Massage World Issue 116 Autumn

FEATURES

8 Oncology Massage for Breast Cancer Patients

Susan Findlay explains the importance of therapeutic touch for patients recovering from breast cancer, emphasising that a practitioner with appropriate training is vital.

12 The Joy of Learning Lomi Lomi Massage Through Love Rosalie Samet shares the storey of Hawaii where life was a celebration and rejoicing of the Love they lived in.

16 The Physiology, Philosophy and Physics of our Clinical Reality

Being in clinic is the unknown to find the known. Owen Lewis writes about dealing with uncertainty in a clinical environment, prompting us to ask better questions.

22 K9 Massageguild

Canine massage was first introduced in 2021. Natalie Lenton introduces The Lenton Method that was clinically trialled and then developed to specifically address myofascial pain in the dog.

40 Working with a Seated Client

When working with a seated client there is a temptation to rely on your upper body and hands to do the work. Darien Pritchard talks us through techniques that can be used to avoid working too hard with the hands while giving a chair massage.

Massage World are delighted to be part of the the FHT Excellence Awards which are back again this year to celebrate the work of their members and this year with the addition of two new categories.

Launching 11 years ago, the FHT’s Excellence Awards showcase the company’s leading holistic practitioners and how they are making a difference to people living in their local community – from helping clients improve their health and wellbeing to providing tailored learning and support to students and qualified therapists.

This year FHT sees the introduction of two new categories: the ‘Lifetime Achievement Award’ and the ‘Volunteer Service Award’, recognising their members who have dedicated their career to the health and wellbeing of others and who have gone above and beyond to give their time to hospitals, charities and good causes.

The ceremony will take place online over the duration of the week commencing 7th November with 2 award winners being announced per day. All entries will be judged by a panel of experts, with the winners being announced via all social media platforms.

The FHT Excellence Awards 2022 categories are:

• Complementary Therapist of the Year

• Beauty Therapist of the Year

• Sports Therapist of the Year

• Green Therapy Business of the Year

• Inclusive Therapy Business of the Year

• T utor of the Year

• Student of the Year

• FHT Ambassador of the Year

• L ifetime Achievement Award NEW

• Volunteer Service Award NEW

Keep your eye on FHT’s social media channels to find out if you or a colleague has won one of their prestigious awards.

New Roles at The Massage Company

The Massage Company (TMC) continues to take the health and wellness industry by storm with its existing franchise portfolio of 5 successful positive-growth businesses, new centres launching in 2022 and a team of over 80 massage specialists in the UK.

With its very own National Training Program, training is as individual as you are. Sports, Maternity, Swedish and Deep Tissue may be the most taught techniques, however, this brand has a focus on the wellness of both its clients and massage therapists as one. A working environment which has been ergonomically designed for both the members and team’s benefit. Certification and accreditation, core values, theory and practical training are all part of the foundations of helping you become an industry expert. The team culture within The Massage Company is powerful, the opportunity to grow quickly, both personally and professionally whilst you gain experience from industry leading experts and learn new skills isn’t comparable, it’s unique.

Their effort is in the detail, not just the leading rates of pay, fixed hour contracts and employee benefits every month. This innovative brand wants to empower both its team members and its clients. As The Massage Company helps both client and team members mental and physical health through massage treatments, it recognises the need for industry leading specialists – just like you!

Passion, commitment, and development of both its team and members health are at the heart of The Massage Company’s business. Investment in your future while delivering the highest quality massage to members, is what makes this a business set to stay on the high street.

If you’re ready to commit to your future in wellness, then it’s time to get in touch with The Massage Company. For current positions available go to www.massagecompany.co.uk/jobs or contact Lisa Barden lisa@massagecompany.co.uk T: 07825184009

For more information on becoming a part of this leading franchise business and PR enquiries contact Kate Sheppard-Payne kate@massagecompany.co.uk T:07701 360009

Realigned at the CHP Conference 2022 The Business Xchange Hub, Marco Polo House, Surrey 15th October 2022

The Complementary Health Professionals (CHP) annual conference returns for another year and as with previous years, the annual conference will have a theme that revolves around a central case study which will be explained and presented by the speakers.

This year’s theme is Musculoskeletal Disorders with Jana Mitackova, the director of Spiral Stabilization UK, who will be kick starting the conference with a discussion on the revolutionary exercise method for spiral stabilization. Meghan Mari from Jing Massage (who is a regular contributor to the event), will be speaking about the Jing Method which focuses on advanced clinical and sports massage for neck and shoulder pain. This includes whiplash which is one of the most common conditions in the United Kingdom.

As well as speakers, the event offers workshops for a handson understanding of musculoskeletal disorders, including the postural analysis and a neuroskeletal re-alignment therapy workshop. During this, there will be a demonstration on how

UNLEASH YOUR INNER YOGI

Meghan Mari

& views

Jana Mitackova

to properly examine a patient to best conduct treatment by focusing on re-alignment points and each attendee will be able to put this new knowledge into practice by conducting in pairs.

Finally, and as usual, you can expect an amazing buffet that is fully catered for all attendees throughout the event, and dietary requirements can be highlighted via email after a ticket is purchased. These are free to Premium Members and £60.00 for non-members.

For more information or tickets go to: www.complementaryhealthprofessionals.co.uk

OM Yoga Show, Alexandra Palace, London | 14th – 16th October 2022

You do not want to miss this year’s event at Alexandra Palace in London as it marks the 15th year of hosting the largest yoga gathering in Europe. There will be lots of stands offering their latest products and innovations, along with presentations led by experts in their fields.

Dr Michael Cohen will be presenting the unique patient self-treatment insights that he has crafted from his 30 years of practicing in the Chiropractor/Acupuncturist field. With first-hand experience with native healing techniques in over 30 countries, this presentation will be a highlight for those wanting relief from pain and aches.

If you are interested in testing your physical limits, you won’t want to miss Ruth Ashdown’s presentation on bringing the love of yoga and its magic to athletes searching for a new challenge. There are many more exciting presentations that may inspire you or quench your thirst for knowledge.

Tickets can be purchased at: london.omyogashow.com

training with Helen Mary Perkins

MENTOR

Using Massage to Support Patients with Breast Cancer

Susan’s first love is dance,anything to do withof movement. Sheas a nurse in Canadaleft the profession when shethe UK as she wanted a deeperconnection with her clients. For manyworked in both health andteaching 20+ classes a weekrunning GP referral schemes. Shemake better use of all herwhich led her to retrain asMassage and Remedial SoftTherapist. Currently she is theNLSSM and specialises inOncology Massage. She is theSports Massage: Hands onTherapists and is the Sportsfeature writer for Massagevolunteers her time as amember of

BY SUSAN FINDLAY

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In the UK, breast cancer will affect 1 in 8 women and astoundingly, 55,000 women are diagnosed with breast cancer each year (only 350 men receive the same diagnosis). So it is likely that you may know someone who has received this daunting news. Maybe you have received it yourself.

Being diagnosed with cancer can make people feel as if their world is slowly crumbling beneath their feet. They may feel like a spectator of their own life, watching powerlessly from the side lines, often feeling scared or even angry. There is no correct way to feel - everyone will respond in a way that is unique to them.

ongoingand business support

A breast cancer diagnosis will be one of the scariest moments in a woman’s life, but as difficult as it may be, it is important to remain positive because the statistics for breast cancer survival are far from bleak.

8 in 10 women are said to make a full recovery from breast cancer; this inspirational statistic is a direct result of advancements in treatment and care. There are also options available to help with recovery and relaxation after a cancer diagnosis.

Coming from a massage therapy background, I have always been interested in investigating ways of implementing therapeutic techniques to help patients with the recovery process. Some of the ways that have shown benefits have been oncology massage, touch, talking, listening and mindfulness.

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Oncology Massage for Breast Cancer Patients

Oncology massage is a form of therapeutic touch; it is a great way to help patients through the recovery period after breast cancer and will encourage them to feel more relaxed. However, I must make it clear that any form of massage should not begin unless a therapist has an appropriate qualification. It is a complex disease and as a result, the treatment is correspondingly complex. Therefore, it requires an excellent level of understanding in order to deliver a safe massage. It is very important we work holistically and support the conventional medical treatment plan.

Cancer treatment can range from radiotherapy, chemotherapy, or surgery. It’s a huge amount of personal responsibility with no room for the inexperienced.

Benefits of Massage Therapy

Now that the warnings are out of the way, I can move onto the parts we all want to know about, namely the benefits.

Oncology massage for breast cancer has been proven to help in a number of areas:

Relaxation of both mind and body

Improving immune function

Symptom relief such as pain, nausea, and fatigue

Relieving anxiety and depression

A lleviating tension in muscles or tissue

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USING MASSAGE TO SUPPORT PATIENTS WITH BREAST CANCER

type of technique is typically referred to as manual lymphatic drainage. As the circulation to the lymphatic system is increased, it helps to drain lymph fluid from the surrounding tissue and by doing so decreases the risk of disease or infection.

Furthermore, another incredibly important factor in oncology massage for breast cancer is the psychological benefit. As I mentioned earlier, receiving a cancer diagnosis can be incredibly stressful and an anxiety provoking time, but fortunately we can use our hands-on and listening skills to play a significant role in enhancing our client’s sense of well-being. One of our main intentions is to offer a therapy that can help their recovery to be as stress free as possible.

Having regular massage can obviously help relieve stress and anxiety but it has also been shown to reduce stress hormone levels as well as increasing serotonin and dopamine levels. This isn’t only attributable to lying down and detaching yourself from the chaos of daily life. As much as this might help, massage therapy has been proven to stimulate the Vagus nerve, as well as activating our parasympathetic nervous systemslowing our heart rate and breathing, and as a result making us feel calmer.

Often when we are stressed, we will carry a lot of tension in our muscles and this is often reflected in how we breath and move, causing shallow breathing, increased respiratory rates, tension in

the upper shoulders and tight jaws. All of this can be ameliorated with massage. Oncology massage treatment should include a holistic whole body approach.

Is Massage Therapy Safe for Breast Cancer Patients?

This is a question that I have heard a lot of people ask - the simple answer to this is yes, it is completely safe, but it needs a considered approach. You might not be able to work directly on the area of concern because there are modifications that will need to be made, i.e. location, timing, position, technique, to name a few. However, there is usually something that can be offered that will improve our client’s sense of well-being.

As with many things in life, people can misunderstand and propagate misinformation and one of these myths is that massage can spread cancer cells. This is false because there is no evidence to support this claim unless one condition is met - specifically that you are working directly on a tumour site. Tumours do not like compression, so avoid them. We also need to consider other forms of treatment, such as chemotherapy and radiotherapy, whilst paying attention to surgical sites and their stage of health. Typically, once a full case history has been taken and it is suitable for a therapist to work in the area, an oncology massage therapist will work in stages to rehab the tissue choosing techniques based on the presentation.

Apart from the slightly more obvious benefits, it is worth noting that oncology massage for breast cancer can also assist with lymphatic drainage by stimulating the lymphatic system. This

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Further Forms of Touch

When undergoing breast cancer treatment or in the recovery stages, it is important to find ways that will assist with relaxation. As I mentioned earlier, oncology massage is a good way to relieve stress and tension as well as assisting with recovery. But this may not be everyone’s preference and so there are other forms of touch therapies that also have beneficial qualities:

· Shiatsu: This is a type of Japanese massage that is typically focused on alleviating stiffness

· Acupressure – Working with meridians and pressure points, this type of therapy works through touch and can be helpful for relieving stress and pressure

· Reflexology – Typically this is focused on applying massage therapy techniques to the hands and feet

All of these can have stress relieving qualities and are a good way to help with mindfulness and relaxation.

Listening to the Patient

When someone receives a cancer diagnosis, it can not only have a detrimental impact on the patient, but it can also affect the friends and family close to them. A lot of people who have received a diagnosis may feel they have to put on a brave face for the people around them.

As a therapist, offering a listening ear from an impartial point of view could help alleviate stress and allow the patient to unburden any heavy thoughts they may be carrying around. It is important not to compromise their

privacy by forcing a client to speak, but if they wish to chat during their massage therapy, then actively listening could help them feel more at ease.

This story, that was relayed to me recently, exemplifies this point. A massage trained therapist could not offer her mother a massage as she did not have the appropriate oncology training, so she found someone who was certified and knew what she was doing. After the session, she asked her mother how it went, what did the therapist do and if she was happy? She replied that it was the best massage she had ever had. High praise indeed. What did the therapist do? She massaged the mother’s hands. The therapist approached the session from the viewpoint of the client. She focused on what her client’s needs were and did not deliver a predetermined massage session. All the mother wanted was to feel relaxed and listened to and it was important that she felt she could tell her story and be heard. This demonstrates the value of touch and a mindful therapist.

Encouraging Mindfulness

Mindfulness is a term I am sure you have heard being thrown around a lot. It has become a very popular within many different health communities, and as a result, it is somewhat overused. However, it is very important in relation to breast cancer recovery. To clear up any confusion that may be surrounding this word, mindfulness typically refers to focusing on the present moment while accepting your feelings, thoughts,

and bodily sensations. Some ways that mindfulness can be practised are through breathing techniques (slowly in through the nose and out through the mouth) and meditation.

As a therapist, it is good practice to recommend mindfulness to patients recovering from breast cancer in between massage therapy sessions, in order to encourage relaxation and minimise stress in the absence of a therapist.

One way you can encourage this is by teaching clients the acronym STOP. If they feel they are becoming overwhelmed with stress and their mind starts racing they can practice this technique.

◆ S – STOP what you are doing and sit down for a moment

T – TAKE deep breaths, breathing in through your nose and out through your mouth - inhale for the count of two and exhale for the count of two

O – OBSERVE your thoughts and emotions

P – P ROCEED with something that you feel will help you, it could be having a cup of tea, reading a book, or going for a walk. Whatever it may be, make sure it is something that makes you feel safe and comfortable.

Mindfulness techniques can also be encouraged both before and after a massage to maximise the potential for relaxation.

The Final Word

For any woman, receiving a diagnosis of breast cancer can be extremely stressful and scary. But as hard as it may be, we must focus on the positive outcomes, because a breast cancer diagnosis is no longer a death sentence. The success rates of recovery are higher than ever before.

As an experienced massage therapist, I firmly believe that the correct approach can pull clients through the toughest of times and I am incredibly grateful that I am in a position to help people through their breast cancer recovery journey.

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FIND A THERAPIST DIRECTORY:

Covid-19 Protocols

If you are looking for a certified oncology massage therapist, please visit my website www.susanfindlay.co.uk/oncology-massage-therapist-directory

SUSAN’S BLOG:

Further reading can be found on my website www.susanfindlay.co.uk/blog

Subject titles include:

• The Vital Role of Complementary Therapy

• The Mindful Touch

FAVOURITE PODCASTS AND RECOMMENDED READING:

• The Doctor’s Kitchen - Dr Rupy Aujla

• Feel Better, Live More - Dr. Rangan Chatterjee

• How Can We Support Our Clients’ Return to Health Holistically

• What is Oncology Massage?

date about all the current policies, procedures. I cannot say this for every PA, but I do know that those sitting as board members of the GCMT (The General Council of Massage Therapies) played a significant role in getting information out to all their members.

• How Can Massage Help Mental Health?

• Oncology Massage: An integrative approach to cancer care by Janet Penny and Rebecca L Sturgeon

• S pecialising in Oncology Massage

• Cancer and Massage Therapy: Is What They’re Saying True?

I was heartened to see that so many therapists joined in on the conversation, how the profession started talking as a unified body, and how we got behind our professional associations, with GCMT emerged as a body with influence. It is now up to us to support our PA’s in their efforts to petition the government to recognise the value of higher education within the profession.

• Keep Healthy after Cancer by Prof Robert Thomas

So, what can you do? The good news is, the more education and experience you have the easier it will be for you to re-establish yourself. For those therapists that are new to the profession, it is important that you have a niche, a specialism that places you in a position of greater value. Your expert skills will establish you firmly and increase the need for your services.

VIDEO LIBRARY:

Please feel free to listen to my free webinar about the Benefits of Oncology Massage www.susanfindlay.co.uk/video-library

• The Cancer Revolution: Integrative Medicine - the Future of Cancer Care by Patricia Peat

• M edicine Hands: Massage Therapy for People with Cancer by Gayle MacDonald, MS, LMT

I want to leave you with thoughts of encouragement; we all know how important massage is and the thought of a future without it is daunting, both for our clients and ourselves as professionals. I cannot see massage stopping; whilst we may have to improvise and adapt, we will certainly survive.

SUSAN FINDLAY

Susan’s first love is dance, sport, anything to do with the joy of movement. She trained as a nurse in Canada but soon left the profession when she came to the UK as she wanted a deeper connection with her clients. For many years she worked in both health and fitness, teaching 20+ classes a week and running GP referral schemes. She wanted to make better use of all her knowledge which led her to retrain as a Sports Massage and Remedial Soft Tissue Therapist. Currently she is the director of NLSSM and specialises in teaching Oncology Massage. She is the author of Sports Massage: Hands on Guide for Therapists and is the Sports Massage feature writer for Massage World. She volunteers her time as a board member of GCMT.

Susan’s first love is dance, sport, anything to do with the joy of movement. She trained as a nurse in Canada but soon left the profession when she came to the UK as she wanted a deeper connection with her clients. For many years she worked in both health and fitness, teaching 20+ classes a week and running GP referral schemes. She wanted to make better use of all her knowledge which led her to retrain as a Sports Massage and Remedial Soft Tissue Therapist. Currently she is the director of NLSSM and specialises in teaching Oncology Massage. She is the author of Sports Massage: Hands on Guide for Therapists and is the Sports Massage feature writer for Massage World. She volunteers her time as a board member of GCMT.

You can

her

Massage Mondays for free weekly massage videos www.susanfindlay.co.uk

You can join her on Massage Mondays for free weekly massage videos www.susanfindlay.co.uk

Hellicar, Lauren. “Coronavirus: What Support Is Available For Small Businesses And The Self-Employed?”. Simplybusiness.Co.Uk, 2020, https://www.simplybusiness. co.uk/knowledge/articles/2020/06/coronavirus-support-for-small-business/.

PATIENTS WITH BREAST CANCER

The Joy of Learning Lomi Lomi Massage Through Love

BY ROSALIE SAMET

The story of Hawaii is essentially a sacred love story about the people’s deep reverence for Nature, their Beliefs, Traditions and Customs and for their People, their Ancestors’ and their Progeny. The People were in love with the beauty, power and magic of Life and they, in return, felt truly loved by Life. For them Life was a celebration and rejoicing of the Love they lived in!

Their joy of being alive and having the wonderous natural abilities to savour and appreciate, to nurture and to love, to know gratitude and forgiveness, to think happy thoughts and feel generous emotions, to make good things happen, to freely surrender to the moment in the here and now, to experience the profound wisdom of the inner worlds and the outer worlds as One never-ending Continuum of Goodness, to feel the powerful Presence of Life in every moment and in all things and to share their blessed existence equally and fully with everyone in their communities.

Lomi Lomi, the traditional healing massage of Old Hawaii, is essentially the love of the Hawaiian people expressed through empowered tender-hearted touch, expanded awareness of spiritual possibility, deep concentration and focus and high intention for positive outcomes while in joyful surrender to a reciprocal state of kindness in the present moment.

Learning Lomi Lomi is about learning to fall in love with this beautiful story, through the art of massage lovingly bestowed by conscious human touch upon a lucky recipient who may feel a multitude of unfamiliar yet thoroughly wholesome and welcome meaningful sensations at the same time.

These can include being moved by the rhythms of gentle but powerful waves of energy generated by the flowing strokes which release trapped memories and tensions and at the same time receiving pure unconditional nurture that communicates sublime goodness to flesh, mind, and emotion while being softly embraced by the joyful security of Existence.

All this and so much more is possible in just one massage session when conditions are favourable, and the Practitioner understands how to use their skills appropriately and effectively.

One may wonder how it is possible, over a short period of time, to successfully teach a student, with no previous experience or knowledge, to share this love storey of

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Hawaii reliably and confidently with their future clients.

Becoming a student of old-world traditional Lomi Lomi massage is first and foremost a gracious act of trust, hope, courage, and patience with an unconventional and unfamiliar learning process that promises to gradually unfold its silent secrets only in direct response to openhearted sincere student participation.

Students are gently ‘invited’ (required really) to surrender to a host of unknown and unexpected aspects that often arise during this curiously intriguing training. The element of surprise and of meeting the unknown, hopefully comfortably and with good humour, while observing ‘surprising’ personal responses, is an important stretch for the expanding consciousness venturing outside the box of ordinary expectations.

These challenges are inevitable and necessary as the contrast between the ancient world and the modern world is so different to our ordinary everyday experience. To learn about their world, students must first be willing to step outside the boundaries of their own world and allow themselves to sink, as best as possible, into the vastness of theirs. Through repeated visualisations and ceremonies this change gradually becomes a reality as

students assimilate into themselves the Hawaiians’ extraordinary heartmind of Aloha that permeated their entire being and world view. Their quiet state of universal unconditional loving kindness and care also gradually begin to become the students normal state of consciousness both to the learning itself and to the methods of making transformational massage. Ultimately this persuasive influence may show student and practitioner how to live their lives to fullest potential. Their first experience of the embracing magnitude of Aloha is pure magic as new meaning to life and love open before them. As a truthful and practical path to liberation, wholeness, and wellbeing, it is then a choice and privilege to walk its full length for the rest of life if so desired. Thus, a gift given for a moment to demonstrate a principle, may indeed carry through a lifetime. From humble beginnings, the

comprehension of Aloha can blossom into a bounty that offers greater and greater blessings and benefits!

The classroom then becomes a place where love can safely build and flourish. Many ceremonies are performed to support the presence of this goodwill while releasing all contrary vibrations. The first is a prayer that cleanses the environment, ‘inviting all frequencies less than love and harmony to be instantly transmuted and disappeared from the entire space, including the students, and replaced by love and light’. The second vital ceremony focuses wholly upon the students to strengthen their energetic presence, heart-centred awareness, focus, and intentions. The third ceremony is designed to facilitate an optimum response from the body about to receive massage through cleansing and energising. Most often this is another student as groups work in pairs giving and receiving massage. By the time these ceremonies are completed, students are in a serene and loving state of altered awareness ready to engage with the awaiting body. These dynamic preparations act in a shamanic way to transform an ordinary experience of massage into an extraordinary experience. It is the combination of precise attention to detail combined

THE JOY OF LEARNING LOMI LOMI MASSAGE THROUGH LOVE

From humble beginnings, the comprehension of Aloha can blossom into a bounty that offers greater and greater blessings and benefits!

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THE JOY OF LEARNING LOMI LOMI MASSAGE THROUGH LOVE

release blockages and limiting beliefs and old habits, discover new learning skills, change concepts, increase capacity, strengthen commitment, redefine life goals, find meaningfulness and discover everything that is needed to progress successfully. The self-development process can sometimes arouse uncomfortable degrees of resistance but with time to evaluate and adjust to what is happening, this can settle into a happy resolution as the student moves past themselves into the greater potential just ahead.

with unconditional heart-felt goodness that makes all the difference.

The performance of Lomi Lomi massage is a refined art, worked through highly skilled and specialised craftmanship. Within the loving conditions of the classroom, learning can be relatively quick, but skill develops with repetition and time and the degree of sincere commitment that is poured into it.

Learning to make the individual massage strokes so unique to this style of massage is also an unexpected ‘delight’ on many levels. At first, this delight may be interpreted as confusion, awkwardness or even impossibility, as the body and mind adapt to an aligned whole-body movement that ripples through from feet to fingers! Every stroke carries the entire Wisdom of Hawaii in its making and is capable, when skilfully performed, of transporting the receiver into the highest dimensions of self. Learning strokes is important, but more important than these is the Wisdom that moves through them.

The Syllabus falls into four major sections. Each deal with an important aspect but of course, it is the whole that gives this style its true power. These sections are the Massage Skills, the Hawaiian Wisdom, Practitioner Development and Client Considerations.

Much emphasis is placed upon the Practitioner’s ability to become a clear vessel of communication between the wisdom held within the work and the client. Built within the Training are daily opportunities to gain clarity of self,

Lomi Lomi Training is all about the student discovering their best self, both as a person and as a Practitioner. Essentially, each student learns at their own speed and style and within the group, each can be at a slightly different place. This is a good discipline that allows each to work to their own capacity and in their own time and at the same time avoid that nervous continual looking back over one’s shoulder to see how well one is keeping up with the group. Each student can then more easily monitor and appreciate their own progress. It is important to realise that Lomi Lomi is a complete massage system in itself and as such, the student is urged to ‘grow’ into its great capacity rather than resist the learning and attempt to shrink its potential down to their level.

With luck the compounding influence of seeing, feeling, evaluating, and comprehending may ignite forthright and decisive action for lasting positive change. The more fully the student and practitioner are dedicated to this path, the greater is their progress.

Although the 12-day Practitioner Training offered by the HMUKTC is a first step along a lengthy journey if pursued to its end, it is indeed a worthy foundation to build upon and a proud initiation into a comprehensive body of wisdom that has endured throughout the ages. Multi-level and multi-dimensional, the practice of Lomi Lomi has many manifestations and possibilities.

Regardless of what name it is given, or which aspect of the work is emphasised, its essential focus is upon wholesome healing and empowerment, be that physical, emotional, sensual, or spiritual.

predictable, its message touches all who truly long to be able to give love and in return, to truly be able to receive love. A Practitioner of this style of Lomi Lomi often chooses Love as their strongest motivating value followed by a desire for deep inner peace, selfknowing and self-sufficiency and to fulfil themselves through benevolent service to the betterment of humanity.

Lomi Lomi Practitioners like people and wish to help them heal their wounds and realise their aspirations through profound acts of loving kindness that speak messages of hope and encouragement to body, mind and soul.

ROSALIE SAMET

Rosalie is the UK’s leading Master Practitioner and Trainer of the sacred art of Hawaiian Massage. Bringing together the best of Lomi Lomi Massage and Kahuna Bodywork, she has created her own unique, compelling, and life-changing style of teaching. Synthesizing ancient with modern, the Practitioner Training is an authentic, inspiring, and spiritual interpretation of traditional massage from Hawaii.

Rosalie is a member of the Massage Training Institute, the Complementary Therapist Association, the Federation of Holistic Therapists, and the Think Tree Hub.

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BY OWEN LEWIS

Reading this magazine, studying with Born to Move, or being in clinic is an exploration into the unknown to find the known. Unlike most articles and books I’ve read, workshops attended and courses studied, this article is not attempting to find certainty, truth, answers or fact; instead it aims to ask better questions.

Uncertainty is a clinical reality that can support or undermine our capacity to become expert practitioners.

Many of us feel we don’t have sufficient knowledge or need more techniques, and may feel a failure to unravel the complex problem that clients present us with.

The result is often a hesitant blinkered approach as we revert back to old habits and protocols rather than allowing our

imagination to flourish and expertise to develop. Our clinical reality is the battle with these inner demons of uncertainty.

Here I suggest that this uncertainty is actually a necessary tool in the clinic. Let us look to the dusty world of philosophy, a somewhat unusual place to find a practical guide towards clinical excellence. Such a guide allows researchers and practitioners as a

flexible framework to direct a espoke assessments and treatments. It’s time we move away from the conventionally rigid protocols that restrict us to working on symptom rather than the cause.

Our work as practitioners is exceedingly complex and as we progress in our professional lives we can find a deeper level of confusion and become slightly more comfortable with the certainty

of uncertainty. But this does not just happen, it must be part of our continual development as practitioners.

Research is certainly one of those Marmite subjects. Love it or hate it, research can help our practice. However, its power over our work can also damage credibility and confidence.

Gradually some researchers are starting to dovetail their research to enrich and be informed by clinical experience. Case studies are gaining some credibility, it is no longer all about randomised control trials. The result is that research is coming off its lofty perch in the clouds and is being brought down to ground level, and into our clinics and studios.

Unfortunately there is still a tendency for research to be singular, considering one variable often out of context. Research such as ‘A study comparing hip flexion and lower back pain’ is still all to common. This type of research, while interesting, does not reflect our clinical reality. Our clients more often exhibit multiple impairments and persistent pain. Their lower back pain is linked with their lack of hip flexion, associated with their poor ankle dorsiflexion that stems from the fear created by the whiplash of a car accident that manifests in the headaches and chronic tension in their occipitals that was exacerbated

by the childhood asthma and lack of motion at their second rib. My treatment must therefore include neural, dural, articular, myofascial, psychological and motor programming components for that individual. Figuring that all out, finding these interrelationships and discovering the best place to intervene was yesterday’s ‘normal’ client. There is clearly no protocol and no research that will ever cover the complexity of the individual client.

The change from the absolute power of research would, I expect, please the medieval patron saint of universities and scholars, Thomas Aquinas. Aquinas challenged the prevailing assumption that “the human mind cannot know any truth unless by light of God”. In the medieval world of Thomas Aquinas it was a universally held view that everything important for us to understand had to come from the single approved source: God. Aquinas realised many of the great philosophers and thinkers that he studied were Pagans, or at least not Christians. He carefully opposed the view of the church realising that one could know things without knowing anything about God. Aquinas was particularly concerned that the Bible, as such a prestigious

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source of information, could swamp observation. He feared that people would be so impressed by these revelations from authority that they would discount their own powers of observation, reflection and experience.

Today, tension between higher authority and personal (dare I say, clinical) experience remains. The modern version of Aquinas’s observations is the refusal of almost any kind of knowledge that doesn’t come with the backing of data, experiments, mathematical modelling and peer-reviewed journal references. The higher-authority may not be God, but it still exists. But before we dismiss research completely, a word of warning from the ‘prince of paradox’ the English philosopher G.K. Chesterton. Chesterton remarked that “the problem with people who lose belief in God [and here we might replace God with ‘higher authority’] is not that they end up believing nothing, but that they will believe in anything.”

I’m sure no one wants a war between researchers and practitioners that, like any war, would “not determine who is right — only who is left” (Bertrand Russell) PIC1. However, it is a war that often exist within each of us. Part of us represent the absolutist: the part that enjoys standing on the granite rock of anatomical truth, with plain unvarnished objective fact at the centre. Counter to that view is the relativist within, that mocks these concrete ideals in favour of situational and individual-specific critical thinking. As we turn to the high priest of relativism, Nietzsche, who explains that “There are no facts, only interpretations”. This concept seems to echo our clinical need to deal with each individual, individually.

Many of us still hold scientific research up as the bastion of certainty and truth. The irony of this is that research is based on uncertainty. Doubt is the bedrock of science. The greatest scientific minds are not certain. Even Darwin who begins The Origin of the Species with a less that certain “It seems to me”. Or

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the physicist Richard Feynman who clearly values doubt: “Doubt is clearly a value in science. It is important to doubt and that the doubt is not a fearful thing, but a thing of great value.”

In research, being unsure drives further investigation, develops better hypothesis and improves future research. Research proves and perpetuates this idea, and demonstrates this by one of the most common statements in all of research: “more research is needed.” By this simple statement the researcher is telling us they are still doubtful of the nature of their truth and, critically, are still willing to continue to explore.

I would hope that this spirit of exploration is mirrored in our clinics. Unfortunately, most of our clinical training is significantly different. Initial training often revolves around our ability to follow protocols. Training in certainty may well undermine our confidence and imagination. Protocols are most often the result of the current gold standard of research, randomised control trials (RCTs). Research that better reflects the complexities found in clinic is now showing the limitations of this generalist approach. Protocols are significantly limited to a rigid one-size-fits-all approach. Perhaps we are still unduly affected by the Roman anatomist Galen. Galen influenced medical thinking, both clinical and research, for thousands of years. He produced some brilliant work but also taught a version akin to a medical Gospal of certainty. Galen’s treatments worked, he claimed, “on everyone except those who were going to die anyway.”PIC2

It is gradually becoming an accepted view that protocols don’t or can’t work for everyone. This presents a problem to clinicians who rely on protocols.

It forces clinicians to learn how to develop hypotheses, to test and retest and develop ideas all in the time and space available in our clinics and studios. While possible, this is difficult.

The result of such difficulty is to revert back to habitual patterns of treatment. The irony being

that we are asking our clients to change, while we are failing to do so ourselves.

The point I’m attempting to make here is that doubt is a useful tool. That when coupled with both research and intuition becomes a powerful weapon in positive change.

It is clear that both research and clinical experience is important. Problems arise when we insist exclusively on either one or the other. Perhaps the fad of research-based practice is just as limited as intuition-based practice when compared to a combined approach of allowing intuition to stand on the foundation of research.

To be a great researcher or have clinical excellence we needs similar skills. To be able to develop sound hypothesis, test and re-test, use doubt and being comfortable with uncertainty are all essential skills.

To improve our research and so our clinical skills I suggest we all need to

improve our skills of questioning. You might like to consider the following questions when next you get a chance:

How can doubt improve clinical excellence?

Are protocols still relevant?

How do you develop sound hypothesis in your clinic/studio?

Does research reflect clinical reality?

What are you most certain of?

What are you most uncertain of?

While you improve your flair for metacognition, the skill of thinking about thinking, let us continue to dare to doubt.

2What is your current area of interest? Is it the shoulder, hip, ligaments or fascia. Are you finding that this current area of interest has allowed you to notice more and more clients presenting with this problem. But is this true or does your current view create the rose-tinted spectacles that distorts your reality?

Physicists such as Neils Bohr have long known that a quantum of light, or photon, will behave like a particle or a wave depending on how it is measured. This suggests that reality is what you choose it to be. Bohr beautifully explained this when he stated that “A physicist is just an atom’s way of looking at itself.” Bohr like Schrödinger (and his cat) all came to realise that the “observer is the observed” (Krishnamurti). The actual process of assessment can alter the assessment itself. No wonder then that doubt creeps in when we assess our clients. How can I know, with any certainty, what it is that I assess daily in my clinic?

Take this idea further and we encounter the ideas of Descartes. In his explorations Descartes asks us to doubt everything. That in order to be “a real seeker after truth, it is necessary that at least once in your life you doubt,

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as far as possible, all things.” His questions doubt our senses, he points out can deceive. An idea confirmed by the simple illusions and fake news stories. Today our reality, with the influx of Zoom into our clinical lives, looks more like the film The Matrix. This film cultivated Descartes' ideas that there is a ‘real’ world as we sense it but actually the characters inhabit a complex computer program. Ideas such as these lead us quickly to climb this strange ivory tower and we begin to doubt reality. All this philosophising calls for a dose of something real. Time to return to earth and get practical and solid.

Stand up. Place your hands on your pelvis, better still your iliac crest. Turn to the right and note how your right foot supinates and your left pronates. Still looking forward? Result, your head has rotated to the left, relative to your torso. This simply describes some of the biomechanics of normal human movement. Information like this can be used in the assessment of your clients. Imagine that a client comes to you complaining of foot pain. You assess the feet and note a difference in the height of one arch compared to that of the other foot. Knowing what you do about the predictable nature of human biomechanics, as outlined above, you change your client’s pelvic position, back to neutral. ‘Hey presto’ their foot position and reported pain has improved. No longer are you at the beck and call of foot pain protocols. Now you are treating the cause and creating long-term changes. In this simple example, the pelvic rotation was causing the poor foot alignment, foot mechanics and the cause of the reported pain.

Of course you can reverse this idea and change feet to affect the pelvis for another individual with another pattern. To add a third dynamic, consider how the neck/head position might have driven either the pelvic rotation and/or the foot position. As you delve into this, you’ll find that

the variations are almost endless. This endlessness reflects the complexity and individuality of each of your clients. Fundamental principles, not protocols, will allow you to use this method causal over symptom based treatment. To predict outcomes, use doubt to explore and make longer lasting positive change for each uniquely individual client.

One of the principles of the Born to Move workshops is to empower clinicians to ask better questions. We aim to embrace doubt and so act more like a curious researcher constantly asking why. The consequences of this approach

are to search and find causes through a collaborative exploration between client and practitioner. This replaces the hierarchical ‘I know best’ approach that places the practitioner in the impossible position of being expected to know all the answers. This approach is not some kind of final form of miraculous insight or absolute truth. In the place of rote learnt protocols is a principled based, ever changing form of insight and imagination. Together with our clients we at Born to Move are content to explore as our understanding unfolds towards increasing order and complexity.

OWEN LEWIS is a highly experienced and educated clinician. An accomplished teacher of many years he has recently teamed up with James Earls to create Born to Move. Born to Move is a comprehensive set of courses that are not confined to any one doctrine but blends and utilises James and Owen’s varied and extensive understanding of the body in movement. Being taught by Owen is to experience simplicity within the complex. Seeds of knowledge watered by a wealth of clinical relevance.

Clinically Owen has gained a distinguished reputation. Grounded in his extensive anatomical and biomechancial understanding he works alongside his clients. Taking a principle based framework that allows the discovery of individually tailored, effective solutions to problems and empower change.

His diverse interests in art, anatomy, philosophy and movement to ensure his workshops are a pleasurable part of your training.

borntomove.com

THE PHYSIOLOGY, PHILOSOPHY AND PHYSICS OF OUR CLINICAL REALITY

The point I’m attempting to make here is that doubt is a useful tool. That when coupled with both research and intuition becomes a powerful weapon in positive change.

Donna Woodcock Massage Therapist

To nd 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

Professional help when you need it

“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”

The Rise & Rise of Clinical Canine Massage Therapy

BY NATALIE LENTON

Have you ever considered offering massage to dogs alongside your human practice? According to the PDSA, in 2022, 52% of UK adults own a pet, with 27% of UK adults owning a dog, giving an estimated population of 10.2 million pet dogs in the UK alone. Clinical canine massage therapy has exploded in popularity over the last decade and with more people owning dogs than ever before, owners are looking towards complementary therapies to help their four-legged friends. But before you start entertaining the idea of treating dogs, there’s a few things that you need to know

But is it rewarding? Natalie Lenton, Director of the Canine Massage Therapy Centre and Founder of the professional association the Canine Massage Guild, says, “If you are someone who has a passion for dogs and complementary healthcare then this career path takes job satisfaction to a whole new level. In canine massage therapy, we get to help the dog, most frequently with mobility or performance issues, and we also get to help the human client by supporting them with concerns they have for their dog’s health and welfare. Our dogs are pivotal in our lives, not only providing us with companionship and the excuse for nice walks, but more than that, they give us unconditional love and a state of presence that makes the human to canine relationship unique. Many people are turning to canine massage to improve their dog’s physical health and vets are referring dogs for massage who are unable to tolerate NSAIDS”

Firstly, unlike with human clients, you can’t just go ahead and treat. To be able to treat dogs, a therapist has to comply with the Veterinary Act 1966 and Exemptions Order 2015, and this means having the relevant training and insurance in canine massage therapy as well as obtaining veterinary consent for each dog that is treated. These standards were set by the Royal College of Veterinary Surgeons (RCVS), as canine massage comes under Section 19 of the Act meaning that massage therapy for dogs is classed as a minor act of veterinary surgery.

Overkill? Probably not, as providing massage to animals is distinctly different to providing it to their human

counterparts. The therapist has to consider how working with the nonverbal client presents several challenges including taking into account:

• Canine behaviour and body language

• Bite risks

• The unique aspects of canine anatomy and physiology

• Adaptations and variations of technique

• Pain perception

• Floor work, couch work and positional variations

• Pain presentation and symptoms

• Canine pathologies

• Canine handling skills

Typical clients of the canine massage therapist include dogs with physical trauma, for example, soft tissue injuries and issues sustained from activities of daily living such as strains, trigger points and myofascial pain, as well as providing chronic pain management for dogs with orthopaedic conditions like arthritis, hip dysplasia, spondylosis and luxating patella. Other types of canine clients can include abused or traumatised dogs, agility and sporting dogs, and lots of senior dogs whose owners utilise the therapy to improve mobility and manage pain in the dog’s twilight years with often very profound results.

In terms of its efficacy, much as with human massage, it’s going

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to depend on the level of training and practice of the individual therapist.

There are several canine massage courses available in the UK with differing course content, but the most important piece of advice is to find a course that teaches the practical element in person. Whilst theory can be completed via distance learning, a student’s full potential can never be reached if all learning is online. You may choose your course based on content, the location or even price, but if you want this as a career or to supplement your existing practice, then consider the level of training you will receive as this will determine your future success. Ask yourself, can you learn everything you need to know on a 1-day course to effectively help a dog’s injuries/ condition? And more importantly, would you want your dog treated by a person who had never had handson supervision and only done a short course? It’s questions like this that your potential future clients will ask too.

The Canine Massage Guild (Guild) is a professional association for Clinical Canine Massage Therapists, aiming to raise industry standards. All members have trained with the Canine Massage Therapy Centre Ltd, (CMTC) on the Clinical Canine Massage Practitioner Programme (Practitioner Programme) externally accredited by LANTRA which has a successful track record of training therapists for over 10 years. Indeed, both the association and the training company have gone on to change the face of canine massage therapy with the world’s first clinical trials in canine massage therapy.

Evidence-based research

Last year, the world’s first peer-reviewed research on clinical canine massage therapy and the Lenton Method™ was released in the Vet Record published by the prestigious British Veterinary Journal. The Canine Massage Guild and Canine Massage Therapy Centre worked with Winchester University and University Centre Sparsholt to produce this pioneering research.

University Centre Sparsholt is one of the UK’s leading providers of undergraduate courses for the land and environment. It has strong links with The Royal College of Veterinary Surgeons as well as a large number of RCVS Approved Training Veterinary Practices in the south of England.

Winchester University’s Centre for Animal Welfare is an interdisciplinary centre that undertakes research, teaching and public engagement in the field of animal welfare. In the most recent Research Excellence

Framework (REF 2014) 82 percent of its submitted research was considered to be recognised internationally, with seven out of eight units of assessment achieving world-leading quality. The study, named the ‘Effect of massage therapy on pain and quality of life in dogs: A cross-sectional study’ (Riley, Satchell et al, 2021) was across 527 dogs and the results of the study showed that over 95% of dogs respond to clinical canine massage therapy, and most specifically the Lenton Method®

Guild practitioners use the exclusive Lenton Method® of massage to treat soft tissue injuries and MSK conditions following veterinary referral direct from the practice or as client-led.

Practitioners assess and treat issues with gait, posture, daily activity, behaviour, and performance, known as the Five Principles of Pain, seeking to improve a dog’s quality of life.

Guild practitioners were asked to complete a standardised report per dog documenting life history variables (e.g. age, breed, sex), clinical diagnoses and known or deduced aetiologies, and number, severity (score) and improvement status (improved/ worsened/no change) of each Five Principles of Pain parameter before massage therapy commenced and after each of a maximum of three massages. Practitioners were asked to record if they considered the dog had improved post-treatment.

Wellness, quality of life and mobility improved across all breeds and ages of dog with improvements

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typically seen after the first treatment and increasing after the first session.

The Lenton Method®

So, what is clinical canine massage therapy and the Lenton Method?

Therapists in the Canine Massage Guild have trained for 2 years with the Canine Massage Therapy centre to master 4 disciplines of massage from the human world including Swedish, Sports, Deep Tissue and Myofascial Release, both the direct and indirect method. But where the therapy differs is in the provision of the Lenton Method, a modality invented by Natalie Lenton, the founder of both the Canine Massage Therapy Centre and Canine Massage Guild which celebrates its 10th anniversary this year.

The Lenton Method® is a 3-tiered approach to the evaluation, treatment and reevaluation of the canine patient who presents with soft tissue or musculoskeletal injuries and/or degenerative diseases like canine osteoarthritis. It is also used for emotional trauma and abuse cases. “The dog holds trauma and emotional distress in their myofascial network, just like the human. Over the years I have seen profound changes not just in the dog’s mobility and motor output but importantly in the way they process sensory input with my method which tends to get results between 1 to 2 3 sessions.”

The Lenton Method consists of the following:

Tier 1 - Advanced Palpation – the practice of informed touch involves the therapist’s ability to read and translate texture, tone tenderness and temperature of the many muscles of the body (the 4T’s) using a comprehensive and structured palpatory procedure. Guild therapists also utilise the ‘3 Interconnected Qualities of Fascia’ model (Luchau 2015) simultaneously with the 4T’s for assessment and re-evaluation of your dog’s soft tissues and fascial planes. The therapists use a range of palpatory techniques and are trained in appropriate grip modulation and force control for a comfortable experience for the dog who is often a lot more discerning and critical of touch than their human client counterpart. Palpatory literacy is a key skill necessary for gaining a thorough picture of primary and secondary issues including overcompensation and habitual patterns of tension arising from soft tissue, orthopaedic and neurological issues.

Tier 2 - BodyMapping – During their training, therapists commit to memory a comprehensive anatomical map of the dog’s musculature and fascia along with the precise locations of injuries which include strains, trigger points, hypertonicity and myofascial pain as catalogued over a decade by Natalie Lenton. This promotes consistency between practitioners and is utilised in conjunction with Tier 1: Advanced Palpation.

The 7 Protocols – A series of complex direct myofascial releases to address chronic structural imbalance and fascial dysfunction as a result of soft tissue injury or degenerative joint disease. Following Tiers 1 & 2 the 7 protocols are preceded by Swedish, sports and deep tissue massage. The 7 Protocols are applied with often profound and long-lasting results as determined by the indicators presented and the outcome achieved and are a key factor in the success of the therapy. Typically, a therapist will have 60 techniques across 4 disciplines and the Lenton Method and 7 Protocols at the end of the 2 year training.

“Dogs have a way of making us become very present and just like with humans, they all have individual personalities, characters and pain levels.”

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Further CPD can be accessed after the course in Manual Lymphatic Drainage, Neuromuscular Facilitation, Stretching and a range of other modalities for the dog.

Natalie Lenton says “Dogs have a way of making us become very present and just like with humans, they all have individual personalities, characters and pain levels. The dog can’t be told what massage is, why it’s happening or how to behave. It’s the role of the therapist to create meaning and trust and on a different level and communicate that. This means that a lot of the training we provide is to get the human student to listen to themselves on a different level too.

The dog can perceive things that the human client can’t and that means the therapist must employ a very different level of selfawareness and control. The dog can hear the heartbeat of the therapist, they can smell different hormones and chemicals on the breath and body of the therapist as well as other smells the therapist carries. They can detect brainwaves and other frequencies emitted by the therapist, so we train people in a very different way from how a human therapist is trained. Training in canine massage is a journey of self-discovery as well, it’s not just a case of press here, do this technique and this will happen. Dogs have made me a better person, they have made me reflect on myself and be more honest with myself on who I am and where I want to improve”

The dog gets a chance to be heard on a different level with this therapy and to feel better in their body and mind so they can experience greater freedom in life. The clinical canine massage therapist gets to walk between the human world and the animal world every day and make profound changes in the dog’s life. There is a great sense of honour, of trust and magic when you watch a session of canine massage therapy.

“When I train students, I will often say, “We train you and the dogs teach you”, and to me, that’s what makes it the most beautiful therapy in the world.

To find out more about Canine Massage Therapy 1 day self-interest workshops across the UK and the 2 year Clinical Canine Massage Practitioner Programme, visit www.k9-massage.co.uk Email: jenny@k9-massage.co.uk

To find practitioners in the UK and other parts of the world visit www.k9massageguild.co.uk

Read the ‘Effect of massage therapy on pain and quality of life in dogs: A cross-sectional study’ (Riley, Satchell et al, 2021) https://bvajournals.onlinelibrary.wiley. com/doi/10.1002/vetr.586

OF DOGS

RESPONDED POSITIVELY

CLINICAL CANINE MASSAGE THERAPY

Five Principles of Pain

of

Gait, Posture,

with

from

Living, Behaviour, Performance. Assessment is made before each treatment.

Advanced Palpation

A specialised procedure whereby therapists read and translate muscle / fascia injury / dysfunction using precise palpatory techniques, grip modulation and force control to comfortably assess pain.

Natalie Lenton, founder of the Canine Massage Guild and Canine Massage Therapy Centre, and creator of the Lenton Method®

Body Mapping

A comprehensive standardised anatomical map of primary and secondary areas of muscular injury and fascia dysfunction, used with palpation. Promotes consistency between practitioners.

Seven Protocols

A unique set of complex, direct myofascial

utilised to address chronic structural imbalance and presenting pain.

Preceded by sports, deep tissue and Swedish massage.

“This groundbreaking study is set to revolutionise the way we think about clinical canine massage therapy.”

Adrenal Fatigue & Stress

By Amanda White

Even though stress is considered commonplace in our day-to-day life, it can lead to many problems. Adrenal burnout or the exhaustion phase is where the body has coped with long-term stress but cannot cope any longer, and symptoms start to show.

Signs of adrenal imbalance could include any of the following:

• Exhaustion / Burnout intolerances / Rapid heartbeat /Headaches

• Poor memory and concentration

• Low or fluctuating mood

• Frequent colds / Infections

• Problems with sugar, salt or stimulants / Constant hunger

• Menstrual difficulties / Skin problems

• Muscle pain / Flu-like symptoms / Headaches

• Lowered sex drive / Hair loss or thinning

• Sweating / Palpitations / Rapid heartbeat / Panic attacks

The adrenal gland controls the bodies fight and flight system. Increased stress and anxiety cause a release of adrenalin into the blood supply. This response is your body’s instinctive response to stress from unexpected events.

What is stress?

Many things lead to stress – from areas of physical, environmental, or emotional issues. We tend to feel less stress if we have time, experience, and the resources we need to manage a situation.

An accepted definition of stress (from Richard S Lazarus) is that stress is a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual can mobilize.

Hans Selye (one of the founding fathers of stress research) in 1956 quoted “stress is not necessarily something bad – it all depends on how you take it. The stress of exhilarating, creative successful work is beneficial, while that of failure, humiliation or infection is detrimental.”

What are the adrenal glands?

The adrenal glands are triangular-shaped glands that sit on top of both kidneys.

The glands contain two different hormone-producing areas: the adrenal medulla and the adrenal cortex.

The adrenal cortex - works on the production of steroid hormones. The adrenal medulla - secrete water-soluble hormones adrenaline and noradrenaline directly into the bloodstream in stressful situations. This triggers the fight and flight response by preparing the body for an emergency.

The adrenal gland controls the bodies fight or flight system. Our busy lifestyle puts considerable stress on our bodies. Increased stress and anxiety cause a release of adrenalin into our blood supply, increasing the heart rate and muscle tension, readying the body to react quickly to the specific situation. Even though these situations appear commonplace, the adrenals still react, building up chemicals in the body. Initially, the body responds quickly to these stimuli, however over a long period of time the body adapts to the stress and sooner or later stops being able to cope and you then get the exhaustion phase/burnout, where you are more likely to go down with flu-like symptoms and stimulants such as coffee, or forced to stop working as the body can’t cope with being pushed any further. One of the big problems with burnout is that you often don’t notice that it’s happening until it’s too late.

Case History

When I saw Jack, he was very stressed at work and was feeling under pressure to keep up with his caseload. He felt tired, anxious and was starting to get panic attacks. He had a twitchy eye and was getting quite irritable and not sleeping well. Jack was also craving stimulants to keep himself going.

I recommended he learn some stress release techniques such as Emotional Freedom Therapy (EFT), increase his water intake, adding a 50mg B complex tablet, a Milk Thistle tablet to calm his liver energy, and for him to stop the caffeine completely as 1 cup of a stimulant such as tea or coffee stays in the body for 24 hours and doesn’t allow the body to switch off properly as it is being continuously topped up. Jack also received acupuncture to boost his adrenal (kidney energy). For the 1st week,

Jack suffered a bit with headaches as he went through a caffeine withdrawal. After a week he said he missed the caffeine, but he felt calmer, the panic attacks reduced in number and his eye stopped twitching. Over the next few weeks with the treatment, plus the acupuncture all his symptoms cleared, and he was able to cope again at work. “Thank you Amanda for giving me my life back”.

How do I fight stress?

The 3 major approaches to manage stress are:

1/ Action-oriented: By confronting the problem causing the stress and then changing the environment or the situation.

2/ Emotionally oriented: You might not have the power to change the situation, but you can manage the stress differently by changing your perception of the situation and the way you feel about it.

3/ Acceptance-oriented: Where something has happened over which you have no power and no emotional control, and where your focus is on surviving and getting past the stress.

• Increasing water intake, as our body needs water to flush out toxins. If you are dehydrated (it’s the difference between a free-flowing stream or a stagnant puddle).

• Adding a 50mg B complex tablet, as the more stressed you are the more B vitamins you absorb therefore the more you need. (Be aware the B vitamins can turn your urine fluorescent yellow and this is ok).

• A Milk Thistle tablet to calm the liver energy as the liver in Chinese philosophy works with the emotions of anger, frustration and irritability.

Take Vitamin C as this is necessary to protect the adrenals from high levels of free radicals produced during times of stress.

• A Calcium & Magnesium supplement is helpful as the Magnesium works with muscle aches and aids sleep, and Calcium helps calm an overactive nervous system.

• Stop the caffeine completely as 1 cup of a stimulant such as tea or coffee stays in the body for 24 hours and doesn’t allow the body to switch off properly, as it is being continuously topped up. This includes coke, green tea, and energy drinks.

• Balance blood sugar levels – by reducing excess sugar and eating more slowly digested carbohydrates. But in smaller amounts as wheat-based products and high carbohydrate diets can make you tired.

• Eat more antioxidant-rich food, fruits and vegetables.

• Increase intake of oily fish and take fish oils – if the skin is dry or itchy.

• Cut down or stop alcohol as this can irritate the liver and make the symptoms worse.

• Eat regularly but healthy foods to keep the blood sugar balanced.

Exercise can help lift moods and aid detoxification but avoid excess or high intensity as this can drain the adrenals. Gentle regular exercise that calms the mind and body such as walking, dancing, yoga or swimming can aid proper adrenal recovery.

Deep breathing – can be calming as when we are stressed we tend to curl in on ourselves. Dropping the shoulders down and slightly back opens the chest area and allows for deeper breaths.

Stress Management needs lifestyle changes, such as the above to maintain a calmer mind and body. There are many areas you can work with, but it pays to take a 3-prong approach by working with the nutritional, emotional and physical sides.

• Start a relaxation technique such as (EFT) Emotional Freedom therapy, which is a technique where you tap on points on the body that are linked to different emotions and works as a flush or a release valve for emotional stressors.

• NLP (Neuro-Linguistic Programming) helps you change your way of looking at things and think more positively.

• Music, meditation and visualisation techniques to relax the mind and find a relaxed state.

• Find time to turn off, power nap with deep breathing and relax.

Make sleep important - drink a camomile tea before bed as it helps relax the body.

The best way to manage burnout is to prevent it from happening in the first place. Consider your health and mental state as important parts of your life and develop new ways of enjoying life more. Take it back to basic needs. Remember to seek help from friends, family, and therapists if you need it.

STRESS RESPONSE SYSTEM

Amanda Madeleine White is a Registered General Nurse, Licenced Acupuncturist, Cert Education, Health Consultant, and the founder and CEO of SKART International Ltd. Structural Kinesiology Acupressure Release Technique (SKART) is a cutting-edge new diagnostic and therapeutic technique that is designed, trailed, and used for the efficient management of back, neck, hip, and leg pain. During her career in nursing (RGN 1989), Amanda developed ME & back problems. This sent her on a journey of discovery. From there, she travelled to China to study basic acupuncture with a group of trainee doctors. When Amanda returned, she completed 3 years of training to become a qualified acupuncturist (British Acupuncture Association) in London. Amanda has been on a lifelong journey into complementary therapy, searching for answers and cures. She has also trained as an Advanced Kinesiologist, Reiki Master, NLP master practitioner and EFT therapist, whilst curing herself of several issues along the way. To share her passion and knowledge, she chose to qualify as a certified teacher (Cert Ed) so that she could start training other individuals in these subjects, that she feels passionate about. info@myskart.org

“Another day above ground is a good day!”

What the new evidence tells us about stretching

Stretching – it’s good for you- isn’t it? Surely it’s common wisdom that stretching makes you feel better, increases flexibility, prevents injury before sports challenges, improves athletic performance, reduces muscle soreness after exercise and alleviates the pain of a bad back (that is if you actually DID the exercises your physio had prescribed). Runners and cycling magazines promote the value of stretching for “leaner,thinner bodies”, Google harangues us with ads for stretching-friendly lycra clothing, and yoga has never been more popular. Stretching has become a whole industry in itself with ever- fancier names applied to the latest stretching methods. Indeed it can be dizzying to try and keep up with the current state of the art stretchy technique. Stretching is “dynamic, baliistic, proprio- neuro- facilitated, active isolated, passive, contracty- relaxy and above all finger lickin’ good!”

Yet an explosion of academic interest into stretching over the past decade has suggested that maybe stretching isn’t the absolute panacea for all ills that it has been built up to be. The truth is much more complex than the simple dichotomy of “stretching is good for you” or “stretching is useless and a waste of time”. So lets break down the magic from the myth, hyperbole from hard fact, as we look at the academic evidence and expose the real truth about stretching.

STRETCHING THE TRUTH Using stretching in massage

BY RACHEL FAIRWEATHER

Common Wisdom about stretching

If you are at all interested in bodywork, complementary therapies or the health and fitness industry you will probably subscribe to one or more of the following beliefs about stretching.

◆ Stretching helps you be more flexible - it permanently lengthens short and tight muscles

◆ You should stretch before you work out as it helps prevent injury

◆ If you stretch before and after exercise it helps prevent and reduce muscle soreness (known in the trade as DOMS – delayed onset muscle soreness)

◆ Stretching before an event helps improve performance in sport

◆ Stretching makes you feel good

◆ Stretching is helpful for musculo-skeletal pain such as a bad back

What the evidence says

Lets take each of these beliefs one by one and see what the research evidence has come up with.

Stretching helps you be more flexible

Well yes it does – numerous research studies have shown that regular stretching does indeed make us more flexible. If we regularly stretch our hamstrings we should be able to reach further (Decoster 2005) Depending on your starting place this may mean you are now able to do up your shoelaces while standing, get further into that pesky forward bend in yoga or win that circus job you have been after.

However what is fascinating is that the reason we can stretch further is probably nothing to do with elongating the muscles permanently. A thorough systematic review of academic studies on the subject (Weppler 2010) proposes that any change in muscle (or connective tissue) length is transient and in fact the only reason we can go further on repeated exposure to stretching is due to an alteration of sensation only. In other words our brains just get used to stretching a little further each time – our resting muscle length remains exactly the same. Bad news for health and fitness magazines promising a “longer leaner body” through stretching!

Mixed news on this one. There is conflicting evidence as to whether stretching can prevent injury and the somewhat unsatisfying conclusion when reviewing all of the evidence is that stretching “might prevent some injuries in some sports at least some of the time”

There are several authors who have looked at all the research studies out there – for example a systematic review of the literature by Thacker et al (2004) concluded that “Stretching was not significantly associated with a reduction in total injuries”. This is not particularly helpful for the athlete wondering if they should stretch or not before exercising –the authors’ summary of the study ends with the politician’s “we can neither confirm or deny” type advice that:

“There is not sufficient evidence to endorse or discontinue routine stretching before or after exercise to prevent injury among competitive or recreational athletes.”

Another systematic review (Hart 2005) was less circumspect, concluding baldly “Limited evidence showed stretching had no effect in reducing injuries.”

However it seems that perhaps stretching may help to reduce injury for some sports but not others (Witvrouw et al 2004). Stretching seems to reduce injuries in sports that involve bouncing and jumping activities with a high intensity of stretch-shortening cycles (SSCs) (e.g. soccer and football]. However when the type of sports activity contains low-intensity, or limited SSCs (eg: jogging, cycling and swimming) stretching may not be helpful in preventing injury. This is seen in the literature, where strong evidence exists that stretching has no beneficial effect on injury prevention in these sports.

Other authors (Woods 2007) suggest that it has been difficult to interpret all the available research due to the number of different stretching techniques used and felt instead “that certain techniques and protocols have shown a positive outcome on deterring injuries.” They recommend that a warm-up and stretching protocol

should be implemented prior to physical activity. The routine should allow the stretching protocol to occur within the 15 minutes immediately prior to the activity in order to receive the most benefit.

Small et al 2008 concluded that although static stretching does not reduce overall injury rates, there is preliminary evidence that static stretching may reduce musculotendinous injuries.

It also seems that stretching as a regular routine rather than just before you exercise is more likely to reduce injury – so going to that regular yoga class may be more likely to reduce your possibility of injury than the short stretching procedure before sports. (Shrier 2007)

Stretching helps prevent and reduce muscle soreness (DOMS)

The research is pretty unequivocal on this one – it doesn’t, or at best only a little bit. A large review of all the relevant studies (Herbert 2011) concluded that:

“The evidence from randomised studies suggests that muscle stretching, whether conducted before, after, or before and after exercise, does not produce clinically important reductions in delayedonset muscle soreness in healthy adults.”

There was one large study showing that stretching before and after exercise reduced peak soreness over a one week period but this was only by, on average, four points on a 100-point scale. Hardly something to write home about.

Stretching before an event helps improve performance in sport

There is a bit of a shock-horror headline about this one as research over the past decade has suggested that not only does stretching have less impact than previously thought on performance but in some cases actually has a negative impact. That’s right – depending on the sporting event, pre-event stretching may actually cause you to do worse.

This finding specifically applies to sports that require isolated force or power (such as jumping) –in these cases stretching prior to an event can cause diminished performance. This is true whether the stretching technique used is

USING STRETCHING IN MASSAGE

static, ballistic or PNF. So elite basketball players would jump less high if they stretched immediately before playing. Maybe this was the problem in the 1990s movie “White men can’t jump” –perhaps the white guys were sticking too strongly to their pre- event stretching routine!

On the other hand, regular stretching at other times (not immediately before an event) actually improves the results for many sporting activities including enhancing running speed. (Shrier 2004). In other words regular stretching after exercise or at a time unrelated to exercise is more beneficial than your pre-exercise stretching “warm up” routine.

So if you want to improve general sporting performance, get to that regular stretching or yoga class!

Stretching makes you feel good

This is an easy one to prove or disprove as it is firmly based on the scientific foundation of your own personal laboratory. Does stretching make you feel good? Great – do more of it! Do you hate it? Then find another way to exercise or increase flexibility if you need to.

The potential psychological benefits of stretching seem to have been largely overlooked in the research studies as lets face it, academics are usually in pursuit of more “science-y” things to prove. Yet anecdotal evidence suggests that humans love to stretch – it helps us feel more balanced, less tired and is a good form of stress relief. Stretching is the basis of spiritual practices such as yoga – the poses (asanas) help prepare the body for the contemplation of meditation afterwards. Eastern massage practices such as Thai massage and shiatsu incorporate stretching as an integral part of the art. The purpose of these stretches is not to increase flexibility but to promote balance and harmony in the meridians and energy of the body.

One of the few studies conducted on stretching and mood was in a Spanish workplace that implemented a short

You should stretch before and after you work out as it prevents injury

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Stretching Techniques for the Massage Therapist

So now we have looked at the evidence, what different methods of stretching can be incorporated into our massage treatments?

There are a myriad of different types of stretching used by the bodywork therapist both within a treatment and for client self care purposes. Stretching has always been big in manual therapy both East and West - Thai massage, shiatsu and Tuina all feature stretching as an integral part of the therapy. Massage therapists, Physiotherapists, osteopaths, chiropractors, personal trainers, Pilates teachers and the emerging role of yoga therapist (using yoga techniques for the treatment of pain conditions) all use stretching techniques to varying degrees for rehabilitation of acute and chronic pain conditions.

In addition to a range of benefits, stretching also looks and feels impressive to the client - I had one woman who came back to me solely on the basis that you “did that stretchy thing to my neck that no- one else ever did”. My lovely Thai massage teacher Asokananda (sadly no longer with us) had a great phrase for some of the more dramatic stretches of Thai bodywork dubbing them “show business massage”. At Jing we always use these stretches when we want to “show off” - at exhibitions a few classy stretches is enough to bring a crowd gathering! I know it’s shallow but hey massage can be a lonely business so take the attention when you can get it, I say.

The names of different stretching methods can be bewildering so it is helpful to break them down into 3 broad categories of how the muscle is stretched: static, dynamic and pre-contraction stretching. We will also discuss a couple of ‘newer’ forms of stretching: therapeutic stretching and fascial stretching.

1. STATIC STRETCHING

This good old traditional method is still the most popular and widely known form of stretching. In static stretching the muscle is elongated to the point of a stretching sensation and held in position. This can be done in 2 ways:

◆ Passively with a therapist or partner (client lies on their back and therapist takes hamstrings to the point of stretch and holds leg in position). This is also the type of stretching commonly used in shiatsu and Thai massage

◆ Actively where the client is engaged in the movement (client lies on back and raises leg themselves; then takes leg into full stretch with assistance of rope, belt, or the hands. This could also be achieved by placing leg against wall. This is the type of self stretching used in yoga poses.

2. DYNAMIC STRETCHING

Dynamic stretching can be divided into active and ballistic. It is REALLY important to understand the difference between ballistic and other forms of active stretching as they can seem similar but are actually quite different

Ballistic stretching

This involves bouncing at the end range of a stretch - the good old reach for your toes and bounce up and down in the same position is a ballistic stretch for the hamstrings. PE teachers in the seventies were big on this one as was Jane Fonda (although she apparently corrected herself in later teachings so she should not be blamed entirely for the fad that probably bumped up an entire generation’s musculoskeletal injury rate) Ballistic stretching is generally not recommended due to its potential for injury - as the American Academy of Orthopedic Surgeons sternly warns on their website “Do not bounce your stretches. Ballistic (bouncy) stretching can cause injury” (Orthoinfo.aaos. org, 2014) .Personally I love that the orthopaedic surgeons are using the word bouncy. Although ballistic stretching is generally not recommended for most sports people, there is some new evidence suggesting that ballistic stretching significantly increases tendon elasticity and therefore might be helpful for both preventing and treating tendon injuries (Witvrouw 2007; Mahieu 2007). Indeed ballistic stretching may well regain its place in the sun as new fascial research suggests that elastic type bouncing movements are important to build the “silken fascial bodysuit” needed to prevent injuries to the connective tissue. The fast dynamic stretches included in Schleip and Mullers (2013) Fascial fitness suggestions are modified forms of ballistic stretching.

Active stretching

This type of stretching involves the client actively moving their limb through a full range of motion to the end range and repeating the cycle several times. Examples of active stretching include:

Dynamic Stretching - a dynamic standing stretch of the hamstring involves swinging the leg back and forth to the end range.

Active isolated stretching - this involves several repetitions of a movement to end of range followed by assistance into a short stretch by a therapist or the client themselves using a rope or belt.

It is easy to get confused between ballistic stretching (boo hiss - bad for you) and active stretching (yayy great) as they both seem a bit “bouncy”- the big difference is that in active stretching techniques you are taking the limb or body part through a full range of motion each time whereas ballistic stretching involves bouncing up and down

on a fully stretched muscle. If ballistic stretching is “bouncy” then active stretching could be considered more “swingy”. Yes I know- highly technical language, but do keep up.

3. PRE-CONTRACTION STRETCHES

This involves a contraction of the muscle being stretched or it’s agonist before stretching. PNF (proprio- neuro facilitated stretching) and MET (muscle energy technique) both fall into this category. These type of stretches seem to “trick” the body into a greater stretch and are fantastic for increasing range of motion especially in the short term.

“Newer” forms of stretching are usually variations on one of the above themes. Two of our favourite new ways of working with stretching include:

4. THERAPEUTIC STRETCHING

Developed by osteopath Eyal Lederman, (2013) this form of stretching emphasises the functional requirements of the desired ROM increase and is based on the scientific principles of training. Lederman contends that stretching exercises used in the clinic should approximate the desired functional tasks for the client and emphasises the maximal part that must be played by the client in their own self care. Lederman provides extensive academic support to back up his theories which happily all boil down to common sense principles.

5. MYOFASCIAL STRETCHING

The fascial fitness work of Robert Schleip and Divo Muller (2013) uses two approaches: -Fast dynamic stretching very similar to old style ballistic stretching (but carried out with a ninja type presence and focus) -Long slow stretches that attempt to engage long fascial continuities. John Barnes also teaches long slow fascial stretching with stretches held for a minimum of 90120 seconds.

Recommendations for using stretching in treatment

Stretching in treatment will only achieve limited results and clients should be taught self stretching routines to supplement treatment. Stretching as part of regular routine will be more effective both for treatment of pain and prevention of injury for athletes

In general, there are few differences in outcome between different methods of stretching. Type of stretching used should be chosen with outcome and individual client differences in mind

Stretching will be more effective if combined in the treatment after heat, fascial work and trigger point work

For pre-event massage, stretching should not be carried out immediately prior to performance especially for sports requiring a lot of jumping or explosive power. However, carrying out stretching prior to other warm up activites should not adversely affect performance and may help to reduce musculo-tendinous injuries. Active stretching methods such as dynamic stretching or active isolated stretching are likely to be more effective for pre-event massage.

RACHEL FAIRWEATHER

Rachel is author of the best selling book for passionate massage therapists – ‘Massage Fusion: The Jing Method for the treatment of chronic pain”. She is also the dynamic co-founder and Director of Jing Advanced Massage Training (www.jingmassage.com), a company providing degree level, hands-on and online training for all who are passionate about massage. Come and take part in one of our fun and informative short CPD courses to check out the Jing vibe for yourself!

Rachel has over 25 years experience in the industry working as an advanced therapist and trainer, first in New York and now throughout the UK. Due to her extensive experience, undeniable passion and intense dedication, Rachel is a sought after international guest lecturer, writes regularly for professional trade magazines, and has twice received awards for outstanding achievement in her field. Rachel holds a degree in Psychology, a Postgraduate Diploma in Social Work, an AOS in Massage Therapy and is a New York licensed massage therapist. jingmassage.com | 01273 628942 | © Jing Advanced Massage

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Speaking to customers on the phone and email for the last 20 years, there are a few common features many therapists want for their table but cannot get for one reason or another.

Increasingly, more and more therapists are looking for as wide a table as possible. Not only to cater for larger clients but also just to give their clients more room on the table. More room for many clients equals more comfort which often equates to greater relaxation and a better treatment outcome for both the therapist and client. But oftentimes it’s not possible to get the widest table as they themselves are short in stature which would mean leaning over a wider table and possibly jeopardising their own posture during treatments. The solution for many therapists lies in the very aesthetically pleasing, hourglass shaped curved massage tables.

They give a generous 30 inches width or 76cms in the shoulder and foot area but taper into 26 inches or 66cms in the waist area which means you the therapist can get in closer to the body and the client gets ample room where it matters most.

In a nutshell, you’re offering the client maximum comfort while making sure you can still lean fully over the lumbar area with ease. All that plus the best quality foam, upholstery and build quality in the world from the Earthworks brand.

For more information check out the 3 models (1) Earthworks Comfort Flat, (2) Earthworks Comfort Liftback and (3) the Earthworks Touch Plus at www.MassageWarehouse.co.uk or call 01443 806590 for advice or any questions you may have.

The luxurious DayDream range by Spa Essentials was designed to offer everything a therapist needs to provide an

Breaking the mould! Why curved treatment tables are sometimes a better fit!

New and Improved EcoTubs at Songbird Naturals

Professional Massage Waxes without the plastic

At Songbird Naturals, we’ve been supplying our all-natural professional Massage Waxes and Balms in biodegradable, recyclable and compostable EcoTubs since 2018 to positive response. Over the last two years, we’ve been developing this range of plastic-free packaging.

Our first-generation brown EcoTubs served us well over the years, and it was an exciting journey for us as we brought this innovative biodegradable packaging to the massage world. However, the brown EcoTubs had their limitations in terms of durability and oil seepage, and we were keen to develop a higher quality, more durable pot in a bespoke design; something that could really stand up against traditional plastic packaging. Over a year of trials and testing followed to develop a pot that could maintain the integrity of the wax inside, while looking striking on any therapist’s shelf.

In March 2021 we released our secondgeneration EcoTub. Designed and manufactured in the UK especially for Songbird Naturals, these new EcoTubs feature a sleek design with a beautifully smooth finish. The reinforced cardboard used to make the tubs means these new EcoTubs are significantly sturdier than our firstgeneration EcoTubs, while maintaining their biodegradable, recyclable and compostable credentials. We’ve tested these EcoTubs extensively for durability and leakage, and the issue of oil seepage through the cardboard is now a thing of the past, meaning customers can continue to purchase with confidence.

Our newest EcoTubs are now available in 100g and 300g sizes across our entire range of waxes and balms. The introduction of EcoTubs has allowed us to reduce our plastic packaging

and streamline our sizing range. We recognise that biodegradable packaging is not going to be appropriate for everyone (for example, therapists delivering poolside treatments). However, for those who want the choice, we feel it’s important to offer customers the option to purchase plastic-free if they so wish. As a business, we firmly believe we have a responsibility to continuously explore ways of operating in an ethical and environmentally conscious way. By purchasing a wax or balm in one of our EcoTubs, you can ensure that every element of your order – from the product itself to the materials it’s packaged and delivered in – is completely recyclable.

We’re proud of the development of our EcoTubs, both from a structural and an environmental standpoint. In fact, the launch has been so successful that

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our sister company in New Zealand, Tui Balms, also now offers EcoTubs as part of their packaging range. But we will continue to keep a keen eye on the latest developments in environmentallyconscious packaging, to ensure we continue to offer the highest quality products to our customers at an affordable price.

Our EcoTubs are not the only new addition at Songbird Naturals. In the last twelve months we have released three new blends in our Massage Wax range:

• Calming: a beautifully rounded Massage Wax with essential oils of Cedarwood, Mandarin, Myrrh and Neroli.

• Active: a restorative and gently warming blend with essential oils of Ginger, Black Pepper, Turmeric and Rosemary, rounded off with Orange and Lavender.

• Connect: an exotic and sensuous blend of Ylang Ylang, Patchouli and Palmarosa essential oils, offering a deeper connection to the massage for both client and therapist.

To explore our full range of waxes and balms for Massage, Reflexology and Fascial Release, and to find out more about our EcoTubs, visit www.songbirdnaturals.co.uk

We also offer a 25% discount to all professional and student therapists. To register your professional account with us, visit www.songbirdnaturals.co.uk/professional-application

No Such Thing As a Knee?

BY JULIAN BAKER

One of my favourite podcasts is called ‘No Such Thing as a Fish.’ Hugely entertaining, it explores the natural and scientific world and comes up with some of the most amazing facts you can ever imagine and lots that will blow your mind. And yes, it’s true, there is no such thing as a fish!

There are so many things that we have accepted as undisputable facts in our minds, that when they are challenged or broken down, the result can make us feel quite uncomfortable or defensive. Changing ideas and challenging certainties that people have around the human body, manual therapy and particularly anatomy is something that I actually quite enjoy. I’ve been running human dissection

classes for manual therapists for over a decade, looking at the body in ways that the anatomy books tend to overlook. One thing I ask of those attending is to be prepared to dissect their own deeply held truths and understanding of the human form and to look for what is really there rather than what they want or hope to see. It’s interesting to see what approaches or ideas really hold up under such scrutiny. Seeing

people’s initial resistance to sometimes quite opposing approaches, slowly shift is really rewarding and generally results in someone being more able to see the body from a more joined up perspective.

Sometimes stories or ideas get repeated so often that their origins and validity become hazy. The stories then just become fact, even if they’re not. At this point challenging or even

questioning them is to be seen as trouble making or heretical. There are countless ideas and ‘truths’ that one could challenge; core stability or even the idea of a core at all, the iliotibial band (not really a thing), the iliotibial band and its role in injury or pain, sacroiliac joint movement and instability, Anatomy Trains, psoas release, biotensegrity etc etc.

As with so many myths and theories there is a germ of truth in the basic idea and this then gets extended and spun to infinitely more strange ideas, to the extent that entire therapeutic approaches are founded around something which is, at best hazy, incomplete or untrue.

Much of the problem stems from the principles of anatomical study and its focus on specific structures and systems. By studying these anatomical structures as a collection of indisputable facts, we create a sense of the absolute. We name a specific muscle, say this is its origin, insertion, nerve and this is what it does. None of this is false or incorrect, but doesn’t allow for how the structure might integrate or operate with

anything other structure, organ or bit of tissue and even where things join up, the connections are for the most part conveniently ignored.

It’s not uncommon for muscles to converge into one place and create multiple attachments around a small area. The greater trochanter of the femur is a good example, being the attachment site for five muscles: gluteus medius, gluteus minimus, piriformis, obturator externus and obturator internus. Various conditions or problems may be associated with this area and these attachments, such as (syndrome alert): greater trochanteric pain syndrome, trochanteric bursitis and ITB syndrome. Yet is still no consideration as to how the muscles that attach to the site, function as a joined up unit when they get there. In dissection, these structures become indivisible as they converge around the top of the femur and effectively become one unit. A starting point for better understanding of joined up function, might therefore be the creation of a new name for the collection of these five structures, that reflects their location and perhaps their combined role.

anatomyworks

NO SUCH THING AS A KNEE?

Although uncommon, there are a few places where conjoined structures have been named and assigned a combined role, the rotator cuff being one example. Another christened junction is found around the knee: pes anserinus - PA, the name given for the joining up of three muscles; sartorius, gracilis, and semitendinosus. Pes anserinus literally means ‘goose’s foot’ and refers to the appearance of these when they insert on to the medial tibia rather than any suggestion of their combined function being similar to a flighted bird.

When looked at individually these are associated with flexion of the knee and hip, some hip adduction, rotation of the knee and some stabilisation, but when considered as a unit - PA, there is no combined role or suggested function that gets discussed, only syndromes or problems such as a bursitis.

The arrangement at the upper end of these muscles is interesting, as they create a tripod effect around the pelvis. The sartorius comes off the anterior superior iliac spine - the ASIS, the gracilis comes from the pubic bone where it is strongly blended into the fascia of adductor longus, and the semitendinosus comes from the ischial tuberosity, the sit bone, as part of the hamstring group. Any muscle is a pretty cool structure when looked at individually, but it’s when they join up together on the medial side of the tibia that things get really interesting. In most images the PA will be shown as being fairly well and clearly separated at their insertion point near the tibia, but the reality is very different.

The fascia of the lower limb is known as the crural fascia and envelopes all the muscles of the leg, fusing with the periosteum of the leg bones and even blending with the interosseus membrane between the tibia and fibula. This fascia is also the same stuff that we would call the iliotibial band and at it’s lower part, wraps itself around the Achilles tendon several times. As the

anatomyworks

a) Patella b) Medial gastrocnemius

The entire lower leg is covered with a strong fascial bag that weaves in between muscle and bone and thickens around certain structures.

muscles that make up PA come under the knee, as well as being wrapped in this larger bag, they are also wrapped in sheaths that seem to allow smooth movement to take place within the space. They are far from being separate as the text books would tell us, but are tightly contained within strong fascial bags, that then continue down onto the tibia, as well as around under the patella.

From my perspective, the tissues of all of the PA, muscle included, represent a hugely loaded area, responsible for absorbing, distributing and transferring force from the feet and lower leg into the pelvis, communicating tensional variations from stride and step and adjusting joint positions on a constant basis.

From the treatment and assessment angle, any pain or presentation in the knee, wherever it comes from or presents, has tension or dysfunction within this grouping as a potential cause and is generally a reliable first place to visit. It could also lead to an understanding of pelvic imbalance if the individual muscles are tracked back.

Sports performance and repeated hamstring or knee injuries will in my experience often start here as a logical junction, even where pain is from the lateral side. The sheer length of the connective tissue connection also means that tensions into the tibia

a) Tibia b) Patella

We can see the different directions that the fascia takes as it comes over the top of where pes anserinus sits and how the fibres continue down the leg, wrapping around both muscle and bone.

(shin splints for example) and even ankle sprains, could be significantly affected by any changes, adverse loading or inflammation to this group.

This kind of approach requires a different way of thinking about existing anatomy and is helped along by a different way of dissecting and presenting the findings. Anatomy as a science hasn’t changed much in several hundred years and from within an academic setting doesn’t see that it needs to. When teaching medical undergraduates, this might be understandable, but teaching manual therapists the same incomplete anatomy that doesn’t work for medicine, seems a bit daft. Bits that join up to each other obviously have a relationship to some degree, even if it’s not immediately obvious and evolution would have quickly

JULIAN BAKER

a) Vastus medialis b) Patella

c) Crural/tibial fascia d) Tibia

When dissected differently, the patella and fibres of pes anserinus can be seen as blended. The crural fascia over the tibia has been cut away from the bone which it would normally wrap around.

got rid of bits if they weren’t doing something practical or functional

Pes anserinus is of course just one example of where joining things together allows for a different perspective and there are literally hundreds more examples that I could discuss. Medical advancement has been enormous over the years, allowing us to fight cancer, undertake open heart surgery, operate on brain tissue and much more. Yet at the same time we still can’t sort out the thing that takes most hours away from work and loses industry the most money every year: back pain.

Centuries old anatomy and the way it’s taught is, I believe, much of the problem and it might be time to think differently. After all statistically speaking most of us won’t get cancer, but most of us will get back pain.

Julian has worked in the top medical schools and universities around the UK, gaining plaudits and praise wherever he has run a class. His approach of shaking up traditional anatomy and reframing it in ways that relate to the field of manual and movement therapies has brought him a world wide following and plaudits from every corner of the anatomical and manual therapy field.

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. functionalfascia.com

THING AS

KNEE?

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Working with a Seated Client Part 1: Protecting your hands

BY DARIAN PRITCHARD

SAVING YOUR THUMBS IN KNEADING

Having a (clothed) client seated enables you to work on his/her shoulders, neck and head, and, in a portable massage chair, to work down their back. However, massaging without oil is harder work on your hands than doing oil massage - and even harder if your client is wearing thick, unyielding clothing. Consequently, there’s quite a temptation to rely on your upper body strength to ‘muscle through’, and to work too hard with your hands.

So it’s crucial to: look after your hands, particularly making sure to use your thumbs and fingers sparingly; use large areas of your hands when possible (and use your forearm and elbow if you know how to use them sensitively and effectively);

and position and use your bodyweight to save overusing your shoulder and arm muscles.

In this article, we’ll look at some important aspects of looking after your hands, whether your client is seated in an ordinary upright chair or in a portable massage chair. In the next two articles, we’ll look at good ways of using your body in these two situations.

Future articles in this series will look at how to integrate hand use and bodyuse in common massage strokes. These articles are extracted from Dynamic Bodyuse for Effective Strain-free Massage which is designed to promote good bodyuse as an integral part of doing massage. The book presents guidelines on how to reduce poor working habits that take a cumulative toll on the practitioner’s body while being most effective.

The thumbs are the area that massage practitioners most commonly strainprimarily due to putting too much pressure through them too often, especially with them hyperextended.

Figure 1 – Kneading with the thumbs at the back of the shoulders

In seated massage, it’s quite common to start working into the upper trapezius by kneading the muscle, squeezing between your fingers at the front and your thumbs behind. However, this can be hard work on your thumbs, especially if you have small/ slender/ hypermobile thumbs, and/or you are working on a client with a large build and/ or well used shoulder muscles. Pushing your thumbs forward with them hyperextended puts pressure on them - so avoid doing too much of this.

Figure 2 – Pushing and pulling with the hand

You may find it useful to feel the muscle first with your thumb (or fingers) to get a measure of the tone and tensions. But then an effective alternative is to ‘wring’ the muscle with your whole hand, pushing the muscle forward with the heel of your hand and then pulling it back with curled fingers. This saves your thumb completely, while enabling you to apply firmer pressure.

Figure 3 - Double-handed pushing and pulling

This works best if you use both hands together - with your bottom hand maintaining the ‘squeeze’ shape, while you push and and pull it with your top hand.

bodymechanics

SAVING YOUR THUMBS IN PRESSURE STROKES

Figure 4 - Putting great pressure through the thumbs

Another common practice, which also puts great pressure on the thumbs, is to press down into the shoulder muscles with the tip of the thumb. The thumbs get overused for this because they are great tools for focusing pressure on small, specific areas of muscle and because of their ability to

bodymechanics

monitor the muscle responses (due to the concentration of sensory nerves in the tip of the thumb).

Figure 5 - Coordination for the ‘reinforced thumb’

A much better way of applying pressure via the thumb is to use the ‘reinforced thumb’. You are using the the thumb of your bottom hand, applying pressure onto it through the heel of the hand on top.

Make sure that the joint of your thumb (the interphalangeal joint) is in the groove between the two bulges of the heel of your hand (the thenar eminence at the base of your thumb, and the hypothenar eminence on the little finger side of your hand). This ensures that you are pressing down on the two sections of your thumb (the two phalanges) and NOT on the thumb joint.

Figure 6 and 7 - Using the ‘reinforced thumb’

Keep the fingers of your top hand relaxed, and totally relax your bottom hand. The top hand is the active one in this technique, and your thumb is a passive

tool for the top hand to press on and move around. You can do small focused sliding or circling strokes with this technique, not trying to slide over the skin/clothing, but just moving them as far as they will stretch. This means that you are effectively moving sustained pressure over the underlying muscles. When you’ve worked on one area for a while, move on to the next area and do the same.

SAVING YOUR FINGERS

Figure 8 - Supporting the working fingers

When the client’s head is supported in a portable massage chair, you can support your working hand with your other hand to save your fingers when you’re squeezing the back of their neck. Maintain the squeeze with your fingers and stretch the muscles by using your supporting hand to move the sustained squeeze around - to further reduce the work of your fingers.

Figure 9 and 10 - Pressing under the base of the skull

Similarly, you can reduce the pressure and increase the effectiveness of pressing with

your fingers under the base of the client’s skull (into the suboccipital muscles) by supporting them with your other hand.

EFFECTIVE HAND PRESSURE

Figure 11 - Hand on hand pressure

In fact, wherever possible, use both hands together to reduce the pressure on each one. Obviously this is easier when the client is supported in a portable massage chair, so that you are not having to use one hand to keep them upright.

LOOKING AFTER YOUR WRIST

The wrist is the second most common area of strain for massage practitioners (after the thumb).

Figure 12 - Applying pressure with a bent wrist

The greatest strain arises from applying pressure through the palm with the wrist bent back (hyper-extended).

Figure 13 - Applying pressure with the wrist straighter

Therefore, whenever you are applying pressure through your palm, try to have your wrist straighter.

Figure 14 - Supporting the wrist

In addition, supporting you wrist with your other hand will further reduce the pressure on it.

USING YOUR FOREARM TO SAVE YOUR HANDS

Figure 15 - Stiffening up to apply pressure

Applying pressure on your client’s shoulders can lead to hunching over and tensing your own shoulders to deliver this pressure.

Figure 16 - Using the forearm for pressure

Instead, if you have been trained in the skillful use of the forearm, widen your stance and use this tool for the pressure.

CONCLUSION

Be alert to the extra demands on your hands of working without oil. Reduce the pressure on them by supporting your working hand with your other hand whenever you can. Take care not to put pressure through your thumbs or wrists with them hyperextended. And learn to use your forearm and elbow skillfully to save your hands, wherever possible.

DARIEN PRITCHARD

Darien has over thirty years of experience as a bodyworker, including twenty five training massage professionals, and over twenty of teaching a range of professional development courses for massage practitioners. He pioneered a focus on the practitioner’s bodyuse as an integral part of massage training in the UK, including ‘Hands Free’ Massage (using the forearm and elbow to save the practitioner’s hands). He also teaches RhythmMobility® (rhythmical techniques for release, energising and rebalancing the body). He coauthored Anatomy, Physiology and Pathology for the Massage Therapist (2001), a textbook for massage students and practitioners in their early years. This article is an extract from the career-maintenance reference book Dynamic Bodyuse for Effective Strain-Free Massage (2007).

Balens, Specialist Insurance Broker, joins PIB Group

BY DAVID BALEN

Balens story as a specialist Insurance Broker for the Health, Wellbeing, Fitness and Beauty sectors dates to the early 1990s and is firmly rooted in David Balen’s personal passion to provide insurance policies that are specifically and specially designed for Health and Wellbeing practitioners.

David has always had an interest in, and passion for, the non-conventional sides of life – he became interested in natural approaches to health and wellbeing and spiritual philosophy when travelling to India in the 1960s, he trained and taught as a Yoga teacher in the 1971, and in the 1980s he did an ITEC Massage course, (although never took the final exams). He later trained as an energy healer and taught the subject. David’s family background, and later own work life was in insurance, and he joined the family business in 1971. These twin threads merged in the 1990s, when David combined his personal experience and interest in Health and Wellbeing with his family knowledge of Insurance to provide a quality Professional Liability policy that met the complex insurance needs of then growing but under supplied Health practitioners’ community.

Scroll forward 30 years and Balens, as one of the largest brokers for the Health, Wellbeing, Fitness and Beauty professionals in the UK, continues to grow and develop in service of their clients, and remains a family run business (Joe and Josh Balen – David’s sons, are now joint MDs of Balens, and his daughter and stepdaughter both also work in the business). Balens has also continue to champion the needs of their clients with insurers. With an ever-changing business climate this has become more challenging over recent years, and thus the decision was taken earlier this year for Balens to join PIB Group, to help take the business to the next level and ensure they can continue to provide quality insurance products for their clients for many, many years to come.

David said of the move “We understand

that clients may be surprised by this move, but for us, it is a natural evolution. PIB are a great fit for Balens as they have similar ethics and an ethos which resonates. They’re very collaborative and will invest to help us grow our systems and service, whilst leaving our brand intact”

Balens name, brand, personnel, and specialty will carry on as before. David will continue as Balens Chairman and both Joe and Josh remain as Managing Directors, so there will be no break in continuity from client’s point of view. The specialty and focus on Health, Wellbeing, Fitness and Beauty professionals will stay and Balens will remain a family run brokerage, continuing to do what they do best, but with the significant benefits that joining a larger group will afford.

Balens have been looking after the insurance needs of Health and Wellbeing professionals from the Republic of Ireland since the early 1990s and branched into mainland Europe following client demand in 2005. They had set up a Dutch office in 2014, and following the UKs decision around Brexit in 2016, set up a separate business, Balens Europe B.V. in 2018 gaining approval from the Dutch financial regulator the AFM in 2019. This has allowed them to continue to service the needs of their European clients through this business, whilst Balens Ltd deals with the UK client base. Unfortunately changes to insurer appetite during the Covid pandemic resulted in withdrawal from many of the EU countries that Balens had been operating in. The hope now is that with joining PIB Balens will soon once again be able offer their services to more colleagues on the Continent.

Josh Balen noted “PIB are a dynamic growing Group, both within the UK and EU, we believe that this collaboration and investment in systems and people will enable us to offer better products and an enhanced service to our clients, associations, and other business partners. We are very excited for this next phase in our journey to begin.”

PIB itself is a growing insurance intermediary group, with a focus on specialist and niche insurance sectors, collaboration and a client centric approach to what they do. They reached 13th place on the 2020 Sunday Times Virgin Atlantic Fast Track 100, a report that recognizes Britain’s top 100 private companies with the fastest-growing sales over the previous three financial years.

PIB currently comprise of over 60 Brokerages across Britain, Europe and the wider world. Balens will be joining PIBs Schemes and Affinities Division, which is a smaller select group within the UK, and includes the UK’s leading childcare insurance specialist Morton Michel; Fish Insurance, providing specialist insurance for people with pre-existing medical conditions, disabilities and mobility issues; and Thistle Insurance focusing on leisure and lifestyle commercial professional risks. All keeping their own character and benefiting from the collaboration of the wider team, Balens will fit well within the group.

Approval has been received from both the UK and Dutch financial regulators for the deal to be completed, and once finalised Balens will formally become part of the PIB Group, whilst remaining the Specialist Insurance Brokerage their clients know and love.

David said “To our valued clients, associations, and other business partners we would like to say thank you all for your loyalty, hard work, and dedication to our sector. Your continued support of Balens means the world to us! We look forward to being of service to you all for many years to come.”

For more information please visit: Balens website - Balens and PIB Group | Balens and PIB

PIB Group | National coverage, local service

Balens are a Specialist Insurance Broker for Health, Well-being, Fitness and Beauty Professionals. Further articles and information regarding insurance and risk management may be found on Balens website.

Rely upon a handmade UK sourced futon product and choose Futon Pacifika

n this age of call centres and robots, it’s sometimes hard to talk to a professional craftsman about your requirements.

Such a company though is Futon Pacifika - manufacturer of high quality, handmade futon products for massage, yoga, meditation, exercise, or home use. Their small workshop in Cornwall uses solar electricity to manufacture their handmade futon products, using all UK sourced materials.

With over 22 years’ experience, Futon Pacifika can help you to decide what layer materials and thickness would best suit your personal situation or application.

As a Thai therapist himself, Gary understands just how much the client benefits from a focused, comfortable therapist. Whether your body work is based on the floor or a table, a new futon, or new accessories, may help to revitalise your treatment and increase your client’s positive experience.

As well as a comprehensive standard product range, Futon Pacifika offer a

custom size service for any specific applications you may have in mind, e.g. for a van, yurt, or boat.

“Thanks very much for the mattress. All my clients love it... It holds more heat too, so will be fabulous in the winter. Thanks again for your patience, great service, and products.”

- “The bag kit arrived safe and sound yesterday... Looks and feels like another quality item that should last for years. Thanks again.”

“My futon has arrived, exactly on time as you predicted. It’s absolutely beautiful. The quality is phenomenal, with good thick cotton, and I love the cover and sheets with the Futon Pacifika logo.”

“It’s amazing, I love it! Colours are beautiful, quality is brilliant... Perfect!”

With recent feedback like this, it confirms that Futon Pacifika are doing the right things, with clear intentions. Helping you to help others with products that are made to last!

Recommended for quality and service by the Shiatsu Society UK (among others) and with over 250 schools, clinics, and 3000 individual practitioners on their books, Futon Pacifika continue to provide a professional product.

Rely upon a handmade UK sourced futon product and choose Futon Pacifika.

Email your requirements, shopping list or leave a phone message so we can return your call. We are confident that we can create your perfect working platform.

We just need to understand / agree what that is!

Gary:

CASE STUDY

Defining Touch

BY NICOLLE MITCHELL I.T.E.C

Massage has so many benefits, but would defining your identity be one that immediately comes to mind?

About 800,000 people in Britain now have dementia. This number is set to rise to one million by 2021, as the population ages.

Dementia is now affecting more people at a younger age, with many of these being diagnosed in their forties. Alzheimer’s disease affects the majority of those who have dementia and often people are diagnosed with more than one type of dementia.

Dementia is an umbrella term for an organic disease of the brain that affects cognitive function. It is progressive and there is no cure, although certain interventions can slow its progress. Much research is still needed to determine the cause of the disease, which depends on the type of dementia diagnosed, but we do know that dementia can be related to lifestyle choices. For example, those who lead lifestyles that compromise the vascular system, may become more prone to vascular dementia. Similarly, prolonged alcohol abuse can increase the risk of developing Korsakoff’s syndrome, a neurological disorder affecting memory and mental interaction. Furthermore, Alzheimer’s Disease has been termed “Diabetes type III” by claims that it may well be linked to eating junk food.

In 2006, I was invited by a local nursing home to come and offer massage and aromatherapy to some of the residents. I quickly found that I had difficulty connecting and communicating with many of the residents, particularly those who suffered from dementia. There were no courses or books about massaging people with dementia, so I read around the subject and set out to learn how to improve my communication methods and find the most effective massage styles. I felt it would be useful to compile the information and practical tips I learned along the way, especially how to approach people with dementia and the techniques best suited to their condition. This eventually led to the development of my course, Massaging People Who Have Dementia.

My research began with Contented Dementia written by Oliver James. This book is about an approach called SPECAL (Specialised Early Care for Alzheimer’s)– a wrap around personalised approach to communicating and improving life for people with dementia, developed by Penny Garner. Additionally, I attended Penny Garner’s SPECAL course, where she brought some of her written approaches to life, enabling attendees to better empathise with people who have dementia, which helped me to renew my approach in massage. I’m Still Here, written by John Zeisel, was a sensitive, insightful and inspirational book that also helped build my skills to communicate more effectively and compassionately. I would recommend this book to anyone who wishes to improve life for someone living with dementia.

An important aspect of massaging those with dementia is remaining empathetic and aware of the client’s emotional state. Establishing a good rapport with the client is crucial to the ability to understand and communicate effectively on the client’s terms. Gaining a personal history, as well as a medical history, is very helpful, as well. It is important to build open relationships with the patient’s carers, family and friends to help paint a portrait of your client’s passions and interests, thus putting people at ease and helping them feel comfortable in your company.

Another pertinent subject in the programme is called “Permission & Touch”. It is necessary to listen with eyes, ears and hands, especially when verbal communication may be impaired. I recommend becoming familiar with the Mental Capacity Act 2005 and the Human Rights Act 1998 which provides guidelines within which you must work. The FHT helped guide me through the inclusion of this part of the manual for my course. I have continued to research other legislation, speaking to colleagues about the ethics around gaining permission from vulnerable people. It is important to pay heed to permission throughout the massage, just as one would in a general clinical practice i.e. if going too deeply with a client, adjusting and reassuring before moving on. It is the same when treating a person with dementia, but more detective skills might be necessary to establish their needs.

Due to these unique sensitivities with physical and emotional closeness, less-invasive techniques, such as hand massage, are usually well received and a good place to start. Regardless of which approach I use, clients rarely need to remove clothing- perhaps only roll up a trouser leg or remove shoes and socks. “Back rubs” through clothing can be soothing for some people, as well as head or face massage. I was inspired by a piece of video footage by Naomi Feil, who conducted some validation therapy with a lady called Gladys. I now use similar strokes for face massage, which I have named “caressing the brow” & “wiping away tears”. These nurturing strokes can be reminiscent of parental attention and love received as a child, especially while sick. Many clients (although not all) respond very positively to such nurturing touch. It can be reassuring when you feel scared or lonely. However, face massage can be very intimate, so it is necessary

casestudy

DEFINING TOUCH

to make a judgement as to whether or not this would suit the client.

The use of adjusted massage strokes and techniques in specific areas has shown great benefit to clients with dementia. For example, the pressure points most beneficial to improve memory and ease depression often associated with dementia (GV19- 23); manipulation of certain “hotspots” located on the body to treat and improve circulation to the brain (between cervical vertebrae 1 & 2 & thoracic vertebrae 3) which improves vital oxygen & nutrient supplies. LV3 is useful for easing anger, frustration and emotional problems, as well as addressing Parkinsonian tremors. Parkinson’s disease is often associated with Lewy Bodies, another form of dementia whereby proteins get deposited in the brain cells, disrupting normal cognitive function.

The course also offers practical insights related to massaging clients with dementia. For example, keeping proper posture is important when treating people in hospital or nursing home environments. One woman I treated, at the end stage of the disease, was often laid in bed. I would lower her bed, place a cushion under my knee and keep my other foot flat on the floor, in order to give me as much movement to sweep up and down my client’s legs. I could then attend to my client while retaining good posture. As I was administering a soothing massage to my client’s legs, we both got lost in the repetitive momentum of effleurage. Without planning, I had changed my style and

casestudy

DEFINING TOUCH

as I realised this, I noted the massage movement and decided to use it again as my client had responded so well- and tried it on other clients, too. Over time, I named the move “T-effleurage”, a technique you can use kneeling or standing at a couch or bedside to reduce strain on your body. I think part of our job as therapists is to enjoy going with the flow and playing with our medium; retaining awareness and opening up the creativity within in order to better treat our clients.

Here are some of the benefits that massage can offer to those suffering from the unique conditions of dementia:

Massage creates a positive environment via non-verbal communication.

It sends a message of care and well being to those who may feel confused by speaking with others and creates a safe opportunity for the recipient to express their feelings, if they desire. Often a client wants to reciprocate the care they are given, as did the gentleman who used to kindly cradle my face in his hands.

Massage and aromatherapy can provide comfort, especially at the end of a life.

Essential oils, like fragonia, frankincense & sandalwood can subtly reduce anxieties & support patients in a more peaceful, gentle death.

It can provide an opportunity to reminisce, especially when you use oils to trigger memories for your client. One gentleman I see each week was raised in India as a boy and he delights in smelling sandalwood before I add it to his blend.

Massage improves connectivity.

Touching someone in a nurturing way for 20 seconds or more releases oxytocin & dopamine which help us build loving, trusting relationships, in turn building self-worth & self-esteem. Statistics show older people are touched less as time goes on. One study by the Alzheimer’s Society discovered that The average amount of time that people with dementia in care homes spend interacting with staff or other residents (excluding care tasks) is 2 minutes in every 6 hours. (Alzheimer’s Society ‘Home from Home’ report ’07). You may be the only person touching your client in a meaningful way for any

period of time. Sustained touch, coupled with awareness, improves health on many levels. Starve a person of touch and you starve them of wellbeing.

Massage provides a “time out” for the person with dementia, as well as their carer.

By creating a peaceful, healing situation, clients may reduce “challenging” behaviours, which are very often linked to pain which people are unable to communicate. Additionally, massage helps to release endorphins and can reduce pain and lessen the need for painkillers.

Applying meaningful touch can help people retain a sense of identity.

Additionally, massaging those with dementia:

Boosts immunity

Can improve disrupted sleep patterns

Calms anxiety and frustration associated with dementia

◆ Eases associated depression by releasing well being hormones

Improves circulation to the brain, encouraging a better supply of oxygen and nutrients to help the brain function at its best

Strengthens balance, mobility and some proprioception issues associated with dementia

I have learned so much from so many of my clients, but I suppose the biggest lesson for me is to enjoy each and every moment that life brings. Memory defines who we were and who we are now, but so can touch, by helping us focus on being here and now.

NICOLLE MITCHELL I.T.E.C

Nicolle has been practicing massage since 1998. She has worked therapeutically with children, young people & people with special needs for 20 years, specialising in the field of dementia since 2006. Nicolle has developed the first approved/accredited course about “How to Massage People with Dementia” in the UK. In October 2012, she won the FHT’s Excellence in Practice Innovation award for developing the course which she delivers in Cornwall & London. Nicolle is planning on facilitating training & seminars around the UK in forthcoming months. Nicolle is happy to provide training in your area; please feel free to contact her to discuss details. For more information about Nicolle and her course, please visit the following websites: www.thelittlemassageclinic.co.uk www.massagefordementia.co.uk

Complementary Therapy

Survey

Bringing natural healing into every home Photizo Light Therapy

Photizo Home Care is a range of hand-held LED photobiomodulation devices some of which are Medically CE approved for use on both short-term acute, and long-term chronic pain caused by a variety of health conditions, as well as skin conditions including wounds.

Photizo Home Care devices are simple to use, rechargeable and portable for use in the home or by a professional practitioner to integrate into a therapy or holistic practice.

“Light is the medicine of the Future”

Dr. John Ott, Pioneer in Photobiology author of Health and Light

Like the fuel & ignition system of a car working together in harmony, the human body requires fuel (in the form of nutritional high quality food), oxygen, clean water and a spark (in the form of light) to ignite the process of metabolism.

Photobiomodulation (PBM) or Red Light Therapy also known as LLLT (low level light therapy) with red and near-infrared light is one of the most scientifically researched areas of photomedicine (LLLT) to date.

Just like photosynthesis in plants, the response of our body to PBM is photochemical. PBM assists the body to increase cellular energy and ignite the body’s innate healing mechanisms resulting in faster, more efficient natural healing and regeneration.

“I have been using it to treat my own hamstring tendonitis, as well as my dog’s iliopsoas strain. We are both back running at full strength and I am delighted. So now we use the Photizo as part of our maintenance routines.”

Katrina Hands, Remedial and Sports Massage Therapist, Biomechanics Coach,

• Relieves and helps manage chronic pain

• Medical CE for Chronic Pain

• Effective in treating acute short-term pain and inflammation associated with overuse or impact injuries

• Medical CE for Non-Chronic Pain

• Helps wound healing, from a chronic leg ulcer to a cut or bad bruise, as well as many more skin traumas

• Medical CE for Wounds

Designed for use on domestic pets, horses and many other species to aid faster natural healing, reduce swelling & inflammation and pain

Stimulates collagen and elastin production for beauty applications including anti-ageing, skin blemishes and skin rejuvenation

application to be integrated into everyday massage. “Thank you so much for excellent training, I thoroughly enjoyed all aspects of the course and the LIM benefits. You are an inspirational teacher.”

Please see more details on our website.

E: info@theuklc.com www.theuklc.com

Bristol College of Massage and Bodywork

Bowen Technique

Bristol College of Massage and Bodywork offers Diplomas in Holistic Massage (Level 4), Remedial and Sports Massage (Level 5) and Indian Head Massage (Level 3 Certificate) in Bristol and Worcester. Set in our spacious, cool premises in the heart of Bristol and The Fold, Bransford, we also provide an extensive CPD programme for qualified therapists taught by national and international tutors including:

as a mobile therapist.

Details:

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

Lomi Lomi Introductory Workshop

Practitioner Training in Hawaiian Lomi Lomi Massage

Introductory Hawaiian Lomi Lomi Workshops are held on the first day of every full Practitioner Training as both share the same syllabus.

In this Workshop you will:

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

Massage for Womens' Health

Massage and Pregnancy

Details: Contact us for course dates. T: 01373 461812

isceral Massage

Acupressure for Facial Release

upping Therapy

C hair Massage

E: info@thebowentechnique.com www.thebowentechnique.com

ncology Massage with Susan Findlay

Myofascial Release with Ruth Duncan

lleviating Headaches

Prenatal Massage Training

Deep Tissue Massage

Heat as Medicine

alinese Massage

Hot Stones

Advanced Hands Free Massage

Eastern Foot Massage

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

Details:

ntro to Remedial and Sports Massage

Courses are run throughout the year.

For more info and to book: www.bristolmassage.co.uk

1 Day Course with pre-course study £160 + vat T: 01782 285545 or 01782 639777

E: carol@comfyspatraining.co.uk www.comfyspatraining.co.uk

Practitioner Diploma Course in Painless Spinal Touch

Gladwell School of Massage

The ultimate treatment for backache and musculoskeletal problems.

Gladwell School of Massage is open to everyone who has an interest in the healing arts, whether you are a practitioner or a complete beginner. Our courses include Thai Yoga Massage - the latest and most effective table massage techniques, Postural Assessment - muscle testing and rehabilitation, Chair Massage, and much more. Expert tuition is provided by Daniel and his daughter Lila (see below), at popular locations in the UK or at their retreat home in Greece. www.gladwellschoolofmassage.com

An advanced remedial therapy that corrects postural distortion and consistently brings pain relief as well as a sense of lightness and well-being.

www.lightouch.co.uk

A relaxing and energizing whole-body treatment for the client while it is strain-free for the practitioner. In-person as well as online courses and webinars.

Details. In-person in Devon UK Module 1 - October 20, 21, 22, 23 2022

2- November 18, 19, 20 2022 https://lightouch.co.uk/spinal-touch-course-in-devon-uk/

Painless Spinal Touch Online Course https://lightouch.co.uk/spinal-touch-course-international/

E xperience the wisdom and paradise of Hawaii through guided visualization

R eceive and give basic back of the body Hawaiian Massage strokes

With Rosalie Samet. Dynamic, spiritually rich and life-changing authentic massage from Hawaii synthesizes ancient with modern in exceptional 12 Day Practitioner Training of highest UK standard. Intensive, Fast Track and Progressive options. CPD Workshops. Blend powerful massage skills, energy techniques, Huna wisdom and Aloha. Daily massage exchanges, small happy classes. Accredited by FHT and CThA with 2-day Assessment for Certification

Details:

Sense the dance-like grace, ease, and alignment of your body flowing with the rhythm of the ocean waves

FAST TRACK One Module of 4 days each –every month over 3 months.

Use hands, forearms and body weight to create the long, flowing, continuous and beautiful strokes unique to Lomi Lomi

Autumn: Oct 10*– 13, Nov 07–10, Dec 05 – 08

INTENSIVE Three Modules of 4 days with one day off between each.

Advance your bodywork to new levels of depth and connection

T: 01273 730508

Bring the Spirit of Aloha into your hands to give your clients more meaningful nourishment, revitalisation, inner calm, and relaxation

Accredited by the CThA, FHT, Think Tree Hub

E: info@hawaiianmassage.co.uk www.huna-massage.com

Number of CPD Points gained varies per Practitioner Association Cost: £135

Introductory Workshop Dates 2022 July 7th, October 1st, October 6th 2023

McTimoney College of Chiropractic

February 4th and 16th

T: 01273 730508

E: info@hawaiianmassage.co.uk www.huna-massage.com

RockBlades Education Instrument Assisted Soft Tissue Mobilisation (IASTM)

We have been training chiropractors for over 45 years and have graduated many massage therapists who recognised that they needed additional skills and knowledge to enable them to help more clients. We deliver two programmes providing a Masters in Chiropractic. One is suitable for school leavers and is taught during the week and one is specifically designed for mature learners wishing to change their career. This programme is taught over one weekend a month and through summer schools in each year which allows students to continue to work whilst training. Both programmes are registerable qualifications with the General Chiropractic Council. This is a perfect way to upskill, building on your knowledge of anatomy and physiology to learn more about clinical conditions and the practical adjustment skills you need to make a difference. ‘I always wanted to be a chiropractor – I just never knew it would be this good!’

Add the RockBlades (IASTM) method to your skillset to enhance your treatments and reduce hand fatigue. The ergonomically designed smooth edged RockBlade and Mohawk tools combine with cutting edge education to produce this internationally acclaimed course run throughout the UK.

We also have a popular triple evening live stream course with a unique assessment and certification process.

Details: Intakes in January (Manchester and Abingdon) and September (Abingdon) www.mctimoney-college.ac.uk

Dates: Courses available throughout the UK and via Live Stream Visit: www.RockTape.co.uk London | Bristol | Birmingham | Nottingham | Brighton | Liverpool

RockPods Cupping EducationMyofascial Dry Cupping

The RockPods cupping course was our most popular course of 2020 and 2021. Join us to find out why this modern and unique approach to cupping is proving so popular. Through a combination of soft tissue mobilisation and movement you will discover new possibilities for cupping in modern manual therapy.

RockTape Kinesiology Taping Education

The worlds leading Kinesiology Taping Education from RockTape UK will teach you everything you need to know to get the best results from this fantastic treatment and rehabilitation tool. Join us for one or two days for an evidence informed highly practical and fun course. We also have a popular evening live stream course with a unique assessment and certification process.

Daniel@RockTape.co.uk

Tel: 01206 615464