Massage World - Issue 111 by mwcommsltd

MASSAGE WORLD

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Massage Mentors:

Susan Findlay’s Top Tips for 2021 Fascia & Movement

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Issue 111 2021

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Connections Between the Fascia of the Lower Limb

Seated Acupressure:

The Magic of the Middle

Fascia, Bio-tensegrity & Scoliosis £5.00

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welcome e m o c l e w welcome editorial by Wendy Kavanagh

EDITOR

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Wendy Kavanagh

FEATURES

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“As a result of the advert, on the CThA Members Forum, I have one new holistic massage therapist who has joined the team and is very much appreciated by the clients” Donna Woodcock

Massage Therapist

To find out how the CThA helped Donna and hundreds of other members last year just when they needed it, call a member of the CThA team on: 0845 202 2941or visit our website at: www.ctha.com

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contents

issue 111 2021 Features

8 Five Top Lessons Taken From 2020

Susan Findlay reflects on the ups and downs over the past year and shares some of the lessons she has learnt.

12 Seated Acupressure: the Magic of the Middle

The middle third of the back is usually under a lot of pressure to ‘perform’ in situations that can be extreme or relentless. Pauline Baxter explains some of the techniques that are effective while giving seated acupressure.

17 Myofascia and Real-Life Movement

As a therapist, it is our duty to understand how the client moves. In this article, James Earls emphasises the importance of practical learning, rather than relying purely on anatomical texts to understand the complexity of human movement.

22 It’s All on the Web – Making Connections Between the Fascia of the Lower Limb

Through Earle Abrahamson and Jane Langston’s study of the fascial web, one has a potential landscape to weave the connections in and through body systems, discover the value of each and bridge gaps in knowledge and application.

34 The Importance of Fascia and Bio-tensegrity in the Treatment of Scoliosis Emma Gilmore talks about fascia and bio-tensegrity, then looks at how to effectively treat scoliosis with this important knowledge.

42 How to Create a Covid-19 Specific Communications Plan

For massage therapists and other bodyworkers, 2020 has proved extremely challenging. Marta Kalas talks about the importance of communication during the pandemic as regulations and guidelines continuously change.

22 Regulars 3 6 32 54

Editor’s Welcome News & Views Reviews Course Listings

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news&viewsnews&viewsn 2020 FHT Excellence Award winners announced The FHT is delighted to announce the winners of this year’s FHT Excellence Awards… FHT Complementary Therapist of the Year – Mary Atkinson, FFHT In recognition of the support she has provided thousands of people, across the world, by sharing live Story Massage sessions online throughout the pandemic.

FHT Green Therapy Business of the Year – Anne Bramley, MFHT, and Helen Saunders, MFHT For co-founding Wellbeing at Whistlewood, an initiative set in 10 acres of woodland, where guests can take part in a range of experiences and activities in the great outdoors, to help them connect with nature and improve their wellbeing.

FHT Beauty Therapist of the Year – Stephanie Chaytor, MFHT In recognition of setting up two successful businesses – Karma Beauty and Karma Boutique - and for the support she has provided clients during the pandemic.

FHT Sports Therapist of the Year – John Molyneux, MFHT For the telephone and online support he has provided mature clients to help them stay active throughout the pandemic, when he has been unable to see them in person.

FHT Student of the Year – Anya Rae, MFHT In recognition of her determination to overcome a number of personal challenges and return to education in order to share the benefits of complementary therapy with others.

FHT Tutor of the Year – Jennifer Young, MFHT For developing a free accredited infection control course to support professional therapists returning to work after the first lockdown.

Christopher Byrne, FHT’s President, commented: “Every year, our judges are overwhelmed not just by the volume of entries we receive for the FHT Excellence Awards, but by the incredible stories behind each nomination, and how our members are helping to make a real difference to the lives of others. This year, of course, it has been particularly heartwarming to learn how so many of our members have been finding new ways to connect with their clients and other therapists, at a time when coronavirus has made it difficult or even impossible to provide support in person. A warm congratulations to all of our 2020 FHT Excellence Award winners, as well as our finalists, who are all doing incredible work and really helping to shine a spotlight on what excellence looks like in our industry.” The FHT Excellence Award would normally be presented to the winners in person at an annual conference organised by the FHT, however due to the pandemic, this year’s celebrations were conducted remotely, as part of a special online FHT Excellence Awards Presentation.

www.fht.org.uk

FHT Local Group Coordinator of the Year – Tim Djossou, MFHT For excelling in his role as an FHT coordinator and organising a series of virtual meetings for his group members to learn about the connection between mental health and nutrition.

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wsnews&viewsnews&views ThinkTree

Hello Member, We hope you are well and managing during the new national lockdown (Published 4 January 2021, Last updated 6 January 2021) which the government asked us all to adhere to on 4 January 2021. This is in response to the growing concerns of the new variant of coronavirus and its rapid increase throughout the UK. We are aware of the discussions within the industry as to whether we are allowed to work or not and there is contradictory advice being given. As your PA our understanding is that close contact services are required to close as part of the national lockdown. The reason for this lockdown is to try to get on top of a virus that is currently killing in excess of 1,000 people a day and which is having devastating effects on the health of even more. Based on the government advice and guidance – now passed into law - it is now clear that no close contact work should be carried out until any such time that the lockdown is lifted or there are changes to the government advice and guidance. The government has also now updated its rules for close contact work safely: https:// www.gov.uk/guidance/working-safely-during-coronavirus-covid-19/close-contactservices#national-lockdown This clearly states this is “Guidance for people who provide close contact services including hairdressers, barbers, beauticians, tattooists, sports and massage therapists, dress fitters, tailors and fashion designers” It goes on to say “Close contact services are required to close”. There is no discussion of caveats, exceptions or loopholes – if you work in the close contact industry then you must close and remain closed until we are informed that the government rules have changed. We are reading arguments where people are saying they are part of the “Healthcare” services. We need to be clear on what constitutes a healthcare service in the UK – these are services which are regulated and assessed by CQC or are an allied health profession (other regulated healthcare providers such as paramedics, osteopaths, chiropractors). These are all statutorily regulated industries. The other clause that could give a way for some to work is that which refers to “services relating to mental health”. We recognise that massage does of course have a positive impact on mental health – however – the insurance take on this is that Mental health assessments should be carried out before any treatments given and if you do not have the requisite skill and knowledge refer to a medical professional. Remember that you are only insured for something that you are qualified and competent to carry out – this includes a mental health assessment, if you are not trained and qualified to carry out a mental health assessment then you cannot use this as a reason to continue with treatments. Even if you are qualified and competent to carry out a mental health assessment you should not assume that this means you can then carry out a close contact treatment, you would need to get clearance for this from both your local authority and your insurance company. If you interpret the guidance differently you are of course free to discuss this further, on an individual basis, with both your insurance company and your local authority. As professional therapists ourselves we understand and appreciate the frustration of not being in a position to help and support your clients. However, we must follow the scientific, medical and government advice and guidance and the greatest care we can give to our clients at the moment is to follow the government guidance, close our businesses and stay at home. There are breakthroughs in vaccinations and medical advice which gives us hope and light at the end of the tunnel. We are confident you will take the appropriate action and not put yourself, your client or family at risk. Follow us on Facebook for our latest updates.

The National Massage Championship With an estimate from the Government that most of the UK population will have been vaccinated against Covid-19 by the end of this Summer The National Massage Championship will be returning to Olympia Beauty on Sun 3 - Mon 4 October 2021 for the third year and opens for the first time to international competitors across the entire competition! This incredible event welcomes all qualified massage therapists and bodyworkers to compete for a trophy or two in 6 competition categories! The competition will be taking place on the Gallery level at Olympia London. Qualified therapists are invited to showcase their technique and bodywork skills in six different categories including Advanced Massage, SPA/Wellness Massage, Freestyle Massage, Eastern Massage, Chair Massage and Clinical Massage. Bringing together qualified massage therapists of all backgrounds, The National Massage Championship is run by therapists for therapists and judged by our panel of international judges with extensive professional massage therapy experience. We look forward to seeing you there!

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Susan Findlay: Massage Mentor

5 Top Lessons Taken From 2020 1 It goes without saying that whilst this year has been stressful, there have also been benefits. I have found that from tough times comes growth - not just on a personal level but on a business level. This is a time in which we need to dig deep, be creative and push forward - it is not the time to collapse in a heap and give up.

Out of discomfort comes growth

Pain + Reflection = Growth. I heard that this morning from an online personality. However, you must have each part for this to work! If you remove the word ‘reflection’ you are left with just ‘pain’ – all the negatives with no positives. I know It has been challenging for many, and my suggestions come from my own personal experiences of hardship. I have lost a lot, and I have had to work so much harder, not just for the monetary reward but simply to keep things going and make the necessary adjustments to move forward. When we are in discomfort, and when life hits us hard, we need to be open to learning - we have had lots of opportunities to take away many lessons from the past year. So much of our identity is linked to work, and many of us have experienced the confusion associated with feelings of being in this limbo. There are ways in which you can return to stability through service, and below are some suggestions about how you can serve, so you never feel lost. Let us continue onto the next lesson.

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massagementor 5 top lessons taken from 2020

Resilience

We all have had to adjust to the restrictions that result from Covid. Surviving depends on the ability to be flexible and to adapt to the situation - without being dynamic fear and reluctance to change will negatively affect your business. In general, life is stressful. Historically we have adopted coping mechanisms that allow us to function even prior to Covid many of us were already feeling the effects of trying to manage the stress levels in our busy lives. Under normal conditions stress is one of the modern-day health concerns that has been shown to affect our immune systems. This can play a significant role in disease, but under current pandemic conditions, our stress levels have been ramped up, and conditions like depression and loneliness have tripled. Dealing with these increased levels of stress and the demands it places on our mental wellbeing has been challenging, but for some of us the stressful conditions have not been limited to the pandemic. Many of us have had further challenges, if you were one of the unlucky ones and had further disruption or loss, you possibly experienced a more profound sense of sadness that might have left you feeling stunned, frozen in disbelief, or questioning how much more you could take. My story comes from running my school plus a private practice and a number of online courses under Covid restrictions whilst simultaneously losing both my websites to a ransomware attack! Obviously, we had to make adjustments to our delivery as well as supporting our students and graduates, all of which demanded a lot of time and energy. It was an odd situation because people looked to us for answers despite our total lack of pandemic experience, but we just adopted

the attitude of ‘we can do this’. An almost ‘Bob The Builder’ level of positivity got us through. Together, can we fix it? Yes, we can. We found ways to deliver the courses. Working under very stressful conditions, we made significant changes and have managed to keep most of them, it was like purging the old ways and bringing in a freshness that made sense. I was the Marie Kondo of Massage, you might say. The courses now look and function better than ever, as do our two new websites, and we found an amazing platform in which to host and deliver them. Obviously, I would have preferred the less stressful option, but sometimes life throws you a curveball and you have to respond! I am sure some of you have taken advantage of this dead time to maybe sort out your clinics, do a bit of redecorating, revamp your booking systems, clean out closets and do some online CPD courses etc. We all did stuff that we normally would not have had time to do, and maybe you have made some changes based on my next point.

Decide what really matters

Many people shyly admitted that they benefited in many ways from the time spent in lockdown. Many have said that they have never been so fit and healthy. Some have even adopted the hermit style of living as a more permanent way of existence. Others have retired or switched careers after realising that their priorities had changed. But for us who still want to do this job, we have had to find ways to make it sustainable. By slowing down, I could actually see what mattered. It’s like walking in the countryside after being in the city for years, without a break. I was able to take a deep breath of fresh, crisp air and for once there was no noise, no busyness, just a sense

of being. I started to listen to my internal rumblings. Not so much the remnants of a badly cooked Christmas turkey I hasten to add, more that I asked myself if I was sticking to my values, was I following my truth? I started to re-evaluate and focus on what was important. This is different for each of us, but it is essential to be honest, find a moment to hear your own voice and not be caught up by external distractions.

Creativity on steroids

The number of challenges I have faced recently has forced me to think creatively on so many occasions, I honestly believe if you approach a situation with the attitude ‘I can find a solution’, you often will. This leads me to the number one question I get as a mentor: ‘how can I connect with my clients and keep my business alive?’ The constant barrage of problems that we faced last year had a powerful impact on our ability to think, feel and move forward. Don’t forget that it also affected our clients and their abilities to cope! The emotional effect on everyone’s health has been entirely predictable - there has been a massive increase in depression, loneliness and other emotional problems. Isolation has pushed the limits of our better selves and that of our clients, with this is mind, keep the communication lines open, reach out in kindness and compassion, extend your hand freely and listen deeply. It is so important for your clients to feel that they have been heard. We can create more solutions when we connect, here are some suggestions for creating a business that supports your clients. • Start an email list • Produce a regular short newsletter with some tips for staying healthy • Offer a mini webinar on ideas for staying active • Tell your clients what they can expect when they return • Post changes you’ve made to your clinic • Send your favourite healthy recipe (mine is basil courgette spaghetti – you can find the recipe in my blog) • Send a post card (yes they still do exist) Issue 111 2021

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vid-19 Pr otocols

massagementor

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5 top lessons taken from 2020

My final lesson is Gratitude

It is not the last lesson I took away from 2020, but if I shared them all I might have to write a book. e about all It is easy to say ‘stay positive’, ‘look the current policies, pro on the bright side’, but sometimes very know that cedures. I those sittin cannot say to do. Gratitude does not have to g as board assage The thishard m for every P embers of rapies) pla A,things, be for tangible th but I and it also does e G yed a signifi CMT (The mbers. Gehave cant role in n e ra l not to be for C o u getting info ncilmajor events! You was hearte rmadon’t tion o Susan’s have ut toto ashout ned to see ll theirit from the rooftops first love that so ma he professio is d or announce it on social media – you first love n y anc s th pcan erapists join ort, anyt Susan’s e, n started ta hin ed in on th lking as a u g sional asso to keep it as private or as public as you like. is dance, sport, d e o with conversatio the joy o nified body, ciations, w f movanything n, for opening your and how w Simply being grateful ith GCMT e to do with ement. S us to supp e got behin merged as trained he ort our PA’s d o a a u b r s o a • Recommend the best book you eyes in the morning, the feel of a crisp d the joy of movement. in y n w th u ith influenc r eir efforts to ue of highe s e in bu soon Canada e. wind r educhave petition the It is n ation recently onoyour She as a nurse left th w face, or even a ttext within thread governmJanuary e ptrained what can y r o e e fe n p c t ssbut ro a to fe m ionsoon recfrom ssion. ou do? 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I dauntinand ave to imp T g is , c it takes practically no time at all. better use of all her knowledge would be: e s b a u m o n th e n rovisesuggestions e ot see mas T fo d h r ia e l and adapt, r S a pist. Cu oft sage stopp Sometimes it feels like thedeasy we will cert rrled which retrain irector o enther ing; whilst ly stohe ainly surviv • To start off my initial session f NLSSM is tand he e. option is just to collapse andte doanothing, asa anSports d specMassage ching On with an intake, to update the ia li s e s c ologRemedial especially if you are on youra own. Therapist. y MassaSoft Tissuein uthWhy information of an existing client or or of Spo ge. She is bother even getting dressed? 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Seated Acupressure: The Magic of the Middle By Pauline Baxter n Seated Acupressure massage, we tend to focus on the upper body, including the back, neck, shoulders, head, arms and hands. These are prime areas for holding stress and tension with modern technology being an obvious major contributor. The current pandemic has exacerbated this with people having lost loved ones, unable to meet with family and friends, working in essential services as a key worker, working from home, losing their job, financial pressures, emotional pressures, and many other issues now highlighted. The human body can only take so much. Massage has many benefits for both body and mind. Self-care has dropped down the list of priorities in the current situation, yet it is probably even more important. As massage practitioners, we know we can help but must remember that unless medically qualified to do so, we should not diagnose an illness or disorder, or claim to ‘treat’ a person. A bit of an oxymoron when the appointment is often referred to as a massage treatment, and we are often taught to provide a treatment plan for clients! We are all aware there are many different types of massage available, and not every type suits everybody. One advantage of Seated Acupressure is that it is applied over clothes and can be a relatively short treatment (see, I told you the word ‘treatment’ is often used as a replacement to appointment!). If I were going to pick one part of a Seated Acupressure massage as being particularly effective (and it just happens to be my favourite part), it would be work on the erector spinae (e.s. band), specifically the section that lies either side of the spine along the middle third of the back. Don’t get me wrong, I love the whole massage, and it was a close call between the middle and upper third of the e.s. band. You may have a different favourite part of the massage. Let me explain my choice.

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massagefeature seated acupressure: the magic of the middle

1 The middle third of the back is usually under a lot of pressure to ‘perform’ in situations that can be extreme or relentless. Initially, consider when working at a desk and using a desktop computer. Many of you offer corporate massage. Pre-Coronavirus you would go into company offices to provide a service which aims to help alleviate the potential problems arising from daily computer work. This is where the ‘magic’ of massage can be so effective. In the corporate environment, there is a tendency for an individual to sit for hours at a time without standing up or moving around. They may start out sitting in what is considered to be good posture, but with the best will in the world, it is far too easy to slide forward on the seat, slump the lower back, round the shoulders, lean slightly to one side and extend the head forward when looking at the screen, or bend the head forward to look at the keyboard. The body is a fantastic thing, and it can deal with a lot. However, the demands being made in this situation are often excessive, particularly as it can be day after day, month after month and even year after year. Even the human body has limits! Lockdown over the summer meant I spent a lot more time working at the computer than usual. Interestingly, it has given me an even better understanding of what many of my corporate clients go through with daily working life. By focusing on my increased first-hand experience, I have been evaluating how I can help my clients further. Aside from the obvious points of sitting correctly, getting up and moving on a regular basis, hydration, nutrition etc, as a massage practitioner I know I can massage my own muscles to help ease tension (though you can’t beat having someone else do the work for you!). But there are limits to the handson massage you can do for yourself for the middle part of your back, simply because it is difficult to reach. This is why it’s probably my favourite part of receiving a Seated Acupressure massage and also why I think it is one of the most effective parts of the massage.

The body is a fantastic thing, and it can deal with a lot. However, the demands being made in this situation are often excessivey.

2 With that in mind, what are the best Seated Acupressure techniques for massaging this area? Good question and one to which we probably all have different answers. 1. GENERAL WARMING UP TECHNIQUES A Seated Acupressure massage includes more than just acupressure techniques. The range of techniques you use will depend upon your own abilities, qualifications and experience., not forgetting your client’s personal health history and current situation/requirements. Before you begin to target a specific section of the back, it is important to warm up and prepare the muscles of the whole back. This gives you a lot of information, including how the individual muscles feel, the opportunity to compare the two sides of the body and any muscular imbalances, and your client’s sensitivity to touch. Type of technique includes the more general kneading, rubbing/ friction, rocking and gentle stretching. Some are applied from the side of your client, others with you standing directly behind your client. General techniques are also great at helping your client relax, both mentally and physically.

2. DOUBLE FOREARM PRESS Having completed overall back warming techniques, you can then start to be a little more specific. A great acupressure technique for the middle section of the back is the double forearm press. This has the potential to cover a relatively large area in a horizontal plane. As the name suggests, you apply pressure through your forearms, which is done by transferring your body weight (rather than using muscle strength). A word of caution, always use the ‘fleshy’ underside of your forearms closer to the elbow (flexor muscle area) and not the ulna border, which would be painful for your client and uncomfortable for you. Stand directly behind your client and once your arms are in position as shown in the photo and described below. You should then adopt the basic kata stance for Seated Acupressure which is one foot forward, one foot back, with your back and back leg making a Issue 111 2021

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massagefeature seated acupressure: the magic of the middle

continuous straight line to help protect your own posture and make it easier to transfer body weight safely. Turn your palms to face your client, allowing you to place the softer underside of your arms across the back horizontally, crossing the spine. Your focus for your contact is the e.s. band, right forearm on the right e.s. band, left forearm on the left e.s. band. Keep your shoulders, arms, and wrists relaxed. Apply controlled pressure by gradually transferring bodyweight through the arms (do not use muscle strength). Remember the pressure should be applied in a direction that is perpendicular to the back. As you apply the gradual pressure, you may start to feel the spine on the underside of your arms. If so, allow your forearms to slightly ‘contour’ the back, so you still apply pressure into the es band but not directly on the spine. It is only by applying pressure in a controlled manner that this technique becomes effective. Too quickly and you run the risk of triggering a reflex action, resulting in your client flinching and being uncomfortable.

3. DOUBLE FIST PRESS An additional or alternative technique to the double forearm press is the double fist press. This works the e.s. band on both sides. Perpendicular pressure is gradually applied using a ‘loose’ fist using the ‘flat’ of the metacarpals rather than knuckles. Ensure you avoid direct contact on the spine.

4. SINGLE FIST PRESS You will see the techniques mentioned start out as general and cover a larger area, whilst working both sides of the spine simultaneously. As the muscles begin to relax (and your client!), you can be more specific by working on smaller areas. This allows you to work deeper into the muscle and focus on one side at a time, e.g. moving to a single fist press on one side. In this case, it is important for you to support your wrist to maintain stability. Use your left fist when working on the right-hand side of the client, and vice versa. This allows you to place the ‘flat of the knuckles’ on the crest of the e.s. band and fingers pointing away from the spine. By supporting your wrist with your other hand, you stabilise your wrist and can then apply controlled pressure. 14

5. MID BACK ELBOW PRESS Moving on from here, a very effective technique is the elbow press. However, this can be a strong technique that must be applied with care. You will be familiar with the elbow press used on the upper back, which involves using the point of the elbow. As you move down the back, you have to adapt to ensure the technique is safe and comfortable, both for you to apply and your client to receive. There can be a lot of tension in the e.s. band and in this area of the back it can be easy to ‘slip’ off the crest of the muscle and either laterally onto the ribs or medially, onto the spine. Not nice for either the client or you! Even after the more general ‘warming up’ techniques, it is important to maintain a gradual application of pressure to avoid slipping. When working on the left side of your client, your left hand acts as a guide, with the thumb resting along the spine and fingers to the side. Although in the following picture you cannot see the left thumb itself, you can see where it lies. The thumb acts to protect the spine, and the fingers act to give stability and help isolate the area on the e.s. band on which you are going to work. The right elbow can then be used to apply the pressure into the specific point on the e.s. band. You will notice the angle of the forearm in the picture is more horizontal than when applying the elbow press higher up the back. This is simply to make it more comfortable for you, as the massage practitioner, to apply towards the lower part of the back. The angle will vary from person to person, so you will need to find what works best for you. Note that the flatter the right forearm, the more general the technique. If you want to be more specific, use the point of the right elbow.

6. DOUBLE THUMB PRESS LAT BORDER ES It is also possible to use the thumbs to apply pressure onto the e.s. band. However, to protect your thumbs do not apply a great deal of pressure. This technique is more suited to light pressure and when working on the lateral border of the e.s. band in the lower back area (outer bladder meridian) as this can be a very sensitive area. There are so many more techniques that can be used, and it is impossible to cover them all here. As a professional massage practitioner, you need to select the most appropriate for both your client and you.

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W : aosm .co.uk

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Seated Acupressu r

seated acupressure: the magic of the middle

e Diploma Course content co nsists of home stu dy (video pre practica l work. A ll sections must be c ompleted. Part 1 Fri 5 M ar – (P 1) O n line c lass (2 hrs) M o n 8 Mar – (P61) Pra 5 ctica l (7hrs) Part 2 Fri 19 Maabilities, r – (P2qualifications …you must always work within your experience with the ) On lineand c la ss 2 hrs) additional considerations history and current(requirements. Moofnyour 22client’s Mar health – (P2) Practica l (7 hrs) Sework is one further set of guidelines to which you should As mentioned earlier, you must always your atewithin dA cupreadhere, sThere s uand retheyRbelong addition to those mentioned abilities, qualifications and experience with the additional efrtoouteyou. syourhIneown r risk assessment and previously, you will carry history considerations of your client’s healthF ri 1and2 current M a r – (P 1 ) identifyO hown youli will risks. If, after completing requirements. That does not mean you can only use nminimise eyoucdolanotany s s (comfortable 1 hr) going ahead your risk assessment, feel techniques learned in your Seated Acupressure qualification M o n 1 5 M a r (P with 2 massage (forc whatever Your risk for Seated Acupressure massage and your Swedish massage ) Pra tica lreason) (3 hthenrsdon’t. )particularly assessment should be constantly updated, in light techniques for Swedish massage. Far from it! I would Mass age At The D es k Fri 26 Mar - (P1) O n line c lass (1 hr) Mon 29 March-If(P you have previously returned to 2) Practicadecided l (3 htorsdelay, massage or have ) make

encourage you to draw from these different qualifications and the techniques you practice in order to tailor a massage for your client that is safe and effective for both your client and for you. After all, providing massage is your livelihood, and you would be foolish to compromise your health in the process. With the current Covid-19 pandemic, it is even more essential that you do not compromise the health of either you or your client and you should always work within the guidelines of the Government, your Professional Association, insurance provider and local council. This will include wearing a required level of PPE.

of the ever-changing Covid-19 situation.

ALL pra ctical trainsure you keep up to date and massage in responsibly safely. g will takand e pla ce at www.kingsm More details a vaila oorc linic ble at www.aosm.c o.uk

Pauline Baxter A 10 year background in Health & Fitness Club Management laid the foundation for Pauline’s venture into the world of complementary therapies. Over 22 years later, that journey has been, and continues to be exciting, rewarding and ever-evolving. Notable events include becoming a tutor for Academy of On Site Massage (AOSM) in 2000, director and owner of AOSM in 2006, a regular contributor to industry magazines since 2010, development and growth of additional On Site Massage training, and a judge at the National Massage Championships in 2018 & 2019. www.aosm.co.uk | 0118 391 4313

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advertorial

Encouraging Intelligent Movement in a Sedentary Society Tools Facilitating Neuro-Myofascial Release at Home & in Clinic ractitioners who have attended the British Fascia Symposium in recent years may recall the buzz generated around Energy for Health’s stand where many delegates tested the FlexxiCore products which help practitioners and their clients work deeply and effectively with fascia health. The beauty with both devices is their versatility and accessibility – including cost – for all age groups and fitness levels. Thanks to the marvels of tensegrity, both the FlexxiCore Challenger and the FlexxiCore Passive Exerciser elicit a series of natural responses through the transmission of waves throughout the fascia. As well as triggering neuro-myofascial release, the nervous system responds to the oscillations and ripples of movement with deeper breathing and a boost to circulation. While these FlexxiCore devices can never replicate the individual care and precise targeting of manual treatments, they effectively mimic the natural patterns of exercise itself, complementing the handson approach of a practitioner in a way that clients positively enjoy. As no compression or manipulation is involved, adhesions and distortions in the neuro-myofascial web are gradually released with minimal intervention. The FlexxiCore Passive Exerciser has its origins in the martial arts and Shiatsu traditions of Japan, combining the energising and stress-releasing effects of Japanese “Goldfish Exercise” with the back-care features of the Continuous Passive Motion (CPM) devices first designed by a Canadian Orthopaedic Surgeon. CPM equipment is used by back care professionals to ease spinal problems by encouraging the flow of synovial fluid between the discs. This helps to reduce inflammation and ease pain by supplying nutrients and oxygen to the tissues, at the same time helping to expel the toxins that arise from inflammation. These passive exercisers gently swing the feet, creating a pulsing motion in the area of the dantian energy centre, and generating a fish-like motion through the spine. As a Class 1 Medical Device that is

typically used as a pre-treatment adjunct to a hands-on session so as to help the client relax physically and mentally, the FlexxiCore Passive Exerciser helps therapists to reach their desired outcomes more effectively while reducing their physical work. The FlexxiCore Challenger is based on Whole Body Vibration (WBV) technology - a proven method of accelerating the effects of exercise with over 200 published studies covering its many beneficial effects. For example, at least 10 studies have reported WBV-induced increases in strength, power and performance in young healthy adults*. The original Power Plates® found in many gyms are sophisticated devices, but are generally unsuitable for home use - and too bulky and expensive for most practitioners to invest in. The FlexxiCore Challenger is reasonably priced, built to last, and far more versatile. It combines vibration and oscillation with different programmes that create an exercise-like experience, helping to generate elasticity in the fascia. Trials undertaken with the Challenger (42 participants - age range: 39 – 85) saw substantial improvements in just 60 days in 16 different categories of benefit, including Core Muscle Strength; Energy Levels and Stamina; Fitness/Performance Levels in Other Activities; Posture; Muscle & Joint Aches, Tension and Stiffness; Toning; Pain & Headaches; Sleep Patterns; Improved Balance; Better Motivated to Exercise Generally; Stress Release. Lessons from COVID During the COVID pandemic we are seeing many people reassessing their priorities. Though the media tends to view everything in terms of a quick vaccine fix, the reality is that viruses will never be “beaten.” What individuals need more crucially is the resilience to co-exist with viruses in all their mutations. Recent research** shows that patients with severe COVID-19 disease generally have shorter telomere lengths - a typical sign of aging. Studies show that telomere shortening is accelerated by lack of exercise, chronic stress, poor nutrition, and being overweight.

*Delecluse et al. 2003; Roelants et al. 2004; Ronnestad 2004; Savelberg et al. 2007; Bosco et al. 1998; Lamont et al. 2008, 2009, 2010; Di Giminiani et al. 2009; Torvinen et al. 2002. ** Source: Aging, 2021; doi: 10.18632/aging.202463

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Myofascia &

Real-Life Movement By James Earls

In my 30 years as a therapist and teacher, I have seen significant improvement in the attention given to human anatomy by soft tissue therapists of all kinds. When I first trained, there were three main references available for bodywork and the anatomy text I was given which covered the anatomy and physiology of the entire body in 82 pages. For a keen reader, it was a frustrating time to learn massage.

ach decade of my career has seen development in one area at a time. During the ‘90s, I saw the growth of sophisticated therapeutic techniques, primarily driven by Leon Chaitow and Mario-Paul Cassar’s texts. The new millennium brought the dawn of fascial related texts with Tom Myers’ Anatomy Trains’ publication and the popularisation of ideas drawn from Dr Rolf’s structural integration. This was combined with the rise of John Barnes’ ‘myofascial release’ and the various teachers that brought his approach into Europe. While the awareness and understanding of fascia continues to grow, it coincides with invigorated interest in detailed anatomy. Access to dissection classes increased recently and made the years between 2010 and 2020, the decade of anatomy. Now, as we go further into the ‘20s, we can bring our awareness to the purpose of that anatomy – movement. But, to understand movement, we need an expanded vocabulary that enhances and supports our vision. That vocabulary is not easy to access. It is not available in most of our textbooks as they tend to focus on either dealing with pathology or giving us yet more detail on the idealised anatomy of dead and inert bodies. The main goal as therapists is to enhance the quality of life for our clients. Our clients are moving during their everyday to-ings and fro-ings – they are reaching, bending, turning, and twisting. Our clients walk to the shops, get in and out of cars, mount stairs, and go for a swim or a run – regularly using and challenging their body to do things that our textbooks have not enabled us to describe. The decade of soft tissue techniques gave us tools to manage pathologies. The decade of fascia taught us that everything is connected. The decade of anatomy has helped improve our accuracy. But, can we accurately describe why a shoulder restriction might aggravate flexor hallucis longus? As a therapist, it is our duty to understand how the client moves. Saying ‘everything is connected’, or, ‘it’s because of the kinetic chains’ are not helpful

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anatomyrefocused mysofascia & real-life movement

answers. The statements might be correct, but this series is for you if you want to move to the next level and comprehend movement. We will explore concepts and vocabulary that will build to give you the skills and vision to understand real-life movement. Real-life movement is very different from ‘anatomy-book movement’. I believe each anatomy text should start with a disclaimer stating that every ‘action’ listed within is based on a fantasy situation where the body is floating in mid-air, held by some kind tractor-beam that allows the lightest part of the body to move when a single muscle contracts. That is not reality. In reality parts of our body (most commonly our feet or our pelvis) are anchored to a surface and influenced by the dynamics of friction and gravity. Neither of these dynamics appear in or is acknowledged in general anatomy textbooks. Still, along with other dynamics and forces, they will significantly influence which muscles

Figure 1 – Planes of Movement The planes of movement diagram is included in most textbooks, and many people make the mistake of assuming that movement can happen in one plane. Movement happens in each plane all of the time, but most often, a movement can be described using the ‘coordinate system’ of the planes.

contract and when they contract during movement. It is impossible to understand the complexity of human movement from standard anatomy texts; they just don’t provide the tools. There has been a general tendency in our profession to ‘totemise’ certain body parts in response. I am sure you have seen how anatomical elements are exalted to an all-important status as the sources of all good or evil in the body. At various times and in various schools of thought, the psoas, gluteus maximus, the diaphragm, or the foot have been recipients of such heightened attention. That degree of focus on a few tissues is in spite of, and in contradiction to, the tensegrity-based and anatomical reality of ‘everything being connected’. Anatomical interconnectedness creates an interdependence between the tissues that communicate and distribute forces throughout the whole body. One of the reasons anatomy-book learning is relatively straightforward is because it presents anatomy from within a controlled environment – the difficulty with real-life movement is that many more variables are brought into a complex equation that makes it almost impossible to predict an individual’s response to a movement. Whilst it may be reassuring to the therapist to be given an A-B-C approach to treating low back, rotator cuff issues, or an anterior head position, the reality is that each client has been exposed to their own unique equation of movement variables. Breaking down your client’s individual movement strategies will let you create unique and appropriate treatments, using your soft tissue skills with anatomical accuracy and ensuring that the client can use better movement patterns. The anatomy of movement cannot be rote memorised in the way we learned our ‘origins, insertions, and actions’. Understanding movement requires juggling numerous principles in one’s head, and it is these principles that we will explore through this series. Interestingly, one of the first and most empowering vocabularies is included in the first few pages of most anatomy texts – the use of movement planes. The three planes - sagittal, frontal, and transverse - are often

skipped over, and as a result, they are under-used and misunderstood (fig. 1). We must address the elephant in the room by acknowledging that there is no such thing as sagittal, frontal, and transverse plane movement—there is just movement—and movement happens in all three planes all of the time. The use of planes is a construct that facilitates the description, and thereby the analysis, of the threedimensional complexities of movement. To just say that everything is “a spiral” or everything “just moves” does not empower our exploration of what is going on and why. The three planes provide a coordinate system that describes position and action for anatomy, just as longitude and latitude serve a similar function for navigation. There are no actual lines on the Earth, but longitude and latitude give us a convention to know where we are, where “somewhere else” is, and how to get from here to there; the three planes of motion give us a similar power for describing the anatomy of movement.

Figure 2 – Complex 3D Printed Object The rise of 3D printing shows the power of using three coordinates. The movement of the continually moving print head is guided by 3D plotting along the X, Y and Z axes. Human movement can be just as beautiful and complex, and can also be broken down into the same three axes, but in anatomy, we call them sagittal, frontal and transverse.

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Figure 3 – Photo of sagittal plane swings Standing in a comfortable neutral, bring your arms overhead and then swing them forward and down, up and back.

The use of planes becomes especially accurate when combined with an understanding of real and relative motion which we will explore in a future article. Our aim is to increase the ability to see and describe the interactions between movement and anatomy, and the best way to do this is to stand up and move. Position yourself comfortably. To appreciate the benefits of the vocabulary let’s do a quick and easy movement and anatomy experiment – stand with your feet on the floor, roughly hip-width apart and pointing in whichever angle is most comfortable for you. Now, swing your arms up and over your head, and then down towards your knees - swing back and forth a few times and feel what happens in your spine, hips, knees, and ankles (Fig. 3). If you followed the instructions, you would probably have felt your spine flex and extend, your hips and knees flex and extend, and your ankles plantar and dorsiflex. The lesson is simple – movement that happens in the forward and backward, predominately sagittal plane movement results in flexions and extensions in the joints. We can extend the same principle to a movement in the frontal plane by swinging our arms side-to-side over our heads (fig. 4). This movement will provoke side-bending of the spine, AD and ABduction of the hips, along with inversion and eversion at the ankle. To experience the reaction in the transverse plane, bring your arms straight out in front of you and swing them left to right (fig.5). It should be no

Figure 4 – Frontal Plane Starting in neutral with your arms overhead, swing your arms to the left and right.

surprise that transverse plane movement causes rotations through the body – spine and hips, especially in this case. You may also feel your feet adapt by alternately pronating and supinating as you turn from one side to the other. Although it is possible to have anatomical variations that create different responses, most of us will have similar reactions to these movements if we: 1. Make the arm movements large enough and with enough momentum 2. Allow the body to respond naturally and not try to prevent the reaction travel through – for example, many movement teachers will ‘stabilise their pelvis’ during the movement which prevents the lower body from reacting and limits the reaction to the upper body. Similarly, an injury may prevent you from letting the reaction happen. 3. Make sure your environment allows the natural response. If you did the exercise sitting on a chair, the contact with the chair would prevent the reaction into the lower body. If you are wearing supportive, tight shoes or orthotics, you also might not feel the feet reacting in the same way. There is much that we can learn from just these simple exercises. The first and perhaps most important is that movement direction creates reasonably predictable reactions in our bodies, and these reactions are determined by our joints. If we use the knees as an example, the first movement in the sagittal plane created flexion and extension but

Figure 5 – Transverse plane Swinging your arms left to right in the transverse plane causes a series of rotations through the body. Issue 111 2021

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anatomyrefocused mysofascia & real-life movement Figure 6a. Right hand reach across body Feel your body’s reactions as you reach your right hand forward and then across to the left. Try to reach as far as comfortable without moving your feet. Remember how far you reach and then return to neutral.

very little happened in the knee joints during the frontal and transverse plane movements (some movement does happen, but it is slight). During the frontal plane and transverse plane movements, less happened at the knee, but there was more happening in the ankles and feet – inversion/eversion and pronation/ supination respectively. This brings us to the second main principle- it is the architecture of the joints that determine the reaction. The knee joints are ‘designed’ with an extensive range of flexion and extension but very little rotation or AD/ABduction. Sagittal plane movement can use knee flexion/ extension – or- conversely, knee flexion/ extension can be used for sagittal plane movement depending on whether the knees are reacting (as in the exercise above) or acting to create a movement (such as for a squat). However, the nature of the architecture can allow the joint to move in the direction of the overall movement, or the architecture can prevent the joint from contributing. In the case of the knee joint, the congruency of the bones and ligaments when standing provide very little ability to AD/ABduct or rotate. In our exercise, the lack of movement in certain directions at a joint means that the movement is not absorbed by the tissues associated with that joint and the movement travelled further below the knees and into the ankles and feet which could contribute to the frontal and transverse plane exercises.

This brings us to the final, and most important principle – if a joint cannot contribute to a movement request, it will either cause a reduction in the overall range of the movement, or extra movement will be requested from another joint(s). To experience this, stand again, and from a neutral position, reach your right hand straight forward at shoulder height and then across to your left (fig. 6). Try to reach as far as you comfortably can without either repositioning your feet or causing discomfort. Take note of two things: 1. The distance that you reached we’ll call this your overall range of movement. 2. The reaction in your right foot – did it pronate? And, did you place some pressure on your big toe to return from the reach? Now, try the movement again but this time do not let your scapula protract, keep it anchored on your back as you try to reach your right hand the same distance you achieved before.

Figure 6b. Right hand reach without should protraction. Anchor your right shoulder blade against your back and then repeat the same movement without letting the shoulder protract. Try to reach the same point as before, but be aware of how your body responds as you reach and return.

What happened? Could you reach as far? How did you try to compensate for the loss of a range of motion of the shoulder? Everyone will have a slightly different reaction, but I am sure many readers will have felt some extra pronation of the right foot and, perhaps, a little more strain in the flexors of the big toe to help you return. The following articles will explore many of the dynamics that will help you understand the body’s real-interconnectedness and how the soft tissues and skeleton respond when the body is moving, and momentum is present. Each article will address one or two vital aspects of anatomy that you will not have covered in basic training and open new doors for your creativity in practice.

James Earls been a dedicated manual therapist for almost 30 years. During the last 20 years he has have specialized in myofascial approaches to bodywork and co-authored ‘Fascial Release for Structural Balance’ and ‘Born to Walk’. While teaching myofascial anatomy around the world he encountered many interesting models and became especially interested in the functional movement work of Gary Gray. After being awarded the highly regarded GIFT Fellowship from the Gray Institute I managed to blend my understanding of myofascial anatomy and functional movement into his second book – ‘Born to Walk’ – which has been translated into numerous languages with an updated second edition released in 2020. His work combines my interests in functional, evolutionary and comparative anatomy to explore the ‘truths of movement’. He firmly believe that by understanding normal, everyday movement we are better able to understand the limitations our clients may experience and thereby develop appropriate, fun and individualised movement practices for them.

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F I

FASCIAL ANATOMY FOR MOVEMENT • A series of fascial anatomy online and in-person courses and lectures • Online fascial based movement classes • Fascial focused yoga classes and workshops • Short fascial anatomy workshops for movement and manual therapists Fascial focused dissection courses in Winter 2021 and throughout 2022 at the Plastinarium in Germany with Gary Carter (lead dissector and designer for the Fascial Net Plastination Project). Gary Carter brings the very latest in Fascial research including new groundbreaking information. Collaborations with leaders in the field of Fascial research, movement practices and so much more.

For more information please contact Info@naturalbodies.co.uk • 07778 403578

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I t ’s All on t he Web – Making Connections Between the Fascia of the Lower Limb By Earle Abrahamson and Jane Langston he human body is a complicated web of cells, tissue, organs and systems that enables unique movements and structures, clearly distinguishing humans from other creatures. This organisation of the body forms a framework for learning and applying anatomy in practice. Too often, the teaching of the human body becomes defined according to successive layers of cells and tissue, each with unique and specific features. Students are encouraged to learn system by system often failing to find key connections between them. Through a study of the fascial web, one has a potential landscape to weave the connections in and through body systems, discover the value of each and bridge gaps in knowledge and application. This is particularly useful for practitioners who often face daunting and difficult decisionmaking situations where one technique may be insufficient in treating or managing a condition or pathology until connections between structure and function

become visible and understandable. In learning the lower limb anatomy, students typically define common regions and explore osteological and arthrological features as distinct learning clusters – bones and joints, in other words. Muscles, nerves, blood vessels are added to complete the lower limb as a functional system, yet hidden in the tangled arrangement of these tissues, lies the cardinal connector: fascia. Through fascial connections the lower limb is able to fulfil its role of weight bearing and locomotion. This article reveals the connections between the fascia of the lower limb by exposing the hidden webs that form complex septa and compartments for housing anatomical structures and features. In doing so, a greater appreciation for including fascia as a principal component of the lower limb anatomy becomes apparent.

What is Fascia?

Schleip and Findley (2007), cited in Lesondak (2017) define fascia as the soft tissue component of the connective tissue

system that permeates the human body, forming a whole body continuous threedimensional matrix of structural support. It interpenetrates and surrounds all organs, muscles, bones and nerve fibres, creating a unique environment for body functioning. Schleip and Findley (2007) are to be applauded for attempting to define this remarkable tissue. Their definition, whilst relevant, does not fully recognise the importance of the fascial system. What is known is that fascia is inextricably linked to each body component, it compartmentalises, separates, defines, and supports the body in its action and often inaction. Through understanding fascia as both a tissue and system, one can begin to conceptualise the complex matrix (see pic 1) Whilst one definition of fascia may never be sufficient, scientists have attempted to categorise fascia into sections such as superficial, deep, meningeal and visceral and then study the intersections between fascial groupings.

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We have a leg to stand on – understanding the lower limb fascia

The lower limb is described as a component part of the appendicular skeleton, connected to the rest of the body through the pelvic girdle. The inguinal ligament encased within its own fascial web is the boundary between the lower limb and lower abdomen. (see pic 2). Benjamin (2009) suggests that fascia of the lower limb is a serial continuity of the different fasciae, whereby the gluteal fascia continues with the fascia lata, the crural fascia, and lastly, the plantar fascia. The many functions of the deep fascia of the lower limb include its role as ectoskeleton for muscle attachments, and the creation of osteofascial compartments for muscles. An analogy for this could be a fruit jelly. The jelly represents the fascia, which flows around the pieces of fruit, holding each in a position, surrounding each piece with the same substance. Come back to thinking about the limb and we can see that fascia as a continuum would indeed wrap around every structure within the limb, so every part of the limb is connected to a continual web. Fascia’s role in venous return, and the fact that it serves as a protective sheet for underlying structures has also been recognised. The dissipation of tensional stress within ligamentous and tendinous structures and their attachments to bone (entheses). As our understanding of the anatomy and physiology of these structures expands, the important role of the deep fasciae in the interaction among the different muscles of the limbs has become more apparent. The deep fasciae could be considered to be like a bridge, passing over the joints and the septa to connect

different muscles, but recent studies also recognise a primary role in the perception and coordination of movements, due to the unique mechanical properties and dense innervation of these fasciae. Many anatomy teachers teach that the skeleton provides the strength for support within the body. If we remove the muscles, the skeleton is nothing more than a cluster of bones. Biotensegrity is a structural design principle that describes a relationship between every part of an organism and the mechanical system that integrates them into a complete functional unit. The biotensegrity geometry model explains that when stress is applied to the body, that stress is distributed rather than compressed. This begins to explain how local injuries can soon become global patterns of strain. The work of Tom Myers focusses on identifying and defining the fascial trains within the body to show how strain patterns are distributed within and throughout the connective tissue system via Biotensegrity. The implications of fascia as a tensional network and framework within the body means that we must consider soft tissues when we perform muscle tests; a muscle can only work if the fascia surrounding and within it is under the correct tension. No body part works in absolute isolation, so reductionistic approaches to soft tissue therapy are not true representations of their effects in therapeutics. Awareness of such concepts as Biotensegrity and fascia deepen our understanding of soft tissue and help us to direct our therapeutic approach more appropriately.

The shape of fascia

Fascia carves shapes into the human form and enables the passage of vessels and nerves to travel through and between septa and muscular compartments. Take for example the femoral triangle, which is a wedgeshaped area located within the superomedial aspect of the anterior thigh. The triangle is defined by the fascia lata forming its roof, the pectineus, iliopsoas and adductor longus muscles forming the floor, the superior border formed by the inguinal ligament, the medial border by adductor longus and the lateral border by the sartorius. Travelling through the triangle we can identify medial to lateral: the femoral vein, artery and nerve. This enables practitioners to locate pulses, recognise deficiencies in venous return and understand the entry of the femoral nerve into the lower limb. A second important shape defined within the posterior aspect of the lower limb is the popliteal fossa. This fossa is a diamond formed superiorly by the semibranosus and biceps femoris and inferiorly by the two heads of the gastrocnemius. Key anatomical structures traverse the fossa as they supply and innervate the leg namely: Popliteal artery and vein and common tibial and fibular nerves. These shapes would not be possible

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making connections between fascia and the lower limb

without the convergence of fascia that mould these unique pockets to facilitate the efficiency of the body, and help support the important structures embedded within, such as lymph nodes and lymphatic vessels. Through cadaver dissections we learn to appreciate how fascia interacts with body tissue, creates supporting and supportive structures and directs the attachment and functioning of contractile and noncontractile tissues. It is important to note that in reality, the different layers we have learned and treated are continuous and not simply single. These intersecting layers provide a ground map for navigating the body terrain. The superficial fascia is a collagen layer that divides the hypodermis into three distinct layers: the superficial adipose tissue, a membranous intermediate layer, or true superficial fascia, and the deep adipose tissue. The thickness of the two adipose tissue layers varies in the different zones of the limbs, determining specific, regional relationships between the superficial fascia and the skin, and between the superficial and deep fasciae. The deep fascia consists of a lamina of connective tissue that is, generally, easily separable from both the underlying muscles and the overlying superficial fascia. In fact, there is virtually an uninterrupted plane of gliding between the deep fascia and the muscles surrounded by their epimysium, with just a little layer of interposing, loose connective tissue to facilitate gliding. A few strong intermuscular septa originate from the inner surface of the deep fascia of the lower limbs and extend between the muscle bellies, dividing the thigh into different compartments, and providing an origin to some lower limb muscle fibres. The retinacula are typically regional specialisations of the deep fascia; in particular, they are thickenings of the deep fasciae and,

as such, are not separable. They appear as a strong fibrous bundle in a criss-cross arrangement of the collagen fibres. In a few specific regions, the muscles of the lower limb connect with the deep fascia via fibrous expansions or direct insertions of their muscular fibres. For instance, the iliotibial tract could be considered the tendon of the tensor fasciae latae and the gluteus maximus muscles, it is also a reinforcement of the fascia lata. It has extensive attachments to the lateral intermuscular septum in the thigh and many muscular fibres of the vastus lateralis muscle also originate from this septum. Therefore, during movement of the lower limb, the lateral intermuscular septum is stretched proximally by the gluteus maximus, and distally by the vastus lateralis muscles. Similarly, the sartorius, gracilis, and semitendinosus muscles form the pes anserinus in the medial portion of the knee, but they also extend some expansions into the medial aspect of the crural fascia. Distally, the proximal portions of the gastrocnemius muscle are inserted directly onto the fascia, so that these muscular fibres could be considered as tensors of the fascia, and anteriorly the tibialis anterior muscle and flexor hallucis longus insert onto the overlying fascia and the intermuscular septum (see pic 3.) A good image to summarise this arrangement is the fibrous layer surrounding the segments of an orange. This fibrous web ensures the segments connect. Whilst it may be convenient for us to separate the components into smaller functional units it is often impractical to do so. Learning how structures work together allows one to connect components, recognise movement and capsular patterns, assess the entire limb and make informed decisions

about treatment and rehabilitation. Fascia directs our focus around learning to connect what really matters. This article has offered a brief overview of the key fascial anatomy of the lower limb by identifying the shapes, prominence and importance of the tissue and system. Through our understanding of fascial lines and connections, we learn to see the unseen and associate formation with function. The duality between structure and function is best captured by Andrew Still (1899) who wrote: “there is no real difference between structure and function; they are two sides of the same coin. If structure does not tell us something about function, it means we have not looked at it correctly.”

References:

Benjamin, M. (2009). The fascia of the limbs and back – a review. Journal of Anatomy, 214, 1-18. Lesondak, D. (2017). Fascia – What it is and why it matters. Handspring Publishing, UK. Images supplied courtesy of Handspring Publishing

Earle Abrahamson is registrant member to the CNHC board, Chair of the General Council for Massage Therapies (GCMT) and Course Leader in Sports Therapy at the University of East London. Together with Jane Langston he authored “Muscle Testing: A Concise Manual” and runs an anatomy company called Learn Anatomy Ltd. He was part of the medical team for the London 2012 Olympic and Paralympic Games, and London 2017 Athletics. Earle has received several awards for his teaching and clinical work, including a National Teaching Fellowship. Jane Langston is co-author of “Muscle Testing: A Concise Manual” (Handspring Publishing). She remains a Fellow of the Institute of Biomedical Science, having worked in pathology departments in the National Health Service in England for over 20 years instilling in her a love of anatomy and physiology. Jane and Earle are directors of Learn Anatomy Ltd, which offers refresher A&P courses and summer schools. Jane represents Amatsu Therapy International UK on the General Council for Massage Therapies (GCMT), playing an active part in the GCMT COVID-19 crisis response team. “Muscle Testing: A Concise Manual” can be purchased via Handspring Publishing https://www.handspringpublishing.com/ product/muscle-testing-a-concise-manual/ Further information on Muscle Testing courses and Anatomy & Physiology refresher workshops can be found here: www.learnantomy.uk Further information on training courses can be found here: www.hands-on-training.co.uk

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Welcome to

The International Professional Association with a difference For complementary, beauty/SPA, alternative and integrated healthcare and wellbeing

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Cuddle T herapy Is it the Answer to a More Connected Society? By Madelaine Winzer

For some, a busy coffee shop might be the worst place to try and get some work done. But for me, it offers a fresh environment with fewer distractions and new sounds, allowing me to notice what is going on around me. A guy at the counter is ordering a black Americano while on the phone, the two girls next to me stare at their phones while their coffees rest next to them, and the man in the corner is listening to music through his blue headphones.

Technology

We live in a world where we appear to be more connected than ever. The invention of smartphones means we can contact whoever we like, anywhere in the world, making communicating with others accessible and straightforward. Social media allows us to see what our friends and family are up to without even sending them a message. It also allows people to curate an image that is entirely different to who they really are, and sometimes the façade that everything is perfect can spill over into real-life, keeping relationships superficial. Technology allows people to work remotely, which has been necessary recently with Covid-19. Working remotely has been positive for some people’s mental health as it has meant less time commuting. However, it has also meant that workers have spent more time on Zoom and less type interacting day to day with other workers, and for some people that can be quite isolating. It has meant missing out on workplace handshakes, friendly hugs or pats on the backs. Research commissioned by mind shows that work is the main reason for

people’s stress, followed by finances, then health. Over half of people drink to cope with work-related stress, while other people use smoking, antidepressants, over the counter sleeping aids and prescribed sleeping tablets as their coping mechanisms. Right now, there are one in six workers struggling with depression, anxiety and stress. There is still a culture of fear and silence surrounding mental health issues, so how do we break the taboo?

Healing by Gentle Touch

Human touch is a basic human need like food and water, without it humans cannot thrive. In South America, Spain, France and Italy, affection and touch is part of everyday life, but the UK, USA and other Eastern European countries are among the most touch-deprived countries in the world. Conventions in the latter countries often push people from initiating affectionate touch with those who are not directly related to them, and there is often an uncertainty for adults who even consider hugging or physically reassuring a student or child. It is important that children are

receiving touch, as a lack of touch and other sensory stimulation as children can leave us stunted later in life. Touch is mostly unconscious during social interactions, but bringing an intention to the interaction makes it more conscious. It is a language of compassion, which leads to bonds and connections with other people which are vital for wellbeing. The health benefits of physical touch are vast, and are known to improve the function of your immune system, reduce levels of cortisol, and reduce diseases associated with the heart and the blood. Touching can range from harmful to neutral to positive. There are many ways to initiate positive touch including welcoming someone through a kiss on the cheek or a handshake, having a massage by a qualified practitioner, going for a haircut at your local hairdressers, or offering someone affection that you care about. I have listed a few examples, but the good news is you can also experience some of the benefits of touch through yoga, cuddling a pet or self-touch.

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Cuddle Therapy

Hugging your partner increases levels of oxytocin (the love hormone) significantly, as well as other Happy Hormones like dopamine, and serotonin. When Happy Hormones are woken up and released into our bodies we experience feelings of happiness, relaxation, improve mood, and lower levels of depression. Research suggests hugging or cuddling for more than six seconds oxytocin and serotonin are released at very high levels.

But what if you don’t have a partner?

Professional cuddling may be the answer. It can be done one or one or in ‘cuddle parties’, where people wear pyjamas, eat snacks, chat and snuggle. Cuddle parties allow adults to explore communication, affection, and boundaries. They can be great to meet new people and feel a sense of intimacy and closeness to others. Cuddle therapy may heal old wounds and allow individuals to start trusting their instincts again. Some men and women get cuddle therapy as their emotional needs are not being met in relationships. We still live in a society where men are less likely to express themselves because they fear being vulnerable is considered as a weakness. It is a world which is constantly changing and sometimes hard to adapt to, so cuddling with a professional allows clients to feel a sense of safety with a trusted practitioner and let their guards down. After a career in the fashion industry, Rebekka Mikkola decided to become a cuddle therapist as she wanted to do something more meaningful. Rebekka recognised the need for tactile connection and co-founded company Nordic Cuddle, one of the fastest-growing cuddle therapy companies based in London. She now deals with men and women who are desperate for human touch. The cuddle therapy sessions she provides involve platonic hugs, handholding and gentle arm rubs, combined with talking therapy. Rebekka has more than 800 hours of cuddle therapy experience, working with men and women, young and old, including a few well-known celebrities. Her company has been approached by a law firm, as they felt that cuddle therapy could prove useful for clients suffering from stress. They have now entered a

referral programme with them, along with another very complementary organisation. “Our shared needs are much more important than our differences” – Rebekka Mikkola It is easy to be judgemental when you consider somebody paying for cuddling, but some older people go for long periods of time without affectionate touch, and that can have psychological and emotional consequences. People have always paid for intimacy in one form or another, and cuddle therapy is a growing niche which allows people to slow down and just be. A cuddle isn’t going to solve all of our problems, but it is a step in the right direction. If you are curious about cuddle therapy, then why don’t you try it for yourself this Autumn!

References

Morin, A. (2018) Why the Internet Has Made Us Lonlier Than Ever. Psychology Today [online] Available at: https:// www.psychologytoday.com/gb/blog/what-mentallystrong-people-dont-do/201810/why-the-internet-hasmade-us-lonlier-than-ever [Accessed 7 Sep 2020]. Palmer, D. (2016) ‘Why do we touch?’ Touch Pro [online] Available at: http://touchpro.com/why-do-we-touch/ [Accessed 7 September 2020]. Shark, L. (2019). What Does It Mean to Be Touch Starved? healthline [online] Available at: https://www.healthline. com/health/touch-starved [Accessed 7 Sep 2020]. Mind.(2013). Work is biggest cause of stress in people’s lives. Mind [online]. Available at: mind.org.uk [Accessed 7 Sep 2020]. NICE. (2011). Common mental health disorders. Nice [online] Available at http://www.nice.org.uk/guidance/ cg123 [Accessed 9 September 2020]. Holt-Lunstad, J., Smith, T.B., M., Harris, T,. & Stepheson, D. (2015). Loneliness and Social Isolation as Risk Factors for Mortality. Perspectives on Psychological Science, 10(2),227-237. doi:10.1177/1745691614568352 [Accessed 7 Sep 2020]. Rewire Me. (2015). Available at: https://www.rewireme. com/happiness/hug-therapy-high-touch-healing-hightech-world/ [Accessed 9 September 2020]. Nordic Cuddle. (2020). Available at: https://www. nordiccuddle.com [Accessed 9 September 2020].

Madelaine Winzer is a freelance writer who lives in London. After many years racing internationally as part of the GB Olympic Development Squad for Triathlon, Madelaine continues to have a strong interest in health and wellbeing. She has a degree in Sociology and is constantly developing her skills by attending workshops and courses.

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advancedcpdadvancedcpdad Your Bodywork Blueprint for Massage Success – The Jing “Fix in Six” Approach to Treating Chronic Pain

Pain is all around us! Being a massage therapist is not always an easy business. Massage therapists, often more so than any other manual therapy profession, are constantly faced with the issue of chronic pain- that is, pain that persists long beyond the usual healing time for an injury. We are often the last point of call for clients who have run the usual gamut of the medical equivalent of the butcher, the baker and the candlestick maker (GP, MD, physiotherapist, chiropractor, osteopath). These increasingly desperate clients eventually turn to massage, way down the line, often after months or years of dealing with constant daily pain.

sk any successful massage therapist about the problems that make up their caseload and you are likely to hear the following shopping list of client woes. Back pain, sore neck and shoulders, herniated discs, carpal tunnel syndrome, RSI, sporting injuries, frozen shoulders, rotator cuff injury, headaches, migraines, funny undiagnosed pains, plantar fascitis, stress related conditions, fibromyalgia, IBS. Need I go on? Chances are you either have one of these conditions yourself and are just “putting up with it” or know several people who do. Think of the closest 5 people to you – are they experiencing

some kind of pain? Does it affect the quality of their life? Do you wish you could help them so that within the month their pain was drastically reduced or maybe even gone forever? The hard truth is that if you want to be good at your profession you need to become an expert in treating chronic pain. The public certainly seems to be voting with their feet in that respect and are increasingly seeking our services for pain relief. A survey by the American Massage Therapy Association (AMTA) found that in 2013, 43% of individuals sought massage for medical reasons with 88% believing that massage can be effective in reducing pain (Amtamassage.org,

2014) Surveys estimate that a staggering 45% of the UK population is suffering from musculo-skeletal pain. That’s an awful lot of Brits with bad backs! So if you haven’t yet got a thriving business, being able to provide therapeutic outcomes for chronic pain conditions is one of the most consistent ways of building your practice. As most of us are well aware, clients in chronic pain are rarely able to find long term relief via more orthodox medical routes, leaving them knocking at the door of alternative health care providers. If you gain a reputation for successful treatment of these conditions you will never again be waiting for the phone to ring wondering where the next client is coming from!

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pdadvancedcpdadvancedcpd The massage therapists’ dilemma

As a massage therapist the responsibility to help our clients with these conditions can feel overwhelming; we long to help but often just don’t know how. Our basic qualifying courses in the UK are usually shamefully inadequate when it comes to preparing us to deal with chronic pain – qualifying courses in the UK are generally around the level of 100 hours as compared to the 1000 hours required in many states in the USA or the whopping professional 3000 hours that Canadian massage therapists invest in their education. Our qualifying course usually teaches us a good relaxation massage (if we are lucky!) and gives us a long list of terrifying contraindications. Treating anyone in pain seems difficult if not downright impossible. Looking around for massage CPD to increase our skills, we feel overwhelmed by the options out there in terms of training - so many techniques, so little time! And who to trust! So many massage courses claiming to cure all – but are they the complementary therapy equivalent of the used car salesman? Big on promise but low on results?

The bodywork blueprint

This was how I felt as a novice massage therapist – I longed for a bodywork blueprint or a massage “recipe book” that would tell me exactly how I needed to treat each condition that came into my clinic. My desire to find the key to unlocking client pain literally took me all over the world seeking further advanced massage training - from New York city to a hill top village in Thailand to a remote farm in Bavaria! My list of further massage training reads like an A,B, C of bodywork – Amma, acupressure, body reading, cranial work,…. …..manual manipulation, meridians, myofascial release…. stretching, soft tissue release, stomach manipulation, trigger point, Tuina, Thai massage. These are just a selection of the techniques I have tried and tested in my clinic. Everything that I learned I came back and tried out in my own practice on real clients in real pain. Some of the massage techniques worked well and were easy to put into practice;

others were much harder to perfect and took greater mastery to get results. Frustratingly some techniques worked on some people but not on others, even if they seemingly were experiencing similar symptoms. I kept working, refining, trying new things, adding in different elements, taking away others. Without a doubt there was no single technique or bodywork approach that worked on all of the people all of the time. It seemed that a combination of massage skills was always more effective. But which massage techniques? In which order? Slowly and surely after treating literally thousands of massage clients over many years, I started to find an approach that gave me the best results, consistently, time after time with the greatest number of clients. The combination of techniques I was using enabled me to reduce client pain in 1-6 weekly sessions. For many common conditions, clients would typically experience 80-100 percent pain relief at around session 3. The results were consistent with many different types of musculo-skeletal conditions, including those that had been persistent for many years and had been treated by both orthodox medical approaches and other bodyworkers including physios, chiropractors and osteopaths. Of course not everything worked all the time – but the results were significant

enough that I was getting more and more people out of pain and my reputation and business was growing without need for further marketing. The results were exciting and the approach that I refined in my clinic all those years ago has become the cornerstone of the Jing method – the tried and tested approach to treating musculo – skeletal pain with advanced clinical massage techniques. We have been teaching this particular combination of techniques for over 10 years now and our students and teachers have consistently reported the same results- dramatic relief from common pain in 1-6 sessions, building businesses and reputation. We have refined the approach to produce the “bodywork blueprint” I longed for all those years ago – a tried and tested template for massage therapists to follow. There is a great saying – “the teachers job is to shorten the journey” – and I take that very seriously. No other massage therapist should have to spend the amount of time and money that I did knocking my head against brick walls to get a result. If you know the right techniques to use you can get great results, time after time and build the life and business you desire. Issue 111 2021

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advancedcpdadvancedcpdad The X factor - the Jing Method of Combined Advanced Clinical Massage techniques

In my A-Z search to find the massage methods that were the most effective, I never came across a technique that began with “X.” Why? I realized that the elusive “X factor” lay not just in one single technique but a creative combination of massage skills. Without a doubt this is the best way to achieve effective results; for example trigger point therapy is a fantastic technique, but will gain even better results if combined with fascial release and stretching in a treatment. The concept of a Gestalt - “the whole is greater than the sum of it’s parts” nicely illustrates the Jing method philosophy – the combined effect of these skills is magically greater than would be gained through the individual sum of these techniques alone. So just what are the techniques I am talking about? And how can we combine them in a treatment for maximal results? Step one: Take an effective case history and assessment Developing good assessment and evaluation tools enables your practice to move onto a truly professional level. Quite simply, a good assessment enables us to plan effective treatments that achieve the goals or outcomes that the client desires. From a business point of view, achieving good outcomes leads

to satisfied customers, which leads to a thriving and interesting practice. A good assessment enables you to see whether your treatment is working and gives you measurable benchmarks so both you and your client are able to assess progress. Assessment is usually divided into 4 components, which you can remember, by the acronym “HOPS”: • H -Health history questions (usually known as your case history or medical intake) • O- Observations (i.e.: of posture) • P- Palpation (of soft tissues including muscles and fascia) • S- Special Orthopaedic Tests (specific tests that help us to identify problems more precisely) Step two: Correct Application of Heat or cold The results of your treatment can be greatly enhanced with the application of appropriate hydrotherapy. In general, many chronic conditions respond best to heat whereas acute conditions with observable swelling are traditionally treated with cold (ice packs or direct moving ice application). Apply hot or cold to the painful area before your hands on techniques and you will find you get better results. Using hot stones in your treatments is a wonderful way of being able to combine the therapeutic physical effect of heat with the luxurious feeling of a fabulous massage. You can also teach your client to apply hot or cold for themselves as a useful self help technique between treatments. Step Three: Fascial Work Myofascial work (MFR) is a powerful technique to add into the mix of your treatment plan for addressing musculoskeletal problems. MFR techniques address the body’s fascial system, that is, the 3D fibrous connective tissue that holds the body together and gives it shape. Most commonly taught massage techniques fail to address the fascia, thus denying practitioners a large piece of the puzzle when treating pain conditions. All the different fascial layers in the body should slide over each other like a well oiled machine but often due to emotional or physical trauma, cross linkages and

stuck layers can develop. MFR techniques aim to restore mobility in the fascia and soften connective tissue that has become rigid, with highly effective results. Fascial techniques should be performed without any oil therefore it is often most effective to do these at the beginning of your treatment. Step Four: Release all the muscles around the affected joint using trigger point therapy Thanks to the work of Dr Janet Travell, the doctor who pioneered trigger point work in the US, we have a growing body of evidence that many pain conditions are actually caused by trigger points or small contraction knots in the msucles. Studies suggest that trigger points are a component of up to 93% of the pain seen in pain clinics and the sole cause of such pain as much as 85% of the time. Trigger points are known to cause or contribute to low back pain, carpal tunnel symptoms, tennnis elbow, neck pain, migraines, jaw pain, and many kinds of joint pain mistakenly attributed to arthritis. They can cause sinus pain and congestion, nausea, chronic dry cough and are thought to contribute to fibromyalgia. To gain truly efective results in the treatment of pain with trigger point techique, we recommend treating alll the muscles around the joint. This is a really important principle of treatment as most pain conditions will involve more than one muscle. So for example, if you have a client with a shoulder problem you will need to check the following muscles for trigger points: trapezius, rhomboids, supraspinatus, infraspinatus, teres minor, teres major, serratus anterior, subscapularis, latissimus dorsi, deltoid, pec major, pec minor, biceps, triceps and coracobrachialis. Step Five: Use acupressure and meridian based techniques Knowledge of relevant meridians and acupressure points can greatly enhance your treatment results. According to Traditional Chinese Medicine, meridians are the energy highways of the body and acupressure points are where this energy can be accessed and influenced. Recent research suggests strong connections between the meridians and the myofascia, with acupressure points being places where the fascia can be accessed at deeper levels. In my own clinic I have found a knowledge of acupressure points and meridians to

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pdadvancedcpdadvancedcpd pdadvancedcpdadvancedcpd be an excellent additional tool in the treatment of pain. So if you know relevant acupressure points, use them! Step Six: Stretching Techniques Once trigger points and myofascial restrictions have been removed, stretching will enable shortened muscles to return to their natural length, realign scar tissue to create a functional scar and promote energy flow in meridians to optimise healing. You can use stretching with everyone from the athlete to the elderly and enable your clients to take greater control over their own health by teaching them to stretch between sessions. PNF stretching, Muscle Energy Technique and Active Isolated Stretching are all incredibly useful to get results in the effective treatment of pain. Step Seven: Teach your client a self - help technique to use between sessions Placing control over healing back in your client’s hands is an incredibly powerful psychological tool. There are many safe self help techniques that are within your remit as a massage therapist – for example instructing clients how to treat their own trigger points, showing self stretching, or teaching simple breathing and relaxation exercises to help deal it all with Bringing stress. Make sure youtogether are only teaching your client When you gathered your information from the techniques forhave which you areallinsured and knowledgeable various aspects of youradvice assessment process are (ie: don’t give nutritional if you are not ayou nutritionist) in a position to make an informed judgement about a treatment plan. Make sure you have really listened to client, notsecret: just with your earsmagic but your informed Theyour golden The of Six touch and that your assessment is on snap “If you only knew the magnificence ofnot thebased 3, 6 and 9, judgements. Be prepared to modify your treatment then you would have a key to the universe.” -Tesla plan as you go along depending on what you find with further about the nine, but 3 and 6 certainly play Not sure exploration of the tissues and how your client responds. a major part in the Jing method. For some reason many massage therapists feel they have to completely Bringing assessment skills into your work will enhance reduce people’s pain in one session or they have failed. your practice tremendously; try some ideas out bearing Conversely, other practitioners see clients week in in mind the words of Socrates: “ Four things belong week out for months without anything changing. to a judge, to hear courteously, to answer wisely, A golden secret is the “power of six”. If you are presented to consider soberly and to decide impartially.” with a client in pain, you will need to recommend that they come to see you once a week for up to six weeks to acheive a reduction in their pain. Once you see a consistent

reduction in pain that lasts between treatments (usually around the dawn of the other magical number -week 3) you will increase the time between treatments (maybe now seeing them once every 2 weeks.). Eventually, if they remain pain free between the lengthened time of treatments, move them onto maintenance treatments of once a month or whatever suits. In our experience, clients who have had one musculoskeletal pain problem will end up with another along the line so maintenance treatments are a great part of everyone’s health care routine. This lets your client know exactly how much time and money they need to spend before expecting to see a result. For most musculoskeletal pain problems you will see a reduction in pain by at least week three. If at this point you are seeing no improvement you will need to change something about what you are doing or refer the client onto someone else you think may be better placed to help. The 6 week approach is a ballpark figure that works for most musculoskeletal problems. If the problem is longstanding then the time period to recovery may be lengthened. On the other hand, some problems can be easily resolved after a couple of treatments.

Putting in all together

The above steps are like a tried and tested recipe – include all of these ingredients in your treatments and you will see an increase in your ability to get results. You will also need to use your own skill and creativity to determine which of the ingredients may be needed to a greater or lesser extent as the exact “recipe” will vary from client to client. So each treatment will be different, challenging and exciting for both you and the client! Good luck!

Rachel Fairweather is author of the best selling book forfor passionate massage therapists Rachel Fairweather is author of the best selling book passionate massage therapists––‘Massage ‘MassageFusion: Fusion:The The Jing Jing Method for the of chronic pain”. Method fortreatment the treatment of chronic pain”. She is also the dynamic co-founder Director of Jing Advanced Massage Training(www.jingmassage.com), (www.jingmassage.com),a a She is also the dynamic co-founder andand Director of Jing Advanced Massage Training company providing degree level, hands-on and online training who are passionateabout aboutmassage. massage.Come Come and and company providing degree level, hands-on and online training forfor allall who are passionate in one of fun our fun informative short CPD courses check out the Jing vibefor foryourself! yourself! take take partpart in one of our andand informative short CPD courses to to check out the Jing vibe Rachel has over 25 years experience in the industry working advanced therapistand andtrainer, trainer,first firstin inNew NewYork York and and now Rachel has over 25 years experience in the industry working asas anan advanced therapist now throughout throughout theDue UK. Due to extensive her extensive experience, undeniable passion and intense dedication, Rachelisisaasought soughtafter afterinternational international guest the UK. to her experience, undeniable passion and intense dedication, Rachel guest lecturer, lecturer, writes regularly for professional trade magazines, and has twice received awards foroutstanding outstandingachievement achievement in in her her field. field. writes regularly for professional trade magazines, and has twice received awards for Rachel holds a degree in Psychology, a Postgraduate Diploma Social Work, an AOSininMassage MassageTherapy Therapyand and is is a a New New York Rachel holds a degree in Psychology, a Postgraduate Diploma in in Social Work, an AOS York licensed licensed massage therapist. massage therapist. jingmassage.com | 01273 628942 | © Jing Advanced Massage April 2019 | Photos: all © Jing Advanced Massage; except 3 & 4 ©Handspring Publishing jingmassage.com | 01273 628942 | © Jing Advanced Massage April 2019 | Photos: all © Jing Advanced Massage; except 3 & 4 ©Handspring Publishing

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bookreviews Fascial Stretch Therapy (2nd edition) Ann Frederick & Chris Frederick The beautiful new edition of this highly successful book, written by Ann and Chris Frederick, directors of the Stretch to Win Institute, is packed with theory and practice, including a host of beautifully illustrated assisted stretches. Fascial Stretch Therapy™, Second edition is a practical and highly applicable manual for any massage therapist, movement instructor, physical or occupational therapist, athletic or sports trainer, fitness instructor or osteopath – in fact for any hands-on practitioners who wants to learn new skills and improve therapeutic outcomes. It clearly demonstrates how FST™ assessment, treatment, and training are used in a variety of common circumstances encountered in manual therapy and athletic training. Ann and her husband Chris are both certified by Thomas Myers in Kinesis Myofascial Integration and are the authors of the popular book Stretch to Win. Ann and Chris directed their own highly successful center for Fascial Stretch Therapy, physical therapy/physiotherapy, Structural Integration, chiropractic, acupuncture, sports massage and Pilates for nearly 20 years. They are now Directors of the Stretch to Win Institute at www.stretchtowin.com, where they offer certification training workshops in Fascial Stretch Therapy. Publisher: Handspring Publishing IBSN: 9781912085675 Price: £40.00

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Scars, Adhesions and the Biotensegral Body: Science, Assessment and Treatment Jan E Trewartha & Sharon L Wheeler This highly illustrated book explains the effects of scars and adhesions on the body through the lens of biotensegrity, a concept that recognizes the role of physical forces on their formation, structure and treatment. It includes contributions from specialists in the fields of fascial anatomy, biotensegrity, movement, surgery and other manual therapies. It takes a comprehensive approach to providing a better understanding of these complex issues and will be valuable to every handson practitioner. The text is supported with online videos demonstrating five ScarWork therapeutic techniques. Jan is the founder and director of the British Fascia Symposium. She has been in healthcare since 1979, originally training as a State Registered Nurse in the Queen Alexandra Royal Army Nursing Corps (QARANC), working with patients on the wards and in the operating theatre; a superb if non-deliberate foundation for her future career. Sharon Wheeler’s unconventional early schooling gave her a taste for the unusual. She found a welcome home at Esalen Institute and taught Esalen’s Massage program in the sixties. Sharon was fortunate enough to study with Dr. Ida Rolf, PhD, who trained her in Structural Integration in the summer of 1970. Further training in Rolf Movement and Advanced Structural Integration in the seventies consolidated her skills in this work. Her love of working with people and attempting the apparently impossible, combined with a particular skill in sensing disruptions to the body’s three-dimensional flow have combined to generate Sharon’s two ‘discoveries’: ScarWork and BoneWork. She teaches these new modalities in workshops around the world. She maintains a private practice in Structural Integration at home in Port Orchard, Washington, USA. Publisher: Handspring Publishing IBSN: 9781912085460 Price: £39.00

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bookreviews The Vital Nerves A Practical Guide for Physical Therapists John Gibbons The Vital Nerves is a comprehensive, must-have roadmap to the functional anatomy of the nervous system. Enriched with anatomical drawings and detailed explanations, it explains neurological testing, common neuropathies, and differential diagnoses, and is an indispensable resource for physical therapists and bodyworkers. Osteopath, lecturer and author John Gibbons offers an accessible introduction to the peripheral nervous system (PNS). Alongside real case studies and guidelines for hands-on work with clients and patients, The Vital Nerves demystifies and makes accessible everything from how to diagnose nerve conditions to understanding how our cells communicate. Gibbons provides critical insights into the structure and functions of the PNS; the body’s response to stimuli and how it knows what to do; the sympathetic and parasympathetic nervous systems; understanding the stress response; and how reflex testing can aid in diagnosing conditions like Multiple Sclerosis, Parkinson’s Disease, and paresthesias. The Vital Nerves addresses practical, common considerations like how to: • Assess the nervous system using a patella (reflex) hammer, myotome (muscle) testing and dermatome (sensory) testing • Determine whether pain in the posterior part of the thigh is caused by the sciatic nerve, piriformis or simply a hamstring strain • Decide at what level a disc may have herniated • Differentiate between upper and lower motor neurone disorders • Know what to do with the findings of your neurological assessment and the circumstances under which to refer patients for more specialist care.

The Author

John Gibbons is a registered osteopath, author and lecturer for the Bodymaster Method®. He specialises in the assessment, treatment, and rehabilitation of sports injuries and supports over 75 sports teams in his busy clinic at the prestigious University of Oxford, as well as teaching his acclaimed Bodymaster Method® to physical therapists throughout the UK and internationally. Gibbons is also the author of A Practical Guide to Kinesiology Taping for Injury Prevention and Common Medical Conditions, Muscle Energy Techniques, The Vital Glutes, The Vital Shoulder Complex and Functional Anatomy of the Pelvis and the Sacroiliac Joint.

Aromatherapy: A Practical Approach, Second Edition Vicki Pitman This comprehensive guide to aromatherapy provides thorough coverage for students and is also an excellent reference for practitioners. It includes all the information required by students training on aromatherapy courses accredited to Levels 3 or 4. This book: · contains revised and in-depth detail on the characteristics, chemistry, sourcing and safe application of essential oils · covers the effects of odours on mind, body and emotions · provides tutors with an ideal support text for any advanced-level aromatherapy course · provides a clear focus on clinical and professional aromatherapy, making it suitable for all quality accredited aromatherapy courses · contains colour photography for each of the essential oils · includes case histories providing true-life examples · discusses the adjunctive role of aromatherapy in community settings such as hospices, education, special needs and hospitals.

The Author

Vicki Pitman has over twenty years experience of aromatherapy as a practitioner, tutor, lecturer, researcher, and therapist in hospice care. She is a member of the International Federation of Aromatherapists and also a qualified medical herbalist (F.URHP). She gained an M.Phil. in Complementary Health Studies from Exeter University and has authored several books and articles on herbal medicine, the history of traditional medicine, reflexology, as well as aromatherapy. ISBN: 978 1 905367 99 3 PRICE: £21.99

lotuspublishing.co.uk

AUTHOR: John Gibbons, ISBN: 978 1 913088 18 7, PRICE: £19.99

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The Importance of Fascia and Bio-tensegrity in the Treatment of Scoliosis By Emma Gilmore

am going to briefly talk about fascia and biotensegrity, I will then look at how to effectively treat scoliosis with this important knowledge. I am sure you are now all aware of the beautiful, fractal like fascial system, it is alive, dynamic and responsive. Fascia a connective tissue, is the most abundant tissue in the body, fascia also forms the largest system in the body, as it is the system that touches all other systems……..the insides of cells are connected to the outside via the fascial matrix.1 We also know that fascia possesses ten times more sensory nerve receptors than its muscular counterpart 2 and is described as a “mechanosensitive” (pressure sensitive) signalling system with an integrated function akin to that of the nervous system”.3

When one part of our body is compromised, the entire structure responds, as we compensate to minimise the problem. Understanding this is key to finding the root cause of a problem and not just treating its symptoms. Our fascia is one complete interconnected whole, from a micro cellular level, to the macro whole being level. Fascial micro-tubules touch everything in our body from a cellular level up and run throughout the body offering support and structure.

Tensegrity In Brief:

The bio-mechanical approach to the body, in which we were considered to be a series of building blocks, with movement coming from a system of pulleys and levers is outdated. The understanding of fascia and the fascia informed approach to the body

moves us away from a parts-based perspective, “the whole being a sum of its part” towards a system based on the perspective of “the whole is greater than the sum of its parts”. We are in-fact bio-tensegrity structures, where no one part moves in isolation. The seamless fascial system enables our body to function as one unified whole. Bio-tensegrity unifies our system into a seamless, fascially organised whole, managing forces with maximum efficiency – a dynamic system where everything is involved in all function, at all times, no matter what. Fascia is part of a body-wide tensegrity system. It is this seamless interconnected continuum which makes the fascial system so important to us, as bodywork therapists, we need to be aware of it and to understand the implications of the body-wide tensegrity system. Only

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casestudy the importance of fascia and bio-tensegrity in the treatment of scoliosis

when we have an understanding of this can we begin to understand fascial compensations – how a restriction in one area of the body can lead to other restrictions and compensatory patterns throughout the entire body. The dynamic fascial system can tighten with injury, postural compensations, surgeries, repetitive movements and so much more. The compromised fascia has reduced local adaptability, reduced ability to lengthen, shorten or glide over adjoining structures, it becomes bound down and hardens, often laying down extra collagen fibres as a form of protection. THE SPINE who’s hallmark is flexibility & movement is considered a tensegrity tower, a tower that integrates with the limbs, the head and the visceral system. A change of tension anywhere within the tower is instantly signalled to everywhere else in the body, and there is a total body response. We know that the spine and our entire fascial system works equally well the right way up, upside down, in sea, land, air or in space. It maintains it structure and form, as it is suspended, floating in a mesh of fascia. The importance of bio-tensegrity and the fascial system simply cannot be ignored when it comes

to any form of bodywork and treating pathologies such as Scoliosis. SCOLIOSIS: Scoliosis is an abnormal curvature of the spine. The spinal curve may develop as a single curve (shaped like the letter C) or as two curves (shaped like the letter S), the vertebra may also rotate, and a common presentation is also a winged scapula. In children and teens, scoliosis often does not have any noticeable symptoms and may not initially be noticeable until it has progressed significantly. The two most common forms are degenerative scoliosis and idiopathic scoliosis. Most often this condition has no known cause, in which case it is called idiopathic scoliosis. While the cause is unknown, idiopathic scoliosis does tend to run in families. The specific genes involved have not all been identified yet, and there could be factors beyond genetics as well. About 3% of the population is estimated to have idiopathic scoliosis. There are three orthopedically approved options exist for combating scoliosis: observation, bracing, or surgery. We have the opportunity to support clients and prevent surgery, which is definitely preferable. With this understanding of fascia and an overview of the importance of bio-tensegrity let us look at how a pathology such as scoliosis affects both form and function. As the spine

develops an “S” or “C” curve, as it is drawn out of alignment the bio-tensegral body begins to compensate around the new body shape. There is potential for the lungs, digestive, urinary and reproductive organs to be compromised by the adapted shape of the body. The clients’ compromised form affects its function. With the right skills we have the potential to help slow or reverse the development of scoliosis, reducing pain and improving function on many levels.

Treatment Overview:

There is no set protocol, and we need to respond to our clients’ presentation. However, I am going to offer an overview of a suggested treatment plan which may help prevent a deterioration of scoliosis as well as assist to reverse a scoliotic curve. There is potential for the greatest change at the most restricted area(s). A postural observation is required, to assess the severity of the scoliosis; observe both anteriorly as well as posteriorly – keeping a broad overview and an awareness of a 3D bio-tensegrity model. If you have not identified a scoliosis before your client is on the couch, you can also observe and assess in prone. A scoliosis often presents with one side of the back being higher than the other, the ribs appearing more prominent. Issue 111 2021

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casestudy the importance of fascia and bio-tensegrity in the treatment of scoliosis

Treatment with Fascia Informed Bodywork:

Once you have identified a scoliosis and the area with the most potential for change; this is where you will commence treatment. Be aware that even though (as above) the contact is made posteriorly – the effect of treatment will travel beyond your hands. Changes will take place throughout the system, work slowly, gently and be responsive. Have a clear intention to “reverse the curve”.

Phase 1 Place 2 completely flat, soft responsive hands on the ribs (see orange arrows) which have been pulled out of alignment by the spine. Allow hands to soften and contour the body. Make contact & invite change. Do not apply pressure, or the system will resist you. Your still hands connect with the fascial tissue & the fascia will start to respond. When working fascial, oftentimes there is a sense that bones and the soft tissue merge into a unified fascial whole. As the tissue responds, the body will slowly begin to realign, the ribs may move, slowly follow the movement. Witness and follow the changes, which may take place beyond your hands - through the body, legs or arms. Be patient and responsive, with bound down fascia, it may be appropriate to hold one technique for up to 15-20 minutes, this will allow for adequate the change in the tough inelastic collagen fibres. Your hands do not move on the skin.

PHASE 1: Use the bones as a handle into the fascial system. Make completely flat handed contact on the most compromised area. Seemingly unrelated sensations may be felt in other areas of the body at any time, this is simply because they are in fact related, we are an interconnected whole. It is essential to understand this and to treat the body as one complete interconnected whole. See above

TO FINISH: with the correct touch, the body will take up the offer of change, the bio-tensegrity of the body will adapt, and structures moved into a less compromised position. We now need to allow the system to settle into the new normal and for realignment to complete. The occiput sits at the top of the spine and sacrum at the bottom of the spine; if the spine has moved, you need to allow for completion of this movement. I suggest a sacral hold and or an occipital cradle hold. In a prone position simply place a soft, flat hand under the sacrum, wait for a settling and change. The sacral hold will allow for any changes to move through the body inferiorly. The occipital cradle hold will allow for movement to complete superiorly. Gently take hold of the occiput, settle yourself, with soft responsive hands wait for the body to take up the offer of change.

In this before and after photo, (results after one session). The winged scapular right is in a better position, there are less creases in the right waist indication a more upright position. The “windows” created by the space between the arm and the body are more even right to left. The exaggerated curvature has lessened. In this before and after photo, (results are after one session). The head is in a more upright position.

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wo r k You can teach selfmassage or partn er massage in grou with all clinical w ps. As ork, you would ne ed to do a consul ever y participant tation with to ensure you are working safely. Yo send the consulta u could tion form in advanc e and then set the date for the group time and massage. Client re cords and consulta w ou ld ne tions to beand the importanceed of fascia the treatment of scoliosis keptbio-tensegrity in the sameinca pacity as always.

casestudy

Phase 2

sou rcing

ge subject and it ta kes real skill and subtlety to re this well. It is on e of the most impo rtant things we can facilitate fo r clients right now . Re ally take o explore this, as it is this that will se rv e them once ave gone. What le ts them know they ar e ok? What tes a sense of happ iness and health? What is it that em know they are ok? Allow them to think about they are really stuc k, you could of fer ideas. king their pet, wat ching the sunrise or sunset, ning to the birds, curling up in bed reading, ng a relaxing bath with candles, mai ntaining ga pose, listening to meditation. hem to describe th eir recourses, as th ey do this tch and listen, do es their expression ch ange? their voice change ? Does their postur e change? se improve, you kn ow they have chos en a good rce. Ask them to no tice their body – ho w is ng right now? You could point out to them if oice, breathing or posture has change d and rage them to use this resource if in need.

ment of ever y day we can go to our resources to help mbody and simpl y remind ourselve s that we are ok. a multitude of othe r skills that can be used remotely, r Embodiment; bo th of which are hu ge subjects e explored at a late r date. Offering cl ie nt s a thorough ing of pain can as sist in the reductio n of pain.

Insu rance considerations

Anterior hand: fingers point towards acromion process. Make flat hand connect into the fascia, settle until the bone and soft tissue become a unified fascial field. With very gentle pressure invite change ost insu – anM opening ofra the region. Use visualisation and intention to ncpectoral e compa nies will cover you invite change. for online w same w

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H ow to charge for remote work ?

PHASE 2: There is no set protocol, and we need to respond to what we witness as the client’s body changes. However, where the ribs have been drawn anteriorly the scapula will have been affected, this may be a winged. The whole pectoral, clavicle region may also I pe rson ally adversely have been client into supine, observe, again feel you affected. should With charfor ge change. the sam e asone work there is most potential Place hand in cl if yo inicwhere , as it is your expe u wover ere rie nc e an the clavicle pectoral region and the other hand posteriorly on d kn ow ledge that yothe clients are paying ur for. intention Some thinvite scapular – with a clear the to return to a more erapis ts body are ch scalfunctional ar gi ng e, depend a sl id ing ing ho shape ie open region and invite scapula to return w afpectoral fected th e client ’s wage ha Covto idits -19. s optimal See left. be Otherposition. en by ther

apists are charging “by donation”, an most clients are ex d tremely generous w ith this method. As with clinical w ork – less is of ten more, don’t tr y to too much, be quie “do” t and resourced in yourself, and hold space for some po the sitive chanOur ge to ta bodywork needs ke place. Goo In m this e before know and d lu ck howafter , let you get on, I am to of be reinforced photo, (results are after ferin g bespoke tuby remote work - by one ition in session). The head is indo a nation – un yoga appropriate til theor lock do w n is over. more upright position. strengthening exercise, As I said, this is re encourage the ally an introto duct or y guide to he or build online or u commence body to remainlpinyothe remote treatm ents. All the subjec be explored in de ts above can position. I would tail; many of new the ideas such as movement, resour breathwork, recommend regular cing, shut tling , group work,so pain could be who or you treatment, can unders tanding le workshops. I su gg es you success ideas and get in to build on tthe ofe ex pl or e thes uch if you would like tosession. the first know more.

Gilmore was a judGilmore Emma the National Massage Championships, is a founding member of ge at thwas e Naajudge tionaat ia Researchthe l Mass agisecurrently Fascia Research Society (FRS), and a book on fascia and the body-mind Champwriting Soc iety (FRS), and ionship s, isshares a fouher is currentherapist . Having bee nddetailed complex. Having been a bodywork for 25 years, Emma knowledge ing mem tl y writing a book ber of in n a bodywork on th fa accessible and engaging way. She encourages all students to develop their own style, drawing sc erapis ia a cessible andan n t d fo th r 25 yea , Em e body-m entheir gagpersonal ind ing way ma sh on knowledge and experiencers when dealing with clients. a re . S s h h e er en detailed know courages all st on their person ledge udents to devel al knowledge a op theione nthe d ex perie r ow Emma’s journey through world ofn bodywork been a very personal ofn self-development style, ce whenhas dea li n g w it h cl ie healing and it is with this understanding and sensitivity she sharesnher knowledge. journey throand ts . ugh th world of bodywork h ment and hea1 Dr. JameseOschman a2007 s bee PhD. 2008 2 Van der Wal 3n Langevin ling and it is w a ver2006 y personal one ith this underst of selfanding and se nsitivity she sh ares her know ledge.

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Aromatherapy Relief for Arthritic Pain Rheumatoid arthritis is a painful, chronic condition affecting many people in the UK. Essential oils have a role to play in helping to reduce pain levels, as Penny Price explains.

round 400,000 people in the UK are now living with Rheumatoid Arthritis (RA), a chronic and very painful condition. The disease usually involves inflammation of one or more joints, usually in the hands, feet and wrists. (The term arthritis is made up of ‘arthro’ from the Greek word arthron for joint, which becomes ‘arthr’ before a vowel as in arthritis, and ‘itis’, meaning inflammation.) The approach to treatment is two–fold. First, the relief of pain and symptoms with analgesics and non–steroidal anti–inflammatory drugs; secondly, modification of the disease process so that progressive functional impairment can be slowed down or stopped. This can include short–term use of steroids. Where there is inflammation there is usually pain, fluid retention and heat, and these are the issues that this article will address, along with aromatherapy products for steroid–damaged skin.

Essential oils for pain and inflammation

Plai (Zingiber cassumunar) Zingiber cassumunar is known to be anti–inflammatory, helpful for pain relief, a muscle relaxant, and also a local anaesthetic. Plai is widely used by massage therapists to combat joint and muscle pain, and the pain caused by joint deterioration in arthritis. Forty per cent of this oil is made up of alcohol components, which are responsible for the oil’s pain–relieving properties. Plai also contains significant amounts of monoterpenic compounds which make it warming, bracing and tonic.

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Aromatherapy German chamomile (Matricaria chamomilla) Matricaria chamomilla is one of the best–known anti–inflammatory essential oils. It is anti-spasmodic and calming and used to treat arthritis, inflamed skin, headaches and emotional symptoms such as irritation, anxiety and depression. The sesquiterpenes in German chamomile essential oil, in particular chamazulene which produces its blue colour, are responsible for the majority of its calming and anti–inflammatory effects. Marjoram sweet (Origanum majorana) Origanum majorana is analgesic, anti–infectious, calming, expectorant and neurotonic. It is used to treat arthritis, migraine, headaches, respiratory infections and sinusitis. The oil is composed mainly of monoterpenes and alcohols, the terpenes being responsible for the warming and anti– infectious effects and the alcohols for the analgesic and tonic effects. Rosemary cineole (Rosmarinus officinalis) Rosmarinus officinalis ct cineole is analgesic, antibacterial, anti–inflammatory, antispasmodic and neurotonic. It is most often employed for treating arthritis, rheumatism and fluid retention, although it can also be used for colds, coughs and (traditionally) loss of memory. This chemotype is composed mostly of monoterpenes and oxides. The terpenes are bracing and warming, while the oxides are cooling and help ease joint pain. Lavender (Lavandula angustifolia) Lavandula angustifolia’s many attributes include analgesic, anti–inflammatory, antispasmodic, sedative, and cicatrisant effects. It is best known for its stress–relieving properties, benefits for treating skin conditions (making it very useful for steroid–damaged skin), aches and pains, arthritis and stress. Composed almost entirely of alcohols and esters it is not difficult to see how it is effective in so many areas. Alcohol components help to alleviate pain and are also tonic, while ester components are cell– regenerating and anti–inflammatory.

Carrier oils for pain and inflammation

Arnica oil (Arnica montana) Arnica is a macerated oil that is beneficial to the circulatory system and the skin. It is best known for its ability to help bruising and pain, guarding the skin against steroid damage and giving protection against bruising. Calendula oil (Calendula officinalis) Calendula oil is highly anti–inflammatory and anti– spasmodic which makes it useful in arthritic conditions to help reduce swelling and to calm the areas affected. Calendula may also help the healing process after joint replacement operations. Carrot oil (Daucus carota) Carrot oil, rich in vitamins A, B, C, D, E and F, is used to help arthritis because it is anti–inflammatory. Since carrot oil is also an effective skin rejuvenator it can help the skin to cope with steroid damage.

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Hydrolats for pain and inflammation Hydrolats contain many natural steroidal–type molecules that naturally reduce pain and swelling without damag- ing the skin or other organs. For arthritis, the hydrolats can be used in compresses, baths, creams, lotions and as skin sprays. Rosemary (Rosmarinus officinalis) Rosemary hydrolat can be mixed into a cream for application to the joint areas of the body. Use 80ml of thick base cream, 20ml rosemary hydrolat and add 10 drops each of rosemary and lavender essential oils for maximum benefit. Apply twice a day for the best effect. Chamomile (Chamaemelum nobile) Chamomile is a traditional remedy for inflammatory conditions. The hydrolat can be used in the bath (50ml) or in a body cream: use 80ml thick base cream and 20ml chamomile hydrolat, adding rosemary and chamomile essential oils to enhance the blend if necessary.

Arom for ar

Sage (Salvia officinalis) Sage hydrolat is anti-inflammatory, calming and has slight analgesic properties to help reduce pain. Soaking the German chamomile, a well–known anti–inflammatory oil, is often used to help relieve arthritic pain hands in warm sage hydrolat for 20 minutes can be very beneficial for arthritic hands, followed by a massage with essential oils of lavender, plai and rosemary.

Conclusion

Rheumatoid a many people helping to red

We have many wonderful aromatic tools to help us treat clients who are living with arthritis. Mixing and blending oils for clinic use and for ongoing home treatment can bring relief for the condition, bringing your client a new balance and harmony.

Bibliography

Battaglia S (2002) Complete Guide to Aromatherapy. ICHA, Brisbane Lawless J (1995) Complete Essential Oils. Element Books, Dorset Price L & Price S (2002) Aromatherapy for Health Professionals. Elsevier, London Price S (1993) Aromatherapy Workbook. Thorsons, London Valnet J (1980) The Practice of Aromatherapy. C Daniel, Saffron Walden

r a A Penny Price An aromatherapy painful c practitioner for nearly 30 involves i years, Penny Price teaches joints, usu aromatherapy in the UK and wrists. (Th abroad. She founded Penny ‘arthro’ fr Price Aromatherapy Ltd and the Penny for joinPrice t, which becomes ‘art Academy and currently serves onar the IFPA thrit is, and ‘itis’, mea ni ng i Council. The approach to treatment is pain and sympt oms with anal anti–inflammat ory drugs; seco dise111 Issue 41 ase2021 process so that progre can be slowed do wn or stopp short–term use of eroids. 10/02/2021st21:41 W

How to Create a Covid-19 Specific Communications Plan for your Massage Therapy Business By Marta Kalas

For massage therapists and other bodyworkers, 2020 has proved extremely challenging. It has also put a spotlight on the importance of excellent communication. The evolving nature of the pandemic and the introduction of regulations and guidelines, including the differences across the four nations in the UK means there is always something new to communicate!

iven what is happening, it is no surprise that clients get confused. This is why it is very important that you have a specific Covid-19 communications plan so you can communicate in a timely and clear fashion and help to address any confusion that may have arisen.

The easiest way to deal with this is to create a package of tools that will help you stay on top of the changes and the ever-increasing regulation and actions you need to take. For example, Thomson Screening has developed a toolkit to help people work through what’s needed and how to activate it. The toolkit provides training and sample documentation. The good news is, none of these activities is new; small businesses do them all the time. What’s different is that now businesses need a specific “Covid flavoured” version. A good communications plan will be the cornerstone of the successful management of your business under Covid19. Your pre-Covid communications plan, if you already had one, will need to be adapted to be specific to the current situation. What will remain the same, and what will be different? How can you prepare this, and carry out the work, with the minimum amount of re-inventing the wheel? How can you adapt what you already know and have to this ever-changing situation? Let’s start with the basics.

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businesstools Covid-19 specific communications plan

Any communications plan needs to include the following characteristics: 1. Understanding your audience 2. Listening actively 3. Being clear about what you want to say (simply) 4. Using the appropriate channel(s) 5. Making sure your communication is timely.

some will rely on science or authority, and some will be just the opposite. Your communications plan needs to be mindful of this and cater to the different needs of your audience. It may need you to say the same thing from three different perspectives to cater to three different needs of particular groups of clients ( and also staff or suppliers or other audiences you may have). The key to getting this right is understanding your audience, and you can do this by listening actively.

Before we take each of these values in turn and work through how they need to be adapted, let’s add one step, at the very beginning: know your trusted sources of information!

Listen actively to your clients You need to listen and hear what your audience or different groups in the audience, whether internal or external to your business) are most concerned about. For example, is it rules around social distancing? Or mask-wearing? or something else?

The best sites to visit are the most important government websites. These are the first places you will need to check regularly. One of the difficulties at the moment is that there is so much conflicting, confusing or out of date information circulating. Go straight to the horse’s mouth, check the government websites first.

You also need to show people that you are there, that you are listening, that the measures you are putting in place are to protect them and meet their needs. The actions you take need to be about them - and they need to understand that in your communications. Just acting, but not communicating, can lead to misunderstandings and a break-down in trust.

• https://www.gov.uk/coronavirus • https://www.gov.uk/guidance/nhs-test-and-tracehow-it-works#people-who-develop-symptoms-ofcoronavirus • Office of National Statistics, Coronavirus Roundup https://www.ons.gov.uk/ peoplepopulationandcommunity/ healthandsocialcare/conditionsanddiseases/ articles/coronaviruscovid19roundup/2020-03-26 • Finding your local Health Protection Team: https://www.gov.uk/health-protection-team • Moderate and high-risk factors: https://www.nhs.uk/conditions/coronavirusCOVID-19/people-at-higher-risk/whos-at-higherrisk-from-coronavirus/ Now, let’s take a look at each step and how it needs to be adapted for Covid-19: Understanding the audience Under the current circumstances your clients and also staff if you are in a larger setup, will be much more sensitive to different types of communication, and this will not necessarily be along the lines you may expect. Essentially, we are talking about people’s ability to handle uncertainty and manage risk, and this has nothing to do with their job, their level of education or even their age. Some people will be very risk-averse,

Be clear about what you want to say If you need clients to wear a mask at all times, or if they only need to wear them in certain areas - be clear about this. If areas within your place of work are off-limits to external visitors, ensure they are obviously labelled. Above all, your communications need to be clear, simple, and, if necessary, repetitive. Just look at how the NHS is using simple words and lists of no more than three or four items. Don’t assume just because you’ve said it once, everyone has heard it or taken it on-board. Avoid using abbreviations or acronyms. And remember, this is not a time to be original or funny. Finally, it really helps to give some specific examples and little personal touches: show that you have considered the needs of disabled staff and clients, or perhaps those who rely on lipreading. Use the appropriate channels These days there are dozens of communications channels your website, Twitter, WhatsApp, newsletters, window/door signage etc. Choose the right platforms for the audience and for the message. Make use of as many channels as you can and be consistent with your messages. Normally you’d be using a slightly different approach in each channel, but in your Covid-19 related communications, it is really important that there is no misunderstanding. Start by creating a list of all possible “channels”: website, newsletter, sign on the door, training materials, Twitter Issue 111 2021

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businesstools Covid-19 specific communications plan

feed, LinkedIn post, everything you can think of. Use templates as much as possible as this will save time and keep the communications consistent. Ensure anyone involved in any form of comms (social media, web editor, marketing flyers, poster designs, advertising) know what your Covid-19 messaging is and when and how to include it. Make sure your communication is timely This is where Covid-19 related communications get really tricky: things change very fast (or they may stay the same), which makes it very difficult to plan. You want to make sure you have not left out of date information on any of your communications, and you want to be sure you are always in line with the most recent government or Public Health guidelines. Yet, you cannot spend every hour, every day, checking and updating everything.

Once you’ve set everything up, it’s simple to set a weekly reminder in your diary, to check that everything is still correct and relevant; it’ll only take only a few minutes. So, when the Prime Minister announces a change, or you get notified by your local public health representative, you will have everything in one place to update. That way you’ll keep your clients and staff updated and do the best you can for your massage/bodywork business in difficult times.

Fortunately, there are a couple of tricks and tips you can use. These are not new, they should be familiar to you, and in Covid-19 related messaging they are essential: • In electronic communications (websites, newsletters, chats, etc.) use links directly to the relevant government websites. (see list above) • Used shared file systems (e.g. Google Drive, One Drive or Dropbox) for templates and drafts. • Have a log of where these templates are used, to make sure you don’t miss one of them. • It is an extra few minutes to get everything in one place when you start, but it will pay dividends many times over when you suddenly need to change something.

Marta Kalas is co-founder of Thomson Screening, developers of the Thomson Covid-19 Test Manager software platform that enables testing providers to scale irrespective of where, how, and what test is carried out. Functions include automated reporting at local and national level for bodies including Public Health, Community Health and Employers with data reporting into other systems, as required. A separate module using questionnaire and risk assessment methodology enables local residents to self-report Covid-19 symptoms with automated reporting to local (or national) Public Health and the ability to automatically push out messaging specific to the individual with symptoms. Thomson Covid-19 Test Manager is designed to adapt rapidly to fast-changing requirements and is fully scalable. The Innovate UK grant enables Thomson Screening to utilise investments made in the core functionality of the company’s products used in the NHS, especially its SchoolScreener Imms product, to rapidly repurpose and deploy the software. Web: https://workscreener.com/covid-19-test-manager/ Twitter: https://twitter.com/SchoolScreener/ Facebook: https://www.facebook.com/Schoolscreener/ LinkedIn: https://www.linkedin.com/company/thomsonscreening/ Sources: https://www.gov.uk/coronavirus https://www.gov.uk/guidance/nhs-test-and-trace-how-it-works#people-who-develop-symptoms-of-coronavirus Ethnicity and mortality rates up to 15th May 2020 in England and Wales: https://www. ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/articles/ coronaviruscovid19relateddeathsbyethnicgroupenglandandwales/2march2020to15may2020

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Diseases and Disorders of the Respiratory System – Part 3 By Ruth Hull Reflexology is a holistic therapy that treats a person rather than a disease and every treatment should involve a thorough working of all the reflexes of the body as well as the reworking of any reflexes that are found to be out of balance or congested. owever, sometimes it helps to have a basic understanding of certain diseases and disorders so that you can, in addition to giving a full treatment, spend some extra time focusing on reflexes that will deepen the effects of your treatment. In this chapter you will find suggestions for reflexes that can be worked for some specific diseases and disorders. Please be aware that these are only suggestions and that there are many different approaches to treatments.

Please also be aware that this chapter should not, in any way, be used to diagnose a condition. Reflexologists are not medically trained and should not diagnose conditions or attempt to treat them in the place of conventional medical treatment.

S tudy To p t ip: If you forget everything else, try to remember the following: • If there is pain, work the brain • If there is inflammation, work the adrenals • If there is mucous, work the ileocaecal valve

Asthma Chronic inflammatory disorder of respiratory system. Airways narrow in response to stimuli, resulting in coughing, difficulty breathing, wheezing and inability to exhale easily. Stimuli range from pollen and house dust mites to cold air and emotional upsets. Direct reflex • Lungs • Trachea/bronchi Associated reflexes • Chest/intercostal reflexes on dorsum of foot • Diaphragm • Adrenals • Ileocaecal valve • Liver • Spleen • Lymphatics Bronchitis Inflammation of bronchi. Characterised by excessive mucous secretion, productive cough with sputum, wheezing and difficulty breathing. Causes vary from infection to exposure to irritants. Direct reflex • Lungs • Trachea/bronchi Associated reflexes • Chest/intercostal reflexes on dorsum of foot • Diaphragm • Adrenals • Ileocaecal valve • Liver • Spleen • Lymphatics Emphysema Disintegration of alveolar walls that leaves large spaces in lungs which fill with air. Person is unable to exhale this air and is constantly exhausted from breathing out. Irreversible condition caused by cigarette smoke, air pollution or occupational exposure to industrial dust. Direct reflex Lungs Associated reflexes • Chest/intercostal reflexes on dorsum of foot • Solar plexus • Diaphragm • Adrenals • Liver • Spleen • Lymphatics Hay fever Seasonal allergy resulting from exposure to pollens and other airborne substances. Characterised by sneezing and itching of eyes, nose, roof of mouth and back of throat.

• If there is stress, work the solar plexus and diaphragm

Direct reflex Head (including face, nose, sinuses, mouth)

• If there are toxins or waste, work the organs of elimination (lungs, liver, kidneys, large intestine, lymphatics and skin)

Associated reflexes • Adrenals • Ileocaecal valve • Lungs • Liver • Spleen • Lymphatics

• If there is infection, work the lymphatics, liver and spleen

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reflexology Hyperventilation Abnormally fast breathing when body is at rest. Characterised by dizziness, tingling sensations and tightness across chest. Direct reflex Solar plexus (on both hands and feet) Associated reflexes • Diaphragm • Lungs • Adrenals • Brain • HP-6 acupoint on wrist Pharyngitis (Throat infection) Infection of the pharynx (throat). Symptoms include sore throat, pain on swallowing and occasional earache. Can be caused by bacteria or virus and often accompanies common cold. Direct reflex Throat Associated reflexes • Thymus • Liver • Spleen • Lymphatics Pleurisy Inflammation of pleura. Symptoms include chest pain, rapid and shallow breathing and referred pain to neck and shoulder. Causes vary and include bacterial or viral infection, injury, cancer, irritants, drug reactions or other diseases.

Pneumonia Inflammation of lungs due to infection and inflammation of alveoli. Symptoms include sputumproducing cough, chest pain, chills, fever and shortness of breath. Can be caused by bacteria, viruses or fungi. Direct reflex Lungs Associated reflexes • Adrenals • Solar plexus • Diaphragm • Liver • Spleen • Lymphatics Pulmonary embolism Blockage of pulmonary artery by embolus (material carried in blood, e.g. blood clot). Symptoms vary but generally characterised by sudden shortness of breath, rapid breathing and extreme anxiety. Usually caused by blood clot formed in a person who has kept still for a long time, such as due to prolonged bed rest or long aeroplane flight. A person with a pulmonary embolism should be under the care of a doctor.

Tuberculosis (TB) Contagious infectious disease caused by airborne bacteria. Can affect any organ of the body but usually affects the lungs. Bacteria destroy parts of lung tissue which is then replaced by fibrous connective tissue or nodular lesions called tubercles. Symptoms include coughing, night sweats, sense of malaise, decreased energy, loss of appetite and weight loss. Reflexology is contraindicated during the infectious stage. When a person is no longer infectious and is recovering from tuberculosis, a full and general treatment is recommended with emphasis on the lungs, lymphatics, liver, thymus and spleen. Whooping cough (Pertussis) Contagious bacterial infection. Begins with mild cold-like symptoms and develops into severe coughing fits characterised by prolonged, high- pitched indrawn breath or whoop at end of them. Coughs also produce large amounts of thick mucous. Reflexology is contraindicated during the infectious stage. When a person is no longer infectious and is recovering from whooping cough, a full and general treatment is recommended with emphasis on the ileocaecal valve, lungs, lymphatics, liver, thymus and spleen.

Sinusitis Inflammation of sinuses. Characterised by pain, tenderness and swelling over affected sinus as well as nasal congestion and postnasal drip. Usually caused by allergy or infection.

Direct reflex Lungs

Direct reflex Sinuses

Associated reflexes • Adrenals • Solar plexus • Diaphragm • Liver • Spleen • Lymphatics

Associated reflexes • Head (including face and nose) • Ileocaecal valve • Adrenals • Chest/lung • Lymphatics • Liver • Spleen

This extract is from Ruth Hull’s ‘The Complete Guide to Reflexology’ Ruth Hull is a freelance writer who specialises in natural health. Born and educated in Zimbabwe, she completed a degree in Philosophy and Literature before studying and practising complementary therapies in London. She now lives in South Africa and is married with two children.

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Detailed chapters on each of the body systems: skin, hair and nails; skeletal system; muscular system; nervous system; endocrine system; respiratory system; cardiovascular system; lymphatic and immune system; digestive system; urinary system; reproductive system Muscle tables listing the origin, insertion, nerve supply and action of each muscle Ideas and exercises to bring classroom learning to life Helpful revision tips for home-study Multiple-choice tests to challenge your knowledge

Have fun as you revise with a variety of word searches, crosswords, colouring and labelling exercises, matching columns and word puzzles designed to challenge your knowledge Cue cards, mnemonics, mind maps, spider diagrams and ideas for working with others Multiple-choice mock exam papers covering the whole A&P syllabus Excellent value for money compared to many other A&P texts – exactly what students need!

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Learn the reflexes associated with the musculoskeletal system, nervous system, respiratory system, cardiovascular system, lymphatic and immune system, digestive system and reproductive system Includes additional useful 'reflexions' and practical tips not covered in other textbooks Guidance on the cautions and contraindications to reflexology Explore hand reflexology and other complementary therapies Enriched with over 350 colour illustrations and photographs Clear, concise, and easy to absorb

; em;

The perfect companion to Ruth Hull's 'The Complete Guide to Reflexology', or any other reflexology textbook Integrate your knowledge on the theory of reflexology with discussion questions, vocabulary tests, crossword puzzles, wordsearches, colouring and labelling exercises and more Create your own ‘practitioner’s manual’ – a series of illustrated notes on how to apply reflexology for each body system Test your knowledge with 10 mock exam papers (answers are provided)

s–

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Academy of On Site Massage

T: 0118 391 4313 info@aosm.co.uk www.aosm.co.uk M: 07930 266 427

Training Specialists in

Seated Acupressure Diploma Seated Acupressure Refresher Massage At The Desk A mixture of home & on line study, plus essential classroom practical work, all combine to provide thorough training to the highest standards. All sections must be completed for the relevant course. Courses take place in March and September 2021.

£395

£260

Further details can be found on our website www.aosm.co.uk Please note our new contact no: o118 391 4313 “Probably the best taught course I have been on” Justine Thornton

£295

0208 450 7999

£475

All practical training will take place at Kingsmoor Clinic, Oxfordshire www.kingsmoorclinic.co.uk

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ngscourselistings courselistingscoursel courselistingscourselistingscourselistings Academy of On Site Massage – Seated Acupressure Diploma Applied over clothes, and predominantly working on the back, neck and shoulders, this massage takes less time than couch massage, can be carried out almost anywhere, and has an amazing ability to leave the client feeling refreshed, relaxed, yet invigorated. Perfect for your client to help counter balance the effects from sitting at a desk for much of the day (office or home). Perfect for the practitioner as it is such a versatile form of massage therapy. Seated Acupressure Refresher A great opportunity to refresh and adapt your skills in a Covid world.

UK UK Lymphology ClinicsClinics Lymphology Lymphatic Healthcare and Education Lymphatic Healthcare and

Advancing training in our ground-breaking therapies to give knowledge and understanding of the lymphatic system for those who want to confidently expand their careers in a new therapies dimension!to give Advancing training in our ground-breaking Details: knowledge and understanding of the lymphatic system for Breastthose who want to confidently expand their careers in a new Cancer Aftercare - Lymphatic Pressure Therapy - Six Months Training - 55 CPD points dimension! New and unique, this advanced training offers maximum beneficial Details: for breast cancer clients. Encouraging five elements of aftercare Breast Cancer Aftercare - Lymphatic Pressure Therapy - Six for range of motion to restore muscle connection for recovery mobility and balance, whilst stimulating lymphatic return for an Months Training - 55 CPD points overall post-operative improvement. VTCT Approved. For caring, New and unique, this advanced training offers maximum empathetic therapists confident in their own ability to provide beneficial aftercare for breast cancer clients. Encouraging five standards of UKLC aftercare! Must have six months excellent elements recovery for practice. range of motion to restore muscle trainingof and six months massage connection for mobility and balance, whilst stimulating lymphatic Lymphatic Integrated Massage - One Day Attended Course - 12 A 4 Spiritual, Practical & for who’s ACPD 4 day day Spiritual, & Theory Theory course course for therapists therapists who’s return for anPractical overall post-operative improvement. VTCT points passion is to nourish and nurture every women through any stage passion is toa nourish and nurture women through any stage of of Encouraging new approach towards every effective lymphatic Approved. For caring, empathetic therapists confident in their their reproductive life. A unique blend of ancient, intuitive and sacred their reproductive life. A unique blend of ancient, intuitive and sacred stimulation. This two-part course of three weeks home study own ability to provide excellent standards of UKLC aftercare! techniques. theoryMust and one daysix practical results in a short powerful techniques. have months massage training andtherapy six months practice. application to be integrated into everyday massage. Details: Details: Lymphatic Integrated Massage - One Day Attended Course - 12 “ThankNational you so much for excellent training, I thoroughly enjoyed all 2018 and International Courses: 2018 National and and International Courses: CPD points aspects of the course the LIM benefits. You are an inspirational Belgium, Belfast, Brighton, Manchester, Bristol, London teacher.” Belgium, Belfast, Ireland, Ireland, Brighton, towards Manchester, Bristol, London Encouraging a new approach effective lymphatic Pleasestimulation. see more details on our website. This two-part course of three weeks home study

Education

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UK Course content Clinics consists of home study (video presentation), UK Lymphology Lymphology Clinics group on line study and classroom practical work. All sections Lymphatic Healthcare and Lymphatic Healthcare and must be completed. Education Part 1 Education

Advancing our give Friin 5 Mar (P1) On line class (2therapies hrs) Mon 8to – Advancing training training in our –ground-breaking ground-breaking therapies toMar give knowledge of system (P1) Practical (7hrs) Partlymphatic 2 knowledge and and understanding understanding of the the lymphatic system for for those who want to confidently expand their careers in a new Fri 19 Mar – (P2) On line class (2 hrs) Mon 22 Mar – those who want to confidently expand their careers in a new (P2) Practical (7hrs) dimension! dimension!

Seated Acupressure Refresher Details: Details: Fri 12 Mar – (P1) On line class (1 hr) Mon 15 Mar Breast Cancer Cancer Aftercare -- Lymphatic Pressure Therapy - Six Breast Aftercare Lymphatic (P2) Practical (3 hrs) Pressure Therapy - Six Months Training 55 Months Training -Massage 55 CPD CPDAtpoints points The Desk New this training offers maximum your existing skills to a shorter yet effective massage New and and unique, unique,Convert this advanced advanced training offers maximum beneficial aftercare for breast cancer clients. Encouraging five your client is sitting at the desk, in an ordinary chair. whilst beneficial aftercare for breast cancer clients. Encouraging five elements for of to restore ALL practical training will take at muscle elements of of recovery recovery for range range of motion motion to place restore muscle connection for mobility and balance, whilst stimulating www.kingsmoorclinic.co.uk connection for mobility and balance, whilst stimulating lymphatic lymphatic More details availableimprovement. at www.aosm.co.uk return return for for an an overall overall post-operative post-operative improvement. VTCT VTCT Fri 26 Mar - (P1) On line class (1 hr) Mon 29 March Approved. For caring, empathetic therapists confident in their Approved. For caring, empathetic therapists confident in their (P2) Practical (3 hrs) own ability to provide own ability to provide excellent excellent standards standards of of UKLC UKLC aftercare! aftercare! Must have six months massage training and Must have six months massage training and six six months months practice. practice. Lymphatic Massage One T: 0118 391-- 4313 Lymphatic Integrated Integrated Massage One Day Day Attended Attended Course Course -- 12 12 CPD E: info@aosm.co.uk CPD points points Encouraging approach www.aosm.co.uk Encouraging aa new new approach towards towards effective effective lymphatic lymphatic stimulation. This two-part course of three stimulation. This two-part course of three weeks weeks home home study study theory and one day practical results in a short powerful theory and one day practical results in a short powerful therapy therapy application application to to be be integrated integrated into into everyday everyday massage. massage. FTT Beauty and Training Centre “Thank “Thank you you so so much much for for excellent excellent training, training, II thoroughly thoroughly enjoyed enjoyed Well established training centre since 2000, Warm and friendly all aspects of the course and the LIM benefits. You are an all aspects of the course and the LIM benefits. You are an environment based in Hertfordshire. Close to the M25 and inspirational inspirational teacher.” teacher.” M1. Offering a wide range of both Complementary and Beauty Please details our whether it’s an NVQ Level 2, 3, 4 or CPD Fast Track Please see see more more Courses, details on on our website. website. Accredited Diploma. Small groups (Max. 4) allowing for more T: T: 07599 07599 985648 985648 personal attention to the individuals. Courses are tailored to meet individual needs, suitable for beginners and qualified E: E: info@theuklc.com info@theuklc.com therapists. www.theuklc.com www.theuklc.com Details: Call office for full details on dates and times

Bowen Bowen Technique Technique T: 01727 768559 /07796268782

A therapy A soft soft tissue tissue remedial remedial therapy which which is is gentle gentle on on both both E: enquiry@ftt-beautyandtraining.co.uk practitioner and client while still being powerfully effective. practitioner and client while still being powerfully effective. Add Add www.fttbeautyandtraining.co.uk Bowen Bowen to to your your existing existing practice, practice, offering offering it it as as an an alternative alternative to to new new and and existing existing clients. clients. Training Training is is rigorous rigorous but but fun fun with with an an emphasi emphasi ss on on your your practical practical skills. skills. Download Download our our prospectus prospectus one one from Join many Part 1 courses on from the the website. website.Gladwell Join one one of of the the many Part 1 courses on offer offer School of Massage across across the the UK. UK. Gladwell School of Massage is open to everyone who has an

Details: interest in the healing arts, whether you are a practitioner or Details: a complete beginner. Our courses include Thai Yoga Massage Contact Contact us us for for course course dates. dates. - the latest and most effective table massage techniques,

T: Postural Assessment - muscle testing and rehabilitation, Chair T: 01373 01373 461812 461812 Massage, and much more. Expert tuition is provided by Daniel E: E: info@thebowentechnique.com info@thebowentechnique.com and his daughter Lila (see below), at popular locations in the UK or at their retreat home in Greece. www.thebowentechnique.com www.thebowentechnique.com www.gladwellschoolofmassage.com Prenatal Prenatal Massage Massage Training Training

Training Training with with Comfy Comfy Spa Spa Training Training Company Company enables enables you you to to specialise in pregnancy massage. Our Post Graduate specialise in pregnancy massage. Our Post Graduate course course will will teach teach you you all all the the important important do’s do’s and and don’ts don’ts along along with with practical practical skills of to deliver skills Issue of how how111 to 2021 deliver aa beautiful beautiful ritual ritual spa spa treat treat for for mum mum to to be be and and baby baby bump. bump. To To qualify qualify for for training training in in this this unique unique & & beautiful beautiful course all you need is a certificate in A&P and massage. Free course all you need is a certificate in A&P and massage. Free belly belly casting casting is is included included with with this this course. course.

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Details: Details:

Womb Womb & & Fertility Fertility Massage Massage Therapy Therapy

T: 477511 T: 07713 07713 477511 theory and one day practical results in a short powerful therapy E: info@fertilitymassage.co.uk E: info@fertilitymassage.co.uk application to be integrated into everyday massage. T: 07599 985648 www.fertilitymassage.co.uk www.fertilitymassage.co.uk “Thank you so much for excellent training, I thoroughly enjoyed E: info@theuklc.com all aspects of the course and the LIM benefits. You are an www.theuklc.com inspirational teacher.”

Please see more details on our website. Gateway Workshops™ Gateway Workshops™ Gateway Workshops™ Gateway Workshops™ offering recognised one day T: 07599 985648 Gateway Workshops™ offering recognised onediploma day diploma diploma massage, massage, Gateway Workshops™ offering recognised one day beauty and also on-line complementary therapy qualifications. massage, and also on-line complementary therapy E: beauty info@theuklc.com beauty and also on-line complementary therapy qualifications. qualifications. Courses for Courses for all all levels, levels, CPD CPD courses courses for for therapists, therapists, courses courses for for www.theuklc.com Courses forbeginners all levels, CPD courses therapists, courses for complete looking to for learn massage or beauty, gain a

complete beginners looking to learn massage or beauty, gain a complete beginners looking to learn massage or beauty, gain a qualification or a total career change. qualification or a total career change. qualification or a total career change. Recognised, affordable and insurable training allowing you Recognised, affordable insurable training allowing you to to use use Recognised, affordable andand insurable training allowing you to use Bowen Technique these therapies professionally to gain an extra income, in a clinic or theseA therapies professionally to gain an extra income, in a clinic or therapies professionally to gain an extra income, in a clinic or soft tissue remedial therapy which is gentle on both as mobile therapist. therapist. as aaamobile mobile therapist. practitioner and client while still being powerfully effective. Add Details: Details: Details: Bowen to your existing practice, offering it as an alternative to Please check our web sitesite for all the courses we offer - regular Please check our web for all the we offer -- regular Please check web site foroptions all theincourses courses we offer regular new andour existing clients. Training is rigorous butIreland. fun with an weekday and weekend London, UK and monthly monthly weekday and weekend options in London, UK and monthly weekday in London,our UKprospectus and Ireland. Ireland. emphasi s onand yourweekend practicaloptions skills. Download one from the website. Join one of the many Part 1 courses on offer www.gatewayworkshops.com www.gatewayworkshops.com www.gatewayworkshops.com across the UK. Details:

Practitioner Training Contact us for course dates. in Hawaiian Practitioner Training Practitioner Training in in Hawaiian Hawaiian Lomi Lomi Massage T: 01373 461812 Lomi Lomi Massage Lomi Massage With RosalieLomi Samet. Dynamic, spiritually rich and life-changing With Rosalie Samet. spiritually rich life-changing E: massage info@thebowentechnique.com authentic fromDynamic, Hawaii synthesizes ancient with modern in With Rosalie Samet. Dynamic, spiritually rich and and life-changing authentic massage from Hawaii synthesizes ancient exceptional 12 Day Practitioner Training of highest UK standard. authentic massage from Hawaii synthesizes ancient with with modern modern in in www.thebowentechnique.com exceptional 12 Day Practitioner Training of highest UK standard.

Intensive, Fast12 Track ProgressiveTraining options. CPD Workshops. exceptional Dayand Practitioner of highest UK standard. Blend powerful massage skills, energy techniques, Huna Intensive, Fast Track and Progressive options. CPD Workshops. Intensive, Fast Track and Progressive options. CPD Workshops. wisdom and Aloha. Daily massage exchanges, small happy Blend powerful massage skills, energy techniques, Huna wisdom Prenatal Massage Training Blend skills, techniques, Huna classes.powerful Accreditedmassage by FHT and CThAenergy with 2-day Assessment for wisdom and Aloha. Daily massage exchanges, small happy classes. Training with Comfy Spa Training Company enables you to Certification and Aloha. Daily massage exchanges, small happy classes. Accredited by FHT and CThA with 2-day Assessment for Certification specialise in pregnancy massage. Our Post Graduate course will Details: Accredited by FHT and CThA with 2-day Assessment for Certification teach you all the important do’s and don’ts along with practical Details: FAST TRACK One Module of 4 days each – Details: every month 3 months. ofover how deliverof ritual FAST TRACK One Module days – FAST skills TRACK One to Module ofa4 4beautiful days each each – spa treat for mum to be Autumn: Oct 10*– 13, To Nov 07–10, for Dectraining 05 – 08 in this unique & beautiful baby bump. qualify every month over 3 every and month over 3 months. months. INTENSIVE Three Modules of 4 days with one day off between each. course all you need is a certificate in A&P and massage. Free Autumn: Oct 10*– 13, Nov 07–10, Autumn: Oct 10*– 13, Nov 07–10, Dec Dec 05 05 – – 08 08 belly casting is included with this course. INTENSIVE Three Modules of 4 days with one day off between INTENSIVE Three Modules of 4 days with one day off between each. each.

T: 01273 Details:730508 E: info@hawaiianmassage.co.uk Courses are run throughout the year. T: 730508 T: 01273 01273 730508 1 Day Course with pre-course study £160 + vat www.huna-massage.com E: info@hawaiianmassage.co.uk

E: info@hawaiianmassage.co.uk T: 01782 285545 or 01782 639777 www.huna-massage.com www.huna-massage.com E: carol@comfyspatraining.co.uk www.comfyspatraining.co.uk McTimoney McTimoney College College of of Chiropractic Chiropractic We have been training chiropractors for over 45 We have been training chiropractors for over 45 years years and and have have Gladwell School of Massage graduated many massage therapists who recognised that they

graduated many massage therapists who recognised that they Gladwell School ofand Massage is open to everyone who has an needed additional skills knowledge to enable them to needed additional skills andarts, knowledge toyou enable them to help help or a interest in the healing whether are a practitioner more clients. We deliver two programmes providing a Masters in more complete clients. We deliver two programmes providing a Masters in - the beginner. Ourfor courses include Thai Yoga Massage Chiropractic. One is suitable school leavers and is taught during Chiropractic. One is suitable for school leavers and is taught during 10/02/2021 21:41 latest and most effective table massage techniques, Postural the week and one is specifically designed for mature learners wishing the week and one is specifically designed for mature learners wishing Assessment - muscle testing and rehabilitation, Chair Massage,

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MEMBERSHIP AND INSURANCE

THERAPY MAGAZINE

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LOCAL SUPPORT GROUPS

The Federation of Holistic Therapists (FHT) is here to help you and your therapy career ﬂourish, with tailor-made insurance policies, our exclusive members’ magazine, International Therapist, as well as training courses, local support group meetings, special events and the professional recognition that comes from being a member. We also hold the largest Accredited Register of complementary healthcare therapists independently approved

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