This handout is specifically intended to be a resource for my own patients so they can better understand their home care program. It is also a resource of ideas for other therapists to try out in their own practice. Medical researchers may find some of the statements as working hypotheses for some clinical trials.
The process that I use to help people get out of pain and restore normal movement is called Core Movement Massage. I combine a detailed knowledge of muscles, fascia, and bones, with an understanding of complex whole body movements that connect through the Core of the body. The word Core refers to the pelvis, and low back and all the muscles that attach to them front and back. This is where your strength resides. It is the link from your powerful legs to your dexterous hands. It is involved in all movement either positively or negatively. Massage encompasses any manual technique applied to soft tissue that positively affects their comfort, length, and ability to move.
My background in this field started out at the Muscular Therapy Institute where I learned general massage therapy and injury evaluation. This gave me entrée into the world and culture of body work. I did thousands of general massages on a wide cross section of people. To be more effective I studied NeuroMuscular Therapy, NMT, became certified and taught it for several years. NMT is much more specific in that you learn the anatomy in much more in depth. Palpation is very specific. You also learn how to create symmetry in the body. Muscle imbalances create distortions that drive strain and pain patterns. NMT can create rapid and dramatic change in soft tissue. The pressure used is deep and direct. It is not tolerated well by everyone and not appropriate for all conditions.
To help more people with more sensitive bodies I embarked on a 20 year certification process in CranioSacral Therapy, CST. In this modality you use only 5 grams of pressure. This is about the weight of a nickel. You address asymmetry and distortions in the central nervous system which includes the head and the base of the spine and everything in between. It is so light that you can promote change without inciting any defensive responses. This is particularly useful for very sensitive people like those with fibromyalgia. I learned how to listen at a deeper level than ever before.
All of these modalities helped free the body of tension and improved general comfort but failed to address problems relating to dysfunctional movement patterns. I would hear many times that you feel great after a session but the habitual posture and movement patterns gradually (or quickly) brought on the same symptoms. Having a strong movement background myself I was drawn to a form of movement awareness and education called Core Movement Integration. This developed as a rendering of The Feldenkrais Method ( service mark) by one of his trainers Josef Dellagrotte, PhD . I took many years of training, became certified and still teach it. The goal is no less than to take charge of how you use your body. In a treatment session you get the somatic feeling of comfortable movement but you have to practice it daily to make it your own.
The massage techniques that I employ are specific to your goals of less pain and better movement. If I was to do a whole body massage I would create a generally relaxed body but there would not be enough attention on your specific issues. Instead I do enough testing to be able to target which muscles are the most involved in your personal pattern. I do not use a lubricant if I want to work the fascia or connective tissue that wraps the muscles. Lubricant in the form of lotion is used to massage muscles. As much as possible I try to use the least amount of force with the maximum amount of suggestion to the soft tissue. I have had many patients say ‘You’re like the muscle whisperer. You touch it in such a way that the tissue just lets go’.
How much force that is used is negotiable. As spokes person for your body you get to say when the pressure is uncomfortable no matter how light it is. On the other hand some people know that their bodies require heavy pressure to release. I am a firm believer that you do what works. Each person is different. No two sessions are alike.
The overall goal is to solve the immediate problem of pain, and have the relief last. My role is to reduce the pain in the soft tissue and to discover the underlying posture and movement pattern that perpetuates it. This is a learning process for both of us. I expect that you will feel better at the end of the session and that you will have some knowledge of how you can maintain it. It is not a process where I fix it and your habitual posture and movement break it. There are 168 hours in the day. A treatment lasts only an hour. The other 167 hours have far more influence on whether you maintain long term gains.
Although understanding all the nuances of ones body may seem like an overwhelming task, getting out of an acute dysfunctional pain pattern is indeed doable. The body gives you all the information to let you know what is the right path. I like to say that pain is a great teacher. Recovering from an episode of severe pain can be thought of as a learning experience. Don’t waste a perfectly good pain message.
Practically speaking there is a real cost in time and money to therapy. I like to think that self awareness in the service of physical comfort is very valuable. There are few therapies that address body problems from this perspective. Teaching a person how to fish is more important than just giving them the fish. There are phases to my treatment process. The first phase is to solve the immediate problem. I use massage, NMT, CST and movement to do this. The second phase is to teach you enough about how your body works so that you are empowered to maintain the solution. At this time you have the choice of maintaining some connection to the therapy by scheduling some maintenance sessions say on a monthly basis or you may feel that treating as needed is more your style.
Personally I prefer prevention over cure. It is human nature to lose motivation once you are out of distress. You lapse into bad habits. We all do. Getting sessions at some appropriate frequency helps to keep you mindful and motivated to stay in touch with your body.
- Use a calm mind to do the movements. You can’t fill a cup that is already full. So empty your mind of expectations, fears, goals, and whether you are doing it “right”. Doing the movements in this way is more like a moving meditation than like an exercise
- The goal is comfort. The end result is to achieve an improved level of ease while you are doing the movement and after the end of the session. If you are straining in any way then you are doing it wrong. There is another way of using your body. There are 3 basic options you have:
- Do the movement smaller. Think moving just one inch at a time.
- Do it in very slow motion.
- Do it differently. Refer to the next principle.
- Start the movement with the right “Fred”. I am referring to Fred Astaire the most famous dancer of his time. He would dance with Ginger Rogers in many movies. The image that is useful here is that Fred initiated the dance move and Ginger seamlessly sensed the intention and followed. If you are doing a movement and it hurts you can always make that body part Ginger and find a different Fred. For example move your ribs more to turn your neck. Turn your pelvis more to move your ribs. There is a succession of different Freds that can move a corresponding succession of Gingers. It like the old saying” The knee bone is connected to the thigh bone. The thigh bone is connected to the hip bone , etc.
- Rest frequently. Even in a simple movement there is much to absorb. By resting you will avoid being overwhelmed with new sensory input and you can separate the actions so your mind can better focus on the distinctions and uniqueness of each set.
- No pain all gain. There is a role for strenuous exercise and stretching. We do need strong and loose muscles. If you are reading this handout you probably have limitations around these 2 activities. So many of my patients tell me that it hurts to do exercise, but they feel that this is the only way to get better. If you are
getting better then fine. If not then refer to the next principle.
- Take your foot off the brake before you apply the gas. Who hasn’t forgotten to release the parking brake before stepping on the gas? You can drive all around town but the car is sluggish and would express its resistance when you start smelling the burning brake. For each movement there is a muscle that moves it one way and another muscle that moves it in reverse. The muscles that move your leg forward are not the same as the ones that move it back. The muscles that move it back have to relax so the muscles that move it forward don’t have to work so hard.
- Be gentle with yourself. Think of how children learn how to crawl. They keep trying out different paths to get that shiny object they want and they learn what works. They persevere. No child gives up on walking because it took too much time.
- Instructions From Within and assorted videos available from Josef Dellagrotte, PhD . Check his web site to acquire
- Awareness Through Movement Moshe Feldenkrais, PhD
- Acquiring the Feldenkrais Profession, Yochanan Rowerant
- You tube videos on Feldenkrais Method, Alexander Technique, and Core Integration.
- Try out the Feldenkrais Baby on YouTube it is funny and instructional
- You Tube Core Integration Josef Dellagrotte for additional videos.
- My own DVD, Core Movement Integration.