Originally published in Massage Bodywork magazine, June/July 2000.
Copyright 2003. Associated Bodywork and Massage Professionals. All rights reserved.
I am sitting on my chair
at a quiet beach.
The sun is shining brightly.
Warm waves lap at my feet
as they dangle in the water...
I move my feet together
and scoop the warm water over my shoulders
and scoop the warm water over my face...
then scoop the warm water over my head
covering me with a warm waterfall.
This soothing verse, often accompanied by relaxing music, begins the rhythmic ROM Dance sequence. The ROM Dance -- or Range of Motion Dance -- is a gentle exercise and relaxation training program designed especially for people with pain and other physical conditions which may limit range of motion. Getting the most from their joints is especially important for those people (especially the elderly) who have joint conditions, because range of motion can shrink with disuse.
Initially developed for use by patients suffering from rheumatoid arthritis, an autoimmune disorder which can make movement painful and stiff, the ROM Dance originated in 1981 at St. Mary's Hospital Medical Center in Madison, Wis. Diane Harlowe (MS, OTR, FAOTA), an occupational therapist and researcher, and Tricia Yu (MA), a health educator and t'ai chi instructor, were challenged by their patients who complained of the boredom and monotony of traditional therapeutic exercises. In response, Harlowe and Yu developed this routine to encourage patients to keep moving each day.
Almost 20 years later, the ROM Dance is going strong. It is practiced by people of all ages and it is taught nationwide by physical and occupational therapists, nurses, dance and recreation therapists and instructors in hospitals, senior centers, nursing homes and other rehabilitation centers. And while it continues to be recommended for individuals with rheumatoid arthritis, it is widely used as a therapeutic intervention for cancer, Parkinson's disease, heart disease, stress management and gastrointestinal problems. In addition, massage therapists have found practice of the ROM Dance benefits their clients, and often add elements of the exercise to a massage session.
Sarah Watts, a nationally certified massage therapist and ROM Dance instructor, reports that she has found practice of the ROM Dance technique to be helpful to her clients with cases of osteoarthritis, high blood pressure and heart problems. "I'm constantly using parts of the dance with clients who come for massage," she said, "and encouraging them to join a local ROM Dance group. Basically, the ROM Dance monitors joint range of motion, so any client who needs to gain strength, improve balance and increase flexibility can benefit from it. And I've found that the specific imagery and gentle prose used in the dance enhances relaxation for almost anyone. The important thing to remember about the ROM Dance is that it is a flowing progression of dance movements, rather like I want my massages to be -- a flowing progression throughout the body."
Watts related the positive effects of the ROM Dance for an 84-year-old client who fell and broke her humerus close to the shoulder. "Her recovery period was good and she regularly received physical therapy and massage. With the addition of the ROM Dance, her shoulder elevation, retraction, depression and protraction all improved, as well as her elbow extension and flexion, and shoulder external and internal rotation. She enjoyed what she did and it boosted her confidence as she reclaimed her strength and flexibility."
Another client in her 80s came to Watts for massage three months after having major heart surgery. "Her shoulders were internally rotated," said Watts. "In other words, her heart was being protected at the cost of her postural alignment. With 30 minutes of ROM Dance movement, which opened up the chest via shoulder retraction and sustained abduction against gravity, she was breathing deeper, her spine came into alignment and she had gained confidence that she no longer needed to 'protect' her chest. She walked out of that session 2 inches taller and smiling to herself."
Irene Crabtree has been an active participant in a weekly ROM Dance group at Madison's Atwood Community Center for the past four years. "My knees have arthritis and the movement is good for them," said the 87-year-old. "The ROM Dance helps me stay active. My feet are worked all the time, and I find the rotation movements to be really helpful."
Another devoted member of the Atwood Center ROM Dance group, 73-year-old Marion Belle Peckham, said regular practice of the dance greatly improves both her emotional and physical well-being, and gives her better agility in her hands and feet.
Georgina Forbes, 68, has found improved range of motion after an injury to her upper left arm. "Plus, the ROM Dance is so relaxing," she said, "and I feel very graceful as I do it."
Leola Raymond, 80, said she is reminded of the ROM Dance each time she showers. "I think of the part in the poem that says, 'I scoop the water over my head,' and find this visualization is very soothing and good for me," she said.
"Although it only takes about seven minutes, there's so much woven into the ROM Dance," said Harlowe, a ROM Dance co-originator. "It can be used as a door through which people can enter into a whole new way of thinking about themselves and wellness."
This seven-minute exercise routine offers participants a comprehensive range of motion. The movements include slow reaches both from seated and standing positions. Virtually every muscle and joint get a chance to move. There is even a special hand exercise routine. And the ROM Dance can easily be adapted to meet the needs of specific individuals. While the "original" ROM Dance sequence is accompanied by a poem which choreographs movements in sunlight, other versions have been developed, including "The ROM Dance in Moonlight" and "The ROM Dance Seated," designed in response to requests from people with sun sensitivity or lupus (the autoimmune disease of connective tissue) and those in wheelchairs. "While the main purpose of the ROM Dance is to help maintain and improve joint flexibility, some people also find that it affects their strength and endurance," said Yu.
The slow, graceful quality of the ROM Dance is borrowed from the fundamentals of t'ai chi ch'uan, an ancient Chinese mind/body exercise that enhances flexibility, strength, balance and coordination. T'ai chi trains the practitioner to be calm while alert, both strong and flexible, and to relax in the midst of stress. Its principles train natural postural alignment and reinforce proper body mechanics. Medical research is beginning to verify its positive effects on the cardiovascular and pulmonary systems, physical balance, the immune system and emotional health.
While t'ai chi itself is more complicated and demanding of coordination than the ROM Dance, it is practiced mindfully with special attention to breathing and relaxation in motion -- principles also integrated into the ROM Dance program. The ROM Dance teaches participants to relax despite pain, to move gently and slowly in order to maintain the ability to move, and to develop sensitivity to and awareness of subtle changes in the body. Its unique foundation blends Eastern movement and self-awareness with Western therapeutic techniques. Through regular practice, the slow, fluid ROM Dance can enhance mental focus, body awareness and imagination. It can also help train the mind to override the body's toxic responses to stress. "The ROM Dance is about drawing from the energy of everything around us," said Yu.
The movements of the ROM Dance are coupled with poetry aimed at getting people to relax and put aside the stress of their lives. The original version of the dance has the participant visualize being at the beach, splashing in the water and feeling the sunlight, meeting a friend, sharing thoughts and finally parting. "The concept of imaging gives a person a sense of connection not only with the natural world but the universe at large, and that can be very healing," said Harlowe, noting that in part of the dance, participants wind up playing with imaginary sunbeams.
"The poem gives meaning to the movements," said Yu, "making them easier to remember and follow, like a cue. It also creates pleasant images of warm water, sunshine and friendship that help people relax while they are doing the exercise."
Both Harlowe and Yu stress that the ROM Dance is most effective and enjoyable when it is practiced with attention to the seven principles for maintaining mental focus. These are: 1) attention to the present, bringing thoughts to the here and now, rather than to concerns about the past or future; 2) diaphragmatic or deep breathing, which promotes relaxation; 3) postural alignment; 4) awareness of movement; 5) slow movement; 6) relaxed movement, both of which focus attention on the quality of feelings within the body; and 7) the use of imagination which can enrich the experience and contribute to a person's feelings of well-being. Since it is difficult to describe the rhythm, flow and quality of the ROM Dance sequence's movements, videotapes of each version have been developed to assist in the learning process. Both a pilot study and an efficacy study have shown the ROM Dance to be an effective alternative to traditional range of motion exercises.1
The following personal experiences provide more bird's-eye tributes to the wide range of benefits offered by the ROM Dance.
- "As I turn 60 I appreciate having the ROM Dance as a total-body exercise program that I both enjoy and can easily continue into my later years," said Carol Karls, a "regular" at Yu's ROM Dance and modified t'ai chi fundamentals class at the Tai Chi Center in Madison. "I love how soothing and relaxing it is, and having been told that I will eventually have arthritis due to past joint fractures, I'm happy to have the ROM Dance as my 'ace in the hole'."
- Nancy Baillies, a registered nurse and regular participant in Yu's class, said practicing the ROM Dance has given her long-term help in keeping both mind and body active and healthy. "It helps me to know the possibilities of movement in gentle and safe ways, and I feel more in touch with both my body and my mind as a result," she said. "The slow, relaxed movement, balance and shifting of weight allows me to both move and meditate so that afterward I feel more energized and refreshed, more self-confident and calm. This form of exercise is comparable to Feldenkrais and the Alexander technique, where the total body-mind-spirit is engaged. As an R.N., I also feel the potential in combination with more freestyle movement and thought, and other therapies, is critical as we adjust to illness and growing older."
- Bob Buzecky, 69 and also a member of Yu's class, said, "I get an invaluable sense of peace from the classes that flows over into the rest of my life." His 64-year-old wife Eva, who is also a t'ai chi and ROM Dance instructor, said, "For me, this is a fountain of youth. Every time I do the ROM Dance I remark to myself, 'How good it feels to move.' The poem appeals to my artistic nature and makes the movements dance-like and not mechanical like much of physical therapy. And as a teacher, I know how healing it can be. Many students have shared with me their physical improvements."T'ai Chi Helps to Balance, Energize
In addition to the ROM Dance, Sarah Watts finds the practice of t'ai chi to be extremely useful. "As a massage therapist, my breathing and body alignment awareness is vital to my flow of energy," she said. "A knowledge of good body mechanics is essential to my health management, and I owe it to each client to be balanced, energized and relaxed for each of my sessions. Several of my clients now attend t'ai chi and ROM Dance classes as part of their health management. It's important as professionals to be aware of how our clients can lower blood pressure, improve their breathing and positively enhance their longevity. Participation in the ROM Dance and t'ai chi does all of this.
"Before I begin a massage," she continued, "I suggest my clients place their right hands on their chest and left hands on their belly and lie there for a few minutes to tune into the rhythm of their breathing. It's relaxing, it stimulates circulation and is helpful in preparing for a bodywork session."
Susan Vaughan, who has osteoporosis, finds the combination of t'ai chi fundamentals and the ROM Dance has worked wonders. "Both my balance and my concentration have greatly improved," she said, "so I don't worry as much about falling as I once did."
Randi Savage, a nationally certified massage therapist, t'ai chi instructor and psychiatric nurse, practices t'ai chi on a daily basis. "Not only does this maintain my health; it also enhances my practice as a massage therapist," she said. "I begin each day with t'ai chi warm-up exercises that help my muscles to loosen and stretch. And I use basic t'ai chi principles to assist me in how I 'move' when working with clients. I am able to have better posture and use proper body mechanics when I give a massage, and my body is relaxed and moving freely. I release any tension and move with ease, helping me to prevent overuse injuries, fatigue and boredom. This helps me stay creative, as well as mentally and physically challenged -- and I also believe it helps prevent burnout. I strongly believe that even if a therapist learns only the daily warm-up exercises for t'ai chi it will help them maintain health and prevent illness and injury."
Savage also passes on some of her t'ai chi expertise to her clients. "I teach them how energy can contribute to tight muscles, stress and illness, and I enjoy teaching some of the t'ai chi warm-up stretches and moves for body awareness and breathing," she said. "Introducing t'ai chi to my clients allows me to be creative, have fun and feel good about teaching new things to my clients."
This proactive approach has paid off for Savage's clients. "They've reported a variety of positive effects on their bodies and in their lives," she said. "Several have used t'ai chi to get through their days with less stress, some have used it to focus on their breathing, some students use it to relieve test anxiety and several others view their t'ai chi practice as a way to nurture themselves and cultivate positive change," said Savage.
"As bodyworkers," said Watts, "we are constantly going the extra mile for our clients. I feel we need to work in harmony with all healing modalities that enhance health. When clients leave our studios or offices feeling better on all levels, we've contributed to the health of an individual, a family and a community."
The ROM Dance Network is dedicated to linking professionals, sponsoring workshops and distributing ROM Dance program instructional materials. For more information about the ROM Dance or to order any supportive instructional materials, including illustrated text and videotapes, call the Network at 800/488-4940, or visit its website at www.romdance.com. For more information on t'ai chi, visit www.taichihealth.com.Deborah Fritsch is a Madison, Wis.-based freelance writer.References