with todayâ&#x20AC;&#x2122;s level of awareness about what makes a more effective training regime you will still come across those who do not utilise massage. If this is the case, your approach will need to EH VLJQLĂ&#x20AC;FDQWO\ WHPSHUHG XVLQJ VORZHU DQG lighter movements.

Injuries are common, especially with novice marathon runners. You will come across things like strains, sprains, contusions, stress fractures, spasms, cramps, the effects of dehydration and low fuel levels. If you go in too heavy you could exacerbate these conditions. A sign that a stress fracture is

present is their reaction to your touch, it will include intense sharp pain, therefore it is important to assess the VLWXDWLRQ JHQWO\ Ă&#x20AC;UVW or you could be the reason for a more serious injury. With cramps or spasms, you can sometimes see the tissue moving, other times you can feel it. If you have never witnessed someone experiencing a spasm or cramp have a look at this example: www.youtube.com/watch?v=sqWl61tnsIQ If a participant comes to you with an apparent injury, you should follow the acute injury protocols that you have been taught that predominantly focus on interventions that exclude hands on work. If you have been working and travelling with a team and are very familiar with their needs as a post recovery therapist, your approach might be quite different, it might include more advanced soft tissue interventions that would help to either stabilize, adjust and reset functional movement, however it is technically not the same as post event work.

Recovery sessions are in great demand for sports massage therapists, especially during seasonal work for local sports teams and clubs that take place outdoors i.e. rugby, football, tennis, running etc. It is certainly worth checking out, especially if one of these sports really interests you, as it is a great way to network and get your foot in the door.

In summary, even before you start, it is necessary to understand the type of event theyâ&#x20AC;&#x2122;ve participated in, the state of their tissue health, if they have any injuries and what their training experience has been including massage. Now let us move onto the actual massage.

Less is more. The body is very smart and the idea that we are the â&#x20AC;&#x2DC;healersâ&#x20AC;&#x2122; is tempered by the tissueâ&#x20AC;&#x2122;s ability to do the job, an ability honed by millions of years of evolution and natural selection. However, with an eye on future employment opportunities, we have a role to play, but we need to understand what that role is and I would say that it is to assist and support the

vigorous. It tends to be more rhythmical, and when I â&#x20AC;&#x2DC;meltâ&#x20AC;&#x2122; in to the tissue it is with a mindful intent and slower.

tissueâ&#x20AC;&#x2122;s return to a healthier state. Avoid RYHU WUHDWLQJ WKLV LV QRW WKH EHVW WLPH WR ÂśĂ&#x20AC;[ â&#x20AC;&#x2DC;a client, post event work often only requires us to help relax the client psychologically and physiologically, the tissue will take it from there and continue the recovery process. Consider yourself the assistant.

I have produced a free short video that introduces you to post event massage WKDW \RX FDQ Ă&#x20AC;QG DW ZZZ \RXWXEH FRP watch?v=bt3leHwLEbM. It is one of a few I have produced, but it gives you a good idea of how to start and simplify your hands on approach.

Following on from the â&#x20AC;&#x2DC;less is moreâ&#x20AC;&#x2122; principle another consideration is what if theyâ&#x20AC;&#x2122;re in the midst of performing a series of events, i.e. doing the 3 Peaks Challenge IRU WKH Ă&#x20AC;UVW WLPH F\FOLQJ DFURVV $PHULFD or going from country to country as a professional tennis player? All of these endeavours are different, but your approach must be to respect the conditions that your client presents with and make the appropriate adjustments such that your work is supportive, rather than putting yet another strain on the body. Massage can be YHU\ EHQHĂ&#x20AC;FLDO EXW DSSOLHG WRR YLJRURXVO\ and it could rob them of their energy, lowering their performance. Itâ&#x20AC;&#x2122;s obviously desirable that they speak favourably about your talentsâ&#x20AC;Ś

The techniques I usually rely on include very EDVLF RQHV VXFK DV HIĂ HXUDJH SHWULVVDJH compression, vibration, rocking, distraction, stretching, MET and Transverse STR. All of WKHVH DUH PRGLĂ&#x20AC;HG ZLWK QRWKLQJ EHLQJ WRR

Something we havenâ&#x20AC;&#x2122;t talked about yet are the conditions in which you might Ă&#x20AC;QG \RXUVHOI ZRUNLQJ LQ 7KH\ DUH QRW DOO glamorous and at times I have found myself working in the most miserable conditions; rain slating down, cold wind, even snow, under an open tent, but this all adds to the memories that build a strong character, that said, you need to come prepared for all conditions. Some of the extra things I have brought include a supply of warming EODQNHWV D KRW Ă DVN RI VZHHW WHD H[WUD pairs of dry socks, even a tuck. Anything that you think might make your clients more comfortable, of course the extras are dependent on the season, but you will make a lot of friends this way and people will remember you for your kind thoughtfulness.

Even though sports massage is known for being a deeper, more invigorating form of soft tissue work, it does not need to be and it is important we taper our sessions to meet the needs of the client. It is time that we break the old mould that it must be painful to be good, as brutal force under these circumstances will not achieve the best outcome.

he pressure/compression strokes commonly used in massage include: â&#x20AC;¢ â&#x20AC;&#x2DC;frictionâ&#x20AC;&#x2122; strokes (covered in an earlier article); â&#x20AC;¢ the application of stationary pressure (including trigger point techniques); â&#x20AC;¢ and sliding pressure strokes (including adaptions of techniques from shiatsu and deep massage).

This article focuses on the potential IRU VWUDLQLQJ \RXU WKXPEV Ã&#x20AC;QJHUV DQG wrist when applying either stationary or sliding pressure. It covers ways of reducing this, including by using other ¶WRROV· VXFK DV \RXU NQXFNOHV Ã&#x20AC;VW forearm and elbow to save your digits.

The next article will look at how to use your body to deliver the pressure, rather than just standing still and relying on your shoulder muscles.

This series of articles are extracted from Dynamic Bodyuse for Effective Strain-free Massage which is designed to promote good hand and body use as an integral part of doing massage.

The book presents guidelines on how to reduce poor working habits that take a cumulative toll on the practitionerâ&#x20AC;&#x2122;s body and how to work most effectively.

The thumbs and wrists are the two areas of the hand most commonly at risk of strain through doing massage.

Thumb strains are most often caused by regularly using them to apply pressure, especially with WKHP K\SHUH[WHQGHG Ã&#x20AC;JXUH $ 6LPLODUO\ DSSO\LQJ SUHVVXUH ZLWK WKH ZULVW EHQW EDFN Ã&#x20AC;JXUH 1B) is the most common cause of wrist strain in massage. Applying pressure and kneading DUH WKH PDVVDJH WHFKQLTXHV ZKLFK SXW WKH PRVW SUHVVXUH RQ WKH WKXPEV Ã&#x20AC;QJHUV DQG ZULVWV 3UHVVXUH WHFKQLTXHV DUH WKH Ã&#x20AC;UPHVW VWURNHV LQ WKH PDVVDJH UHSHUWRLUH ,I \RX KDYH TXLWH ODUJH DQG strong hands, pressure strokes may not cause you problems unless you use them too often, too forcefully, or with your digits hyperextended. So youâ&#x20AC;&#x2122;ll need to be discerning about how you use your hands.

+RZHYHU PRVW RI XV VKRXOG RQO\ XVH RXU WKXPEV DQG Ã&#x20AC;QJHUV VSDULQJO\ IRU DSSO\LQJ SUHVVXUH If you feel discomfort developing in your digits, reduce how much you use them for pressure techniques or avoid using them altogether. This is especially important if you have small, VOHQGHU RU K\SHUPRELOH Ã&#x20AC;QJHUV DQG WKXPEV ZKLFK DUH YXOQHUDEOH WR VWUDLQV ZKLFK FDQ OHDG WR pain and weakness over time, and sometimes contribute to the development of arthritis in the

joints (especially in the thumbs). Use other massage â&#x20AC;&#x2DC;toolsâ&#x20AC;&#x2122; such as your forearm for ZLGHVSUHDG SUHVVXUH DQG \RXU Ă&#x20AC;VW RU HOERZ for focused pressure.

increase the pressure that you can deliver Ă&#x20AC;JXUH <RX¡OO JHW WKH VWURQJHVW VXSSRUW E\ KDYLQJ \RXU RWKHU SDOP DFURVV \RXU Ă&#x20AC;QJHUV

When you are applying pressure, thereâ&#x20AC;&#x2122;s a temptation to stand still, and to tense your shoulders and rely on muscle power alone, which stiffens your hands. The next article will look at how to use your body dynamically to avoid this and to make your pressure work more effective.

Be careful when using your thumbs to apply pressure Unless you have large, strong thumbs, using them for pressure point work puts considerable pressure on them, especially when you are working on large, well-used muscles.

$YRLG KDYLQJ \RXU Ă&#x20AC;QJHUV K\SHUH[WHQGHG Ă&#x20AC;JXUH ,QVWHDG KDYH WKHP VWUDLJKW RU very slightly curled, which is the strongest position for pressing through them because RI WKH ZD\ WKDW LW HQJDJHV \RXU VWURQJ Ă&#x20AC;QJHU Ă H[RU PXVFOHV

When you use one hand alone, you are likely WR EH WHQVLQJ \RXU Ă&#x20AC;QJHUV DQG \RXU ZULVW

to provide stability for your hand, and to provide the power. So, whenever you can, SODFH \RXU RWKHU KDQG RYHU \RXU Ă&#x20AC;QJHUV WR reduce this effort and to simultaneously

Avoid hyperextending your thumb when \RX¡UH SUHVVLQJ ZLWK WKH WLS Ă&#x20AC;JXUH ZKLFK puts the greatest pressure on it, and can lead to strain over time.

the bones of your thumb (the phalanges) without pressing on the joint, which rests snuggly and safely in the â&#x20AC;&#x2DC;grooveâ&#x20AC;&#x2122; EHWZHHQ WKH WZR Ă HVK\ EXOJHV DW WKH EDVH of your hand (the thenar and hypothenar eminences).

In addition to the pressure on your digits, thereâ&#x20AC;&#x2122;s also pressure on your wrist when youâ&#x20AC;&#x2122;re applying pressure through your hands (and the potential, over time, for wrist strain).

Thereâ&#x20AC;&#x2122;s three ways of reducing this: â&#x20AC;˘ keeping your wrist relatively straight; â&#x20AC;˘ supporting your working hand with your other hand, or using both hands together for pressure techniques; â&#x20AC;˘ and using your forearm or elbow to save your wrists entirely (as covered below).

Whenever possible, XVH WKH ÂśUHLQIRUFHG WKXPE¡ WHFKQLTXH Ă&#x20AC;JXUH 5 A, B) - using the heel of your top hand to deliver power to the underneath thumb ZKLFK UHVWV Ă DW DQG UHOD[HG RQ WKH FOLHQW¡V body (refer back to the article on Friction techniques).

One of the challenges of this technique is to keep your thumb relaxed. In fact, try to keep the whole of your underneath hand relaxed, as youâ&#x20AC;&#x2122;re only actively using the heel of your top hand in this technique. Press on

Take care not to let your wrist bend or buckle ZKHQ \RX¡UH DSSO\LQJ SUHVVXUH Ă&#x20AC;JXUH

which could strain it over time if it happens regularly.

,QVWHDG NHHS LW UHODWLYHO\ VWUDLJKW Ă&#x20AC;JXUH

but not rigid to avoid straining it, so that power is transmitted relatively undiminished to your hand. To apply

For greater pressure on a small area, use WKH SRLQW RI \RXU HOERZ Ă&#x20AC;JXUH 7KLV should be used carefully because itâ&#x20AC;&#x2122;s such a sharp tool. Guide it with your other hand for the greatest precision. This enables you to relax your shoulder, so that youâ&#x20AC;&#x2122;re more able to monitor the clientâ&#x20AC;&#x2122;s responses and adapt to them. more pressure without bending it, use the other hand on top.

Whenever possible, use your other hand to VXSSRUW \RXU ZRUNLQJ ZULVW Ă&#x20AC;JXUH RU XVH ERWK KDQGV WRJHWKHU Ă&#x20AC;JXUH WR UHGXFH WKH workload on each one.

)RU VPDOO DUHDV XVH WKH Ă DW VXUIDFH RI \RXU SUR[LPDO SKDODQJHV WKH Ă&#x20AC;UVW VHFWLRQ RI \RXU Ă&#x20AC;QJHUV JUDGXDOO\ VOLGLQJ \RXU KDQG V DZD\ from yourself. Use one hand and support it ZLWK WKH RWKHU KDQG Ă&#x20AC;JXUH RU XVH ERWK hands together, each one providing mutual VXSSRUW IRU WKH RWKHU Ă&#x20AC;JXUH ,Q WKLV latter way of working, make sure youâ&#x20AC;&#x2122;re not putting pressure on the vertebrae.

As you continue to slide your hand away from yourself, youâ&#x20AC;&#x2122;ll need to roll onto WKH VLGH RI \RXU Ă&#x20AC;VW WKH RXWVLGH HGJH WR FRQWLQXH VOLGLQJ ZLWK SUHVVXUH Ă&#x20AC;JXUH

This is also a better tool for larger muscles.

Use your other hand to support your ZRUNLQJ Ă&#x20AC;VW

7KH ÂśVRIW IRUHDUP¡ WKH EHOOLHV RI WKH Ă H[RU muscles) is ideal for applying widespread pressure (while saving your hand and your wrist entirely) for the largest muscles Ă&#x20AC;JXUH $V \RX JOLGH LW RYHU DQ DUHD guide your forearm with your other hand - to control the movement and, when necessary, to increase the pressure.

Pressure techniques probably wonâ&#x20AC;&#x2122;t cause you problems if you have large, strong hands, unless you use them too often, too forcefully, or with your digits hyperextended.

However, if you have small, slender, or K\SHUPRELOH Ă&#x20AC;QJHUV DQG WKXPEV XVH WKHVH strokes carefully and sparingly.

The thumbs and wrist are in danger of being strained in pressure techniques, particularly if you consistently have them hyperextended when youâ&#x20AC;&#x2122;re applying pressure. If you feel discomfort developing in your digits, reduce how much you use them for applying pressure or avoid using them altogether for this.

7R UHGXFH WKH SUHVVXUH RQ \RXU Ă&#x20AC;QJHUV thumbs and wrist, avoid: â&#x20AC;˘ having your digits or wrist hyperextended;

Using your index knuckle to dig into tissue would provide you with a very VSHFLĂ&#x20AC;F IRFXV RI SUHVVXUH HVSHFLDOO\ when you are focusing on a single point.

However, using it alone is hard work so, whenever possible, use your knuckles together and guide them with your other KDQG Ă&#x20AC;JXUH 7KLV ZLOO HQDEOH \RX WR work with both force and precision, for example when youâ&#x20AC;&#x2122;re working close to bones such as the vertebrae.

â&#x20AC;˘ consistently applying more pressure than is comfortable through them; Â&#x2021; XVLQJ \RXU Ă&#x20AC;QJHUV RU WKXPEV ZKHQ \RX could use larger â&#x20AC;&#x2DC;toolsâ&#x20AC;&#x2122; (your knuckles, Ă&#x20AC;VW IRUHDUP RU HOERZ

For broad sliding pressure, use your SUR[LPDO SKDODQJHV WKH VLGH RI \RXU Ă&#x20AC;VW RU your forearm. Use your knuckles or elbow IRU PRUH VSHFLĂ&#x20AC;F SRLQW SUHVVXUH $QG whenever possible, use your other hand to support and guide your working hand/ forearm.

liopsoas tendonitis is more commonly known as snapping hip syndrome, but others names given to the condition include coxa saltans and dancer’s hip.

The condition is associated with popping, FOLFNLQJ RU VQDSSLQJ VHQVDWLRQV RQ KLS ÁH[LRQ and extension. In some instances, these sensations can be accompanied by a loud noise, but are often pain-free to start with.

As the condition progresses, movement can become painful, range of motion can become reduced, and further injuries can develop, VXFK DV LQÁDPPDWLRQ RI WKH DVVRFLDWHG tendon or joint damage.

There are three types of snapping hip syndrome: internal snapping hip, external snapping hip and intra-articular snapping hip.

Also referred to as extra-articular snapping hip, these two are the most common types of snapping hip syndrome.

During internal snapping hip, the iliopsoas tendon can become tight and produces a snapping sensation or noise as it moves over the iliopectineal eminence, the bony protrusion of the pelvis, as illustrated in the images below.

Another site of internal snapping is at the hip joint. In this instance, snapping occurs

when the rectus femoris tendon moves back and forth across the ball and socket joint on ÁH[LRQ DQG H[WHQVLRQ During external snapping hip syndrome, the iliotibial band or the gluteus maximus often becomes tight and produces a snapping noise when moving over the greater trochanter of the femur.

In many cases, internal and external snapping hip can be caused by muscle imbalance and weakness, either around the hip joint or within the pelvis.

This is often due to the iliopsoas becoming shortened and tight, while the gluteus PD[LPXV EHFRPHV ZHDNHQHG RU PLVÀUHV Alternatively the gluteus maximus, minimus and medius can become tight and shortened, leading to restricted movement within the hip joint.

However, if one muscle demonstrates restricted movement and tension upon testing, often secondary muscles within the area and opposing muscles will also be affected.

In contrast to extra-articular snapping hip, intra-articular snapping hip is linked to mechanical changes in the hip joint itself, such as an acetabular labral tear, loose bodies within the joint, cartilage defects and biomechanical changes. As a result, the condition can take much longer to resolve. Further investigation with the use of X-ray and MRI may be needed to identify the cause of intra-articular snapping hip, which would obviously require referral to a consultant.

Sports or deep tissue massage can be used to reduce tension in the associated muscles and the ‘snapping’ tendon. Massage application should focus on treating the associated muscle and surrounding area, including the quadriceps, and paying particular attention to the rectus femoris and the origin of the associated muscle.

Treatment should also cover the adductor muscle group, along with the tensor fascia lata, and gluteus medius, minimus and maximus. If treatment time allows, stripping the iliotibial band and coverage of the hamstrings will help to improve range of motion around the hip joint. It’s also useful to close the treatment with passive or PNF

(proprioceptive neuromuscular facilitation) stretching, to help address muscle memory and maximise range of motion at the joint.

Advising rest from sport or exercise programmes while symptoms cause pain will allow the condition time to heal.

Alternatively, active rest can also be advised.

This would involve reducing activities that are hip focused and switching to upper body H[HUFLVH VXFK DV VZLPPLQJ ZLWK D Ă RDW between the legs or using an arm bike.

7R PD[LPLVH WKHUDS\ EHQHĂ&#x20AC;WV EHWZHHQ treatments, the client can use a myofascial

release ball to help reduce tension in the muscles around the hip. Using the palm, the FOLHQW FDQ UROO WKH EDOO ZLWK Ă&#x20AC;UP SUHVVXUH RYHU the muscles at the front of the hip and thigh, to the side of the hip, down the iliotibial band and over the gluteal muscles.

The stretches in Table 1 will help to maintain muscle function and length, and reduce muscle tension. While symptoms are present, ideally these stretches should be done two to three times daily, to aid muscle memory and movement. Each stretch should EH KHOG IRU WR VHFRQGV

Stabilising the pelvis through core development can help to improve long-term stability. In some instances, stabilisation of the gluteus medius may also be needed.

Useful core stabilisation exercises include forward plank, side plank, the bridge, back extensions, alternative arm to leg lift, and the side clam (for the gluteus medius).

Again, while symptoms are present, these exercises should be done two to three times GDLO\ ZLWK HDFK SRVLWLRQ KHOG IRU WR seconds.

his wet, gluey abundant connective tissue network functions as our body’s shock absorber, it literally absorbs every impact that we encounter throughout our life – from our embryological beginnings through to today. Every single stumble, trip or fall impacts our fascial system, causing the fascia to lose its physiologically adaptive structure. This is commonly referred to as “binding down”.

As our shock absorber, very minor accidents such as stumbling over a curb or jolting when a train stops - so small they are often not considered injurious – will affect the fascial system. These small impacts are cumulative. As fascia absorbs these shocks it changes in structure, it starts to dehydrate, ELQG GRZQ DQG GHQVLI\ 6XSHUÀFLDO IDVFLDO

restrictions are visible to the naked eye and can be readily palpated; restrictions deep in the system (beyond the original injury or impact) can by palpated by a trained therapist.

These fascial restrictions – initially perhaps – seem as though they have made little or no impact upon us, they do not cause immediate pain or seem to restrict movement or impede function.

However, restrictions in any part of the three dimensional network that is fascia, can impose negative stress on adjacent, as well as distant structures. This can lead to compensations throughout the whole system.

Most of us, as well as sustaining a multitude of stumbles have had bigger impact injuries, falls for example - off ladders, out of trees, off horses, during

sport, tripping upstairs etc. Our fascial system will have absorbed all of these - perhaps again without any obvious issues apparent at the time of impact. However, all of these injuries cause the ground substance to dehydrate, GUDZLQJ FROODJHQ Ă&#x20AC;EUHV FORVHU WRJHWKHU FUHDWLQJ density in the fascia & causing compensations throughout the fascial system â&#x20AC;&#x201C; which is why clients will frequently say things like â&#x20AC;&#x153;I was just SLFNLQJ XS D SLHFH RI SDSHU IURP WKH Ă RRU DQG my back went.â&#x20AC;? What has actually happened here? Finally the fascial system which has taken countless minor trauma impacts (as well as some bigger impacts), has compensated & compensated and is now too bound down, and unable to respond to the demands made upon it. The bound down fascia has lost its contractibility, and is now compromising other areas and structures, perhaps causing nerve impingement. It may seem as though the symptoms have appeared suddenly, however the fascial system has been progressively compromised over the years, in fact over our entire life.

More severe injuries, such as whiplash, will also impact the fascial system in the same way as above. Impact sports such as rugby, American football, even running (especially on tarmac), will have a high impact on the fascial system: think about the repercussions of pounding on a pavement on the shock absorbing fascia, and think about the ricochet of sensations that pass through the body with each step. Patients who have engaged in impact sport over a long period present with systemic damage to their fascial system, and may require a course of treatment to improve the condition of the fascia and therefore its function.

Other impacts or injuries that are frequently overlooked are those sustained in utero, during labour and delivery, (think of the pressures imposed on the baby during a vaginal birth, as it descends the birth canal and is eventually ejected into this world and born). These pressures all impact the fascial system causing restrictions and therefore compensations.

Let us now look at other factors that will negatively affect or compromise the fascial system. â&#x20AC;&#x201C; quickly fosters the development of additional cross-links LQ IDVFLDO WLVVXHV 7KH Ă&#x20AC;EUHV ORRVH WKHLU elasticity and do not glide against one another, become stuck together and form

tissue adhesions. An immobilized joint â&#x20AC;&#x201C; for example - after a few weeks will have limited PRELOLW\ DV FKDRWLF JURZWK RI FROODJHQ Ă&#x20AC;EUHV form in all directions. impact the fascial system, as chronic mechanical stress (caused by repetitive movements) results LQ LQFUHDVHG OD\LQJ GRZQ RI FROODJHQ Ă&#x20AC;EUHV - as protection - and decreased hydration of the ECMâ&#x20AC;&#x2122;s ground substance. Before the popularisation of fascial techniques, we ZRXOG KDYH DGGUHVVHG VSHFLĂ&#x20AC;F PXVFOHV LQ cases of repetitive strain injuries, now we would address the fascial restrictions found in the related area, as well as beyond.

â&#x20AC;&#x201C; can have its roots in either physical or emotional experiences, and will impact the fascial system. Fascia is a bio-tensegrity system, which adapts to the demands placed upon it, therefore habitually poor posture, which continually overloads the system, will damage fascia and cause dysfunction along the lines of the tension imposed. When body segments are pulled out of alignment and muscles are required to maintain static positions â&#x20AC;&#x201C; either stretched/contracted (â&#x20AC;&#x153;locked longâ&#x20AC;?) or shortened/contracted (â&#x20AC;&#x153;locked shortâ&#x20AC;?) â&#x20AC;&#x201C; we see increased fascial bonding and thixotrophy (thickening) of the surrounding extracellular matrix (ECM).

In cases like this we will always need to OHQJWKHQ WKH Ă&#x20AC;EURWLF VKRUWHQHG WLVVXHV Ă&#x20AC;UVW to allow the other structures to rearrange and support the body in its â&#x20AC;&#x153;newâ&#x20AC;? original position. surgeries compromise the fascial system in several ways, multiple layers of fascia are cut during surgery and the naturally hydrated tissues dehydrate. As the eminent plastic surgeon Jean-Claude Guimbertueau has shown; during surgery the structures quickly dry up when exposed to the atmosphere or to the heat emitted by the lights in the operating theatre. These GHK\GUDWHG Ă&#x20AC;EUHV DGKHUH WR HDFK RWKHU DV well as the surgical instruments.

During post-surgical healing collagenous Ă&#x20AC;EUHV RQH RI WKH PDLQ FRPSRQHQWV RI fascia) are laid down in a haphazard fashion, to provide strength to the weakened, compromised incision site and beyond.

7KHVH Ă&#x20AC;EUHV IRUP D ODUJH SRUWLRQ RI WKH visible and palpable scar tissue.

Unfortunately â&#x20AC;&#x153;Scar-tissue formation is D QRQ VSHFLĂ&#x20AC;F SURFHVV QDWXUH GRHV QRW repair and re-shape living matter exactly as it was before injury, the results are often disappointingâ&#x20AC;? . However myofascial release techniques can help to restore tissue structure which is compromised during the formation of the scar.

The external appearance of a scar can be misleading, because it does not always indicate the extent of the tissue destruction beyond. This is where our skill as manual bodywork therapists comes into its own; with patience and practice we can learn to feel beyond our hands, deep into the fascial system. With

sensitive, experienced hands we can palpate initially the restrictions and then the release in the tissues as they â&#x20AC;&#x153;let goâ&#x20AC;? and rehydrate, returning to health.

To be clear, Guimberteau states that adhesions are often referred to as scar tissue, but in reality adhesions are a complication of scar tissue, which is the result of a wound, such as a surgical incision. Adhesions are also amenable to change, by manual therapy. have a very negative impact on the fascial system, burnt areas are visibly bound down as well as palpable. The external force of the heat dehydrates many tissue layers, strands of FROODJHQ Ă&#x20AC;EUHV DUH GUDZQ FORVHU WRJHWKHU creating a dense adhered tissue mass, which loses its dynamic and adaptable structure.

Radiotherapy and chemicals also cause burn injuries; all burns can be effectively treated with great patience and sustained myofascial techniques. For those of you IDPLOLDU ZLWK 0)5 WUDQVYHUVH KROGV RU Ă DW hand compressions are effective when maintained for several minutes or more. part of the immune response occurs as a result of exposure of tissues and organs to harmful stimuli

such as microbial pathogens, irritants, or toxic FHOOXODU FRPSRQHQWV 7KH ,Qà DPPDWRU\ SURFHVV compromises the fascial system; this can be in response to injury (as above), where the LQà DPPDWRU\ UHVSRQVH LV SDUW RI WKH ERG\¡V natural healing process, disease or as side effects to medication. Adhesions may form in WKH SUHVHQFH RI LQà DPPDWRU\ GLVHDVH VXFK DV Crones, Endometriosis, Rheumatoid or Psoriatic Vasculitis, Celiac disease) or conditions such as complex regional pain syndrome.

7KH LQĂ DPPDWRU\ UHVSRQVH FUHDWHV LPEDODQFH LQ WKH FHOOXODU Ă XLGV UHVXOWLQJ LQ IDVFLDO DGKHVLRQV LQ VFDU WLVVXH Ă&#x20AC;EULOV WKLFNHQÂŤ this creates stiffness and loss of mobility and LQWHUIHUHV ZLWK WKH DELOLW\ RI WKH Ă&#x20AC;EULO WR VOLGH over each other and adhesions are formed.

D YHU\ EULHI GHĂ&#x20AC;QLWLRQ RI WUDXPD LV that it is an occurrence or series of occurrences that overwhelm the body, this can be either physical, emotional or both and will impact the fascial system.

To understand how trauma is stored in the physiology of the body: Just pause for a moment, sit comfortably and think about a deeply upsetting incident that has occurred to you (take your time over this). As you recall this incident notice want happens in your body, what bodily sensations arise? The sensations

you are feeling are impacting the physiology of the body, impacting the fascial system and creating fascial restrictions. Are the areas you notice familiar to you? Are you aware of your own holding patterns?

My experience as a bodywork therapist shows me that emotional trauma is frequently held in the diaphragms of the body (sometimes referred to as transverse slings or body straps).

At all these junctures there are fascial rich structures, creating transverse bands through the body, these frequently hold the emotional component of injury. To an advanced MFR therapist, these fascia restrictions can be palpated beyond the hands and with the correct touch and holding can be released, enabling the emotion to be processed slowly and safely. I will discuss this further in another article.

To conclude, the fascial network binds down, caused by the various factors and pathologies mentioned above; restrictions are created in the area of injury, as well as further into the fascial network. Restrictions and compensations throughout the entire system affect function, as the whole dynamic 3D system is impeded. Bound down fascia can cause pain and decrease mobility, it can also compromise all body systems, for H[DPSOH UHVWULFW FDUGLR YDVFXODU Ă RZ O\PSK Ă RZ FRPSURPLVH WKH IUHH Ă RZ RI LQWHUVWLWLDO Ă XLG DQG LQWHUUXSW WKH WUDQVPLVVLRQ RI QHUYH impulses.

Fortunately all the fascial restrictions mentioned above can be palpated and treated by the trained therapist, relieving symptoms, improving function, restoring homeostasis and therefore health.

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My membership’s running out and I’m not sure whether to stay with my current association or move to another” or even “I’m not sure I see the point of renewing… what do I get for my money?”

That might be because, originally, the main reason you joined an association is because a friend let you know that you could get cheaper insurance if you belonged to a certain association.

Maybe when you were starting out also found it really helpful to get to know a few people and discover opportunities, which is also a valuable function of a professional association, the networking aspect – whether in person or on-line.

The drivers also come from external forces. For instance, it’s also the case that some places where you practice or volunteer will require you to belong to a professional association of some kind and this makes sense because it is one way of acknowledging that you are working to an industry standard FRGH RI FRQGXFW DQG HWKLFV 7KHUH DUH RWKHU EHQHÀWV LQ FRPLQJ together under a common umbrella: while not everyone makes use of the membership logos that associations provide on their business card, website or social media, a good number do, realising that it may add some credibility or demonstrate you work to high standards.

So what else is a professional association there to do for you? Some answers might be: • +HOS FOLHQWV ÀQG PH • 2UJDQLVH JRRG &3' RSSRUWXQLWLHV • .HHS PH XS WR GDWH YLD QHZVOHWWHUV PDJD]LQHV

Are these alone worth the subscription cost? Therapists are notoriously price sensitive – feeling that there is something to be paid out for with not much in return.

This is the nub of a real issue. The other thing that therapists are notorious for is not being great at marketing themselves – especially when they set out. Is there something that can be done about this and help therapists in the area in which many of them tend to struggle?

When ThinkTree Hub was formed, this was one of the key questions that we asked ourselves. How can we truly support therapists and act with a much wider remit. Our vision was to help equip therapists with the tools they needed for their

success. Thatâ&#x20AC;&#x2122;s why we partnered with The Therapists Business Club, Aroma Beeâ&#x20AC;&#x2122;s and Optimal Vitality so all members have access to opportunities for coaching and mentoring.

2XU DLP LV WR SURYLGH WKH ZLGHVW UDQJH RI EHQHÃ&#x20AC;WV RI DQ\ DVVRFLDWLRQ ² PDNLQJ WKH Ã&#x20AC;QDQFLDO JDLQV IDU RXWZHLJK DQ\ cost of joining. One way we do this is to get all our listed training provider partners to offer discounts on their CPD and TXDOLÃ&#x20AC;FDWLRQ FRXUVHV WR PHPEHUV ,I WKHUH·V D FRXUVH \RX NQRZ you want to doâ&#x20AC;¦ it makes sense to come via our site. You PLJKW HYHQ Ã&#x20AC;QG WKDW WKH VDYLQJ RQ RQH FRXUVH RXWZHLJKV WKH cost of joining 2XU YLVLRQ RI SDUWQHULQJ ZLWK H[SHUWV LQ WKHLU Ã&#x20AC;HOGV DOVR means our members have access to industry-leading courses.

Because education itself it really dear to us we also support those of you who are thinking of branching into training but QHHG D OLWWOH VXSSRUW WR IHHO FRQÃ&#x20AC;GHQW LQ UXQQLQJ RU LPSURYLQJ FRXUVHV :H KDYH EHJXQ WR RIIHU WKH FRQÃ&#x20AC;GHQFH EXLOGLQJ training you need at a value-for-money price.run by education experts.

Our one day â&#x20AC;&#x2DC;Planning Successful Coursesâ&#x20AC;&#x2122; training is generating exceptional customer feedback, the content of which has been carefully distilled from a lifetime working in teaching, managerial and quality assurance roles within colleges and universities, internationally and across the UK. This modular programme succinctly presents all the essential knowledge and skills practitioners and training providers need to plan, deliver, assess and evaluate their own high quality CPD or accredited training courses.

The newly launched ThinkTree Online Learning Hub demonstrates our commitment to CPD, with both free and paid training materials uploaded every month. ThinkTree members automatically receive up to 50% discount with a unique voucher code. Newly launched programmes include:

â&#x20AC;&#x201C; a uniquely sequenced and progressive series of lessons and linked quality management resources GHVLJQHG VSHFLÃ&#x20AC;FDOO\ WR VXSSRUW \RX WR HVWDEOLVK RU GHYHORS HIÃ&#x20AC;FLHQW TXDOLW\ DVVXUDQFH F\FOHV WR XQGHUSLQ \RXU HGXFDWLRQ and training courses This is a service aimed at all the highly experienced therapists out WKHUH 7KH\ DUH KLJKO\ VSHFLÃ&#x20AC;F DGYDQFHG OHYHO WUDLQLQJV offering deeper learning concepts and showcasing practical strategies. The kind of training youâ&#x20AC;&#x2122;d love to do to take your WKHUDSLHV WR WKH QH[W OHYHO EXW ZKLFK LV RIWHQ KDUG WR Ã&#x20AC;QG DW a local level. â&#x20AC;&#x201C; provides exceptional value for money as you can study the course materials on-demand from the comfort of your own home.

Weâ&#x20AC;&#x2122;re also pioneering other training topics centred on what you need as an individual. These include vital areas such asâ&#x20AC;&#x2122; the development of business and management skills, harnessing the power of social media, utilising technology to support and automate essential business functions plus general marketing and promotion strategies that grow your businesses.

Our approach for all our members is to provide guidance and support throughout their career with incentives such as: â&#x20AC;¢ )LQG D WKHUDSLVW RQ WKH ZHEVLWH â&#x20AC;¢ 'LVFRXQWHG LQFHQWLYHV WR LQFOXGH SURGXFWV DQG VHUYLFHV IRU \RX DQG \RXU EXVLQHVV â&#x20AC;¢ ( 0DJD]LQH â&#x20AC;¢ 1HZVOHWWHU â&#x20AC;¢ :HELQDUV â&#x20AC;¢ %ORJV DQG VRFLDO PHGLD FRPPXQLWLHV â&#x20AC;¢ ,QWHUQDWLRQDO 3URIHVVLRQDO 5HFRJQLWLRQ â&#x20AC;¢ %XVLQHVV DQG SUDFWLFH VXSSRUW IURP H[SHUWV â&#x20AC;¢ *OREDO LQGXVWU\ DQG LQQRYDWLYH UHVHDUFK QHZV

This is just the beginning as we are building relationships with other partners to offer even more incentives.

ThinkTree doesnâ&#x20AC;&#x2122;t stop at therapists and training providers, we are in the business of educating those who are interested in health and wellbeing but not yet trained. Therefore, we have an DIÃ&#x20AC;OLDWHV FDWHJRU\ ZKLFK DOORZV LQWHUHVWHG SHRSOH WR MRLQ DQG sample the courses and also take advantage of incentives such as products and services. Our mantra is â&#x20AC;&#x2DC;prevention is better than cure and an informed choice is essential â&#x20AC;&#x2122;, which is why our newsletters, blogs, research updates and webinars will help keep you informed and give you the choice to carve out a career in health and wellbeing.

Because we have a global reach we can share good practice and showcase highly successful research and methodologies used internationally for our members. Examples include Our Turkish trainers, Hamman Massage, can bring you authentic treatments â&#x20AC;¦ etc or Aufgas from Brussels, whoâ&#x20AC;&#x2122;s focus is on aromatherapy in SPA treatments. We have professionals who have joined us from areas such as Darwin Australia, Cape Town in South Africa, Jerusalem in Israel and Turkey who name a few, which is fast growing.

A BRAND NEW one day course to support Johnsâ&#x20AC;&#x2122; Vital Glutes Book!

In â&#x20AC;&#x2DC;The Vital Glutes & Psoasâ&#x20AC;&#x2122; Master-Class osteopath, author and respected bodywork specialist John Gibbons looks at two of the most neglected areas of the body: the gluteal & psoas muscles. <RX·OO OHDUQ KRZ WR LGHQWLI\ VSHFLÃ&#x20AC;F VRIW tissue dysfunction and weakness within the gluteal & psoas musculo-skeletal system, and to harness powerful 0XVFOH (QHUJ\ 7HFKQLTXHV DQG VSHFLÃ&#x20AC;F exercises to restore function to your athletes and patients.

Develop an increased understanding of advanced soft tissue techniques. <RX ZLOO JDLQ D JRRG XQGHUVWDQGLQJ RI VRIW WLVVXH release (STR), muscle energy techniques (MET), strain-counterstrain (SCS) and positional release 35 <RX ZLOO DOVR OHDUQ DGYDQFHG P\RIDVFLDO techniques in which we will focus on the area RI WKH ORZHU OXPEDU VSLQH VSHFLÃ&#x20AC;F VKRXOGHU problems and neck pain as well as other areas of the body; these techniques once learnt can then be employed immediately into your repertoire of soft tissue skills so that you can successfully treat more patients with a variety of musculo-skeletal problems.

Deepen and increase your ability to treat shoulder problems This one-day course is very intense and on completion you will have the knowledge and practical experience necessary to identify, assess and treat VSHFLÃ&#x20AC;F G\VIXQFWLRQ ZLWKLQ WKH VKRXOGHU complex, which will in turn lead to greater treatment success, happier FXVWRPHUV DQG D PRUH SURÃ&#x20AC;WDEOH business.

o on- be honest. What do you think? 100? 500? Surely not more than that! After all you are a mindful massage therapist, right?

Would it shock you to know that the AVERAGE user in the UK touches their smartphone over WLPHV per day! And thatâ&#x20AC;&#x2122;s just the average user â&#x20AC;&#x201C; the heavy users amongst us (probably all of those running our own businesses) are proper addicts with 5,400 touches per day.

And that is just your phones. Add to that computer use, tablets, a love of gaming and you start to have an idea about the amount of time per day we spend staring at screens, WDSSLQJ DQG FOLFNLQJ VZLSLQJ DQG VXUĂ&#x20AC;QJÂŤ Surely that canâ&#x20AC;&#x2122;t be good for us? Wasnâ&#x20AC;&#x2122;t the online revolution supposed to free us from hordes of paperwork, enabling us to do things quickly and easily on the go? Yet instead as a nation we are glued to our phones, heads down, swiping, touching, checking social media, having torrents of information coming at us faster than we can even process. The paperwork we hoped to leave behind is now just being carried around with us every minute of every day. (FIG 1) We are all addicts and we donâ&#x20AC;&#x2122;t even realise how much this new lifestyle is taking its toll. Reliance on technology is negatively affecting us on every level â&#x20AC;&#x201C; mental, physical and social.

Yet with every problem comes an opportunity. Our dependence on technology means that the general public is hungering

for the very genuine and vital form of communication provided by massage therapists via the medium of touch.

Technology is causing us real problems and the informed and skilled massage therapist is ideally placed to â&#x20AC;&#x153;reach out and touch someoneâ&#x20AC;? as the song goes!

Research is increasingly showing us that our over reliance on technology can have serious effects on our psychological feelings of well - being. In particular our brains have just not evolved to cope with the amount of information they are trying to absorb on a daily basis.

Our constant checking of our phones or emails is in effect training our brains to be permanently distracted. This has serious knock on effects for our ability to think and concentrate.

The constant restlessness and distractibility of the average technology user is linked to increased depression, anxiety and â&#x20AC;&#x201C; in the case of gamers- aggression. It is also affecting our ability to be contemplative, to engage in WKH NLQG RI IUHH Ă RDWLQJ LPDJLQDWLYH WKLQNLQJ that is conducive to imagination, new ideas and relaxation.

Worryingly it is also affecting our ability to be empathic â&#x20AC;&#x201C; to tune into what others around us are feeling. You have probably experienced this yourself at some point â&#x20AC;&#x201C; maybe when you were baring your soul to a friend or family

member only to have them glance distractedly at their bleeping phone as you were speaking.

â&#x20AC;&#x153;Life is too sweet and too short to express our affection with just our thumbs.

Touch is meant for more than a keyboardâ&#x20AC;?

Kristin Armstrong So what does this have to do with you as a massage therapist? First of all, it is important to realise that more and more folks are craving the beauty of silence and meaningful contact.

And YOU can provide that - more than ever the world needs those who are working with the â&#x20AC;&#x153;hands, the head and the heartâ&#x20AC;? (FIG 2) Touch is a basic human need, yet we are forsaking the genuine connection of touching others for the mindless contact of touching our phones. As our swiping, tapping and clicking increases, we are at the same time diminishing the possibility of meaningful human touch within our society.

Touch is a necessary part of human development and our feelings of well-being.

Research has shown that touch: â&#x20AC;˘ Inspires positive thinking and expands trust â&#x20AC;˘ Reduces social anxiety and stress â&#x20AC;˘ Boosts the immune system and lowers blood pressure

As the habits of technology take their toll, people everywhere are starting to recognise and pay for the privilege of literally being “switched off”. Retreats are proud to advertise themselves as “unplugged”, mindfulness courses are everywhere and stressed out hipsters are reverting to their “unsmart” Nokias to try and stem their addictions.

You too can capitalise on this trend whilst genuinely helping others.

Massage can do so much to ease the stresses of modern daily living. Providing time for your clients away from their technology is becoming increasingly precious. Make sure you let people know in your advertising the beauty DQG EHQHÀW RI ZKDW \RX SURYLGH

Your phone is not just a pain to your peace of mind but also to your hands, wrist and neck. Massage can not only help the “techno generation” through the provision of pure, beautiful relaxation but also through providing pain relief for many of the ailments associated with technology use.

We have probably all heard about carpal tunnel syndrome but how about blackberry

thumb, gamers wrist, ravers wrist, Rubiks wrist DQG VW\OXV ÀQJHU" 7RGD\·V ZRUOG QHFHVVDULO\ involves a staggering amount of activities that require the day to day use of our hands and arms, not just for work but leisure time too. This inevitably leads to pain and injury as our poor limbs and digits beaver away to try and keep up with the ever increasing demands of our techno driven lifestyle. Stop and think for a minute about what you have done today- answered some emails, texted a few personal and business associates, surfed the web for that new holiday and this is even before you have embarked upon your incredibly hand intensive occupation of massage!

It’s not surprising that repetitive strain injury (RSI) is one of the biggest causes of time off work in the UK. The health and safety executive estimated that in 2017/18 approximately 197,000 people in Great Britain suffered from an ULD (upper limb disorder). This caused a loss of 2.6 million working days.

The good news is that massage therapists and other bodyworkers are ideally placed to treat these conditions as they usually stem from overuse of soft tissue structures (combined with other psychological and social factors).

Many conditions can be resolved within 1-6 weekly treatments with a combination of trigger point work, myofascial release and appropriate stretching techniques. Other conditions may need a longer period of gently supporting the body back to health; again massage therapy can be the key modality to promoting healing.

Imagine the impact on your business through being able to treat these conditions FRQÀGHQWO\ DQG VXFFHVVIXOO\ , KDYH KDG excellent results in my own clinic in treating these disorders and in many cases have been able to help clients avoid surgery or more invasive medical treatment.

There are so many conditions affecting the hands and wrists it I easy to feel confused.

Here is a simple guide to the different conditions out there and tips for successful treatment:

In recent years, CTS has become a catchall diagnosis for any pain in the hand and wrists. It is important to realise that there are many other conditions that can cause symptoms in these areas and some of these will be discussed later in this article. True &76 KDV TXLWH D VSHFLÀF GHÀQLWLRQ LW is impingement of the median nerve ZLWKLQ WKH FDUSDO WXQQHO ),*

The carpal tunnel is an oval passageway created by the structures of the wrist. The carpal bones create the bottom of the tunnel and the transverse carpal ligament, also NQRZQ DV WKH Ă H[RU UHWLQDFXOXP IRUPV WKH WRS RI WKH WXQQHO ),* ,Q HDFK LQGLYLGXDO WKH FDUSDO WXQQHO LV D Ă&#x20AC;[HG VSDFH DOWKRXJK LW FDQ vary in size from one person to the next.

The median nerve: This is one of the three nerves that innervate the forearm and hand: the other two are the ulnar and the radial nerves.

The median nerve has to pass through the Ă&#x20AC;[HG VSDFH RI WKH FDUSDO WXQQHO WRJHWKHU ZLWK other soft tissue structures including the nine WHQGRQV RI WKH IRUHDUP Ă H[RU PXVFOHV :LWK so many structures passing through a small space, it is easy to see how carpal tunnel syndrome can develop. If the amount of space in the tunnel is decreased, the pressure on the median nerve can increase causing the classic nerve impingement symptoms of CTS including:

â&#x20AC;˘ Pain, numbness and weakness of the hand. Pain is classically felt in the palmar side of the wrist radiating into the hand, typically affecting the palm, thumb, index Ă&#x20AC;QJHU WKLUG Ă&#x20AC;QJHU DQG ODWHUDO KDOI RI WKH ULQJ Ă&#x20AC;QJHU 7KLV LV WKH LQQHUYDWLRQ SDWWHUQ of the median nerve) â&#x20AC;˘ Loss of function of the hand if severe and not treated. Untreated CTS can result in permanent nerve damage, as nerve tissue cannot regenerate.

Orthopedic tests can help you determine whether the entrapment is at the carpal tunnel or from other soft tissue VWUXFWXUHV 7UHDW WKH ZULVW Ă H[RUV H[WHQVRUV and include the cervical and shoulder girdle area with advanced soft tissue techniques such as trigger point and MFR. Use fascial techniques around the palmar fascia and wrist to release pressure in the carpal tunnel.

Thoracic Outlet Syndrome can cause very similar symptoms to CTS (ie: tingling and numbness down the arm and hand) yet can be very easily resolved through appropriate massage therapy and stretching.

Like CTS, Thoracic Outlet Syndrome is a nerve impingement syndrome. The crucial difference in this case is that the nerve impingement does not take place near the carpal tunnel but instead at the neck or in some cases the chest. If we trace the nerves of the hand and forearm back â&#x20AC;&#x153;upstreamâ&#x20AC;? to WKHLU VRXUFH ZH Ă&#x20AC;QG WKDW WKH\ DOO FRPH IURP D common origin- the brachial plexus. (FIG 5) The brachial plexus is a network of branches of spinal nerves C5-T1. If you look at an anatomy book you will see that the brachial plexus passes not only between the

scalene muscles in the neck but also between the pectoralis minor (deep to the pectoralis major in the upper chest) and the ribs. It then branches into the nerves of the arm, the most important of which are the radial, median and ulnar nerves.

So what do you think might happen if the scalenes or the pectoralis minor become tight as they are very likely to do from our habitual rounded shoulder/ head forward position of GHVN DQG FRPSXWHU ZRUN" 7KDW¡V ULJKW 7LQJOLQJ numbness and pain down the arm â&#x20AC;&#x201C; your FODVVLF ´FDUSDO WXQQHOÂľ V\PSWRPV ),*

Use trigger point and myofascial techniques to release myofascial restrictions in the tissues â&#x20AC;&#x201C; focus on scalenes and pectoralis minor. Advanced stretching and soft tissue release will enable the tissue to return to a normal resting length and minimise the risk of compression.

Over-use injuries are often of slow onset; you start to get some pain, you ignore the pain and keep typing or massaging, re-injuring the tissues, causing more tissue damage. (FIG 7) Tendons become irritated, the repetitive stress causes micro WHDULQJ RI WKH PXVFOHV OHDGLQJ WR LQĂ DPPDWLRQ and scar formation. In the early stages of injury the pain may be mild and only when doing the offending activity. Eventually without intervention, the severity of the pain increases and may also be present at rest and during other activities such as writing, picking up a kettle, carrying a bag or picking up a child.

It is important to realise that RSI is usually associated with other psychological and social factors such as feeling out of control at work or overwhelmed.

Overuse tendon pathologies (tendinopathies) are common soft tissue disorders caused by repetitive or excessive stress.

Some classic tendinopathy conditions are: â&#x20AC;˘ Tennis Elbow (Lateral epicondylitis): This is degenerative damage to the common extensor tendon of the forearm muscles.

(FIG 10) â&#x20AC;˘ Golfers Elbow (medial epicondylitis): degenerative damage to the common WHQGLQRXV RULJLQ RI WKH ZULVW Ă H[RUV

In my clinical experience, hand and wrist pain that results from long term overuse usually needs a more gentle and long term approach. Gentle myofascial work combined with craniosacral therapy seems to get better results than intensive trigger point work as the body can be very sensitive. Check in with your client at each session about whether they experienced any post- treatment discomfort and modulate your techniques accordingly.

Blackberry thumb has become the common term for a form of repetitive strain

injury caused by the frequent use of the thumb(s) to press buttons on smart phones, or other mobile devices. The medical name for this syndrome is De Quervains syndrome â&#x20AC;&#x201C; a degenerative process affecting the tendons at WKH ZULVW WKDW PRYH WKH WKXPE VSHFLĂ&#x20AC;FDOO\ WKH extensor pollicis brevis and abductor pollicis ORQJXV ),*

Dequervains typically presents with pain on the lateral aspect of the wrist. A simple diagnostic test is to put your affected hand as if you were hitchhiking and then tuck the thumb inside the closed Ă&#x20AC;VW ,I LW KXUWV ZKHQ \RX PRYH \RXU Ă&#x20AC;VW WRZDUGV WKH Ă RRU XOQDU GHYLDWLRQ WKHQ this is a positive sign for 'HTXHUYDLQV )LJ

Traditional tried and tested methods for tendinopathies including â&#x20AC;&#x153;blackberry thumbâ&#x20AC;? include myofascial and other soft tissue work to the corresponding PXVFOHV DQG FURVV Ă&#x20AC;EUH IULFWLRQ WR WKH LUULWDWHG tendons. Use supportive nurturing work like Swedish, hot stone and cranial work.

The informed massage therapist will never forget that chronic pain patterns are often caused by trigger points. Incorporating trigger point therapy into your massage work will enable you to provide dramatic relief to many chronic pain conditions - hand and wrist problems are no exception. Very often myofascial trigger points are the sole cause of pain, numbness, tingling, stiffness, burning RU VZHOOLQJ LQ WKH KDQGV DQG Ă&#x20AC;QJHUV 7ULJJHU points in the scalenes or pectoralis minor (FIG 11A and 11B) can cause the muscle to shorten leading to Thoracic Outlet symptoms. Numbness in the hands and Ă&#x20AC;QJHUV FDQ DOVR EH FDXVHG E\ WULJJHU SRLQWV LQ the serratus posterior, serratus anterior, triceps, coracobrachialis, brachialis, supinator, extensor FDUSL UDGLDOLV EUHYLV Ă H[RU FDUSL XOQDULV Ă H[RU digitorum and pronator teres.

(FIG 12A and 12B)

7KLV ERRN H[SORUHV WKH LQĂ XHQFH WKDW WKH 6WHFFR PHWKRG KDV KDG RQ PRGLI\LQJ the clinical practice of Fascial Manipulation carried out by an international group of highly experienced practitioners. Fascial Manipulation is based on a model that LQĂ XHQFHV D QHZ SDUDGLJP IRU WKH P\RIDVFLDO VNHOHWDO V\VWHP DQG LV D PHWKRG that has been well received by physiotherapists, osteopaths, chiropractors and massage therapists. There is an absence of research published into this method, however this book provides valuable clinical expertise and judgment as contributors present and explain a series of case reports. They each discuss how their understanding of the musculoskeletal system and the role of the fascia in interactions between musculoskeletal and internal systems has changed since encountering this approach and what impact this has had on their practice.

Their opinions can be valuable to anybody interested in approaching fascial work and their personal accounts will provide ulterior historical background to the development of Fascial Manipulation itself.

This beautifully designed book is written in a clear, approachable style, aimed at DQ\RQH VWXG\LQJ UHĂ H[RORJ\ DW OHYHOV RU )RU XVH ERWK LQ WKH FODVVURRP DQG as a home study resource, it provides everything the student needs to meet the curriculum requirements of all the major awarding bodies. &RQWDLQV GHWDLOHG &DVH VWXGLHV KDQG UHĂ H[RORJ\ SDWKRORJ\ DQDWRP\ DQG much more.

The textbook for Anatomy and Physiology for Therapists and Healthcare Professionals provides all of the necessary information for anybody studying anatomy and physiology at level 2 or 3. Containing comprehensive pathology of all body systems, along with detailed and accurate anatomical drawings, it meets the standards required by all of the main professional bodies for massage, aromatherapy DQG UHĂ H[RORJ\ $W WKH HQG RI HDFK FKDSWHU WKHUH LV D VWXG\ RXWOLQH and also multiple-choice questions to help students revise. This textbook stands out from the others as it contains many unique features that other textbooks do not include and is the only resource students would need to complete their studies.

Ruth has also created a workbook which complements the Anatomy and Physiology textbook, that can be used in conjunction with any other anatomy textbook at level 2 or 3. It is the perfect study and revision aid and can be used either in class or as a separate self-study resource. It contains vocabulary tests, multiple-choice questions, mock exam papers and much more.

Dr Ruth Hull has been working in natural health for nearly 20 years as a therapist, lecturer and writer. She is a registered Homoeopathic 'RFWRU 5HĂ H[RORJLVW $URPDWKHUDSLVW DQG +HDOWK &RDFK 5XWK KDV published three books, lectures at university level and regularly presents at health conferences and seminars while continually furthering her own education in Integrative Health and Functional Medicine. Ruth has a private practice in Perth, Australia, and an online health coaching practice for individuals looking to improve their health through changing their lifestyles.

ew contacts, new ideas, helpful information and guidance in areas of running a business that you either haven’t thought about, you have thought about but dismissed, have thought about but keep avoiding (yep, been there!).

Many of us work on our own and networking is a way of meeting other small businesses owners. It can be very lonely working on your

own. You have to self motivate and action those parts of the business you either don’t enjoy or maybe don’t know how to do.

Attending networking groups/meetings can be an excellent way of giving you the guidance and the boost you need to progress.

But how do you know which networking group or meeting to attend?

There are sooooo many out there!

• The best way to start is by doing some research.

• Speak to friends who also run their own business. What groups/meetings do they attend?

• Search online for the more local groups.

Some groups are free, some charge a fee. Those that charge a fee should allow you to visit at least once free of charge.

â&#x20AC;˘ Think about what you want to gain from attending the group/meeting. â&#x20AC;˘ Many groups meet regularly.

Some require you to attend each month, while others are more â&#x20AC;&#x2DC;ad hocâ&#x20AC;&#x2122;.

can connect with others who have a passion for therapies. Here, you can hear from excellent speakers about the latest therapies and business ideas, take part in outings and social events, enjoy treatment swaps and share practice.

â&#x20AC;˘ Having carried out your research, select a couple to attend. â&#x20AC;˘ Talk to others at the meeting.

Ask questions. â&#x20AC;˘ Sometimes it is easy to tell straight away if that particular networking event is for you. If you are not sure then perhaps attend the next meeting. â&#x20AC;˘ Remember to evaluate. Did you get what you wanted from attending the meeting? â&#x20AC;˘ <RX PD\ Ă&#x20AC;QG \RXUVHOI UHJXODUO\ attending a group/meeting just for the company. â&#x20AC;˘ Perhaps some members have become friends and it is nice to catch up.

demands can change daily. I need the Ă H[LELOLW\ WR PDNH FKDQJHV DW VKRUW QRWLFH The important thing for me is that I know why I am attending the group/meeting and know what I want to gain from being there.

Sometimes I â&#x20AC;&#x2DC;Networkâ&#x20AC;&#x2122;.

Sometimes I â&#x20AC;&#x2DC;Notworkâ&#x20AC;&#x2122; (you know what I mean!!!)

Social Media Social media can be used to promote your EXVLQHVV DQG Ă&#x20AC;QG SRWHQWLDO FXVWRPHUV connect with people who are in the same LQGXVWU\ DQG Ă&#x20AC;QG RWKHU SHRSOH ZKR PD\ compliment your skills or inspire you.

Instagram is great for photo updates and videos, while Facebook is better for closed interest groups and forum discussions.

LinkedIn LinkedIn is a professional platform that gives individuals the opportunity to list their skills and experience. It has a place where customers can leave feedback, which is great for potential customers, along with an option for blog updates so you can keep individuals up to date with happenings in your business.

What do you do?

I like to call that â&#x20AC;&#x2DC;notworkingâ&#x20AC;&#x2122; rather than â&#x20AC;&#x2DC;networkingâ&#x20AC;&#x2122;. In other words I am going to the meeting to catch up with others and see how they are getting on with their business. Sometimes I come away with something useful for my business that I hadnâ&#x20AC;&#x2122;t considered or thought about. Other times I come away happy to have caught up with friends.

I personally prefer the more relaxed PHHWLQJV WKDW , FDQ DWWHQG ZKHQ LW Ă&#x20AC;WV in with my work, rather than the more structured meetings which require greater commitment. But thatâ&#x20AC;&#x2122;s because my work

As mentioned in the article, people network for different reasons and ultimately we do it to share our passions and meet people we can form both professional and personal relationships with. Technology makes it very HDV\ WR Ă&#x20AC;QG JURXSV WKDW VXLW XV DQG DV D massage therapist there are lots of groups available online which you can sign up to.

Local Hubs The FHT (www.fht.org.uk) is a great place ZKHUH \RX FDQ Ă&#x20AC;QG ORFDO KXEV ZKHUH \RX

Maintaining your network Building a successful network takes time and in order to maintain it, it is suggested that networkers continue to add to their network by using as many resources as possible, while maintaining the connections they have already made within their network.

soft-tissue moves to re-balance the body, helping to heal itself. She said: â&#x20AC;&#x153;Initially I applied Bowen therapy while Brenda was seated but within a couple of sessions, she was able to lie down on the couch which allowed us to work more effectively on the fascia (connective tissue). â&#x20AC;&#x153;My aim was to help support the muscles around the joints to improve Brendaâ&#x20AC;&#x2122;s mobility and thereby reduce pain. It has been a real pleasure to see her condition improve so markedly,â&#x20AC;? added Helen.

The sense of wellbeing and relaxation that comes from Bowen gives me emotional and spiritual support in addition to the physical EHQHĂ&#x20AC;WV $W KRPH , XVH %H[WHUV 6RGD &U\VWDOV WR GUDZ RXW Ă XLG WKDW DFFXPXODWHV DURXQG the joints, soaking my feet as well as using a hand mitt containing crystals. Once swelling is UHGXFHG MRLQWV EHFRPH PRUH Ă H[LEOH HQDEOLQJ me to move more easily.

My doctors are aware that I enjoy Bowen Technique and can see that I look and feel better. While it might not work for everyone, I recommend people keep an open mind and give it a go.

hile some provided temporary relief, and others worked well IRU D VSHFLĂ&#x20AC;F SUREOHP ² VXFK DV acupuncture or manual lymphatic drainage â&#x20AC;&#x201C; it is Bowen Technique that has hugely improved my quality of life.

Since being referred to Bowen therapist Helen Mary Perkins, I have been able to cut down on painkilling medication and maintain a more positive outlook avoiding the depression that might otherwise overwhelm me. It helps with mobility enabling me to keep driving and retain some independence. $W Ă&#x20AC;UVW LW VHHPHG XQOLNHO\ WKDW VXFK D JHQWOH therapy could have any impact at all on my condition, which has required many surgeries.

Bowen has been a revelation and Helen an absolute lifesaver, a therapist whose empathy and intuition matches her professional skills.

2Q P\ Ă&#x20AC;UVW YLVLW , ZDV VXIIHULQJ WHUULEO\ ZLWK P\ EDFN VKXIĂ LQJ LQWR +HOHQ¡V URRP KDOI EHQW over. I left the session feeling lighter and more optimistic, looking forward to my next visit.

Helen explains Bowen as a series of precise

For more about Helen please visit www.

KHOHQSHUNLQV FRP 7R Ă&#x20AC;QG \RXU QHDUHVW %RZHQ therapist go to www.bowen-technique.co.uk or www.bowentherapy.org.uk

be contributing factors as well ass Stress.

It is harmful to individuals as their immune systems attack healthy body tissue and cause MRLQWV WR EHFRPH LQĂ DPHG PDNLQJ WKHP WKHQ release chemicals which damage nearby bones, cartilage, tendons and ligaments. If it isnâ&#x20AC;&#x2122;t treated the joint can lose its shape and alignment or become completely destroyed.

It can be treated with light exercise, good nutrition and also massage. During remission, therapeutic massage can effectively prevent LQĂ DPPDWLRQ DQG PDQDJH V\PSWRPV WKURXJK HQKDQFLQJ R[\JHQ Ă RZ DLGLQJ WKH transportation of nutrients and removing toxins from surrounding tissues of affected joints.

Since stress may be a predisposing factor to WKH GLVHDVH Ă DULQJ XS PDVVDJH IRU UHOD[DWLRQ LV EHQHĂ&#x20AC;FLDO DQG FDQ UHGXFH GLVFRPIRUW In the early stages, careful joint mobilisation and massage around joints to reduce stiffening in the soft tissues are helpful to maintain mobility in the joints. In the later stages, stretches or manipulations of the spine are contraindicated, particularly in the cervical region, because this could disturb or break bony fusions that may have developed between the vertebrae.

Be aware that clients who are on painkillers may have reduced sensation and be less able to give accurate feedback about pressure or range of movement.

Rheumatoid arthritis is a long-term autoimmune condition, which mostly affects the joints causing pain, swelling and stiffness.

There is no single cause of rheumatoid arthritis, but genetics, hormones and smoking can

inter is a time we should all be keeping our bodies extra healthy, with vitamin D levels lower during these shorter daylight hours bugs can thrive. There is, however, one system – the lymphatic system - which SOD\V D YLWDO UROH LQ RXU DELOLW\ WR ÀJKW LQIHFWLRQ DQG GLVHDVH DQG ZRXOG WKHUHIRUH EHQHÀW IURP some seasonal help with additional continued attention to eliminate infection effectively.

The lymph system is involved in producing white blood cells (lymphocytes) that seek out, capture and destroy foreign substances – such as bacteria and other “invaders” – and subsequently tries to remove them from the body.

Slight tingling sensation underneath WKH WRQJXH FDQ EH WKH ÀUVW VLJQ or symptom of an imminent cold.

This is your lymphatic system detecting invasion and starting WKH ÀJKW DJDLQVW LQIHFWLRQ LQ WKH submandibular lymphoid tissue. A sore throat accompanied by runny nose, coughing and sneezing is the way lymph excretes waste through the lungs.

With the mouth and lungs RIWHQ WKH ÀUVW FRQWDFW HQWU\ SRLQW for infection rightly placed here are an abundance of lymphatics and lymphoid tissue. The mucosaassociated lymphoid tissue (MALT), is a diffuse system of small

concentrations of lymphoid tissue found in various sites of the body and these include the oral passage, nasopharyngeal tract, lung and salivary glands. MALT is populated by lymphocytes such as T cells and B cells, as well as plasma cells and macrophages.

Tonsils are large clusters of lymphatic cells IRXQG LQ WKH SKDU\Q[ 7KH\ DUH WKH ERG\¡V Ă&#x20AC;UVW line of defence as part of the immune system.

Although tonsillectomies occur much less frequently today than they did in the 1960s, it is still among the most common operations performed and typically follows frequent throat infections but also leaves you more vulnerable ZLWK OHVV DELOLW\ WR Ă&#x20AC;JKW LQIHFWLRQ If the spleen detects potentially dangerous bacteria, viruses, or other microorganisms in the blood, the spleen and lymph nodes create white blood cells called lymphocytes. We can live without a spleen, although people who have lost their spleen to disease or injury are more prone to infections. Scattered in the splenic pulp are lymph nodes, each containing an arteriole network. Lymphocytes released from the lymph nodules pass directly back into the blood stream. The splenic vein joins the hepatic portal vein and broken-down products of phagocytic activity from the splenic cells are carried straight to the liver.

Bone marrow is a key component of the lymphatic system, producing the lymphocytes that support the body`s immune system.

Formation produces approximately 500 billion blood cells per day.

Lymph nodes, around the joints of the ERG\ ZKLFK DUH Ă&#x20AC;JKWLQJ LQIHFWLRQ FDXVH SDLQ because they are swollen with infection and an over stretched outer capsule with extra O\PSK Ă XLG ,I WKHVH DUHDV DUH VZROOHQ DURXQG the throat and chin, regularly pressing in and around all these areas will help to keep your O\PSKDWLF V\VWHP Ă RZLQJ QDWXUDOO\

For some, however, sinus congestion persists, long after returning to work or school,

resuming exercise, and getting back in to the swing of social activities. In these colder months, I have heard many of my clients say, â&#x20AC;&#x153;I was sick several weeks ago and Iâ&#x20AC;&#x2122;m feeling much better, but my nose is still stuffy,â&#x20AC;? or, â&#x20AC;&#x153;Iâ&#x20AC;&#x2122;ve mostly recovered from my cold, but I still have a headache and post nasal drip!â&#x20AC;?.

This is a clear indication they need lymphatic drainage. Underestimated by so many, it is a real immune-boosting handson therapy. Any increased movement of O\PSKDWLF Ă XLG ZLOO KHOS WR LPSURYH WKH Ă RZ of the lymphocytes, macrophages and waste Ă XLG LQ WKH O\PSKDWLF V\VWHP DQG XOWLPDWHO\ VWLPXODWH WKH ERG\CV DELOLW\ WR Ă&#x20AC;JKW LQIHFWLRQ even residual and niggling effects long after ZH KDYH UHFRYHUHG IURP D FROG RU ψ X ,I \RX RU \RXU FOLHQWV Ă&#x20AC;QG ´UHVLGXDOÂľ DIWHU HIIHFWV RI an infection which does not clear up fully and continues, the body needs more lymphatic Ă RZ DQG PRYHPHQW LW LV D VLJQ WKH V\VWHP LV struggling and continues to create symptoms.

When performed directly to the neck and head, these techniques can help the sinuses GUDLQ Ă XLG WKDW PD\ KDYH EHFRPH VWDJQDQW decreasing headaches, sinus pressure and postnasal drip. Lymphatic drainage technique is painless and extremely effective â&#x20AC;&#x201C; all reasons why it is one of my favourite methods to help clients dealing with stubborn sinus congestion and pressure. This can be exactly what is needed to get over the last stubborn remaining symptoms of that never-ending winter cold.

Discovered in the 1930`s, manual lymphatic drainage originated from swollen lymph nodes and sore throats as a proven and effective method of natural healing to alleviate painful symptoms. Toxins and residual waste are a major contributing factor in the development of disease â&#x20AC;&#x201C; virtually all disease. Lengthy recovery allows toxins to build up and remain in the body, eventually causing harm to some degree â&#x20AC;&#x201C; from general aches and pains, to degenerative and autoimmune diseases, all the way to cancer.

Therefore, during winter I highly recommend regular lymphatic massage and self-lymphatic drainage - of head and neck lymph nodes to help speed up the removal of any residual waste; the body just needs assistance with this slow-moving infection Ă&#x20AC;JKWLQJ V\VWHP IRU D PXFK IDVWHU UHFRYHU\ DQG longer-term healthier body.

<YHWWH -RUGDQ 8. /\PSKRORJ\ &OLQLFV )RXQGHU DQG 7UDLQLQJ 'LUHFWRU LV SUHVHQWLQJ \HDUV RI UHVHDUFK IRU /\PSKDWLF 3UHVVXUH 7KHUDS\ IRU VXE FOLQLFDO EUHDVW FDQFHU DVVRFLDWHG O\PSKRHGHPD DW WKH VW 8. /\PSKDWLF 6FLHQFH 0HHWLQJ RQ WK )HEUXDU\ # /\PSK6FL8. $ YHU\ SURXG PRPHQW IRU 8./& DQG WKH RWKHU WKHUDSLVWV ZKR KDYH KHOSHG EUHDVW FDQFHU VXUYLYRXUV RQ WKHLU MRXUQH\ -XOLHWWH &URVV IURP 7KH 2OLYH 7UHH &DQFHU 6XSSRUW DQG $QQD 3DUVRQV RI 7KH 2DN 7UHH &OLQLF :RUWKLQJ

3URPRWLQJ %UHDVW &DQFHU $IWHUFDUH 8./& LV ODXQFKLQJ LQ 0DUFK WKH Ă&#x20AC;UVW PRQWKO\ /\PSKRHGHPD $ZDUHQHVV &OLQLF DW WKH 2OLYH 7UHH &DQFHU 6XSSRUW &HQWUH LQ &UDZOH\ :HVW 6XVVH[

eing practical and realistic, you have to decide for what purpose you want to use your vegetable RLO <RX PD\ DFFHSW RQH TXDOLW\ RI RLO for your massage or aromatherapy purpose as it is to be used quickly, and quite another for a product which goes into a cosmetic that has to live in hot conditions on a hot shelf for three years. There is no simple answer to the question of what is the best. The intended purpose is paramount. Whilst I subscribe to the basic philosophy of organic, crude, virgin, I cannot impose this view or clearly justify it in every external use. Matters are a little more straightforward with ingestion. â&#x20AC;&#x2DC;The whole is greater than the sum if its partsâ&#x20AC;&#x2122; is the dictum of holistic thought.

It is the idea of synergy, as promoted

VLQFH WKH ¡V 0XFK HIIRUW LQ GLHWDU\ advice is based upon analysis claiming that one source is as good as another in terms of chemistry. People, however, seem to have some substances that suit them better than others. This should not be overlooked. Whole oils, VD\ FUXGH RU XQUHĂ&#x20AC;QHG DUH SRWHQWLDOO\ packed with synergistic materials.

Very little work about thia has been taken forward with skin care, which in medical terms is a bit of a Cinderella. vegetable oils unfortunately do not rate highly enough in most materia medica.

Vegetable oils have practical uses, but are also part of the food, cosmetic and pharmaceutical industries. Exotic oils like andiroba, babassu, monoi and tamanu, all tell their own tale of faraway delights. This touch of the

mysterious and luxurious may have little bearing on practical application and results, they can simply be fashions.

If an oil transits half way across the worls, then it is likely to need some stabilisation or change its nature to be usable.

7KH WHUPV ÂśFUXGH¡ ÂśYLUJLQ¡ DQG ÂśUHĂ&#x20AC;QHG¡ are, to say the least, hazy. The best quality is not always what we expect.

Oils are obtained from nuts, seeds and occasionally pulp or fruit seed, as in olive or avocado. â&#x20AC;&#x2DC;Crudeâ&#x20AC;&#x2122; simply refers to the end material or oil of the extraction process itself, whereas WKH WHUP ÂśUHĂ&#x20AC;QHG¡ LQGLFDWHV IXUWKHU processing or industrialisation. The term â&#x20AC;&#x2DC;virginâ&#x20AC;&#x2122; is applied to a type of crude oil.

oil. Good almonds are best for eating, chocolatiers and cake makers! Bacteria, as stated, are not supported by oil but other toxins may be. This is why, if you buy crude or virgin oil, you should buy the best. crude oil being used to GHVFULEH LWV UHĂ&#x20AC;QHG SDUWQHU

&UXGH PHDQV XQUHĂ&#x20AC;QHG ,W GRHV QRW mean process-free. Crude oil or its starting material, will have been at least cleansed, dried, shelled, crushed, sometimes heated to sterilise or to deactivate natural enzymes , SUHVVXUHG DQG Ă&#x20AC;OWHUHG 9LUJLQ RLOV DUH crude oils obtained by mechanical process> production should be at an appropriate temperature to maintain the components in an unaltered state. crude virgin oils are more or less supposed to be preserved by the antioxidants they naturally contain. The shelf life will depend upon the type and number of fatty acids, the number of double bonds and the nature of the few extra components in the oil , such as natural antioxidants, and the conditions in which they are stored. For sure you ZLOO Ă&#x20AC;QG D ORW RI LQIRUPDWLRQ DERXW WKH

When buying specialist oils, itâ&#x20AC;&#x2122;s a worthwhile exercise to check up on the storage facilities of your supplier.

Some companies operate virtually from garden sheds and back rooms. Internet sitesare notorious for disguising poor resources behind multi-media displays.

Some suppliers have open barrels and large headspace in large volume containers, a sure way of encouraging degradation. They may store in the wrong type of plastic container. Look for the suppliers who store under nitrogen, and when you acquire good oils use them quickly when opened.

Sometimes extra antioxidant is added, usually natural or synthetic vitamin E, tocopherol, which is found naturally in Wheatgerm Oil. 7KH TXHVWLRQ RI UHĂ&#x20AC;QLQJ LV YHU\ UHOHYDQW to the starting material â&#x20AC;&#x201C; the nuts, seeds and fruit. If the original material ZDV QRW Ă&#x20AC;W IRU KXPDQ FRQVXPSWLRQ was old, deteriorating, fermenting, even larvae or worm-ridden, then the harmful elements such as moulds or yeasts may contaminate the resulting

Virgin: Oil obtained soley by mechanical means and supposedly where heating has not altered the oil Extra Virgin: Selected for taste and odour. When applied to olive oil an acidity of less than 1% Fine Virgin: This term allows for higher acid values to 1.5% Semi-Fine: $FLG YDOXHV RI DUH allowed . This is the â&#x20AC;&#x2DC;normalâ&#x20AC;&#x2122; or orinary oil Virgin Lampante: A term used for Olive Oil. High acid values. Lamp oil destined IRU WKH UHĂ&#x20AC;QHU\ RU LQGXVWU\ EXW GRHV Ă&#x20AC;QG its way to Aromatherapy as it is cheap 5HĂ&#x20AC;QHG Covers a multitude of possibilities. Acid values adjusted and certainly possible from virgin oil Pure: Indistinct term that may mean a EOHQG RI YLUJLQ DQG UHĂ&#x20AC;QHG Residue: A term you are unlikely to see.

It is solvent extraction oil from spent, cold pressed materials and is destined for industrial use, commercial cooking and cosmetic oils

Jan Kusmirek is a medical herbalist, clinical aromatherapist and author. He is co-founder of the Fragrant (DUWK &RPSDQ\ WKH 8.¡V OHDGLQJ SURGXFHU RI DURPDWLF UDZ PDWHULDOV DQG Ă&#x20AC;QLVKHG JRRGV Jan has written one book on aromatherapy â&#x20AC;&#x201C; Liquid Sunshine: Vegetable Oils for Aromatherapy â&#x20AC;&#x201C; as well as a booklet â&#x20AC;&#x201C; Aromatherapy for the Family: An Introductory Guide to the Use of Holistic Aromatherapy for Harmony and Well-being. www.jankusmirek.wordpress.com

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Janey Lee Grace

The dayâ&#x20AC;&#x2122;s programme was rounded off by conference host, Janey Lee Grace - a UHJXODU SUHVHQWHU RQ 5DGLR DQG 8. +HDOWK 5DGLR DQQRXQFLQJ WKH ZLQQHUV RI WKH )+7 ([FHOOHQFH $ZDUGV ZKLFK VHUYH WR UHFRJQLVH WKRVH UDLVLQJ WKH EDU LQ therapy training and practice.

President of the FHT, Chris Byrne, says: â&#x20AC;&#x153;Everyone at the FHT is extremely proud of this event, not least because of the incredible speakers who took time out of their very busy schedules to share with us their vision of what truly integrated healthcare looks like.â&#x20AC;?

â&#x20AC;˘ Complementary Therapist of the Year â&#x20AC;&#x201C; Jane Sheehan

For developing a new delivery model for a complementary therapy service within an NHS palliative care unit.

+HOG DW 7KH .LQJ¡V )XQG /RQGRQ RQ WK 1RYHPEHU WKH conference got under way with two presentations that focused on research. Professor Nicola Robinson discussed some key issues surrounding the collection and use of evidence base for therapies such as acupuncture, while Dr Julie McCullough highlighted the SRVLWLYH Ă&#x20AC;QGLQJV RI D WULDO WKDW ORRNHG DW WKH LPSDFW RI DQWHQDWDO UHĂ H[RORJ\ RQ ZRPHQ ZLWK SUHJQDQF\ UHODWHG ORZHU EDFN DQG RU pelvic girdle pain.

Delegates also enjoyed listening to presentations from two RI WKH PRVW LQĂ XHQWLDO *3V LQ KHDOWK FDUH 'U 0LFKDHO 'L[RQ who discussed the potential for complementary therapists to get involved in social prescribing and personal health budgets, and Sir Sam Everington, who provided an insight into the Bromley By Bow Centre, which offers a range of integrated services to create a healthy community. Both GPs stressed that itâ&#x20AC;&#x2122;s important for therapists to â&#x20AC;&#x2DC;win over the heartsâ&#x20AC;&#x2122; of medical professionals and although this can take time, it is important to persist.

(Insert Image â&#x20AC;&#x201C; FHT Conference Michael Dixon) Talks by Anita Mehrez, MFHT, a member of the complementary health and wellbeing team at The Christie NHS )RXQGDWLRQ 7UXVW DQG -HQQLIHU <RXQJ 0)7+ IRXQGHU RI %HDXW\ Despite Cancer, also offered delegates an insight into how different therapies can be used alongside conventional medical care to support those impacted by cancer.

Michael Dixon

â&#x20AC;˘ Sports Therapist of the Year â&#x20AC;&#x201C; Nefeli Tsiouti

For helping improve health and reduce injuries in dancers, professional artists and other movers.

â&#x20AC;˘ FHT Local Support Group Coordinator or the Year â&#x20AC;&#x201C; Alison Brown

For sharing the content of her group meetings via a number of online platforms for therapists unable to attend in person.

â&#x20AC;˘ FHT Student of the Year â&#x20AC;&#x201C; Brian Jauncey

For his inspirational story of retraining as a complementary therapist following KLV Ă&#x20AC;UVW KDQG H[SHULHQFH RI XVLQJ WKHUDSLHV IRU D EDFN LQMXU\

â&#x20AC;˘ FHT Tutor of the Year â&#x20AC;&#x201C; Gwyn Featonby

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hospitalization improved relaxation and decreased pain, stress, and opioid use in this sample of women after unplanned cesarean births.â&#x20AC;&#x2122; Pre- and post-natal massage is becoming increasingly popular in the UK. As long as the right training is provided and where i ndicated, it seems to be a welcome help to mothers. Itâ&#x20AC;&#x2122;s pretty clear that if it FDQ UHGXFH VWUHVV LW ZLOO KDYH D EHQHĂ&#x20AC;FLDO LPSDFW RQ WKHLU KHDOWK LQ general at this important time in their lives. https://www.ncbi.nlm.nih.gov/pubmed/30102886

7KLV UDQGRPL]HG FRQWUROOHG WULDO ORRNHG LQWR WKH HIĂ&#x20AC;FDF\ RI FRQQHFWLYH tissue massage to reduce postoperative pain in primiparous women Ă&#x20AC;UVW WLPH ELUWKV RQ 3RVWRSHUDWLYH 'D\ DIWHU XQSODQQHG FDHVDUHDQ birth. It was carried out in family / newborn units of a large teaching hospital in the northeastern United States. There were 165 participants. Those in Group 1 received a 20-minute massage, those in Group 2 received the usual standard of care, and those in Group 3 received 20 minutes of individualized attention. They all completed questionnaires to measure overall pain, stress, and relaxation at Time 1 and again 60 minutes later. Daily numeric pain ratings and medication consumption data were retrieved from the electronic health care records. Latent growth modeling and analysis of variance were used to analyze data, as appropriate. There were some positive outcomes: RESULTS: Participants in Group 1 had increased relaxation (p < .001), decreased pain (p < .001), decreased stress (p < .001), and decreased opioid use on Day 1 (p = .031) and Day 2 (p = .006) of the hospital stay after the intervention compared with the other groups. Additionally, opioid use in Group 1 decreased linearly, whereas the control groups had a nonlinear pattern of change.

CONCLUSION: Using massage therapy during postoperative

From: Parkinsonism and Related Disorders, 7th August 2018, pii: S1353-8020(18)30333-X. https://doi.org/10.1016/j.parkreldis.2018.08.003 [Epub ahead of print]

INTRODUCTION: Researchers at the Struthers Parkinsonâ&#x20AC;&#x2122;s Center in Minnesota, USA noted that three prior surveys in the US have shown that 40-85% of patients with Parkinsonâ&#x20AC;&#x2122;s disease have used complementary therapies (CTs) â&#x20AC;&#x2DC;to relieve symptoms not fully addressed by pharmacologic and rehabilitation therapies currently available through medical clinics and programs.â&#x20AC;&#x2122; They wanted to look into this further.

Patients willing to participate in a survey were asked to complete a mailed copy to be brought into the clinic upon their next visit, and the results were as follows:

â&#x20AC;&#x2DC;RESULTS: 272 of 435 people with Parkinsonâ&#x20AC;&#x2122;s disease who completed the survey (62.5%) had tried some kind of CT, including a higher proportion of women than men (75.7% vs 53.8%; p < 0.01). Massage was the most frequently used therapy followed by yoga, Tai Chi, meditation and acupuncture. A high proportion of patients found the CT to be effective, for instance meditation was viewed as helpful by 85% of patients. Almost 2/3 of patients said they would be willing to participate in a research study of a CT. CONCLUSIONS: Complementary therapies are frequently used by people with Parkinsonâ&#x20AC;&#x2122;s disease coming to our center, and are viewed to be helpful for both motor and non-motor symptoms.

Formal research assessments of therapies such as meditation are warranted.â&#x20AC;&#x2122; It is always good to see the positive approach of combining medical healthcare with complementary therapies where appropriate. With growing research and awareness, hopefully patients, healthcare providers and complementary therapists can have a have a better understanding of the potential of combined approaches to medical conditions. https://www.ncbi.nlm.nih.gov/pubmed/30245174

From: Psychoneuroendocrinology. 2018 Nov 14; 101: 193-203. https://doi.org/10.1016/j.psyneuen.2018.11.016 [Epub ahead of print]

administered massage and there were no differential effects on SCR (skin conductance responses). Subjects were also willing to pay more for the hand massage. Plasma oxytocin increased after both massage by hand or machine, but more potently after massage by hand. Both basal oxytocin concentrations and increases evoked by hand-, but not machine-administered massage, were negatively associated with trait autism and attitudes towards social touch, EXW PDVVDJH E\ KDQG HYRNHG FKDQJHV ZHUH VLJQLĂ&#x20AC;FDQW LQ KLJKHU as well as lower trait individuals. Increased neural responses to hand vs. machine-administered massage were found in posterior superior temporal sulcus and medial/lateral orbitofrontal cortex but not somatosensorycortex. Orbitofrontal cortex and superior temporal cortex activation during hand massage was associated with the amount of money subjects were willing to pay and between orbitofrontal cortex activation and autism scores. Thus, handadministered massage can potently increase oxytocin release and activity in brain regions involved in social cognition and reward but not sensory aspects of affective touch. Massage by hand induced changes in both oxytocin concentrations and neural circuits involved in processing social affective trust may have therapeutic potential in the context of autism.â&#x20AC;&#x2122; Other research such as this study by Susan E. Levy and Susan L. Hyman: https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC2597185/, and the work of Dr. Louisa Silva (http://www.qsti. org/), has examined the relationship between autism and issues RI WRXFK VHQVRU\ SUREOHPV DQG VRFLDO VNLOOV Ă&#x20AC;QGLQJ PDVVDJH and other complementary approaches to be effective. Another interesting study actually found that the relationship between oxytocin and autism is more complicated than we thought, and that it may not always be particularly relevant: https:// www.npr.org/sections/health-shots/2014/08/04/337836721/ oxytocin-isnt-lacking-in-children-with-autism-researcherssay?t=1543276849615.

Indeed, as Levy and Hyman state in their study, there needs to be PRUH UHVHDUFK VR WKDW ZH FDQ Ă&#x20AC;QG WKH EHVW DSSURDFK WR WUHDW WKRVH affected by autism.

Oxytocin is the hormone associated with love and also, empathy, trust and social skills, as further studies have shown. It has been argued in various research that children with autism can be GHĂ&#x20AC;FLHQW LI R[\WRFLQ 7KLV ZDV WKH IRFXV RI %HFNHU HW DO ¡V VWXG\ â&#x20AC;&#x2DC;Massage may be an important method for increasing endogenous R[\WRFLQ FRQFHQWUDWLRQV DQG RI SRWHQWLDO WKHUDSHXWLF EHQHĂ&#x20AC;W LQ disorders with social dysfunction such as autism where basal oxytocin levels are typically reduced. Here we investigated oxytocin release and associated neural responses using functional near infrared spectroscopy (fNIRS) [used for functional neuroimaging] during hand- or machine-administered massage. 40 adult male subjects received 10 min of light foot massage either by hand or machine in a counterbalanced order and then rated pleasure, intensity, arousal and how much they would pay for the massage.

Blood samples were taken before and after each massage condition to determine plasma oxytocin concentrations. [â&#x20AC;Ś]Results showed subjects gave higher ratings of pleasure, but not intensity or arousal, after hand- compared with machine-

https://www.ncbi.nlm.nih.gov/pubmed/30469087

ll of you will have Continuing Professional Development or ‘CPD’ requirements if you belong to CNHC, a professional association and/or a governing body – but what is it and how can you keep up with your requirements across multiple organisations without it costing a fortune?

CPD is the term used to describe the ongoing SURFHVV RI OHDUQLQJ DQG UHÁHFWLRQ WKDW SUDFWLWLRQHUV IURP all healthcare professions carry out. Most professional associations and governing bodies require a certain number of CPD hours or ‘points’ that practitioners need to do each year to maintain their registration or membership. It is likely that much of your CPD work will overlap, but you should check requirements early on to avoid a last-minute panic.

Learning about the latest techniques and new developments helps you evolve and improve the service you provide – and also keeps your clients safe where relevant. It is a truly rewarding experience to be part of a profession that is always learning and developing, and

at CNHC we try to foster this amongst our registrants. &1+& GHÀQHV &3' ¶DV D UDQJH RI learning activities through which professionals grow and develop throughout their careers to ensure that they retain their capacity to practise safely, effectively and legally within their evolving scope of practice’. This could be case reviews undertaken with colleagues, time spent reading profession journals or free training undertaken for volunteer work. In short, CPD does not need to cost you an arm and a leg!

Many practitioners fear that CPD means doing courses and they worry that they can’t afford to keep up if that’s the case. The CNHC CPD policy is clear that we do not only require taking new courses - we recognise a range of lowcost or no-cost activities – many you may already be doing as part of your everyday practice.

In order to get the most from your CPD requirements, the

main thing is to think about how the activity supports your learning and development and then how you can put that learning directly into practice.

Below are some examples of activities that could be directly relevant to your profession/s: • UHDGLQJ RU ZULWLQJ DUWLFOHV RU ERRNV DERXW \RXU SUDFWLFH RU WKHUDS\ • WDNLQJ SDUW LQ UHVHDUFK • FDUU\LQJ RXW DXGLWV RU HYDOXDWLRQV RI \RXU practice • DWWHQGLQJ ZHELQDUV • SUHSDULQJ D FDVH VWXG\ ZKLFK GHPRQVWUDWHV \RXU OHDUQLQJ DQG GHYHORSPHQW • UXQQLQJ D ZRUNVKRS RU WUDLQLQJ VHVVLRQ WKDW LV QRW SDUW RI \RXU XVXDO ZRUN

• UHFHLYLQJ VXSHUYLVLRQ RU PHQWRULQJ • SHHU VXSSRUW GLVFXVVLQJ EHVW SUDFWLFH ZLWK IHOORZ WKHUDSLVWV

If you are registered with CNHC, you need to complete a minimum of 15 hours’ CPD each year for one therapy with a minimum of 10 hours being directly relevant to the registered therapy and 5 hours may be general learning to support overall development. Additional hours are required for those who are registered for more than one discipline.

We encourage registrants to decide what you need to stay up to date and where you want to expand your practice to best meet the needs of your clients. To maintain the integrity of our accredited register, we undertake a CPD audit via a random sampling each year. If you are selected, you will be required to provide a copy of your CNHC UHÁHFWLYH &3' ORJ VKHHW IRU \RXU ODVW IXOO UHJLVWUDWLRQ \HDU For more information about CNHC’s CPD requirements and to download the CNHC CPD log sheet, visit: https://www.cnhc.org.uk/cpd-registrants.

If you get selected as part of the random sampling, there is no need to fret as your submission highlights so much of the incredible work you are all doing. Last year, several CNHC registrants were featured in our monthly newsletter or approached to provide a blog.

• ZRUN VKDGRZLQJ • DWWHQGLQJ RU SUHVHQWLQJ DW FRQIHUHQFHV ZKHUH \RX LPSURYH \RXU NQRZOHGJH DQG VNLOOV And below are some examples of general learning to support your overall development: • PDUNHWLQJ EXVLQHVV GHYHORSPHQW WUDLQLQJ RU DFWLYLWLHV • OHDUQLQJ D QHZ ODQJXDJH • ÀUVW DLG WUDLQLQJ

CPD is an excellent tool to develop your career – just don’t leave tracking your activities until the last minute. Keep a running log of your progress throughout the year, and remember – CPD isn’t just about taking courses!

challenge massage therapists. I mentor to listen more than they speak. You will build more solid relationships by listening and asking questions than by talking. Some new massage therapists listen so that they can respond. Itâ&#x20AC;&#x2122;s as if they feel they need to prove something. Oftentimes they miss a clientâ&#x20AC;&#x2122;s potential to spell out the issue they came to resolve, or they miss getting the information necessary to give clients their perfect massage.

People want to be heard.

Listening creates a pause and also shows a fellow human an enormous amount of care, respect, and support. You are more likely to connect with clients during sessions if they Ă&#x20AC;UVW IHHO KHDUG Overlooking someoneâ&#x20AC;&#x2122;s need to be heard denies them a comfort required to build a successful business relationship. Standing back and observing is sometimes more powerful than having a lot to say.

Listening means being fully present, XVLQJ DOO Ă&#x20AC;YH RI \RXU senses, and coming

from a place of wanting to authentically learn about someone else. You are not Ă&#x20AC;JXULQJ RXW WKH SHUVRQ UHSOD\LQJ ODVW QLJKW¡V Ă&#x20AC;JKW ZLWK D IULHQG ZRQGHULQJ ZKDW \RX are going to do after work, or thinking of a brilliant response. Your undivided attention is on listening to what the other is saying.

Focus on the client and in your sessions quietly change the world one body at a time.

After someone is done talking, repeat back to them what you heard with similar vocabulary and in a gentle tone. You can use this technique in all your relationships.

It helps two people make sure there is clear communication. Sometimes when you repeat back what you think you heard, a person will correct you or add more information. The process of repeating back helps fewer miscommunications to occur.

After you carefully listen, repeat back, and are clear on the session the client requestedâ&#x20AC;&#x201D;you must provide it! A client who walks away feeling heard is the best

gift you can give them, the entire massage community, and your massage practice.

The respect you build with your clients has a direct effect on the massage community in its entirety. The best interactions are when a client leaves feeling like they received the session they requested. Listening is the gateway to understanding, building solid relationships, and excelling in all areas of your life and profession.

The more you listen, the better you will JHW DQG WKH PRUH \RX ZLOO VHH WKH EHQHĂ&#x20AC;WV of being open to other peopleâ&#x20AC;&#x2122;s words.

When you are talking, you are sharing knowledge you already have obtained.

When you listen, the possibilities to receive and learn are endless. Many times, people pass by and ask, â&#x20AC;&#x153;How are you?â&#x20AC;? but donâ&#x20AC;&#x2122;t wait for the answer. Questions have become gestures, and the power of listening is left behind.

ACCREDITED SPORTS MASSAGE & SPORTS THERAPY TRAINING

BY CORE ELEMENTS INCLUDING: Level 3 & 4 Sports Massage Therapy Level 5 Diploma in Clinical Therapy and CPD courses in: Electrotherapy, Manual Therapy & Joint Mobilisations Rehabilitation | Dry Needling | Dry Cupping Kinesiology Taping

To find out more contact Dawn Morse: T: 07887 535766 E: Dawn@coreelements.uk.com WWW.COREELEMENTS.UK.COM

As our name suggests, we are specialists in Seated Acupressure (On Site) Massage training. Attention to detail in the execution of the Massage for both Client and Practitioner ensures the highest level of individual safety, competence and effectiveness. We also provide a range of ongoing personal development with our one day additional skills training for Seated Acupressure.

'HWDLOV 2019 Seated Acupressure Diploma Reading (P1) (Su/Mon) 27/28 Jan + (P2) (Sun/Mon) 24/25 Feb 6KHIĂ&#x20AC;HOG (P1) (Sat/Sun) 16/17 Mar + (P2) (Sat/Sun) 06/07 Apr London (Hammersmith) (P1) (Sat/Sun) 13/14 July + (P2) (Sat/Sun) 27/28 July 6KHIĂ&#x20AC;HOG (P1) (Fri/Sat) 06/07 Sept + (P2) (Fri/Sat) 27/28 Sept Abingdon (P1) (Sun/Mon 27/28 Oct + (P2) (Sun/Mon) 17/18 Nov 2019 Massage At Your Desk 6KHIĂ&#x20AC;HOG 6DW -DQ /RQGRQ )UL $SU 2019 Seated Acupressure Refresher 6KHIĂ&#x20AC;HOG )UL )HE /RQGRQ )UL 0DU

On this intensive 12-month Course you will: Revise and consolidate general massage techniques â&#x20AC;˘ Learn advanced soft tissue techniques â&#x20AC;˘ Analyse touch /connection /palpation â&#x20AC;˘ Explore injury and recovery - analysis and treatment â&#x20AC;˘ Discover the how to massage in non-clinical settings â&#x20AC;˘ Investigate Posture and Core Stability â&#x20AC;˘ Examine Flexibility/ Stretching/Relaxation â&#x20AC;˘ Gain knowledge of Nutrition & Sports Psychology â&#x20AC;˘ And MORE. 'HWDLOV CPD Workshops; Muscle Energy Technique; Myofascial Release; Soft Tissue Release

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Light Touch Training for therapists wishing to develop their sensitivity and awareness.

Learn from the people who wrote the books! Expand your understanding of myofascial connections through body and gain new skills directly from the experts. Learn to address postural and functional patterns by combining manual and movement skills.

T: 028 9058 0764 E: workshops@anatomytrains.co.uk www.anatomytrains.co.uk

Hands-on experience, these workshops will change the way you view the body and enhance your understanding of anatomy.

Open only to therapists and body workers, including students.

'HWDLOV London venue

E: amandyh@aol.com

Well established training centre since 2000, Warm and friendly environment based in Hertfordshire. Close to the M25 and M1. Offering a wide range of both Complementary and Beauty Courses, whether itâ&#x20AC;&#x2122;s an NVQ Level 2, 3, 4 or CPD Fast Track Accredited Diploma. Small groups (Max. 4) allowing for more personal attention to the individuals. Courses are tailored to meet LQGLYLGXDO QHHGV VXLWDEOH IRU EHJLQQHUV DQG TXDOLĂ&#x20AC;HG WKHUDSLVWV 'HWDLOV &DOO RIĂ&#x20AC;FH IRU IXOO GHWDLOV RQ GDWHV DQG WLPHV

T: 01727 768559 /07796268782 E: enquiry@ftt-beautyandtraining.co.uk www.fttbeautyandtraining.co.uk

T: 01509 551513 E: admin@ukmassagecourses.com www.ukmassagecourses.com

'HWDLOV Sharon Wheelerâ&#x20AC;&#x2122;s 4 day ScarWork courses run around the country; light touch and effective work for scars and adhesions Fascial Unwinding and Energy Awareness courses (4 day) The Fascia-Energy Connection (1 day) Body Realignment diploma (physical & emotional trauma healing) (1 year) - starts early 2019 Tutor: Jan Trewartha (Founder/Director of the British Fascia Symposium) $317 DFFUHGLWHG %&0$ DIĂ&#x20AC;OLDWHG WUDLQLQJ VFKRRO

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The London School of Biodynamic Psychotherapy (LSBP) was established in 2000, at Gerda Boyesenâ&#x20AC;&#x2122;s request, to carry forward the professional training in Biodynamic Body Psychotherapy previously taught at the Gerda Boyesen Centre.

LSBP offer a four year UKCP accredited diploma training in Biodynamic Body Psychotherapy, along with CPD workshops throughout the year.

LSBP provides professional practitioner Biodynamic Body 3V\FKRWKHUDS\ FRXUVHV SURPRWHV UHVHDUFK LQ WKH Ă&#x20AC;HOG and serves as a professional body for Biodynamic Body Psychotherapists. LSBP is a member of the Humanistic and Integrative Psychotherapy section of the United Kingdom Council for Psychotherapy (UKCP) and also of the British Massage Therapy Council (BMTC) and the Association of Humanistic Biodynamic Massage Therapists (AHBMT).

Through its membership of UKCP/HIPS, LSBP is directly involved in maintaining the standards of the psychotherapy profession, having a seat on the UKCP registration board.

'HWDLOV January 2019

T: 0207 263 4290 E: admin@lsbp.org.uk www.centreforbodypsychotherapy.com

Advancing training in our ground-breaking therapies to give knowledge and understanding of the lymphatic system for WKRVH ZKR ZDQW WR FRQĂ&#x20AC;GHQWO\ H[SDQG WKHLU FDUHHUV LQ D QHZ dimension!

'HWDLOV Breast Cancer Aftercare - Lymphatic Pressure Therapy - Six Months Training - 55 CPD points New and unique, this advanced training offers maximum EHQHĂ&#x20AC;FLDO DIWHUFDUH IRU EUHDVW FDQFHU FOLHQWV (QFRXUDJLQJ Ă&#x20AC;YH elements of recovery for range of motion to restore muscle connection for mobility and balance, whilst stimulating lymphatic return for an overall post-operative improvement. VTCT $SSURYHG )RU FDULQJ HPSDWKHWLF WKHUDSLVWV FRQĂ&#x20AC;GHQW LQ WKHLU own ability to provide excellent standards of UKLC aftercare!

Must have six months massage training and six months practice.

Lymphatic Integrated Massage - One Day Attended Course - 12 CPD points Encouraging a new approach towards effective lymphatic stimulation. This two-part course of three weeks home study theory and one day practical results in a short powerful therapy application to be integrated into everyday massage. â&#x20AC;&#x153;Thank you so much for excellent training, I thoroughly enjoyed DOO DVSHFWV RI WKH FRXUVH DQG WKH /,0 EHQHĂ&#x20AC;WV <RX DUH DQ inspirational teacher.â&#x20AC;?

Please see more details on our website.

T: 07599 985648 E: info@theuklc.com www.theuklc.com

A soft tissue remedial therapy which is gentle on both practitioner and client while still being powerfully effective. Add Bowen to your existing practice, offering it as an alternative to new and existing clients. Training is rigorous but fun with an emphasi s on your practical skills. Download our prospectus one from the website. Join one of the many Part 1 courses on offer across the UK. 'HWDLOV Contact us for course dates.

T: 01373 461812 E: info@thebowentechnique.com www.thebowentechnique.com

A 4 day Spiritual, Practical & Theory course for therapists whoâ&#x20AC;&#x2122;s passion is to nourish and nurture every women through any stage of their reproductive life. A unique blend of ancient, intuitive and sacred techniques.

'HWDLOV 2018 National and International Courses: Belgium, Belfast, Ireland, Brighton, Manchester, Bristol, London

T: 07713 477511 E: info@fertilitymassage.co.uk www.fertilitymassage.co.uk

Gateway Workshopsâ&#x201E;˘ offering recognised one day diploma massage, EHDXW\ DQG DOVR RQ OLQH FRPSOHPHQWDU\ WKHUDS\ TXDOLĂ&#x20AC;FDWLRQV Courses for all levels, CPD courses for therapists, courses for complete beginners looking to learn massage or beauty, gain a TXDOLĂ&#x20AC;FDWLRQ RU D WRWDO FDUHHU FKDQJH Recognised, affordable and insurable training allowing you to use these therapies professionally to gain an extra income, in a clinic or as a mobile therapist.

'HWDLOV Please check our web site for all the courses we offer - regular monthly weekday and weekend options in London, UK and Ireland.

www.gatewayworkshops.com

With Rosalie Samet. Dynamic, spiritually rich and life-changing authentic massage from Hawaii synthesizes ancient with modern in exceptional 12 Day Practitioner Training of highest UK standard.

Intensive, Fast Track and Progressive options. CPD Workshops.

Blend powerful massage skills, energy techniques, Huna wisdom and Aloha. Daily massage exchanges, small happy classes. $FFUHGLWHG E\ )+7 DQG &7K$ ZLWK GD\ $VVHVVPHQW IRU &HUWLĂ&#x20AC;FDWLRQ 'HWDLOV Fast track Mar 14-17; April 11-14; May 9-12 Summer fast track July 6-9; Aug 8-11; Sept 5-8 Intensive Feb 23â&#x20AC;&#x201C; march 5 or 8; Summer Aug 03-11 or 16 Progressive March 16-17; April 13-14; May 11-12; June 16-17; July 13-14; Aug 10-11 Introductory workshops Feb 23; March 14; July 6 and Aug 3

T: 01273 730508 E: info@hawaiianmassage.co.uk www.huna-massage.com Training with Comfy Spa Training Company enables you to specialise in pregnancy massage. Our Post Graduate course will teach you all the important doâ&#x20AC;&#x2122;s and donâ&#x20AC;&#x2122;ts along with practical skills of how to deliver a beautiful ritual spa treat for mum to be and baby bump. To qualify for training in this unique & beautiful FRXUVH DOO \RX QHHG LV D FHUWLĂ&#x20AC;FDWH LQ $ 3 DQG PDVVDJH )UHH belly casting is included with this course.

'HWDLOV Courses are run throughout the year.

1 Day Course with pre-course study ÂŁ160 + vat

T: 01782 285545 or 01782 639777 E: carol@comfyspatraining.co.uk www.comfyspatraining.co.uk

We have been training chiropractors for over 45 years and have graduated many massage therapists who recognised that they needed additional skills and knowledge to enable them to help more clients. We deliver two programmes providing a Masters in Chiropractic. One is suitable for school leavers and is taught during WKH ZHHN DQG RQH LV VSHFLĂ&#x20AC;FDOO\ GHVLJQHG IRU PDWXUH OHDUQHUV ZLVKLQJ to change their career. This programme is taught over one weekend a month and through summer schools in each year which allows students to continue to work whilst training. Both programmes are UHJLVWHUDEOH TXDOLĂ&#x20AC;FDWLRQV ZLWK WKH *HQHUDO &KLURSUDFWLF &RXQFLO This is a perfect way to upskill, building on your knowledge of anatomy and physiology to learn more about clinical conditions and the practical adjustment skills you need to make a difference. â&#x20AC;&#x2DC;I always wanted to be a chiropractor â&#x20AC;&#x201C; I just never knew it would be this good!â&#x20AC;&#x2122; 'HWDLOV Intakes in January (Manchester and Abingdon) and September (Abingdon)

www.mctimoney-college.ac.uk

The Oxford School of Massage provides high quality accredited training courses in Oxford, Salisbury and Windsor which recognise the importance of the link between the physical body, the mind and the emotions in delivering a truly holistic client based massage treatment. Established in 1988 as a centre of excellence for massage training, we pride ourselves in being able to offer small classes in a friendly and caring environment. We offer a high level of personal attention to all of our students in the pursuit of combining the technical skills needed for massage with the sensitivity and awareness of the subtle aspects of healing work.

'HWDLOV Courses commence each September

T: 07714 464577 E: enquiries@oxfordschoolofmassage.com www.oxfordschoolofmassage.com

The workshop is designed to give a taste of traditional Thai Yoga Massage Therapy (TYMT) and is an ideal introduction for anyone planning on doing the full diploma course or those just looking for an insight into the art.

'HWDLOV Workshop Fee: ÂŁ45 per day Complete booking form on website

E: mail@paadena.co.uk www.paadena.co.uk

Professional training in the heart of the city â&#x20AC;˘ Currently enrolling for Post Graduate courses in Exeter â&#x20AC;˘ All diploma courses are APNT accredited â&#x20AC;˘ One of the most highly regarded professional bodies â&#x20AC;&#x201C; Est.1986 by Mario Paul Cassar â&#x20AC;˘ Fantastic training with excellent results â&#x20AC;˘ 75% of our Remedial Massage Diploma students gained distinction in their exams. â&#x20AC;&#x153;That was a fantastic diploma course! There is an equal mix of theory and practical and it is well integrated to suit your individual learning needs. Right from the start you are hands on and the encouragement and support you receive from tutors and fellow students is second to none. I feel like I have joined a community that will help me on my new found path. I would not hesitate to recommend the school and this course.â&#x20AC;? â&#x20AC;&#x153;Fantastic course, inspirational content & exemplary delivery.â&#x20AC;?

Belinda Silcox 'HWDLOV Remedial Massage Diploma: 12 days over 9 months ÂŁ1095 Indian Head Massage Diploma: 4 days over 6 weeks ÂŁ295 Hands Free Techniques: Protect your body: 2 days ÂŁ195 Myofascial Release Diploma: 9 days ÂŁ995 Pelvic Diaphragmatic Release: 1 day ÂŁ95 Deep Tissue Massage: 2 days ÂŁ195 Special Needs Massage: 1 day ÂŁ95 Thai Massage: 2 days ÂŁ195 Fantastic Range of individual CPD days: ÂŁ95 Full CPD list see website. Individual tuition offered with a tutor to suit your needs.

T: 07711 656011 E: info@schoolofbodywork.com www.schoolofbodywork.com

$ WKUHH KRXU ZRUNVKRS IRU TXDOLĂ&#x20AC;HG PDVVDJH WKHUDSLVWV LQWHUHVWHG in integrating aromatherapy into their practice. Learn about how aromatherapy works and how to use SB Holistic Magic products for your clients. No extra insurance required. Safe for all clients over six years. Can be taught at your massage school.

Contact Dr. Sarah Bryan, Ph.D, MTI (regâ&#x20AC;&#x2122;d), MIFPA, CNHC (regâ&#x20AC;&#x2122;d)

T: 07949 654779 E: sarah@sbholistic.co.uk www.sbholistic.co.uk

We offer a great range of advanced & accredited courses for 0DVVDJH 7KHUDSLVWV 5HĂ H[RORJLVWV 'HOLYHUHG LQ 6RXWK (DVW Wales, so easily accessible from the South West, the Midlands and Wales.

'HWDLOV 25+ courses including: Courses with Darien Prichard & Joanne Perkins Reg. Osteopath: Hands Free Massage (DP); Freeing the Shoulders (DP) Releasing the Lower Back (DP); Understanding Neck Pain (JP); Myofascial Release (JP); Kinesio Taping (JP) Course Venue: Caerphilly Room at The Holiday Inn Express, Newport, NP10 8BD

T: 029 20 591118 E: enquiries@teachtherapy.co.uk www.teachtherapy.co.uk

$W ZPW FRPSDQ\ ZH RIIHU Âś<0&$ DZDUGV¡ DFFUHGLWHG TXDOLĂ&#x20AC;FDWLRQV in Level 3 sports massage diploma and the level 4 sports PDVVDJH FHUWLĂ&#x20AC;FDWH 7KHVH TXDOLĂ&#x20AC;FDWLRQV DUH DLPHG DW OHDUQLQJ a new therapy and/or updating an existing one. We also offer workshops for additional CPD on topics that further explore the relationship between anatomy, soft tissue dysfunctions and rehabilitation. Classes are small and friendly offering home study units alongside practical workshop sessions. Further information is available on the website www.wmt.company.

25% discount to all massage world readers.

'HWDLOV Range of CPD days: 1 day ÂŁ85 Level 3 sports massage diploma: 8 practical days over 6 months ÂŁ1650 /HYHO VSRUWV PDVVDJH FHUWLĂ&#x20AC;FDWH SUDFWLFDO ZRUNVKRSV RYHU months ÂŁ1250

T: 07870538914 E: admin@wmt.company www.wmt.company