Terra Rosa

E-Magazine
Open information for massage therapy & bodywork

No. 5, June 2010 www.terrarosa.com.au

Contents Welcome to our fifth issue of Terra Rosa e-

magazine, our free e-zine dedicated to body-
02 Structural Integration—Michael workers.
Stanborough, MA
We got a range of great articles for you, start-
06 An interview with Shari Auth ing with an introduction to Structural Integra-
tion (SI) by Michael Stanborough. More on fas-
08 Simulating Fascia & Injury—
cia by our Italian bodyworker, Mau, showing a
Maurizio Ronchi
simple example how to simulate injury and
09 Muscle Palpation Assessment trigger points. We have an interview with
and Orthopedic Massage by Dr. Shari Auth, the creator of the Auth Method of
Joe Muscolino Forearm Massage and also the author of the
best selling DVD.
14 High Heels and Back Pain by
Erik Dalton PhD Erik Dalton gives an excellent article on high
heels and back pain. And we also look into the
16 The Danger of High Heels hazard of high heels on the ankle, knee and
18 Chronic Neck Pain & The Core foot.

21 Myofascial Streching for the Dr. Muscolino, who will come to Australia next
Arm & Shoulder - Walt Fritz, PT year, review the art & science of muscle pal-
pation. Whitney Lowe shows you an alterna-
22 Dorn Spinal Therapy & Breuss tive to stretching. Then we look at the neck
Massage - Barbara Simons and its core muscles. Walt Fritz will show you
effective myofascial stretching for the arm,
24 An Alternative Approach to
shoulder & neck.
Stretching - Whitney Lowe, LMT
And don’t forget to read Six Questions to Mi-
27 Research Highlights
chael Stanborough and Barbara Simon.
29 Six Questions to Michael Stan-
We hope to keep you informed and enter-
borough
tained. Thanks for all of your support and en-
30 Six Questions to Barbara joy reading. Stay healthy.
Simon
Sydney, June 2010.

Disclaimer: The publisher of this e-magazine disclaim any responsibility and liability for loss or damage that may result from articles
in this publication.

Terra Rosa e-magazine No. 5, June 2010 1

Structural Integration
History
Dr Ida Rolf originally called her
unique form of bodywork therapy
“Structural Integration” (SI) when
she developed it over 60 years ago.
For many decades her work was
known most commonly by the nick-
name “Rolfing”, a term that arose
during Dr Rolf’s development of
the method at Esalen Institute in
California. When the residents and
visitors there received her treat-
ments they described it as being
“Rolfed” – saying they’d been
Structurally Integrated somehow
just didn’t do justice to the ex-
perience.
However over the last fifteen years
or so the term Structural Integra-
tion has returned to prominence as
a number of schools throughout
the world began to offer programs
in the methodology and philoso-
phies of Dr Rolf. In 2002 the Inter-
national Association of Structural
Integrators (IASI) was formed.
Amongst its missions was the goal
to provide a framework of curricu-
lum standards for schools of SI that
honoured both the original intent
of Dr Rolf and the developments
arising in the field that were being
integrated in diverse ways into
each of these schools. There are
currently 18 certified programs in
the world including SI Australia in
Melbourne and the Australian
School of Applied Structural Inte-
gration & Somatic Studies in the
Gold Coast. The most recent IASI
Terra Rosa e-magazine No. 5, June 2010
By Michael Stanborough, MA
symposium, held in Denver, at-
tracted presenters from most of
the member schools as well as im-
portant contributors to fascial re-
search from outside of the SI com-
munity.
The Method
So just what was it that the re-
markable Dr Rolf conceived of?
Through personal exploration and
academic knowledge, she devel-
oped the insight that the earth’s
gravity exerts a continuous influ-
ence on the balance of the body,
locking into place any of the dis-
tortions caused by injury, poor
posture or post-surgical scarring.
Her PhD into biochemistry led her
to the understanding that system-
atically manipulating the pliable
connective tissue, known as fascia,
held the key to structural re-
balancing and from this a more
aligned, energised person would
emerge. These soft-tissue mobili-
Certified Advanced Rolfer
Director, SI Australia
Member of the IASI
sation techniques would lead in
time to a realignment of the body
so that it returned to its natural
posture.
This was accomplished through
what become known as the Ten
Series or “The Recipe”. Each ses-
sion in the series works on a spe-
cific part of the body to systemati-
cally release the accumulated
stiffness and stress in that area.
The innate ability of the body to
adapt skilfully and economically to
gravity is progressively restored.
As the series progresses the natu-
ral postural controls return and
“standing up straight” and more
importantly, moving freely, be-
comes the normal state.
Balance between the inner core
and the outer sleeve is re-
established with an accompanying
increase in vitality and vigour. As
the body moves away from the
debilitating effects of muscular
imbalances with their associated
tension and pain, movement be-
comes more fluid and effortless.
This ease in movement shows up in
every day activities as well as in
sports and the performing arts. In
fact, a number of well-known
sports people and dancers credit SI
with enhancing or extending their
careers.
As well as being a manipulative
therapy that restores natural
movement and posture, SI has an
educational component. Dr Rolf
2
 Structural Integration
realised quite early on that the
changes that the therapist brought
about in her clients would go
deeper and last longer if they would
change their habits of body use.
These days SI practitioners fre-
quently engage with a client’s
movement habits during sessions.
This is often done through deliber-
ate and mindful client movement
made during the manipulations as a
way of taking advantage of neural
plasticity. Imagery and increased
awareness of weight, position and
internal sensation will also be used
to influence the internal body maps
that control movement.
The evidence is now strong that
good connective tissue manipulation
and movement education can make
long lasting changes to posture,
performance and pain reduction.
Because of the consistency of these
outcomes SI has moved from being
an alternative therapy that enjoyed
a reputation for helping people feel
more balanced and grounded, par-
ticularly when other approaches
had failed to provide a solution, to
a recognised bodywork method that
rehabilitates patients with long
standing soft-tissue, postural and
movement restrictions.
Clinical Implications
Tom Findley, MD, PhD and Certified
Advanced RolferTM, is Associate
Director for Research, War-Related ple to benefit from Structural Inte- vated by mechanoreceptors which
Illness and Injury Study Center, at
the East Orange VA Medical Center pain such as a bad back or neck,
in New Jersey. This centre is de-
signed to specifically serve veterans inflammatory arthritis. It’s also as- sympathetic tonus as well as a
with medically unexplained fatigue sociated with good outcomes for
and pains, and has highly special-
ized equipment to measure bal-
ance. Findley’s researchers have
found subtle balance problems in
many veterans with unexplained
pains as well as in persons with
chronic fatigue and fibromyalgia.
Dr. Findley did a case study with his
Structural Integration clients who
have myofascial pain, including
Terra Rosa e-magazine No. 5, June 2010
some who have chronic fatigue or
fibromyalgia. He measured their
balance before and after the Struc-
tural Integration using balance
measurement tests. Everyone who
had a balance problem improved.
Performance Implications
If you ask a New Yorker how to get
to Carnegie Hall they’ll most likely
answer “practice, practice, prac-
tice”. Renowned concert pianist
Leon Fleisher, who made his Carne-
gie Hall debut at 16 years of age,
had done just that and through a
gruelling schedule of practice and
performance developed a debilitat-
ing over-use syndrome. This led to
the loss of use of his right hand and
a frustrating decade of teaching,
conducting and performing pieces
for the left hand. After exploring
tion often produces the feel of im-
dozens of diagnostic and therapeu-
mediate tissue release under the
tic avenues in an attempt to return
therapist’s hand. It was thought
to two-handed playing, Fleisher dis-
MFR altered the mechanical proper-
covered SI. 10 months later, after
ties of fascia by permanently alter-
receiving many treatments from
ing its length via alteration of the
Advanced RolferTM Tessie Brungart,
bind between the collagen fibres.
Fleisher made a triumphant return
Robert Schleip, a RolferTM, con-
to Carnegie Hall and has since re-
ducted a literature study and
turned to touring. In early 2009 he
showed that this theory is not feasi-
released to critical acclaim his first
ble as a much stronger force or
CD in twenty years. Brungart was
longer durations of strain would be
subsequently invited to present her
required for a permanent elastic
work to the National Institute of
deformation of fascia. However he
Health.
found that fascia and connective
Clinically, the largest group of peo- tissue in general is densely inner-
gration has some type of myofascial are responsive to manual pressure.
Stimulation of these sensory recep-
general stiffness or non- tors is responsible for a lowering of
change in local tissue viscosity.
specific conditions such as scoliosis,
Robert Schleip continued his study
cerebral palsy and post-surgical
and research on fascia and obtained
scarring.
a PhD in 2005. Dr Findley (above)
From Practice to Research and Dr Schleip thought it was due
time that the scientists that were
Although SI is known to be effective studying fascia meet with the clini-
clinically, in the early days there cians that were treating it. They
was a lack of a physiological and planned a conference where the
scientific explanation of how it finest researchers in fascia were
works. Myofascial (MFR) manipula- invited to present their scientific
3
 Structural Integration
research. The First International
Fascia Congress on Facia was held
on 4-5 October 2007 at Harvard Uni-
versity in Boston. In this congress,
manual therapists learned new ter-
minologies and theories on fascia.
Among the new concepts: fascia is
directly involved in force transmis-
sion from one tissue to another and
this has major implications in ex-
plaining how the body functions;
fascia’s ability to glide smoothly on
other tissues can be altered, pro-
ducing restrictions; manual treat-
ments that address the fasciae can
influence cells and molecules via
mechano-transduction, producing
changes in intracellular biochemis-
try and gene expression (this was
one of the really startling presenta-
tions).
mean when we say the “whole Schleip’s ongoing research into the
The success of the congress led to body” have expanded greatly. mechanoreceptors within connec-
the 2nd Congress of Fascia Research, We’re continuing to look at the me- tive tissue.
two years later, held at the Free chanical properties of fascia and
University, Amsterdam, 27-30 Octo- it’s clear from the two Fascia Re- Tom Myers continues to develop his
ber 2009. This Congress included search Congresses that there’s still anatomy trains concept with lots of
two sessions where therapists and a lot to learn about what properties engaging material in the latest and
researchers met. Manual therapists of fascia account for the changes excellent edition of Anatomy Trains
presented in brief a variety of man- brought about by SI. as well as on his website. The fas-
ual and tool-assisted modalities, cial dissections are particularly
with the intention of informing sci- Other lines of questioning and con- wonderful.
entists about their techniques and cept formation are drawing on the
assumed theories behind them. In fascinating advances in the under- The blending of SI with various
this congress, therapists learnt standing of neuroplasticity. Sandra schools of body-centered psycho-
about the dynamic reconfiguration and Mathew Blakeslee’s The Body therapy therapy continues. So too
potential of the collagen network, Has a Mind of Its Own has captured does the exploration of the spiritual
which can occur within seconds. the attention of many SI practitio- dimensions of SI such as Will John-
This suggests that the effect of ners as has Norman Doidge’s The son’s work with aspects of the
manual therapy can be immediate Brain That Changes Itself. Now awareness practices of Buddhism.
and significant. we’re considering how the various Going forward we’ll be dancing,
“interventions” of SI – pressure, looking into microscopes, sensing
The future stretch, guided movement and self- into ourselves and others, heading
sensing to name a few – affect body to the dissection room, boning-up
Where is SI going? The concepts,
maps and sensory-motor connec- on the structures of the nervous
insights and methodology we inher-
tions. The insights of these books system and looking on in awe at
ited directly from Dr Rolf are all
lend a new depth to the under- images of probes half the diameter
right there in the foreground, sum-
standing of the work of French of the wave length of light teasing
marised in some sense by simply
dancer, movement teacher and the human genome out of fibro-
referring back to her seminal in-
RolferTM, Hubert Godard. For Go- blasts. It should continue to be
sights – for human well being, look
dard, perception, meaning and co- stimulating!
to gravity, fascia and the whole
ordination create our gravity re-
body.
sponse perhaps even more than the Read also 6 questions to Michael on
However, the discussions we have fascia. This emphasis on the nerv- page 29.
about gravity, fascia and what we ous system dovetails well with

Terra Rosa e-magazine No. 5, June 2010 4

 Deep Tissue Massage
& Myofascial Release
Workshops
with Art Riggs
Sydney & New Zealand
November 2011
Deep Tissue Massage
Deep Tissue Massage is much more than just a “hard mas-
sage.” In contrast to just relaxing muscles, the specific
lengthening of fascia and muscles and tendons offers many
benefits such as freer joint movement, benefit for inju-
ries, better posture, and feelings of well-being.
Art Riggs
Art Riggs is a Certified Advanced Rolfer® and massage
therapist who has been teaching bodywork since 1988. He
is the author of the best selling Deep Tissue Massage and
Myofascial Release book and DVDs. He also frequently au-
thored articles for Massage and Bodywork Magazines in the
US. He has conducted numerous workshops for health spas
and for medical professionals, including physical thera-
pists. He also teaches his work internationally including UK
and Europe to bring them the knowledge and experience
that he has gained with his work. He lives and practices in
San Francisco bay area.
Terra Rosa e-magazine No. 5, June 2010
5
FUNDAMENTALS OF TOUCH
Sydney: 4, 5, 6 November 2010, New Zealand: 13,14,15 No-
vember 2010
This class covers all aspects of Deep Tissue and Myofascial Re-
lease work with nuts and bolts emphasis upon broad under-
standing and cultivating your touch and body mechanics.
INTEGRATED FULL BODY DEEP TISSUE MASSAGE
Sydney: 8, 9 November 2010
This workshop will provide you with the skills to smoothly inte-
grate your specific deep tissue and myofascial release tech-
niques into a fluid full body massage, and will be a great re-
fresher if you feel you need some review.
ADVANCED DEEP TISSUE MASSAGE & MYOFASCIAL RE-
LEASE
Sydney: 25, 26, 27, 28 November 2010
This series expands the initial skills taught in “Fundamentals”
workshop and offers a step by step movement up the entire
body, offering more specific information, anatomy and strate-
gies for all parts of the body.
Don’t miss this is a unique experience and
rare opportunity to train with Art Riggs.
Book Now as Places are Filling Up.
Venue in Sydney:
NatureCare College, 46 Nicholson st. St Leonards.
NSW 2065.
5
An Interview with Shari Auth,
Creator of the Auth Method of
Forearm Massage
When and how did you decide to
become a bodyworker?
I went to massage school almost by
accident when I was 23. I was in-
terested in going to medical school
and went to massage school at
night to get some education in al-
ternative medicine, I discovered I
had a gift and never left the pro-
fession.
How did you come up with the
Auth method of forearm mas-
sage?
Out of necessity. The Auth Method
of Forearm massage developed
naturally in my first several years
of working full time as a massage
therapist. I knew I wouldn't last
long in this very laborious profes-
sion if I didn't learn to work effi-
ciently and effectively. The Auth
Method is effortless for the practi-
tioner and feels wonderful for the
client. The Auth Method takes the
therapist's body into account, it is
a way of working that is ergo-
nomic, and when practiced cor-
rectly feels totally effortless, even
when practicing deep tissue.
What makes Auth Method differ-
ent from other bodywork?
The Auth Method is different be-
cause it was developed by a mas-
sage therapist for massage thera-
pists. It was designed with the
therapist's health and longevity in
mind. The Auth Method utilizes
body weight not muscular force to
engage the tissue. The Auth
Method doesn't poke or prod; it's
even, slow and patient. It's creates
Terra Rosa e-magazine No. 5, June 2010
a bodywork experience that is
deep but not painful.
What are the benefits of Fore-
arm Massage?
Here is a list I complied recently
on the benefits of Forearm Mas-
sage:
More Leverage:
By using your forearms you’ll have
a steady, strong base of contact to
lean onto.
Increased Career Longevity:
Many massage therapists leave the
profession because of wrist or
hand injury. By using your fore-
arms you’ll be able to protect the
fragile joints of the hands.
Greater Surface Area:
With an increased surface area of
contact, you can work on more of
your client in less time, making
your practice more efficient. Your
clients will feel like they are get-
ting more for less.
Increased Durability:
A stronger tool lasts longer. The
forearms are larger and less fragile
than the fingers or thumbs, so your
massage practice will thrive
longer.
Effortless Deep Tissue:
Because you’ll have more leverage
when working with your forearms,
the deep tissue work you do on
your clients will be less demand-
ing. You’ll be able to work deeper
on your clients, with less fatigue.
Satisfy the Massage Needs of Lar-
ger Clients:
The forearms are a big tool capa-
ble of doing bigger jobs. This
makes them ideal for working the
larger muscle groups of any of your
clients, as well as addressing the
6
 Interview with Shari Auth
massage needs of your larger cli-
ents.
More Contact:
Clients come to massage therapists
for contact. By using the forearms,
you increase contact with your
clients. This contact is comforting
to your clients.
It Feels Good:
Forearm massage is just as sooth-
ing as massage with the hands. It
might take time to develop sensi-
tivity in the forearms, but the sen-
sitivity is there. Listen to your cli-
ent’s body, it will tell you how fast
and how deep to go. Remember,
massage isn’t something we
do to our clients it’s something we
do with them.
Can you tell us about how Qi
Gong practice can help in doing
bodywork and massage?
I teach simple Qi Gong exercises in
my workshops and on my DVD, to
help MT's develop better body me-
chanics while working. Qi Gong
encourages a stance that is like a
tree, grounded in the legs and re-
laxed in the upper body. This is
perfect for bodyworkers. Qi Gong
keeps the therapist grounded in
Terra Rosa e-magazine No. 5, June 2010
their own body. Qi Gong is a very
slow martial art, so it slows the
therapist down, which client's find
very relaxing.
What do you find most exciting
about bodywork therapy?
Watching people's lives transform
for the better.
What tips can you give to mas-
sage therapists to prolong their
career?
Get regular bodywork. Adopt a
conscious movement practice, ie.,
martial arts, yoga, pilates, dance,
gyrotonics etc. Use your forearms Shari Auth, L.Ac., LMT, NCBTMB
instead of your hands for the ma- Shari Auth is the creator of the
jority of your massage. Listen to Auth Method of Forearm Massage
your body and it's needs. Con- and the instructional massage
sciously breathe, both on and off DVD, Auth Method: A Guide to Us-
the job. ing the Forearms. She is a licensed
massage therapist and acupunctur-
ist, and is also certified in the Rolf
What are your interests these
days? Method of Structural Integration.
Ms Auth teaches continuing educa-
Cultivating a loving marriage....I'm tion workshops for massage thera-
getting married this summer! pists, has a full-time practice in
the healing arts in New York City,
and has been practicing since
1995. For information on her prac-
tice in NYC, please
visit shariauth.com.
Auth Method Instructional DVD
Learn to massage without taxing the delicate joints of the
hand and increase career longevity. Learn to give a full body
massage using the forearms as the primary tool. These tech-
niques can be used for both deep tissue work and light circu-
latory massage. This DVD teaches simple qi gong exercises for
better body mechanics, as well as, how to use body weight to
engage tissue, depth of pressure, speed of strokes and devel-
oping sensitivity in the forearms.
7
Simulating Fascia & Injury
Maurizio Ronchi

In this article, I will try to demonstrate using simple

analogy, how injury and deformation on fascia can af-
fect our body.

I used a Glad Wrap (polyethylene) sheet to simulate a

fascial sheet, a myofascial expansion, perimysium or
thin aponeurosis.

I simulated an injury or insult to the fascial sheet using a

finger or a small ball that exerted pressure on the sheet
and created deformation without a lesion.

My question is, can an injury resulted from external con-

dition (such as traumatic accident) or from internal con-
dition (such as dislocation , oedema) can create this
type of damage on the fascial structure?

If yes, then is the deformation is temporary or perma-

nent?

My hypothesis is that the deformed fascia will arouse a

repair or remodelling process e.g. stimulating the densi-
fication of collagen or the tensile forces of the adjacent
muscles or tendons or fascial expansion will try to re-
store the damage.

It may be that as a result of the deformation or repair

process, can possibly create a myofascial trigger-point?

And manual manipulation can help the process of resto-

ration?

In the event when the injury create a lesion, what will

happen and as scar developed, similar to scar in the
muscles, what kind of difference in its physical proper-
ties?

I would love to hear your comments and opinions, please

email me: ik2yxk@libero.it and I’d be happy to hear from
you.

Maurizio Ronchi is a bodyworker, sports athlete, and instructor. He likes to play extreme sports, including 100
m track and long jump, basketball, judo, and climbing. He was a track and field instructor since 1979, Climb-
ing instructor since 1992. In the last 25 years, he has worked for athletes on various sports and at the moment
working for SEREGNO RUGBY as a sports bodyworker.

Terra Rosa e-magazine No. 5, June 2010 8

 Muscle Palpation Assessment
and Orthopedic Massage
by Dr. Joe Muscolino

The Art and Science of Muscle Pal-

pation

When performing clinical orthope-

dic massage on a client, having an
accurate assessment of the tone
and health of each of the muscles is
imperative. After all, with orthope-
dic massage, working to loosen tight
muscles is usually our main objec-
tive. Probably the two most com-
mon presenting complaints of a cli-
ent are stiffness, in other words loss
of range of motion, and pain. By
massaging tight muscles, we strive
to relieve pain and restore range of
motion. To make an accurate as-
sessment and know which muscles
need to be worked requires a num-
Figure 1. A, Knowing the attachments of the deltoid allows us to accurately place our
ber of assessment skills. Foremost palpating fingers. B, Knowing the actions of the deltoid, we ask the client to abduct the
among these is muscle palpation. arm at the glenohumeral joint, making it contract and become easier to palpate.

Muscle palpation can be broken into

two parts. The first part is locating
the target muscle that we are look-
ing to find. Once accurately lo-
cated, the second part is to assess
its health, in other words feeling for
its tone by determining whether it
is tight or loose. Although assessing
the tone of the muscle is clearly the
most important aspect of palpation,
it cannot be performed unless we
first determine with certainty
where the target muscle is located.
Effective massage usually requires
working a muscle from attachment
to attachment. But if we are not
quite sure exactly where the bor-
ders of a muscle are, how do we
know when we are working it and
when we aren’t. Further, if a client
presents with a tight area, and we
cannot determine exactly what
muscle or muscles are involved,
then how can we counsel the client
as to what activities likely caused
their problem?
So, the key to effective muscle pal-
pation for orthopedic massage lies
in being able to accurately locate
each of the target muscles. And for
each target muscle, there is a pal-
pation protocol that can be per-
formed to accomplish this. Unfortu-
nately, muscle palpation is often
not well learned by students and
therapists alike. As a matter of
course, it is often presented in text-
books and taught in the classroom
as a series of protocols that are
memorized instead of being under-
stood. As with most things that are
memorized, they are often forgot-
ten or become fuzzy in time, leav-
ing us with weak palpation assess-
ment skills.
The art and science of muscle pal-
pation lies in the fact that muscle
palpation protocols do not need to
memorized; rather they can be rea-
soned out by learning some basic
common sense guidelines. Knowl-
edge of these guidelines then allows
us to figure out how to palpate each
muscle of the body, equipping us to
become powerful and effective
clinical orthopedic therapists! The
focus of this article is to discuss a
few of the fundamental guidelines
that are necessary when learning
the art and science of muscle pal-
pation.

Terra Rosa e-magazine No. 5, June 2010 9


The Art of Muscle Palpation: Knowing how to choose
The first two guidelines are what the best action of the tar-
can be called the science of muscle get muscle can be rea-
palpation because they are based soned out if we know the
on knowing the attachment and ac- actions of the target mus-
tion information of the target mus- cle and we also know the
cle that we learned in our science actions of the adjacent
(anatomy and physiology/ muscles.
kinesiology) classes. Guideline #1 is
to use our knowledge of the attach-
ments of the muscle to know where
to place our palpating fingers. For
example, if we are palpating the
deltoid, then knowing that it at-
taches from the lateral clavicle,
acromion process, and spine of the
scapula, to the deltoid tubercle on
the humerus allows us to place our
palpating fingers on it (Figure 1a).
However, as we explore this mus-
cle, how do we know if at a certain
point we have strayed off it and are
now on a different muscle? Further,
if instead of the deltoid our target
muscle is deep instead of superfi-
cial, how do we know that we are
palpating it and not adjacent mus-
culature? In these cases, it is help-
ful to utilize Guideline #2 which is
to know the action(s) of the muscle
to have the client engage it and
make it contract. In the case of the
deltoid, we can ask her to abduct
her arm at the glenohumeral joint
(Figure 1b). The deltoid contracts
and becomes palpably harder and
we can easily feel the entirety of
the muscle, discerning it from the
adjacent soft tissues. These first
two guidelines form the fundamen-
tal basis for locating a target mus-
cle. They require that we either
recall the attachments and actions
that we have learned, or go back
and look them up.
Beginning the Art of Muscle Palpa- In Guideline #2, we asked the client is where errors so often occur. In-
tion
The key to effective palpation is
not just feeling the target muscle,
but being able to clearly discern it
from the adjacent muscles and
other soft tissues. This requires the
Palpation
contraction of the target muscle to
be as isolated as possible. For this
reason, our goal is to have only the
target muscle contract, and all the
adjacent muscles remain relaxed.
This brings us to Guideline #3,
which is choosing the best action of
the target muscle when we ask the Figure 2. A, Adding resistance to flexion of
client to engage and contract it. For the hand at the wrist joint causes the flexor
carpi radialis (FCR) to contract, but it also
example, if our target muscle is the
causes the adjacent palmaris longus (PL),
flexor carpi radialis of the forearm/
another wrist joint flexor, to contract. B,
wrist joint and we ask the client to Adding resistance to radial deviation of the
flex the hand at the wrist joint, not hand at the wrist joint causes the FCR to
contract but the adjacent PL to remain re-
only will the flexor carpi radialis
laxed.
contract, but so will the adjacent
palmaris longus (Figure 2a). This
will make it difficult to know when
Guideline #4, adding resistance to
we are on the flexor carpi radialis
the client’s contraction, can be
versus the palmaris longus. The an-
used.
swer is to choose radial deviation as
the action instead of flexion (Figure
This was seen in Figure 1b; the
2b). Now the flexor carpi radialis
therapist used his left hand to add
will engage and can be palpated,
resistance to abduction of the cli-
but the palmaris longus will remain
ent’s arm. The optimal amount of
relaxed. Knowing how to choose the
resistance that should be added
best action of the target muscle can
varies from muscle to muscle and
be reasoned out if we know the ac-
client to client, so we need to be
tions of the target muscle and we
willing to be creative and experi-
also know the actions of the adja-
ment. If the muscle is not clearly
cent muscles. Our goal is to find an
felt with a little resistance, we add
action of the target muscle that is
more; if the muscle is not clearly
different from the actions of the
when adding a fair amount of resis-
adjacent musculature.
tance, we add less.
Perfecting the Art of Muscle Palpa-
Adding resistance is often the key
tion
to finding the target muscle. But it
to engage the target muscle so it deed, it is this step that is often
would be easier to palpate and inaccurately portrayed in many
books and articles on palpation.
would stand out. But sometimes,
simply asking the client to contract When resistance is added, it is im-
the target muscle does not cause a perative that we do not add resis-
strong enough contraction to make tance across a joint that does not
need to be crossed. If our contact
it palpably clear. In these cases,

Terra Rosa e-magazine No. 5, June 2010 10

 Palpation
forearm pronation, it is important
that our hand contacts the distal
forearm, not the hand (Figure 3).
Otherwise, adjacent wrist joint
flexors (flexor carpi radialis, pal-
maris longus, flexor carpi ulnaris)
will contract, making it impossible
to be sure when we are on the pro-
nator teres or when we have veered
off onto these other muscles. Yet
another example is the brachiora-
dialis. When palpating this muscle,
it is often recommended to resist
flexion of the client’s forearm at
Figure 4. When palpating the brachioradialis
the elbow joint by “shaking” their and adding resistance to flexion of the fore-
hand. However, doing this causes us arm at the elbow joint, the resistance
to cross the client’s wrist joint to should be added by contacting the client’s
add resistance against their hand, distal forearm, not her hand.

Figure 3. When palpating the pronator teres which will cause adjacent muscles
and adding resistance to pronation of the (extensors carpi radialis longus and
forearm at the radioulnar joints, the resis- brevis) to contract as well, making
tance should be added by contacting the
it difficult to discern the brachiora-
client’s distal forearm, not her hand. ABOUT THE AUTHOR:
dialis from them. In this case, add-
ing resistance properly requires Dr. Joe Muscolino has been a mas-
When resistance is added, it contacting the client on the distal sage therapy educator for 24 years.
is imperative that you do forearm as seen in Figure 4. He is author of The Muscle and Bone
not add resistance across a Palpation Manual, with Trigger
Although many more guidelines ex-
joint that does not need to Points, Referral Patterns, and
ist to continue and perfect the art
be crossed! of muscle palpation, these first four Stretching; The Muscular System
Manual, the Skeletal Muscles of the
on the client crosses another joint, guidelines form the fundamental Human Body, 3rd Edition; and Kine-
we will in effect ask the client to basis for muscle palpation. When
applying these guidelines, the key is siology, the Skeletal System and
contract other muscles, and this Muscle Function; as well as other
will cloud our ability to discern the to critically think through the pal- publications by Mosby of Elsevier
target muscle. Remember, our goal pation protocol by utilizing our Science. His books are being trans-
is to isolate a contraction of the knowledge of the attachments and
lated into seven foreign languages.
target muscle so that it can be dis- actions of the target muscle as well He also runs numerous continuing
cerned from the adjacent muscula- as the attachments and actions of education workshops. He can be
ture. the adjacent muscles. Armed with
critical reasoning skills and accurate reached at www.learnmuscles.com.
There are many examples that dem- palpation assessment, we can be CREDITS:
onstrate this. In Figures 2a and 2b, effective clinical orthopedic thera-
note that the therapist contacted pists! All illustrations reproduced from
and added resistance to the palm The Muscle and Bone Palpation Man-
(body) of the client’s hand; he did For a thorough discussion of all 20 ual, 2009, Elsevier.
not cross over the finger joints to muscle palpation guidelines, along
press against the client’s fingers. with illustrated palpation protocols Photography Yanik Chauvin / El-
Doing so would have caused the cli- and video demonstration of the sevier
ent’s finger flexor muscles (flexors palpations protocols, see The Mus-
digitorum superficialis and profun- cle and Bone Palpation Manual,
dus) to also contract, making it dif- with Trigger Points, Referral Pat-
ficult to discern the flexor carpi terns, and Stretching, by Joseph E.
radialis from them. Another exam- Muscolino, 2009, published by
ple is palpation of the pronator Mosby of Elsevier Science
teres. When adding resistance to (www.learnmuscles.com).

Terra Rosa e-magazine No. 5, June 2010 11

 Deep Tissue Massage,
Stretching &
Joint Mobilization
Sydney & Brisbane
July 2011
Intermediate & Advanced Techniques for
the Neck
Sydney: 2-3 July 2011, Brisbane: 9-10 July 2011
The first day will cover body mechanics for deep tissue work and
stretching for the neck, including: How to use your core to easily per-
form deep work to the neck, How to safely massage the musculature
of the anterior neck, and How to perform multiplane stretching of
the neck.
The second day covers Advanced Stretching Techniques and Joint
Mobilization. Dr. Muscolino will describe and demonstrate: How and
why CR (also known as PNF), AC, and CRAC stretching techniques
work and advanced safe joint mobilization techniques.
Intermediate & Advanced Techniques for
the Low Back & Pelvis
Sydney: 4-5 July 2011
This workshop is structured similarly to the neck workshop. The first
day will cover body mechanics for deep tissue work and stretching for
the lower back & pelvis. The second day will focus on advanced
stretching and how to safely perform joint mobilization.
Terra Rosa e-magazine No. 5, June 2010
Deep Tissue Massage, Stretching &
Joint Mobilization
The focus of these workshops is to learn how to work clinically utilizing
deep pressure, basic and advanced stretching, and joint mobilization
techniques; and to do so more efficiently by working from the core with
less effort so you do not hurt yourself. In effect, how to work smarter
instead of harder!
Working clinically and efficiently can be done simply by learning a few
basic guidelines of proper technique that Dr. Joe Muscolino will show you.
An invaluable workshop for anyone who does sports, clinical, and/or re-
hab. work!
Dr. Joe Muscolino
Dr. Joe Muscolino is a licensed chiropractic physician and has been a mas-
sage therapy educator for 24 years, with extensive experience in teaching
kinesiology and musculoskeletal assessment and technique classes.
Dr. Muscolino has authored 8 major publications with Mosby of Elsevier
Science, including "The Muscle and Bone Palpation Manual, with Trigger
Points, Referral Patterns, and Stretching" He also writes the column arti-
cle "body mechanics" for the AMTA's massage therapy journal.
Don’t miss this unique experience to
train with Dr. Joe Muscolino.
Book Early as Places are Limited
12
 This book combines muscle & bone anatomy &
palpation, trigger points & stretching all in one
book! Available from www.terrarosa.com.au
With more than 1,000 vibrant, full-colour illustrations and over
4 hours of detailed video demonstrations, THE MUSCLE AND
BONE PALPATION MANUAL is the most visually engaging way to
help you master and successfully apply palpation techniques in
massage therapy. This innovative text uses unique, richly de-
tailed photographic illustrations of muscles as they appear under
the skin to give you a thorough understanding of effective palpa-
tion. This comprehensive guide provides unparalleled prepara-
tion for professional success.

To enhance muscle palpation illustrations and text in this book, a set of 2 DVDs (included
free in the book) contains over 4 hours of video demonstrating the muscle palpations of
the book. This DVD set also contains cameo presentations by some of the most prestigious
names in the world of massage therapy education, including Tom Myers, Leon Chaitow,
Whitney Lowe, Bob King, Gil Hedley, and many more.

Additional free online resources are included on the companion Evolve website, including
technique videos for the intrinsic muscles of the hands and feet, interactive review exer-
cises, a massage research PowerPoint presentation, and joint motion information.

Key Features
 Full-colour musculoskeletal overlays depict muscles and
bones exactly as they appear when palpated to help you lo-
cate tissues and landmarks with confidence.
 Trigger points and referral patterns included for each muscle
provide convenient access to guidelines for additional client
assessment and treatment.
 Massage-specific treatment options guide you from palpation
and assessment to practical treatment application.
 Stretching protocols and illustrations broaden your treatment
capabilities.
 Comprehensive Body Mechanics chapter details 10 guidelines
to help maximize efficiency during practice.
 A massage stroke atlas with information on draping tech-
niques, massage strokes, and fundamental characteristics of
touch helps you efficiently treat clients.
 Detailed explanations and full colour drawings for bone and
bony landmark palpation provide a comprehensive resource
for bone palpation.

Terra Rosa e-magazine No. 5, June 2010 13

 High Heels and
Back Pain
For over a century, the biome-
chanical effects of heels in every-
thing from running shoes to stilet-
tos has puzzled researchers and
fired controversy. When standing
barefoot, the perpendicular line of
the straight body column creates a
ninety degree angle with the floor
(Fig. 1A). On a two-inch heel, were
the body a rigid column and forced
to tilt forward, the angle would be
reduced to seventy degrees, and to
fifty-five degrees on a three-inch
heel (Fig. 1B) Thus, for the body to
maintain an erect position, a
whole series of joint adjustments
(ankle, knee, hip, spine, head) are
required to regain and retain one's
erect stance and equilibrium.
The slope or slant of the heel, rear
to front, is called the 'heel wedge
angle'. The higher the heel, the
greater the angle. On the bare
foot there is no wedge angle. The
bottom of the heel is on a level
one hundred and eighty degrees,
with body weight shared equally
between heel and ball. Inside the
heeled shoe, the wedge angle
shifts body weight forward so that
on a low heel, body weight is
shared forty percent heel, sixty
percent ball; and on a high heel
ninety percent ball and ten per-
cent heel.
Under these conditions the step
sequence is no longer heel-to-ball-
to toes and push-off, as with the
bare foot. With heels two or more
inches in height, little weight is
borne by the heel of the foot caus-
ing the push-off phase to arise al-
Terra Rosa e-magazine No. 5, June 2010
by Erik Dalton PhD
most wholly from the
ball (Fig. 2). In this
reflex adjustment,
scores of body parts -
- bones, ligaments
and joints, muscles
and tendons -- head
to foot must instantly
change position. If
these adjustments
are sustained over
prolonged periods via
habitual use of higher
heels, the strains and
stresses become
chronic, causing or
contributing to com-
pensatory strain pat-
terns ascending up the
kinetic chain.
In an article published
in December 2009 at
The Journal of Injury,
Function and Rehabili-
tation, a research
team compared the
effects on knee, hip,
and ankle joint mo-
tions of running bare-
foot versus modern
running shoes. Sixty-
eight healthy young
adult runners who cur-
rently utilize modern
running shoes for
training were selected
for participation.
None of the partici-
pants had a history of
musculoskeletal injury
and they each ran an
average of 15 miles
per week. The experi-
14
 High heels & back pain

ment was designed so participants

ran on a treadmill linked to a mo-
tion analysis device. They each
engaged in a short treadmill run
session with running shoes, and in
an identical short session barefoot.

While some manual therapy tech-

niques such as foot and ankle mo-
bilization and structural alignment
provide temporary relief from gait-
induced distress symptoms (Fig. 3),
long-term, they are largely inef-
fectual in re-establishing natural
gait. Why?
Figure 5 © 2010 www.erikdalton.com
Because natural gait is biome-
chanically impossible for any shoe-
wearing person. The shoe's ele- stirrup and leg muscles (Fig. 5). explain the performance domi-
vated heel shortens the Achilles This not only places more stress on nance of marathon runners from
tendon and tightens calf muscles them to achieve needed propulsion nations where the barefoot state is
sometimes leading to conditions (loss of ground reaction force), but common from infancy to adult-
such as plantar fasciitis and heel power must be borrowed from hood.
pain (Fig. 4). elsewhere -- knees, thigh muscles,
hips, and trunk. Both tendons,
The heeled shoe "steals" much of ligaments and muscles are, of
the body's antigravity propulsive course, vital to step propulsion and
power by weakening the fascial gait stamina -- which may help

Terra Rosa e-magazine No. 5, June 2010 15

 The Danger of High-Heels
The idea that high heels can be
hazardous to your health isn't new.
Several research have found that
high heels can contribute to the
development of a variety of condi-
tions from arthritis, chronic knee
pain, sprained ankles, back prob-
lems, and development of corns
and calluses to hammertoes.
A research published in The Lancet
Journal in 1998 and 2001 reported
that the altered forces at the knee
caused by walking in high heels
may predispose to degenerative
changes in the joint. Walking with
wide-heeled and narrow-heeled
shoes increased peak knee varus
torque by 26% and 22%, respec-
tively. These findings imply that
wide-heeled shoes cause abnormal
forces across the patellofemoral
and medial compartments of the
knee, which are the typical ana-
tomical sites for degenerative joint
changes or osteoarthritis.
Recently, researchers at Boston
University School of Public Health
and the Institute for Aging Re-
search in a study found that the
types of shoes women wear, spe-
cifically high-heels, pumps and
sandals, may cause future hind-
foot (heel and ankle) pain. Nearly
64 percent of women who reported
hind-foot pain regularly wore these
types of shoes at some point in
their life.
Published in the October 2009 is-
sue of the journal Arthritis Care &
Research, the study examined the
association between shoe wear—
beyond just high-heel use—and
foot pain. The researchers, who
analyzed foot-examination data
from more than 3,300 men and
women in The Framingham Study
from 2002-2008, say past shoe
wear among women is a key factor
for hind-foot pain. They found no
significant link between foot pain
and the types of shoes men wear.
While foot pain is a common com-
Terra Rosa e-magazine No. 5, June 2010
plaint in the U.S. adult popula-
tion—foot and toe symptoms are
among the top 20 reasons for phy-
sician visits among those 65 to 74
years of age—relatively little is
known about the causes of foot
pain in older adults. Women are
more likely than men to have foot
pain; however, it is not known if
this is due to a higher prevalence
of foot deformities, underlying
disease, shoe wear, or other life-
style choices.
From a list of 11 shoe types, study
participants were asked about the
one style of shoe they currently
wear on a regular basis, what they
regularly wore during five age pe-
riods in the past, and if they ex-
perience pain, aching or stiffness
in either foot on most days. Nearly
30 percent of women and 20 per-
cent of men reported generalized
foot pain, which is in line with
other foot-pain studies. Ms. Du-
four’s team, however, found a sig-
nificant association in women who
reported hind-foot pain and past
shoe wear that included high-heels
and pumps.
The shoe types were divided into
three categories:
1. good (these shoes had firm non-
flexible soles and good support at
the back of the shoe, this included
athletic shoes and casual sneakers)
2. bad (these shoes lacked support
and structure such as high-heeled
shoes, sandals, and slippers)
3. medium (shoes with an interme-
diate level of support including
hard- or rubber-soled shoes and
work boots).
More than 60 percent of women
reported wearing “poor” shoes in
the past, compared to only 2 per-
cent of men (13 percent of women
said they currently wear “poor”
shoes).
When we walk, a significant bio-
mechanical shock is delivered to
the foot each time our heel strikes
the ground. “Good” shoes, such as
sneakers and other athletic foot-
wear, often have soles and other
features that soften this shock and
protect the foot. The heel and an-
kle take the brunt of this shock,
which may be why women who
wear high-heeled shoes often re-
port pain in this part of the foot.
In the UK, Rupert Evans, an acci-
dent and emergency doctor at Uni-
versity Hospital of Wales in Cardiff
said that he has seen an increase
in the number of women being ad-
mitted to hospital with injuries
caused by high heels. Injuries
ranged from sprained ankles to
broken bones and dislocations –
and in some cases caused perma-
nent damage. He estimated that
up to half a dozen women were
now being admitted to his depart-
ment with shoe-related injuries on
weekend evenings.
He advised that women should
stick to shoes with heels less than
4 cm. He added that he was not
advising that women should stop
wearing high heels altogether, but
advocating wearing them in mod-
eration.
References
Alyssa B. Dufour, Kerry E. Broe, Anne
H. Walker, Erin Kivell, Uyen-Sa D.T.
Nguyen, Marian T. Hannan, David R.
Gagnon, Howard J. Hillstrom. Foot
Pain: Is Current or Past Shoewear a
Factor? Arthritis Care & Research, 2009
D Casey Kerrigan , Jennifer L Lelas,
Mark E Karvosky.Women's shoes and
knee osteoarthritis. The Lancet Vol-
ume 357, Issue 9262, 7 April 2001,
Pages 1097-1098.
16
The Hazard of High Heels
Posture

The knee High heels push the centre of gravity in

the body forward. taking the hips and
The altered posture of walking in spine out of alignment.
high heels places excess force on
the inside of the knee, a com- Pressure
mon osteoarthritis site. A study
High heels may make legs look longer. But
found that women who wears
as the heel height goes up, so does the
high heels can increase the pres-
pressure on the forefoot.
sure on knee joint as much as
26%.

Calf
Gastrocnemius and soleus contract and ad-
just to the angle of the high heels creating
shortened and tight muscles.

Achilles tendon
When the front of the foot moves down in
relation to the heel. the Achilles tendon
Ankle injuries tightens up. The higher the heel, the
shorter the tendon becomes, creating heel
High heels impair balance: a wearer is at
pain.
a greater risk of falling. which could lead
to a sprained or broken ankle.

Pump bump
The rigid backs or straps of high heels can
Metatarsalgia irritate the heel, creating a bony enlarge-
ment also known as Haglund's deformity.
High heels force the body's weight to
be redistributed. Prolonged wear can
lead to joint pain in the ball of the
foot.

Morton's neuroma Bunions Hammertoes

Heel height and a narrow toe box can
create a thickening of tissue, around a
nerve between the third arid fourth
toes. which can lead to pain and numb-
ness in the toes.
Tight fitting shoes can cause a bony
growth of the joint at the base of the big
toe, which forces the big toe to angle in
toward the other toes, resulting in pain.
A narrow toe box pushes the smaller
toes into a bent position at the middle
joint. Eventually. the muscles in the
second, third and fourth toes become
unable to straighten, even when there
is no confining shoe.

Neuroma

Terra Rosa e-magazine No. 5, June 2010

 Chronic Neck
Pain & The Core
Chronic neck pain
The human neck is a complex sys-
tem of muscle, bone, joints and
connective tissue. Chronic neck
pain is increasingly becoming com-
mon in the modern society. The
incidence of neck problem is re-
ported to be greater in modern-
ised, western society with the
prevalence in the adult population
being reported to be between 6-
22%1. Another study in Canada in-
dicates that 67% of individuals will
suffer neck pain at some stage
throughout life2. With an increas-
ing reliance on computer, neck
pain has become a great challenge
in bodywork. Effective manage-
ment of this condition is essential
not only for symptoms relief, but
more importantly, for the preven-
tion of recurrent episodes of neck
pain.
Neck muscles predominately pro-
vide head stabilisation demands, it
is estimated that neck muscles
contribute about 80% to the me-
chanical stability of the cervical
spine3. The other 20% is provided
by the osseo-ligamentous system,
which occurs mainly at end of
range postures. Muscles provide
dynamic support in activities
around the neutral and mid-range
postures, which are common dur-
ing functional daily tasks.
In a paper published in the Euro-
pean Spine Journal in 20074, Swiss
researchers examined the correla-
tion between the presence of neck
pain and alterations of the normal
cervical lordosis. They examined
Terra Rosa e-magazine No. 5, June 2010
using x-rays two groups of people:
54 people with a history of neck
pain and 53 without. They found
no significant difference between
the two groups. The authors con-
cluded that the presence of such
structural abnormalities in the pa-
tient with neck pain must be con-
sidered coincidental, i.e. not nec-
essarily indicative of the cause of
pain.
Muscle weakness
Muscle weakness and impairment
is a key feature of chronic neck
pain5. Janda’s theory suggests the
cervical flexor muscles become
dysfunctional in the presence of
neck pain. Simple clinical me-
chanical measures also demon-
strated a reduction in the strength
and endurance capabilities of the
cervical flexor muscles in neck
pain.
New research from the University
of Queensland by Deborah Falla &
Paul Hodges analysed myoelectric
signals using new sophisticated
technology of surface electromyog-
Janda’s upper crossed syndrome is characterised
by tightness of the upper trapezius, pectoralis
major, and levator scapulae and weakness of the
rhomboids, serratus anterior, middle and lower
trapezius, and the deep neck flexors, the scalene
muscles.
raphy (EMG) to determine pre-
cisely abnormal muscle function.
Results from their research demon-
strated that people with chronic
neck pain will show the following
conditions:
 impairment in the deep cervical
muscles, which are considered
to be functionally important for
joint support and control,
 deficits in muscle co-ordination
which could result in poor sup-
port and potential overload on
cervical structures,
 insufficiency in the pre-
programmed activation of cervi-
cal muscles,
 inefficient neuromuscular acti-
vation, and
 greater fatigability of superfi-
cial cervical muscles.
The core of the neck
This research from Australia iden-
tified deficits in the motor control
of the deep and superficial cervi-
cal flexors in people with chronic
neck pain. This is characterised by
a delay in onset of neck muscle
contraction associated with move-
ment of the upper limb.
Studies also demonstrated a reduc-
tion in the strength and endurance
capacity of the cervical flexor and
extensor muscles in people with
neck pain. Sternocleidomastoid
(SCM) and anterior scalene (AS)
muscles showed greater fatigabil-
ity at moderate loads, and also
during low load sustained contrac-
18
 Chronic neck pain
tions. have an understanding of abnor-
malities in the muscular system as-
The research also found that people sociated with painful dysfunctional
with neck pain demonstrated an joints. Recent research have signifi-
altered pattern of muscle activation cantly advanced our understanding
characterised by reduced deep of the impairment in the deep and
flexor muscle activity during a low superficial cervical flexor muscles
load functional task and increased in people with neck pain syn-
activity of the superficial cervical dromes. Based on the muscle defi-
flexors.5 cits considered to occur in neck
Whilst direct evidence of deep cer- pain, two types of exercise pro-
vical extensor muscle dysfunction grams have been proposed in the
has been identified in people with literature to address cervical flexor
neck pain, the new research showed muscle impairment. These two
evidence of the deep cervical flexor types of exercise programs are fo-
(DCF) muscles impairment in. The Neck flexors (from Gray’s Anatomy) cused on two different functional
DCF muscles, including the longus requirements.5
amount of force as compared to
colli, longus capitis, rectus capitis The first exercise regime consists of
normal person.
anterior and rectus capitis lateralis. general strengthening and endur-
The DCF muscles are histologically Researcher Deborah Falla suggest ance exercises for the neck flexor
and morphologically designed to parallels between the deep core muscles. These exercises involve
provide support to the cervical lor- neck flexors in neck pain with trans- high load training and thus recruit
dosis and the cervical joints. Now verse abdominis and multifidus dys- all the muscle synergists that is,
research has demonstrated reduced function in people with lower back both the deep and superficial mus-
activation of the DCF muscles or the pain.5 cles. For example, strengthening
neck pain patient.5 the neck flexor muscles is achieved
Chronic neck pain is a complex na-
People with chronic neck pain have ture of muscle impairment as op- by performing a head lift manoeu-
a disturbance in the neck flexor vre which would recruit all muscles
posed to simple weakness.
synergy, where impairment in the capable of contributing to this ac-
deep muscles is compensated for by Implications for rehabilitation tion including, SCM, AS, longus colli
increased activity in the superficial and longus capitis. A typical exer-
Neck strengthening exercises have cise program would train the cervi-
muscles (SCM and AS).
been shown to be beneficial in pre- cal flexors with the controlled head
Reduced neuromuscular efficiency venting and treating work-related lift exercise and focus on training
indicates that people with neck musculoskeletal disorders of the endurance and increasing the num-
pain required greater muscular ac- neck. When developing exercises ber of repetitions.
tivity to produce an equivalent for treatment, it is necessary to
The second exercise regime has
A Summary of the major neck muscles

Flexion Extension Lateral Bending Rotation

Sternocleidomastoid Splenius Capitis Ipsilateral Ipsilateral Splenius Capitis

Sternocleidomastoid
Longus Capitis Semispinalis Capitis Ipsilateral Splenius Capitis Ipsilateral Levator Scapulae

Longus Colli Levator Scapulae Ipsilateral Ipsilateral

Semispinalis Capitis Semipinalis Capitis
Longissimus Capitis Contralateral
Sternocleidomastoid,
Contralateral
Semipinalis Capitis

Terra Rosa e-magazine No. 5, June 2010 19


been designed to focus on the
muscle control aspects and aims at
improving control of the muscles
within the neck flexor synergy. In
contrast to more traditional high
load strength and endurance exer-
cises, low load exercise is used to
train the coordination between the
layers of neck flexor muscles. With
this protocol, patients perform and
hold progressively inner ranges of
cranio-cervical flexion (C-CF) while
trying to minimize activation of
the superficial flexors. General
strengthening exercises are not
recommended in the early stages
in this exercise approach as it is
considered that general exercise
will not necessarily address the
dysfunction between the deep and
superficial muscles. Thus specific
Terra Rosa e-magazine No. 5, June 2010
Chronic neck pain
emphasis is first placed on re-
educating the deep and postural
muscles and general strengthening
exercises are only introduced once
the imbalance between the deep
and superficial neck synergists has
been addressed.5
References
1
Fejer R, Kyvik KO, Hartvigsen J.
The prevalence of neck pain in the
world population: a systematic
critical review of the literature.
European Spine Journal
2006;15:834-48.
2
Cote P, Cassidy JD, Carroll L. The
Saskatchewan Health and Back
Pain Survey: the prevalence of
Advanced Myofascial
Techniques Workshops
in Australia 2011
Til Luchau
Join the Most
Distinguished Teachers
for workshops in Australia
neck pain and related disability in
Saskatchewan adults. Spine 1998;
23:1689–98.
3
D. Grob, H. Frauenfelder, and A.
F. Mannion The association be-
tween cervical spine curvature and
neck pain. Eur Spine J. 2007;
16:669–678.
4
Panjabi MM, Cholewicki J, Nibu
K, Grauer J, Babat LB, Dvorak J.
Critical load of the human cervical
spine: an in vitro experimental
study. Clinical Biomechanics
1998;13:11–7.
5 Falla D. Unravelling the complex-
ity of muscle impairment in
chronic neck pain. Manual Therapy
2004; 9:125–133
Larry Koliha
20
Myofascial Stretching for the
Arm and Shoulder
By Walt Fritz, PT
Arm Pull
In Myofascial Release, Arm Pull is a
powerful technique used to release
fascia in the wrist, arm, shoulder,
thoracic, and cervical areas. Here
we design a self arm pull tech-
nique which you can do yourself.
Arrange a yoga belt so that the
loop end is loosely enclosing the
hands and wrist. Tie or secure the
free end to a doorknob or similar
sturdy object. Do not grip the belt
tightly and pad the strap under the
wrist if needed.
Slowly lean away from the door,
taking up the slack in the belt until
you feel the first barrier. Allow the
arm to telescope out from the
neck and shoulder, allowing any
three dimensional movement or
Terra Rosa e-magazine No. 5, June 2010
unwinding to occur. Hold the
stretch for a minimum of three
minutes or as directed by your
therapist.
Arm and Shoulder Stretch
This is an effective way of using a
yoga strap to stretch and release
the arm, shoulder, and neck. Sim-
ply loop the end of the strap
through the buckle and slide your
hand through the loop. Keep the
loop loose enough so that there is
no excessive pressure. DO NOT
GRASP the loop; instead let the
hand hang loosely. If padding is
needed, fold a washcloth or similar
under the strap to avoid cutting
into the wrist.
Step on the loose end of the strap
and lean in the other direction.
Play with the amount of strap that
hangs down to the side to assure
that you are getting mild traction
once you begin to lean. Explore
different directions of body lean to
isolate areas of tightness in your
body. Once you have found signifi-
cant areas of restriction, remain in
that position for 3-5 minutes. Al-
low your body to move in response
to the releases. Repeat on both
sides as needed.
Walt Fritz is a licensed physical
therapist with a B.S. in Physical
Therapy and B.A. in Community
Mental Health from SUNY Buffalo.
He’s been actively practicing Myo-
fascial Release since 1992 and
have instructed at over fifty Myo-
fascial Release Seminars in the
United States and Canada. He is
the leader of the Foundations in
Myofascial Release Seminars™ .
With over 24 years experience as a
physical therapist, he combines
the best of traditional physical
therapy interventions with the
state of the art methods of Myo-
fascial Release. His website is
www.myofascialpainrelief.com
21
Dorn Spinal Therapy &
Breuss Massage
by Barbara Simon
The Dorn Therapy
The therapy of Dorn is a gentle
treatment for the spine and all
joints and is suitable to help cli-
ents presenting back and neck
pain. It has been developed in Ger-
many some 30 years ago from a
farmer called Dieter Dorn. He him-
self had an accident which led him
to a healer, a “bonesetter” as peo-
ple called him, and he showed him
the magical treatment which, af-
ter having seen many doctors and
specialists, finally gave him relief
after only 2 treatments. With this
experience he decided that he
himself wanted to go out and help
other people with back pain, using
this treatment and after his first
successful treatment on his wife,
she had been suffering from severe
migraines for more than 10 years,
word spread and the neighbours
and friends came along to experi-
ence his “magic hands”. I know
that many fabulous treatments and
healing techniques started simi-
larly, as a folk medicine and a se-
cret, often kept by one person and
lost after this persons death. But
fortunately in this case, Dieter
Dorn eventually became convinced
that he had to share his secret and
therefore there are now many
Dorn practitioners around the
world helping thousands of back
pain sufferers every day.
But how does Dorn Spinal Ther-
apy work?
It starts with the checking of the
leg length, as 80% of people have a
difference in their leg length, of-
ten without knowing it. Any differ-
Terra Rosa e-magazine No. 5, June 2010
ence is balanced by easy exercises
to bring back the joints of the
lower limbs into their correct posi-
tions. These joints are the hip,
knee and/or ankle and obviously
work happens on the longer leg,
not on the shorter like in most
other modalities. Now that the
legs are balanced, the coccyx, sa-
crum and ileum is the next area to
check. It is examined for any twist
and balanced with gentle pressure
and movement. Once the persons
'base' is balanced, we can move on
to the spine itself.
Deviated vertebrae are brought
back into place by the pressure of
the thumb towards the spinous
processes of the spine. For this
procedure to take place it is essen-
tial for the client to move their
arms or legs in a swinging motion,
depending on which area he is be-
ing worked on. This movement re-
laxes the muscles and keeps the
spine flexible so the vertebrae can
slip back into position.
Many problems such as headaches,
dizziness, ear and/or eye problems
can be the result of nerve pressure
in the cervical area of the spine.
By using this gentle massage tech-
nique these problems can be
solved. To work on this area the
head is gently turned whilst the
therapist finds the deviated verte-
bra and then moves it back into
position.
With this technique tendons and
ligaments are not stretched or
overstretched; they adapt after a
very short time and support the
muscles to keep the vertebrae in
position.
In case of sore or uneven joints
there are some easy exercises to
reduce pain and move the joints
into their correct positions.
The whole treatment is gentle and
not dangerous, no cracking or
abrupt movements are used, just
the thumb on a specific area. The
patient will not be surprised by
sudden movements, the practitio-
ner stays in communication with
the patient and never goes beyond
their pain threshold. To support
22
 Dorn therapy & Breuss massage
the successful treatment there are
very simple and quick exercises
that help the client to keep the
structure in place and also to take
responsibility for their own getting
better. They have to understand
that it is not the practitioner who
fixes them but it is their dealing
with their body that improves their
wellbeing.
The spine is not only the central
“support organ” of the body but
more important the protective
coating for the bone marrow, the
higher “command organ” for all
functions of the organs, tissues,
even each cell in the body. Pain,
malfunction and tissue changes –
not only in the back but also in
every other body region – are often
caused by an irritation of the
nerve that comes out of the bone
marrow due to a displacement or
blockage of one or more verte-
brae. This means that e.g. a poor
digestion can be related to a dis-
placed vertebra in the correspond-
ing area and therefore can be
treated via the spine. So this
means that it always is worth hav-
ing your spine checked for any ail-
ments that cannot be cured or be-
fore undergoing surgery.
“sometimes it would be advisable
to have the second thoracic verte-
bra checked before implanting a
cardiac pacemaker” is one of Di-
eter Dorn’s humorous comments.
And from my own experience I can
say that yes there are cases where
surgery could be avoided just be-
cause the client had the chance to
see a Dorn Spinal Therapy practi-
tioner.
Terra Rosa e-magazine No. 5, June 2010
Dorn Spinal Therapy is also a pre-
ventative treatment as it gives the
opportunity to pick up developing
problems in the spine and inter-
rupt the process before serious
problems start emerging. There-
fore Dorn Spinal Therapy is also a
fantastic treatment for children
and teenagers, in fact for them it
works the best as their body is still
so adaptable and easy to move.
Breuss massage
The Breuss massage is a gentle and
sensitive massage for the spine
which is often combined with the
Dorn Spinal Therapy. By gently
stretching the spine the discs get
decompressed which enables the
St. John´s Wort oil, used in the
massage, to penetrate. Breuss uses
the image of a sponge to explain
the process. A sponge under a 50kg
weight becomes very thin. But by
pouring water on the sponge it ex-
pands to its normal size. Similar
happens to the discs. When they
soak up the oil they expand and
the distance between the verte-
brae increases, allowing more
flexibility for the spine. The secon-
dary effect of the massage is its
incredible relaxing effect. St.
Johns wort oil is known as a nerve
relaxant and that is what happens
during the massage. Even the
toughest people seem to melt un-
der this massage procedure and
finally allow themselves some re-
laxing moments. This massage can
even be used as an add-on mas-
sage for just your normal massage
procedure, particularly if you have
done a very deep remedial mas-
sage.
This simple but effective treat-
ment is now available in Sydney,
Melbourne and Perth. Barbara
Simon is running workshops to
widen the accessibility for poten-
tial clients as well as for practitio-
ners. It means an easy to learn
skill that can add to the effective-
ness of anyone working in body
works: Massage therapists, Osteo-
paths, Chiropractors, Physios etc.
For more information on the tech-
nique, testimonials and workshops
go to www.backcaresolutions.net
or call Barbara Simon on
0407946294
The Dorn Spinal Therapy DVD is
available from
www.terrarosa.com.au
Read also 6 questions to Barbara
on page 30.
23
An Alternative
Approach
to Stretching
by Whitney Lowe, LMT
This article first appeared in the
November 2009 issue of Massage
Today, www.massagetoday.com.
Clinicians, athletes and rehabilita-
tion specialists advocate stretching
as a means for injury prevention
and treatment. The primary pur-
pose of any stretching technique is
to enhance pliability and flexibility
in the soft tissues. It is also rou-
tinely incorporated with massage
in the treatment of pain and injury
conditions. There are many differ-
ent stretching techniques, which
all fall into one of three primary
categories: static, ballistic or ac-
tive-assisted stretching.
Static stretching is the most com-
mon. In static stretching, you bring
the target muscle into a length-
ened position and hold it there
until you have achieved the de-
sired stretch. The ideal length of
time to hold a static stretch is de-
bated in the literature and the
results appear inconclusive. Some-
where around 15 to 20 seconds is a
common time frame that achieves
good clinical results.
Ballistic stretching is used most
commonly in the athletic environ-
ment. During a ballistic stretch,
you bob or bounce into a stretch to
encourage tissue elongation in the
muscle. Ballistic stretching works
by using the momentum of the
moving limb to extend past the
initial limitation of range of mo-
tion. Many people oppose the use
of ballistic stretching because the
rapid elongation of muscle tissue
Terra Rosa e-magazine No. 5, June 2010
in the bouncing motion can acti-
vate the stretch reflex, which
would be counterproductive to
stretching.
In active-assisted stretching, the
client actively engages a specific
muscle contraction prior to, or
during, the stretching procedure.
There is a variety of active-
assisted techniques and they go by
different names such as PNF, mus-
cle-energy technique, active iso-
lated stretching or facilitated
stretching. There are slight varia-
tions in each of these methods,
but they are all based on the neu-
rological principles of post-
isometric relaxation (PIR) and re-
ciprocal inhibition. Experiments
that compare active-assisted
methods with static or ballistic
stretching show the greatest range
of motion gains with active-
assisted methods.
Immediately following an isometric
contraction, there is an increased
degree of relaxation in that same
muscle. This immediate reduction
in neurological activity is called
the post-isometric relaxation (PIR).
The methods of active-assisted
stretching use the window of re-
duced neurological activity during
the PIR to engage a stretch of the
target muscle after it has isometri-
cally contracted. Stretching during
the PIR is more effective than
stretching without the prior iso-
metric contraction.
The other neurological principle
that is of important in active-
assisted stretching methods is re-
ciprocal inhibition. When an ago-
nist (target) muscle contracts,
there is a neurological inhibition of
its antagonist (opposite) muscle.
The reduction in neurological ac-
tivity in the antagonist muscle is
called reciprocal inhibition. Be-
cause reciprocal inhibition de-
creases neurological activity in
muscles opposite the ones being
contracted, it is helpful to use dur-
ing stretching procedures. Stretch-
ing of the target muscle is en-
hanced when its opposite muscle is
contracted at the same time (Fig.
1).
The various techniques of active-
assisted stretching advocate differ-
ent lengths of time to hold the
isometric contraction prior to
stretch. Initial research has indi-
cated that a relatively short period
of nonmaximal isometric contrac-
tion (about 3 seconds) seems most
effective for holding the contrac-
tion prior to stretch.1 These meth-
ods also vary in the length of time
that the stretch is held. A study
investigating active-assisted
stretching compared stretch dura-
tion times of 3 seconds and 30 sec-
onds and found no significant dif-
ference in the outcomes between
the two time periods.2 More re-
search is needed to determine the
ideal stretching method(s). It may
turn out that the optimum stretch-
ing method depends on the situa-
tion in which it is being used.
24

Figure 1: Hamstring stretching with recipro-
cal inhibition. During this hamstring stretch
the practitioner will engage the hip flexors
concentrically by attempting to further flex
the hip. Engaging the hip flexors causes
reciprocal inhibition of the hamstring group
Effective Stretching Procedures
Each of the stretching procedures
mentioned above must take into
account the biomechanical and neu-
rological properties of the myofas-
cial unit. Therefore, all stretching
procedures engage two primary
components: the physical stretch of
muscle and connective tissue
(mechanical effects) as well as the
reduction in neurological resistance
to stretch (neuromuscular effects).
Fascia is interwoven throughout
muscles in an extensive network. It
has viscous properties that respond
better to slow, sustained tensile
loads and resist rapid elongation.3
The process of connective tissue
gradually lengthening when a sus-
tained stretch is applied to it is
called creep. The extensive fascial
network running through all muscles
suggests greater benefit for longer-
duration stretching methods to take
advantage of connective-tissue
creep.
The neurological resistance to
stretch is primarily governed by a
specialized proprioceptor called the hamstrings and hold it for about 30
muscle spindle. It is responsive to
both the rate of muscle stretching
and the amount of stretch in the
tissue. If the muscle is stretched
too fast or too far, the muscle spin-
dle sends signals to the central
nervous system and an immediate
Terra Rosa e-magazine No. 5, June 2010
Stretching
muscle contraction is engaged to
prevent overstretching. This imme-
diate muscle contraction is called
the myotatic (or stretch) reflex.
Stretching procedures attempt to
minimize any recruitment of the
stretch reflex.
An Alternative Method
Figure 2: Enhancing a hamstring stretch.
Manual-therapy practitioners have
The practitioner uses one hand to hold
been excited by recent research the limb in the stretched position and the
other hand applies the fascial elongation
studies enhancing our understand-
technique to the target muscle group
ing of the physiological properties (hamstrings).
of fascia. We have recently learned
that fascia contains contractile cells
and is capable of releasing its con- stretch are emphasized by combin-
traction and further elongating ing these myofascial and active-
assisted stretching techniques. I
when a prolonged tensile load is
have found this stretching method
applied to it.4 Armed with this new
helpful with a number of chronically
understanding, we can use the
tight muscles. In the future, it will
physiological properties of fascia to
be valuable to perform comparative
enhance stretching procedures.
studies with this and other stretch-
Combining active-assisted stretch-
ing techniques to find out which
ing methods with fascial-elongation
ones are most effective under vari-
methods would address both the
ous clinical circumstances.
neuromuscular and connective-
tissue components of the stretching
References
process.
1. Sharman MJ, Cresswell AG, Riek
Consider hamstring stretching as an
S. Proprioceptive neuromuscular
example of how this works. Engage
facilitation stretching: mechanisms
the hamstrings in a short 3-second
and clinical implications. Sports
non-maximal contraction. Release
Med 2006;36(11):929-39.
the contraction and bring the ham-
strings into a stretched position 2. Smith M, Fryer G. A comparison
(Fig. 2). Have the individual at- of two muscle energy techniques
tempt to further stretch the ham- for increasing flexibility of the ham-
strings by attempting to flex the hip string muscle group. J Bodyw Mov
as far as possible (as they did in Fig. Ther Oct 2008;12(4):312-7.
1). This movement engages the re-
3. Taylor DC, Dalton JD, Jr., Seaber
ciprocal inhibition process and en-
AV, Garrett WE, Jr. Viscoelastic
courages further lengthening. While
properties of muscle-tendon units.
this position is held, apply a myo-
fascial-stretch technique (with the The biomechanical effects of
hand or back side of the fist) to the stretching. Am J Sports Med May-
Jun 1990;18(3):300-9.
to 60 seconds. Holding the myofas-
4. Schleip R. Fascial plasticity: a
cial stretch encourages relaxation
new neurobiological explanation. J
of the fascial contractile cells and
Bodyw Mov Ther 2003;7(1):11-9.
enhances connective tissue creep.
Both the neuromuscular and con-
nective-tissue components of the
25
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Terra Rosa e-magazine No. 5, June 2010 26

 Research Highlights
Massage therapy may help re-
lieve symptoms of depression
Depression is a huge public health
problem, and treatment is often
inadequate, Dr. Wen-Hsuan Hou of
I-Shou University in Kaohsiung, Tai-
wan and colleagues note in their
report.
While massage can ease stress and
tension and may have emotional
benefits, the use of massage ther-
apy in depressed patients is
“controversial,” the investigators
note, and “there is no qualitative
review of the treatment effect of
massage therapy in depressed pa-
tients.”
To investigate further, they
searched for randomized con-
trolled trials of massage therapy in
depressed patients. They identi-
fied 17 studies including 786 peo-
ple in all. In 13 of the trials, mas-
sage therapy was compared to an-
other active treatment such as
Chinese herbs, relaxation exer-
cises, or rest, while four compared
massage to a “no treatment” con-
trol group. Investigators also used
a range of methods for evaluating
mood and depression in study par-
ticipants.
Overall, the studies, which were of
“moderate” quality, showed that
massage therapy had “potentially
significant effects” in alleviating
symptoms of depression, the re-
searchers report in the American
Journal of Psychiatry.
It’s not clear from the analysis,
they emphasize, whether a person
would need to undergo regular
massage therapy for benefits to
persist.
There are a number of ways
through which massage could help
people with depression, the re-
searchers note, for example, by
Terra Rosa e-magazine No. 5, June 2010
reducing stress and inducing re-
laxation; building an “alliance”
between the therapist and patient;
and by causing the body to release
the “trust hormone” oxytocin.
Hand and feet massages pro-
vide consolation for bereaved
relatives
Receiving soothing massages for
eight weeks after the death of a
loved one can provide much-
needed consolation during an in-
tense, stressful period of grieving,
according to a study in the April
issue of the Journal of Clinical
Nursing. Eighteen people who had
lost a relative to cancer took part
in the study. Participants ranged
from 34 to 78 years of age and in-
cluded widows, widowers, daugh-
ters and sisters. Nine chose foot
massage, eight chose hand mas-
sage and one asked for both. Only
three had previous experience of
soft tissue massage.
“Details about the massage study
were included in an information
pack provided by the palliative
care team when people’s relatives
died” says lead author Dr Berit S
Cronfalk from the Stockholms Sjuk-
hem Foundation, a Swedish pallia-
tive care provider. Relatives were
offered a 25-minute hand or foot
massage once a week for eight
weeks and could choose whether
the sessions took place at home,
work or at the hospital. “Soft tis-
sue massage is gentle, but firm”
explains Dr Cronfalk, who carried
out the research with colleagues
from the Karolinska Institutet.
“This activates touch receptors
which then release oxytocin, a
hormone known for its positive
effects on well-being and relaxa-
tion. “In this study the hand or
foot massage was done with slow
strokes, light pressure and circling
movements using oil lightly
scented with citrus or hawthorn.
“The relatives were then encour-
aged to relax for a further 30 min-
utes.”
Baseline data was collected on the
participants during a 60-minute
interview before the programme
started and a further 60-minute
interview was conducted a week
after the massage programme fin-
ished.
The interviews with the partici-
pants, which have been published
in the Journal’s annual comple-
mentary therapy issue, showed
that they derived considerable
benefits from the programme.
A follow-up six to eight months
after the study showed that 17 of
the relatives had moved forward
with their lives, but one had suf-
fered further emotional problems
after the death of another close
family member. “All the people we
spoke to used the word consola-
tion” says Dr Cronfalk. “The mas-
sages provide physical touch and
closeness and helped to diminish
the feelings of empty space and
loneliness that people felt. “Study
participants also told us that the
massages helped them to balance
the need to grieve and the need to
adapt to life after the loss of their
relative.”
Massage eases anxiety, but no
better than simple relaxation
does
A new randomized trial shows that
on average, three months after
receiving a series of 10 massage
sessions, patients had half the
symptoms of anxiety. This im-
provement resembles that previ-
ously reported with psychother-
apy, medications, or both. But the
trial, published in the journal De-
27
 Research Highlights
pression and Anxiety, also found
massage to be no more effective
than simple relaxation in a room
alone with soft, soothing music.
“We were surprised to find that
the benefits of massage were no
greater than those of the same
number of sessions of
‘thermotherapy’ or listening to
relaxing music,” said Karen J.
Sherman, PhD, MPH, a senior in-
vestigator at Group Health Re-
search Institute. “This suggests
that the benefits of massage may
be due to a generalized relaxation
response.”
The trial randomly assigned 68
Group Health patients with gener-
alized anxiety disorder to 10 one-
hour sessions in pleasant, relaxing
environments, each presided over
by a licensed massage therapists
who delivered either massage or
one of two control treatments:
* Relaxation therapy: breathing
deeply while lying down
* Thermotherapy: having arms and
legs wrapped intermittently with
heating pads and warm towels
All three treatments were pro-
vided while lying down on a mas-
sage table in a softly lighted room
with quiet music. All participants
received a handout on practicing
deep breathing daily at home.
Unlike the two control treatments,
massage was specifically designed
to enhance the function of the
parasympathetic nervous system
and relieve symptoms of anxiety
including muscle tension.
Using a standard rating scale in
interviews, the researchers asked
the patients about the psychologi-
cal and physical effects of their
anxiety right after the 12-week
treatment period ended and three
months later, Dr. Sherman said.
Terra Rosa e-magazine No. 5, June 2010
All three of the groups reported
that their symptoms of anxiety had
decreased by about 40 percent by
the end of treatment—and by
about 50 percent three months
later. In addition to the decline in
anxiety, the patients also reported
fewer symptoms of depression and
less worry and disability. The re-
search team detected no differ-
ences among the three groups; but
the trial did not include a control
group that got no treatment at all.
Family members reduce stress
in advanced cancer patients
with 14 minute massages
Advanced cancer patients who
regularly received massages aver-
aging 14 minutes or more by a
partner or family member declined
in stress scores over four weeks,
according to results of a study re-
ported at the 7th annual confer-
ence of the American Psychosocial
Oncology Society.
In the study, sponsored by the Na-
tional Cancer Institute, 97 care
partners followed the instruction
of a DVD program to provide mas-
sage to patients at home. The
multi-ethnic sample represented
21 types of cancer (nearly half
with breast cancer), over half with
either stage III or IV cancer.
The study looked at the effects of
massage by a care partner (spouse
or family member) over four
weeks. According to the principal
investigator, William Collinge,
PhD, president of Collinge and As-
sociates, “The number of massages
averaged about four per week
across all patients, but the dura-
tion of massages was particularly
important for stage IV patients. At
four-week follow-up, 78% of those
who averaged over 13.75 minutes
per massage had reduced stress
scores, while only 15% of those
receiving briefer massages did, a
significant difference. It appears
that 14 minutes is some kind of a
‘tipping point’ where the effects
of massages by family members
accumulate and reduce stress in
these patients over time.”
The study also looked at the imme-
diate effects of massages by care
partners and found significant re-
ductions in stress/anxiety (44%
reduction), (34%), fatigue (32%),
depression (31%), and nausea
(29%). These reductions are on a
par with what might be expected
from a professional massage thera-
pist, Collinge said, and bode well
for improved quality of life in can-
cer patients.
According to Collinge, “It appears
that care partners receiving video
instruction can achieve some of
the same results as professional
practitioners. This has important
implications for patient quality of
life, but also for caregiver satisfac-
tion. Caregivers are at risk of dis-
tress themselves – they can feel
helpless and frustrated at not feel-
ing able to help. This gives a way
to help the patient feel better and
increase their own effectiveness
and satisfaction as a caregiver. It
also appears to strengthen the re-
lationship bond, which is important
to both.”
28
 6 Questions to
Michael Stanborough
1. When and how did you decide
to become a bodyworker?
1978. I was living in Sydney and
thought about going to the osteo-
pathic college that a friend of
mine was teaching at. But I also
wanted to travel and live where I
could ski. So I ended up in Boulder,
Colorado at the Boulder School of
Massage. At that time it was one of
the foremost schools in the world
and attracted students from all
over the place. It was a very excit-
ing time – I think we all had a no-
tion that massage was a path to
“change the world” for the better.
One body at a time.
2. What do you find most exciting
about bodywork therapy?
Getting to have authentic contact
with people.
3. What is your favourite body-
work book?
My own. And after that "Job’s
Body" by Deane Juhan. Wow. What
a great book. His writing style and
the breadth of his wisdom are both
inspiring.
4. What is the most challenging
part of your work?
Finding the pathways to the mind
through the body – not so much
challenging but it’s something that
makes the work fascinating and at
SI Australia
http://www.siaustralia.org
Terra Rosa e-magazine No. 5, June 2010
times, profound. In some sessions
there is whole symphony playing,
not just a few nice instruments
and this is simply delightful.
5. What advise you can give to
fresh massage therapists who
wish to make a career out of it?
1. Get an electric height adjust-
able table. Today!
2. Go to Pilates classes and get the
core strength thing happening.
3. Work at about 50% of maximum Michael Stanborough, M.A.
output. No heroics trying to do the (Communication Theory, Victoria
perfect, life-altering massage. University), is the director of SI
Australia and the Stanborough
4. Charge more than enough –
Educational Group. He has prac-
think rent, taxes, super, holidays
ticed Structural Integration Rolf-
and so on. Too many people charge
ing®) for the past 25 years and
too little.
was a full instructor at the Rolf®
6. How do you see the future of Institute in Boulder, Colorado. He
massage therapy? is the first Australian to be certi-
fied to teach by the Rolf® Insti-
More evidence-based. Some of this tute. Michael is the instructor of
will be good. I fear it’s going to the best selling DVD series Direct
come at the expense of the “heart Release Myofascial Technique. See
and soul of massage”. Touch for Michael's website: http://
healing and nurturance will be re- www.myo-fascial.com.au or
placed in some measure by touch www.siaustralia.org
that is informed only by a scien-
tific rationale. I’d like to see a
blend of both these streams –
evidence-based and the more hu-
manistic approach - but the cur-
rent climate seems pretty much
oriented towards the former.
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 6 Questions to
Barbara Simon
1. When and how did you decide
to become a bodyworker?
I finished my studies to become a
Natural Therapist in 1996 and after
that I had enough of mind work
and wanted to do something with
my hands. So I looked into Dorn
Spinal Therapy which back then
was still very new even in
Germany. I liked the simple and
quick learning and that's how I
started in bodyworks.
2. What do you find most exciting
about bodywork therapy?
The fast results I can get and the
benefits I can create in clients.
3. What is your favourite body-
work book?
Basic Clinical Massage by James
Clay and David Pounds.
4. What is the most challenging
part of your work?
As I am now training other health
care practitioners for me the most
challenging part is to get students
interested in learning Dorn Spinal
Therapy.
Terra Rosa e-magazine No. 5, June 2010
5. What advise you can give to
fresh massage therapists who
wish to make a career out of it?
Make sure you charge according to
your services. Most massage thera-
pists don’t value themselves
enough and therefore don't charge
enough money for the hard work
they do. But it is important to set
the value right - for yourself and
for your clients, massage is very
hard work and you want to be
acknowledged for it.
Also make sure you find your niche
in which you specialise. I have
seen so many massage therapists
going from one training to another,
trying to be everything to every- Barbara Simon is a Natural Thera-
pist, trained in Germany, and spe-
one. But reality is, clients are
looking for specialised service and cialising in Dorn Spinal Therapy. In
not for the Jack of all trades. 2000 Barbara moved to Australia
with her family where she intro-
6. How do you see the future of duced Dorn Spinal Therapy not
massage therapy? only as a therapist but also as a
successful trainer in Dorn Spinal
Massage Therapy will always have Therapy for health care practitio-
a place especially now that more ners. Apart from Dorn Spinal Ther-
and more companies hire massage apy she also studied Remedial
therapists to do work place mas- Massage, Reflexology, Ear acu-
sage and with that opening up an puncture and Bach flowers.
understanding about the benefits
of massage therapy even for
people who might have never
thought about it. Also more and
more people recognise that they
need to distress from time to time
and massage certainly can offer
that too.
http://www.backcaresolutions.net
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