Massage World Issue 117 Winter

Earle Abrahamson

Pauline Baxter

Kate Browne Ruth Duncan

Rachel Fairweather

EDITOR Madelaine Winzer

FEATURES

Susan Findlay

Earle Abrahamson

Emma Gilmore

Pauline Baxter

Jane Langston

Siobhan Cosgrave

Meghan Mari

Ruth Duncan

Rachel Fairweather

Nana Mensah

Greg Morning

Susan Findlay

Jennie Parke Matheson

Giacomo Sandri

Sunita Passi

Sarah Jane Tepper

Mary Sanderson

Ian Tennant

Madelaine Winzer Randa Zaid

Madelaine Winzer

Mark Woollard

Marina Young

GRAPHIC DESIGN Victoria Osborne

GRAPHIC DESIGN Victoria Osborne

MEDIA

SOCIAL MEDIA Pia Singleton

MEDIA COMMUNICATION C J Newbury

COMMUNICATION C J Newbury

PUBLISHERS NK Publishing

PUBLISHERS NK Publishing ADVERTISING Please call the Massage World office T 0207 370 6953 or Jackie Bristow T 01963 361 753

ADVERTISING Please call the Massage World office T 020 7387 2308

FOUR QUARTERLY ISSUES

FOUR QUARTERLY ISSUES

£20 UK Student: £15 of World: £40 ISSN 1474-4171

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How to contact us

HOW TO CON TACT US

Network Business Centre, Suite 10 282 Earls Court Road, London SW5 9AS

Millions of people have been staying inside and working from home, highlighting the huge impact our living space has on our lives as we interact with clients, friends, and families through the likes of Zoom and Skype. COVID-19 has caused a mass of anxiety throughout the world, especially for massage therapists as caring touch is integral to our industry.

The Festive break and New Year is a wonderful time of year when we can spend time with loved ones and take a well-earned break. I know I love exchanging the crowds of London for the cosy pubs with log fires and homecooked down on Exmoor for a week or so over the festive period.

Massage therapists have had to think outside the box when it has come to remote working. Emma Gilmore talks about the different ways you can work from home as a massage therapist and what you need to take in consideration when doing so. Some massage therapists have taken this time to improve their websites and social media platforms, while others have taken this time to expand their knowledge through research and online courses. In this issue Greg Morling gives some new perspectives on research designs that might truly reflect the way we work and the wellbeing we hope to foster in out clients, while Kate Browne explains the ways in which art can be used to learn anatomical terms.

It is an uncertain time so try to stay positive and enjoy the summer!

In this issue of Massage World, we have focused on the skin as it is the largest organ of the body and skincare as a market segment is growing rapidly compared to other areas of the beauty industry. Do men and women need different products? Randa Zaid answers that question as society continues to fray and bend perceptions of gender. On another note, Siobhan Cosgrave takes an Ayurvedic Approach to Skin Health by looking at what impacts skin health and how we can take steps to support our skin health, so we shine from the inside out. Susan Findlay our regular contributor gives us an insight into Skin cancer prevention and and early detection, the earlier skin cancer is diagnosed the better the outcome. We all have something that lights us up and for Danny Jensen, it is being part of the massage industry. He shares his inspiring journey and hopes to educate others on the benefits of massage.

MADELAINE WINZER Freelance writer @madswinz

Massage World, The Crypt Centre Mary Magdalene Church Munster Sq, London, NW1 3PL 020 7387 2308 info@massageworld.co.uk www.massageworld.co.uk

DISCLAIMERS

T/F 0207 370 6953

E info@massageworld.co.uk

W www.massageworld.co.uk

DISCLAIMERS

The publisher has taken all reasonable measures to ensure the accuracy of the information in Massage World and cannot accept responsibility for errors in or omissions from any information given in this or previous editions or for any consequences arising thereof. The Editor may not always agree with opinions expressed in Massage World but allow publication as a matter of interest, nothing printed should be construed as Policy or an Official Announcement unless stated. No part of this publication may be reproduced in any form or by any means whether electronic, mechanical and/or optical without the express prior written permission of the publisher.

publisher has taken all reasonable measures to the accuracy of the information in Massage World cannot accept responsibility for errors in or omissions any information given in this or previous editions or for consequences arising thereof. The Editor may not always with opinions expressed in Massage World but allow publication as a matter of interest, nothing printed should be construed as Policy or an Official Announcement unless stated. part of this publication may be reproduced in any form or means whether electronic, mechanical and/or optical without the express prior written permission of the publisher.

PRINTED BY www.bishops.co.uk

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EDITOR Wendy Kavanagh

FEATURES

8

Skin cancer facts and signs every MT should know

Skin cancer prevention and care is all about knowing the facts, prevention and early detection, the earlier skin cancer is diagnosed the better the outcome.

12 Does skin have a gender?

We all have skin, and all genders need skincare. Human skin has almost the same structure regardless of gender and a good skincare routine is one that benefits both men and women.

16 Soft Tissue Release

Mary Sanderson wrote Soft Tissue Release –A Practical Handbook for Physical Therapists over two decades ago now and every good massage college in the UK had a copy. We have published an extract from the recently released fourth edition.

30 Chronic pain

Rachel Fairweather our regular contributor on Continual Professional Development explains the Jing blueprint for bodywork success - the Jing “fix in six” approach to treating chronic pain.

36 MASSAGE ON DEMAND – is this what we really need?

Through modern technology there have been a wide range of APPS and Websites developed for the consumer to book massage therapy and the therapist to offer massage therapy on demand.

40 Applying Marma Therapy in Bodywork

Learn and practice Marma Therapy to support therapeutic application in bodywork to help heal your client’s pain through energy points and promoting spiritual health.

52 To Join or Not to Join a Professional Association – Is that the Question?

Earle Abrahamson asks the industry a very important question about membership associations and with more and more companies asking for membership certificates and advanced CRB checks this is a must read article.

news & views

WORLD MASSAGE MEETING AT COSMOPROF

WORLDWIDE BOLOGNA

For 54 years this trade exhibition has been a reference event for the entire beauty industry and for 2023 there is a spotlight on important innovations for the beauty sector and massage therapy.

Cosmoprof Worldwide Bologna will be held from 16 to 20 March 2023 in Bologna: after the excellent results of the last event, with 220,057 operators from more than 140 countries and more than 2,700 exhibiting companies from 70 countries, stakeholders from all over the world will get together in Bologna to discover the most cuttingedge trends, innovations and technologies.

For the beauty salon & spa sector, four intense days full of insights and inspirations are expected. From Friday to Monday, the main companies in the professional beauty and nail sectors will present their novelties to distributors, owners of beauty centres, beauticians and nail technicians looking for original treatments for their customers.

Among the main initiatives the World Massage Meeting is a not-to-be-missed format. The event will offer a higher professional training path focused on innovation, change and propensity for excellence. Personal well-being treatments and massages are services that are increasingly in demand by consumers, but they are also a strategic ally to connect with the client, help them get rid of stress and increase the positive effects of simpler treatments. Through the presence of authoritative speakers who will be given the task of reading and making understandable the current market scenario, World Massage Meeting will allow participants to fully understand the HOW, WHY and WHAT of the challenges and opportunities of this sector.

For all the updates relating to the Cosmoprof Worldwide Bologna 2023 initiatives, visit the website www.cosmoprof.com and follow the event's social media profiles.

The fourth National Massage Championship took place on Sunday 2 and Monday 3 October at Olympia Beauty

The National Massage Championship (The NMC) 2022 took place on Sunday 2 and Monday 3 October at Olympia Beauty, hosted at Olympia London. The event attracted over 100 competitors representing eight countries across six categories and received sponsored entries by over 15 massage and spa companies, making it our biggest to date. The NMC is created in partnership with Kate Tora of CityLux Massage and Carl Newbury of Massage World Magazine and sponsored by the FHT, Balens Insurance, IMA and Massage Warehouse.

On Sunday 2 October, we started the competition with some incredible techniques in the Freestyle category, some from participants who travelled overseas to compete. The Spa/Wellness category also took place on Sunday, displaying a real nurturing care and connection with the client. You could feel the energy and work these therapists had put into developing their skills. The Eastern category always brings beautiful presentation and a unique skillset, as did the Chair category, with so many innovative and new approaches to seated chair massage.

Monday 3 October saw the Swedish/Deep Tissue category take place, with therapists focussing on client wellbeing. This year the Advanced/ Medical category were combined – our second most popular category and so many advanced therapists (and some doctors/physiotherapists too) focussed on showcasing more advanced clinical moves that left spectators inspired.

The NMC attracts a huge number of spectators every year, and this year was no different. The event is so much more than a championship –our incredible judge line-up are there to support all participants, provide quality feedback and praise their incredible work and skillsets. It builds confidence in therapists, expands their horizons and brings profile to individuals, businesses, practices and techniques. We’re excited to announce the winners of this year’s National Massage Championship are:

2022 Judges Excellence Award Winner: Yupa Jiamsranoi

Swedish/Deep Tissue

Gold: Sam Young

Silver: Sarah Wigham

Bronze: Andrea-Oana Dumitrescu

Advanced/Medical

Gold: Chadanit Morris

Silver: Laura Garcia Lopez

Bronze: Stelian Rosca

SPA/Wellness

Gold: Yupa Jiamsranoi

Silver: Surichit Prance

Bronze: Siobhan Warden

Freestyle

Gold: Jacques Humpch Poullard

Silver: Thatsawan Nikki Hofford

Bronze: Thatsawan Nikki Hofford

Chair

Gold: Tamer Morsy

Silver: Gabriela-Elena Miu

Bronze: Laura Garcia Lopez

Eastern Gold: Jirapa Perryman

Silver: Georges Busuttil

Bronze: Chadanit Morris

Enter the NMC in 2023 here www.olympiabeauty.co.uk/ thenmc-2023/

inquiry at the MP Drop-in event on Tuesday 1st November 2022

On the 28th September 2022, the All-Party Parliament Group on Beauty and Wellbeing (APPG BAW) launched an investigation into the value of complementary therapies in supporting the nation’s physical and mental health and wellbeing, combating the pressure currently on the NHS.

The FHT, alongside collaborative sponsors, National Hair and Beauty Federation (NHBF) and SpaBreaks UK, were proud to congregate at the Houses of Parliament on Tuesday 1st November for the MP Drop-in event, showcasing the benefits of complementary therapies. Thank you to FHT’s Board member, Judith Hadley, for her time and effort on this enquiry. We’d also like to thank FHT Members, Collette State and Sue Bell, for their time and commitment.

The event proved to be a huge success, allowing a selection of MPs to learn more about the complementary therapy sector and see for themselves the long-lasting and significant benefits they can have on the nation’s overall health and wellbeing.

According to 2021 findings, the global complementary and alternative medicine market is expected to expand at a compound annual growth rate of 22% until 2028, meaning it’ll be worth more than $404 billion. The industry’s monetary value is just one of the reasons that an inquiry has been launched to investigate the influence of complementary practices on personal and societal health. The inquiry, co-chaired by Carolyn Harris MP and Judith Cummings MP, will

industry, consider how to ensure the viability of businesses and jobs, and review potential government interventions to support the sector’s future.

The chairs say: “Treatments such as massage can play a vital role in helping those with long-term health conditions manage their symptoms. Equally, highly trained complementary therapists can play a preventative role in helping to identify health conditions in their clients. With our NHS under increasing pressure, it is more important than ever that the benefits of complementary therapies are recognised.”

• t he value the sector brings to the UK’s economy and society

• how complementary treatments can play a preventative role in supporting people’s health and wellbeing, or support those with existing health conditions

• how the NHS can be better integrated with the sector

• t he skills gap facing the industry and how we can attract talent

• how has the pandemic changed demand for these services

• how to ensure the long-term growth of the sector and ensure those that work in it are able to make a good wage.

Skin Cancer & Prevention

Susan’s first love is dance, anything to do with of movement. She as a nurse in Canada soon left the profession when she the UK as she wanted a deeper connection with her clients. For many she worked in both health and teaching 20+ classes a week running GP referral schemes. She make better use of all her knowledge which led her to retrain as Massage and Remedial Soft Therapist. Currently she is the NLSSM and specialises in Oncology Massage. She is the Sports Massage: Hands on Therapists and is the Sports feature writer for Massage volunteers her time as a member of GCMT. her on Massage Mondays weekly massage videos www.susanfindlay.co.uk

BY SUSAN FINDLAY

Skin cancer prevention and care is all about knowing the facts, prevention and early detection, the earlier skin cancer is diagnosed the better the outcome.

Did you know that 86% of melanoma cases are preventable? It is important as a population that we are aware of who is more vulnerable and why, if you love tanning on bed or beach you run a higher risk, especially if you tend to burn. If you must spend long periods of time outdoors because of your job it is important to take measures to minimize that risk. Skin types also play a role, I am fair and therefore have less melanin protection from UV rays, hence I am mindful that I cannot go outside during the brightest and hottest periods of the day. I love going to places like Costa Rica for the great nature reserves, diving sites, and ancient treks, but I must watch my exposure, once I did not and was so badly

burnt, I found the sheets too painful to rest on my skin and I could not go out for days. This was not the way I wanted to spend my holiday and unfortunately it is considered an event that would in the future increase my risk of skin cancer. There are different types of skin cancer, basal cell carcinoma (BCC), squamous cell carcinoma (SCC), melanoma and Merkel cell (rare)carcinoma (MCC). As you might have guessed BCC is the abnormal and uncontrolled growth from the basal cells in the outermost layer of the skin known as the epidermis, the same goes for SCC. BCC and SCC are less aggressive than MCC melanomas because the latter can form in cells known as melanocytes and can spread to other organs more rapidly. MCC is the one that is associated with

AN INTERESTING FACT:

Prevalence of skin cancer rankings for various countries included Australia who were at the top but surprisingly the UK’s UV score rated second followed by New Zealand. It is important we get our Vitamin D from the sun, but this can be achieved first thing in the morning and later during the day.

tanning beds, sunburns and/or darkened tanned skin because UV radiation triggers mutations in the melanocytes resulting in abnormal uncontrolled cellular growth.

community.

MASSAGE MENTOR ◆

ABOUT MELANIN

Naturally darker skinned people have more eumelanin and fair skinned people have more pheomelanin, the former has a protective element to it while the latter does not, explaining why dark skinned people have a lower risk of skin cancer.

What are we looking for?

Follow this easy chart ABCDE when assessing a mole or blemish.

Epidermis

Dermis

Hypodermis

Types of Skin Cancer

Suamous Cell Carcinoma

Basal Cell Carcinoma Melanoma

If there is a new mole (especially after the age of 21), or the colour, shape, size, or texture of an existing mole changes or is continuously itchy, hurts or forms a crust and bleeds for more than 3 weeks, it needs to be checked out.

When assessing your client’s skin, if you see something that is slightly different or abnormal measure it or take a picture and keep it on their records so that next time they come in you can compare it and if there ae any changes as mentioned previously, I recommend that they have their GP look at it. When suggesting that they see their GP there is a delicate balance to be struck between encouraging

them not to ignore it but not creating unnecessary worry, I will sometimes write their GP, however it is important to obtain consent first from your client to ensure they are comfortable with this option before you go ahead. Often my clients appreciate my writing to their GP because they sometimes feel shy about approaching their doctor, for various reasons, but frequently they feel that their lack of knowledge and understanding are a barrier in their ability to share their concerns.

Early detection is important but sometimes what is cancerous to us looks like a mole or even a blemish that is just taking its time to heal. In one of my courses, one of the therapists mentioned that her father-in-law had this ‘ulcer’ that would not heal, it looked like the top of a volcano, open, raised, and had been like that for a long time (at least 6 months). He had been to see his GP but was told it was nothing to worry about and to give it time to close. I respect my colleagues in medicine but we all do make mistakes, so in this instance I encouraged her to seek another opinion. It tested positive for cancer cells. So, if you have a concern, or you’re unsure, it is best to be on the safe side, the testing is easy and inexpensive.

Skin cancer does not just affect humans, recently my dog had a mole on

his underside that started to increase in size, I watched it for a few months but I was not worried at the time as it did not display any signs that it was malignant. It still had a good shape with distinct edges, not particularly bubbly, it had a consistent dark colour to it, however it was raised and the size had doubled in a couple of months. To be on the safe side I felt it necessary to have it biopsied and as expected it was nothing to be concerned about, it was only a fluid filled cyst which was negative for cancer cells. Had I not checked it out and it turned out to be nasty I would have been devasted. Follow the same principle with your humans, you are their eyes especially when it comes to moles on the back.

There are times that despite being cautious and doing all the right things skin cancer can still occur. This is true in the next story.

Nancy’s story…

Aktinic Keratosis is caused by sun, this usually doesn’t lead to skin cancer, but sometimes it can. I always wore sun factor 50-100, did what I thought were all the right things but in 2020 I got this mark on my face in late summer. Please note as you can see my face has numerous totally harmless marks and

massagementor

today’s challenges

Covid-19 Protocols

that you undertake further training that will enable you to understand what modifications you need to make to ensure both you and your client are safe.

SOME INTERESTING FACTS FROM SKINCANCER.ORG

1.

2. Your risk

I also advocate working within a team environment rather than independently, being part of a co-ordinated effort will maximize your clients journey back to health. There is also the matter of whether your insurance will cover you without having done a comprehensive training course. You do not know what you don’t know, the ‘unknown unknowns’ as Donald Rumsfeld famously said.

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.

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.

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.

highly curable. Self-examination is the way to go but I am like most of my clients, I don’t tend to notice changes, or do self-inspections, I know I should but there are a million excuses for why I don’t. Unless there was something causing me discomfort, skin changes will go under my radar. So, a mole on my back would definitely go unnoticed unless it was of a size that would catch on a piece of clothing when getting dressed. Hence, most moles go unnoticed. Take special care to make a note of them and in subsequent sessions notice if there are any changes.

So where can you go from here? There are a lot of online resources and organisation that offer advice and information about the various types of cancer, the world of digital information can be a wonderful thing. I also highly recommend the online course called MASCED https://pro.masced.uk/ It is both comprehensive and well presented and an inexpensive investment that will improve your assessment skills. While I have not seen many cases in my career the few that I have come across could have very well saved someone’s life.

3. When detected early the 5-year survival rate for melanoma is 99%. The survival rate drops to 68% if the disease reaches the lymph nodes and 30% if it spreads to distant organs.

4. Basal cell carcinoma is the most common form of skin cancer and the most frequently occurring form of all cancers

Treatment Options

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.

References

Procedures can range from surgeries, laser, and light-based treatments as well as radiation therapy. Medications include topical therapies, drugs that are injected, infused intravenously, or taken orally (chemotherapy). One of my clients opted for immunotherapy and had a successful outcome without having to be treated with any of the above.

SUSAN FINDLAY

“Coronavirus And The Impact On Output In The UK Economy - Office For National Statistics”. Ons.Gov.Uk, 2020, https://www.ons.gov.uk/economy/ grossdomesticproductgdp/articles coronavirusandtheimpactonoutputintheukeconomy/june2020#:~:text=It%20 is%20clear%2C%20that%20the,the%20largest%20recession%20on%20 record.&text=Furthermore%2C%20Quarter%202%202020%20is,downturn%20of%202008%20to%202009.

Can we work with someone who is receiving treatment?

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, taeaching 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.

“Set Up A Business”. GOV.UK, 2020, https://www.gov.uk/set-up-business. 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/.

You can but as I point out every time I’m asked this question, it is important

You can join her on 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

Musician Bob Marley died from acral lentiginous melanoma at the age of 36

for melanoma doubles if you’ve had more than 5 sunburns

Massage changing!

JOIN the JING ongoing professional mentoring and business support group to RECEIVE:

Donna Woodcock Massage Therapist

Advice and tutorials on how to diversify your practice into offering

Advice and help on both hands-on and online self-care client cases.

Up to date information on COVID guidelines for massage therapists. Exclusive community Zoom sessions with inspirational leaders Meg

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

“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”

Are Different Skincare Products For Men & Women Necessary?

BY RANDA ZAID

Throughout history, whether it has been in the marketing of toys, education or parenting techniques, society has been split into pink and blue camps. We have been conditioned from a young age to classify colours and images as feminine or masculine. However, in recent years there has been a societal emphasis on utilizing a more inclusive language to advocate equality.

The strong move towards gender neutrality avoids discrimination based on a person’s sex or gender. So why then is there still an invisible line in the toiletries department of some retail stores as the flowery pastel packaging clearly meant for women gives way to darker, monochromatic skincare products with the reassuring signage that states ‘suitable for men.’ Is this not now an antiquated, sexist marketing ploy or is there any evidence that we need to differentiate between skincare for men and women?

Does skin have a gender?

We all have skin, and all genders need skincare. Human skin has almost the same structure regardless of gender and a good skincare routine is one that benefits both men and women. People of all genders need to care for their skin. It’s a health thing.

The focus in any skincare routine should be the needs of your skin and not your gender. Is your skin oily, dry, sensitive or a combination? Your gender doesn’t determine your skin type and by specifying products in this way, many people might be missing out on

optimising their skincare routines. Men and women eat the same food after all. They might prefer some different flavours, and some might eat more than others but many ingredients are the same and enjoyed by both. We don’t market food to feed male and female bodies differently so why do we do it when it comes to feeding our skin?

Why are products currently marketed at different genders?

Gender sells. Historic binary genderation goes back a long way, with many toys defining differences between the sexes: skipping ropes and dolls for girls; marbles and toy boats, trains, and cars for boys. Girls liking pink and boys liking blue is instinctual for most of us. This conditioning informs our thinking well into adulthood and the cosmetics industry has for some time had the same mentality. It bought into the masculine versus feminine trope and used stereotypes as extremely powerful marketing tools.

The colours in women’s products are soft and muted and the fragrance is flowery—roses, lilies, cotton and spring meadows—but men’s products are dark and smouldering with the emphasis on strength and the packaging is scattered with adjectives such as ice, glacier, shark and savage to ramp up the tough guy image. Strong, earthy smells are associated with masculinity, but shouldn’t be up to individuals what type of smells they prefer?

GlobalData, which provides expert analysis for companies in the world’s biggest industries, reports that rising expectations from consumers are now driving up the transition to gender-neutral products and smart retailers are already re-designing their stores in a shift away from the traditional male and female sections.

Don’t buy into the hype

Just because a product says it is for women or men doesn’t mean both can’t use it.

It might be marketed differently but it doesn’t mean it’s not the same. In 2015 the New York City Department of Consumer Affairs found that women’s skincare products cost up to 13 per cent more than those marketed at men and women tend to buy more skincare products than men.

Surely men and women’s skin are different?

Everyone’s skin is different. Men’s skin is around 20 – 25 per cent thicker than women’s. It contains more collagen and elastin and tends to produce more oil due to the amount of testosterone in the male body. This can make men more prone to breakouts. But women too have certain levels of this hormone, it’s not exclusive to men. Although there are some minor differences, they are not enough to warrant a gender-focused skincare industry.

There have been concerns in the past that male skin would be sensitised due to shaving which has led to products for men being branded as lighter. But it’s unnecessary to differentiate in this way and these traditional views are rapidly disappearing. The American Academy of Dermatology has found there is no medical or scientific reason for products to be divided by gender. Products should be all about feeding the skin, regardless of gender. A product for oily skin is just that and can be used by both sexes for the same results.

Do it like an Egyptian

Beauty held significant value in ancient Egypt and the possession of an x or y chromosome had no bearing on the products they used for their self-care. Both men and women went to great lengths with their skincare routines with the emphasis on cleanliness. Taking care of the body was necessary for good health and warding off evil and the same products have been found in the graves of both men and women.

In modern society we have tended to view self-care as being just for women

skinmatters

and many men haven’t wanted to be seen taking that sort of care for themselves. But that is changing. We need to get away from the idea that taking care of our skin is about preventing wrinkles or focusing on anti-ageing. It’s not about vanity, it’s about nourishing our skin and taking care of ourselves. It’s less about gender and more about being holistic. Today’s men and women are more likely to be focused on greener, cleaner formulas than gender.

Choosing suitable products

Start with products that suit your skin type. Keep it simple. We really don’t need hundreds of different products. Find a routine that works for you and stick with it. The days of husbands and boyfriends having to be coerced into using a face wash or moisturiser are diminishing in our enlightened world, but if men are embracing a skincare routine for the first time it makes sense to look for natural products. Don’t make the leap from never using skincare to suddenly slapping on something with a harsh retinol base. The key ingredients to look out for are products with antioxidants and vitamins, especially A, C, D and E as well as B12 for hydration. The fewer the ingredients the better. A gentle cleanser with milk and honey or an olive oil soap won’t strip away the skin’s natural oils. A high-factor sunscreen in the morning should set you up for the day. Overnight an oil-based moisturiser will calm and nourish. And that is all anyone really needs, with perhaps a serum boost a couple of times a week for added hydration.

Skincare in the future

Society’s perceptions of gender are constantly being changed and blurred and although there has been a sharp rise recently in genderneutral skincare with some wellstablished brands being joined by newcomers in this market, other brands need to work hard to be a part of this inclusive environment.

In 2021 CosmeticDesign-Europe, a leading online news source for the

RANDA ZAID

cosmetics industry has predicted a ‘beauty for all’ trend over the next five years. And Beautystreams, the insight platform for the beauty industry around the globe, says the market is set to move up a further gear from gender-neutral to gender-freedom. It would seem skincare brands now need to focus less on the gender of their customers and more on how their products make people feel. And as customers we need to focus on our skin’s type and needs and ignore the gender-focused hype.

Randais founder of Hayaty Natural, a genderless skincare brand inspired by the wisdom of the ancient Egyptians. Using medicinal botanicals like Black Seed (so beloved of the Ancient Egyptians they called it the ‘blessed seed’) and a combination of plant-based ingredients sourced from local communities in Randa’s homelands of Egypt and Italy, each formulation follows ancient recipes developed by the Pharaohs to provide an holistic approach to self-care. Hayaty is Organic, Vegan, Fairtrade, Cruelty- and GMO-free. Packaged in recyclable glass and card, each bottle comes with a hand-made Egyptian papyrus to inspire us to love ourselves and our environment.

Website: https://hayatynatural.uk Facebook: https://www.facebook.com/hayatynatural Instagram: https://www.instagram.com/hayatynatural/ TikTok: https://www.tiktok.com/@hayatynatural LinkedIn: https://www.linkedin.com/in/randazaid/

Sources: New York City Department of Consumer Affairs; The American Academy of Dermatology; CosmeticDesign-Europe.com; Beautystreams.com; GlobalData.com

Society’s perceptions of gender are constantly being changed and blurred... brands need to work hard to be a part of this inclusive environment.

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Soft Tissue Release

Trunk & Neck - part one

BY MARY SANDERSON

Extract from Soft Tissue Release - A Practical Handbook for Physical Therapists

The Spine

The spine (fig. 1) consists of 33 individual vertebrae: seven cervical, twelve thoracic, five lumbar, five sacral (fused) and four coccygeal (fused). Although only small movements occur between the vertebrae, the combined action of all of them facilitates good overall spinal mobility. Between the vertebrae are cartilaginous discs, which make up approximately onethird of the total height of the spine. The vertebral column is maintained in its upright posture by strong ligaments and muscles; it has three natural curves (four if the sacral curve is included), which together with the intervertebral discs are responsible for absorbing shock. Flexible, strong muscles will enhance the fluid content of the discs and allow efficient maintenance of the spinal curvature.

Most people will suffer backache at some point in their lives, although maintenance of correct posture can reduce the likelihood of injury problems. Good spinal posture places minimal strain on the muscles that maintain the body’s stance. If the body sways from its neutral position, the movement is counteracted by muscles which contract eccentrically. If an inefficient posture is continued, then adaptive responses lead to poor health

of the muscles, muscle imbalance and dysfunction in the form of reduced muscle strength, loss of spinal mobility, nerve root irritation and pain generally.

Postural adaptation often develops over many years, and someone may not be aware of a problem until the tension and imbalance give rise to a traumatic injury, such as a prolapsed disc.

The position of the pelvis is affected by the abdominal muscles and spinal extensors as well as the hip flexors and extensors. An increase in the lumbar lordotic curve will result in tight hip flexors and back extensors, weak abdominal muscles and a tendency to compensatory thoracic kyphosis. The side flexors need to be evaluated with regard to lateral imbalance. Massage therapists must be systematic in treating the hips and antagonists with any presentation of back pain.

There are many different types of stress placed on posture, and the therapist needs to be aware if the subject suffers from any of these. There may be a structural problem, such as a leg length discrepancy. Occupational factors, for example driving for long hours or sitting behind a keyboard, may be involved. If sports are the cause, the problem could be repetitiveness, such as in long-distance cycling, or

Figure 1. The spine (lateral view).

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the spine. The longissimus (middle layer) and the spinalis (medial layer) attach to the skull and to the cervical and thoracic vertebrae. There are many complex muscle contractions that always occur, as the erector spinae also controls flexion of the spine and stabilises the non-weightbearing side, to prevent the pelvis from dropping, during side flexion. The erector spinae is also critical in maintaining the secondary curve.

The transversospinalis muscles are found deep to the erector spinae; in order, starting with the most superficial, these are the Figure 2. Deep back muscles.

an overload of one side of the body, such as in golf or tennis. The root of the problem needs to be addressed and altered if possible. Maintenance massage of the back area is invaluable.

Correct posture is still not well understood by the general public so, following treatment, postural awareness should be discussed along with mobility, stretching and strengthening exercises. When someone presents with any neurological deficit or acute symptoms, input from a medical practitioner is essential, and STR may not initially be appropriate where protective spasm and severe inflammation are present. Traumatic injuries sustained from heavy lifting or falling, and sciatic, disc and degenerative conditions, will benefit from having the soft tissues strong, supple and in balance; the timing of the introduction of STR should be carefully considered for maximum benefit. STR can help improve movement patterns and relieve nerve root irritation.

Spine Extension

Major Muscles: Erector spinae (iliocostalis, longissimus, spinalis), quadratus lumborum, interspinales, multifidus, semispinalis and gluteus maximus (from a flexed position). The contraction of all three muscles on both sides of the erector spinae is the main contributor to extension of the back. The iliocostalis (lateral layer) has attachments that run the length of

MUSCLE EFFECTS OF MUSCLE RESTRICTIONS

Thoracic

Spinalis

Postural deviations of upper torso, particularly lateral flexion and minor posterior rotation. Restricted upper body movement, especially flexion and contralateral rotation at segmental levels. Scoliosis.

Longissimus thoracis Stiff thoracic region and reduced flexion in thoracic spine. Could contribute to overall reduction in lumbo-pelvic rhythm, with link to lumbar longissimus.

External intercostals

Lumbar

Iliocostalis lumborum

Increased difficulty with inspiration and decreased ‘bucket handle’ rib motion.

Increased lumbar lordosis when in neutral stance, with reduced contralateral side bending.

Longissimus thoracis Could impact on lumbo-pelvic rhythm and reduce ease of lumbar flexion.

Thoraco-lumbar

Multifidus

Quadratus lumborum

Internal obliques

External obliques

Rectus abdominis

Localised decreased contralateral lumbar side flexion and rotation. Reduction in lumbo-pelvic rhythm.

Increased ipsilateral flexion in neutral position. Reduction in lumbo-pelvic rhythm. Changes in gait. Perception of short leg on tight side with supine leg-length assessment.

Limitations on contralateral posterior torso rotation and side flexion.

Reduction in ipsilateral posterior torso rotation.

Increased thoraco-lumbar flexion. Concomitant reduction in ease of inspiration and thoraco-lumbar extension.

Other

Latissimus dorsi

Trapezius and rhomboids

Increased kyphotic posture.

Mid-upper thoracic spine ipsilateral rotation.

SOFT TISSUE RELEASE: TRUNK & SPINE

semispinalis, multifidus, rotatores and interspinales. The deepest muscles cross only one or two vertebrae.

Spine Side Flexion

Major Muscles: Quadratus lumborum, erector spinae, intertransversarii, obliques, rectus abdominis and multifidus. Side flexion is produced by the muscles on the side being flexed. When standing on one leg, the quadratus lumborum acts strongly on the non-weightbearing side to stop the pelvis from dropping. It also stabilises the twelfth rib during forced expiration, by fixing the origin of the diaphragm. When the quadratus lumborum muscles on both sides contract, they are responsible for lumbar spine extension and stability.

Spine Rotation

Major Muscles: Obliques, multifidus, rotatores and semispinalis. During rotation to one side, contraction of the external oblique on the opposing side and contraction of the internal oblique on the same side occurs. The external oblique is the most superficial side muscle. Its upper origins on the anterior ribs interdigitate with serratus anterior and the lower origins with latissimus dorsi. The internal oblique lies below the external oblique and runs diagonally in the opposite direction above the transversus abdominis.

Fascia of the Trunk

The trunk, like the rest of the body, is covered with superficial and deep fascia.

The deep fascia of the neck area is thick and strong, enveloping the muscles, and supports and connects the trunk to the muscles of the shoulder girdle and upper limb. There is a specialised deep layer of fascia in the lower back known as the thoraco-lumbar fascia. It consists of three layers located in the lower thoracic, the lumbar and the sacral regions. The posterior layer is superficial to the erector spinae, and the latissimus dorsi partially arises from it. The middle layer is situated between the erector spinae and the quadratus lumborum. The anterior and thinnest of the layers is located in front of the quadratus lumborum. All three layers converge at the lateral border of the erector spinae. This then extends to form an origin for the transversus abdominis and internal oblique.

MFR locks are very beneficial in ensuring that the muscle regains full separation. As many of the lower back muscles in particular are very strong, the quality of the lock is crucial for any release to occur.

The deep fascia of the abdomen is thin and elastic to allow expansion of the chest and abdomen. The lower abdomen is covered by the aponeurosis of the external oblique which merges at the linea alba with the external oblique of the other side.

Spine Extensors, Side Flexors and Rotators – Treatment

With the subject in a side-lying position, make a secure reinforced lock just

above the sacroiliac joint close to the spine; advise the subject how to perform a posterior tilt of the pelvis (fig. 3). The pressure should be directed slightly towards the head. The pelvic tilt provides a small stretch but the movement is controlled and precise.

Although trunk flexion can be used, the movement may prove too severe for a lock to be maintained. Apply locks and move up the whole of the lumbar area, then return and treat more laterally to the initial locks. Treat around the sacroiliac joint with two or three MFR locks and either a pelvic tilt or flexion of the spine or hip.

For the quadratus lumborum, use one thumb reinforced with the other (see fig. 4); take the depth of the erector spinae and drop in on the lateral border of the muscle, in between the rib cage and the pelvis. Maintain this pressure while the subject extends and adducts the hip and abducts the arm.

Treatment of the erector spinae can continue until you reach an area not affected by the stretch from the pelvic movement. This procedure is usually only beneficial around the lumbar area. For release in the erector spinae further up the back, it will be necessary to lock as the subject flexes the trunk; instruct the subject to arch the back or to push backwards into the lock (figs. 5 & 6).

The direction of pressure in this case should be towards the base of the trunk.

On occasion, weight-bearing STR may prove to be a useful technique. STR can be performed with the subject

SOFT TISSUE RELEASE: TRUNK & SPINE

Figure 3. Active STR to the erector spinae as the pelvis is posteriorly tilted.

Figure 4. Active STR to the quadratus lumborum

Figure 5. Active STR to the erector spinae in the thoracic region – a lock is attained and the subject arches their back.

standing and holding onto a wall or the couch for support or on all fours (fig. 7); apply an MFR lock and instruct the subject to flex or side flex the spine. Another useful position is with the subject on all fours; lock in on either side of the spine as the subject arches into the ‘angry cat’ stretch (fig. 8), and release the lock as the subject returns to neutral.

Seated STR also works well, even on the larger individual. Because the muscles are under tension it is advised to treat the top layer of the thoraco-lumbar fascia, rather than trying to delve into the extensors. Apply an MFR lock while securing the subject across the front of the hips, and instruct the subject to side flex or flex the spine (fig. 9); severe muscle shortening can be relieved because of the fascial release. By having the subject’s arm raised on the side being treated, the stretch on the latissimus dorsi may enhance the STR effect.

Also, with the subject seated, the quadratus lumborum can be targeted and the subject can side flex (see fig. 10).

For the thoracic region, working with rotation can prove to be valuable in restoring correct movement patterns. Use your elbow to gently engage the semispinalis thoracis, once the superficial shoulder girdle muscles have been released, and instruct the subject to rotate the spine to the same side for a stretch. Also, lock deep into the laminar groove to address the multifidus muscles; instruct the subject to rotate to the same side for a stretch.

Spine Flexion

Major Muscles: Rectus abdominis, obliques, and psoas major/minor (when the insertions are fixed). Flexion occurs during concentric contraction of the muscles on both sides of the spine. The flexors also affect the position of the pelvis by modifying its tilt and subsequently the curvature of the lumbar spine. Attachments of the abdominal muscles to the pelvis, at the symphysis pubis, and muscles within the abdominal wall are all occasionally torn, with consequent fascial adherence.

Thickening of the fascia can occur with poor posture, leading to further postural imbalance and weakness. If the spine flexor muscles are weak, the pelvis drops, the hip flexors and spine extensors become hypertonic in relation to the spine flexors, and the lumbar curve tends towards lordosis.

SOFT TISSUE RELEASE: TRUNK & SPINE

Figure 6. Active STR to the erector spinae using an elbow. as the pelvis is posteriorly tilted.

Figure 7. STR to the erector spinae in a weightbearing position.as the pelvis is posteriorly tilted.

Figure 8. STR to the erector spinae as the subject arches into the ‘angry cat’ stretch.

Figure 9. STR to the erector spinae in seated.

Figure 10. STR to the QL in seated.

Treatment of the erector spinae can continue until you reach an area not affected by the stretch from the pelvic movement. This procedure is usually only beneficial around the lumbar area.

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SOFT TISSUE RELEASE: TRUNK & SPINE

Correct, isolated strengthening of the abdominal muscles is necessary to regain lost strength.

Spine Flexors and Rotators – Treatment

With the subject in a supine position, treat the rectus abdominis: start from the origin on the pubis with an MFR lock, then instruct the subject to perform a very minimal side flexion. Progress to the outer borders of the

muscle on one side, hooking under it while the subject side flexes. Angle the lock carefully near to the insertions to avoid bruising from the bone.

See the section on hip flexors for treatment of the psoas (page 44). The obliques may be treated in a similar fashion, by applying pressure as the subject side flexes. Alternatively, use a side-lying position, in which a trunk rotation can be used to provide adequate stretch for a release. Locks must be

applied away from the movement, and pressure should be angled to produce a shallow MFR lock.

Treatment in a seated position is an excellent way to add in a greater range of movement when addressing the rectus abdominis or the oblique muscles. Use broad surface locks, such as the whole hand (fig. 13) or a soft fist (fig. 14), and instruct the subject to side flex to the opposite side. For release of the internal oblique muscle, lock and rotate to the opposite side for a stretch; for release of the external oblique, lock and rotate to the same side.

Compression of the Abdomen

Major Muscles: Transversus abdominis, obliques and rectus abdominis. These muscles increase abdominal pressure and provide a muscular support for the pelvis, abdomen and viscera.

Respiration: Inspiration

Figure

Major Muscles: Diaphragm, external intercostals, levatores costarum, serratus posterior and superior, pectoralis minor and SCM.

12. A cross-section of the trunk.

Figure 11. Abdominal muscles.

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Respiration: Expiration

Major Muscles: Transversus abdominis, subcostales, transversus thoracis, internal intercostals, obliques, latissimus dorsi and quadratus lumborum (fixes ribs).

Diaphragm

The diaphragm (fig. 15) is a large sheet of dome-shaped fibrous muscle that separates the thoracic and abdominal cavities. As it contracts it is drawn downwards, and the subsequent change in pressure causes air at atmospheric pressure to enter the lungs. When it relaxes it returns to its initial position and air is expelled from the lungs.

During forced expiration, for example during moderate or heavy exercise, the expiratory muscles become involved in order to drive air out more quickly. Through their contraction, there is an increase in abdominal pressure that pushes the diaphragm up more quickly to expel air faster.

The transversus abdominis (the deepest of the abdominal muscles) is the most powerful expiratory muscle. The internal and external intercostal muscles criss-cross the ribs and are responsible for drawing the ribs together (for expiration) and apart (for inspiration) respectively.

Respiratory

– Treatment

Muscles

Treatment of the respiratory muscles can be beneficial for anyone. Postural deficiencies can affect respiratory patterns due to the diaphragm’s attachments on the rib cage and lumbar vertebrae, and equally the other way. STR will have a positive effect on asthma sufferers. Athletes will find it can improve their breathing techniques, as the chest adopts a new lightness and freedom.

Ensure that the subject is in a comfortable supine position with the knees and hips flexed. Gently curl your fingers behind and in front of the lower ribs (fig. 16) towards the anterior attachments of the diaphragm while the subject is slowly inhaling; hold

Figure

Figure 15. The diaphragm.

SOFT TISSUE RELEASE: TRUNK & SPINE

Figure 13. STR to the oblique muscles using the whole hand.

14 STR to the oblique muscles using a soft fist.

STR will have a positive effect on asthma sufferers. Athletes will find it can improve their breathing techniques, as the chest adopts a new lightness and freedom.

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the position and allow inhalation to finish. Still maintaining the pressure, instruct the subject to exhale gently; after exhalation, release the pressure. For the intercostal muscles, a side-lying position is a good way of exposing the ribs. Lock in between the ribs (fig. 17), hold the pressure and instruct the subject to breathe in and to breathe out.The external intercostal muscles are the most superficial and are therefore more directly affected by this technique.

Originally published in 1998, Soft Tissue Release: A Practical Handbook for Physical Therapists was the first ever book to be written on soft tissue release and its reputation as one of the most highly respected textbooks on the subject is as strong today as it was then. Now in its fourth edition, this latest version contains the most up to date information on the role of fascia and even more comprehensive anatomical imagery to illustrate the theory and techniques involved.

Soft tissue release (STR) is an effective treatment approach designed to be easily integrated by any therapist working with pain, injury and movement dysfunction. Put simply, STR involves a ‘lock and stretch’ of tissue – but how exactly does it work, what is accepted as ‘best practice’ in terms of application, and how can it be used alongside other tools and techniques?

In this highly practical guide, Mary Sanderson shares a comprehensive range of techniques she has found to be the most beneficial during her own successful career as a physical therapist and lecturer. Detailed chapters present the prerequisite theory of how STR works, comprehensive advice on the treatment of over XX individual all of the main muscle groups and specific guidance on how to modify techniques across different settings.

Soft Tissue Release: A Practical Handbook for Physical Therapists is a complete reference guide for students embarking on clinical practice, therapists from all backgrounds wanting to understand more about pain management, or any individual wishing to harness the power of soft tissue release to treat their own pain.

MARY SANDERSON

Mary is a specialist in soft tissue therapy and has been a senior tutor for the London School of Sports Massage (LSSM) since 1994. She has run her own private practice in St Leonards on Sea, East Sussex, for over 25 years, treating a wide range of clients including elite sports people, musicians and performers. Mary also regularly presents on CPD programmes for manual therapists, personal trainers and coaches.

Figure 16. STR to the diaphragm

Figure 17. Lock into the intercostal muscles in between the ribs.

Treatment in a seated position is an excellent way to add in a greater range of movement when addressing the rectus abdominis or the oblique muscles.

Is It Time to Review What We Say About Fascia & How We Think We Can Treat It?

BY RUTH DUNCAN

All of us were taught about the nervous system in our manual therapy training. But, often anatomy and physiology (A&P) were taught as stand alone systems where their integrated workings were either missed or lost. This, for many of us, resulted in an inadequate understanding of how systems influence each other in health and disease.

A&P helps us to assess risk, identify contraindications, understand pathologies and helps us build client rapport through knowledge. As some qualifications involve treating injuries (and pain), A&P is relevant to providing the best evidence informed practice (EIP), building an appreciation of tissue damage, repair and what we can do to assist recovery to promote a return to pain-free active lifestyle (or sport).

However EIP involves much more than A&P and some may argue that A&P is not even relevant to an EIP. However, EIP prompts us to become more discerning in our professional decisions including how we claim

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our therapy works, often called the ‘mechanism of action’. EIP also promotes best practice where all therapists should reflect regularly on what they have been taught, how they practise and review any new evidence, science and guidance. As a result, we replace outdated practice with contemporary evidence continually providing the best care for our clients that we can.

Fascia is often heralded as ‘the missing link in traditional healthcare’ (Barnes 1990). Most fascial commentary begins with describing fascia as being previously thought of as a packing organ and continues with new evidence that supports its greater role and responsibilities in health and disease. There is no doubt that fascia research is amazing and has offered scientific explanations including the potential for fascia to be involved in the metastasis of cancer (Friedl and Alexander 2011), menopause symptoms (Fede et al. 2019), low back pain (Shilder et al. 2014) and myofascial pain syndromes including Fibromyalgia (Pratt 2021) and (Stecco et al. 2011). But, this doesn’t necessarily translate to how we can fix, stretch, release or resolve fascial dysfunction

using fascia-oriented manual therapies such as Myofascial Release (MFR). Many studies researching fasciaoriented therapies report evidence of benefit, albeit low, compared to nonintervention such as fascia and headaches (Ajimsha 2011), low back pain (Wu 2021), temporomandibular pain (Kamir 2010), chronic musculoskeletal pain (Laimi 2018) and scar tissue therapy (de Valois 2021). However, many journal papers simply avoid mentioning the potential mechanism of action or state that how the intervention works remains unclear. Additionally, consideration for bias, variability and reliability requires critical evaluation in all journal studies. For decades, we have discussed fascia as being a matrix which supports, separates and protects everything else. We have described it as the container of the mind and the keeper of trauma. We also have described how we can touch the intricate fascial web, following its spirals, twists and turns that influence its structure and, as a result, we can release the body’s stored physical and emotional traumas. For every Myofascial Therapist reading this, this will be something which you can identify with and appreciate what is being said as they have plausibility appearing to fit with what we believe we feel happening under our hands and what our clients experience. I remember attending the Fascia Research Congress (FRC) in 2009 in Amsterdam, Netherlands where Tom Myers was challenged by a presenter who suggested that deep fascial tension and fascial connections could not be described as trains or lines. Tom’s reply was simply that he knew what he felt under his hands. What we feel, what we interpret and what we intuit comes from experience and does play a part in EIP. However, despite clinical results, experience does not provide reliable scientific evidence but instead provides what is known as anecdotal evidence. Each one of us has our own style, belief and opinion that is reflected in our own treatment approach regardless of our training. While this offers diversity for the ever-increasing assortment of

clients’ needs, the result is inconsistency potentially resulting in poor practice standards. Additionally, we can become very protective of our titles, who we trained with and preferred treatment approaches which can be considered as bias that also contradicts an EIP.

Dr Robert Schleip, a prominent fascial researcher, described fascia as the ‘Cinderella of orthopaedic tissues’ (Schleip et al. 2010) as the fascial tissues have finally come to the ball and been noticed by the medical and research community. He also presented a lecture at the 2012 FRC in Vancouver Canada titled ‘Alice in Wonderland: Getting Curiouser and Curiouser’ discussed by the Association of Massage Therapists Ltd in Australia in one of their magazine articles (Schleip 2014). The theme here is not Disney characters, although some critics may be quick to point this out which, in itself would be confirmation bias, but Dr Schleip is indicating that there is still the great unknown regarding fascia and how we may be able to treat it resulting in rabbit hole after rabbit hole.

Furthermore, due to fascia’s ability to morph and adapt to stimuli, statements like ‘fascia is alive’ (Schleip et al. 2022, p265) and comparisons with spiral energy and bird murmurations imply a somewhat mystical and magical quality to it. On one hand, this embraces holism, attracting a personality type who resonates with this style of language and, as such, becomes a meaningful component of their clinical results. Yet, on the other hand, arguably this places fasciaoriented therapies into pseudoscience and often leads to them being criticised by traditional healthcare professionals.

Is it time to take a serious look at current evidence and become more evidence informed, refining our terminology, language and explanations of the properties attributed to fascia?

As an MFR training provider, I have always made it a priority to apprise myself of current research and evidence, integrating it into all of our training programmes

so that our students not only have valuable practical skills but also have a fundamental theoretical framework helping them to evaluate, consider and reflect on treatment approaches.

Now into my 3rd decade of teaching MFR however, there is still the unanswered question of ‘what happens when we touch?’ Anecdotally, I know that MFR makes a difference not just to my clients but to the thousands of clients treated by the wealth of skilled therapists who have trained with me. Despite my experience, science hasn’t yet been able to identify exactly what makes MFR different to any other style of manual therapy (if indeed it is) and why it can have such a profound effect on our clients.

There are many models and hypotheses as to how MFR may mechanically work including piezoelectricity and the semi conductive nature of fascia (Oschman in Schleip at al. 2022 p188), thixotropy (Schleip 2003), viscoelasticity (Yahia 1993) and fluid dynamics (Meert in Schleip et al 2022, p294) and (Bordoni 2018). There are also many models regarding the structure of fascia including biotensegrity, chains, bags and lines. Yet, none of these models offer definitive answers on what we actually do to the fascia, if anything.

However, there is an ever growing

body of evidence about touch, sensation and pain. The power of touch has been researched for decades with the most familiar researcher on touch being Tiffany Field from the Miami Touch Institute. Her research generally indicates that touch benefits wellness, reduces stress and improves relaxation and sleep. More recently, a complex interplay of biomechanical and neurophysiological mechanisms have been suggested as an appropriate and worthy concept as a potential mechanism of action for manual therapy including MFR (Bialosky et al. 2009) and (Bialosky et al. 2018). This correlates with the concept discussed by Dr Schleip for almost two decades and is a current and on-going area of fascia research (Schleip 2003).

Fascia has been heralded as a sensory organ due to its high mechanosensitivity. According to Dr Helene Langevin ‘connective tissue functions as a bodywide mechanosensitive signaling network’ (Langevin 2005) and as a result, may influence the experience of pain (Langevin 2021) and (Shilder et al. 2014). This is because fascia is embedded with nerve receptors which discriminate pressures and loading as well as tissue chemical and temperature changes. All tissues have this capability, identifying changes to

their structures, accommodating and adapting as necessary to maintain balance and harmony (allostasis).

But, how could the sensory nature of fascia help us to understand how we may be able to influence it?

You will have all heard about the 5 senses, taste, sight, hearing, smell and touch. You may have been taught about the integumentary system, that is the skin, hair, nails and exocrine glands. Mostly, you may have been taught about the skin as that’s what we physically touch in all manual therapy. You may have been taught that the skin is a sensory organ because it senses, or discriminates against, different types of touch. A long and light nurturing massage effleurage stroke is determined by different nerve receptors embedded in skin than those which determine cross-fibre friction and, the physiological changes as a result of those different styles of touch can be different too.

Most literature discusses the skin as being the largest sensory organ. However, fascial anatomy research is disputing this as it is now suggested that the fascial system contains approximately 250 million sensory nerve endings (Fede et al. 2022) and (Schleip 2022 p. 157) whereas the skin is said to have only 200 million nerve endings.

Considering this information, it is plausible that touch transmitted via the skin, including MFR, could stimulate millions of nerve endings, sending signals to the brain resulting in physiological changes that also rely on many different factors unique to each individual as suggested in the Bialosky et al. (2018) model. This is quite different to previous suggestions of a more mechanistic approach of tissue change by manipulation that I previously mentioned.

The nervous system is a 2-way street. When impulses are generated from the periphery, outside of the brain and spinal cord, such as in touch from manual therapy, they move along nerves as action potentials (electrical signals) towards the brain. This is called afferent signalling. Hence the term ‘affective touch’ as it has an affect on the body.

Now into my 3rd decade of teaching MFR however, there is still the unanswered question of ‘what happens when we touch?’

When impulses are generated from the brain and spinal cord and move out to the periphery along nerves, they have an effect on the body such as moving a joint. This is called efferent signalling. Simply put, affect is to influence change in the body and effect is a response due to change. If we have this 2-way street of both afferent and efferent processing, it can’t be done by the skin alone.

Every tissue type, organ, bone and vessel are innervated. Even nerves have their own nervous system, called nervi nervorum. This means that all information about your internal and external environment is sent to your brain via nerves. This obviously includes the fascial system and suggests that when the skin and all underlying

structures feel pressure from manual therapy, they transmit this information via the nervous system to the brain resulting in a response or action some of which are experienced as feelings. These experienced feelings result in physiological changes involving hormones, neurotransmitters and cellular exchanges which reduce stress, modulate tissue tone and reduce the experience of pain amongst others.

In the second edition of Fascia: Tensional Network of the Human Body published in 2021, Dr Schleip validates these concepts with this quote stating : ‘However, today an increasing number of practitioners are basing their concepts to some extent on the mechanical sensory nature of the fascia and it’s assumed

ability to respond to skilful stimulation of its various sensory receptors’ (p 158).

He also describes in many articles and books his own experience with providing fascia-oriented therapy to anaesthetised patients who had provided him permission for his nonempirical study. He had to concede that anaesthetised patients did not respond to his treatments in the same way as fully conscious patients did (Schleip 2022 p.157). This leads us to assume that the nervous system is likely to be a key player in manual therapy.

In addition, physiological changes are also derived from contextual meaning and play an important role in the Biopsychosocial approach within an EIP. You may have previously known contextual meaning as placebo but in fact, these are meaningful measures that ask your client what matters to them and not what’s the matter with them. For example, a client may want treatment from you as they believe in your capabilities as you helped their friend. It may matter that a client gets treatment from a specialist scar tissue or MFR therapist as they have read on social media that these treatments are the best for their pain. These beliefs can potentially enhance treatment outcomes. The question here is however, how much of our treatment outcomes are actually related to the belief that a therapy works versus the actual mechanical tissue changes by our chosen therapy?

There is no doubt that the science of touch and pain is vitally important. Yet, despite the value of the A&P of touch, most therapists are not taught enough detail about the nervous system or how psychosocial factors influence health to use them in their practice to their advantage. This potentially may be perpetuating the confusion and unsupported claims of how manual therapy works and what it can fix.

Additionally, touch means something different to everyone. It is not as simple as just the nervous system. It involves beliefs about what that touch may do as well as culture and previous experiences. It also

massagemodalities

involves the trust and rapport between client and therapist, now called the therapeutic alliance, and it involves the entire contextual environment of the treatment session. All these components influence what your touch means to each individual client.

While it seems that we are closer than ever before to extrapolating a mechanism of action, it is still unclear if fascia-oriented therapies affect the body differently to any other manual therapy. Additionally, we have to accept that all manual therapies may have greater similarity than we would like to believe where no model or trademarked method, known as a modality empire, has superiority (Ingraham 2022). However, despite this, the therapeutic relationship involves many components such as client communication, psychosocial factors, self-efficacy, resilience and beliefs and should not solely rely on a mechanism of action thus moving from a ‘doing to’ relationship to a ‘being with’ relationship.

As a result, it is becoming more evident that revision of both teaching and the practice of fascia-oriented therapies needs to be addressed as current evidence does not support many of the claims routinely used. Furthermore, the terms ‘fascia-focused’ and ‘fasciaoriented’ are somewhat obsolete. The only thing we definitely know that we can touch is the skin. While some research suggests that we can influence deeper structures such as the gliding mechanisms attributed to hyaluronan (Pratt 2021), further studies are required.

In our Certificate in Integrated Myofascial Therapy (CiMFT), I introduce mechanosensation and how touch

RUTH DUNCAN

discrimination can be used to offer insight into how MFR may affect the body via the nervous system. Not only that, by understanding the anatomy of fascia, its innervation and the importance of what touch means to your client, you are better equipped to choose appropriate MFR techniques to meet client needs resulting in more productive and client-focused treatment outcomes.

There is definitely an ‘out with the old and in with the new’ attitude across the profession especially regarding the mechanisms of action.

Question what you were taught. It’s perhaps time to reevaluate, revise and update.

References

Barnes, JF. (1990) Myofascial Release: The Search for Excellence. Malvern PA. Friedl, P., & Alexander, S. (2011). Cancer invasion and the microenvironment: plasticity and reciprocity. Cell, 147(5), 992–1009. https://doi.org/10.1016/j.cell.2011.11.016

Fede, C., Pirri, C., Fan, C., Albertin, G., Porzionato, A., Macchi, V., De Caro, R., & Stecco, C. (2019). Sensitivity of the fasciae to sex hormone levels: Modulation of collagen-I, collagen-III and fibrillin production. PloS one, 14(9), e0223195. https://doi.org/10.1371/journal.pone.0223195

Schilder, A., Hoheisel, U., Magerl, W., Benrath, J., Klein, T., & Treede, R. D. (2014). Sensory findings after stimulation of the thoracolumbar fascia with hypertonic saline suggest its contribution to low back pain. Pain, 155(2), 222–231. https://doi.org/10.1016/j.pain.2013.09.025

Pratt RL. Hyaluronan and the Fascial Frontier. International Journal of Molecular Sciences. 2021; 22(13):6845. https://doi.org/10.3390/ijms22136845

Stecco, C., Stern, R., Porzionato, A., Macchi, V., Masiero, S., Stecco, A., & De Caro, R. (2011). Hyaluronan within fascia in the etiology of myofascial pain. Surgical and radiologic anatomy : SRA, 33(10), 891–896. https:// doi.org/10.1007/s00276-011-0876-9

Schleip, R., Zorn, A. and Klingler, W. (2010) “Biomechanical properties of fascial tissues and their role as pain generators,” Journal of Musculoskeletal Pain, 18(4), pp. 393–395. doi: 10.3109/10582452.2010.502628. Available at https:// www.rolfing.berlin/wp-content/uploads/zPDF/ Schleip2010_JMusculoskPain_post-print.pdf

Myofascial Release UK (MFR UK) teaches a variety of myofascial approaches including sustained myofascial techniques, compression and traction techniques, position of ease techniques, direct soft tissue mobilisation, rebounding, unwinding and fascial self-care and rehabilitation approaches. MFR UK also teaches fascial assessment, pelvic, sacrum and spinal evaluation and pelvic balancing techniques using pelvic positioning wedges in part 2 of the structural series. MFR UK welcomes those with a minimum of a level 3 handson qualification such as sports massage, holistic massage, Bowen, Shiatsu, Craniosacral therapy, Thai massage and similar. Also welcome are osteopaths, sports therapists, physiotherapists and chiropractors.

Further details can be found on www.myofascialrelease.co.uk Email: info@myofascialrelease.co.uk | Tel: 0333 006 4555

Schleip et al (2022) ‘Fascia: Tensional network of the the human body, 2nd eds. Elsevier Ltd, Poland. Schleip, R. (2014) A Journey in Fascia Wonderland with Robert Schleip: Bridging the Gap Between Clinicians and Scientists. Association of massage therapists ltd, pp. 6-9. Available at https://www. fasciaresearch.de/publications/AMT_2014Journal.pdf Schleip, R. (2003). Fascial plasticity - A new neurobiological explanation: Part 1 and Part 2. Journal of Bodywork and Movement Therapies. Available at https://functionalfascia. com/wp-content/uploads/2017/06/ Schleip-Fascial_Plasticity.pdf

Yahia, L. H., Pigeon, P., & DesRosiers, E. A. (1993). Viscoelastic properties of the human lumbodorsal fascia. Journal of biomedical engineering, 15(5), 425–429. https://doi. org/10.1016/0141-5425(93)90081-9 Available at https://pubmed.ncbi.nlm.nih.gov/8231161/ Bordoni, B., Lintonbon, D., & Morabito, B. (2018). Meaning of the Solid and Liquid Fascia to Reconsider the Model of Biotensegrity. Cureus, 10(7), e2922. https://doi.org/10.7759/cureus.2922

Ajimsha M. S. (2011). Effectiveness of direct vs indirect technique myofascial release in the management of tension-type headache. Journal of bodywork and movement therapies, 15(4), 431–435. https://doi.org/10.1016/j.jbmt.2011.01.021

Wu, Z., Wang, Y., Ye, X., Chen, Z., Zhou, R., Ye, Z., Huang, J., Zhu, Y., Chen, G., & Xu, X. (2021). Myofascial Release for Chronic Low Back Pain: A Systematic Review and MetaAnalysis. Frontiers in medicine, 8, 697986. https://doi.org/10.3389/fmed.2021.697986

Kalamir, A., Pollard, H., Vitiello, A., & Bonello, R. (2010). Intra-oral myofascial therapy for chronic myogenous temporomandibular disorders: a randomized, controlled pilot study. The Journal of manual & manipulative therapy, 18(3), 139–146. https://doi.org/10.1179/106698110X12640740712374

Laimi, K., Mäkilä, A., Bärlund, E., Katajapuu, N., Oksanen, A., Seikkula, V., Karppinen, J., & Saltychev, M. (2018). Effectiveness of myofascial release in treatment of chronic musculoskeletal pain: a systematic review. Clinical rehabilitation, 32(4), 440–450. https://doi.org/10.1177/0269215517732820

de Valois B, Young T, Scarlett C, & Holly E. (2021). An evaluation of a ScarWork service for cancer survivors experiencing adverse effects of surgery and/or radiotherapy. European Journal of Integrative Medicine, 44. https:// doi.org/10.1016/j.eujim.2021.101327

Bialosky, J. E., Bishop, M. D., Price, D. D., Robinson, M. E., & George, S. Z. (2009). The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Manual therapy, 14(5), 531–538. https://doi.org/10.1016/j.math.2008.09.001

Bialosky, J. E., Beneciuk, J. M., Bishop, M. D., Coronado, R. A., Penza, C. W., Simon, C. B., & George, S. Z. (2018). Unraveling the Mechanisms of Manual Therapy: Modeling an Approach. The Journal of orthopaedic and sports physical therapy, 48(1), 8–18. https://www.jospt.org/doi/10.2519/jospt.2018.7476

Langevin H. M. (2006). Connective tissue: a bodywide signaling network?. Medical hypotheses, 66(6), 1074–1077. https://doi.org/10.1016/j.mehy.2005.12.032

Langevin H. M. (2021). Fascia Mobility, Proprioception, and Myofascial Pain. Life (Basel, Switzerland), 11(7), 668. https:// doi.org/10.3390/life11070668

Fede et al. (2022). Innervation of human superficial fascia. Frontiers in Neuroanatomy, vol. 16. Available at https://www.frontiersin. org/articles/10.3389/fnana.2022.981426/full Ingraham, P. (2022) Modality Empires: The trouble with the toxic tradition of ego-driven, trademarked treatment methods in massage therapy, chiropractic, and physiotherapy. PainScience Blog. Available at https://www. painscience.com/articles/modality-empires.php

© Fascia Research Society. Photography by Thomas Stephan

Clients Who Don’t Get Better The Complex Conundrum of Chronic Pain

Persistent central sensitisation is a feature of many chronic conditions such as low back pain

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

Those of you who are regular readers of my articles will know that there are many great soft tissue techniques that have proven effective in reducing chronic musculo-skeletal pain. The bread and butter techniques of an advanced clinical massage therapist are a creative combination of fascial work, precise trigger point therapy, acupressure and stretching. Using an amalgamation of these techniques within a treatment can often get a reduction of pain quickly and easily with common conditions such as back pain, rotator cuff issues, headaches, sporting injuries and RSI.

As a rule of thumb (what other rules could we possibly have as manual therapists!) we look at treating the condition once a week for up to 6 weeks with an expectation that we will be achieving a substantial reduction in pain by week 3. Without a doubt this works for most of the people most of the time.

Sounds great right?

Yet sometimes people just don’t get better. Clients with exactly the same condition, treated in exactly the same way, can have entirely different outcomes.

Why? Frustrating yet fascinating, this riddle turns us back to the drawing board to understand what could possibly be going on in the complex mystery of pain that just doesn’t go away.

Fig. 1: The biopsychosocial model of pain posits that chronic pain is influenced heavily by both psychoclogical and social factors

The issue is not always in the tissues

Consider these 2 cases that I treated a few years ago:

Anna: Aged 25, developed pain in her right forearm. Working as a marine biologist she was fit and healthy, her job involved a great deal of physical activity and she had no significant emotional stresses. She presented as cheerful and positive about my ability to help her pain.

Martha: Aged 60, developed a similar pain in her right forearm. She was tearful and stressed. Her office job was really getting too much and she felt overwhelmed by the day to day demands. She would love to retire but was worried about the financial implications.

Who do you think got better first? Yes of course you’re right – Anna was pain free within a miraculous single treatment (wish all my clients were like that!) whereas Martha (treated with the same techniques) was still in pain several sessions later. She subsequently made the decision to retire and is finally living an idyllic pain free life!

Herein lies the dilemma of the working massage therapist – the “issue is not always in the tissues!” People are unique individuals and their own complex psychological make up, attitudes and personal history can affect the outcome of our treatments considerably. Our ability to help people out of pain is influenced by a complex array of factors including:

• Current emotional state of the client

• Age

• Past history of issues such as anxiety, depression or experience of trauma

• Client’s belief in your ability to help their pain

• Attitudes to health – does the client see themselves as generally well or healthy

• Beliefs about the current pain issue and its consequences– does the client believe this is a condition that will affect them for long term? Or do they see it as a short term, easily resolvable issue?

• Their sense of control over the pain condition – do they feel helpless and at the mercy of experts or do they believe they can make a difference themselves

Interestingly, even sociological factors can also play a part in our experience of pain. For example, one study of those suffering from longterm whiplash pain discovered that poor recovery was associated with factors such as:

• Being female

• Larger number of dependents,

• Married status,

• Not being employed full time, low income

• Low education

• Lawyer involvement!

Clearly working with pain conditions is not a straightforward issue. Pain is not just about whether there are injuries or restrictions within the soft tissue and joint structures of the body but is highly coloured by our attitudes, beliefs and expectations.

This model of pain is known as the “biopsychosocial model” (FIG 1). In the biopsychosocial model the experience of pain is believed to be a combination of biological, psychological and social factors. Understanding the biopsychosocial model is vital for

massage therapists – pain is NOT just due to structural factors such as misaligned vertebrae, tipped pelvises or differentials in leg length but is much more complex.

The issues in the tissues versus the pain in the brain

So if the pain condition is not always coming from damage to the tissues, what exactly is going on? In his likable and readable books and talks on pain biology, neuroscientist Lorrimer Moseley (Google him- he’s great!) summarises prevalent research that shows how chronic pain is a perception of the brain rather than always being an accurate representation of what is happening at the tissue level. Thus, the sensation of pain can be mediated by a variety of factors including emotional state, previous experience, expectations and sense of control over the pain condition.

This phenomenon is known as sensitisation. This is a neurological process by which the central nervous system can “change, distort or amplify the experience of pain”. In other words the brain can act like a faulty stereo speaker that at whim can turn up the volume of the pain or significantly change the sensation. (FIG 2) Under normal circumstances, for example after injury, sensitisation is a good thing, causing the injured area to feel hypersensitive to touch or movement thus protecting the tissues from further damage. Usually this pain and sensitisation will diminish as the person heals and the pain response will return to normal levels.

2: The brain can act almost like a faulty stereo speaker that can “turn up” or “turn down” the volume of pain sensations

Fig.

However for some people, persistent central sensitisation can be maintained long after tissue healing has taken place. In other words the client is in (real) pain even though there is no longer any injury or damage. This persistent pain sensitisation has been shown to be a feature in many of the client conditions that are staples of the massage therapist’s clinic – for example chronic low back pain, TMJ, headaches and long term neck pain (main image). It seems that some of the factors mentioned above (previous experience, attitudes to health, emotional state etc) can have a significant influence on whether the client develops this persistent pain sensitisation response.

Understanding the role of the central nervous system in persistent pain sensitisation is very different from dismissing pain as being “in the head” or “psychosomatic”. These kind of beliefs are unhelpful to the client and will not solve the problem. The pain is very real and not imaginary, it’s just that the CNS has amplified the normal signals.

Pain sensitisation is the reason why, in my 2 clients above, Anna was so much easier to treat than Martha. For Anna, the issues were very much in the tissues, meaning a speedy recovery following treatment. However for Martha, her feelings around her job, current anxiety and lack of sense of control

contributed to a persistent pain sensitisation response. Good bodywork alone was not the answer – effective treatment needed to also factor in the effect of the “pain in the brain”.

The treatment sandwich approach – intervening in psychology rather than physiology

So as bodywork therapists how are we expected to deal with these amplifying and distorting effects of the central nervous system? Surely we deal with bodies not the mind? Right?

Wrong. Every time you interact with a client you are interrelating with their personal psychology and belief system. Whether you realise it or not your attitudes will have a direct effect on whether the person gets better.

Significantly, your client’s healing process depends not just on the handson techniques used but also the quality and content of the practitioner- client interaction. (FIG 3)

As a massage therapist you have 2 significant opportunities to interact and connect verbally with your client – the first is during the client consultation at the beginning of the treatment; the second is at the end where feedback and self -care suggestions can be given. I call this the “treatment sandwich” – manual techniques are

Fig. 3: Your client’s healing process depends not just on the hands-on techniques used but also the quality and content of the practitionerclient interaction.

slotted in between the beginnings and endings of slices of verbal clienttherapist interaction.

The importance of these verbal components in enhancing client recovery from pain conditions cannot be over-emphasised. The consultation aspect of the treatment enables the practitioner to assess the role of potential perpetuating and aggravating factors in the client’s pain condition, provide support and reassurance, and where appropriate reflect information back to the client to assist them to make informed choices.

Similarly, the self -care suggestions form an important part of the healing process as they are handing responsibility back to the client to take control of their health. As a mental health professional for many years I was well aware of the crucial concept of “empowerment “ in recovery and working with many pain conditions is no exception. Helping the client to feel that there is something they can do for themselves to decrease their pain is often the key to recovery.

Practical suggestions for client self care and education

Although the issue of chronic pain is complex there are some simple ways that you can help your client without taking on the role of counselor:

• Emotion: Research has shown that increasing psychological well -being causes an associated decrease in pain. It is definitely a skill to be able to identify within your consultation if psychological factors may be a significant contributor to the pain condition, without making the time into a counseling session! Questions such as “Was there anything else going on for you when the pain started” can be very revealing as can asking the client to rate their current stress levels on a scale of 1-10. Be prepared to probe a little without being intrusive; always remain open minded and non judgmental.

Fig. 4a & 4b: Movement is an effective way of decreasing chronic pain. Encourage your clients to engage in activities they enjoy – dancing is just as good as yoga!

I f you feel psychological factors may be playing a part, your recommendations may vary from suggesting talk therapy (CBT is particularly helpful for chronic pain) to suggesting the client might need to take more time for themselves or call their friends more.

• Physical Activity: Movement is good! And most of us don’t do enough of it. Activities such as walking can not only increase wellbeing but have also been shown to decrease chronic low back pain. Encourage your clients to return to the activities they enjoy or to walk to work rather than driving. (FIG 4A and 4B)

Using Pacing and gradual exposure

One of the challenges around recovery for clients in pain is determining how to advise them on exercise, movement and the challenge of returning to both necessary and enjoyable activities. All too often clients in pain fall into some level of inactivity due to their pain levels.

Clients’ attitudes often fall into the categories of “boom and bust” (push through the pain then drop with exhaustion) or “avoidant” (avoiding potentially painful activities altogether).

A more sensible approach involves gradually increasing the level of the activity in question. Movement is important in recovery from chronic pain and it is important your client is encouraged to gradually return to the activities they enjoy.

1. Decide with your client which activities they want or need to work on (cycling, walking, tennis, playing with kids, dancing)

2. Determine their baseline - this is the amount of activity the client can do without pain flaring up. (Might only be 3 minutes cycling

on a flat surface but thats a good start)

3. Encourage a planned progression of the chosen activity - the client does a little more than they did yesterday but not much more (i.e.: 4 minutes cycling the next day)

4. If the pain flares up return to the previous baseline for a while

• Catastrophising: The client’s experience of pain can be dramatically influenced by their anxieties and beliefs about their condition – this tendency is known in psychology as catastrophising (FIG 5). Unfortunately the medical profession sometimes doesn’t help with this tendency – a friend of mine who went to the GP with a simple back pain was referred to the disabled hydrotherapy group! She was convinced she was going to be in pain for the rest of her life whereas in actuality the pain was likely to be a simple soft tissue injury. Explaining to your clients about the concept of pain sensitisation helps them to understand that there may be other reasons for their pain other than tissue or structural damage. This in itself can be profoundly empowering and help them to make the necessary lifestyle changes to make a difference.

RACHEL FAIRWEATHER

Rachel is author of the best selling book for passionate massage therapists – ‘Massage Fusion: The

Method

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

Fig. 5: The client’s experience of pain can be dramatically influenced by their anxieties and beliefs about their condition. This tendency is known in psychology as catastrophising

Jing

for

A Practitioner’s Guide to Clinical Cupping Effective Techniques for Pain Management and Injury

Daniel Lawrence

REVIEWED BY XXXXX

n this highly practical guide, acclaimed physical therapist and international lecturer Daniel Lawrence dispels some of the myths around cupping therapy and shows how it deserves to be viewed as a highly credible and versatile therapeutic tool in modern practice

Cupping―an ancient therapy which uses vacuum cups placed over the skin to treat a wide range of health conditions―appears in one of the earliest medical textbooks ever written and has been used in cultures around the world for thousands of years.

Though much maligned by its perception as a “complementary therapy,” the emergence of modern research supporting the use of cupping to treat musculoskeletal conditions has seen it enjoy a huge resurgence in recent years. You only need look at the unmistakable cupping marks visible on Olympic swimmers to see how valued it is within professional sport.

An ancient treatment, a new way Presented with clear descriptions, colour photographs, and QR codes linking to online video tutorials, Lawrence’s approach to dry cupping offers enhanced treatment outcomes and methods that are more readily accepted by Western medicine and modern manual therapy bodyworkers. These are techniques that deliver maximum benefit whilst minimizing some of the less desirable after-effects of more traditional methods.

Starting with the history of cupping, the book guides you through the principles of application with illustrated protocols for musculoskeletal conditions of the foot, ankle, lower leg, knee, thigh, hip, back, shoulder, wrist, hand, elbow, and neck.

Whether you are looking to treat Achilles tendinitis, carpal tunnel syndrome, or low back pain, Lawrence illustrates why cupping is a safe and effective choice of treatment. Where this book differs from others, however, is that it introduces the concept of using passive and active movement in a treatment. In this way, cupping can be viewed as an enhanced form of both massage and exercise rehabilitation. Couple this with a valuable

understanding of how these techniques influence the nervous system and cupping now stands up to “evidence-based” scrutiny. This is modern cupping!

ISBN: 1913088332

From £10.69 on amazon.co.uk

Massage on Demand

Is this what we really need?

BY JENNIE PARKE MATHESON

In the same way that the membership value of PA’s is now a more pressing question, the way to access more clients, and rapidly, is becoming key. Covid ransacked our client bases, so rebuilding our businesses is the big challenge.

Added to which the supplementary equipment originally needed to make our workplaces covid safe, the additional paperwork required to ensure that we as therapists are safe has massively grown our workload - and costs. And now the recession on top of Covid is biting. Massage has slipped back into the “treat” approach instead of the “necessary” approach, as people simply can’t afford it. It also depends on where you live/work and the economy there. I see messages on social media wanting a good therapist – but on the cheap. It is as ever, but more pressing now. At least some are happy to pay, rather than the endless requests to provide massage for free. So a whole new approach is potentially needed. Welcome the massage app. Gradually developed over recent years, they are designed to help easy access for clients seeking therapy. Focussed on mobile therapists. They fall into a number of distinct categories. Initially either Multi-disciplined or Single Discipline. Multi-disciplined apps offer a wide range of bookable trades people – for example carpenters, plumbers, electricians – and therapists of all types. There is massive choice. Although it includes many therapies, there is not a huge understanding of what it involves by those that set it up - so the marketing and terminology is slightly odd. An example of this type of app is BARK. Single-discipline (for us) is therapy oriented –usually under the following headings: Wellbeing, Health & Beauty, Massage Therapy. Because they are

focussed on complementary therapy, they use recognisable terminology and are clear about the services on offer – though it does differ as to whether they call their personnel massage therapists or masseuse/ masseur. And the fixed prices vary according to where in the UK they are.

The value for you is that in joining such a team it can help augment existing business for you – or if you’re starting out replace the need for a personal website and generate all business.

It depends on what you want

In the simplest of versions, after a phone interview, you join their team. And you are then marketed via their website. A profile/bio, a photo – and contact details. Well known mobile organisations use this method – for example Urban and City. Importantly for the client, they are very diligent in vetting you. Checking qualifications, insurance, DBS, specialities, so there is a complete picture of who you are and what you do. But not all apps are that straightforward. They get more and more complex in terms of how they operate, or what services they offer.

Some replace what had been booking services, some are offering additional financial services – and some offer documentation facilities. To encourage the building or rebuilding of businesses without the heavy weight of business management. You need to be quite savvy to manage these services.

With some apps the client contacts you, either directly or via the app. With some you contact them – they provide “leads”, giving you the choice of who you approach. Some apps even offer template text or email approaches. In general these are short, over simplistic, and very generic.

To go with these apps, there is a new language. Therapists are now often referred to as the “pro”. As a client you get a chance to check with “the pro.” Make of it what you will….

They are very clear to the client that they are easing up the whole accessibility process. And how they vet their

therapists for quality – qualifications, insurance, DBS etc. What is not so clear is how they vet the potential clients.

As a mobile therapist you are usually visiting the client in their home - or as is becoming more frequent, hotel rooms. It can leave therapists very exposed, in multiple ways. The question is how do you vet a client? Can you vet a client?

Safety – Self Protection

The big question is how/whether these apps provide any support/ safety for you. It is clear the client is well covered. Are you?

There have been some widely reported incidents recently, both where clients have taken advantage of therapists, and where therapists have taken advantage of clients. With the support of a good PA, these individuals can be prosecuted. However, it is important to stress that these are extremely rare occurrences, though must not be dismissed. Our responsibility to ourselves is to selfprotect. Many PA’s have been exploring this, some offering verbal support via mentoring, others via physical training.

But what’s it like on a day-to-day basis, making assessments. Talking to one app, they advised me not to accept any requests for massage that came in after midnight. Which shows they have no way of vetting clients; therefore it is up to you. In this case if you make contact with the client, then they have your personal details. They can then call

you. 99% of the time that’s fine, however… Therefore as a therapist you must trust your sense of self. Having the freedom to say No to any potential client if it doesn’t feel right. This is hugely important. If any app requires you to accept any potential advance, then their motives need to be questioned.

Finance

How does this operate? Does the client pay you and you then pay a percentage to the app. Or is it the other way round. The client pays the app, and they pay you – minus their percentage. What is the percentage? How far in arrears are you paid. Will the app also deduct extras. If so, what, when and why? What expenses can you claim? Travel, disposables etc. Some apps want an up-front fee from you and, should you respond to a “lead”, there are credits that you buy to make contact with those “leads”. The intention is to make back your investment, and there are always various incentives. However, there are no guarantees.

Managing the Business side

Whether clients come via an app, your own website, or word of mouth, you must still fulfil all the legal requirements. Accurate information, documentation, GDPR compliant etc. Some of these apps offer to do it for you, some will conduct initial checks with client. Some won’t. It’s up to you to work out the parameters – and to programme in the time required. You still need

to have

As a mobile therapist you are usually visiting the client in their home - or as is becoming more frequent, hotel rooms. It can leave therapists very exposed, in multiple ways. The question is how do you vet a client? Can you vet a client?

industryinsights

MASSAGE ON DEMAND

copies of all the paperwork, whoever initiates the contact. So make sure you know what’s what before you commit.

It is also still vital (wise) to conduct a risk assessment for each new client. This will help you asses their suitability and your safety. Do not forget that each therapist has the right to say NO.

And finally, a good app will be there for you if you need support, whatever that support is.

Appraisal

For an appraisal of these apps, there are assessment pages showing which are most effective. The Massage Warehouse created such a list in 2020. Today it’s a completely different set.

So, questions to ask

◆ How does the booking work?

◆ What happens when a request comes in?

◆ How is the documentation managed?

◆ How do I communicate with the client?

◆ How is the finance managed?

◆ How am I protected?

Advantages

◆ The marketing (or some of it) is done for you

◆ Fills in gaps to your schedule ◆ Helps create a new business ◆ Helps develop an additional client base

◆ Fees are pre-ordained, so no need to negotiate ◆ They can offer the complete business package ◆ No spam emails coming via your website

Disadvantages

◆ Are clients adequately vetted. Can they be? ◆ What safety do you have? ◆ What support are you offered? ◆ The marketing package – is it sufficient?

◆ The finance package - how are the finances managed?

Conclusion

There are clearly pros and cons to using an app. There are a lot of advantages, but whatever your choice it is a personal one, made by weighing up the whole situation. If it works for you, that’s great. If it doesn’t, then that’s great too…

JENNIE PARKE MATHESON is a soft tissue specialist and an accredited tutor, with 15 years’ experience. She has a private practice in North London and runs workshops & courses for both newcomers & qualified therapists. She served on the Boards of MTI, GCMT and CNHC between 2019-2021, and co-wrote the operational guidance for therapists throughout the covid pandemic.

Do not forget that each therapist has the right to say NO.

Applying Marma Therapy in Bodywork

Marma (vital point) therapy, also known as the effective yet gentle ‘sukshma’ technique, has long been regarded in the East for supporting the emotional as well as the physical body. Through marma (vital point) therapy, we can treat specific vital points on the human body – this is one of the greatest healing secrets of Ayurveda, an ancient Indian health and healing tradition. It can be used to detoxify, strengthen and revitalise the body, for rejuvenation and relaxation or to release blocked energy. In this article, I will aim to explain the theoretical basis of marma (vital point) therapy, and then provide a detailed, fully illustrated guide to its use.

You will also discover the key components of marma chikitsa (the process), prana and nadi connection, pathways of prana/nadi, development of pain in the body, principles of treatment and how marma (vital point) therapy can be truly transformative for mental and spiritual evolution and maintenance/ preventative health measures.

The Chakras

First, we need to understand the three energy centres within the (astral) body. At the deepest layer lie seven vital energy centres. We can’t see or feel them, they won’t show up in an X-ray or MRI. Yet for thousands of years, Eastern cultures have recognised their importance to our physical, emotional, spiritual, and mental health.

BY SUNITA PASSI

In Sanskrit, an ancient Indian language, chakra means “wheel” or “circle.” Balanced chakras can be visualised as spinning vortices revolving in a clockwise direction at particular frequencies. When imbalanced, chakras may spin counterclockwise and/or the energy may move horizontally or vertically. Each chakra is associated with and stimulated by a specific colour, and by sounds that vibrate at a similar frequency.

How energy flows in and out of the chakras will greatly affect us. Balanced chakras allow energy to flow freely, thus promoting health, vitality, and

harmony. Life experiences such as illness, trauma and stress can cause imbalances, and chakras may become blocked (deficient) or overloaded (excessive).

Imbalances produce a wide variety of ailments and disturbances. Often imbalances are temporary, but they can persist, resulting in chronic illness, disease, and habitual patterns of thinking, feeling, and behaving. Fortunately, chakras can be cleared, rebalanced, and energised through yoga, controlled breathing (pranayama), meditation and applying marma (vital point) therapy in Ayurvedic bodywork.

The Nadis

Similar to our nervous system, our energetic (astral) body has thousands of channels that energy flows through – those channels are nadis and they are a vital part of promoting health, vitality, and harmony.

The Sanskrit word ‘nadi’ translates to ‘tube’ or ‘flow’, or as we call the nadis, channel. In terms of the nadis, it refers to the astral channels that energy or psychic current uses to run through the astral body. Just like our

physical body has an elaborate central nervous system, our astral body has one too—a network of nadis—which you can experience through the self-development process. Because these tubes or channels aren’t tangible like blood vessels and arteries, and to date, they aren’t something people have been able to do experiments with or conduct research on, so you won’t find them in your anatomy or physiology textbook.

What is their relationship to Chakras?

Essentially, nadis and chakras are part of the same system. While nadis are the infinite network of energy pathways through which prana circulates the body, chakras are where the energy actually comes from - the epicentres.

As said, the Sanskrit word ‘chakra’ means ‘wheel’, symbolising the energy centres that exist within and around our astral body. We focus on 7 major chakras in the human body:

• Svadhisthana (Sacral Chakra) – Location - At the tailbone. Energy: Creativity, Sexuality

• Manipura (Solar Plexus Chakra) – Location: On the spine, at the level of the navel. Energy: Wisdom, Power

• A nahata (Heart Chakra) – Location: On the spine, at the level of the heart. Energy: Healing, Love

• Vishuddha (Throat Chakra) – Location: On the spine, at the level of the throat. Energy: Communication

• Ajna (Third eye Chakra) – Location: Centre of the forehead. Energy: Awareness

• Sahasrara (Crown Chakra) – Location: Crown of the head. Energy: Spirituality

Along with transporting prana energy, the nadi system also circulates a different, yet equally important cosmic energy from one chakra to another—the kundalini energy (shakti).

Kundalini shakti is the serpent-like cosmic force that sleeps at the base of the spine. When activated (or awakened), the kundalini energy flows from our Muladhara or root chakra to the Sahasrara or crown chakra. It’s believed that Shiva, the deity of supreme consciousness and stillness, resides in the Sahasrara chakra.

When the kundalini shakti travels through the spinal column and enters the Sahasrara chakra, it engulfs and heals all the imbalances in our body, enabling the divine consciousness to influence all the activities in our life, at which point we may attain awakening.

What is Marma?

Through applying marma therapy in Ayurvedic bodywork we can access the energy/astral body to help our clients.

Marma is a sanskrit word meaning hidden or secret. A marma point is a juncture on the body where two or more types of tissue meet, such as muscles, veins, ligaments, bones or joints. Although marma points are much more than a casual connection of tissue and fluids, they are points of the vital life force. When imbalances block the movement of free-flowing energy in the body, the resulting stagnation leads to physical and mental discomfort and disease.

When we touch marma points we stimulate the body’s biochemistry to produce exactly what the body needs, including neurochemicals and hormones that heal the body, mind, and consciousness.

Role of Marma

There are four basic purposes of marma:

1. It removes blocks in energy channels called srotas.

2. It pacifies vata dosha, (air and space elements), bringing it to its normal path— especially vyana vata, (a subdosha which controls the autonomic nervous system)

3. It creates physical, mental and emotional flexibility. Because of ama (toxins) and because of vata, human beings after 35 or 40 years of age become rigid — and this happens to animals and plants too. As vata increases in our body, we experience degeneration. This rigidity can mean becoming fixed in ideas, emotions, and physical movements

4. This gentle treatment creates an opportunity to experience powerful and dynamic transformation at the physical, mental, emotional, and spiritual levels by building a positive link with the unconscious mind. Many times people are not able to go outside their ‘comfort zones.’ They think they have absolute limitations. After marma is activated, they can start taking positive steps in their life.

For each marma point, we can extend treatment with gemstones, crystals, flower essences and essential oils. The process of marma (vital point) therapy is called marma chikitsa and it is where profound healing and transformation begins.

For training in Ayurvedic massage therapies with the Tri-Dosha Academy, see: www.tri-dosha.co.uk. 2023 course dates: 3-7 April; 9-13 October.

SUNITA PASSI brings a wealth of classroom and practical experience to students in the UK. She is the founder of TriDosha, a premium skin and body care line and training academy that pioneers whole body wellness based on the ancient Indian health system and healing traditions of Ayurveda. Located in Nottingham UK, TriDosha is a small independent company led by Ayurvedic expert Sunita Passi, whose grandfather introduced her to Ayurveda from a young age.

The Author of The Doctor Won’t See You Now | Staying healthy while the medical system is re-botted, Sunita is highly regarded for her knowledge and expertise in the therapeutic aspects of Ayurveda. As well as being the principal instructor of teaching Ayurvedic bodywork students in the UK, she shares techniques for self-treatment for laypersons looking to activate self-healing through her social media pages www.sunitapassi.com

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NOT TO MENTION THE ADDED BENEFITS

- Fully certified training.

- Ongoing training and development.

- Great rate of pay.

- 2 bonus schemes, in addition to regular pay.

- Fixed shifts. - FREE massage per month.

- Welcoming staff room.

- CPD over 3 years.

- Great team atmosphere.

- Contracts of employment.

- Paid holiday and pension.

We understand that training is the future of our business. Our TMC Training Programme is a growing part of our focus, and every Massage Therapist will undergo both training and live practice before working with us.

- Ergonomically designed treatment rooms built for massage treatments.

- Further training to become a specialist in: Deep Tissue, Sports, Classic Swedish and Maternity. JOIN US.

An Ayurvedic Approach to Skin Health

BY SIOBHAN COSGRAVE

Our skin really is a big deal! It is the largest organ of the body and an important endocrine organ playing an significant role in the synthesis of vitamin D and other hormones. (4)

Our skin is our first line of defense against the outside world and external pathogens. Skin also protects against water loss and regulates our temperature by dilating and constricting blood vessels near the surface of the skin to control the transfer of heat outside of the body. Skin is a sensory organ detecting sensations of heat, cold, pressure, pleasure and pain. (5) The skin keeps essential fluids within the body and assists in the removal of waste products through sweat. Our skin has many functions but can also be prone to more than 3,000 skin conditions. (7)

It is a common misconception that looking after skin is only an external issue as truly healthy skin is achieved from the inside out.

“True Beauty comes from within”

The Ayurvedic approach to skin care recognizes that skin health is far from superficial but rather an expression of our internal and emotional health. If you

are experiencing any skin issues such as eczema, psoriasis, rashes, blotchiness or dull skin rather than focusing on topical treatments, internal imbalances need to be uncovered and corrected.

The Doshas

In modern science the human body begins with cells. A group of cells form the tissue, a group of tissues form the organ, a group of organs form systems and a group of systems is the human body. Ayurveda explains the human body in a different way. According to Ayurveda, there are three primary life forces derived from the five elements (air, either, water, fire, earth) that are responsible for all physical and psychological functions in the body and mind. These are known as the three doshas, vata, pitta and kapha. (2) Everyone is born with their unique mix of doshas (usually with one dominant dosha) called prakriti (constitution) which needs to be kept in balance to remain well and healthy. Our prakriti also influences the

quality and tendencies of our skin. (3)

Vata dominant prakriti types tend to have dry skin which may appear rough or chapped with cracks on the hands and feet being common. Vata skin tans easily but the circulation may be poor leading to pale lips, nail beds and skin. (3)

Pitta’s skin is characterized by heat so is prone to inflammation, rashes, acne, skin flushes and red looking skin. Pitta skin burns quickly in the sun. Pitta skin is usually combination/oily. (3)

Kapha skin can appear thick and oily and feel cool or clammy to the touch. The skin is often very smooth in appearance, may have large pores and appears healthier during dry and hot weather. (3)

Pitta resides in the skin and is responsible for the colour, texture and temperature of our skin as well as its lustre and glow. It also governs the process of sweating and processes everything that is externally applied to the skin (lotion, cream, oils, medications) or anything that passively comes in to contact with the

skin such as pollution, dust, allergens. The blood, the liver, and agni (digestive fire) all have a strong pitta presence and a direct impact on skin health. Excess pitta in any one of these areas can have an amplified effect on the skin. Keeping pitta systemically balanced supports healthy skin and will help prevent skin irritations from occurring. (6)

Importance of Agni (Digestive Fire)

In Ayurveda we are not what we eat, but what we are able to digest and absorb. If agni is weak then food cannot be properly digested and may ferment in the gut leading to the accumulation of ama (toxins). Weak agni will also prevent nourishment from food being extracted and absorbed. Ama can circulate within the body affecting the quality of the blood. In Ayurveda, the skin is considered to be the cream of the blood that rises to the surface. The foundation of good skin, therefore, is balanced blood chemistry. (2) Blood quality is a direct result of the

strength of agni. The stronger the agni, the cleaner the blood will be and in turn, the healthier the skin. The weaker the agni, the more ama will be present in the blood which increases the likelihood of inflamed skin, puffy skin, acne, dull skin and skin conditions. This is why, when looking to improve the skin, Ayurveda frequently looks to the digestive system first and uses blood purifying herbs. (7)

A healthy liver is also vital for good skin health as it is the primary organ of detoxification endlessly filtering and detoxifying the blood. The liver also plays a significant role in digestion and metabolism.(7)

Importance of Daily Elimination

In Ayurveda healthy daily elimination is passing at least one or two bowel motions daily. This is also a sign of strong agni. The bowel motion should be well formed, not be sticky and should only have a mild odor. Not passing a bowl motion daily means wastes are not being removed from the body and can be absorbed

in to the bloodstream contributing towards skin issues. Improving agni, staying hydrated and implementing stress management techniques will all aid regular bowl movements.

Daily sweating is also required to help the body remove waste. Often people suffering with skin conditions experience difficulties in sweating due to obstructions in the body’s fatty tissues. Practicing udvartana (see below) can help break down blockages in fatty tissue to help the body to sweat.

Emotions

The skin is deeply influenced by stress and emotions. Cortisol is a hormone that is produced when we are stressed. Prolonged stress can cause excessive amounts of cortisol which contributes to imbalances within the doshas and digestive system leading to inflammation and skin disorders. (3)

The liver processes and breaks down hormones and is responsible for the smooth flow of emotions. If it becomes overburdened with cortisol, adrenaline or other hormones then it’s ability to clean the blood is compromised and toxins can be pushed out through the skin causing rashes, inflammation and conditions such as eczema. (3)

How to Support Skin Health

If you are suffering from any skin condition, a qualified ayurvedic practitioner will be able to determine the underlying causes of your condition and devise a treatment plan to re-establish balance within the body and mind.

A generalized approach to healing skin conditions or obtaining glowing skin is to ensure digestion and elimination are functioning well, manage stress, process emotions, and keep pitta and your prakriti balanced.

Improving Agni & Elimination

• Eliminate ultra-processed foods such as packaged foods, readymade foods and foods high in white sugar

• Reduce caffeine, nicotine and alcohol

• Favor freshly cooked warm foods that are easy to digest

such as basmati rice, soups and stews

• Eat in a calm environment free of electronic gadgets or devices so you fully focus on your food

• Eat slowly and stop when 75% full to leave space for digestive juices

• Don’t eat until the previous meal has been digested

• Try to eat your largest meal at lunchtime when digestion is strongest

• Don’t eat late at night so food is digested before sleep

• Go for a short walk after eating to aid digestion

• Eat regularly and at the same time every day

• Include good fats such as ghee, coconut oil, sesame seed oil and olive oil

• Include digestive spices such as ginger, fennel, cumin, coriander and turmeric

• Reduce foods that irritate the skin like spicy (cayenne, chili), sour or acidic (lemon, pickles, fermented)

• Avoid cold drinks and sip on warm water throughout the day Managing Emotions and Stress

It is important to feel and acknowledge emotions so that they can be released and let go of. Emotions that fester or become stagnant will contribute to liver congestion. Practices such as meditation, yoga and mindfulness help to cool and quieten the mind, aid digestion, elimination and to balance the doshas.

Herbs for Skin Health

Ayurvedic and herbal medicines are customized to each individuals prakriti, imbalances and digestion. It is always best to seek advice from a qualified practitioner who can select the correct herbs and dosages.

Neem (Azadirachta indica)

Neem is one of the best detoxifying herbs that is used in Ayurveda that is excellent for combating heat and inflammatory conditions. Its bitter taste stimulates the appetite and digestion, increases the flow of bile, enhances liver function, purifies the blood and destroys toxins. Neem pacifies pitta and kapha but can aggravate vata unless it is

combined with other herbs to offset this. (8) Manjishta (Rubia cordifolia)

Manjishta is one of the best pitta reducing, detoxifying herbs. It clears heat and ama from the blood. It is excellent for stubborn skin problems. It helps to improve appetite, digestion and supports the liver. (8)

Sandalwood (Santanlum album

Sandalwood has a cooling and calming effect on the mind and body. It relives pitta and is used for many skin conditions or for glowing skin. (8)

Gotu kola (Centella asiatica)

Gotu kola helps the skins natural ability to heal while pacifying all three doshas. It improves circulation, is detoxifying and anti-inflammatory. (8)

Aloe vera ((Kumari)

The gel from inside the inner leaf has a cooling and soothing action within the body. It is good for excess pitta in the blood and for inflammatory conditions. It’s an excellent bitter tonic for the liver and digestive system. Aloe can also be used topically for allergic and inflammatory skin conditions. It can heal burns, rejuvenate skin and reduce wrinkles. (8)

Self-Care Practices for Skin Health Abhyanga (Self Oil Massage)

Abhyanga is the practice of massaging the whole body with warm oil. It is very nourishing for the nervous system helping to relax the body and mind. Abhyanga helps to improve circulation, counteract

the dryness of vata therefore reducing lines and wrinkles. It also helps to loosen toxins under the skin encouraging them to flow in to the digestive tract to be eliminated through the bowel.

Abhyanga is best performed with sesame seed oil. Coconut oil is cooling so can be used if pitta is high or in the summer. For the face rose hip oil, jojoba oil, Bakuchi oil and carrot seed oil are good.

How to do Abhyanga

• Select the oil according to your prakriti, in case if you don’t know your prakriti then sesame oil is best for everyone as it balances all dosha

• Make sure that oil is warm, sit on a stool or comfortable seating and take some oil on your palm and apply it to the scalp using your fingers. Massage the head with gentle circular strokes

• Now apply oil to the ear and face gently and continue the massage for few minutes

• Massage on to your chest and limbs use long strokes for the limbs and circular for joints

• Massage your whole body with love and patience, it can help to relieve stress and tension

• Give extra attention to the head, ears, and foot

• R inse the oil off in a warm bath or shower

Oils for Prakriti

DOSHA OIL

Vata Sesame seed oil or almond oil

Pitta Sesame seed oil or Coconut oil Kapha Sesame seed oil

• Vata person: Abhyanga should be practiced daily and should be performed in a warm environment, sudden exposure to a cold environment should be avoided after practicing abhyanga

• Pitta person: Oils that are cooling in nature are preferred. The oil that is at room temperature should be used in the summer season and slightly warm oil during winters

• Kapha person: The amount of oil used should be less for Kapha person. Always warm the oil before applying it to the body

Abhyanga Dos

• Should be practiced by everyone every day

• Abhyanga is practiced especially during cold weather as it counteracts the drying effect of cold weather

• Select the oil based on season and any health condition/dosha imbalance

• Give special attention to the head, ear, and feet

• Be gentle and make sure the strokes that are slow and steady

• Let the oil soak in to allow the oil to be absorbed more deeply

• Take a warm bath after every abhyanga

Abhyanga Don’ts

Avoid this practice in case of:

• High fever

• Cardiac diseases

• Skin diseases

• Acute inflammation

• Open wound

• Recent fractures

• One should not practice abhyanga after having a meal or in case of severe indigestion

• Avoid during the menstrual cycle as it can create a weakened state of the body

Udvartana

Udvartana is the practice of rubbing the body with a herbal powder such as triphala or chick pea flour. It helps to liquify fat for removal from the body. Stimulate the lymphatic system, balances both kapha and pitta, further encourages detoxification and circulation, and helps remove excess oil from the skin following abhyanga.

How to Perform Udvartana

• Start from the bottom of the feet to the top and use swift and vigorous movements.

• Triphala powder is generally recommended for this, but a simple chick pea flour can also be used for the massage.

• Silk gloves or dry brush can be used in a person with oily skin and kapha imbalances

• Strokes are against the direction of hair growth and upward and towards heart from hands. Upwards and towards groins for legs. Circular strokes on stomach and breasts.

• Wash the powder off after the Udvartana and apply moisturizer on the skin to avoid dryness.

Avoid in case of:

• Dry skin

• Eczema

• Skin open wounds

• While taking Medications that might irritate your skin

Kansa Wand

The Kansa wand is an ancient Ayurvedic tool known for its gift of stimulating lymphatic drainage, massaging away puffiness, invigorating the skin and stimulating marma (acupressure points) that balance and harmonize our mind, senses and the skin. It is made of bronze which has antibacterial and antimicrobial properties.

Using a Kansa Wand

• Take a little bit of facial oil on your face and apply all over your face.

• First step is to activate the marma points on the face by massaging them anti-clockwise three times

• Idea of face massage is to remove excess lymph and to improve blood circulation

• Lymph is like water and is based superficially under the skin so at any point, pressure should be minimal

Bibliography

1. 1. Hebbar D. Dhatu - 7 Body Tissues As Explained In Ayurveda. Easy Ayurveda. https:// www.easyayurveda.com/2013/07/22/dhatu7-body-tissues-as-explained-in-ayurveda/. Published 2018. Accessed October 16, 2022.

2. McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.

3. Smith, V., 2016. Anatomy and Physiology in Ayurveda Dietekon, Switzerland: EIVS Gmbh

4. Datta D, Madke B, Das A. Skin as an endocrine organ: A narrative review. Indian J Dermatol Venereol Leprol. 2022 Sep-Oct;88(5):590-597. doi: 10.25259/IJDVL_533_2021. PMID: 35389023.

5. Withalls C. The skin is a very important (and our largest) organ: what does it do?. The Conversation. https://theconversation. com/the-skin-is-a-very-important-andour-largest-organ-what-does-it-do-91515. Published 2018. Accessed October 16, 2022.

6. Mischke M. Soothe Your Skin Guide. Banyanbotanicals.com. https://www. banyanbotanicals.com/info/ayurvedicliving/living-ayurveda/health-guides/ soothe-your-skin-guide/. Published 2021. Accessed October 13, 2022.

7. SKIN HEALTH - Joyful Belly School of Ayurveda. Joyfulbelly.com. https://www. joyfulbelly.com/Ayurveda/symptoms/ Skin. Accessed October 19, 2022.

8. McIntyre, A., 2012. The Ayurveda bible. Alresford: Godsfield.

SIOBHAN COSGRAVE is a qualified Ayurveda Consultant (diet, lifestyle and herbs). Ayurveda (traditional Indian medicine) is the oldest health science in the world. Siobhan is drawn to its principles of living in harmony with nature and how health is achieved through establishing balance between the body, mind and spirit. https://siobhancosgrave.com/

hrs) at www.kingsmoorclinic.co.ukwww.aosm.co.uk

Professional v Poorfessional Where do you fit in?

BY PAULINE BAXTER

Pre-Covid-19 pandemic, the massage industry as a whole was thriving, with corporate massage (Seated Acupressure - SAM, or On Site Massage) becoming very popular. There were many highly qualified and experienced practitioners offering a valuable service, with a lot of companies recognising the benefits of massage for the health and wellbeing of their employees. Then suddenly, the ‘rug was pulled from under our feet’ as Covid-19 arrived on the scene. Bang. Just like that, the world came to a grinding halt.

uring the first lockdown in 2020, all hands on complementary therapy ceased, as did hands on training. Very quickly, there was an influx of online massage training courses. The nature of massage is that it is ‘hands on’ and so by definition, you cannot carry out hands on training over the internet. Whilst I agree that for massage, there is a certain amount of theory training that can be completed online via Zoom or similar, the physical, hands on, in-person training is absolutely essential.

D

Students need to understand and experience how SAM feels as a whole from a client’s perspective from start to finish. This includes the ‘meet and greet’, health consultation, chair set up, the massage itself (initial contact, individual techniques and their application , specific point locations, quality of touch, empathy with the client etc), post massage advice and aftercare.

From the perspective of giving massage, students need to learn the techniques individually first, in order to understand and experience the ‘how, where and why’, both from theirs and the client’s perspective. It does not make sense for a student to learn from only their own perspective if it is not going to be safe and effective for their client. Similarly, it does not make sense to only consider their client’s perspective if, in the process, they are going to cause themselves an injury.

Worryingly, others do not feel the same way and they offer online massage training/qualifications and in some cases, use only videos and pdf’s as their training medium. Yet somehow, the student can end up with a certificate that allows them to take up insurance and be let loose on the unsuspecting public.

This is a definite case of ‘Poorfessional’ rather than Professional, which is quite scary, and even potentially dangerous to both client and practitioner.

Now, almost three years down the line, the world continues to adapt and emerge from the impact of the Covid-19 pandemic, only to find a number of other challenges growing rapidly. These challenges are having, or will have, considerable impact on the world as we knew it.

point etc. Without doubt, it makes sense to look at your corporate massage pricing, particularly as the cost of travel and supplies increases. But there is another meaning to RRP and that is;

Review Refresh Professional

In terms of SAM and your business, a review is something you would have done in-depth back in 2020 and are likely still doing now, though perhaps

room ventilation between all clients and carrying out a suitable consultation/health questionnaire. It has been suggested that some practitioners are ‘cutting corners’ and not completing these tasks as they should in an effort to get more clients through the door as quickly as possible.

With regard to Seated Acupressure (SAM) or On Site Massage, let’s consider how changes in the corporate world over the last two to three years have affected the way in which we, as corporate massage practitioners, now work.

SAM is generally used as a corporate massage service and provides welcome relief for tense necks, backs and shoulders; something of which there are plenty, and in particular as a result of the hybrid form of working between home and office. How many people have the correct desk set up at home (if they even have a desk!)? In the office, many companies have reduced the physical size of the office and have turned to hot-desking. Invariably, this means the desk set up is not assessed and set up specifically for individuals.

Just as many businesses have had to learn to adapt the way in which they work, the same applies to the complementary therapy industry as a whole. But, there is a difference between adaptation and sacrifice. Put very simply, being able to adapt means being able to adjust/ accommodate/modify. Having to sacrifice means having to surrender/relinquish/ give up. In both cases, the change has the potential to be good and/or bad, depending on the situation and interpretation.

This brings me to the term, corporate RRP. You may think of RRP as an abbreviation for recommended retail price, though it can be an abbreviation of other terms e.g. roasted red pepper, remote radar post, runway reference

on a slightly smaller scale. This would have included looking at the services you previously offered, what alternatives you may have considered, including retraining in something completely different, or adding additional skills and qualifications that do not depend on in-person contact, but which remain in the complementary therapy industry.

If you chose to return to SAM once the relevant regulatory bodies gave the go- ahead with their guidance, did you refresh your skills? This could have been completed in more than one way but should definitely have included you giving and receiving SAM, whilst incorporating any adaptations to the massage you introduced and helping you provide a safe, efficient, hygienic, effective, and professional, corporate massage. Perhaps you attended a refresher training course to help fine tune your skills, once in-person training was allowed.

Having completed the first two points (RR), it brings us to the third point (P).

This is very important and worryingly, for some massage practitioners (whether deliberate or not), their services have become tinged with a little lack of thought and preparation, poor techniques/quality of massage, inadequate training, all of which can contribute to a reduction in or lack of, professionalism.

The practicalities of providing corporate massage need to be efficient, thorough, and hygienic at all times. This includes cleaning equipment and

Exhibitions are returning and you will often see SAM offered on some of the stands. Having been to some exhibitions recently, one situation in particular comes to mind. There appeared to be no health consultation, the chair was not adjusted to ensure the comfort of the client and as for the massage itself, the quality was poor. The practitioner seemed intent on providing strong, rapid, and unsympathetic contact, resulting in the client ‘bouncing’ backwards and forwards. I doubt it was particularly helpful to or pleasant for the client, the practitioner or even the chair. This may well have been an extreme example, BUT it can have quite an impact on all three and it also doesn’t show the complementary therapy industry in the best light.

Here at Academy of On Site Massage we decided to take a lengthy teaching break at the onset of Covid-19 in 2020. Although not yet back to teaching, we do practice what we preach and regularly apply our own RRP. With that in mind, we hope to be back to hands on training from April, albeit in a slightly different format.

PAULINE BAXTER

A 10 year background in Health & Fitness Club Management laid the foundation for Pauline’s venture into the world of complementary therapies. Over 22 years later, that journey has been, and continues to be exciting, rewarding and ever-evolving.

Notable events include becoming a tutor for Academy of On Site Massage (AOSM) in 2000, director and owner of AOSM in 2006, a regular contributor to industry magazines since 2010, development and growth of additional On Site Massage training, and a judge at the National Massage Championships in 2018 & 2019.

www.aosm.co.uk

The practicalities of providing corporate massage need to be efficient, thorough, and hygienic at all times.

Danny Jensen

BY MADELAINE WINZER

After a brief encounter at the National Massage Championships here in London, it was great to catch up with Danny Jensen via Zoom before he jetted off to compete in the Romanian National Massage Championship.

After being presented with a lifealtering back injury, Danny tried and tested various methods to improve his physical condition, however, he had little success in finding a solution. That was until he came across cupping - a form of alternative medicine that is currently trending in the wellness industry and dates back to Chinese, Egyptian and Middle Eastern cultures. It brings oxygen to certain areas of the body which in turn reduces tension and inflammation, helps with blood flow and relaxation, and enhances qi flow throughout the body. For Danny, it was the first session of cupping that significantly reduced the pain he was experiencing; he was able to stand up straight for the first time without pain and move with more fluidity. After this first session of cupping, Danny was intrigued by the cupping process and continued receiving cupping while

also embarking on some courses at Cupping.dk led by Bo Stentoft and Tengbjerg School of Massage. The skills and techniques he learnt during his studies enabled him to work as a therapist where he now treats his own clients. His background in dance also helps him as a therapist as bodily awareness and flow are essential during a treatment. The passion Danny has for massage is reflected in his ongoing contribution to the industry where he travels to various countries to compete in competitions where he can showcase his talent. He has won medals at various National Massage Championships and a silver medal in the chair category at the World Massage Championship held in Copenhagen in June 2022.

He is thankful for the sponsorship he received to compete in the UK National Massage Championship at Olympia, London from Joe Lavin, the Founder of Touch Factor Massage as it has given him the opportunity to meet like-minded

people with who he can exchange ideas and build lifelong friendships with. For Danny, collaborating with others is the most enjoyable aspect of competing as he believes in the importance of educating others on the benefits massage can provide to help people live a more vibrant life. Danny is looking forward to what 2023 has in store!

“Danny Jensen is my former student. I know him as very talented and innovative in his massage treatments. He won 2 medals at the Danish Championships in 2022, as well as medals at both the Baltic Massage Championships in Lithuania and at the Intercontinental Championships in Greece. I am very proud of him.”

Jeppe Tengbjerg, the Founder and CEO of The International Massage Association

Enter the National Massage Championship UK 2023 here www.olympiabeauty.co.uk/thenmc-2023/

“Collaborating with others is the most enjoyable aspect of competing”

To Join or Not to Join a Professional Association –Is That the Question?

Towards a greater appreciation of the meaning of

membership

BY EARLE ABRAHAMSON

The past three years have been fraught with difficulty, challenge, and opportunity. Covid has taught us to reflect and connect in new ways. It taught us to ask different questions and encouraged co-operation. Whilst the ill-effects of the pandemic crisis took centre stage, a more direct concern was emerging. This concern stemmed from observing changes to practice but equally from answers to questions around entitlement and regulation of practice. Whilst we acknowledge the past, we must work together to shape the future of our practice and industry.

The soft tissue industry has rapidly evolved to incorporate a range of practices and philosophies. These diverse practices and philosophies can be troublesome, not in the way they are designed, but how they are perceived and regulated. At present there is growing debate around regulating this largely unregulated industry. There is a

move to revisit and reframe educational and practice standards. A clarion call to protect those who give, and those who receive, massage therapy. A recent channel 4 documentary exposed the darker side of massage and soft tissue therapy practice. The documentary reported on how practitioners prey on clients and use the industry for criminal activity. Although many of the reported incidences appear

isolated and disconnected, there is still significant concern over the number of reported cases and consequences within and beyond the industry. During the documentary, questions were raised around who gets to practice and how the industry operates.

As chair of the General Council for Massage Therapies (GCMT), I am tasked with connecting and representing our industry professionally and ethically. Central to the council’s work are the key relationships it holds with professional associations. A professional association (PA), commonly referred to as a professional body (PB) or in some circumstances, professional, statutory, and regulatory bodies (PSRBs) although this classification is reserved for organisations who play a regulatory role within a profession, is a member organisation responsible for guiding, supporting, and representing its membership.

The GCMT in its efforts to define key terms and concepts argues that a professional association is concerned with connecting individuals within a common profession. In doing so the PA provides an infrastructure for practice and has set rules and regulations to

Joining a reputable professional association (PA) is highly recommended as it ensures support and guidance as you progress through your professional career. It is also your go to place for expanding your knowledge and skills with approved and accredited CPD courses in the field of health and wellbeing. The PA often works with subject matter experts, councils and governing bodies to bring you the latest guidance on modalities and information pertinent to your industry.”

Kush Kumar, Think Tree Hub

which all members must abide. These include, but are not limited to, codes of practice or conduct, professional practice etiquettes, minimum standards of education, and a requirement to continue learning through continued professional development (CPD).

To enable and support members in becoming lifelong learners, many PAs host annual conferences that provide their membership with a focus and discussion around current topics within, and beyond, the industry. PAs are generally governed by an elected board who decide on key strategies to enhance the operation of the PA.

Should we, as an industry, encourage practitioners to join Pas, and if so, how best do we support PAs in representing their members and promoting the industry?

This article aims to provide some critical insight into the benefits of joining a PA, and why membership

of a PA is considered an important professional and developmental move. It attempts to do so, by presenting an overview of the soft tissue industry and a summary of key and current debates relevant to joining and leading professional associations.

As emphasised above, the pandemic crises forced the industry into new ways of working. These often involved adjusting to on-line consultation with minimal physical contact. During the height of the pandemic, many members of PAs grew increasingly concerned over lack of earning, support, and clear communication around future developments. These uncertainties signalled changes within PAs and conceptual benefits of being a member of a PA. Taken in isolation, each PA, had to balance current vs future development and work to rethink and reshape how best to communicate messages of support and purpose.

Globally, however, there was a much greater move for many practitioners (especially those dispersed from their country such as Ukraine), to find a home and re-establish their practice within a foreign land. The need to practice and earn outstripped the need to join a PA and an established community of practice and support.

Within the UK there is currently no statutory requirement for practitioners to join a PA. In fact modes and method of practice differ significantly and so do training courses. Without definitive guidance on practice and protection there appears to be multiple loopholes that serve to confuse and retard the growth within the industry. Despite the fact that regulation is vague, many practitioners choose to join, and often lead a PA, as they recognise the collective importance in being part of a professional community of practice.

Human evolution reveals that humans are social beings. We construct identities and purpose by working with others. There is a need for us to be part of a group and develop our practices, our influence, and our futures, collaboratively. PAs are important places for practitioners to shape their philosophies, connect with colleagues and influence policy and practice. By being a member of a PA, we give voice to our cause and recognise that strength in numbers can lead to change. Amanda Gorman, poet laureate, summarises this in her poem “the hill we climb”.

She argues ‘It is not what lies between us that matters, but rather what lies in front of us.’ The juxtaposition of poetic verse and purpose serves to recognise the influence of union when individuals design together their future objectives. This in a nutshell is the purpose of a PA.

The question is not simply whether to join a PA or not, but rather which PA is best to join. Here the decision to join is bypassed by carefully and strategically considering which PA is best to join. It is important to research each PA, scrutinise the code of conduct and make a decision based on evidence and facts. Consider how being a member of a PA adds value to your practice, but equally how your philosophy of practice, expertise and experience align with the constitution of the PA. Table 1 below, (The list below) [if writing this as a list instead of a table] taken from the GCMT guide to benefits of joining a PA, identifies key considerations when deciding to join a PA. Please note that not all PAs offer these benefits, therefore careful consideration of benefits is critical in formulating opinions about joining a PA.

Benefits of membership

Enhanced credibility and confidence for clients. This could be illustrated through the use of the PA logo. If the PA is an affiliate member of the GCMT for example, this could provide further reassurance that you are a member of a PA that protects standards and works actively to uphold these standards in practice and education.

Provides

networking opportunities

Employment opportunities

Organises and curates professional development opportunities

Offers insurance coverage

Access to professional advice in case of dispute

Marketing and directory listings –promotes your business and work – this may be through free website space on the PAs website

Negotiated discounts for industry products

Subscription to industry publications

Opportunities to contribute to industry publications

The massage industry uses its PAs to support collective campaigns and align difference with commonalities. Working within the soft tissue industry is rewarding but equally challenging. It is important for practitioners to carefully consider their individual and collective role in not only pursuing their field of practice and expertise, but equally using their expertise

to shape necessary changes for the future. Perhaps one way of working smartly is to rethink and reimagine the questions we ought to ask to fully understand the issues we face and will continue to face as we become the instruments for change.

MTI. Together with Jane Langston he has authored two texts on anatomy and muscle testing. Earle is a practising musculoskeletal clinician. He has worked at major sports events including London 2012 Olympics and Paralympics, 2017 World Athletics Championships and the Birmingham 2022 Commonwealth Games.

What does membership of a PA offer and why is being a member important?

EARLE ABRAHAMSON is an Associate Professor in Learning and Teaching at the University of Hertfordshire, National Teaching Fellow, Principal Fellow of Advance HE and inaugural ISSOTL fellow. He is an internationally published author, scholar, registered therapist and psychologist. Born and raised in Johannesburg, South Africa, Earle gained qualifications and expertise in sport science and sports therapy, clinical psychology and educational practices. He is a registrant board member on the CNHC, and former course leader for sports therapy at the University of East London and chair of the

FREE Brochure + Colour Swatch set to help with their decision. Futon Pacifika have increased their Standard Range and can now offer Extra Long Futons (@ 240cm the increase in Platform length enables work on Head / Feet while on the Futon with the Client - replacing the need for an extension)... Futons can also now be manufactured using fully Vegan materials.

“Thank

for excellent training, I thoroughly enjoyed

courselistings

all aspects of the course and the LIM benefits. You are an inspirational teacher.” Please see more details on our website.

T: 07599 985648

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: ◆ Massage for Womens' Health

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:

◆ Experience the wisdom and paradise of Hawaii through guided visualization

◆ Receive 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:

Massage and Pregnancy

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.

V isceral Massage

Details: Contact us for course dates.

Acupressure for Facial Release

C upping Therapy

C hair Massage

T: 01373 461812

Oncology Massage with Susan Findlay

◆ 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

◆ Advance your bodywork to new levels of depth and connection

Autumn: Oct 10*– 13, Nov 07–10, Dec 05 – 08 INTENSIVE Three Modules of 4 days with one day off between each.

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

Myofascial Release with Ruth Duncan

A lleviating Headaches

Deep Tissue Massage

Heat as Medicine

B alinese Massage

Prenatal Massage Training

Hot Stones

Advanced Hands Free Massage

Eastern Foot Massage

I ntro to Remedial and Sports 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.

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

Details: Courses are run throughout the year. 1 Day Course with pre-course study £160 + vat T: 01782 285545 or 01782 639777

Acupuncture and dry needling foundation course

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

Looking for another tool to your toolbox, or another string to your bow?

Your clients are looking for acupuncture and dry needling, and we can train you to become safe, confident and effective in needling skills.

Gladwell School of Massage

Breeze Academy are the UK’s leading Needling education provider.

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.

Our courses are triple-locked quality assured, and consistently rated 5-star – a unique blend of online and faceto-face teaching, meaning less time away from home and work, and less cost!

The face-to-face workshops are fun, practical and engaging, meaning that you’ll be able to apply your learning into practice immediately.

E: breeze.academy/locations/acupuncturecourse-locations

www.gladwellschoolofmassage.com

W: enquiries@breeze.academy

Sports Massage

Take your Sports Massage skills to the next level, and gain your level 4 qualification in Sports Massage Therapy.

Offer way more to your clients, through detailed assessment skills, advanced massage techniques, which you can apply to common musculoskeletal injuries.

Our courses are fun, interactive, and delivered by experienced tutors who have your learning experience at the heart of every course.

Not only is the Sports Therapy industry moving towards Level 4 as the standard qualification, a Breeze Academy level 4 Sports Massage course provides eligibility to our acupuncture and dry needling courses.

E: breeze.academy/locations/sportsmassage-course-locations

T: enquiries@breeze.academy

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

McTimoney College of Chiropractic

2023

February 4, February 16, July 13, October 7, October 12 2024 March 14, April 20, July 18, October 10

T: 01273 730508

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

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.

RockBlades Education Instrument Assisted Soft Tissue Mobilisation (IASTM)

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.

‘I always wanted to be a chiropractor – I just never knew it would be this good!’

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

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

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

T: 01206 615464