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Terra Rosa eMagazine Issue 2

Terra Rosa eMagazine Issue 2

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Published by Terra Rosa
eMagazine for Massage and Bodywork Therapies
eMagazine for Massage and Bodywork Therapies

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Published by: Terra Rosa on Apr 03, 2011
Copyright:Attribution Non-commercial


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Bodywork e-News 
01Editorial 02Integrating Diagnosis and Treat-ment for Bodywork—Kit Laughlin05The Spinal Engine — Erik Dalton09An Integrated Approach to Re-habilitation of Leg Injuries. Part1.—Art Riggs18Unravelling the Mysteries of Un-winding27Lipoedema —Kristin Osborn31Stretching for Plantar Fasciitis33Rwo Shur, Chinese Foot Reflex-ology36The Passivattiva Technqiue forthe Legs—Maurizio Ronchi46Research Highlights47Six Questions to Whitney Lowe48Six Questions to Diana Haynes
Terra Rosa Bodywork e-News 
Issue 2, December 2008 www.terrarosa.com.au
to the second issue of Terra Rosa Bodywork e-news, our new free electronic news magazine dedicated tobodyworkers. It has been a great year in 2008, beginningwith a great start, economy is strong and flowing. However atthe end of this year, we see the drop in the world's economy and our Australian dollar is falling sharply. Inevitably we haveto readjust our prices several times. We hope that the marketwill pick up again and your business will be steady. Be positive.In this issue, we got great articles for you. We focus on the legsand lower extremities. Art Riggs give us a complete range of techniques for leg injuries. This is the firt of a two parts article.Watch out for the next part on our next issue. Our colleaguefrom Italy, Mau shows us his innovative passivattiva tech-nique. Check it out. On the foot, we look at the history of Chi-nese reflexology and stretching for plantar fasciitis. There’salso great articles by Kit Laughlin, and Erik Dalton. KristinOsborn shares her passion with us on Lipoedema, a conditionlittle known. And we look at the mysteries of unwinding.Don’t forget to read our 6 questions to Whitney Lowe andDiana Haynes.We hope to keep you informed and entertained. This e-Newsis dedicated to all of you. If you have something you wish tocontribute, drop us an email: terrarosa@gmail.com. We be-lieve that therapists like you have lots of experiences to sharearound. Thanks for all of your support, wishing you have aGreat Christmas, Happy Holiday and enjoy reading.Sydney, December 2008.
The publisher of this e-News disclaim any responsibility and liability for loss or damage that may result fromarticles in this publication.
Terra Rosa 
The Source for Massage Information
Bodywork e-News 
Integrating diagnosisand treatment forBodywork 
by Kit Laughlin
The question of how a therapistcan incorporate diagnostic tech-niques (assessment of structuraland functional considerationsdeemed relevant to the client'sproblem) into a standard mas-sage treatment is not an easy oneto answer. This question giverise to two additional questions:What are the expectations of theclient, and how may they bechanged for the client's ultimatebenefit?
What is the reason for treat-ment?
The first question may be re-worded: for what apparent rea-son is the client coming to seeyou? The reasons are many andvaried, but chief among them arestress management, neck, mid-dle or lower back pain, optimisa-tion of well-being, or some spe-cific musculoskeletal problem. If stress management is the reason,then the practitioner can explainduring the treatment that thetension that is being explicitly dealt with in the massage sessionis in fact the body's most funda-mental reaction to stress. Ac-cordingly, any one of the ortho-dox approaches to reducingstress is then a natural subject towhich the conversations can turn.So, for example, one might talk about relaxation techniques, orthe use of stretching exercises tochange tension patterns. It is aperfectly reasonable matter, then,to offer to teach the client anumber of such exercises at theconclusion of the session. Onecould shorten the actual massagepart of the session by 10 or 15minutes explicitly for this pur-pose. If the use of the exercisesby the client makes a differenceto this very common problem,you can be sure the client willask you for additional stretchingexercises at a future consultation.
Neck or back pain
One of the most common rea-sons for a client to come to amassage practitioner is for thetreatment of the neck or back pain. The practitioner needs torealise that a client has a specificidea of what it is they want fromyou, but often lacks the languageor concepts with which to articu-late their concerns. In the case of neck and back pain, during thetaking of the client history beforethe massage commences, thepractitioner can float the idea of doing a structural and functionalanalysis some time in the futureas a means of making concretesome possible causes of theirproblem. The initial consultationthen proceeds as normal, with astandard massage being per-formed. During the massage, thepractitioner is gaining a muchclearer idea of where the clientholds tension, and possibly where the client lacks strength aswell. For example, in the case of neck pain, levator scapulae canexplicitly palpated and its ten-sion in relation to surroundingtissues assessed. In the case of back pain, erector spinae (oreven quadratus lumborum) may be palpated, assessed andtreated. Comparisons of left/right development of musclesarticulating the spine can bemade.
Specific conditions
If the client is coming to see youfor a specific musculoskeletalproblem, it is an easy matter forthe practitioner to suggeststretching or strengthening exer-cises as the client's homework,and be certain that this course of action is very likely to yieldmuch faster results than simply being treated by massage. This isbecause dysfunctional patternsof flexibility or dysfunctionalmotor patterns are the main rea-son for these kinds of problems.
What are the expec-tations of the client?How may they bechanged for theclient's ultimatebenefit?
Bodywork e-News 
The vast majority of muscu-loskeletal problems (including,of course, neck and back prob-lems) may be said to be the re-sult of inefficient biomechanics,but so saying does not indicatespecific treatment directions. Tomove beyond a mere descriptionof the problem (even though'biomechanical' does have a nicescientific ring about it!) to atreatment of its cause(s) requiresthat some analytical process beused. As I have published else-where, one such specific and re-peatable process is the assess-ment of physical functions interms of insufficient flexibility orlack of strength. This relatively simple analysis yields specifictreatment recommendations:stretching exercises for areasthat testing reveals to be tight incomparison with what is'normal' for that client andstrengthening exercises for areasshown to be weak. This latterassessment will require an un-derstanding of which musclesneed to be activated and how strong they need to be in relationto other muscles.
Going beyond a 'condition'or 'problem'
There is a further considerationin recommending specificstretching and strengthening ex-ercises, and that is the notion of empowerment. Far too many practitioners---deliberately orinadvertently---disempoweredtheir clients. That is, from thevery first consultation, an atmos-phere can be created wherein thepractitioner and the client bothregard the client as the more-or-less passive recipient of thetreatment being practised. Inother words, the practitioner isput forward implicitly as thefount of wisdom, and the clientthe vessel. Apart from being pa-tronising, a great deal of recentresearch in medical anthropol-ogy suggests strongly that thelikelihood of successful resolu-tion of any problem is lessenedconsiderably if the client is notactively involved in his or hertreatment.
States of mind
So we might say that one couldhave a process reason for recom-mending stretching or strength-ening exercises (that your analy-sis has yielded an understandingof specific biomechanical prob-lems in the client's system) and apsychological reason. This latterreason is simply (and very im-portantly) the creation of an op-timistic state of mind in the cli-ent, and the passing on of spe-cific tools for the client to use toresolve his or the problem. Thisgives the control of the problemlargely to the client---in my view an essential first step up for full,permanent resolution of theproblem. Until the client takesresponsibility for his or her ownproblem, the problem is likely torecur regardless of how effectiveyour treatment is.
Integration of treatmentelements
If the practitioner embraces ananalytic protocol as, for example,outlined in the book 
Overcomeneck & back pain
, the structuraland functional analysis will takeabout 30 minutes in total. As-suming a treatment hour, theremainder of the time can beused in the teaching what theanalysis reveals to be the mostlikely significant two or threeexercises. At a future consulta-tion, you will be able to concen-trate on whichever muscles theanalysis has revealed to be exces-sively tight, in addition to themassage process that you usually use. At the conclusion of themassage, spend 10 minutes re-viewing the previously-taughtexercises with the client. Experi-ence has shown that no matterhow well these exercises aretaught the first time, reviewingthem a week or a couple of weekslater will reveal practise errors;we are all human, after all, andclients (and practitioners) alterthe form of an exercise to makeit more comfortable, and oftenavoid the target area as a result.
Progressing the intensity of the exercises
I have found that once the painof the initial problem has re-ceded, it is usually necessary toteach some strengthening exer-cises in order that the client re-turned to full normal (or, desir-able) function. We might say that in order for rehabilitation tobe considered complete, the cli-ent must move
the pre-injury state of fitness that led tothe initial problem. In respect of neck pain, the anterior neck muscles usually need strength-ening. Any tendency to carry thehead forward of the ideal posi-tion will also need to be cor-rected, and this usually requiresthe strengthening of muscles inthe lower abdominal area. In ad-dition, it will be necessary tocheck the flexibility of the hipflexors,
,in particular. This isbecause the research has shownthat an anterior pelvic tilt can be
Diagnosis & TreatmentDiagnosis & TreatmentDiagnosis & Treatment 

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