Note to Reader:
The following are articles written by myself and my colleagues. I hope these articles help to shed some light on how I work as a massage therapist, and my own self journey through massage and bodywork. For more educational articles on CranioSacral Therapy go to www.upledger.com, on the website’s first page scroll down to Items of Interest and click on CranioSacral Articles, Research Results, Videos, and Newsletter Archives. There is a wonderful collection of articles and the latest research done regarding CranioSacral Therapy. I highly recommend the book, “Your Inner Physician & You” by Dr. John Upledger to better understand CranioSacral Therapy. It my hope that you, the client, enjoy these articles, and they help you to find a body modality that will balance your MIND-BODY-SPIRIT CONNECTION
Picking a Style of Massage Therapy that is Right for You
By Alma Ball
I often get ask by clients, “What kind of massage should I get?” There are as many styles of massage, as there are people wanting a massage. So how do you pick a style that will be affective for you? When deciding on a style of massage, I always think about “What is the purpose of the massage?” “Do I need to relax, is there an acute or chronic pain problem, do I need to address a specific issue, such as an emotional/mental trauma, digestion, nerve pain, or auto immune disease?” There are many body modalities that can address a range of issues. It is the massage therapist’s responsibility to establish the goals of the session with the client.
Any style of massage can be both relaxing and therapeutic, but certain styles lend themselves to achieving specific goals. A tradition Swedish Massage, in which the therapist has a nice rhythmic flow to their style, can achieve relaxation through release of endorphins within the body, improve circulation, and increase a relaxed state that calms the constant chatter that our minds create in our hectic everyday lives. This style of massage can also be deeply therapeutic.
When picking a massage style due to an acute or chronic pain issue, I often turn to bodywork styles that are therapeutic in nature with a specific goal in mind:
Trigger Point Therapy works the muscles in specific patterns to release one muscle or a group of muscles. The goal of Trigger Point therapy is to identify a trigger site in the muscle fiber. Trigger Points tend to form due to hyperirritable spots in the fascia surrounding skeletal muscle. Trigger Points are described as taunt bands of knotted muscle, which can be found by running a finger perpendicular to the muscle fiber. Trigger Points display a muscle twitch, radiate pain, and are taunt or have a hard nodule. Treatment of Trigger Points requires identification, deactivating and elongating the structures affected along their natural range of motion and length. –Source: Davies & Davies 2004..
Myofascial Release is “the movement of contractile or inert tissues in such a way as to effect change in that structure or its related elements. The assessment and treatment are directed at soft tissues with the techniques being active, passive, or both, and may or may not include bone motion. The effect of this treatment may be demonstrated in a change in the targeted soft tissues, the articular structures, neural system, or vascular system. Examples of the use of soft tissue range from facilitation of fluid exchange or restoration of movement in the acutely edematous muscle lesion, to stretching of adaptive shortened contractile or connective tissue. -Source: American Medical Association, CPT Assistant Newsletter, Summer 1995.
Deep Tissue Massage is designed to relieve severe tension in the muscle and the connective tissue or fascia. This type of massage focuses on the muscles located below the surface of the top muscles.. -Source: Wikipedia.
These three styles can be used in combination or as a standalone modality. These styles feel different from each other. For someone who is hyper-sensitive to touch, I would use more myofascial and trigger point techniques. For someone who likes a deeper pressure at times, deep tissue might be the preference. The goal of therapeutic massage is to break through the pain-spasm-pain cycle. If you are a person who has a job that deals with repetitive motion or prolonged positions, such as typing, lifting, or driving, any of these modalities can address these common muscle-skeletal issues, and the pain-spasm-pain cycle. Talking with your massage therapist about therapeutic goals and your sensitivity to touch will help determine the style(s) of massage that will meet your needs.
Do you need a style of massage that address’s MIND-BODY-SPIRIT CONNECTION? All bodywork can address the MIND-BODY-SPIRIT CONNECTION, but some forms of massage and bodywork lend themselves more aptly to achieving this goal. Bodywork modalities like CranioSacral Therapy, Shiatsu and Reflexology can address patterns of stuck energy within the body, meridians and chakras. Someone who is struggling with making decisions, emotional/mental stress, past physical trauma, or wrestling with spiritual questions can benefit from modalities that address, not only the physical effect of thoughts on the body, but also the energetic, spiritual, mental and emotional aspects too.
Clients who are sensitive to touch, have nervous system issues, auto-immune or physical/emotional trauma can have better results with CranioSacral Therapy. It is a non-invasive, light touch therapy, that follows what the body needs to do to release restriction patterns within the body. There are also advance techniques of CranioSacral Therapy which incorporate a dialogue component that facilitates the client to become in touch with their own inner wisdom for self-healing.
"Shiatsu emphasizes correction and maintenance of bone structure, joints, tendons, muscles and meridian lines, whose malfunctioning distort the body’s energy and autonomic nervous system causing disease."-Source: Zen Shiatsu by Shizuto Masunaga with Wataru Ohashi.
Reflexology is the rhythmic and energetic process of working the organs and other bodily systems on the hands and feet. Reflexology’s aim is to correct three negative factors involved in the disease process, such as congestion, inflammation, and tension.
The above bodywork modalities can be used together or as a standalone practice. Each can be used to achieve similar goals. It comes down to what truly resonates with the client for their individual healing purposes.
Another issue to remember when picking a style of massage is your own personal comfort level. Do you prefer to leave your clothes on, rather than completely disrobe? Someone who does not want to disrobe would probably be more comfortable with Shiatsu, Reflexology or CranioSacral Therapy. If you are uncomfortable on the table, you will hold your body tense, and will not experience any sense of relaxation or therapeutic relief. Ask yourself if you are tender to touch or require a deeper touch. Above all else, tell your Massage Therapist what your goals are or explain the type of problems you are having within your body. A good Massage Therapist will ask these questions and discuss your goals for treatment with you.
If you have an acute injury, it is always a good idea to check with your doctor regarding whether you should have a massage or seek other medical help. A person should reframe from having a massage at least 24 hours after a strain or sprain, or if you have continued swelling and redness after 48 hours. This is a good indication that there is something more serious going on with the muscle-skeletal system. Clients that have a history of blood clots, diabetes, heart disease, bulging disk or edema should have a doctor’s okay before any massage therapy is performed.
If you have any questions, your massage therapist should be able to give suggestions on what would be the appropriate for the type of muscle-skeletal problem you are having. My recommendation to clients who have never had a massage is to explore your options. Try to find a massage therapist who is knowledgeable and versatile in different styles of massage therapy and bodywork.
Layers of the Onion: The Way Our Bodies Store Trauma
By Alma Ball
We go through life not untouched or unscathed: physical, emotional and mental traumas find a place to reside in our bodies. The patterns created can lead to acute and chronic pain patterns.
In his book, “Your Inner Physician & You,” Dr. John Upledger describes how trauma is stored in the body, like layers of an onion. Once some restrictions are peeled away, released and balanced, others may show themselves and need attention. This can lead to a stripping away of layers until the therapist gets to the core problem, whether it is physical, mental, emotional or spiritual. The goal is to get to the core layer, i.e.; the problem.
CranioSacral Therapists are trained to use many tools and techniques, such as a Still Point Induction, 10 Step Protocol, Hard Palate Techniques, Positional Tissue Release, Imagery & Dialogue and Direction of Energy Techniques. There is one main difference between CranioSacral Therapy and most other massage therapies. CranioSacral Therapy is an indirect approach, rather than the direct approach of manipulating the muscular tissue to induce a release. It is the CranioSacral Therapist’s job to be neutral and follow the body’s response to facilitate tissue release.
In my own experience of coping with pain, there are two childhood events, which I now believe to be the origins of my acute/chronic pain patterns in my adult life.
As an infant, my father was rocking me in his arms out on the patio, when he fell asleep after a long day’s work. I slipped out of his arms and hit my head on the concrete. My parents were of course concerned and had a doctor examine me. I had no apparent problems at the time, but that was first serious impact to my frontal and parietal lobes, not to mention the force of the impact on my upper cervical vertebrae. The second serious childhood accident, that I can remember is flying off of the monkey bars at school in the second grade. I fractured my coccyx. To this day, I still have problems from time to time sitting directly on my coccyx. I believe these two events were the main contributing factors that lead to severe migraines in my adult life.
There were other contributing factors also. Throughout my life, I have been an active horseback rider. I can remember a nasty incident, while at a summer camp, where I was dragged by a horse. It wrenched the left side of my body badly. There were other numerous spills off of horses in my childhood. In my late twenties, I was active in karate, and can recall a competition where I got wallop on both sides of my temporal lobes. I did not see stars, but I remember being a little dazed, and I certainly lost that round. It wasn’t too long after that competition I started to have light sensitivity, and then the 3 day aura migraines. At the time, I never connected that karate competition to my unexplained light sensitivity and migraines.
Over time a pattern developed in my body of tightness at the base of my head and neck, (Craniobase), popping in my jaw, right hip elevated higher than left and left shoulder higher than the right. I felt like my right shoulder and right hip were being drawn together by an invisible string and thoracic spine was being pulled to the left. Add to this physical pattern, the mental and emotional stress of work and home life, I started having extreme 3 day migraines in my early 30’s.
A CranioSacral therapist is trained to look at what is presently triggering in the body, and also at past physical, mental and emotional traumas contributing to the present problem. For me, compression of the frontal bone, parietals and sacrum at a young age caused significant restriction pattern within my CranioSacral and Muscle Skeletal System. I get physical relief from this pattern when my sacrum and craniobase are released with traction, along with sphenoid and hard palate releases. This pattern in my body can also be triggered when I am under emotional and spiritual stress. Recognizing what is the core cause of the pattern through dialogue and imagery work has been essential to being pain free. Not only has CST helped me to identify past injuries and physical causes of pain, but the modality has helped me to identify when my mental, emotional and spiritual state is triggering pain in my body.
A Miracle with Touch
Nicholas, a four-year-old, was diagnosed autistic approximately twenty-four months prior to starting CranioSacral Therapy (CST). He became our client for a case study looking at the effects of CST on autism. This study was completed in twelve sessions over the course of five months. What we saw happen in that time was nothing short of miraculous. Nicholas went from being hypersensitive to touch to showing us where he needed touch and expressing himself through touch.
The first visit with Nicholas was spent letting him get used to the environment and to us, the two therapists he would be working with. He was extremely sensitive to touch, and he moved around the office stemming (repetitive actions) on various activities. He was obsessed with the water fountain, the therapy ball, the treatment table, and going to the bathroom. He would stay only one to three minutes in one location.
I (Alma) knew that autistic children were extremely sensitive and, as a therapist, I would have to be neutral in my energy when working with Nicholas. What surprised me the most was that our first session was spent almost entirely off the body monitoring his craniofacial rhythm and helping him to release energy. There were points during the session that we were three to six feet away from his body. I believe that Debbie and I earned his trust that first session, showing him we were willing to listen to and facilitate what his body could handle as far as stimuli and touch.
We asked Nicholas’ mother to provide us with a history of behaviors and other concerns she had about her son. Over the five-month period we saw improvement in his stemming behaviors and health issues. We also witnessed remarkable results in his social and developmental skills.
Behavioral benefits observed were decreased stemming on behaviors related to the bathroom (asking to go everywhere he went), obsession with naming types of cars, and wanting drinking water. Health benefits observed were chronic constipation improved to regular bowel movements; sleep patterns improved; and seasonal allergies decreased. Socially and developmentally he made tremendous gains in expressive speech; he tried a greater variety of foods; and he was emotionally peaceful at an all-day SeaWorld trip. Nicolas also displayed improved gross motor skills (balance beam and swimming), increased need for sensory input, and expression of typical preschool behavior (greeting a classmate, playing with a doll). His interest in spelling exploded. He had a growth spurt in height and features.
The most miraculous improvement by far was that Nicholas displayed the ability to be touched and to give touch. He went from not allowing anyone to touch him to allowing a therapist to work inside his mouth. He also learned how to help release certain bones for himself. During the sessions he would start pulling on his nose, on the roof of his mouth, or on his ears when we were working on other areas. By the sixth session he was asking us and his mother for physical hugs.
At this point Nicholas’ focus shifted from individual treatment to refusing treatment until his mother was worked on. Treatments became about the energetic boundaries between Nicholas and his mother.
Nicholas brings a smile to my (Deborah’s) face. He is a sweet, gentle boy who exhibits many autistic behaviors. Most of his behaviors are stemming and operating to “the beat of his own drum.” Nicholas taught us how to work with his hypersensitivity. During our sessions of CST we saw amazing improvements in behavioral, social, and developmental skills. But by far the most fascinating and miraculous occurrence in our work with Nicholas was how he pointed to his mom, a single parent, and wanted us to work on her for six out of the twelve sessions. Oftentimes, one of us would work on Mom and the other one on Nicholas. It was as if he knew that she needed releases that were integral to his own process in healing. If we tried to bypass her, he would refuse treatment until we worked on her. To me it fortified the powerful connection of dis-ease in family groups—what I like to call “sins of our fathers” or “intergenerational healing.”
I (Anna) love to see what a difference CranioSacral makes in children. It is miraculous and with Nicholas it was no acceptation. To watch him grow over the 12 sessions was wonderful. When one steps out of the normal or societal norm of treatments to help their child, as his mother has done is monumental. He has had significant improvements in his behavior from the first session until the last.
The miracle with Nicholas is that in as few as six sessions he recognized not only his need for therapeutic touch, but he directed us to his mother’s need for CranioSacral Therapy.
Deborah Gledhill, CMP
CranioSacral Therapy Practitioner since 2012
Alma Ball, CMT
CranioSacral Therapy Practitioner since 2005
Anna Fortney, RN
CranioSacral Therapy Practitioner since 2012
The Gremlin on My Back: A Look at Trigger Point Therapy
By Alma Ball
My clients have described the cause of their pain in many ways…that stinging, pulling sensation, tightness or a lump in my back, hip, arm or leg. My favorite description was from a young working woman, who stated, after a particular stressful week at work, “The two headed monster is back. I cannot get that Gremlin off my back!”
In our bodies Trigger Points raise their ugly heads in muscle fiber and can cause a person all kinds of pain. When we finally want relief, we want it now. The problem is the Trigger Point may have taken awhile to manifest, or the pain being felt is referred pain, not the primary trigger point, but secondary trigger points, which are known as satellite trigger points. These secondary trigger points can feel like they are the main cause of the problem, but the therapist’s job is to find the primary trigger. By deactivating the primary point, the satellite points alleviate or disappear altogether. (Davies & Davies 2004, 22-23)
The cause of a trigger point happens, when a microscopic unit in the muscle fiber called a sacromere remains in a contracted state of overstimulation. The sacromere is responsible for contraction of muscle fiber. Millions of sacromeres must respond for the smallest of muscle movement to occur. (Davies & Davies 2004, 20)
Our bodies are complex and the instant we decide to say “Enough is enough. I want that pain to go away. I want the Gremlin off my back,” that instant miracle does not always happen. Tracing back to the original event or injury can be hard. In some clients’ cases there may have been multiple injuries. This takes time, and a quick fix does not come in just one massage therapy session. I always ask a client how long they have been in pain. Their answer gives me a frame of time from which to work. This does not mean if someone tells me a year, it will take a year, but I now know there has been time for the main trigger point to have a cascade of many secondary trigger points, which may be affecting an appendage, half of the body or the whole body.
Activities that cause muscle fatigue and develop trigger point symptoms are obvious, such as avoidable muscle abuse and unavoidable muscle abuse. Some common examples of avoidable muscle abuse are repetitive overuse of muscles in work situations, poor body mechanics or a disregard to health issues, such as stress, weight or being over loaded with work or life commitments. The avoidable muscle abuse can be corrected by adapting activities and lifestyle, or changing the environmental factors. Common examples of unavoidable muscle abuse are falls, auto accidents, or any other unpredictable incident that could injure and do bodily harm. (Davies & Davies 2004, 27) We are not in control of those around us, nor can we change the outside environment in which we live.
The important point to remember, when dealing with trigger points, is to identify a problem sooner than later. Issues that are treated promptly can reduce pain, if not vanquish it all together. Severe chronic pain issues can have major reduction in pain, and can be managed with ongoing treatment and/or self-treatment. Clients with chronic pain can experience a breakthrough in treatment where pain goes away completely. At this time, clients who have had chronic or short term pain may feel that treatment is no longer needed. Other clients continue maintenance massage therapy due to their work, stress and life style as a prevention and health choice. These decisions are based solely on the individual and their continued health needs.