Massage Matters, Spring 2013 by David DeWitt

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Slide Matters: Interview with Antonio Stecco, MD Beth Sampson, RMT of the Year Volunteering in Vietnam

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President’s Message

Massage Therapists’ Association of British Columbia

Massage Matters A Journal for Registered Massage Therapists

Please direct your comments to dave@massagetherapy.bc.ca, subject heading “Letters,” where they will be forwarded to the MTABC Board for review. Editor in Chief David DeWitt Editor Lori Henry Published by: BIV Media Group 102 East 4th Avenue, Vancouver, British Columbia V5T 1G2 Tel: 604-688-2328 Sales Victoria Chapman 604-741-4189 vchapman@biv.com Design Soraya Romao Editorial Board Bodhi Haraldsson Brenda Locke Dee Willock Damon Marchand Michael Reoch Mission Statement This publication is intended to provide a voice to BC’s Registered Massage Therapists, a source for the latest research and a vehicle for the general population to understand and respect the valuable work of our RMTs. Massage Matters is published three times a year for Registered Massage Therapists. Funding is provided from the MTABC and advertising revenues. Massage Therapists’ Association – MTABC 180 - 1200 West 73rd Avenue Vancouver, British Columbia V6P 6G5 Tel: 604-873-4467 Fax: 604-873-6211 Toll Free: 1-888-413-4467 Email: mta@massagetherapy.bc.ca

ommunication, as we all know, is a two-way street. It’s something that we, as RMTs, practice every day with every patient. We ask questions, we assess, we share our findings and we help the patient to move forward, to get better, and to change something about their life.  But what happens when that communication isn’t between two people but is instead between a person or group of people, and their professional association? In my mind, it’s still a two-way street. As members of MTABC, we have an expectation about the quality, frequency and helpfulness of communication we receive from our association. The association demonstrates its commitment to the membership several different ways; and in almost every instance, proof of that commitment can be found online on our own web site (massagetherapy.bc.ca). The association works in R&D, gleaning from leaders in the field, and then sharing the results through magazine supplements and news releases. It produces a magazine featuring topics of interest to RMTs, scientific findings and educational and employment opportunities. The MTABC connects with student and graduating RMTs, making them feel welcome but also providing a wealth of information they will need, ranging from business tips to practice standards. Someone from the office attends almost every graduation ceremony, all on your behalf. There’s also Continuing Education (CE); courses the MTABC sponsors and endorses, and other opportunities as well. Often, the MTABC can step in and assist with special events, like organizing the 2012 World Congress Fascia, or it can do something on a smaller scale, like providing access to web-based courses. Importantly, the association also does a tremendous amount of work lobbying for our collective best interests, with insurance companies, governments, other provinces, schools, and even our own College. It isn’t glamorous. There are Board and committee meetings to attend. There are letters to write, and issues to pursue; all with the same objective of furthering our knowledge, our professionalism and our public reach. But what about the other side of the street? How can individual RMTs or even groups of RMTs (at a clinic, in a geographic region, as part of a special interest group) demonstrate their own commitment to increasing the quality and frequency of communicating with the association? It’s an interesting question; I often hear RMTs ask what the association is doing about one issue or another, but much more infrequently hear them ask,‘what can I do to help the association?’ There is always committee work to be done, and if you have the skills to contribute at that level, please let us know who you are and in what areas you can help. Are you qualified to lead a course or teach a workshop? Can you help with outreach, speaking to community groups or students about “registered” massage therapy? Maybe political lobbying interests you but you want some help with how to deliver a well-crafted message? The association can do that. Maybe you are already making a unique contribution in relative anonymity. Why not let us know what you are doing and how it is making a difference? We’d like to share best practices and success stories. At the end of the day, we are all together in this—the RMT profession, the MTABC and the world of health care. None of us can do it alone and we are doing everything we can to help support individual practitioners while promoting the profession. It’s honourable, time-consuming and, oftentimes, fun work. Come join us. Damon Marchand, President

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contents in this issue: Cover: Slide Matters

Volunteering in Vietnam

RMT of the Year

BC Services Card

Research Librarian

15 Interview with Antonio Stecco by Cathy Ryan

Volunteering in Vietnam 5

RMT of the Year

by Lori Henry

Research Librarian 12

by Kristina Oldenburg

Primary points for Fascia Manipulation. Photo Credit: Adapted from an iStock photo

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Slide Matters

And Other Fascial Significant Paradigm Shifting Considerations Interview with Antonio Stecco, MD, on the Fascial Manipulation courses by Cathy Ryan RMT According to Hankinson & Hankinson (2012) Musculoskeletal Disorders are more prevalent than all chronic disease types, making musculoskeletal [soft-tissue] pain and dysfunction the most pervasive health affliction. Myofascial pain is estimated to be the most commonly experienced musculoskeletal pain (Srbely 2010). Meaning, that although the condition is often termed/diagnosed as musculoskeletal – fascia, this may be [at least in part] the pain generating tissue in such cases. 85% of patients receiving care at specialized pain management centres are experiencing myofascial pain (Gerwin 2001) and Myofascial pain syndrome (MPS - aka fibrositis and myofibrositis) is one of the most common disorders encountered by physicians in clinical practice (Rachlin 1994). Yet, given all of this, no standard, universally accepted biochemical, electro-diagnostic, diagnostic-imaging, or physical examination criteria exist for a diagnosis of MPS (Annaswamy et al. 2011) and therefore it is most often an under-diagnosed or misdiagnosed condition (Cummings 2007). Recovery following musculoskeletal injuries has traditionally focused on restoration of strength [muscular force generation and tendon/ligament tensile capabilities] and joint range of motion. Until recently, little attention has been given to restoration of “glide” within the fascial system’s sliding mechanism, likely because up until recently little was known about the sliding mechanism. And indeed fascia in general, has been largely overlooked within the sphere of conventional diagnostics and treatment interventions. Throughout my massage therapy career, fascia has fascinated me, understandably

Antonio Stecco, PhD, Cheryl Megalos, PT, Julie Ann Day, PT, Angela MacKenzie, RMT, and Rodney Jackson, DC | photo: Julie Ann Day

Within the sphere of manual therapy and musculoskeletal pain and dysfunction, the far-reaching and collective value of the work of the Stecco’s cannot be over-emphasized. Their work is revolutionary and paradigm shifting. The MTABC is the official Canadian sponsor of the Fascial Manipulation courses. We are fortunate to have an association who recognizes the importance of this work and makes it possible for their members to have access to such innovative, evidential excellence. The 1st Canadian Level I course (held in November 2012) was a huge success. A second Level I is scheduled for April 2013 with subsequent Level II courses to follow in the fall of 2013 and spring of 2014. For more information contact the MTABC or visit the Fascial Manipulation website at: http://www.fascialmanipulation.com/en/ On a final note: I would like to acknowledge and offer a personal thank you to Harriet Hall for her instrumental role in encouraging the MTABC to sponsor the FRC3 and in bringing the FM courses to Canada.

a career highlight has been attending the Fascia Research Congresses (FRCs). Dr. Antonio Stecco’s presentation at the 1st FRC was a principal accelerant for my fascial obsession that has exponentially heightened since then. A Stecco FRC3 highlight was the fascial system’s

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sliding mechanism. In the human body, available movement and coordination of movement involves more than “the joint(s)” and the central nervous system. Although traditionally,“synchronisation

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of movement was exclusively attributed to the nervous system components, at a certain point, neurophysiologists began to question how the brain alone was able to control all of the variables involved in a motor gestures. The control of movements in the periphery had to be more complex than initially thought” (L. Stecco). Glide between the interfascial planes, endofascial fibers, endomuscular fibers all factor into movement potential and any impediment in the gliding of the fascia could impact available movement and alter afferent input resulting in incoherent movement. A primary aim of Fascial Manipulation (FM) [aka: the Stecco Method] is to restore unimpeded gliding within the fascial system’s sliding mechanism. We will explore this topic with renowned fascia expert, Dr. Antonio Stecco.

Hypothetical function of the Fascial Manipulation technique. (HA: hyaluronic acid; cal: heat)

Hello Dr. Stecco, thank you for taking the time to speak with us and welcome to Massage Matters Canada. AS: Thank you for inviting me.

CR: Dr. Stecco, can you provide us with a general anatomical/physiological overview of the deep fascia (DF) and the fascial system’s

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Volunteering

Volunteering in Vietnam The adventures of RMTs in the Far East

by Lori Henry, Editor Anne Horng, RMT sits with Hien, a four year old girl with a brain injury (and possible Cerebral Palsy) at Nuoc Ngot Orphanage in Phu Loc, Vietnam, trying to coax the girl’s little back to stop spasming. She finally repositions the girl and the spasms decrease. “It’s just hips and flexion,” says Anne about the incident after she returns home to Vancouver. “If you just lift her knees and bend them to support her back, so her back is flatter against the floor, she won’t go into spasm as much. So the mom can just put a pillow underneath her knees or put her legs up on something and [her daughter] will have less spasms.” Anne was on a volunteer trip to Vietnam with the Liddle Kidz Foundation. The notfor-profit American organization “uses the power of touch to reach the world’s most vulnerable children.” She spent 15 days travelling throughout the country visiting orphanages where they taught caregivers how to use touch to improve early development and provide children with oneon-one contact. She had no idea her 12-year career as an RMT would lead her to this kind of work. Anne is now the Supervisor for the outreach program at Canuck Place Children’s Hospice, where students treat the staff, volunteers and family of the children in the program. The goal is to eventually have the children also receive massage therapy. “I have always admired people who donate their time to share their specialized skills, but I didn’t know that there would be opportunities like this for RMTs. When I first graduated, I was so focused on building my practice, I’m embarrassed to say that I didn’t consider how I could contribute to the local

Anne Horng, RMT & Jane Abbott, RMT are working with two boys with HIV at the Social Support Center #2 in Ba Vi (Ha Noi) | photo: Joanne Allen

or global community. I hope that my work with Canuck Place will change that.” Anne’s colleague Jane Abbott, RMT realized a lot earlier on that she wanted to do unpaid work. After leaving her career in corporate finance, Jane knew she wanted to transition into a new occupation that would allow her more flexibility, time to travel, as well as the opportunity to volunteer. Jane Abbot stumbled upon Liddle Kidz Foundation while searching for continuing education courses specifically to work with children. Liddle Kidz founder Tina Allen offers training sessions all over the United States, as well as Vancouver. She teaches

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massage therapists (and others in the health care field) how to use their skills. Ms. Allen’s website states their mission as, “to provide massage therapy to children with special health care needs, who are hospitalized or have been diagnosed with a terminal illness in hospice care.” Unfortunately, Tina’s training session in Vancouver had finished about two weeks before Jane began her search. But Jane noticed a post on the website about volunteering in Vietnam, a country she had fallen in love with on a trip there three years earlier. Perhaps this was the exact

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sliding mechanism? AS: Throughout much of the body the DF is a multi-layer presentation consisting of 2-3 layers of dense connective tissue (CT) and 1-2 layers of loose CT (e.g. fascia lata, brachial, & antebrachial fascia). A loose CT layer is also often present between the deepest most layer of the DF and the underlying layer of epimysium. The dense layers are constructed of parallel bundles of collagen fibers (type I & III). In the loose layers we find collagen, adipose cells, glycosaminoglycans (GAGs) and a rich supply of Hyaluronan (HA). The dense layers transmit force and the loose layers augment gliding/slide between the layers [i.e. constitute the sliding mechanism]. CR: Can you provide us with a general pathophysiolgical overview? What goes wrong and why? AS: Pathophysiological processes [within the sliding layer] are not completely understood. Current hypotheses suggest that increased resistance within the sliding layer — likely due to changes in viscosity — warrants valid consideration.

The first class of Fascia Fitness sitting for the camera | photo: Julie Ann Day

It is known that ground substance (GS) can change its viscosity and that HA, a component of GS, plays a significant role in viscosity changes. HA is a primary component of the loose CT/sliding layer. Mechanical stimulation (e.g. exercise, movement) triggers increased production of HA in the various sliding layers. If overstimulation of abnormally high volumes of HA occurs, HA will tend to aggregate a transformation into a super-molecular structure that changes its ‘normal’ configuration. Aggregation results in increased viscosity, which in turn increases friction or resistance in the sliding layer. Another consideration is that a shift in pH toward acidity tends to instigate HA aggregation as well (e.g. 6.6 - 6.9 pH; possibly

associated with an increase in lactic acid following hard exercise or overuse). CR: What types of impairment/ dysfunction can be attributed to ‘slide mechanism’ interference or dysfunction? What might the patient experience? AS: As the sliding mechanism plays a significant role in movement potential; conversely interference with sliding can impact available range of motion (ROM), so a patient might present with movement difficulties (e.g. quantity and quality of available movement, stiffness). Additionally, slide/glide resistance incites friction, which in turn can provoke neural hyperstimulation (irritation). Neural-irritation can lead to hypersensitization of mechano and nociceptors and as

such correlates with a patient’s experience of pain, allodynia, paresthesia and abnormal proprioception and subsequently altered movement/postural patterns. Generally speaking, pain is the most common reason for a patient to seek treatment and pain can occur with or without ROM limitations/difficulties. CR: Regarding glide interference, what kind of observations/ indicators might the clinician note? AS: The patient’s account of pain — location and referral pattern — is a key indicator: this is furthered by palpation and movement verification. In the FM model specific localized areas — approximately a 1 inch segment — of densification increased viscosity and fibrosis correlate with the patient’s pain presentation – however, the sites of densification are not located at the site of pain. From a biomechanical point of view, these specific points — referred to in FM as centre’s of coordination (CC), centre’s of fusion (CF) — are of greater significance than say that of adjacent or other areas within Continued on page 10

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opportunity she was looking for. “I remember reading the posting initially and thinking, ‘I wish I was the kind of person that did these things. Wait a minute, I can be one of the people that does these things, and that’s what I’ve been working towards!’ ” Jane remembers with a laugh. And off she went, where she connected with Anne Horng and a group of volunteers who would spend 15 days travelling throughout Vietnam to provide training and massage services to orphans and their caregivers. They would arrive at about 9:00 am and Tina Allen would run a

demonstration class in which the volunteers partnered up with caregivers. The volunteers mostly did basic massages for each body part, following a book Tina uses that has pictures and is translated into Vietnamese. These books were given to the orphanages, as well as caregivers and parents who travelled to take part in the training. They could take the books back to their community to share the simple massage techniques. The volunteer group would work this way until lunchtime and then in the afternoon,

would work directly with the children. Anne says that they would “usually try to seek out any kids with disabilities. Typically the kids with severe disabilities aren’t out of their beds and in the common areas, so we would go and try to find them. They were often the ones who needed our attention a bit more.” If the older kids were in school during the morning class, the volunteers would work with them in the afternoon. Often volunteers played games that demonstrated nurturing touch as a way to interact with each

other, as well as teach the younger children. “If you just go in and massage kids for one or two days at one facility,” says Anne, “it’s great, it’s useful, but it’s not going to give you a long lasting legacy of any sort. I think that’s a really big thing about Tina’s outreach. “Think long term: How is this going to help them? The best part was that a lot of the older kids wanted to learn, they wanted to do it for the younger kids. So you’ve got, not just the caregivers, but also the older kids involved. It was really wonderful to see.”

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the sliding layer. It is the clinician’s palpation of resistance to glide/ slide and the patient’s notable increase in CC/CF point tenderness that denotes a malfunctioning/ densified CC or CF. The FM model movement assessment differs from traditional ROM testing – this model takes into consideration myokinetic chain/ sequences of movement. To recap, location of the patient’s pain, observable movement limitations and the clinician’s verification of painful points are the key diagnostic indicators of interference/dysfunction within the sliding layers. CR: The advancement in Massage/Manual Therapy research is being aided by various imaging and measurement tools that can be used to identify biomarkers and denote differences in normal\abnormal tissue presentations, and thereby track pre\post treatment changes. What kind of imaging/ diagnostic tools are you currently using in practice and research, and what are some significant pre/ post FM treatment changes you are seeing? AS: Ultrasound is one commonly used diagnostic tool in practice and research. Changes in viscosity/tissue thickness can be viewed via ultrasound in some regions of the body. The region of the SCM and Medial Scalene are one of the more ‘viewable’ areas and thicker than normal areas in the correlating DF can be seen in patients presenting with chronic neck pain. Subsequently, thickness changes following FM treatment can also be viewed. Ultrasound is also being used to

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look at glide/slide differences (e.g. Langevin’s research comparing LBP sufferers to a non-pain group). The use of ultrasound to view moving tissue still presents some limitations (e.g. complexity and expense of computer software, resolution quality and depth of the tissue). There is currently no ‘gold standard’ in this area of diagnostics and research. EMG, DynaPort and robotics (providing computer generated movement animations) are also being explored as means by which to better understand fascia’s biomechanical role, monitor/measure tissue changes, identify normal and abnormal presentations and denote changes post treatment. CR: On the topic of alignment: I am not an anti-structuralist, but I am not a predominantly structural-istic driven clinician [meaning, perfect alignment is the key to pain free functioning]. The scoliosis case that you shared at the Level I course in Vancouver last fall comes to mind. The X ray image you showed us was of a dramatic spinal deviation (87 degrees), yet following FM treatment your patient has been able to function by returning to work, resumption of activities of daily living and sport/recreational activities with significantly less pain. Dr. Stecco, how much did the actual curvature of her spine change post FM treatment? And from your perspective how imperative is ‘perfect’ alignment with regard to pain-free functioning? AS: There was no significant change in the degree of her

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scoliosis following treatment. Scoliosis [spinal deviation] is not necessarily correlated with pain. With this patient, there are three important components to look at: the scoliosis, hyperkyphosis and hyperlordosis. The impact of the spinal deviations essentially present as ‘overuse’ type syndromes in the paraspinal and other associated musculature’s sliding mechanism, which appears to be the predominant source of the presenting musculoskeletal pain and dysfunction. This patient still experiences some low back pain but not at the debilitating degree she experienced prior to

FM treatment (e.g. missing time at work, stopping all activity). Occasional use of paracetamol (mild analgesic) (2-3 times a month) manages her back pain well, while FM treatment 2-3 times a year effectively addresses her compensatory neck pain. Following treatment she experiences no neck pain between treatments and her episodes of neck pain are occurring less frequently and are quicker to resolve. CR: Regarding a couple of dosage considerations - Direction and Duration: CR: Are there specific direction

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Interview with Julie Day PT (FM Instructor and founding member of the FM Association) – Massage Matters Fall 2011 on page 18: https://massagetherapy.bc.ca/sites/default/files/ MassageMatters_fall11-ebook.pdf Bio: Antonio Stecco, MD Dr. Antonio Stecco is a world-class authority on soft tissue, especially the fascial system. Dr. Stecco was recently elected Assistant-President in the Cabinet of the International Society of Physical Medicine and Rehabilitation. He is the author of numerous journal articles and abstracts presented nationally and internationally, including one Best Poster Award and three chapters in English text. Dr. Stecco’s presentations at the International Fascia Research Congresses have generated world-wide attention and the work of the Stecco’s has created a ripple effect of paradigm shift throughout the manual therapy disciplines. In collaboration with his father and sister [Luigi Stecco PT and Dr. Carla Stecco] and following/furthering Luigi Stecco’s life-long work, several books and numerous papers have been co-authored and published. The Stecco’s have based their model of therapeutic technique on thousands of hours of anatomical cadaver research, clinical case studies and over 35 years of clinical practice. Dr. Antonio Stecco is the current president and one of the founding members of the Fascial Manipulation Association. He is also a certified instructor of Fascial Manipulation.

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considerations and if so what are considerations for determining the direction of the FM technique? Cyriax (fractioning) for example is applied cross-fiber in reference to the underlying muscle/tendon – but articulating fascial layers are not parallel (oblique arrangement at a 78 degree angle). Does this arrangement have any bearing on the direction of FM application? Or are there other factors within the sliding layer that are taken into consideration? AS: Direction of the FM technique is not specific to underlying fiber orientation. Where you feel the restriction is the most significant determinate factor pertaining to the direction the technique is applied, which sometimes can be multidirectional. There are some site-specific considerations (e.g. accessibility and proximity of sensitive anatomical structures; limited space between bones or anterior neck muscles and close proximity of vascular structures). CR: What about duration? How long is FM technique applied for and why? What are the changes that you are listening for or feeling for — indicating a productive change in the sliding layer? AS: Knowing when to stop the technique is a combination of patient feedback and what the clinician is feeling. It takes an average of 3.14 minutes for a patient to report a 50% reduction in what was their initial level of tenderness/pain (e.g. if the patient reported that upon initial contact with the site [CC or CF] their pain level was a 7 on the NRS, it would take approximately 3.14 minutes

for their pain to drop to 3.5). What the clinician is feeling for is a decreased resistance to glide in the direction where resistance was initially strongly felt. From a treatment perspective there are three important factors to consider: disengagement of collagen cross-links, restoration of normal HA presentation and restoration of normal GS/HA fluidity. Our hypothesis is that FM, a provocation-type technique, catalyzes a sequence of chemical events culminating in the restoration of normal quality/ quantity of ground substance (GS) constituents (e.g. HA) within the dense collagen layers of deep fascia. Tracking changes poses some difficulty, as posttreatment tissue biopsy is not reasonable. However biochemical measurements can track inflammatory mediated changes, which typically occur over a 48hour period. CR: What research are you currently working on? What might we expect to see you presenting on at the FRC4 in 2015? AS: Current studies include FM efficacy related to Spasticity associated with neurological disorders and Musculoskeletal Pain and Dysfunction. We are conducting various clinical trials: neck, shoulder, carpal tunnel syndrome and using various instruments/diagnostic technologies (e.g. EMG, DynaPort, Robotics) to assist with these studies and further our understanding of sliding layer pathophysiology and effective treatment interventions. We are also exploring a new pharmascopic track. ◆

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Award

Registered Massage Therapist of the Year

This association is proud to honour Beth Sampson for winning the MTABC 2013 RMT of the Year Award! Beth’s commitment to her profession is amazing. With poise and clarity she expresses her beliefs and holds true to her visions. Beth is a leader among her peers. She understands the impact of current events on the future of her profession, and works diligently towards the advancement of the profession as a whole. “I believe that every one of us has a special and unique contribution to make to our profession. Thank you very much for this award,” says Beth Sampson. Beth served on the CMTBC Board for the past four years during a very challenging and conflicted time, but she remained committed towards finding solutions that both ensured public safety and furthered best practice standards for the profession. Beth also juggles her time running her massage therapy clinic and teaching selfcare and certification courses to RMTs. In addition, Beth is actively involved in her community. She is the Board Chair of “Yoga Outreach,” a Vancouver charity that provides free yoga classes to at-risk communities throughout the Lower Mainland, such as prisons and HIV health centres (www. yogaoutreach.com). When Beth was a WCCMT student, she showed her great leadership skills by founding a student organization dedicated to understanding current issues facing the profession, and organizing school events. As a result, Beth received the Leadership Award for her outstanding contribution to the WCCMT community. It is not hard to see why Beth Sampson is our 2013 RMT of the Year Award winner. ◆

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Beth Sampson, RMT | photo: DT DeWitt

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Card

Coming Soon: The BC Services Card

by Megan Cleveland, Manger of Stakeholder Engagement for the BC Services Card, Government of B.C. Beginning February 15, 2013, the provincial government introduced the BC Services Card, which will be phased in over a five-year period. The new card replaces the CareCard, can be combined with the driver’s licence and also serves as government-issued identification. All BC Services Cards will have an expiry date, enhanced security features and most will have a photograph, which will

An example of the BC Services Card | Government of B.C.

help to improve patient safety and reduce card misuse.

The Medical Services Plan (MSP) will be the first program available through the new card. With this change, and beginning February 15, 2013, there will be a new requirement for most adult BC residents to renew their enrolment in MSP by 2018. New regulations will also come into effect for health care providers, including the duty to verify patients’ enrolment in MSP and the duty to report MSP misuse. For information on these requirements and more, please visit: health.gov.bc.ca/insurance/pros.html

Continued on page 17

STRUCTURAL MYOFASCIAL THERAPY Fall 2013 & Winter 2014 course dates in Edmonton and Vancouver CEU credits available. Dates to be confirmed in May 2013.

Three reasons to attend: 1. Learn to work deeply and efficiently! Our 4-day sessions are dedicated to learning and mastering deep myofascial techniques while exploring a powerful, subjective evaluation method: Postural Somatic Awareness (PSA). 2. Change the way you understand the body! Baron Bodyworks’ Structural Myofascial Therapy Continuing Education courses allow participants to understand how stiffness within the body's myofascial system can create postural problems, injury, pain and generally wreak havoc! 3. Empower yourself and your clients! Rejuvenating myofascial tissue is just one of the many goals and benefits of this work. Clients suffering from stress headaches, postural problems, insomnia or chronic pain can also benefit from this work!

BETSYANN BARON

Level 1 Connecting with the Fascia (4 days, 28 hours)

BetsyAnn Baron is a Board Certified Structural Integrator and member of the International Association of Structural Integrators (IASI). She is also a member of the Fédération Québecoise des Massothérapeutes (FQM).

• Full body myofascial protocol • Evaluation technique: Postural Somatic Awareness • Triple paradigm treatment structure: Relieve, correct, integrate

Level 2 Creating Specificity (4 days, 28 hours) • Advanced techniques including dural balancing

Level 3 Delving Deeper (3 days, 24 hours) • Linking up new fascial techniques throughout the fascial continuum.

Sign up to our mailing list for early bird specials and new course dates! www.baronbodyworks.ca or education@baronbodyworks.ca 14

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Research

A Librarian for the Research Department

by Kristina Oldenburg What’s new in the research department— clinical summaries, a Youtube video, and a librarian! I’m very excited to have recently joined the Massage Therapists’ Association of BC. As the librarian, my job here is assisting members who want to use our electronic resources to research topics of interest. This includes responding to the questions of student members. I’m in the office part-time, but can be reached throughout the week at librarian@ massagetherapy.bc.ca. We do have books, DVDs, and print journals for members to borrow, but most of our library resources budget goes to electronic sources. You can find those once you log in to the MTABC website, and click the Library link. Research articles search box One of my main goals is to make the library page of the MTABC website as user-friendly as possible! Empowering members to find high-quality information whenever they want, wherever they have an Internet connection. The first task was build an “Article databases” search box for the library page, so

Many of the articles are full text, but not all. If you have information about an article but can’t locate it, I want to know. I can often obtain it and email it to you. And if there are enough requests for something, I’ll look into adding it to our collection. So contact me if you are a member who has any questions about accessing resources. Clinical summaries in Dynamed A busy practitioner doesn’t often have time to find and read every research article on a topic, so MTABC has recently subscribed to DynaMed. It’s an easily-searchable collection of clinical summaries, providing a quick way to get an overview of a topic. Information is set out in easy-to-read bulleted points, with links to original research studies if you want to do more in-depth reading. Members can log in to the MTABC website, go to the library page to access DynaMed, and then type in a topic of interest—let’s say neck pain. Click search, then open the summary and have a look. You even have the option to get an email if the information is updated. Just click the little red bell on the side of the page and enter your email address, and you’ll get a

MTABC Librarian: Kristina Oldenburg, MA | photo: DT DeWitt

members can search multiple health and sport science databases at once. It looks a bit like a Google search box, but instead of crawling the open internet it looks only in health and sport science article databases: Biomedical Reference Collection, CINAHL (nursing), Medline, PsycArticles, PsycInfo, and SPORTDiscus (kinesiology). I want these resources to be as user-friendly as possible, but please email me if you want any tips on how to refine your search or use the advanced search features of the database.

Continued on page 17

massage matters ad Jan 2013:Layout 1 30/01/2013 4:49 PM Page 1

Soft Tissue Release (STR) is the "father" of all the recent “release techniques” and has developed into the fastest acting therapy for all acute and chronic soft tissue pain - providing permanent results. Clients injured in sports, at work, or with injuries incurred over time, can all beneﬁt from STR. This 2-day practical hands-on workshop is extremely beneﬁcial for health care professionals. The entire body is covered in this one workshop. Accredited with most provincial organizations including: (CMTBC) – 14 Credits, (MTAM) – 16 Credit, (MTAS) - 16 Credits, (MTAA) 14 credits

UPCOMING 2013 WORKSHOPS June 1-2 June 8-9 August 17-18

Victoria, BC Langley, BC Winnipeg, MB

For the complete

2013

workshop schedule visit our website

For registration and more info visit www.softtissuerelease.ca or contact Jim Bilotta, P: 905-688-7754 or E: info@softtissuerelease.ca b c

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Volunteering

From page 9

Being an RMT especially helped with this kind of work. Not only because of Anne and Jane’s hands on experience, but also because of their education. “I found myself in a position to be able to explain a little better the whys behind what we were doing,” says Jane, “the physiology and the make up of what we were working on. If we’re trying to help a baby get rid of their gas by doing certain motions on their belly, we can explain what organ we’re tapping into, what we’re trying to facilitate, tell them why it’s happening and be able to go a bit more in depth, so they

understand why they’re doing what they’re doing.” All in all, Anne and Jane had positive experiences working with Liddle Kidz and taking time out of their practices to volunteer. Would they do it again? Both of them absolutely would. Anne advises: “But don’t wait as long as me! I’ve been practicing for over 10 years and I haven’t done anything like this and it’s just amazing. I never thought there were [opportunities like this] because I had never heard of anything, but when you start looking around, there are lots of things you can do with massage therapy.” ◆

Anne Horng, RMT at the Social Support Center #2 in Ba Vi (Ha Noi) | photo: Joanne Allen

Learn this amazing assisted stretching technique to increase joint ROM, release fascial restrictions and gain optimal flexibility using Aaron Matte’s Active Isolated Stretching (AIS) technique.” All courses are eligible for NHPC continued competency credits, and are MTAA, MTAS, MTAM, and CMTBC accredited. This 2-day course will enable you to: • Safely and expertly assist your clients’ active stretching movements • Empower your clients with self-stretching routines using yoga straps • Work “smarter not harder” by incorporating these assisted stretching techniques into your massage sessions To register please visit: www.stretchforlife.ca hit “Registration” For more information contact us TOLL FREE at 1 877 757-1756 Or email: denise@stretch-for-life.com Course cost: $430.00 plus GST (includes a NEW, updated AIS stretching manual) 2013 Dates: See website for specific details and to register KELOWNA: May 22nd & 23rd (Wed & Thurs) KAMLOOPS: May 25th & 26th (Sat & Sun) 16

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Research

From page 15

notification when more research is available to update the topic. Video tutorial A Youtube video tutorial demonstrating the article search box and Dynamed is another new addition to the library page (scroll to the bottom to view). Watch for more of these in the coming weeks. Advanced searching in the Medline database is next on my list, but shoot me an email and I’ll consider requests. Existing resources The MTABC has subscribed to electronic research article collections for about five years. These resources are always shifting— publishers have withdrawn our access to some, while our other resources have expanded to include more information sources. We have also added subscriptions to new products, and are always investigating to see what is on the horizon and provides good value. Through the Electronic Health Libraries of British Columbia, a province-wide consortium of university and healthcare libraries, we are able to get excellent discounts on these electronic information sources. What’s upcoming The research director and I are always discussing new ways to make the evidence-informed massage therapy practice as easy as possible. We’re currently setting up ways to “scan the research horizon” and build a webpage with updates on the latest research about therapeutic massage and patient education. I’m also in the process of

Card

updating some of our professional development classes, to reflect changes to the resources. The new courses will incorporate videos, our newer resources, and a more interactive format. So why do we need all this? BC’s registered massage therapists are among the most-educated in North America. Fittingly, that education is extremely practical and hands-on. The MTABC research department works to support scientific research in the field. This contributes to evidence-informed practice and professional currency. Most importantly, this helps patient care. A solid and up-to-date research base is also important for building and strengthening relationships with other healthcare providers, and ensuring that treatment continues to be recognized by insurance providers. Who is your librarian? My professional experience includes teaching physical education students how to use electronic journals, print books, and “open web” resources for their research, at Calgary’s Mount Royal University. I have also done inclass and remote (video tutorial, telephone) research instruction for nursing students at Brandon University in Manitoba. In BC, I’ve worked for the Vancouver Courthouse Library and also provided email reference assistance to members of the BC Association of Kinesiologists. I completed my Master of Library and Information Science at Western University in Ontario. My SFU master’s thesis was about the attempts of two nineteenthcentury physicians to influence public health legislation. ◆

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From page14

where you will find the following resources: • BC Services Card ID fact sheet; • Questions and answers; • eLearning tool; and, • Technical readiness information. Kits with posters, brochures and other communications

materials will be delivered to health providers and other locations in communities across the province at no charge. If you would like more general information, please visit: BCServicesCard.ca or by telephone 1-800-663-7867 (604-660-2421 in Metro Vancouver and 250-3876121 in Victoria). ◆

classified Spring 2013 Advertisement only. No endorsement by the MTABC intended or implied.

Systemic Deep Tissue Therapy® Workshops (also known as SDTT)

(Systemic Deep Tissue Therapy® should not be confused with high pressure treatments)

riginated and developed by Armand Ayaltin DNM, RHT, RMT, and taught by him since the late 1980’s. It consists of its own scientifically-based philosophy, therapist-friendly assessment and treatment. To reduce burnout, body and hand postures are ergonomically designed. Therapy takes its cue directly from the assessment. This innovative procedure is designed to minimize the mental and physical stress of the Tx room. In these Workshops we will teach:

• Philosophy and background • How to treat the underlying cause of pain, often realizing quick and lasting results • How to Structurally Realign the body by collapsing the compensatory-matrix, using specific SDTT techniques at the physical and energetic levels which are: • recognizing the compensatory-matrix • engaging the SNS • manipulating the Fascial-muscle-joint systems • therapeutic intent • treating the relevant meridians • stimulating the patient’s quantum field of healing If as a Therapist, gaining self-confidence, self-sufficiency and effectiveness with reduced chances of self-injury is important, taking these workshops and adopting the Systemic Deep Tissue Therapy® is for you.

Testimonials:

“Thank you so much for this amazing workshop. It will change my life!” W.M. RMT. “This course surpassed my expectations...” B.C. RMT. “Thank goodness there is a way to read the body and respond to its core needs.” J.W. RMT. “Great coverage of biomechanics and application. I like these instructors, cool guys” J.L. RMT. “With 16 years of massage therapy experience I was still expecting to learn something new- those expectations were exceedingly met. The assessment approach alone was enough of a refreshing perspective- with the addition of completely new hands on techniques, this course was thoroughly worth my time and would recommend it to any seasoned therapist. Excellent course, nothing but praise for these innovative and effective techniques that match a thoroughly progressive treatment philosophy, this is truly Massage THERAPY!” Brad Dow RMT.

Autumn 2013: Introductory: September 28-29, Intermediate: October 26-27 Cost: $399. For more info and to register, phone: 604.984.2611 • web: systemicdeeptissuetherapycenter.com t h e r a p i s t s ’

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classified Spring 2013 Advertisement only. No endorsement by the MTABC intended or implied.

MTABC CEC Courses 2012 Registration at MTABC 604.873.4467 or mta@massagetherapy.bc.ca. Or mail to MTABC 180-1200, West 73rd Ave, Vancouver, BC, V6P 6G5. Provide name, phone and email. Cancellation within 3 weeks of a course results in 20% penalty; within 2 weeks, 40%; and within 5 days or “no shows”, no refund. All prices in Can. dollars Massage Therapists’ Association of British Columbia

Banyan Thai Massage

CMTBC CeU approved Courses

A teaching affiliate with the famous “ITM School” of Chiang Mai, Thailand • Thai Massage on the Table: 2-Thursdays April 4 & 11 / 14.0 CEU’s • Thai Foot Reflexology Massage: 1-Friday April 5 / 7 CEU’s • Thai hot herbal Compress Massage: Fri. & sat. May 23-24 / 14 CEU’s • Thai Massage Level 1: 3-Days Nov. 1 - 3 / 24 CEU’s

Introduction to Osteopathic Techniques with Ann Sleeper, RMT 11 PE/A2 Credits 711 Holiday Inn W. Broadway Vancouver Mar 2-3, 2013 – Sat and Sun 9 am – 5 pm Prices: MTA One Month Early $275 Regular $300 Non-MTA One Month Early $385 Regular $425

Fascia: Its Structure and Function - The Shoulder with Mark Finch, Dip Mass, KMI, RMT 14 PE/A2 Credits 711 Holiday Inn W. Broadway Vancouver Apr 13-14, 2013 – Sat. and Sun. 9 am – 5 pm Prices: One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495

Fascia: Its Structure and Function - The Spine with Mark Finch, Dip Mass, KMI, RMT 14 PE/A2 Credits 711 Holiday Inn W. Broadway Vancouver May 18-19, 2013 – Sat and Sun 9 am – 5 pm Prices: MTA One Month Early $322 Regular $350 Non-MTA One Month Early $450 Regular $495

Introduction to Pain, Nociception and Nerves with Dr. Geoffrey Bove 14 PE/A2 Credits 711 Holiday Inn W. Broadway Vancouver Mar 10-11, 2013 – Sun and Mon 9 am – 5 pm Prices: One Month Early $410 Regular $450

End-Range Loading - General with David DeCamillis, D.C., F.C.C.R.S.(c) 14 PE/A2 Credits New Westminster Apr 13-14, 2013 – Sat and Sun 9 am – 5 pm Prices: MTA One Month Early $280 Regular $310 Non-MTA One Month Early $390 Regular $430

For more course details, see MTABC web site www.massagetherapy.bc.ca

Massage Matters Classified Advertising

Massage Therapists’ Association of British Columbia

Visit us on-line to see our complete 2013 Courses listings. Paypal registration available at www.BanyanThaiMassage.com More information / contact: Sharon Brown-Horton, Instructor at 604.773.2645 Interested in hosting a course at your own location? With a minimum of 6 participants, travel may be arranged for ANYWHERE in BC and ALBERTA!!

Hot & Cold Stone Massage 3-day classes - 21 CEUs

Vancouver May 3-5, July 19-21 Victoria May 8-10, Aug 19-21

If you have a product, service or course to advertise call Victoria Chapman at:

Nina Gart 604-459-8646

1-604-741-4189 vchapman@biv.com

www.stonetherapyschool.ca

co-instructed by Natale Rao, RMT & Heather Gittens, RMT “It’s all my favourite techniques from over 30 years of practising eastern and western modalities.”

2013 COURSE SCHEDULE Visceral Manipulation Level One, May 24-26 Fascial Integration Series Membranes & Diaphragms , Sept. 27-29 The Thorax, Nov. 1-3 “Fusion Works" for 24 CEUs

All courses are 17 credits and $450 + taxes All courses are Friday Evenings 6-9pm Sat/Sun 9am-5pm At WCCMT New Westminster

May 10-13 New Westminster | July 11-15 Salt Spring Island “Thai Massage on the Table" for 12 CEUs April 27 & 28 Salt Spring Island | May 25 & 26 New Westminster “Thai Massage" for 24 CEUs June 21-24 New Westminster

To Register contact Heather Gittens at

Vancouver/Kelowna/Vernon/Salt Spring Island

info@bodhitreewellness.ca or 778-574-1174

250-537-1219 18

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classified Spring 2013 Advertisement only. No endorsement by the MTABC intended or implied.

AdvAnce your understAnding of crAniAl sAcrAl therApy With Robert Hackwood, RMT

Dr. VODDEr MLD COUrSES Basic, Therapy I, Therapy II & III April/May 2013 and October/November 2013

Massage in Schools Programme Instructor traInIng

Front of the Head: March 23, 24, 25, and April 6, 7, 8 Back of the Head: September 21, 22, 23 and October 5, 6, 7. Simply TMJ: November 2 and 3.

Vancouver: April 27-28, Oct 26-27 Kamloops: Aug 24-25 www.MassageInSchools.com info@JennJohnsonRMT.com 778-220-0589

WWW.VODDErSCHOOL.COM

604-418-8071 | Dynamictherapies.com

800-522-9862

MAUI, HAWAII; VRINDAVAN, INDIA

The complete schedule of Ann Sleeper classes can only be found at www.annsleeper. com. Muscle Energy, Introduction to Osteopathic Technique, and Treating Legs and Arms courses are offered in Vancouver, Victoria and Vernon. These classes or review sessions can also be organized privately for 2-5 people at her home in central Vancouver.

Travel, learn and earn CEC’s.

Continuing EduCation on LinE 2 hours per course for 2 CEU’s Courses are $50 (incl H.S.t). Easy and efficient way to accrue your CEU’s. ~ no traveling, no time away from work ~ www.cepd.ca • call 1-866-733-9017 for details

ANATOMY & YOGASANA ON MAUI: December 1st – 8th 2013 AYURVEDIC MASSAGE IN INDIA: March 2nd – 20th 2014 Both trips include accommodation, fabulous meals and study. Leigh Milne RMT, E-RYT500 is an experienced RMT, Iyengar certified yoga instructor and educator. For course and instructor details and registration information visit www.thesadhanacentre.com leigh@thesadhanacentre.com or call Leigh 902-273-9642

E-mail Ann at sleeplow@telus.net or call or text 604-671-9172.

Applied SomAticS clinicAl SomAtic educAtion Instructor: Andrew teufel, rMt cHsE, rYt 500 to rEGIstEr: call Applied somatics 250-748-6600 email: info@appliedsomatics.com All Workshops take place Friday to sunday inclusive. As for the tilting Body, Level I Duncan, July 26-28, 2013 As for the stooping Body, Level I Vernon, June 7-9 As for the Arching Body, Level I Vernon, september 20-22

“Two and half years of massage school with the various techniques that didn’t have the same results as Applied Somatics. My colleagues shoulders were chronically tight, even after this time in school. After the weekend Stoops course, incredibly her tissues were relaxed and movement restored. Heather Fergus, RMT”

As for the Extremities and tMJ, Level II november, 8-10

BEFORE

All courses $485 early registration, $565 less than 1 month. $100 non-refundable deposit.

AFTER

“ Cliff, 79, stood 3 inches taller with Applied Somatics. Images 4 weeks apart” b c

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call toll Free 1-866-748-6600

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efficient solution for your patients

Manual Practice Osteopathic studies “Osteopathy is a natural medicine which restores function to the organism by treating the causes of pain and imbalance…” Philippe Druelle, D.O.

Osteopathy provides the necessary therapeutic reasoning skills and manual treatment approaches to achieve optimal results. Osteopathy views the body as a whole. Osteopathic manual treatment focuses on detecting areas of restrictions at any tissue level. Osteopathy functions by assisting the body’s natural healing ability, allowing restricted areas to regain as much of their former mobility as the body will comfortably allow. The College offers complete training including myofascial, visceral, cranial techniques, specific osteoarticular adjustments and clinical methodology. Courses are geared towards guided palpation and practice in order for practionners to be able to integrate their new knowledge to the treatment of patients. The educational program is designed with busy health-care practitioners in mind. The 6 yearly seminars are held over weekends to minimize time lost from current employment, with a low instructor/student ratio.

itional The reference in Trad Practice Osteopathy Manual teaching since 1981

College of Osteopathic Studies

Canadian College of Osteopathy — CCO Collège d’Études Ostéopathiques — CEO

For information / registration 1-800-263-2816 | info@ceo.qc.com | www.ceo.qc.com