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FSMTA Massage Message Magazine Mar/Apr

Published by Florida State Massage Therapy Association, 2015-05-11 21:31:17

Description: March / April Massage Message Magazine.


A Publication of the Florida State Massage Therapy Association MASSAGE MESSAGE March/April 2015 Vol. 30, No. 2 Florida Massage Convention & Trade Show, June 25 - 28, 2015 Classes with Over 35 Leading Educators CE Records Retained OnlineShop One of the Largest Massage Trade Shows!

MASSAGEFlorida State Massage Therapy Association A Publication of the Florida State Massage Therapy Association MESSAGEMARCH/APRIL 2015 MASSAGEC O N T E NVol. 30 No. 2 MESSAGE March/April 2015 Vol. 30, No. 2 Florida Massage Convention & Trade Show, June 25 - 28, 2015 Classes with Over 35 Leading Educators CE Records Retained Online Shop One of the Largest Massage Trade Shows! TS Columns Pg 34 Turning a Case Report Into a Research Poster By Jerrilyn Cambron Pg 36 Hawaiian Lomi Lomi Massage—A Too Well Kept Secret By Tony Crawford9 State & Association News Pg 5 State President’s Message By Leiah Carr, LMT Pg 35 Are You Renewal Ready? Pg 39 Well Done! You Took the FSMTA Sports Team Training: Now What!?! By Michele Weissman News from Around the State Pgs 44-45 Welcome New Members Pg 46 Chapter Calendars Pg 49 14 2015 Massage Convention Speaker Highlights1834 Pgs 9 - 12 Florida Massage Convention & Trade Show Speakers & Sessions Pg 12 Injuries, Inflammation & Assessment By Joseph LaTorre Active Isolated Stretching Pg 13 By Aaron Mattes Assessing 3 of the More Common Wrist and Hand Ailments By Cathy Cohen Pg 14 Parkinson’s and the (Often) Missing Focus of Treatment By Timonth Agnew A Therapeutic Approach to Stone Massage Treating Head, Neck and Face Pg 16 By Dale Montelione Grust Skin Cancer: Get the Facts By Annie Morien Pg 18 Pg 20 UPLEDGER PRESENTERS Pg 22 Visceral Manipulation Applications for Whiplashs/Trauma By Grace Dedinsky-Rutherford Pg 24 3 Things Every Massage Therapist Needs to Know to be More Successful By Jack Ryan Pg 26 Barral Institue Neural and Visceral Manipulation for Concussion and Traumatic Brain Injuries By Lorilyn Dowiak Pg 28 Healing from the Core: A Journey Home to Ourselves By Suzanne Scurlock-Durana Pg 30 Craniosacral Therapy and the Treatment of Post Concussion Syndrome By Marian Sisco MARCH/APRIL 2015 • MASSAGE MESSAGE 3

FSMTABoard of DirectorsEXECUTIVE OFFICERS Leiah Carr Terry Lowder State President 904-477-2277 • State Treasurer Debbie Sieber 239-948-3009 • State 1st Vice President 863-640-3346 • Donna Smith John Romano State 2nd Vice President State Secretary954-654-6427 • 850.914.0041 • Ralph Russ Immediate Past President 863.318.8210 • rvruss@juno.comCHAPTER PRESIDENTS Big Bend Chapter: John Lilly • Keys Chapter: Mary Ann Nelson • Brevard Chapter: Charlene Taylor • North Central Florida Chapter: Bruce Gonseth• Broward Chapter: Abraham Paredes • Central Florida Chapter: Jill Troutman • Palm Beach Chapter: Lesli Lopez • Sarasota/Manatee Chapter: Eddie Hooper • Dade Chapter: Angel Orozco • Southwest Flor ida Chapter: Sydney Sheaffer • Emerald Coast Chapter: James Fritschle • Sugar Dunes Chapter: Wendy Ballasch • First Coast Chapter: Sally Burton • Suwannee Valley Chapter: Michael Bates • massagemoon@yahoo.comFlagler/Volusia Chapter: Greg Neely • or Tampa Bay Chapter: Joyce Prahasky • Gulf Coast Chapter: Marion Padgett • Treasure Coast Chapter: Ross Hoffman • Heart of Florida Chapter: Adele Boyd • adelelmt@gmail.comSTANDING COMMITTEE CHAIRS Bylaws: Krystal Haworth • Legislative: Alex Spassoff • legislativechair@fsmta.orgEducational Standards: Michael Bates • educator@fsmta.orgSPECIAL COMMITTEE CHAIRS Awards: Krystal Haworth Massage Message Magazine: Joyce Prahasky • Membership/Strategic Planning: Brian Boyd • BOMT Liaison: Alex Spassoff Historian: Ralph Russ (State Immediate Past President) MTAW: John Romano (State 2nd Vice President) Insurance Relations: Vivian Mahoney • Professional Relations/Social Media: Manfred Hohenegger • International Relations: Angel Orozco (Dade Chapter President) Sports Massage: Diane Forrester • Legislative Awareness Days: Donna Smith (State Secretary) State Store: Adrien Morell • statestore@fsmta.orgLiability Insurance Liaison: Ron Stephens • Convention/Technology: Greg Neely (Flagler/Volusia Chapter President)FSMTA OFFICE & STAFF CORPORATE OFFICE: Association Manager • vacant Angela Capo, Finance Administrator • finance@fsmta.org978 Douglas Avenue, Ste 104 • Altamonte Spr ings, FL 32714 Laura Scully, Membership Administrator • 407-786-3307 • 877-FSMTA 4 U (877-376-8248) Lynn Rogo, Marketing Administrator • Fax: 877-224-2392 Elaine York, Allusion Graphics, LLC • Magazine Partner email: • Editorial Statement Massage Message is published bi-monthly by the Florida State Massage Therapy Association, Inc., a not-for-profit organization. We reserve the right to edit, accept or reject any material submitted for publication. Advertising appearing in this publication does not imply endorsement of products or services by the FSMTA. Contributors to Massage Message are solely responsible for the statements they make in this magazine. Contents of submissions do not reflect the opinion of the FSMTA. Should the Massage Message choose to publish a submission, the editor reserves all rights to edit content and placement. All submitted articles will be considered but the editor and FSMTA do not guarantee they will be printed. Articles should be educational in nature, designed to be informative and related to the massage profession. Articles should be no longer than 1,500 words and may be edited for content. Massage Message now accepts LETTERS TO THE EDITOR. Please include your name, address, phone and e-mail. Only your name will appear with the letter. By submitting, you authorize Massage Message to print the letter. The editorial staff may edit the letter for content and space restrictions. Submit all articles and letters to: Massage Message, FSMTA, 978 Douglas Avenue, Ste 104, Altamonte Springs, FL 32714 or e-mail: MASSAGE MESSAGE • MARCH/APRIL 2015

Message from AssocSiattaitoen&Newsthe President The season of spring On the Legislative front the Executive Board voted to focus has finally arrived with on further developing, building and working on the local evidence of activity, grassroots efforts this year. As you engage and support growth, and change. these local efforts you will help to give greater strength The same can said to the work performed on our behalf by the Lobbyist and for the FSMTA. The Legislative Chair in Tallahassee. Reach out to your local pace increases as the Chapter President and Chapter Board to learn how you can season progresses. The get involved in the grassroots efforts during our Legislative Corporate Office and Awareness Days. Convention Committee member’s activities FSMTAMembership has many benefits, and we have recently begin to heighten as added more. Be sure to visit the Member Benefits page on we move towards our to learn about the benefits and additional summer Convention. savings available to you. You will find it under the tab This year we have an “Members Login” dropdown listed as “Membership Benefits outstanding lineup of Login”. The password for this area has and continues to be Educators and classes distributed through our Monthly Membership Eblast, through to select from. Through your local Chapter Newsletter, and through our Corporate the Easy Payment plan Office. Login today and learn about all the great ways you for both the Convention can save and the new FSMTA Member Benefits.and Hotel packages you can experience an exciting getawayand a tax deduction too! Register early for the greatest Our Membership Administrator, Laura Scully will be takingsavings. You can learn all the details and register online a little time away from FSMTA to welcome a new additiontoday at to her family. We are excited for her and her family, as they prepare for the birth of their baby. The Executive BoardOur Corporate office staff is focused on budgets, accounting has also recently welcomed our new State Treasurer, Terryand tax reporting at this time of year. They work on the day Lowder. He is quickly learning all of the intricate details ofto day operations of the two Corporations that are managed FSMTA’s financial accounting and reporting procedures. Heby the full Executive Board. We have recently streamlined has an extensive background in banking and finance thataspects of our accounting and banking procedures. These brings valuable skills to our Volunteer Board. The FSMTAnew and improved procedures have eliminated the need faces challenges in growth as most Associations have overfor the FSMTA Association Services, Inc. As a result the the last few years of economic changes. We have workedExecutive Board has voted to dissolve this organization, to streamline procedures, greatly reduce our cost, andwhich will result in a financial cost savings to the FSMTA. improved the value of your membership. Your help in sharingThis action allows all accounting and operations to be about FSMTA with others will help the FSMTA to grow andfocused and reported under the one organization. remain strong. As you and others help to grow FSMTA, not only does this help us become stronger, remain viable, but itThe Florida Legislative session is now open. Our two brings financial rewards to you! Learn more in this magazineLobbyist and State Legislative Chair are keeping a watchful issue of how FSMTA rewards you, as you help grow andeye on any proposed bills that could have an impact on strengthen the Association that supports and works for you!LMT’s and our scope of practice. You can view updates onthe State Legislative page on Any Legislative Wishing you a spring filled with growth and continuedupdates that need to be communicated quickly, are shared abundance! with you through Membership Eblast, and Social Media. Itis important that you keep all of your contact information up Leiahto date to stay connected and informed. You can also stayconnected and informed through the State Facebook page www.FSMTA.organd the exclusive FSMTA Members Facebook group. Be www.MYFSMTA.orgsure to “Like” and “Join” these two social media avenues of www.MYFSMTATHERAPIST.cominformation. MARCH/APRIL 2015 • MASSAGE MESSAGE 5

New Benefit-Earn Cash Back!!FSMTA is excited to introduce our new member referral program. Refer a newmember and receive a $20 Visa/MasterCard for helping FSMTA grow. Simplyhave the person you refer to join click the referred by section on the onlineapplication, and select your name from the member list. You must provide themwith the information of exactly how your name is listed on your membershipcard. If using the paper application, be sure they fill the “referred by” sectionwith your name exactly as listed on your membership card. The more you referwho join the more you can earn!  (Program does not apply to new Student Memberships or those joining who select the monthly auto pay option) Earn FSMTA Buck$ FSMTA is paying it forward to you!Refer a New Member and earn FSMTA Bucks for your efforts.  For every newmember you refer you can earn $15 in FSMTA Bucks. You can use your FSMTABucks towards your membership renewal, convention or state store. Spread theword about the benefits of membership and start earning your bucks today!(Does not apply to Student Membership referrals) 6 MASSAGE MESSAGE • MJAANRUCAHR/YA/PFERBILR2U0A1R5Y 2015

The muscle movement technique that corrects and balances the nervous system. Myo = muscle; Kinesthetic = movement. This is a new technique, not repackaged from another system. New! Action research is currently being conducted on the MYK System at the University of Idaho. No prior knowledge needed to learn how to tap into the power of the nervous system with NO THUMB WORK! Bill per treatment, not per minute. Go online to or call 913.220.5484. Dr. Michael Uriarte Order Our #1 Selling lwEoawitrhenru2cp0lpaCsesEreUos!rs Developer of Home Study Courses Today! The Myokinesthetic System Upper and Lower Home Study is set-up identical to hands on class.UPPER Body Class covers: 2015 SCHEDULE Jan. 24-25 Jacksonville FL Upper Jul 18-19 Des Moines IA LowerPostural Analysis – confirms symptoms match cause Feb 7-8 Atlanta GA Upper Aug 1-2 Wichita KS Lower4 Minute Headache Treatment Session Feb 21-22 Tampa FL Lower Aug 8-9 Portland OR UpperNeck Pain – including disk bulge/herniation, fusions Mar 14-15 Orlando FL Upper Aug 15-16 Orlando FL LowerShoulder problems – rotator cuff, frozen shoulder, Mar 21-22 SC AMTA convention Aug 22-23 Nashville TN Upperpost surgical techniques AClllaHssaensd$s-4O9n5 Mar 28-29 Denver Co Lower Aug 29-30 Milwaukee WI LowerCarpal Tunnel Apr 11-12 Spokane WA Upper Sep 12-13 Davenport IA UpperTennis ElbowDizziness Apr 18-19 OH AMTA Convention Sep 19-20 Phoenix AZ LowerPost Stroke contraction problems Apr 25-26 Panama City FL Upper Sep 26-27 SD AMTA Convention May 2-3 Myrtle Beach SC Lower Oct 3-4 Hartford CT Lower May 16-17 Omaha NE Upper Oct 10-11 Chicago IL UpperLOWER Body Class covers: May 30-31 Cincinnati OH Lower Oct 17-18 Minneapolis MN UpperPostural Analysis – confirms symptoms match cause Jun 6-7 Overland Park KS Upper Oct 24-25 Seattle WA LowerHip and Knee Replacement problemsDiabetic Neuropathy Jun 13-14 Ft. Lauderdale FL Upper Nov 7-8 Little Rock AR UpperSciatica Jun 25-28 FSMTA Convention Nov 12-15 Orlando FL Certification Jul 11-12 Raleigh NC UpperPlantar Fasciitis 2015 FSMTA State ConventionLow Back Pain – disk bulge/herniation; fusions/rodsBalance Issues Have fun and learn to help relieve all types ofCERTIFICATION Class covers: headaches and low back issues. Sign up for Dr. Uriarte’s classes today!In-depth assessmentCase studies qTestimonialsTreat lower fromseated position I would like to let you know how liber- WOW!! What an amazing technique. I have been using your technique forBi-lateral upper treatments ating it is not to lose 2-4 days of work This was exactly what I was looking more than a year now. It still amazesNew thoracic info to migraines. I have been to several for to help some clients that various me to see someone stand up and theirHow to treat the organs neurologists, a headache and pain massage techniques did not solve/ symptoms are gone. This has been an center, acupuncture, MRI’s and more or control their pain issues. After my invaluable treatment that has helped with nowhere near the results I have first class, I helped a client with frozen people who have tried everything achieved with your system. I highly shoulder regain full ROM with no pain and had given up hope. Thank you. recommend this protocol for migraine remaining within a few sessions, we Charlene Rude headaches. Gwyn L. had not been able to accomplish this in 6 months of previous massage.TO RESERVE YOUR CLASS — CALL NOW 913.220.5484 or online go to: All hands-on classes $495 — 2 days — NCBTMB #151119-00 — 20 CEUsP.O. Box 27187 | Shawnee Mission, KS 66225 | E-mail: | MARCH/APRIL 2015 • MASSAGE MESSAGE 7

GET ALL OF YOUR CE’S AT ONE TIME FOR ONE LOW PRICE! FLORIDA MASSAGECONVENTION & TRADE SHOWPresented by the FSMTA JUNE 25 — JUNE 28, 2015 Caribe Royale All Suites Hotel & Convention Center Orlando, FL USASPECIAL NEW LOW PRICING! Online Registration & Class Selections Easy Payment Plan Special Package Programs Express Convention Check-In Classes With Leading Educators CE Records Retained Online Table Check Room Successful Start Program Monte Carlo Fun Night Success Summit-Business Makeover Casino Royale Banquet Fun and so much more! More CE’s Than Any Other Massage Convention In The Country LARGEST FREE MASSAGE TRADE SHOW IN THE NATION Learn More and Register Today at LIKE US ON FACEBOOK: FLORIDA MASSAGE CONVENTION AND TRADE SHOW8 MASSAGE MESSAGE • MARCH/APRIL 2015

Florida Massage Convention Presented by the & Trade Show FSMTAConvention Class PresentersAngel OrozcoGood Morning YogaCathy CohenPutting your Hands to Better UseEric StephensonDeep Tissue Massage Made Easy, & Unlocking Computer Shoulder, & WhereIt is It Aint - Successfully Treating lower Back PainSam Belyea To register,Reflexology for Digestive Dysfunction Part I & II visit www.!David GonzalezSelf Care Strategies for Health Care Professionals, & Introduction to ExercisePhysiology, & A Functional Approach to Stretching & ROMMichael Uriarte“Headaches - Assess, Treat & Resolve within 4 min Part I & II, & Low Back/Hip Problems - Assess, Treat within 5 minutes (Part I & II)“Dr. Wanda Bonet-GascotManaging Emotional Releases with Emotional Intelligence, & UnderstandingFibromyalgia, & Emotional Intelligence Basics for Massage Therapists  Michele Weissman FSMTA Sports Team Training (Part I & II) Joseph Latorre “Injuries, Inflammation and Assessment, & THERAPEUTIC RELIEF FOR THE SHOULDER COMPLEX“  Stacey Shidemantle Ethics, & Medical Errors, & Florida Laws and Rules   JANUARY/FEBRUARY 2015 • MASSAGE MESSAGE 9Dr. Annie MorienSkin Cancer in the Clinic, & Common Skin Conditions Encountered in theClinicRoger GilchristA Comprehensive View of the Human Energy System, & Energy Medicineand Polarity Therapy, & Craniosacral Biodynamics: Essential Principalsand skills, & A Comprehensive View of the Human Energy System

Presented Florida Massage Convention by the FSMTA & Trade Show To register, Convention Class Presenters visit! Laurie Messina Himalayan Salt Stone Massage Part A & B Full Body (Part I & II) Elise DiFalco Foundations of MLD Tour USA (Part I, II, III) &   Boca Lymphlift of the Head, Neck and Face (Part I & II Luann Overmye r Addressing Nerve Pain in the Arm, Shoulder, and Hand with Ortho-Bionomy (Part 1, II & III), & Ortho-Bionomy Releases for the Feet Mukti Michael Buck Vedic Massage Marma, Chakra, Pathway stretchings and rhythmic compressions I, II, III, & IV Oleg Bouimer 7 Secrets of Developing the Best Massage Ever (Part I & II), Sports Rehab Massage for Triathletes (Part I & II), & The Science of Pre/Post Event Sports Massage (Part I & II) Matthew Howe Bodywork for PTSD (Part I & II) Dennis Price Massage for TMJ Dysfunction, & Massage for Enhanced Respiratory Function, & Care for the Forearm, Hand, and Wrist Dr. William Doreste  Cranial Release Techniques Don McCann Tools for Successfully Treating Scoliosis, & Quick Release Technique of Head, Neck and Shoulders Carla S Van Arnam Introduction to Zero Balancing (Part I & II) & Good Morning Taiji10 MASSAGE MESSAGE • Dale Montelione GrustMARCH/APRIL 2015 A Therapeutic Approach to Stone Massage Jane Kordish Save Your Hands! SELFCARE - Care, Injury Prevention & Ergonomics for Massage Therapists (Part 1 & II)

Florida Massage Convention Presented by the & Trade Show FSMTAConvention Class PresentersMichael McGillicuddyPhysical Examination & Joint Assesment of the Lower Body, & The Art and Science of TherapeuticStretching (Part I & II), & Multi-Modality Appr to Sports Therapy - Lower Ext (Part I & II)Aaron MattesActive Isolated Stretching - Shoulder, & Active Isolated Stretching Neck,Hand, WristAriela GrodnerA Taste of Thai Intro & Thai Massage Mat Work (Part I & II) Dan Schmutz To register, Intro to Pranic Healing and Energy Hygiene visit www.!  Kelly Armstrong MPS Scar Release for Massage Therapy, & Introductory MPS Neuromechanical Therapy (Part I & II) Lisa VanOstrand Medical Qigong and Acupressure for DiabetesRoger TolleTrager Tools for Massage Therapists (Part I, II & III)Yusuf MihaylovSegment-Reflex Massage & TMC – evaluation and assessmentTimothy AgnewTreating Functional Pain in Parkinson Patients (Part I & II)Jeffrey FormanActive Muscle Therapy (Part I & II)Mariann SiscoUpledger CranioSacral Therapy for Concussion and Traumatic BrainInjuries Part I & II  John Joseph Ray • MASSAGE MESSAGE 11 Understanding the Scientific Research About Massage and How it MARCH/APRIL 2015 Relates to Me and My Clients

Florida Massage Convention & Trade ShowConvention Class Presenters Lorilynn Dowiak Barral Neural and Visceral Manipulation for Concussion and Traumatic Brain Injuries Part II Kerry D Ambrogio PT, DOM An Introduction to Joint Balancing Grace Dedinsky Rutherford Visceral Manipulation Applications for Whiplash and Trauma – Importance of an Integrative Approach Part I & II Suzanne Scurlock Durana Healing from the Core: Full Body Presence: An OverviewInjuries, Inflammation & Assessment By Joseph LaTorre The course Injuries, Inflammation, by past injuries, repetitive overuse, poor postural habits, and & Assessment discusses the importance lifestyle. This course can shed light on how to become more of understanding injuries, the physiologic confident and competent in determining the mo  st appropriate processes of inflammation, various stages of course of action to take when helping others. healing, types of tissues, types of massage and bodywork, and client assessment. It is I will also discuss how providing manual therapy, client beneficial to have a thorough knowledge education, and self help measures to others can help them of anatomy, physiology, pathologies, and recover faster from injury/s, avoid surgery, better prepare for kinesiology when confronting the challenges surgery, and improve the rehabilitative process in a more of working with injuries. efficient and cost effective way. The course Therapeutic Relief for theShoulder Complex emphasizes the anatomy & Subject matter covered in class may include: Client intake, physiology of the shoulder complex, pathologies medical history, assessment, and reassessment; Familiarity & conditions, client assessment, hands on with musculoskeletal injuries; The cellular, chemical, and techniques, and benefits to the client. This neurologic response to injuries; Articulations and degrees of soft tissue therapy can be utilized for such joint movements; The agonist/antagonist relationship; Various conditions as frozen shoulder, rotator cuff types of soft and hard connective tissue; The importance of injuries, thoracic outlet syndrome, carpal tunnel differentiating between an Injury and Overuse; Stages of healingsyndrome, scar tissue or adhesions, trigger points, and treatment protocols; Indications and contraindications; Invasive vs. Non-Invasive massage methods; Providing client tender points, and postural imbalances educating and self help measures. or restricted range of motion. Let me share with you the The information I provide in this course comes from my correct sequence of manual many years as an internationally known teacher, program therapy techniques I have director, writer/researcher, and practitioner of massage used over the years to therapy. In addition, I have personally overcome numerous identify and correct musculoskeletal injuries and learned the rehabilitative protocol imbalances created for them.

Active Isolated Stretching By Aaron Mattes, MS, RKT, LMT Human movement is more enjoyable when the body is Law of reciprocal inhibition and muscleflexible and capable of performing without restriction. Flexibility contraction (innervation) states thatis not a general factor but is specific to each joint. The primary when a muscle on one side of a jointobstacle to flexibility is the tightness of the surrounding joint is contracted, muscles on the oppositemuscles and fascia. Muscles have the capacity to be stretched up side send a neurological signalto 1.6 times their resting length. However, muscles may strain, to relax or release. Incorporatingtear, or rupture if stretched beyond this length. Muscle-tendon Sherrington’s Law in combinationtears result in bleeding at the site of the tear. Bleeding promotes with a slow rhythmic stretch of noscar formation, which is how a body naturally heals itself. The scar greater than 2 seconds and less than onetissue is much less flexible than non-scarred muscles, tendons, pound of assisted pressure, this provides foror fascia. Whenever flexibility is compromised, muscle weakness a neurologically sound technique that doesn’tand tissue contractures develop. trigger a reflexive antagonistic contraction which would inhibit the stretch potential of the muscles, Our bodies have incorporated a defensive mechanism to fascia and other joint connective tissues.protect tissue from over stretching and trauma. The protectivemechanism involves the stretch sensors within the muscles and Active Isolated Stretching illustrates the facttendons; within the muscles these sensors are called muscle that an individual can stretch properly withoutspindles. The tendon-muscle juncture these sensors are the Golgi endangering the joints, muscles or connectiveTendon bodies. Both of these stretch sensors provide a complex tissues. An important fact is that an individualprotective mechanism known as the Myotatic Stretch Reflex. This can safely assist others in the stretchingmyotatic stretch reflex helps prevent a muscle or tendon from process. Flexibility and proper stretching playoverstretching too far or too fast. The Stretch Reflex of the muscle an important role for enhancing performance,spindles and Golgi bodies sensors help provide coordinated rehabilitation, and wellness. Athleticmuscle contraction and relaxation. These stretch sensors relay the performance and science have convergedinformation up through the nervous system through specialized and established flexibility as a primeneurons called gamma fibers. The gamma fibers encode the determinant of performance for athletes.velocity of the muscle-tendon stretch. This information if thenprocessed in the spinal cord. When the velocity of the stretch is Strong tensile forces of the muscledeemed potentially harmful to the muscles or tendons the spinal and fascia surrounding the specificcord reflexively sends rapid input for a protective contraction of joint determine flexibility. Optimizingthe antagonistic muscles. flexibility through reduction of fascial tension has long been a goal for many Muscles cannot extend without fascia also lengthening. Fascia manual therapists. Pioneers such as a three dimensional fibrous matrix that provides interconnections Janet Travel, Dr. David Simons, Ida Rolf,throughout all cells of the body. Being continuous throughout John Barnes and Moshe Feldenkrais have allthe body, fascia encompasses the sensory organs of the nervous developed techniques for helping restoresystem, blood vessels and lymph channels as well as surround proper physiological myofascial tension. Themuscles, bones and joints, which gives our body structural gentle, specific manual stretch of muscles andintegrity and strength. fascia also creates mechanical, bio-electrical and biochemical responses that promote Fascial distortion by trauma, aging, and posture, hormonal improved vascular and lymphatic circulation,or metabolic disturbances disrupts body homeostasis. These increased oxygenation, removal of the body’sconditions left untreated promote detrimental contractures, toxins, and a more efficient nervous system.inflammation, lymphatic congestion, peripheral vascularobstruction, hypertension and a host of other disease states Active Isolated Stretching has long been aincluding major neurological conditions. modality of successful treatment for orthopedic problems, sports medicine and neurological For the past 45 years Aaron Mattes has developed an conditions. Strokes, Parkinsonism, A.L.S.,innovative therapeutic/preventive technique called Active Isolated Multiple Sclerosis respond consistently. FamousStretching. Active Isolated Stretching has been incorporated into a Kinesiotherapists Prof. Robert E. Shelton andtherapeutic myofascial technique termed the Mattes Method. The Dr. Leonard Greninger were major contributorsMattes Method promotes functional and physiological restoration in helping develop Active Isolated Stretching: Theof muscles, tendons, vertebrae, ligaments and joints facilitating Mattes Method.healthier superficial and deep fascial planes. The Mattes Methodhas incorporated a key concept that only relaxed myofascial Aaron L. Mattes MS. RKT. MS.structures will lend themselves to be maximally stretched. is an internationally known lecturer and author. He Adhering to Wolff’s and Sherrington’s Laws, The Mattes is in private practice inMethod facilitates optimal myofascial stretching of isolated muscles Sarasota, Florida. www.without activating a protective myotatic reflex contraction. The Method utilizes a gradual stretch of no greater than 2seconds, promoting full range of motion and flexibility withoutactivating antagonistic muscle group contraction. Sherrington’s

Assessing 3 of the More Common Wrist and Hand Ailments By Cathy Cohen, LMT Given that we use our hands so and resting your hands from massage, home chores or manual much, is it any wonder that massage hobbies, allows for adequate healing time from normal tendon therapists’ injure their hands, wrists micro tears. Without adequate healing time, edema, scar and fingers? Beauticians, diabetics, tissue and a chronic pain cycle can build. pregnant women, assembly line workers, and chiropractors are also at TENOSYNOVITIS is an inflammation of the synovial a higher risk of hand disorders.1 This article sheaths surrounding the tendons. In my carpal tunnel, foris written to help you assess three of the more example, the connective tissue common dysfunctions: tendon derangement, forming the sheath and the synovial Carpal Tunnel Syndrome and De Quervain’s fluid lubricating the tendon of tenosynovitis. the long finger flexor had become All three of these diagnoses are commonly irritated and dried out. I could classified as Cumulative Stress Disorders. Three actually hear the tendon popping years ago I was delusionally inspired by an in the tunnel during flexion of the obituary of a 94 year old massage therapist. wrist. As we will see, tenosynovitis She was giving four or five treatments a is also a common problem affecting week up to her passing. I thought, wow, if the carpometacarpal (CMC) joint at she could do that then surely this year the base of the thumb. I could add an extra day of practice. Wrong! What started off as some vague TENDONOSIS is a chronic and intermittent morning numbness tendon condition involving progressed to constant tenderness and degenerative changes in the zinging over the thenar eminence, tissue without inflammation being digits 2-4 and a noticeable reduction in present.2 Acute tendonitis and grip strength. tenosynovitis can lead to chronic A hand orthopedist diagnosed Carpal tendonosis. Uneven scarring can Tunnel Syndrome with tenosynovitis of my lead to a weaker tendon, which can long finger flexor tendon. After 25 years of lead to a chronic cycle of injury and re-injury. Regardless repetitive hand motions combined with force of the diagnosis, adequate recovery time is needed for any and my overly enthusiastic drive to massage tendon injury. The sooner the problem is addressed, the better and teach, I too had damaged my wrist. the outcome. Fortunately, these experiences lead me to coach others on caring for their hands. What can go wrong in the carpal tunnel? Two of the problems occurring in the narrow carpal tunnel What can go wrong with tendons? TENDONITIS is inflammation of the involve the tendons and the median nerve. As discussed above, tearing and irritation can occur when tendons are tendons. Because tendons are less vascularized repeatedly pulled across a joint or rubbed together. The tear- and innervated than muscles, you may not and-repair cycle is a normal routine. However, without adequate recovery time or proper joint alignment, the fascia feel the damage to a tendon as quickly as doesn’t have time to reknit itself before you tear the fascial you would to a muscle. Repetitive wrist and network again. In the tight and busy intersection of the carpal finger movement combined with force makes tunnel, the median nerve can be squeezed. manual therapy more susceptible to tendon injury. Symptoms characteristically occur in The squeeze play on the median nerve occurs in at least the base of the thumb or cause pain in the wrist. two ways. First, when the fascia fuzz thickens, the nerve can adhere to the surrounding tissue. When the nerve is restricted Rest will improve the symptoms that from gliding in its fascial sheaths the body may create movement will aggravate. Injury inflammation. The already snug carpal tunnel is then further can occur in the tendons of crowded with inflammatory fluids. the finger flexors passing through the carpal tunnel When there’s too much fluid and too little nerve glide, or to the tendons of the compression of a nerve can occur. A true Carpal Tunnel finger extensors on Syndrome is caused from compression of the median nerve the back of the wrist. in the carpal tunnel. The resulting pain, numbness, tingling or Pacing your workload weakness affecting the thumb and digits 2-4 ensue. When the symptoms are mild, the hand sensations may wake you from sleep. Straightening the wrist or shaking

the hands may alleviate the symptoms. Doctors commonly of 120 pounds of force is being applied on your CMC joint).recommend wearing wrist braces at night since you tend to Reducing the inflammation, bracing the thumb and makingbend the wrist while sleeping. 3 The wrist brace keeps the behavior modifications will eventually reverse this condition.wrists neutrally positioned thus minimizing compression of thenerve. During the FSMTA convention we will further explore self-care protocol in the class, Putting Your Hands to As the symptoms become more moderate, discomfort Better Use. Along with discovering other cumulative stressoccurs both at night and during the day. You may notice problems of the hands, you will perform a 5-step massagedysfunction while driving, talking on the phone or holding routine for the forearms and hands. You will also participatesmall objects. You begin avoiding activities that exasperate the in a 12-step exercise routine for your own self-care.  Withdiscomfort. A doctor’s diagnosis can be useful at this stage. practice, this routine will enhance your grip strength andA doctor will rule out cervical compression, a broken bone, reduce and prevent pain in your wrists and hands. 7 Tocysts, underlying disease processes and other conditions that learn more about establishing a home care routine, visitmay be affecting the median nerve. As the problem becomes more severe, grip strength What can I do now to avoid hand and wrist pain?is lost and pain or numbness is constant. When Carpal Do stretching exercises. Take rest breaks. BetweenTunnel Syndrome is left untreated, the muscular pad of thethumb atrophies. At this point, even surgery may not reverse clients take micro-breaks (at least three minutes each) withthe problem. 4 your hands resting, palms up, on your lap. Build in a habit of shaking them out during a treatment. Change positions If you are experiencing any of these symptoms, see a doctor. frequently. Maintain good posture and wrist position by:To determine if you have any of the 10 risk factors associated Keeping your spine upright and elongated. Keeping yourwith Carpal Tunnel Syndrome, visit, CarpalTunnelCoaching. wrists in a neutral position with little flexion or and take the short Risk Factor Assessment quiz. Wear hand and wrist warmers.Thumb pain Keep your hands and wrists warm. This is especially While Carpal Tunnel Syndrome affects the palm side of important first thing in the morning or before working your first client. Wearing wristbands or fingerless mittensthe hand and wrist and is a compression of the median nerve, keep your wrists warm. Meet with employers to improveDe Quervain’s tendonitis/tenosynovitis affects the back of the workload and pacing. At home, replace tools and handlesthumb, wrist and lower forearm. This condition, also known with more ergonomic ones. Handles that are textured are lessas texting thumb or Mommy’s Thumb, is an inflammation of likely to slip in your grip. Less slip equates to less grippingthe two thumb muscle tendons: abductor pollicis longus and/ effort. Handles, clubs or racquets that are broader generallyor the extensor pollicis brevis. allow a more relaxed, handshake-style of gripping. Pinching movements, such as holding a needle or a key, require more Women are affected 8 to 10 times more often than men. effort. Instead, use a grip that folds all of your fingers toward6 For new moms, the hormonal changes of pregnancy and your palm while keeping the wrist straight.nursing, along with lifting the baby with thumbs hookedunderneath the armpits, can lead to a painful carpometacarpal Exercise and behavior modifications are the golden(CMC) joint. standard for prevention and recovery from cumulative stress disorders. So take care of your hands today! Texting, gardening, racquet sports and other grippingactivities further aggravate the condition. 1 2 Karim Kahn, et al., “Time to abandon the “tendinitis” myth: Painful, Though many massage therapists find the thumb convenient overuse tendon conditions have a non-inflammatory pathology,” BMJ, 2002;to use, its unique structure makes it even more susceptible to 324:626-627.injury. When downward compression is applied to the tip of 3 Private conversation with Dennis Sagini, M.D. Fort Myers, FL 2013the thumb, forces are concentrated into the moveable saddle 4 Private conversation with Dennis Sagini, M.D. Fort Myers, FL 2013joint at the CMC joint. When muscles at the base of the thumb 5 webmd.comrepetitively contract to stabilize the joint, the eventual fatigue 6 Laurianne Greene and Richard Goggins, Save your Hands! The Completeleads to strain on the tendons. Having muscular strength Guide to Injury Prevention and Ergonomics for Manual Therapists, 2nd ed.actually works against you. Pressing harder on the tip of the p.13.thumb causes the metacarpal joint to be pulled more strongly 7 Marian Garfinkel, EdD; Warren Katz, MD et al, “Yoga-Based Interventioninto CMC joint. for Carpal Tunnel Syndrome A Randomized Trial,“ Journal of American Medical Association, 1998; 280(18): 1601-1603. “ For every pound of downward force applied with the tipof the thumb, 10 to 12 pounds of force are concentrated in the MARCH/APRIL 2015 • MASSAGE MESSAGE 15CMC joint.” 6 Next time you are applying 10 pounds of pressure to atrigger point with your thumb, do the math! (Answer: as much

Parkinson’s and the (Often)Missing Focus of TreatmentBy Timothy Agnew When a 68-year-old female pa- ity movement that stems from soft tissue-fascia dysfunction. While tient came to my clinic presenting we cannot guarantee a cure of these symptoms, what we can do with a possible Parkinson’s diagno- is focus on improving the quality of the movements. And this will sis, her first words after stacking an likely improve the symptoms as well. enormous medical file folder on my desk was, “I wish they could figure this The latest research on human fascia is fascinating, and cli- out.” She informed me that she had had nu- nicians cannot exclude its connection to pain and dysfunction. merous tests, had seen a myriad of specialists, Not only does this tissue contain nociceptors (nerve receptors thatyet they were still trying to assimilate all the data for perceive pain) and proprioceptors (receptors that perceive pres- the best course of treatment. Was it multiple system sure), fascia can contract and relax.1 It is also believed to be in- atrophy (MSA) or Parkinson’s? As I watched her volved with emotional health. This knowledge becomes extremely enter my clinic, I noticed her kyphotic posture, important, especially when approaching treatment of the PD pa- a strained limp in her gait, balance issues, and a tient. While a definitive “map” of human fascia, at least in Western grimace across her face as she sat. I said, “For- medicine, remains hypothetical, I support what was “mapped” by get about all of that. How are your daily move- the ancient arts(see Chen)2 - yoga, martial arts, et al. - and what ments?” She then proceeded to tell me that Thomas Myers has done so nicely. The fascia has distinct “lines,” although she had none of the common symp- or myofascial meridians, that have distinct patterns in the human toms (tremor, etc), she could no longer be on body. These “lines” should be a focus when considering exercises her feet for more than a few minutes without (and hands-on work) in manual therapy. Fascial tissue develop- having to sit, and that she no longer could ment can be taught to patients via simple yet specific exercises do many of the things she used to. aimed to improve overall movement and health.3 While Parkinson’s disease (PD) and its related Before embarking on group exercise classes, the patient must diseases manifests in the brain, its be assessed for posture (i.e. kyphosis) dysfunctions and carefully symptoms affect, and can eventually examined for other possible pain patterns (i.e. what I consider disable, normal movement. Changes in fascial sensitivities such as plantar fasciosis and hip or shoulder connective tissue, kyphotic postures, and bursitis). PD patients have a high degree of soft tissue (fascial) muscle atrophy are rarely addressed in a hyperacuity.4 In layman’s terms, the tissue that covers everything typical physical therapy treatment, and this from head to toes is like a great communicator to the entire body. is something I’ve experienced in all of my PD For example, pressure, via acupuncture needle, pulsed electro- patients. Sadly, most of them are coming from magnetic field current (PEMF), or thumb under the large metatarsal 6-12 weeks of this type of therapy, which is (toe) might produce pain or other sensations in the opposite shoul- the common allotted time under medicare. der or even ear. Sometimes the sensation is intense, and removing While exercise programs such as Dance for the force (or pressure) from the toe eliminates the discomfort. This PD, LSVT BIG, and others are recommended type of fascial sensitivity is something I don’t see with healthy and can be beneficial, most PD patients have individuals, at least not in the level of intensity experienced by such a high amount of pain and movement PD patients. Another way to think about fascia is as if you were to dysfunctions that they cannot comfortably en- grab a shirt and pull, all the threads in the shirt would be “pulled,” gage in these classes. Or, if they do, they de- not just in the area you are pinching. Why is this important? The velop injuries that compromise their movements. fascial system must be considered as part of treatment. And it’s not Also, balance is often poor in part due to the in traditional healthcare. changes in postures and weak soft tissues. It does not mean they can never do these type of Before beginning any exercise protocol, treatment sessions classes, it just means the dysfunctions should should be devoted to “correcting” dysfunctions that will inhibit be addressed first. those exercises, or make them uncomfortable to perform. This PD patients can exhibit many common treatment could be many things, such as helping correct posture physical symptoms — tremor, bradykinesia (slow (kyphosis, or a shortened front line in the fascia), by “bowing” the movement), and freezing -yet the symp- front line (or front of the body) by thoracic hyper-extension (lifting the shoulder back while supine), or improving limb movements toms themselves should not be the that have limitation or pain. With a limited range of motion, PD focus of treatment. It’s not that patient cannot perform those big movements in group classes com- these symptoms shouldn’t fortably. The PD patient must be placed on a therapy table and be considered, after all, manipulated through gentle range of motion (ROM) movements, they can be helped; it’s with a focus, first, on the center of the body, the hip (gluteal) re- that all of these symp- gion. The pelvis is the center of the body, and the gluteal region toms often come with should feel freely movable, without restrictions. The entire fascial pain and reduced qual- line from the back of the cranium to the toes should be assessed for Continued on page 17

Parkinson’s and the (Often) Missing Focus of TreatmentContinued from page 16shortness and pain. The fascial lines are “unhinged” with gentle, being moved. Yet repeated repetitionsshort hold range of motion exercises. and weekly work can change gait and balance issues. Another creative One of the more effective ways to treat “dysfunctional func- option is to have the patient performtional” movements is the concept of what I call “opposites.” It is the movements with the eyes closed,not an uncommon pattern, and like many range of motion exer- or with the opposite eye open, and thecises it has been around a while. Since the brain is wired so that other closed.the left side controls the right, these patterns are complimentary.In fact, many athletic trainers force the athlete to swing a tennis There are endless treatment possibilities forracket etc. in opposite hand to achieve better coordination. What the PD patient when the fascial system is considered,I would like to introduce is a more specific approach to this old and when the focus is placed on helping correct thepattern. It involves utilizing, for one, the fascia spiral lines -- those patient’s everyday functional movements. Quality oflines that crisscross the body in the front and back. In simple life should not suffer because of oversights in physi-terms, it involves lifting opposite leg and arm (or even fingers and cal assessment of the patient’s every day movementtoes) against gravity. This can be done in multiple ways, from patterns. We cannot alter the diagnosis, but westanding postures to prone or supine on a therapy table. If the can help improve coping with it.patient is prone (on back) on the table or floor, lifting a straightleg and opposite straight arm together has enormous benefits. Not References:only is it a brain challenge, it forces the cross-body soft tissues to Fascia: The Tensional Network of the Hu-develop. This strengthens some of the major core muscles, andit also helps condition the fascial tissue to be stronger and offer man Body: the Science and Clinical Applica-a more supportive role, especially along the thoracolumbar fas- tions in Manual and Movement Therapy.cia. Yet this movement has to be precise, in that the patient must Robert Schleip, Thomas W. Findley, Peterbe instructed via palpation and verbal cueing, that the arm and A. Huijing. Churchill Livingstone/Elsevier,the leg are not separate units. There must be an intent to begin 2012.the unified movement. The limbs are connected as one, and themovement is as though one will not move without the other. This The Illustrated Canon of Chen Familyis a complex thing, and it often takes a lot of coaching to get the Taijiquan. Chen Xin, 2007.patient to perform the movement as such. I will often have thepatient close her eyes and begin the movement, and if any limb is Müller DG and Schleip R (2011): Fas-out of sync, we will begin the movement again. It is so important cial Fitness: Fascia oriented training forto get this oneness with the movement, and it makes the exercise bodywork and movement therapies. FFthat much harder to achieve, but with so many other benefits. Yearbook.Also, to further involve the spiral lines, the leg and arm should berotated internally during the lift, and then a set is performed with Gibson, W. (2007). Pain sensitivity andthe limbs rotated externally. Weight (ankle and hand weights) can referred pain in human tendon, fascia and mus-be added upon progression, but I never like to use the popular cle tissue. Aalborg: Center for Sensory-Motor(and old school) multicolored elastic bands. Why? While it’s an Interaction (SMI), Department of Health Sci-honest resistance, the resistance changes with the stretch in the ence and Technology, Aalborg University,band, placing great stress upon the joints. (See Hooke’s Law).5 Denmark. Opposites are also extremely effective when employing the Hooke’s law is a principle of physics thatfingers and toes. For many PD patients (and athletes), this exer- states that the force needed to extend or com-cise is difficult, because of the difficulty in coordinating the small press a spring by some distance is proportionalmovements. The patient can be seated, with the arms gently to that distance. That is: where is a constant fac-flexed in the lap. With the hands open, the patient is instructed to tor characteristic of the spring, its stiffness. Theflex first the small finger to the palm of both hands, yet again the law is named after 17th century British physicistmovement only begins as a unit, as both fingers move as a one. Robert Hooke. Hooke’s law - Wikipedia, the freeAnd the movement is slow, with each finger only moving if the encyclopediaother one does. When a precise movement is demonstrated withone finger, it is repeated with the others, and the thumb. This ex-ercise helps functional daily movements, such as gripping (brush-ing teeth) and picking up items. A much more difficult progressionis to have the patient remove shoes and socks, and repeat thesame movement with opposite small toe/little toe. This is whenthings get interesting, as it is very difficult to flex only the smalltoe. The intent, though, is the crucial part. Again, it is effectivewhen the patient closes her eyes and sends the intent to the toe

A Therapeutic Approach to StoneMassage Treating Head, Neck and FaceBy Dale Montelione Grust, LMT We all know how challenging body weight and movement to get extra power without relying massage can be on our thumbs. As on arm strength. a massage therapist for more than thirty years, my poor thumbs have When using stones you must allow them to be an extension had their share of injuries, wear and of your hand – never grip the stone tightly and always keep your tear. There were days I wished I had a wrists as straight as possible. stone thumb that could do the work. CoreStones, developed by experienced Remember – stones are hard! Use your stones as amassage therapists, are a patented cylindrically therapeutic tool to assist you in your sessions and I encourageshaped soapstone massage tool that works as an you NOT to use a stone throughout the entire massage. extension of your hand – particularly your thumbs. We are not designed to massage rocks – we are designed to Typical stones used in Hot/Cold Stone massage soft fleshy bodies. If you keep a stone in your hand Massage can be bulky and difficult to hold throughout the entire session you will likely injure your hands. comfortably in your hand. I taught stone massage workshops using typical river rocks or basalt Clients also report that they enjoy the experience when I stones for several years before co-creating this alternate between stones and hands. The heat of the stone will ergonomically designed massage tool. I found penetrate your hands making it difficult for clients to discern that typical stones compromised my wrists when you are using stones and when you are using your hands. and were not an effective therapeutic tool. When used properly, CoreStones Safety First allow you to maintain a neutral wrist There is growing concern over the safety of Hot Stone position and can be used for myofascial release, trigger point release and deep Massage and proper training in this technique can save you and specific frictioning. your clients from a harmful experience. In addition, the shape fits nicely in the contours of the body, making them There are several decent products on the market that you especially effective when working the can use to heat your stones. You can heat them in water in a neck, along the spine, and on the feet or professional stone heater. This provides you with a thermostatic hands. control to regulate the temperature. You must remember to dry your stones before using them to avoid dripping hot water on Body Mechanics and Stone Massage your client. Cleaning the water is also essential as water can In any type of massage proper body breed bacteria and create an unsafe environment for your stones. mechanics are the key to a lengthy career I have found a multiple temperature towel cabinet to be in massage a nice alternative to water. It is absolutely imperative that you therapy. find a towel cabinet with adjustable temperature control as the Working from typical towel cabi runs at 170 degrees and will make your stones your core and too hot to use. The nice thing about a towel cabinet is that it is a using a lunge stance dry heat and many cabis have an ultraviolet light for sanitization. offers you freedom When using this method you can reheat your stones as you use of movement them so they are hot for the entire session. and will translate as ease and There is a convenient portable heater on the market. It is relaxation to your shaped like an attaché case and can be plugged into a wall outlet client. Remember or into the electric outlet in your car, making it great for house to have your legs calls! and hands mimic each other – your Any heating unit you use must have a temperature control forward leg should be the same as so you can adjust the temperature for safe use of your stones. A your forward arm or you will perfect temperature for use is between 110-120 F. create an uncomfortable torque in your body. I recommend that you invest in an infrared thermometer Many times, I tuck my elbow into my hip to allow me to use my

to test the temperature type of stone when offering contrasting of the stone instead temperatures. of relying solely on the thermostat of the Soapstone is non-absorbent for easy heating unit as stone hygienic maintenance; the counter continues to absorb heat tops in chemistry labs are made from from the source and can soapstone because it is non-absorbent actually be hotter than and therefore non-corrosive. the temperature your unit is set to maintain. In addition to the physical properties of soapstone, there are You must also energetic properties that make it a take into account that great tool for healing and meditation. everyone has a different tolerance for heat Soapstone is believed to assist and certain medical with finding inner peace.conditions will cause a client to be more sensitive. ALWAYScommunicate with your client about the temperature of the It is said that soapstone creates positivestone and empower them to be in charge of their heat threshold. energy around itself and will exert a calming influence on the person using it.Benefits of Hot/Cold Stone Massage The application of heat creates vasodilation which allows It can be used when undergoing great changes in life and allows one to release old routines.the muscle to begin to soften and release – this makes it easieron you and your client when you start to do deeper work. It moves one to action and helps to prepare you for anything! Because the surface of the stone is larger than our thumb,clients can tolerate more pressure and get a deep release of What will you learn in this workshop?muscle tissue without pain. In this fun and informative workshop you We know that heat and slow sustained pressure are effective will learn how to ‘work easy with CoreStones’.in releasing fascia. The warm broad surface of a CoreStone can We will review anatomy and trigger pointsassist you in releasing myofascial restrictions and this enables of the muscles most commonly involvedthe body to have a deep therapeutic release of muscle tissue in headaches, neck pain, and sinus andwith minimal effort on the part of the therapist and minimal face pain – Trapezius, SCM, Scalenes,‘guarding’ from the client. Suboccipitals, Levator Scapula, etc. We will look at three types of headaches When using cold stones it is important to warn your client – temporal, frontal, and posterior. Wethat you will be applying a cold stone. Unlike using heat, you will work with stones and hands toshould hold the cold stone in one place for a few seconds to release muscle tension and trigger pointsallow the body to accept the sensation of cold. associated with pain referral patterns for each area. We will work in the masseter Our bodies have internal sensors that scream ‘oh, that’s hot to ease tension from clenching and grinding.– or that’s cold’ and it can take a few seconds for the brain toregister ‘that’s not so bad’. In addition to learning a therapeutic modality to treat specific dysfunctions, you Cold stones are used to tonify and stimulate. The anti- will experience a facial routine that caninflammatory effect of cold reduces puffiness in the face and be used alone as a deeply relaxing andgives the skin a youthful appearance. It is nice to end a face rejuvenating treatment.massage with cold stones - especially if your client has to getback to work or go about a busy day. My hope is that you will learn how to use stones safely and effectively to make your work Because blood tends to move away from cold, cold stones easier and extend your career. I encourage youcan be used to treat headaches and sinus congestion. to think about techniques you are already using in your session and then imagine how you can A woman experiencing a hot flash will greatly appreciate make it easier on yourself and/or your client bythe use of cold stones. using a stone tool. We can use our elbows for deep specific work, but you can’t heat or cool Alternating hot and cold is very effective in reducing your elbow.congestion and inflammation in an isolated area. In this typeof treatment, it is best to end with cold to allow the body to While learning a new modality that cancontinue to reduce inflammation and congested blood/lymph in bring additional revenue, you will discover a newthe area. This will result in less pain and stiffness for your clients. product that can be used as a self-help or meditation tool for yourself andWhy Soapstone? your clients. Soapstone is the best thermal conductor of any stone – this For further information,is why wood stoves are made from soapstone. It radiates heat go to our website www.evenly, and retains heat for a long time. Soapstone can be used hot or cold so you only need one

Skin Cancer:Get the Facts By Annie Morien, PhD, PA-C, LMT As a massage therapist, I see a lot of new cases of skin cancer than the combined incidence of can- skin. As a dermatology physician assistant, cers of the breast, prostate, lung and colon.”3 I see a lot of skin cancer. I bet that you What does this mean? More than 3.5 million skin cancers have also! Although it is beyond the scope are diagnosed each year in the United States. Skin cancer is of practice of massage therapists to diag- much more common than the combined total of the next four nose, it is within our scope of practice to most common forms of cancers. And like the other cancers, persuade a client to get a skin check, es- skin cancer can be lethal. pecially if we see an unusual spot on the client. Your actions may save a life! Fact #3: There are various skin cancers but the most com- Let’s start with some skin cancer facts mon are basal cell carcinomas (BCC), squamous cell carcino-from mas (SCC) and malignant melanoma (MM). Basal cell carci- Fact #1: “Skin cancer is the most com- noma is diagnosed most often and is the slowest growing skin mon cancer in the USA,”1 and “one in five cancer. Squamous cell cancer is second most common, but Americans will develop skin cancer in their in some cases it has the ability to spread to other body areas lifetime.”2 (metastasize) and cause death. Melanoma is the least common What does this mean? Skin cancer is but the most deadly because of greater risk of metastasis. It is VERY common. If you see five clients across estimated that over 9700 people will die from melanoma skintheir lifetime, it is likely that one will develop cancer in 2014.3 skin cancer. Given the same odds, What does this mean? Melanoma can be lethal because it one in five massage therapists can metastasize to other body areas, sometimes without pre- will develop skin cancer in senting obvious signs or symptoms. In some cases, the diag- their lifetime. You may be nosis is too late. There is no cure once melanoma has spread. one of the five - consider Unfortunately, the number of new cases of melanoma has getting a skin check! steadily increased each year.4 Fact #2: “Each year there are more Fact #4: “Ultraviolet radiation (UVR) is a proven human Continued on page 21

Skin Cancer:Get the FactsContinued from page 20carcinogen.”5 professional body workers across What does this mean? The International Agency for Re- the USA, as well as anatomy, physi- ology and pathology to students at thesearch on Cancer, a group within the World Health Organiza- Florida School of Massage, Gainesville,tion (WHO), placed solar UVR and UVR produced by tanning FL. She is the author of Contagious and In-equipment (i.e., tanning beds, lamps, etc.) in the same class fectious Skin Conditions, A Guide for Manualas other cancer-causing agents, such as cigarettes and pluto- Therapists. She can be contacted at healthand-nium.6 Researchers report evidence that a significant number skin cancer cases are due to UVR exposure from the sun ortanning equipment. Resources 1. Rogers, HW, Weinstock, MA, Harris, Fact #5: “The number of skin cancer cases due to tanningis higher than the number of lung cancer cases due to smok- AR, et al. Incidence estimate of nonmelanomaing.”7 skin cancer in the United States, 2006. Arch Dermatol 2010; 146(3):283-287. What does this mean? Stop tanning! The use of tanningbeds or lamps caused over 419,000 cases of skin cancer in 2. Robinson, JK. Sun exposure, sunthe United States. New high-pressure sunlamps emit approxi- protection, and vitamin D. JAMA 2005;mately 12 times the yearly dose of UVR as compared to the 294:1541-43.sun.5 In addition to skin cancer, UVR exposure causes signifi-cant skin damage. Wrinkles and “liver spots” (which are due 3. American Cancer Society. Cancerto sun exposure and are not related to the liver) are evidence Facts & Figures 2014. http://www.can-of UVR damage. documents/webcontent/acspc-042151. How do you convince a client to get a skin check? pdf. Accessed November 15, 2014. First, get one yourself. Undergo a skin check from a der-matologist so that you can tell your client about your experi- 4. Howlader N, Noone AM, Krap-ence. The dermatologist will reassure you if your skin spots are cho M, et al (eds). SEER Cancer Statisticsnormal (and you can breathe a sigh of relief). If a skin spot is Review, 1975-2009 (Vintage 2009 Popula-suspicious, the dermatologist will take a biopsy of your skin. tions). Bethesa, MD: National Cancer Insti-The biopsy procedure is quick and relatively painless (espe- tute; when compared to biopsies of the breast, uterus, liver, pops09/; Accessed August 22, 2012.etc.). Regardless of the results from the biopsy, most peoplefeel better having a diagnosis rather than spending time worry- 5. National Toxicology Program. Re-ing about the unknown. port on Carcinogens, Twelfth Edition. U.S. Second, if your client has an unusual skin spot, encourage Department of Health and Human Services,him or her to get a skin check. It is beyond our scope of prac- Public Health Service, National Toxicologytice to diagnose, but it is within our scope of practice to call at- Program. 2011: 429-430. http://ntp.niehs.tention to anything different or changing on your client’s skin. Third, educate your clients about the risks of skin cancer. diationRelatedExposures.pdf. Accessed FebruaryMassage therapists see a lot of skin – and at times, skin spots 12, 2012.on clients. When armed with the facts about skin cancer, youwill have greater success in convincing your client to get that 6. El Ghissassi, F. et al., Special report:“strange spot” evaluated by a dermatologist. policy. A review of human carcinogens—part Join our lively discussion and learn about the major types D: radiation. The Lancet 2009; 10(8):751-of skin cancer in the new FSMTA class Skin Cancer in the 752.Clinic. You will see multiple photographic examples of eachskin cancer, and learn about contraindications to massage, 7. Wehner MR, Chren MM, Nameth D,signs and symptoms, and current treatment options. Choudhry A, Gaskins M, Nead KT, Boscardin About the presenter: Annie Morien, PhD, PA-C, LMT, is a WJ, Linos E. International prevalencelicensed Massage Therapist and dermatology Physician Assis- of indoor tanning: a systematictant. She has extensive clinical experience in evaluating and review and meta-analysis.treating patients with various skin diseases. Dr. Annie received JAMA Dermatol. 2014her PhD in Physiology and teaches Skin Disease courses to Apr;150(4):390-400. doi: 10.1001/jamaderma- tol.2013.6896.

UPLEDGER PRESENTER Visceral ManipulationApplications for Whiplash/Trauma By Grace Dedinsky-Rutherford, BSc, RMT According to French Osteopath be far removed from the site of the symptoms. Consequently Jean-Pierre Barral, developer of any treatment to one area may facilitate changes in other parts Visceral Manipulation, up to 90% of of the body. As that old song goes, the head bone is truly musculoskeletal problems have a visceral connected to the thigh bone.component, and this particularly holds true forwhiplash or traumas. To understand why let’s A Two-Way Super Highway explore some important features of the body What Jean-Pierre Barral has added to this body picture is a structure. All ligaments, tendons, fascia and other forms of connective tissue are continuous detailed understanding of the role the connective tissue support throughout the body. They make up a three- system plays in relation to the internal organs – the viscera. It dimensional network comprising about 20% has long been known that musculoskeletal problems and spinal of the weight of the body. Collectively these dysfunction can affect the internal organs by altering the flow of tissues are the support structures which messages in the nerves to the organs. Barral has demonstrated maintain spatial relationships among all else that this connection between the musculoskeletal system and in the body. Most people think our bones the organs is actually a two-way super highway. And most hold us up. But if you were to remove importantly, the traffic leading from organs (and their support the muscles and connective tissues, the structures) to the musculoskeletal system is far greater than the skeleton would soon collapse. The other direction. All of the internal organs are connected more bones act as the framework for the or less directly to the spine by their support membranes. body and as attachment sites for this myofascial system. The bones hold An integrative approach to evaluation and treatment of us apart, and the myofascia holds us any musculoskeletal dysfunction requires assessment of the together, keeps us upright, and either structural relationships between the viscera, and their fascial allows or restricts movement. or ligamentous attachments to the musculoskeletal system. All of the major systems in the body Viscera move like the musculoskeletal system in 3 dimensions. - musculo-skeletal, nervous, circulatory, This ligamentous and fascial support system attaches them digestive, and organs - are enveloped to the posterior wall of the body. If there is tension in the in connective tissue. Characteristics of ligament and fascia, there will be tension and compensations a healthy connective tissue system are in the back body wall and throughout the body. While richly flexibility, elasticity, length and resilience. innervated in other ways, the support membranes of the organs This tissue absorbs and responds to stress, have very few nociceptors (nerves that report pain). We are injury, surgery, illness, emotional trauma rarely aware problems in or near an organ until the ability of and everyday gravitational force. Any of these the musculature to compensate for the problem is exceeded, factors will immediately, or over time, cause and pain or restrictions are experienced in the musculoskeletal an imbalance in the connective tissue system. system. This imbalance is seen as a shortening, thickening, dehydration of the tissue which Gentle manipulation of the visceral support system can impairs muscle function, joint mobility, along improve organ function. At the same time, strain can be taken with proper function of organs. This is usually out of the visceral support membranes as a key component experienced as pain, decreased flexibility, for treating musculoskeletal problems. The focus of education impaired movement and dis-ease of varying for many massage therapists has been the study of how the sorts. structures that lie behind or right along the spine influence the spine’s mobility and function. Visceral Manipulation offers Because of the continuous a method for assessing and treating the influence of those nature of these connective structures that lie in front and away from the spine. Those influential structures can include organs and their fascial tissues no distortion or attachments, peritoneum, the greater omentum or blood imbalance can remain vessels. Gail Wetzler, PT, Clinical Director of the Barral localized. For this Institute, describes Visceral Manipulation as “organ specific reason, the initial cause fascial mobilization.” of a person’s pain or dysfunction can often Continued on page 23

UPLEDGER PRESENTER Visceral ManipulationApplications for Whiplash/TraumaContinued from page 22The Lungs and Musculoskeletal Disorders the outermost of which is suspended The lungs are surrounded by two layers of pleural by ligaments attaching it to the posterior surface of the sternum, mostmembranes. The pleura are essentially fascial sheets associated strongly at the levels of the third and fifthwith organs. The inner or visceral pleura forms the surface ribs. The posterior part of the heart attachesof the lungs. The outer layer (parietal pleura) lines the inner to C4-T4 vertebrae. In a whiplash injury the heartsurface of the chest cavity. At the superior end of the lung, the is suddenly accelerated/decelerated, injuring itsparietal pleura is suspended by a complex of membranes (lung suspensory ligaments. Since these ligaments havesupport membranes) from the middle scalene muscle and the no nociceptors, we are not aware that they aretransverse processes of C1-C3 vertebrae. Pneumonia and other injured. During the healing process, the injuredrespiratory illness can leave scar tissue and adhesions in these membranes become fibrosed, putting tensionlung support membranes. on the lower cervical and upper thoracic vertebrae. This is a major reason why the neck Pneumonia can leave scars in the pleura. Hard coughing usually feels worse weeks after a whiplashcan break ribs. Some of us have had blows to the chest. than it does immediately after the injury. ThisPleural adhesions and contractures accumulate through life, is also why work on the painful areas ofunbeknownst to most of us. We take more than 20,000 breaths the neck tends to produce only short-per day. If there are pleural adhesions, these 20,000 breaths lasting results. Visceral Manipulationwill be taken within an imbalanced system, which forces the restores the length and elasticity of thebody to move around a fixed access (the adhesion). Since the pericardial support ligaments, therebylungs are suspended from the cervical vertebrae, this puts facilitating lasting improvement ina tremendous strain on the neck. The cervical paraspinal cervical and thoracic pain followingmusculature becomes tight in its attempt to resist this pull. whiplash. The pleural contractures will produce cervical As we have seen the membranesdisplacement and restriction. As we have very few sensory supporting the internal organs havenerves in the pleura, we don’t feel the strains around the lung. multiple and extensive connections with theWhat we experience is a chronic stiff neck. Freeing the pleura rest of the support structures. Manipulationoften quickly relieves neck strain and improves head position. of this visceral system has profound and lasting effects on the organization of the In addition, these tensions affect the scalenes which rest of the body. Including the visceralcan impinge on the brachial plexus and vasculature. Pleural system in the treatment of musculoskeletalpulls on the middle scalene routinely impinge on the nerves disorders from whiplash or trauma willsupplying the arm and hand. History of severe respiratory dramatically increase the effectiveness andillness is a known risk factor for carpal tunnel syndrome and long-term results for your clients.other upper limb repetitive strain injury (RSI).The Heart and Musculoskeletal Disorders The heart is enclosed in layered pericardial membranes,Visceral Manipulation, or organ specific fascial mobilization, addresses dysfunction within the cylinder ofthe torso. Each organ has a relationship through its fascial attachment to the spine. Some examples of thisrelationship are:• The mesenteric root of the small intestine can limit the mobility of the spine as it crosses the third and fourth lumbar vertebrae;• A mechanical restriction at the first lumbar vertebra may be influenced through a constant irritation of an old appendectomy scar stimulating the autonomic nervous system;• The cecum/appendix and L1 share this viscero-somatic interchange;• Decreased flexibility of the fascial connection between the bladder and the head of the femur can limit the mobility of both structures;• Dysfunction of the right and left sacro-iliac joint can result from decreased mobility

UPLEDGER PRESENTER 3 Things Every Massage TherapistNeeds to Know to be More Successful By Jack Ryan, LMT/Kerry Ambrogio, PT, DOM According to a 2013 survey, ASYMMETRY OR POSTURAL EVALUATION: Everyone Eighty-eight percent of Americans is introduced to postural evaluation in massage school. We believe that massage can be effective are taught to look for the high shoulder or rotated ilium. But in reducing pain. what does a rotated ilium mean? Is the anterior rotated Ilium Do you have the skills and knowledge the problem or is the posterior rotated ilium the problem? With to help those people looking for pain relief? proper evaluation and critical thinking you can determine More and more people are turning to alternative the dysfunctional side - because the location of pain is notsolutions for pain relief. They are tired of, or don’t always where the problem originates. The following evaluationwant to, take pills from their doctor anymore. techniques can help to clarify the dysfunction further.Prescription medication, in many cases, treats the symptoms but does little to help the cause of RANGE OF MOTION: Restricted range of motion is used a person’s pain. So the patient has to continue to determine the dysfunctional joint or muscle groups. When taking the prescription medications that can we evaluate someone’s hamstring tightness, by doing a strait become addictive. leg raise (SLR) test, we want to see a normal range of motion Of those Americans who had massage of approximately 80 degrees. However if the client only has 45 last year, 77% of them had a massage for degrees of SLR we have to ask is it just a tight hamstring or can medical or health reasons such as pain it be something else that is restricting normal range of motion? management, injury rehabilitation, muscle In many cases a hypomobile or locked sacroiliac (SI) joint can spasms/soreness/stiffness or stress. While cause a limited SLR. only 29% of people surveyed believe a massage is only for pampering. A We learned in massage school that muscles move bones and greater number of people are turning joints. You also have to understand that tight muscles and soft more to massage therapists for pain tissues restrict movement of bones and joints. Can you evaluate relief. This growing trend is making it individual joints to determine if they are fully functional? If they more important for massage therapists to are not functional, that may be one of the underlying causes of be able to evaluate and treat pain in their a persons’ pain. So the question we need to ask ourselves is, clinic, their house calls or even in the spa what soft tissues are affecting those individual joints and what setting. techniques can we use to address and treat the problem? EVALUATION: In order to be more successful, the first thing every massage Restricted joints are best treated with ‘Joint Balancing’ therapist should know is how to evaluate a techniques. The side with restricted range of motion is typically client’s pain. To be effective in helping your the dysfunctional side. Joint Balancing is a technique that treats clients you need to know what the underlying hypomobile joints, hypertonic muscles, and fascial tension. cause of the pain is. By treating the soft tissues with Joint Balancing techniques • Did you get enough training in school you focus on restoring normal function and range of motion to or from your last CE course to correctly evaluate individual joints. your client? • Do you evaluate a new client before TENSION: Tension test or tissue tenderness is what most starting to work with them? massage therapists use to evaluate and focus on when treating • Do you evaluate your client before their clients. We are great at finding the tender muscles or trigger and after each visit? points. But how many ways do you have to treat the tender With all of the CE Courses from the muscles or trigger points? Do you drive your thumb into the D’Ambrogio Institute you will learn the A.R.T.S. trigger point and hope it releases before your thumb gives out? of evaluation. A.R.T.S. stands for; Muscle Balancing uses an indirect technique to cause the trigger points to dissipate by putting the client’s body into a position of A. - Asymmetry or postural comfort to shut off the trigger or tender point. These techniques evaluation. are a pain free way to treat your client. The technique is easy on both the therapist’s and the client’s body. The technique is also R. - Restricted range of pain free because it is an indirect technique that works with the motion. body’s physiology instead of against it. T. - Tension test or SPECIAL TESTS: Finally, special tests are used to evaluate tissue tenderness. the client on a deeper level. Dr. Kerry D’Ambrogio is a Physical S. - Special tests. Continued on page 25

UPLEDGER PRESENTER3 Things Every Massage Therapist Needs to Know to be More Successful Continued from page 24Therapist, Acupuncture Physician and Osteopath. So the tests PAIN FREE TECHNIQUES: Theyou will learn to evaluate your client will come from a variety third thing that massage therapistsof health care fields. These tests are not difficult to learn. need to know to be successful is thatPerforming them can give you a better understanding of your they do not need to cause pain whenclient’s pain and instill confidence in your client of your ability treating, to be therapeutic. I hear time andas a therapist. again from my patients that they saw a massage therapist that used so much pressure on a muscle MULTIPLE TREATMENT TECHNIQUES: The second thing that they were in pain during the treatment and feltevery massage therapist should know, to be successful is how to bruised from the treatment. If a client or patientuse more than one technique to treat their clients. Here in Florida is coming in to you for pain relief, does it makewe are licensed to “manipulate the soft tissues of the human sense to cause more pain with your treatment?body”. It is important to understand that by manipulating thesoft tissues you have an effect on different systems of the body If you are treating a muscle and it is notin order to eliminate pain. You can also use different manual releasing, you need to ask yourself why.therapy techniques to affect those systems. Joint Balancing is Again using proper evaluation techniques willa direct manual therapy technique in which the practitioner determine if the muscle is the primary cause ofpositions the client’s affected joint at its restricted barrier in 1, the dysfunction or if the muscle is just reacting2 or 3 planes of motion. A gentle isometric contraction is used to another underlying problem. The muscleto relax and lengthen the muscle and/or fascial tension and can be reactionary to another problem innormalize the joint dysfunction. Proper joint function can be which case the muscle guards and willaccomplished without “popping” a neck or “cracking” a back, not release easily. So when you try tosince that is not within our scope of practice. Manual therapy release the muscle it can be painfultechniques that manipulate the soft tissues have a profound and non responsive. By evaluating theeffect on the body as a whole. whole body you can determine the primary cause of a clients’ pain. Treating When we work on a client we may be working the soft muscles can be pain free if the truetissues of the body but those soft tissues are connected to and cause of a client’s dysfunction is the jointaffect the skeletal system, nervous system, lymph system, arterial hypomobility and that is addressed first withand venous systems, even the energy systems of the body. As Joint Balancing techniques.therapists you have to understand these systems and be ableto use critical thinking to understand how each technique that Your success will grow by having moreyou use influences these systems. Joint Balancing is just one evaluation skills that build your confidencetechnique that every massage therapist should know how to use and credibility with your clients. New Jointto help their clients who come in for pain relief. Balancing techniques that treat the clients dysfunction and not just the site of the pain, Joint Balancing and Muscle Balancing are the 2 techniques will give your clients more pain relief andthat I can personally say helped me to avoid having back surgery results. Using pain free techniques like Joint16 years ago when I herniated my L-4-5 disc. After suffering an Balancing will make it more comfortable for yourinjury to my back from working too hard and too many hours I client to receive a treatment. Pain free, resultended up in the emergency room in severe pain and spasm. An oriented treatments will make your clientsMRI showed I had herniated my lumbar disc and the orthopedic happier and lead to more word of mouthsurgeon wanted to do emergency surgery. I had seen too many referrals.failed back surgery patients in my practice to want to do surgeryas my first option. Jack Ryan LMT has been a massage therapist since 1993. He is the owner of the I had 2 epidural injections to reduce the acute inflammation. Soar Point Massage Clinic in Sarasota FL. www.I also went for traditional physical therapy. These things only Jack has focusedgave me temporary relief. It was not until I found a therapist his practice on soft tissue pain reliefwho used manual therapy techniques that I truly started to get and rehabilitation. Jack is onmechanical function back and lasting pain relief. It took Joint staff and a teaching assistantBalancing and Muscle Balancing treatments to help my back with the D’Ambrogiotruly rehabilitate. By working with a skilled therapist I was able rehab my back and am now pain free. I am back at work fulltime and can exercise regularly without pain. The more toolsyou have to help your clients the more clients you will be ableto help.

UPLEDGER PRESENTERBarral Institute Neural and Visceral Manipulation for Concussion and Traumatic Brain Injuries By Lorilyn Dowiak The prevalence and seriousness brain, as well as the far-reaching ramifications throughout the of concussions and head injuries body. has reached a heightened aware- ness among professional, amateur and Manual therapy as it applies to the treatment of the nerves student athletes. Much of the visibility has or visceral, follows the standard principles of mobility and been on the National Football League (NFL) as it function. For optimal function, a nerve or organ must be ableconsiders changes in major aspects of the game to to move freely within its surroundings. This applies to the cra-try to reduce the frequency of concussions on the nial nerves as they arise from the encephalon or the cerebral field. However, as reports of headaches, memory trunk, cross various meningeal layers to exit through various loss, depression, sleeplessness, premature aging cranial foramen at the cranial base; just as it applies to spinal – and lawsuits – mount, the NFL, universities nerves as they emerge from either side of the spinal cord and and parents of young players are all paying exit through the vertebral foramen. close attention. “When you get into football, you think Two techniques that have been developed and successful- about hurting your knees, your back, even ly used are taught by the Barral Institute: Neural Manipulation your neck. But your brain, man, no. We (NM) and Visceral Manipulation (VM). Neural Manipulation, didn’t think about that. I didn’t sign up as developed by Jean-Pierre Barral, DO, MRO(F), PT and Alain for that”, said Leonard Marshall, the for- Croibier, DO, MRO(F), examines mechanical relationships be- mer New York Giants defensive end, in tween the cranium/spine hard frame to the dura and neural an interview published in the New York elements. It provides assessment and treatment approaches to Times Magazine cover story, Down by address restrictions of the dural and neural components that Law, November 9, 2014. can occur during a head injury. Visceral Manipulation, de- While that article primarily focused veloped by Jean-Pierre Barral, DO, MRO(F), PT, assists func- on the legal actions that are being taken tional and structural imbalances by evaluating and treating by some former NFL players, who signed the dynamics of motion and suspension in relation to organs, on before the risks to intellectual and emo- membranes, fascia and ligaments. VM increases propriocep- tional well-being were known, it concludes tive communication within the body, something that can be with how all of this attention is affecting severely stunted after a traumatic brain injury. middle school and high school teams – and potentially, the future of the game. Neural Manipulation aims to gently encourage freedom of According to Pop Warner, the nation’s tissue movement within the central and peripheral portions of largest youth-football program, the concerns the nervous system, through discovery of points of restrictions over concussions already have led to a drop within or around the nerve. A fixed or restricted nerve typi- in participation in youth leagues, after years cally loses its ability to glide and/or stretch in length, pressure of steady growth. However, with the stagger- within or around the nerve may increase dramatically, and/or ing estimate of 2 million concussions per year in changes may occur in the nerve’s vascularity, neural and bio- teenage athletes, many more steps need to be chemical consistency. All can lead to functional disturbances taken to protect and treat the injured. in nerve conduction. As the nervous system is involved in all Treating head injuries: The focus on body functions, Neural Manipulation can contribute to restor- treating concussions has been detection and ing balance of the nervous system, as well as to the entire diagnosis; often treatment consists of a “watch organism. and wait” strategy, unless symptoms exacerbate and surgery is required. As clarification of the A review of the anatomy: Individual nerve fibers are mechanisms of injury and the struc- bundled together by connective tissue (endoneurium) to cre- ate a primary fascicle. Large and small primary fascicles are tures involved continues to de- then grouped together by another layer of connective tissue velop, attention is being giv- (perineurium), forming larger secondary fascicles. Again, sev- en to manual techniques eral secondary fascicles are bundled together by yet another capable of accessing and connective tissue (epineurium), forming the nerve trunk. The addressing the vascular, epineurium divides the secondary fascicles from each other structural and neuro- and forms a clear visible external layer of the nerve trunk. logical tissues of the Blood vessels and intrinsic nerves (nervi nervorum) also exist within the bed of connective tissue within the nerve trunk. No- Continued on page 27

UPLEDGER PRESENTERBarral Institute Neural and Visceral Manipulation for Concusion and Traumatic Brain Injuries Continued from page 26ciceptors (pain) and proprioceptor are found within the nerve’s Visceral Manipulation tech-connective tissue. niques can provide a therapist with evaluation tools to discover primary A note of importance: the three connective tissues of a restrictions and the manual skills to en-nerve correspond and are continuums of the three layers of courage tissue releases that can promotemeningeal tissue that surround the brain and the spinal cord. the improved mobility and function.As such, manual techniques of a cranial or peripheral nervecan have an effect on the meningeal layers within the spinal As with other methods of manipulation thatcord and cranium, as well as associated structures (bones, su- affect the body deeply, Visceral Manipulationtures and vessels) within the cranial vault. Herein explains the works only to assist the healing forces alreadybenefit of neural manipulation for those tissues impaired by at work. In applying the techniques, therapistshead trauma and concussions. glide their hands over the patient’s body with a pressure equal only to the weight of their The art of Neural Manipulation lies in applying effective hand. Among the indicators that the organ isamounts of engagement of the connective tissues within the not functioning properly: the temperature ofnerve trunk without excessive compression. Once engaged, the organ is higher, there is higher-density fi-nerve tissue is encouraged to self-release as needed to restore ber around it, and the organ is unmovable tomotion and improve function. This improved proprioceptive the touch. By incorporating the VM tech-information is then transmitted via spinal tracts within the spi- niques, trained therapists can be sure ofnal cord, cerebellum, thalamus and cerebral cortex. benefiting the body rather than adding further injury or disorganization. The same holds true for all of the body’s tissues: optimalfunction of organs, bones, cartilage, etc. requires an environ- Ultimately, when the body is noment in which the continuous forces of pressure and traction longer bound from a restriction of thetransfer harmoniously through the associated connective tis- viscera, it can move with greater ease,sues. Visceral Manipulation is a manual therapy consisting increase its ability to adapt to its envi-of gentle, specifically placed manual forces that encourage ronment, and thus have a greater expres-normal mobility, tone and inherent tissue motion of the vis- sion of health.cera, their connective tissue and other areas of the body wherephysiologic motion has been impaired. For this reason, these Lorilynn Dowiak, PT, will be the pre-techniques may be described as organ-specific fascial mobili- senter for the FSMTA conference topic Barralzations. Institute Neural and Visceral Manipulation for Concussion and Traumatic Brain Inju- How does manipulating the viscera aid healing from ries. Based in Frederick, Maryland, Lori-head trauma? External forces producing head trauma or con- lynn has completed the full training trackcussion affect the intracranial meningeal layers that continue for NM, VM as well as Lymph Drainageinferiorly along the spinal cord, as well as the deeper cervical Therapy (LDT) and is a certified assistant forfascial layers that continue superiorly and insert within the those classes. She also has completed exten-cranial vault. Likewise, deeper cervical fascial layers continue sive studies in Upledger CranioSacral Therapyinferiorly into the thorax, then into the abdomen and pelvic and Brain coursework. In addition to describ-cavities. Forces of impact that initiate at the head may have ing the NM and VM techniques, she will sharefar-reaching functional effects via connective tissue restric- results from a pilot study that incorporated thetions. multiple modalities to address the needs of former National Football League players. Head trauma may produce cognitive impairment, head-aches, emotional and sensory dysfunctions, as well as re- For more information regarding Neural Ma-spiratory, digestive and elimination dysfunctions. One such nipulation and Visceral Manipulation, how itscenario: an individual falls striking the back of her head, im- can benefit your patients, and train-pacting not only intracranial meningeal membranes, but also ing seminars, please go to Bar-the cervical and thoracic spine. In time plural or diaphragmat- tensions begin effecting the individual’s respiration. Manualrelease of the thoracic visceral restriction can improve the in-halation capacity, and indirectly enhance the venous drainageof the cranial vascular system. Improved venous return haspositive effects on intracranial vascular pressure and may re-duce headache symptoms.

UPLEDGER PRESENTERHealing From the Core: A Journey Home to Ourselves By Suzanne Scurlock-Durana, CST-D, CMT For nearly 30 years, I have made only sporadic progress dealing with ongoing hip-and- taught and practiced skills and knee pain resulting from a skiing accident. Mariana finds her techniques designed to help people sessions with Lisa running long because she wants Lisa to be live their lives from a more embodied, pain-free at the end of every session. Despite years of training steady, energized place, in a world and experience treating similar problems, Mariana worriesthat is increasingly challenging. This body of that Lisa’s lack of progress is due to her own failings as aknowledge – concepts and practices – is now practitioner. She wears herself out doing more and more witha full curriculum called Healing From the Core, less and less confidence, and begins to dread seeing Lisa’swhich teaches people—therapists in particular— name on her schedule. The very thought of working on her how to be more fully present at all times both makes Mariana tired. professionally and personally. Living and successfully practicing Lucas’ long-term client, Frank, comes in for his regular bodywork in today’s world places many session two weeks after his son was killed in a drunk- driving energy demands on us. As therapists we accident. As the hands-on session gets underway, Frank’s eyes strive to maintain strong, healthy therapeutic fill up as his grief quietly surfaces. Sensing Frank’s anguish, relationships in our work. As human Lucas imagines what it would be like to lose his own son. He beings we also seek to have more depth feels his heart clutch, then quickly tamps down the feeling so and connection in our personal lives. he can be there for his client. Frank, sensing Lucas’ discomfort, Yet burnout is often the outcome if we stops crying and sinks back into a shutdown place. The rest do not first hold a healing space for of the session is uncomfortable for both of them. After the ourselves. session, they avoid eye contact—and Frank leaves, feeling he Consider the following cases. can never let his guard down with Lucas again. Jim comes home from a full day at the spa after doing a number of back-to- So, what is it that these stories have in common? They back massages. He started the day tired, represent common dilemmas faced by bodyworkers in today’s didn’t take time for lunch, and forgot to massage-therapy world. I first became aware of these types of pay attention to his body dynamics while problems in 1983, as a new massage- school graduate, and working. When he gets home he collapses my understanding has deepened during my 27 years teaching on the sofa, his back aching, too exhausted CranioSacral Therapy and SomatoEmotional Release for the to make something healthy to eat. He Upledger Institute. In my role as colleague, teacher and spends the evening mindlessly watching TV mentor, I’ve seen these and similar scenarios play out again and munching on junk food. He wakes up and again, both in my work with new practitioners and in the next morning even more exhausted than my consultations with advanced bodyworkers who long ago he was the night before and wonders why he mastered their manual skills. dreads going to a job he used to love. Dorothy, a CranioSacral therapist, starts It’s become increasingly clear to me that the outcome the day feeling well, but after working on of any given therapeutic bodywork session is significantly Tyrone, a client with severe, chronic pain influenced by the therapist’s ability to hold a strong, healing from whiplash, she notices that her own presence. This unspoken, unseen connection between neck is aching and that her range of motion therapist and client occurs in every therapeutic bodywork is reduced—problems she didn’t have before session. Making the most of this connection means learning the session. It takes her many hours how to remain grounded, connected and fully present in the face of whatever comes up. to release the aching and stop thinking about the awful This can be daunting, emotional work. It means being situation Tyrone is facing empathetic without taking on the client’s pain. It means in his life. facilitating a healing process without inadvertently violating Mariana is a deep- the client’s boundaries or losing your own. In short, it means tissue bodyworker learning how to be in touch with and nurturing of yourself, whose client, Lisa, has so that your presence can catalyze and nurture the healing process of others. Continued on page 29

UPLEDGER PRESENTERHealing From the Core: A Journey Home to Ourselves Continued from page 28 The importance of “putting your own oxygen mask on help guide your work, moment byfirst”: To be therapeutically effective as a bodyworker, your moment, appreciably increasingenergetic bank account needs to stay in the black. Yet I’d say your effectiveness.that eight out of 10 bodyworkers give their energy away assoon as they get it, because they love helping people. And Developing greater therapeuticin their enthusiasm to help, they fall into the habit of paying presence is also a potent antidote to burnout.attention to other people’s needs before their own. As you learn to nourish yourself with healthy resources, you won’t get depleted when you hold In the short run, you can get away with that. But when you a healing space for another. You will no longercontinue to give from a depleted core, without replenishing pick up the pain, grief or toxic feelings that areyourself, burnout is sure to follow. In order to maintain a steady, often released in the healing process, becausehealing presence for your clients, you need to recognize when there’s no place for them to be absorbed—your reserves are low and develop healthy ways to nourish it would be like trying to put more wateryourself. into a glass that’s already full. So instead of unconsciously absorbing the pain your That’s where a paradigm shift comes in. Rather than putting clients may be discharging, you walk awayyour clients’ needs first, you need to initially focus on your from sessions feeling energized, intact andown self-care. Learning to build and maintain your own store whole.of healthy inner resources has to become your first priority.It’s much like oxygen masks on airplanes. As flight attendants Finally, your confidence in yourselfalways remind us, “You have to make sure your own mask is as a healing presence will increasesecurely fastened before helping the person beside you.” as you embody these skills in your practice. Bodywork practitioners who Healing From the Core teaches you the steps to putting on apply the principles of holding a strongyour own oxygen mask first. Let’s take a moment to look more therapeutic presence develop a deepfully at the reasons why developing a stronger, more stable trust in their feelings, skills, intuitiontherapeutic presence is essential to you and your clients. and wisdom. Practicing the principles of therapeutic presence takes patience and Benefits of presence: Developing a reliable therapeutic ongoing commitment, but it is well worthpresence is one of the greatest gifts you can give yourself the effort. Our work is richest when weand your clients. The benefits to both parties in the healing can be in each moment with our clients,partnership are profound and wide-ranging. in a space of caring and compassion that enables us to receive as well as give to them When you are more grounded and present, clients can in every session. As an added bonus, therelax more quickly. It is easier to let go of tension and soften ability to become a container for someonein the presence of someone who is energetically full and else’s healing brings us into a deeper state ofsteady. Clients feel that their deeper needs are being sensed grace and resonance. Everyone receives fromand taken into account, whether they are consciously aware of this equation. In this paradigm, to give isthis or not. They feel it when you meet them with your touch, indeed to receive.connecting to their tissue fully, and this creates the safety andpermission necessary for deep relaxation and healing. As you become more aware of what nurtures and feeds youin a healthy way, you will become more stable and grounded,and will be more able to accurately honor your client’s internalpace of relaxation and healing. It becomes less and less likelythat you will push them or miss important cues from them.This enables clients to trust their own healing processes andmore fully release places that are tight and restricted. Deeperrelease means more profound healing, a positive outcome forboth of you. Learning to embody a steady, strong therapeutic presencesignificantly increases your ability to feel what’s going on withyour clients. This energetic connection becomes a palpable,rich resource for you, a reliable source of information that can

UPLEDGER PRESENTERCraniosacral Therapy and the Treatment of Post Concussion SyndromeBy Mariann Sisco Although Craniosacral Therapy   (CST) is not a panacea for all post concussion symptoms, it can example, damage to the pituitary or surrounding tissues may be a powerful adjunct to the care affect endocrine function. Other common physical symptoms of individuals whose lives and those of include dizziness, tinnitus, double vision, sleep disorders and their families have been severely altered as fatigue.a result of these symptoms. Success has beenreported clinically by advanced practitioners Although there is some debate as to what causes of CST. Documented results in pilot studies postconcussion syndrome, including risk factors associated have garnered interest by professional medical with preexisting psychological conditions, physical changes to researchers. the brain is considered by many to be a primary cause. There Concussion is the result of the head hitting are professionals who argue that the structural damage and an object or a moving object hits the head. possible disruption in the transmission of neurotransmitters Concussion can also occur when the head causes the dysfunction associated with post concussion and neck are subjected to violent movements syndrome. Practitioners of CST who work with the various without directly contacting an object. This structures of the brain and tissues that affect the brain and can occur during a whiplash type of cranium have found this to be true. injury. In this instance, it is referred to as a contrecoup injury in which the Anatomically, the craniosacral system (CSS) is the deepest brain is thrown against the inside of layer of the fascial system, a continuous network surrounding the cranium. This force then moves every structure of the body. There is even evidence that the brain toward the opposite side of strands of fascia pierce the cellular membrane and connect to the skull resulting in another forceful the nucleus of the cell. Tensile strength of the fascial network contact. Repeated hits resulting in has been measured up to 7,000 pounds per square inch. concussion such as athletes participating These forces combined with the continuity of the fascia helps in football and soccer can lead to a to explain the myriad of symptoms that an individual may cumulative development of symptomology. experience after an injury should have healed. Post concussion Depending on the amount and direction syndrome is one example among many illustrating the affects of the force, vasculature to the brain tears of a tight fascial system on the other systems of the body. and internal bleeding occurs. Also damaged are the neurons, neuronal centers and glial The anatomy of the CSS is relatively simple. The cranium tissue which support the various brain is lined with dura mater, which not only encircles the inner structures. The resulting damage in function surfaces of the cranial bones, but also folds in on itself creating varies across a continuum. Symptoms may not the falx cerebri, tentorium cerebelli and the falx cerebelli show up until later, sometimes a year or more. otherwise known as the intracranial membrane (ICM). The firm This is referred to as post concussion syndrome. attachment of the falx cerebelli at the foramen magnum of the Symptoms are wide ranging and can affect an occiput continues inferiorly with attachments on the posterior individual in a variety of ways. Emotionally bodies of C1 and C2. It continues in the inferior direction and behaviorally, a person may become more without any attachments until it anchors at the S2 segment as irritable and aggressive. Anxiety, depression, the pia portion of the filum terminale within the sacral canal. It apathy and other changes in personality may exits out of the sacral canal and continues as the external dural also occur. Cognitive dysfunction may exhibit segment of the filum terminale blending with the periosteum of itself with difficulties in concentration and the coccyx. (Figures 1a,b,c) In addition, the dura mater extends memory. Physically, there may be out through the intervertebral foramina with the spinal nerves as the dural sleeves. The dural sleeves attach on the vertebral headaches, neck pain as well bodies blending with the paravertebral fascial tissue. These as other seemingly unrelated anatomical attachments help give credence to the continuity pain syndromes and of the fascia and why CST has such far reaching affects. system disorders. For Continued on page 31

UPLEDGER PRESENTER Figure 1a: Dural Attachments to Bone/SkullFigure 1b: Detail of dural attachments including intracranial membraneFigure 1c: Intracranial Membrane There is normally a palpable movement of each of the Detail cranial bones around a specific axis. The scientific validity of cranial bone movement is explored in the article “Craniosacral Therapy…What is it Really?” which can be accessed at Restricted cranial bone movement reflects not only sutural restrictions but also restriction in the underlying meninges attaching to the bone. CST techniques address both types of limitations in mobility. Concussion affects the structures of the nervous system including the glial cells which are the glue or supporting matrix of the structures of the brain. This glial matrix, although of different embryonic origin than the fascia, shares some similar functions. The extracellular fluid matrix transports nutritive substances and removes waste products as well as information via micro biochemical substances. Disturbances of this fluid may inhibit communication between various parts of the brain. The glial cells extend all the way out to the cortical layer of the brain via the glial end feet. These end feet connect directly to the pia mater which is a shrink wrap-like layer for the brain. This pia layer connects to the dura mater

UPLEDGER PRESENTERCraniosacral Therapy and the Treatment of Post Concussion Syndrome of the CSS via the arachnoid layer effects of concussion seek out Craniosacral Therapy as a means of the meninges. Trauma affects to improve function and decrease pain. the bones of the cranium and the dura mater lining the inside of the Bibliography skull bones as well as the sensitive 1. Ricky Williams Pilot Concussion Program . Palm Beach brain tissue. It is suspected that the positive results experienced with CST in post concussion Gardens: Upledger Institute, July 2014. syndrome are the result of affecting not only the 2. Barral JP, Crobier A. Trauma: An Osteopathic Approach. dura and cranial bones but also the glial network attaching directly to brain structures they support Seattle, WA: Eastland Press, 1999. via this meningeal connection. 3. Encyclopedia, A.D.A.M. Medical. Diseases and Condi- CST includes mobilization of each of the bones around its anatomical axis affecting the tions > Concussion. U.S. National Library of Medicine attaching membrane and the glial network -Pub Med Health. [Online] January 15, 2014. [Cited: No- that attaches directly to the meninges of the vember 29, 2014.] nervous system. A frontal lift technique can 4. Debangus. Pst-concussion syndrome. Wikipedia. [On- address tension patterns related to the frontal line] November 8, 2014. [Cited: November 29, 2014.] lobe associated with executive function and concentration. This can affect behavioral changes 5. Cydebot. Extracellular Matrix. Wikipedia. [Online] associated with impaired decision making and focus. November 27, 2014. [Cited: November 29, 2014.]Temporal techniques may address the tinnitus and dizziness associated with post concussion syndrome. All of 6. Wanveer, Tad. The Pia-Glial Connection. Upledger Up-the techniques have the potential to affect the functioning of the date: Palm Beach Gardens, FL: Upledger Institute.deeper structures of the brain via the glial matrix connection 7. Felton D, Jozefowicz R. Netter’s Atlas of Human the meninges of the brain that directly attach to the skull Teterboro, NJ: Icon Learning Systems, 2003.bones. 8. Upledger JE, Vredevoogd, JD. Craniosacral Therapy. Se- Post Concussion Syndrome and the associated symptoms attle, WA : Eastland Press, 1983.have clinically responded to CST. CST continues to generate 9. Gratz, CM. Tensile Strength and Elasticity Tests on Humaninterest and scientific investigation as a viable adjunct in the Fascia Lata J Bone Joint Surg, 1931, Vol. of individuals experiencing the adverse affects of post 10. Paoletti, S. The Fasciae. Seattle, WA: Eastland Press, 2006.concussion syndrome. Meanwhile, those suffering from the 11. Sisco, M. Craniosacral Therapy...What is it Really? . Cy- [Online] June 20, 2012. [Cited: November 29, 2014.] SPECIAL-EARLY BIRD MASSAGE IS A PRICING! WINNING HANDRegister early and save with the FSMTA EarlyBird pricing. Register for convention and yourhotel on the Easy Payment Plan. You can signup, select your favorite classes, and get all yourCEs for one low price! Don’t miss out on thespecial Early Bird prices and the payment planoption. Early Bird rates end June 8th so lock inthe special price and sign up today. Learn moreand register today at MASSAGE MESSAGE • MARCH/APRIL 2015

CrUaplnediogeSracral Therapy John Matthew Upledger, CEO The most trusted, innovative, reliable source for CST training and John E. Upledger, DO, OMM,developer of CranioSacral Therapy • Participate in the most diverse CST curriculum that features over 40 unique course titles • Attend a workshop in one of 400+ cities, in over 60 countries • Learn from a balanced mix of lectures, demonstrations and supervised hands-on practice; take home a comprehensive, illustrated study guide • Become certified by an organization whose programs are known, valued and respected worldwide • Let our skilled Educational Services Counselors help you chart your future • Earn contact hours to satisfy continuing education credits • Join a global alumni network of 100,000 practitioners, residing in 100+ countriesUpcoming Classes: Additional dates and locations at Upledger.comCranioSacral Therapy 1 (CS1) Beyond the Dura 2015 Conference (BTD15)Palm Beach Apr 9 - 12, 2015 Jupiter Beach Apr 22-25, 2015Tampa Bay Jun 11 - 14, 2015Palm Beach Nov 5 - 8, 2015 Sensory Integration for CST Therapists (SICS)CranioSacral Therapy 2 (CS2) Palm Beach May 16 - 17, 2015Palm Beach Nov 12 - 15, 2015SomatoEmotional Release 1 (SER1) CranioSacral Therapy and the Immune Response (CSIR)Palm Beach Apr 30 - 3, 2015 Palm Beach Oct 1 - 4, 2015SomatoEmotional Release 2 (SER2)Palm Beach Oct 29 - 1, 2015 CranioSacral Applications for Conception, Pregnancy and Birthing 2 (CCPB2)SomatoEmotional Release Technique: Palm Beach Apr 18-21, 2015Mastering the Inner Physician (SERTIP)Palm Beach May 28-31, 2015 CST Techniques Certification ApplicantBioAquatic Explorations: Dolphins (BAEC) Preparation (CATP)Freeport Jul 29 - 1, 2015 Palm Beach Apr 22, 2015 START Ask about our Core-Pak Training and Certification Package100TRAINING Save More Than 30% • Coursework Satisfaction Guaranteed!$ MPEORNTH Call or Click: 800-233-5880 | To register, use Priority Code FSMTA 3-4/15 The Upledger Institute International is endorsed by the International Alliance of Healthcare Educators MARCH/APRIL 2015 • MASSAGE MESSAGE 33

COLUMN Turning a Case Report Into a Research Poster By Jerrilyn Cambron, LMT, DC, PhD, President of the Massage Therapy Foundation Have you ever wanted to share one of your interesting Case report or case description – This section shouldcases with other massage therapists? Case reports are a include information on the client such as how long s/he hadgreat way to do this. Typically, case reports are written up the disorder, how it was diagnosed, and what treatmentsand submitted to journals for publication. But there are other were already tried. Include the type of massage therapy orways for this information to be shared. One way is through bodywork utilized, being as specific as possible while alsoresearch posters. being succinct. Adequate details should be presented to allow the reader to have a good understanding of how and A research poster is just like any other informational what was done, but there is often insufficient space for anposter, except that it focuses on research results and is exhaustive presentation of the methods. Do not include thepresented at professional conferences. A poster session client’s name or even a fake name. Simply refer to him or herallows attendees the opportunity to read the poster as “the client.”information at their leisure during the conference and alsoprovides the opportunity for conference attendees to meet Results – In this section, results of the study arethe researchers and discuss the research results in person. reported along with illustrations such as tables and/or graphs. If possible, data gathered should be reduced to One form of research posters focuses on case reports. understandable trends, rather than reporting all individualAlthough there is usually no set presentation style, scientific pieces of data. The poster is an overview of the case, andresearch posters based on case reports follow a fairly the highlights are typically presented such as the pre andstandard format and typically include the following sections: post measures. Title section – Your title should include the client’s Discussion/Conclusions – The discussion sectiondisorder and treatment utilized. For example, a good title is where the author can speak more freely about whatmay be “Trigger point therapy for carpal tunnel syndrome in happened with the case and how the results fit with any othera 43 year old female: a case report.” research in the field. If the case gives a new perspective or leads to possible future studies, this is the section to describe Introduction – The introduction section should provide that information. Limitations of the case report should besome background information on the topic, such as the reported here as well, such as if the data were subjectivelyprevalence of the condition or the cost to society due to the measured by the author rather than objectively through thecondition. You may want to include information on common use of goniometers, x-rays, or other objective tools.treatments for the condition. Frequently the introductionsection identifies a gap in the existing knowledge and References/Literature Cited – All references used inbuilds an argument for why the presented case is needed. the research study should be cited in this section using theAre there no other scientific articles on massage therapy appropriate style. Typically, only scientific journals are usedfor this condition? Are there any other case reports? What as references. Wikipedia and magazine articles are frownedinformation is missing from the literature that your case might upon.fill? This section should also have appropriate references,including only articles from scientific journals rather than Developing a scientific poster is not an easy task. Justpopular magazines or websites. like anything, you will need to go through several drafts before you are satisfied with it. But it will be worth the effort when other massage therapists learn from your experience! More information: There are many examples of clinical case report research posters on the internet. The Massage Therapy Foundation also has many resources on how to develop a case report and how to design a scientific poster. Please feel free to visit our website for more information: MASSAGE MESSAGE • MARCH/APRIL 2015

AssocSiattaitoen&News The Florida Department of Health now requires you profession and choose the “Live Continuing Educationto submit proof that you completed all of your continuing Courses” option on the Course Type page. On the Filtereducation hours before you renew your license. Make sure Results page, you will select the Subject Area of “Relevantyour CE is reported or your license will go delinquent. to and focus on massage therapy techniques” and a Delivery Method that fulfills the “live” requirement. The Department uses CE Broker to verify your continuingeducation hours and it is up to you to make sure all of your Members of FSMTA get a discount:hours are posted before renewing online. If you have an account with CE Broker, you can view Check your records in CE Broker to view the hours that all the credits that have already been reported to yourhave already been posted toward your requirements and account and self-report any additional credits. There arereport any missing hours yourself. many account types available to you: Basic, Professional and Concierge. All members of the FSMTA will receive aDid you know? $5 discount for the Professional Account. To obtain your At least 12 hours must be taken live and relevant to and Association’s code, you can contact Lynn Rogo at lynn. or by phone at 407-786-3307.focus on massage therapy techniques; which may includethe history of massage, human anatomy & physiology, Manage your compliance on the go:kinesiology and/or pathology. These hours must be Find balance when managing your continuing educationcompleted via live classroom instruction (including hands-oninstruction or demonstration). with the CE Broker iPhone or Android App. From within your app, you can Report CE, check your Course History, and You can find these live classroom requirements in CE view your CE Compliance Transcript. You can even upgradeBroker’s Course Search Tool. All courses listed in the Course to a Professional Account using your iTunes or Google PlaySearch are approved and will count towards your license. account. Download our free App today!Go to and click the Course Searchtab in the navigation bar. Select Massage Therapy as your MARCH/APRIL 2015 • MASSAGE MESSAGE 35

COLUMNHawaiian Lomi Lomi Massage—A Too Well Kept Secret By Tony Crawford, LMT Over my 20 years as an L.M.T., I have come across We have all learned in school the typical sequence ofmany therapists who aren’t familiar with the art of Lomi Lomi Swedish massage. Most of us have been taught to work fromMassage. It is not a well known modality, and it is taught in body part to body part. We finish the back then move on tovery few schools throughout the country. I had never heard an arm or leg, rarely going back to the part already worked.of it in my first ten years of practice. Exploring various CEU Your client can “guess” what’s next, when it is time to turncourses, and honestly getting bored with the same old stuff over, and when you are done. This keeps their consciousbeing offered, I discovered a Lomi Lomi workshop. mind working in a logical pattern, following your moves and keeping track of your work. It feels great, but are they re- Other than having the courage to initially sign up for ally relaxing and letting go? Is any emotional healing takingmassage school, taking that workshop was the second most place?important career choice I have made. It was a true gamechanger. This work has changed the way I think about Mas- Lomi works on a different and deeper level. Lomi workssage. It has helped my client’s wellbeing tremendously. It the whole body as one and not just as individual parts. Lomihas increased my business, and, more importantly, it has is best described as a “rhythmic dance around the body.”changed the way I think as I proceed with my life’s journey. It works from the neck, down the back, and down the legs, then back up and over to the other side. This sequence is re- Lomi is also a career saver. It is performing your work peated as needed stopping along the way and concentratingby using your forearms much more so than in Swedish mas- on a leg, a back or arm as the practitioner feels is needed,sage. It is using your body weight to your advantage and then going back to the “dance.”using your hands and fingers to a lesser extent. This a greattool for prolonging your career and helping your body by re- The great part about Lomi is that as you work the muscleducing the everyday wear and tear on your hands and fin- structure becomes warm and loose and deep work becomesgers. so much easier on you and less painful to your client. An example I often use with my students is that a muscle is like What is Lomi? If you think of massage as a powerful a stick of butter. Take a stick of butter out of the refrigera-form of healing, then Lomi must be considered one of the tor. Try putting your finger in it, you can’t. Rub that buttermost profound forms of massage. These are bold words, but for a few minutes and your finger goes deeper and deeper.true. Lomi Lomi loosely translated means to knead, or to Massage, any massage, is no different than that stick of but-rub. It is an ancient form of Hawaiian bodywork that was ter. Lomi has a special way of warming and caring for eachconsidered by some to be a rite of passage for the villagers, muscle so deeper work can be performed easily, painlessly,performed by kahunas and elders. Each community had its and as needed.own style and form of Lomi. At the end of the day it wasstill about healing, healing the body, healing the mind, and Lomi is performed on a clean table using no sheet onhealing the spirit. I have found it to be a form of cleansing, the table itself. I have heard gasps of astonishment fromand through your work and your presence, you can facilitate some therapists when they heard of this practice. The rea-healing, allowing your client to let go of both physical pain, son, however, is rather simple. While your client is in the su-as well as emotional pain. pine position you have complete and easy access to working their back without interference of a sheet. A “run” can be performed by going up the body from the feet, continuing to the hip, and transversing under the back. Or, while standing at your client’s head, you can place your hands under the shoulders and work down to the sacrum area and “lift” and pull your hands back towards the head along the vertebral groove. These are some of the most appreciated runs by my clients. Often as you work a back in this manner you will hear them release pent up emotions. The power of this work is astonishing. Continued on page 3736 MASSAGE MESSAGE • MARCH/APRIL 2015

Refer A Friend & You Could Win!When you refer a friend or colleague you could win a great prize.  Not only will you receivethe other great referral benefits, but your name will be entered for a chance to win a greatprize.  Each drawings prize will be selected by the EC and Membership Chair.  You could win an IPad, Massage Products or other great prize selections. Win you refer afriend we all win by growing a stronger Association that unites, promotes and protects themassage profession, and has since 1939! Hawaiian Lomi Lomi Massage—A Too Well Kept SecretContinued from page 36 There is a powerful healing process that is inherent in Our bodies are memory banks of past emotions and ex-Lomi. A very wise lady told me once that “when you are born, periences. We hold these thoughts in our muscles, in ouryour life is like an empty bowl. As we age and go through cells, and right down to our DNA. In many ways we are ourlife that bowl gets full of stones, issues if you will: life expe- past, and we are our ancestors to whom we share a com-riences, loves, losses, hurts, and sorrows, all of the com- mon bond. Lomi provides a safe and healing space, shouldmon emotions we share as humans. Lomi facilitates a way the client allow for these emotions to surface. You, as a prac-of throwing some of the stones out of that bowl. It can help titioner, are creating and holding a safe and caring space forclear the body and mind of some negative experiences as your client, being totally present and supporting them in theirwell as help to remember a joyous time or person who has healing process.---- Powerful and meaningful work.touched us in a special way”. I have been an L.M.T. since 1996. I was graduated from As I said earlier, standard Swedish massage engages the Swedish Institute of Massage and have been practicingthe conscious mind. The dance of Lomi and the unpredict- in Florida for the past 17 years. I have studied and advancedability of where the practitioner is going next shuts down the my Lomi training through Sacred Lomi. I have taught andconscious mind and allows the subconscious to surface. I practiced Lomi throughout the United States and abroad. Ihave found this to be one of the more intriguing parts of the am currently associated with the Massage program at FSCJwork. Once a client relaxes and stops thinking about what in Jacksonville and work and live on Amelia Island. If I can beyou are going to work on next two things usually occur: total of any assistance with information concerning Lomi, pleaserelaxation and, more importantly, deep healing can be expe- contact me at or you can erienced. mail me at Cell 904 557 8350. MARCH/APRIL 2015 • MASSAGE MESSAGE 37

Find the FSMTA on Facebook! Search for these pages and like them today: State: Florida State Massage Therapy Assoc. (FSMTA) Convention: Florida Massage Convention and Trade Show Members: FSMTA Members (Closed Group) Sports Massage: FSMTA Sports Massage Team Plus, each Chapter has its own Facebook page as well... so look up your Chapter today! SCIATICA? BACK/HIP/LEG PAIN? Online38 MASSAGE MESSAGE • MARCH/APRIL 2015

Well Done! You Took theAssocSiattaitoen&NewsFSMTA Sports TeamTraining: Now What!?!By Michele Weissman, BS, LMT, BCTMB, CNMT, CMMT, CMLD, CKTP Taking the FSMTA Sports Team Training class was can be acquired. Which means that the confidence gap, ina smart move. Good job! Your foundation is set. You are turn, can be closed.”equipped to work with clients who are preparing for and re-covering from physical exercise. THERMAL INJURIES*. You have a high probabil- ity of treating these type of injures. The most common will Now what’s your next move? Find that athlete to work be cramps. Muscle Cramps is an involuntary contractionon! Better yet sign up with your Chapter Sports Chair for the caused by inadequate hydration, electrolyte imbalance ornext Sports Event. Practicing what you learned is what it’s decreased blood flow to the muscles. It is the first stage forall about. Hyperthermia: The rate of heat production exceeds heat dis- sipation. This can occur at temperatures of 75*F (21*C) and But for some this is the hardest part…that first Sports above. Stages of Hyperthermia include the following:Event. The number one myth new Sports Team members tellthemselves is that they are not ready. Boy, does that take me 1. Muscle Crampsback to my first Student Clinic Massage. What an anxious 2. Heat Exhaustionday that was! I was so overloaded with so much to do and 3. Heat Strokeremember while looking poised and confident at the same Let’s start with #3 Heat Stroke. Well, you know that’s atime! All our class could do after that first hour was finished no-brainer. LIFE THREATENING situation. CALL FOR MED-was return back to the lounge area (away from the clients) ICAL SUPPORT 911. Heat Stroke is a LIFE THREATENINGand wail! And moan! And moan some more! But we suc- condition caused by severe dehydration and electrolyte im-ceeded. It may have felt uncomfortable but we prevailed. balance after extreme exposure or exertion, the body can noWe carried on, executed our training, performed to our best longer compensate for the lack of fluids or electrolytes.ability and did it. We just did it. You have already done it. #2 Heat Exhaustion. Sounds menacing. CONTINUOUSYou have already worked on clients. Now we are focusing OBSERVATION. REFER TO MEDICAL if condition persists.the intention of your work to the needs of an athlete. Same Heat Exhaustion is produced after prolonged physical exer-work…well sort of. You know your strokes and techniques tion, caused by inadequate hydration, electrolyte imbalance.from class. Now just use them. Put them to good use and What’s the difference between #2 and #3? The signshelp that client run that race for their favorite charity, to help and symptoms are similar. The signs are more pronouncedthem lose weight or get more fit, reduce stress in their life, or for exhaustion. The symptoms more severe for them combat their diabetes, heart disease, etc. Makes sense, right? First Aid is about the same: rest in the shade near a fan, The second myth a new Sports Team member holds is drink cool liquids, place ice pack or cool wet towels on neckthat they are not prepared to treat injuries. Well that’s com- and upper back, “stomach”, between legs. The more severeplete phooey. We reviewed this in class. So let’s go over it the injury the more ice pack placements. At the Miami Tennisagain. Open the athlete lays supine with ice bags under the neck, It can seem like this is the tricky part, but that’s only be- Continued on page 40cause you may lack the experience. You have the know-how,the information; it’s the confidence you’re may feel deficientwith. Confidence is gained through working, trial and error,making mistakes, working through them. You have enoughtraining to reduce medical errors and injury. So now you canwork competently to build your confidence. » According to The Atlantic’s May 2014 Cover Story,‘The Confidence Gap,’ by Katty Kay and Claire Shipman,“A growing body of evidence shows that, at work and inlife, confidence matters just as much as competence whenit comes to getting ahead.” This “evidence shows just howdevastating this lack of confidence can be. Success, it turnsout, correlates just as closely with confidence as it does withcompetence….. The good news is that with work, confidence MARCH/APRIL 2015 • MASSAGE MESSAGE 39

Well Done! You Took the FSMTASports Team Training: Now What!?! Continued from page 39on the “stomach”, under the knees, on ever means available, cool event par- tomatic action. Nor are they trained tothe elbows, and in between the legs ticipant’s core body temperature (drink treat muscle cramps. Lying down maynear the groin area; ice towels on the cool liquids, sit near fan, use cool wet be the thing that helps the most. Makehead, forehead. They also have an in- towels, place ice pack on neck, back them as comfortable as possible. Thenflatable pool to use as a full body ice and stomach, between legs). start applying your 3 techniques. Oncebath. I went to a local store and bought you do it in a live situation it only getsa $10 plastic kiddy pool. Easy to carry IN ALL CASES, MAINTAIN COM- easier and less the event and fill with ice and towels. MUNICATION WITH EVENT PARTICI-Always confirm the presence of ice at PANT. OBSERVE EYES AND OVER- IN ALL CASES OF THERMAL IN-all sports events with the Event Direc- ALL BODY CONDITIONS. JURIES, MAINTAIN COMMUNICA-tor. I mean enough ice to fill the pool- TION WITH EVENT PARTICIPANT.- 2-3 pounds of ice as a minimum. No Now for the injury that is most com- OBSERVE EYES AND OVERALLneed to fill it with water just yet. It will mon and why we rule at the sports BODY CONDITION. Any event par-melt on its own. event. Muscle cramps. They occur ticipant who has a previous history of most commonly in the legs, calves and either cold or heat related illness is So how many times are you going hamstrings mostly. I did suffer a HOR- particularly prone to suffering the sameto see these severe injuries? Well, it RIBLE cramp in the Adductor/Vastus condition again. So ask in your healthdepends on the duration of the event, medius area. OMG painful!!! An ice history before starting the work: “Havethe location, the training of the athlete, pack was my best friend. Then a little you suffered from muscle cramps, heatthe medication an athlete takes or for- stretching. Always keeping the ice pack exhaustion, heat stroke or hypothermiagot to take, etc. Generally, you will not on. I was alone and this was the best I in the past?”see these extreme conditions all the could do as I struggled on the floor. Hadtime at every event. But that’s the rub my Therapist been there, they would Congratulations again on yourright? (Yes a little pun; couldn’t help it) have applied stretching and direct com- Sports Team membership! I know youIt only takes one client to present this pression. Ice if it continued or if it was are ready to take on your first Sportsway to make it important. It only takes severe. What cramp isn’t severe?! LOL Event. How do I know? Because I’vethat one athlete for you to remember they hurt! These 3 therapeutic applica- been through it…right where you start-your training forever. So now you’re tions: direct compression, reciprocal in- ed. And I can tell you this: You don’tprepared. Cut out your cheat sheet and hibition or approximation, and ice pack know that you know it until you knowhope you don’t have to use it. will let you rule the playground so to you know it. Say that 5 times! But, you speak. These applications sound easy know what I mean, right?! Get thatStages of Hyperthermia enough right?! Everything is easy when confidence…that engine to get you Muscle Cramps: Treatments: 1. Di- you know the answer!! moving, to believe in yourself and your training. Confidence matters. It showsrect Compression. 2. Reciprocal Inhibi- I remember volunteering at the and it grows and lasts a lifetime.tion or Approximation. 3. Ice Medical Tent with no other LMTs, only 30 or so Osteopathic Doctors in Train- So find your LIVE Clinical Sports Heat Exhaustion: 1. Symptoms: ing. The Medical Director asked me to Event. The best day internship you’llheadache, nausea, dizziness, chills, train them on the treatment of muscles ever have. Take the power of ice withfatigue, extreme thirst. cramps. Me! I was “floored”. These 1st you. And remember, it’s only an outcall. and 2nd year medical students don’t re- You got this! 2. Signs: skin is cool and pale, ceive clinical training until their 3rd yearrapid weak pulse and respirations, may of medical school. They were ‘itching’ Lead Instructor for the FSMTAhave profuse sweating. 3. First Aid: to treat a runner. Even with the training Sports Team Training at ConventionCONTINOUS OBSERVATION. Rest in I gave them before the Med Tent filled June 25-28, 2015. For more informa-shade, drink cool liquids, sit near fan, up, it was still a little too daunting for tion about the Sports Team Trainingplace ice on neck; REFER TO MEDI- some Med Students. It’s a little unnerv- and Sports Events, please visit http://CAL if condition persists. ing to have a runner come to you, barely able to walk, whaling and moan in dis- or email Michele at Michele@mpow- Heat Stroke: 1. Symptoms: nausea, tress, unable to fully communicate their ertherapeutics.comirritable, dizziness. 2. Signs: confusion pain and discomfort. First thing is haveto unconsciousness, lack of sweat, them lie down and get comfortable. We *The Thermal Injuries informa-dry and flushed or red skin, very high as Massage Therapists are used to tion was taken from the official FSMTAbody temperature (>103*F), vomiting, using Massage Tables. It’s second na- Training Manual given to each Sportsdiarrhea, rapid pounding pulse, rapid ture, not even an extra thought. Other Team member at the 8 CE class forlabored breathing. 3. First Aid: Con- medical personal do not have this au- Sports Team Training.tinuous Observation and CALL FORMEDICAL! Rest in shade, using what-40 MASSAGE MESSAGE • MARCH/APRIL 2015

Florida State Massage Therapy Association, Inc. 978 Douglas Ave, Ste 104 • Altamonte Springs, FL 32714 Toll Free: 877.376.8248 • Ph: 407.786.3307 • Toll Free Fax: 877-224-2392 • www.fsmta.orgMembership Join this successful, energetic Benefits association of remarkable members!• Optional Professional, For over 70 years the FSMTA has served as Florida’s state professional association Property & Casualty for Massage Therapy. FSMTA membership leads the nation in accomplishments for Insurance the massage profession. Incorporated on June 15, 1939, FSMTA is a not-for-profit• Group Health Insurance Florida Corporation. Options FSMTA is administered by an Executive Board of Directors of LMTs consisting of five• Continuing Education Executive Officers elected by the membership and every Chapter President. The Programs Executive Board Quarterly Meetings are open to membership and the Annual• Legislative Consultants in Membership Meeting is held at the Convention. Tallahassee Monitoring The Chapters are local branches of the FSMTA through which members have a Legislation to Protect Your direct voice in the direction, goals and decision making. The Chapters are admin- Right to Practice istered by a Chapter Board of Directors of LMTs consisting of five Chapter Officers• Subscription to Massage elected by the Chapter membership. The Chapters hold regular, local Member- Message Magazine ship and Board meetings. There are currently 19 FSMTA Chapters in Florida.• Subscription to Local Chapter Newsletter Join FSMTA online at• Annual Convention with Membership Discounts FSMTA Legislative Program• FSMTA Sports Massage Team Legislative Issues affect the entire Massage Therapy Profession! Support from• Local Chapter Meetings every LMT, Student, and Associate Member empowers the profession.• Professional Affiliation & Networking Our Major Accomplishments• Promotional Products• Community Service (With your support the list will grow) Opportunities• Representation at the • Legal designation changed from the Masseur/Masseuse to Licensed Massage Board of Massage Therapist (LMT). Meetings• Use of Logo & All Official • Legislative consultants in Tallahassee reviewing all legislation affecting the Publications Massage Therapy practice and actively promoting the profession.• Organized Grass Roots Legislative Campaign • Changing the terminology in the definition of massage from manipulation of• Membership Certificate, “Superficial Tissue” to “SOFT TISSUE.” Card & Logo Slicks• Member-only section on • Changing Insurance Law enabled LMTs to bill health insurance for Rx services including (a national precedent). Therapist Locator • Maintaining exemption from Florida sales tax on services for all massage therapy services. • Exemption from the 1988 Dietetics Act, enabling LMTs to continue providing nutritional products. • Retaining massage therapy license law during F.S. 480 Sunset Reviews. • Successful grassroots program with a united voice in protecting professional rights. • Annual Legislative Awareness Days at the Capitol. Only YOU can protect your profession and your right to practice. Support the FSMTA Legislative Program. Contribute the equivalent of “just one” treatment per year. Do it today — for your future! MARCH/APRIL 2015 • MASSAGE MESSAGE 41

Florida State Massage Therapy Association, Inc. 978 Douglas Ave, Ste 104 • Altamonte Springs, FL 32714Toll Free: 877.376.8248 • Ph: 407.786.3307 • F: 877.224.2392 • • Membership ApplicationLast Name:_______________________________________________ First Name:___________________________________________ MI:___________Business Name:_______________________________________________________________________________________________________________Mailing Address:______________________________________________________________________________________________________________City:______________________________________________ State:_____________________________ Zip:_____________________ r Home r WorkBusiness Phone:____________________________________ Fax:_______________________ Home Phone (Optional):_______________________Email:________________________________________________________ Referred By:____________________________________________________r I give permission to have my name and business contact information released for profession-related referrals.Please list 3 modalities: 1.__________________________________ 2.____________________________________ 3.___________________________Chapter Membership Membership Level & DuesBased on geographic location - please indicate Please check all that apply.only one chapter affiliation you want to belong tousing the following choices: r Student - Attending an approved Florida Board of Massage Therapy School & haven’t passed the State LMT Exam.r Big Bend (Tallahassee)r Brevard School Name:_______________________________________________________________r Broward r 1 YEAR.............................................$50.00r Central Florida (Orlando)r Dade r Florida Licensed Massage Therapist - License MA#____________________________r Emerald Coast (Escambia/Santa Rosa) r 1 YEAR...........................................$125.00r First Coast (Duval County) r 2 YEARS.........................................$230.00r Flagler/Volusia r 3 YEARS.........................................$300.00r Gulf Coast (Panama City Area) r Member Application Fee*...........$15.00r Heart of Florida (Polk County) *Membership application fee only applies to new LMT members and past-due renewals.r Keysr North Central Florida (Ocala) r Associate - Supporting individual (non-LMT), school, company or organizationr Palm Beachr Sarasota/Manatee r Individual (non-LMT) r 1 YEAR...........................................$125.00r Southwest Florida (Ft. Myers)r Sugar Dunes (Walton/Okaloosa) r School r 2 YEARS.........................................$230.00r Suwannee Valley (Gainesville)r Tampa Bay r Company/Organization r 3 YEARS.........................................$300.00r Treasure Coast (Vero Beach)r State/Member-at-Large r Business r National r Professional Contribution (Optional) r Legislative Support - Our legislative program promotes our profession ........ and protects our right to practice. Please show your support! Contribute the equivalent of “just one” treatment for the year. $____________________ TOTAL AMOUNT ENCLOSED...................................................... $_______________________Applicants interested in Liability Insurance need to complete the separate insurance form. If paying by check, please write separate checks.NOTICE: Please allow four weeks to receive the membership certificate and card. Membership dues and legislative contribution areNON-REFUNDABLE. Dues payments are deductible by members as an ordinary and necessary business expense. In accordance with Section6033(e)(2)(A) of the Internal Revenue Code, members of the FSMTA are hereby notified that an estimated 10% of your FSMTA dues will beallocated to lobbying and political activities and our legislative program and therefore is not deductible as a business expense.AGREEMENT: By signing this application you agree to actively support the profession and educational objectives and purpose of the FSMTA.And pledge to abide by the Constitution, Bylaws, Policies & Procedures and Professional Ethics of the FSMTA, Florida Statutes 480 and 456,Rules Chapter 64B7 and all applicable state and local laws and regulations.Signature:___________________________________________________________________________ Date:_______________________________________ Payment: r Check or money order made payable to FSMTA for amount enclosed $_______________________________________________ r Visa r MasterCard r Discover r American Express Credit Card #_____________________________________________________________ Name on Card:_______________________________________ Exp. Date:________________________________ Charge Amount $:_______________ Signature:____________________________________________ Billing Zip Code:____________________________________________3- or 4-digit Security Code:____________________________________________For FSMTA Office Use Only: Check/Auth #________________________________________________________________________________________ Revised 8/1342 MASSAGE MESSAGE • MARCH/APRIL 2015

FSMTA Professional Liability Insurance Program FSMTA’s exclusive package is offered through the American Massage Council Purchasing Group CONTACT DATAFull Name (First, Middle, Last) Establishment Name (if applicable)Office or Mailing Address (include Suite #) City State ZipOffice Phone Alternate Phone (Home, Cell, etc.) Fax EmailFL Massage License # Massage School Attended License Current?  Yes  No Date Completed Issue Date PROFESSIONAL INFORMATION (FOR QUESTIONS 1 THROUGH 8: IF YOU ANSWER YES, PROVIDE FULL DETAILS ON A SEPARATE SHEET)1. Has any malpractice allegation ever been asserted against you or your associates, or has there been any event or  Yes  No indication suggesting a claim may be made or that your care might have been deficient or caused harm? 2. Has any board, agency, association, or insurer investigated or taken any action involving you or your license / certification? Yes No3. Have you ever had liability insurance refused, declined, canceled, or accepted on special terms?  Yes  No4. Have you ever used any drug or substance that interfered with your ability to perform Massage Therapist duties?  Yes  No5. Have you ever been charged with or convicted of any violation of the law other than a minor traffic offense?  Yes  No6. Do you: do colonic irrigations, treat cancer, epilepsy, practice obstetrics, or make a differential diagnosis?  Yes  No7. List any other health designation you hold (D.C., L.Ac, etc.) ____________Are you separately covered for malpractice?  Yes  No8. Are you providing any Massage service that was not a part of your massage school training program?  Yes  No9. Do you use hot stones on your clients? (if Yes, a hot stone addendum and an additional $25 is required)  Yes  No10. List any entity you want covered as an additional insured-include address: COVERAGE OPTIONS SIGN THEN FAX OR MAIL APPLICATIONSelect your policy limit (includes both Professional & Premises liability I hereby apply for coverage. If provided, charge my credit card for the amountcoverage), along with any coverage options you need, then select the indicated. I hereby declare that the above statements are true, and I have notpayment option that suits you. misstated or suppressed any facts. I agree and understand that my policy is issued in reliance upon such statements, that such statements are deemed $2,000,000 / $4,000,000 @ $154 = material, that untrue statements could void my insurance and that this $1,000,000 / $3,000,000 @ $115 = declaration shall be a basis of, and form a part of my policy. I understand that $1,000,000 / $1,000,000 @ $ 99 = this is a Claims Made policy which will only cover claims made during the General Liability @ $ 49 = policy period arising out of the rendering, or of failure to render, professional Additional Insured @ $10 = services subsequent to the retroactive date. I understand that if the policy @ $110 = terminates for any reason, there is no coverage for claims reported after the Business Personal Property termination date (even though the injury occurred while the policy was in force), unless Extended Coverage is purchased within 30 days after($10,000 Limit - Lloyd’s of London Policy – Incl. Tax) termination. I understand that there is no guarantee that coverage will be renewed. I understand that, if coverage is granted, I shall have the duty to TOTAL DUE: report in writing, within 48 hours, or as soon as practicable, any incidents reasonably likely to involve this insurance, including oral or written patient complaints, threats, or filings of lawsuits. PAYMENT OPTIONS SIGN: DATE: Check  MasterCard  Visa  Discover  AMEX REMIT TO: ALLIED PROFESSIONALS RISK PURCHASING GROUP 1100 Town & Country Road, Suite 1400Card #: Expires: Orange, CA 928683 or 4 Digit Security Code Billing Zip Code:Phone – 714-836-3364 • Fax – 714-571-1863 • Email - • Website -

AssoSctiaatteio&n News Tampa Bay Chapter Hosts “Working with Wounded Warrior Athletes” Training By Donna Smith, State Secretary On January 31st and February 1st Tampa Bay Chapter Community Relations hosted over 50 FSMTA members at Sanford Brown College in Tampa for training in working with a special population of athletes: wounded or injured military athletes. In addition to high attendance from our chapter, we also welcomed members from seven chapters across the state from Emerald Coast to Dade. Sports massage instructor, Lori-Ann Gallant-Heilborn, LMT from Camp Lejeune, NC, traveled to Tampa to teach the two-day workshop, which was open to all Tampa Bay Chapter Sports Massage Team members, all state Sports Massage Team trainers, and the Sports Massage Teams of neighboring chapters. Lori-Ann brought her vast experience performing sports massage at the Olympics, Marine Corps Marathon, Paralym- pics, and the Warrior Games, and everyone agreed she was enthusiastic and engaging as an instructor. Additionally, as- sistant instructors Kristen Paradise and Kaela-Rose Gentile traveled from Rhode Island to support the training. Topics included: the effects of trauma on athletes, work- ing with amputees, and “invisible injuries” such as traumatic brain injuries and post traumatic stress disorder. The weekend opened with a short briefing from the USSOCOM Care Coalition Program Manager, Army Mas- ter Sergeant Pat Gilmore, who spoke about the history of the Wounded Warrior Athletic Reconditioning Program and thanked us for our dedication in training to work with the ath- letes of the program. ***The Tampa Bay Chapter Sports Massage Team will be working with the USSOCOM Wounded Warrior Athletic Recondi- tioning Program athletes later in February at their weeklong Multi- Sport Training & Trials Camp at MacDill Air Force Base in Tampa. 44 MASSAGE MESSAGE • MARCH/APRIL 2015

Palm Beach Chapter NewsBy Lesli R. M. Lopez, Palm Beach Chapter President Congratulations to our Sports Team Members for rep- 50 cash prizes, an aromatherapy wax warmer, and severalresenting our Chapter and FSMTA in service to the runners gift cards valued between $10-25.00 to area food establish-whom received pre-/post- race event massage at the recent ments.EAU PB Marathon & Run Fest on December 6th, 2014.. Itwas a great first experience for Chapter member Jan Bresin- We would also like to extend a warm welcome to sixsky as well as new comers to our Chapter Sports Team, Nic new members to our Chapter (all students). They are: Lau-Sanchez and Lawrence Yundt. This was Larry’s second time ren Farrington, Emily Goodson, Cahrens Lucien, Franciscovolunteering at this event. Rivera Lasanta, Stephanie Sullivan, and Meredes Szehner. Be sure to introduce yourselves to our Chapter Board and Our Holiday Gathering was held at Nana’s Diner in West Members at our monthly meetings.Palm Beach, FL on Dec. 18th. 25 members and 6 guestsparticipated in this social gathering with many receiving the Great things are in our future. We hope that you will wantdoor prizes provided. Among the prizes donated were items to be a part of that growth. Massage is a Winning Hand andfrom members and Bon Vital. Other prizes included two $ a very rewarding profession. Join us at FSMTA Convention at the Caribe Royale June 25-28, 2015.Gulf Coast Chapter PartyBy Donna Smith, State Secretary The Gulf Coast chapter celebrated their annual Christ-mas party at the home of member, Carol Hutschenreuterthis year. We had a pot luck with tasty dishes as membersshowed off their culinary skills. The meats and some sideswere prepared by chapter President, Marion Padgett. Ev-eryone attending received goody bags and participated in adrawing where they chose gifts at a table as their name wasdrawn. We also played a Dirty Santa gift exchange. We allenjoyed the cozy and warm atmosphere and we acceptedthe invitation to hold it at one of our member’s homes. Manythanks Carol and Stephen for a great evening. Calendar of Events April - May 2015April 30 - May 1, 2015............................................... FL BOMT Board Meeting, Tampa Marriott Westshore MARCH/APRIL 2015 • MASSAGE MESSAGE 45

AssoSctiaatteio&n News BECOME A FSMTA MEMBER! ASK ABOUT HOW TO RECEIVE GREAT BENEFITS! Welcome New FSMTA MembersBig Bend Wachob, Suzanne Farrington, Lauren Tampa BayGregg, Kelly Weaver, Karly Goodson, Emily Bobb, Elena Yamaguchi, Aisa Hallman, Sookie Browning, TheresaBrevard Lucien, Carhens Fernandez, RaysaDe La Garza, Daniel Dade Rivera Lasanta, Francisco Janolek, JimHayden, Jill Alvarez, Martha Romero, Jessica Malast, Magdalena Barlet, Beatrice Sullivan, Stephanie Martinez, LidiceBroward Castillo , Estefany Szehner, Mercedez Newman, JenniferAponte, Myrta Lopez, Brydgette Roberts, LenaAtily, Sharon Needell, Lori Sarasota/Manatee Solymosi, PeterBaker, Teresa Ruiz, Christian Amundson, Michelle Wehrman, NancyKonicoff, Beni Velazquez, George Bondi, Peter Wray, ClarissaLee, Sunny Cirillo, JessicaLinton, Melissa Emerald Coast Ingram-Zamora, Mara Treasure CoastLira, Lidelis Chancey, Robin McGowan, Nicole Hanson, JonathanMcNeil, Susan Heath, Christy Navarrete, Lucia Priymak, OlgaMorrell, Andrew Smith, Casey Wallace, JulieOverstreet, Jeff First Coast Warne, Charles Whittemore, John Frame, MichaelCentral Florida Gossweiler, Erika Southwest FloridaAlvarado, Jennifer Moody, Jessica Christian, SebastianBozhinov, Bozhin Pickett, Larry Correa, YennyDean, Jan Murphy, SusanDrake, Cheryl Flagler/Volusia Penado-Chorens, AimeeGibson, Kendra Dematos, Dawn Taylor, MelissaGutierrez, Amy Sapunkov, Yevgeniy Winter, StephanieHobbs, Trista Wilson, KarenKindle, Carolyn North Central Florida Sugar DunesMakin, Theresa Moreno, Maria Gimaeva, IlmiraMena, Charline Ortega, Jenny Klien, RachelRodriguez, Michele Price, JudyShin, Yun Palm Beach Rojas, DeborahTaylor, Dexter Baker, Lenore46 MASSAGE MESSAGE • MARCH/APRIL 2015

Quality • Comfort & FSMTA style Pick your PERFECT Professional image! Order online today to SHOP! MARMCAHR/ACPHR/IAL P2R0I1L520•15M•AMSSAASGSAEGMEEMSSEASGSAEGE 47

FSMTA MEMBER SCHOOLSlink to fsmta member school websites via of Cosmetology Fortis Institute2088 N Courtenay Parkway • Merritt Island, FL 32953 4081 E Olive Rd, Ste B • Pensacola, FL 32514321-452-8490 • 850-476-7607 • jpenton@fortisinstitute.eduAmerican Institute Georgia School of Massage5000C Coconut Creek Pkwy • Margate, FL 33063 415 Horizon Dr, Bldg 200 #275 • Suwanee, GA 30024954-781-2468 • 678-482-1100 • rgarbowski@georgiamassageschool.comBeauty and Health Institute Heritage Institute11309 Countryway Blvd • Tampa, FL 33626 6630 Orion Dr., #200 • Ft. Myers, FL 33912813-749-1800 • 239-936-5822 • evah@heritage-education.comBeauty School of America International Academy1060 West 49th Street • Hialeah, FL 33012 2550 S Ridgewood Avenue • South Daytona, FL 32119305-297-5208 • 386-767-4600 • mez@intl-academy.comBoca Beauty Academy International Spa Institute7820 Glades Rd • Boca Raton, FL 33434 6A Bruin Rd • Bluffton, SC 29910561-487-1191 • 843-815-4884 • lbeach@isispaeducation.comBroward College Loraine’s Academy, Inc.1000 Coconut Creek Blvd • Coconut Creek, FL 33066 1012 58th St N • St Petersburg, FL 33710954-201-2074 • 727-347-4247Center for Neurosomatic Studies Miami Dade College13825 Icot Blvd. Suite 604 • Clearwater, FL 33760 950 NW 20th St • Miami, FL 33127888-570-2680 • 305-237-4088 • dshannon@mde.eduCentral Florida School of Massage Therapy, Inc. Paramount Training Services450 North Lakemont Ave., Suite A • Winter Park, FL 32792 2721 S Federal Hwy • Ft Pierce, FL 34982407-673-6776 • 863-419-3060 • robert@fastcna.comColorado School of Healing Arts Ridge Career Center7655 W Mississippi Ave., #100 • Lakewood, CO 80226 7700 SR 544 • Winter Haven, FL 33881303-986-2320 • 863-419-3060 • eileen.harriman@polk-fl.netCommunity Technical & Adult Education Sarasota School of Massage Therapy4045 Park Blvd • Pinellas Park, FL 33781 5899 Whitfield Ave, Ste 300 • Sarasota, FL 34243727-865-4940 • 941-957-0577 • joe@sarasotaschoolofmassagetherapy.eduCortiva Institute-Florida Soothing Arts Healing Therapies School of Massage1014 SW 7th Rd • Ocala, FL 34471 12605 Emerald Coast Pkwy W, Ste 2 • Miramar Beach, FL 32550352-671-4129 • 850-269-0820 • soothingarts@aol.comDaytona College Southeastern College - Greenacres425 S. Nova Road • Ormond Beach, FL 32174 6812 Forest Hill Blvd, Ste D-1 • Greenacres, FL 33413386-267-0565 561-433-2330, ext 113 • dspatola@sec.eduDaytona State College Southeastern College - St. Petersburg1200 W. International Speedway Blvd, Bldg 320, Room 334 11208 Blue Heron Blvd, Suite A • St Petersburg FL 33716Daytona Beach, FL 32114 • 386-506-3185 727-576-6500 • Space Coast Health InstituteEverest University - Lakeland 1070 S Wickham Rd • West Melbourne, FL 32904995 E. Memorial Blvd, Ste 110 • Lakeland, FL 33801 321-729-9000 • deborah@spacecoast.edu863-686-1444 • Sunstate AcademyEverest University - Pompano Beach 2040 Colonial Blvd • Ft Myers, FL 33907225 N. Federal Hwy • Pompano Beach, FL 33062 239-278-1311 • ahammond@sunstate.edu954-783-7339 SunState CollegeFlorida Academy  2525 Drew St • Clearwater, FL 337654387 Colonial Blvd. Suite 100 • Ft Myers, FL 33966 727-538-3827 • tjones@sunstate.edu239-489-2282 • The Praxis Institute - MiamiFlorida School of Massage 1850 SW 8th Street, 4th Floor • Miami, FL 331356421 SW 13th Street • Gainesville, FL 32608 305-642-4104, ext. 34352-378-7891 • charlotte@floridaschoolofmassage.com48 MASMSASGSEAGMESMSAESGSEAG• ME A•RMCAHR/ACPHR/IAL P2R0I1L52015

ChapterCalendarsBig Bend Chapter - contact John Lilly,, 805-766-8864. Meetings areheld the second Tuesday of every month. Most meetings include a 2 CE presentation. Wehave a chapter party in June and December. Email or call for location or CE information.Meeting information can also be found at Chapter - contact Charlene Taylor,, 321-633-7475.Meetings are held on the second Tuesday of every month on a location rotation betweenCocoa and Melbourne. Always from 6 - 9 pm with 2 CEs. Dessert and coffee will be provided.Please visit our web site to get exact locations and directions. Join usnow on Facebook - FSMTA Brevard Chapter.Broward Chapter - contact Abraham Paredes,, 954-821-4907. Meetings held first Tuesday of each month at Imperial Point Medical Center in Ft.Lauderdale from 7 - 10 pm.Central Florida Chapter - contact Jill Troutman,, 352-434-4629. Palm Beach Chapter - contact Lesli Lopez,, 561-319-1814.Meetings held the third Monday of each month at Marks Street Senior Recreation Complex, Meetings held third Thursday of the month, 6:45 pm - 9:15 pm, at Forest Hills Community99 East Marks Street, Orlando, 32803. Doors open at 6:00 pm. Announcements at 6:30 pm. High School, 6901 Parker Ave., West Palm Beach, FL (January - November). Map located onPresentation of 2 CEs is 6:45 pm-8:45 pm. Check details for each meeting at www.fsmta-cfl. website: . Like us on facebook: FSMTA Central Florida Chapter! Sarasota/Manatee Chapter - contact Eddie Hooper,, 941-356-Dade Chapter - contact Angel Orozco,, 305-854-3100. Chapter 7160. Meetings held third Wednesday of each month. Visit our website www.fsmtasarasota.meetings are held the second Wednesday of each month at Educating Hands, 3883 org for meeting time and location, as well as other important information.Biscayne Blvd., Miami. Meetings begin at 6:30 pm. Southwest FLORIDA Chapter - contact Sydney Sheaffer, anaturaltouchforhealth@yahoo.Emerald Coast Chapter - contact James Fritschle,, 850-485-0552. com. Meetings are held the first Tuesday of each month at 6 pm at Bass Pro Shops,Meetings are held at The Fortis Institute, 4081 East Olive Rd, Ste B, Pensacola, FL, on the GulfCoast Town Center. Visit our website at Monday each month, 6 - 9 pm. Check schedule at Sugar Dunes Chapter - Sugar Dunes Chapter meetings had not been changed yet. OurFirst Coast Chapter - contact Sally Burton,, 904-759-6347. Meetings Destin meetings will be at Soothing Arts Healing Therapies School of Massage & Skin Care atare held at Specialty Hospital Jacksonville, 4901 Richard St, Jacksonville, FL 32207, the third 12605 Emerald Coast Pkwy #2, Miramar Beach, FL 32550, and Beachside School of MassageThursday of the month, 6:45 pm. Check schedule at and Beauty at 362 Beal Pkwy NE, Fort Walton Beach, FL 32548. Contact fsmta_sugardunes@Flagler/Volusia Chapter - contact Greg Neely,, 386-631-8311. for more information.Chapter meetings are held the second Wednesday of each month, 6 - 8:30 pm at Keiser Suwannee Valley Chapter - contact Michael Bates,, 352-214-University Auditorium, 1800 Business Park Blvd, Daytona Beach. 2598. Meetings are held the second Tuesday of each month at Haven Hospice of Gainesville,Gulf Coast Chapter - contact Marion Padgett,, 850-774-0675. 4200 NW 90th Blvd, Gainesville, FL 32606, 6:00 pm.Meetings held second Wednesday of each month at Hancock Bank Community Room from Tampa Bay Chapter - contact Joyce Prahasky,, 813-787-6399.6 - 9 pm, 23rd Street, Panama City. Meetings held third Thursday of each month, 7:30 pm - 9:30 pm, social networking, 7 pm -Heart of Florida Chapter - contact Adele Boyd,, 407-847- Business Meeting and CEs, see website for location details.5349. Meetings are held the third Tuesday of the month at 6:30 pm, no meetings in July Please visit for directions, dates and CE classes.& December. Locations change monthly, check website for locations/presenters/topics. Treasure Coast Chapter - contact Ross Hoffman,, 772-359-3608.Meeting information can be found at Meetings held third Wednesday of each month at Indian River State College Main Campus.Keys Chapter - contact Mary Ann Nelson,, 305-509-0672. are held quarterly and rotate locations throughout the Keys. Meeting times/ Schedules subject to change without notice.locations will be posted in the chapter newsletter that is emailed the 15th of the month.North Central Florida Chapter - contact Bruce Gonseth,, 352-362-9469. Meetings held third Monday of each month at 6:30 pm with CE presenters onmost nights starting at 7 pm at Marion Baptist Association, 1520 NE 14th St, Ocala, FL 34470.Visit our website at Join us on Facebook. MARCH/APRIL 2015 • MASSAGE MESSAGE 49

FSMTA Massage Message Magazine Mar/Apr

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