Originally published in Massage Bodywork magazine, October/November 2004.
Copyright 2004. Associated Bodywork and Massage Professionals. All rights reserved.
Movement in massage sessions brings life to your clients and life to your practice. I have learned this from my own healing and from 32 years of practice. Personal Journey
I was born with congenital cataracts, and after undergoing several unsuccessful surgeries that left my lenses brutally scarred, I was declared permanently blind as a child. I functioned through Braille, and everyone believed this was how I would spend the rest of my life. But I yearned to see.
At the age of 16, I started practicing Bates vision exercises, combining them with movement and self-massage, continually creating new movements, exercises, and ways to relax and stimulate my eyes through massage. Within six months, I could recognize visual objects, and within 18 months I could read print.
Today I hold an unrestricted California driver's license. My recovery was slow, but exciting. When my son and daughter were born, and I learned they too were born with congenital cataracts, I was devastated by the harsh reality of a dominant gene. But, again, through pain I learned a great truth.
After a traumatic third cataract removal surgery on my 3-week-old daughter, Adar, we took her home to recover. To give my wife a break, I lay down next to Adar, armed with a water bottle, hoping to comfort her and help her sleep. Adar started kicking and straightening and bending her arms and legs vigorously, over and over again. Surprisingly, she did not ask for the bottle. She rested and then moved rapidly again and again for about half an hour before falling asleep.
I asked myself, "Am I seeing one of my greatest teachers in front of me?" Here, my infant daughter, covered with bandages, too young to even turn over, moved so spontaneously and then relaxed from it. Look at the adults of today: parking in front of the store, driving when they could walk, doing anything they can do to not move. Their bodies become frustrated and rigid. They miss the time when they were infants and loved to move. If people could reconnect with the time of movement freedom, they might forgo all degenerative illnesses. Instead they are sluggish and sedentary, and what is the result?
In the United States, 23 percent of the population suffers from arthritis. Worldwide, 80 percent of all people suffer from spinal pain. Seven out of eight people wear corrective lenses. The health industry is trying to ameliorate symptoms without working on the cause. After 32 years of working successfully with people suffering with spine, joint, and vision problems, and paralysis, and after getting hundreds of clients out of their wheelchairs, I can confidently state that what's missing in many lives is the love of movement and the awareness of inner sensations. But this zest can be restored through massage.
Let me ask you something. How often do your first-time clients ask you what kind of massage you do? They have heard the names of types of massage: Swedish, deep tissue, and acupressure. But most people when they receive a massage for the first time really don't know what to expect. You probably tell them that while a massage session could consist of only one technique, it is usually a combination of different techniques customized for their body. You explain the differences between Western and Eastern philosophies, between manipulating muscle and manipulating the body's energetic field. During and after the massage, you tell them about the benefits of good nutrition, water, and exercise. Hopefully, you show them some stretches they can do at home between treatments. You are constantly educating your clients. I want to encourage you to infuse your massage practice with movement. The unbelievably good results will surprise you, and your clients will progress much quicker. Body Awareness
After relaxation, the first, most important step in educating clients about health is to teach them kinesthetic awareness. That is, to get them to have a deep sense of their body. When someone uses repetitive movements all day long, they decrease body awareness and diminish sensation because the conscious mind loses interest, and the nervous system function becomes imbalanced. Overuse of some motor pathways and underuse of others leads to chronic tension, numbness, and motor exhaustion. Passive movement work in massage can awaken a person's sensations. Awareness of the body's natural sensations will help a person move better. Research has shown the more you feel, the better you move. And the more tuned in to your body you are, the more fluid your movement can become.
There are several ways a therapist can increase a client's kinesthetic awareness. Before your client even gets on the table, take a good look at her while she talks to you. Watch how she moves and stands. Is she putting more weight on one side of her body? Does she use her entire shoulder girdle to lift her hand? Does she lean forward and put more weight on the ball of her foot rather than having the weight evenly distributed from heel to toe? The part of the foot that receives the most pressure will determine where the body's center is. If she walks predominately on her toes, her center will be in the neck or in the back of her head. If she throws her weight on the balls of her feet, her center is in her chest, causing her back to curve out sharply.
Begin by explaining to your client what you observe and which part of her body she has been using as the center. Then, show her where the center should be, at the abdomen, and ask her to become aware of that area by visualizing the true center and feeling its location. This may be accomplished by having the client simply place her hands over her abdomen and breathe deeply. Ask her to relax the head, neck, chest, and the part of the body that had been operating as the center. Have her notice any constriction and strain she may feel from changing the center of gravity.
Most people tend to stay in the "sagittal plane," with bodies in a constant state of flexion, always moving in a forward direction. Teach your clients to move laterally, broadening the transverse plane. Have your client lie supine on the floor and roll from side to side. She should roll to the right until the left hand touches the floor in front of the chest, then push herself away to start rolling to the left. Then she should push with the right hand to start the roll to the right. Your client should let her hips and legs also gently push her from side to side. Direct your client to try to make the movement light and easy, like a child rolling down a grassy hill. If she becomes dizzy, have her do the palming exercise described in the sidebar. Give this simple rolling exercise as a homework assignment, to be done 100 times a day. Slowly, an expanded sense of awareness of the body will develop. Your client will use muscles she has never used before, let go of chronically overused ones, augment the side muscles, and add better support to the body.
In general, people do not use their bodies to their full range of motion. People feel compelled to remain fixed at a desk or sitting either in a car or in front of the TV. Most ignore their growing stiffness and discomfort. Most of us use products to make our life "easier" -- remote controls for the TV, stereo, and air conditioner; recliners in the living room; beds that conform to the body in the bedroom; gadgets that do all the chopping in the kitchen; and a car with controls on the steering wheel so we don't even have to reach to turn on the radio.
We "protect" the body by using braces to hold the body steady to avoid injury, instead of using the body properly and regularly in the first place. Arthritis can be helped, and perhaps avoided altogether, not by bracing the joints but by massaging the muscles. This increases circulation and gently moves the joints, lubricating them and increasing their range of motion. Our body is made to move. If we do not use our muscles and move our joints regularly, they will start to stiffen and break down. Food and water are our fuel, but movement makes us use the fuel efficiently and keeps our bodies mobile.Rivka
While sometimes braces can be useful for the average person for short periods of time, like immediately after an accident, in the case of paralysis braces can be tools for movement and mean freedom from a wheelchair. Take, for example, the story of Rivka that I share in my latest book, Movement for Self-Healing
. Rivka was 9 years old and had been confined to a wheelchair with polio since the age of 2. She had been fitted with braces three times, but because she was unable to straighten her left knee, her walking placed so much pressure on the braces that they always broke. Both of Rivka's legs were thin and expected to become paralyzed. Her back was stooped and had a lateral curvature in the middle of the spine. One of her arms was very weak; she could lift it chest-high only with a great deal of effort. The other arm was relatively normal. Her neck muscles were so weak she could hardly hold up her head. I explained to the family that the first thing she needed was massage to improve her circulation and bring warmth to her cold limbs. After that some gentle movements could bring flexibility and strength. I showed them she did have some capacity for movement, even in the semi-paralyzed leg, and that the movement in all the limbs could be improved.
At first her family offered little support, and Rivka was not very cooperative in doing her exercises. But after about four visits, Rivka showed some motivation and changes began to take place. Her cold feet grew warm more rapidly with each treatment. She became more capable of limited movement. She could move her feet sideways, backwards, and forwards. Several of her arm muscles grew stronger and appeared to be more developed. She could even lie on her back and raise her legs for several moments at a time.
After three months of therapy, we requested that Rivka be fitted for braces to support the process of learning to walk. Rivka's orthopedist refused to grant the family's request, believing that nothing could help her tolerate braces but surgery, and that even if she could wear braces without breaking them, she would not be able to take more than a couple of painful steps. I was sure the way to straighten her leg was to relax the muscles and gradually strengthen them -- and the only way to achieve that was to keep the leg muscles working and moving. I felt the motions used in walking would be especially effective. It was absolutely necessary she get braces and begin to walk, and we were determined to find another way. We raised the money for the braces through the media, and Rivka blossomed. Before long, she could go down a flight of stairs by herself and walk a whole block.
She also began to awaken as a person. She had been indifferent to herself before, feeling useless and unwanted. Now she began to feel she really mattered. She had been almost completely immobile before. Now she could get out into the world on her own two feet. About three months after receiving her braces, she made a dramatic leap in her improvement. She could walk half a mile in 20 minutes, whereas before it had taken her an hour and a half. Her walking had strengthened her knee muscles and reactivated her lower back muscles, and it became much easier to rotate and stretch her legs. Slowly, her knees straightened until at last they became completely straight. Her formerly paralyzed arms were now fully mobile and growing stronger. After six months in the braces, she walked a mile and gradually increased her speed until she could walk a mile in little more than 30 minutes. The combination of massage and movement was key for this child, once chained to a wheelchair, to find freedom and life.
I believe in the body's ability to improve and unleash its innate power to move beyond limitations, to go farther, to take the next step, then the next and the next, to set up momentum for a new life. Is there a spark inside you or your client that whispers there has to be something else, there has to be another way? We can help our clients realize this truth. Naomi
Naomi was a young woman whose spine locked when she tried to lift both of her twins. When I arrived to treat her, I saw stark fear in her face; fear and pain were inseparable. Although she could get to and from the bathroom by herself, the thought of changing her position from lying on her back to lying on her side, which I asked her to do, seemed impossible to her. I began by massaging her foot. After it relaxed a little, I massaged her leg, then her abdomen, touching her gently and carefully. Her breathing slowly deepened as I worked. I then massaged her other leg from the foot to the abdomen and, although the pain was still there, she almost forgot she couldn't move. She was then able to lie on her side as I worked on her pelvis and hips. After an hour, she could lie on her stomach to allow me to work on her back.
Naomi's lower back was so tight that her contracted muscles felt like stone. In her lumbar region, three vertebrae seemed almost fused. I was able to feel the structural effects of her muscular tension. By the end of our three-hour session, Naomi felt looser, and her breathing was deeper. She was able to sit up, although with great difficulty. I went home and straight to bed, exhausted from the session. But at 2 a.m. the phone rang, and Naomi's husband asked me to return because Naomi was in dire pain. When I saw her, she was on her back again, her face rigid with fear. I asked her to concentrate on her scalp. I wanted her to relax through a slow process of visualization. I asked her to think about the roots of her hair and the skin that surrounded them, and to allow the skin to relax. Then I asked her to imagine the skull filling with nourishing oxygen. Naomi became aware that she was tensing her scalp, and began to release it. Her breathing deepened dramatically.
I slowly massaged Naomi's toes to relax her foot. After 20 minutes, I could touch her foot firmly. The tension in her foot was connected to the tension around the compressed vertebrae. In her foot, I could feel the pain she felt throughout her entire body. As she breathed, and as I massaged, she gradually became aware of the source of her pain, the tension in the muscles of her lower spine. As she breathed deeply, her muscles relaxed and the pain lessened. Naomi's pain was emotional as well as physical; feelings of helplessness, incapability, loneliness, and inability to communicate are common to spine-injured clients.
I was now able to slowly move Naomi's legs sideways, apart, and upward without hurting her. Moving her legs increased the circulation to her lower back, which was still so tense I couldn't touch it. When I asked her to focus awareness on that area, the pain was unbearable. So I asked her to visualize her hands and feet instead and to experience their sensations. Focusing awareness in this way tends to relax the area being focused on, and it increases the circulation both to that area and to the whole body. I massaged Naomi's calves while she lay on her back, releasing many small points of tension in the muscles. I worked on her knees, moving them gently one at a time, and on her thighs, and then her abdomen. It was 5 a.m. when I started to work on Naomi's abdomen. A little while later she was feeling some relief from her pain and longed to see the breaking dawn through the window. I described the soft colors and beauty of the sky. Her breathing deepened as she listened to my description. She relaxed and was able to roll over onto her side. Imagining the beauty of the dawn through her pain, Naomi's spirit was renewed, and her body relaxed. As she breathed more and more deeply her pain diminished. The sky was almost light when her pain finally left her completely.
Fearfully, but without pain, Naomi sat up and slowly rose from the bed. She took three steps without tensing any of her muscles. On the fourth step, her back contracted suddenly and she nearly fell, but I caught her. I showed her how my back muscles would tense, if I forced them to participate in the motion of walking, and how they remained loose and relaxed if I didn't. She felt how the different ways of walking influenced the muscles of my back, and she immediately grasped that the same process occurred in her own back. After that she walked without using or tensing her back muscles. All of my hours of work had been worthwhile. I continued to see Naomi regularly for a year and at the end of that time she was completely well. Possibilities
The point of Rivka's and Naomi's stories is that the body is capable of improving and moving far beyond our limiting beliefs and expectations. We learn that through love, care from the practitioner, and care of family, people's self-esteem can rise, and that they can find the time to work on themselves. And they can learn how to work on themselves correctly. Through massage and movement, you teach them to isolate muscle groups, to work with the specific muscle that is relevant to the function so that they can let go of the muscles that are not. Moving Naomi's ankles fully helped her to release the back. The dogma of the impossible, in most cases, can be dispelled through a great connection between practitioner and client, and through creative innovation that brings to the client the exact movements needed for her circumstance, to help her move out of back pain, arthritis, and other degenerative conditions. Meir Schneider, Ph.D., LMT, international author, healthcare educator, and therapist, is founder of the San Francisco-based nonprofit School for Self-Healing where he teaches and gives certification in the Meir Schneider Self-Healing Method. For more information, visit www.self-healing.org or call the School for Self-Healing at 415/665-9574.