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John
John was a veteran of the Vietnam War who was still suffering from a war injury many years later. He had been dropped from a helicopter into a battle from six or seven feet up and landed on his shoulder with all of his weight. The medics gave him some injections and sent him back out into the field, so he never received any real therapy. Since his return home the injury had become chronic over many years. He had limited range of motion in his arm and was unable to perform in sports, which had been his hobby.
His massage therapist determined that there was deep damage to the deltoid muscle, which had been crushed, and the scarring of the muscle had adhered to the bone and become hardened. In fact he had an area about the size of a quarter deep in the muscle that felt like bone. After deep tissue work the area began to come alive again and over time he was able to enjoy sports again.
Elliot Greene explains, "Sometimes when you get a deep bruise to a muscle it actually calcifies. Also, when scar tissue does not heal well the fibers of the scar can grow in a matted way that impairs movement of muscle tissue—the scar tissue may cross the muscle fibers and restrict them.
"Then, through the adhesions that are formed around the scar, these tissues become stuck to adjacent tissues. In John's case they became stuck to the periosteum, the skin that covers the bone. This is why when he would try to move this muscle, there would be a stabbing pain.
"This particular case took a lot of strength to break up the adhesions. With deep tissue therapy, after the scar begins to soften, the fibers begin to move more parallel to the muscle fibers, thus being less resistant to movement of the muscle tissue. This is 'the stretch hypertrophy law.' Also, the opening up of circulation of lymph and blood helped unfreeze the area."
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The Alexander Technique. This is an approach to psychophysical reeducation. It was developed by the Australian actor F. M. Alexander and works with unconscious patterns of thinking and the resultant movements or postures that become set in the musculature. Such patterns can be made conscious so the student can then become aware of how he/she moves and can make the choice to change patterns, allowing more balance, grace, and ease of movement, thereby reducing and eliminating chronic tension or distortion in the musculoskeletal system. The relationships among the head, neck, and back are of particular importance.
The Alexander Technique is taught in private half-hour to hour lessons. The teacher works with the student to observe and change mind/body habits that interfere with optimal functioning. The teacher uses both verbal and hands-on guidance to help the student experience new ways of moving and embodying him- or herself. It is not a fixed series of treatments or exercises, but often a series of several lessons is recommended. Training to become a teacher takes three years (sixteen hundred hours).
Ortho-Bionomy. Ortho-Bionomy was developed in the 1970s by the bodyworker Arthur Lincoln Pauls. This approach uses gentle, relaxing movements and postures to help the body release tensions and muscular holding patterns. No force or pressure from the practitioner is used. Its goal is a restoration of structural alignment and balance.
Oriental Methods
Oriental methods are based on the principles of Chinese medicine and the flow of energy or chi through the meridians. The geography of the acupuncture meridians is relied upon to determine points of applying the techniques and the ultimate goal is restoration of harmony or balance in the flow of chi. These forms may also be used in concert with herbs and acupuncture.
Pressure is applied by finger or thumb tips to predetermined points rather than by the sweeping broad strokes of Western style massage. Strong pressure or very light pressure may be applied. There are over a dozen varieties of oriental massage and bodywork therapy, but the most common forms in this country are acupressure, shiatsu, Jin Shin Jyutsu, and Jin Shin Do® Bodymind Acupressuretm;.
Acupressure and Shiatsu. These are similar varieties of finger pressure massage. They are both based on applying pressure to a pattern of specific points that correspond with the acupuncture points. Pressure is applied with the thumb, finger, and palm rather than needles.
The goal is the efficient and balanced flow of chi through the meridians. It is believed that where there is tension being held in the musculature, the flow of chi is impaired through those areas, which can lead to chronic problems not only in the musculature but in the associated organs. Stretching and movement are also sometimes used.
Acupressure is the more generic term used for this approach and shiatsu is the Japanese version.
Jin Shin Jyutsu. This approach comes from an ancient Japanese healing tradition that uses touch to restore the internal flow of energy through the body by releasing energetic blockages. A session lasts about an hour and the client is fully clothed, lying on a table. The practitioner uses pulse diagnosis to identify energy blocks and then gently holds or touches a specific combination of two of twenty-six acupuncture points to allow release of the blockage.
As it is practiced in the United States the holding uses less pressure than other forms of acupressure or shiatsu and there is no application of massage-like movements to specific points. Rather the touch is very light and works to balance the flow of energy.
Jin Shin Do® Bodymind Acupressuretm;. This approach was developed by California psychotherapist lone Marsaa Teeguarden. It applies stronger acupressure on the points and for a longer period of time than does Jin Shin Jyutsu. It focuses on the deep release of armoring (muscular tension of physical or emotional origins) through gentle yet deep finger pressure.
Jin Shin Do© incorporates Taoist breathing techniques, oriental acupuncture theory, Japanese finger pressure technique (sometimes holding points for as much as one to three minutes), and Reichian segmental theory (an understanding of how tensions in different parts of the body affect each other as well as particular feelings or emotions).
Energetic Methods (Non-oriental)
In a sense, all the oriental methods described above are also energetic methods in that they are working with energy according to principles of Chinese medicine and view the human being as an energy system. However, there are other energetic methods that are not based on Chinese principles. The most prominent of these are Therapeutic Touch, polarity therapy, and Reiki.
Therapeutic Touch. This method is unique in that it was born and reached its maturation within the context of conventional Western medicine. It was developed in the 1970s by Dolores Krieger, Ph.D., R.N., a professor at New York University, and Dora Kunz, a natural healer. It is a contemporary interpretation of several ancient healing traditions.
It is based on the principle that the human energy field extends beyond the skin and the practitioner can use the hands as sensors to locate problems in it that correspond with problems in the physical body. Disease is seen as a condition of energy imbalance or blocked energy flow. Assessment is done by passing the hands over the body from head to toe at about two to four inches above the surface.
The practitioner then serves as a conduit for universal energy, consciously and actively transferring energy into the recipient. The hands are used to direct and focus the energy, sometimes in rhythmical, sweeping motions. The method is initially taught "off body," meaning the practitioner's hands do not touch the physical body, though later with experience some physical touch may take place.
Since it is not necessary to touch the physical body (what is being touched is the energy field or energy body), this method can be applied in situations where the patient may not be able to tolerate contact (e.g., in postsurgical patients or burn victims). Sessions last up to thirty minutes and can be done sitting or lying down fully clothed.
Therapeutic Touch is currently taught in over eighty universities and thirty countries and is practiced by twenty to thirty thousand health care professionals in the United States and around the world.
Polarity Therapy. This is a form of energy work that was developed by Randolph Stone, a chiropractor, osteopath, and naturopath in the mid-1920s. The practitioner uses subtle touch or holding on specific points to harmonize the flow of energy through the body and also to enhance the body's structural balance.
It is based on the principle that every cell has both negative and positive poles and the body is gently manipulated to enhance the energy flow. Emotional tension or physical pain are released as the flow of energy becomes more properly balanced. Polarity therapy is often given in a series of four sessions and may be accompanied by guidelines for diet and exercise.
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Joan
Joan was a thirty-two-year-old graduate student about to receive her Ph.D. in geology. She was also engaged but had a lot of anxieties about getting married. She sought massage therapy because of chronic headaches. Upon palpating her neck and upper shoulders, the practitioner found the muscles to be very knotty and hard. They had obviously been chronically tense for a long time.
During the course of several sessions Joan began to realize there was a relationship between the headaches, the tension she was holding in her musculature, and memories of having been physically abused as a child. The practitioner encouraged her to explore this with a psychotherapist.
She came back a year later for another series of four sessions. When the tense areas were encountered, she responded differently from before by telling the practitioner, "This really hurts," whereas in the past she had said nothing. The practitioner suggested she rephrase this by saying "I hurt," at which she began to sob as she never had before.
This was a very cleansing kind of release and through it Joan realized that in childhood she had adopted a pattern of numbing out to escape painful feelings. Through four sessions of massage she was able to release that long-held pattern and her fear and mistrust of her fiancee also ceased.
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As Elliot Greene states, "It is very common that someone will come in for one reason, and then they will discover another whole dimension to the problem or to themselves that they want to explore."
Reiki. This is the Japanese word for "universal life force energy." It is an ancient approach in which the practitioner is a kind of healer in the sense that he or she serves as a conduit for healing energy coming from the universe.
The Reiki energy enters the practitioner through the top of the head and exits through the hands, being directed into the body or energy field of the recipient. Reiki is another very subtle form of healing and may be done through clothing and without any physical contact between practitioner and client.
While all the above energetic methods appear to operate on different principles than most other varieties of massage therapy and bodywork, they nonetheless have an important and growing role.
Other Approaches
Integrative Methods. There are other approaches and combinations of approaches that do not fit neatly into any of the above categories. Many massage therapists and bodyworkers use combinations of approaches that could be called integrative massage or integrative bodywork.