Finding Our Legs with Alice Cummins

Some time back, one of my regulars, a dancer, told me of a workshop she'd done, where she felt responses in her body quite similar to those she experienced during and after Bowen. She had my attention!

The workshops are presented by Alice Cummins, a dance and movement artist who has studied Body-Mind Centering in the USA with Bonnie Bainbridge Cohen. To describe it is difficult -  a little like Bowen Therapy, sometimes you just have to experience things.

I went in with some trepidation as someone with zero experience in dance or movement but was made to feel part of it from the beginning. That's not to say that there weren't challenges. When Alice said something like, "Now, express that", I was left momentarily lost as I'm used to expressing through words or paint, not movement. And when she asked the group "How do you fall?", I was quite frozen as the only times I've seriously hurt myself in this life (luckily) have been through falls and the thought of voluntarily falling was a real challenge.

The workshop has given me so much to benefit both my practice and my teaching. Ways of looking at things and using the body that are just that little bit different but make life so much clearer. For example, I have many who struggle with the concept of "the core" and how to use it, with frequent intepretations including locking their psoas or pelvic floor. Alice talked us through embryonic development to understand how to connect movement through our centre. And, she bristles at the use of the word core!

We worked through experiential anatomy, which gave me great ideas of how to work with students in class to help them grasp the application of theory. And, it seems strange after so many years of working in health, but actually making things happen in yourself to understand what you've "known" for years can make you really know it.

It was a very full two days and it's really only scratched the surface. Hopefully I'll have time next year to attend another workshop to pick up more understanding of what I experienced. And experienced is right - by the end of the first day I was wiped out in the way that I am after a Bowen worshop where I have had lots of work done on me and my body is trying to integrate it. And I was cranky - for no reason, just oddly mildly annoyed by everything. The next day, still wiped out, but cranky all gone.

Thanks Alice and I look forward to next year.

Certificate IV in Bowen Therapy 10533NAT Starting soon!

My next round of classes towards the Certificate IV in Bowen Therapy 10533NAT start on September 23rd and 24th.

This class is part of the nationally-recognised training programme offered by Bowen Training Australia RTO#41134, a Nationally Recognised Training provider. The Certificate IV proramme consists of seven hands-on modules where you learn the basics of applying Bowen Therapy for a variety of situations.

The course also involves some distance-learning modules where you'll cover theory aspects such as anatomy and physiology, infection control and practice management. These theory parts are done direct through BTA via online learning. There are some practice logbook hours to complete and some case studies for you to test your new skills and provide true experiential learning. While the distance learning and case studies are self-directed, there is support consistently available throughout.

The hands-on modules will be run from my Sydney CBD consulting rooms, which are easily accessible by public transport. Manuals, tables and towels are all provided, so no need to lug anything with you. You just need your curiosity!

The modules are spaced out with plenty of time in between to practice, do theory and logs, and work out your strengths and weaknesses. You can complete the training in just under a year and you have up to 18 months. In the event that you can't make it to these classes, all BTA instructors run on the same programme, so you can always make a class up with another instructor.

On successful completion of the Certificate IV in Bowen Therapy 10533NAT, you may continue on to the Diploma of Specialised Bowen Therapy 10534NAT to deepen your knowledge of assessment and learn a new set of Bowen procedures for different body areas. You'll also be able to join the Bowen Association Australia, whereby you'll be able to access professional insurance and, once Diploma-qualified, become a health fund provider.

Feel free to make contact to ask any questions or get an information pack!

Lymphatics for Bowen Therapists

A great learning experience will be on offer later this month for Bowen Therapists who are interested in learning more about the lymphatic system and how they can assist lymphatic issues.

On the 27th and 28th of May, I will be running Practitioner Days A and B to revise the Bowenwork from the Certificate IV programme but, to add a little spice, will be focusing on the lymphatic system and how Bowen Therapists can aid it.

We'll look at the lymphatic system, what it is and what it does, how your basic Bowenwork can aid in issues, and also things you can discuss with your clients to help them help themselves.

It is $200 per day, with Day A focusing on lower body work and Day B on the upper body. It's obviously better if you can do both, but I understand that many have limited time available.

You will earn 1 CEU point per hour for your Category 1 (Hands-on Bowen) continuing education requirements for the BAA and Bowtech. So that's 8 points per day.

The days will be held at my rooms here in the Sydney CBD with easy access via trains (Town Hall or St James) or buses. You can also park at the Doamin Parking Station for a flat rate of $10 per day on weekends.

There's no need to lug tables or towels with you either - everything is here. Just bring your manuals and your good selves.

For more information, please feel free to contact me. Please note that this workshop is not part of the nationally recognised training programme, however it is Bowtech-accredited.

Sometimes it is darkest just before the dawn

I don’t like to send patients home after their first session with anything negative in their heads, so normally just suggest that they email or call if they have any concerns. I’ve had a few people lately have quite strong reactions, often involving a flare-up of a chronic condition to a more acute feeling.

This can happen in many therapies, but I tend to notice it mostly in Bowen, and to a lesser degree in Lymphatic Drainage. In naturopathic terms, it is known as a healing crisis, whereby the body (that has long since settled into a chronic disease pattern) is suddenly working its way back to health and often relives some of the more acute symptoms that may have died down or changed over time.

In Bowen this can be noticed as nerves “coming back to life” after settling in to a duller signal or muscles pulling as the body realigns itself. It is no cause for panic and will normally right itself with time and some more sessions until things are properly realigned. If you feel that the pain is impacting on your ability to function normally, feel free to use whatever painkillers you normally would but it is important to not apply hot or cold packs to the area or massage yourself (or get someone else to!) as this will interrupt those clever little impulses that the Bowen Therapy sets up and possibly leave you in your painful place. The exception to this is if you re-injure yourself. If you find yourself in pain due to an acute injury or following the very activity that brought you to me in the first place, you may need to come back in sooner rather than waiting for the full week to elapse. If in doubt, ask!

In regards to Lymphatic Drainage, most of the more dramatic responses have been due to people who have had more serious conditions to start with. Those who have a difficult-to-treat infection such as Lyme (or similar) may have an initial worsening of symptoms. A history of tropical diseases, such as malaria, Ross River or Dengue Fevers, may bring a strong response after treatment. If you’ve had any of these, working in small doses will be the best approach. Other than that, it is normally those who’ve fully enjoyed all the world has to offer that tend to respond more dramatically – people who may already have a lot of stress on the liver can sometimes feel quite off afterwards.

My point is that there is no reason to fear feeling bad after treatment – it is often a really good sign! If ever in any doubt, please get in contact so we can discuss your individual symptoms and be sure.

Taking Responsibility for Your Lymphatic Condition

Anyone who’s ever been to the physio and been given “homework” will know where I’m going with this. When you return to the physio and they ask if you’ve done your exercises or stretches, you can see that they are ready to sigh. All too often, people are “too busy” or “forget” and expect their health practitioner to do all the work for them. When in the realm of physical problems and treatments, taking a pill isn’t enough. It often requires lifestyle adjustments, such as a change to diet or exercise, or even engaging with a variety of specialist practitioners to achieve the best possible result. It requires the person to “own” their condition and work to improve it.

This is just as true for lymphatic problems. As your lymphatics interact with so many bodily systems, it is vital to explore possible interactions with your practitioner and to consider lifestyle adjustments when suggested. The patients who listen to suggestions and make changes to their lifestyles achieve much greater results than those who continue as before and come for the odd treatment.

I’ve already written about the importance of nutrition and inflammatory conditions of the gastrointestinal tract (GIT) in lymphatic drainage, it is important that people consider this, especially in the case of fluid retention in the legs. I’ve had several patients who have tested positive for coeliac, but were told that they could still eat wheat if they didn’t think it affected them. Of course, it did, just not really obviously. This is just one example – it could be all sorts of things. This is best addressed by a good doctor, naturopath or nutritionist. As are conditions that some poor ladies are lumped with, such as endometriosis that also cause inflammation the abdomen.

Similarly, I’ve found over the years that a lot of people with lymphatic problems are highly stressed and prone to over-thinking everything. Some active relaxation or meditation (not just watching telly) will often make a big difference to the level of a lymphatic problem.

But when you come for your consultation we’ll also talk about appropriate exercise levels, workplace factors, when it’s appropriate to wear compression garments and all the various things that can encourage or help fluid build-up in your tissues. If you take this information to heart and look to make positive changes to how you live day-to-day then you should achieve much better results than relying on treatment alone.

What bed should I buy?

I quite often ask people about their sleeping posture, pillow and bed during a consultation, especially when other aspects of lifestyle don’t seem to adequately explain their pain or dysfunction or when they wake up feeling worse than when they went to bed. This inevitably throws the question back to me on what pillow or bed people should buy. The answer… well, there is no one answer.

Just as there are many different shapes and sizes of people, there are many beds – and that’s the way it should be. The first thing to get right is the sleeping posture. Never sleep on your belly – this leads to strained and shortened muscles in the neck and shoulders. You should sleep on back or side with the arms down – arms above the head (either under the pillow or starfish-style) lead to neck and shoulder tension.  From here, you need to get a partner, friend or relative to observe you in your preferred posture.

For back-sleepers, the mattress should be firm enough so that you don’t sag in the middle, but soft enough that it fills out the small of your back and supports the full length of your legs. Pillow-tops are ideal. The pillow should support the head and neck without pushing your head forward or letting it drop back. Ideally, the forehead and chin should make a roughly horizontal line – those who hold their head forward naturally will need a thicker pillow than those with an upright posture.

For side-sleepers, the mattress again should be firm enough so that you don’t sag but also not be so firm that it’s like lying on a board. Again pillow tops are great as you can have firm springs and still be supported. When your friend observes you, they should check that your spine is roughly in a straight line. The pillow should also keep the spine in a roughly straight line without pushing the head up or letting it drop.

Things do get interesting for couples. If you have a 100kg 6’2″ man and a 50kg 5’5″ woman, then they basically need two separate beds. This will call for some compromise, but again, a pillow-top can make the difference with firm springs and a squishy layer on top to allow for difference.

If you’re in a tight space financially, you can always buy a mattress topper from Ikea or a foam overlay from Clark Rubber or even use a blanket or two to add a softer layer. A trick from hotels to firm-up a mattress is to put a piece of MDF between the mattress and base.

For the perfect pillow (or as close as you can get) you can get Sleep Made to Measure. This Sydney-based company builds latex pillows to the measurement of your head, shoulder width, sleeping posture and bed-type to give you the best possible fit for you. You can check them out at sleepmadetomeasure.com .

Plantar Fasciitis

Plantar fasciitis is a painful condition of the underside of the foot, sometimes caused by poor footwear or excessive use. It is normally felt most at the heel and tends to be worse first thing in the morning and eases as the day goes on. Many sufferers spend a significant amount of time stretching their feet before first stepping out of bed in the morning.

So what is it? The plantar fascia is a strip of tissue that runs from the forefoot to the heel, attaching at the calcaneous or heel bone. But that isn’t the full story – if you read the work of anatomist Thomas Myers, it forms part of the Superficial Back Line of fascia that then goes on to include the gastrocnemius (in the calf), the hamstrings, erector spinae and fascia of the scalp. It runs all the way from the ball of your foot to your brow via your back. And that is why some people don’t respond to localised treatment. If your podiatrist only looks at the foot fascia, then they may miss some of the problem. It is important to release the entire line of fascia in case the problem has originated from higher up.

Plantar fasciitis (PF) is damage to the fascia that never gets a chance to heal properly as the area is re-strained daily with activity. If left untreated, it can develop into heel spurs as the body lays down bone where the fascia is pulled away from the calcaneous.

So what can be done? While I can certainly massage for this, there is fantastic work in Bowen Therapy for this exact condition. We release the whole line of fascia and also do some simple taping. The aim is to take the strain off the fascia as it heals by holding the foot in an arched shape.

I’ve had a run of people with this condition lately (as tends to happen), most of whom have flat feet. In the event that improvement is not adequate, then orthotics may be required to continue healing on a longer-term basis.

Bracing your Shoulders

I’ve had a bit of a run of patients with problems around the shoulder area. One common cause of this is using the wrong muscles to stabilise the shoulders when using the arms. The scapula (shoulder blade) is highly mobile with bony joints only with the clavicle (collar bone) and humerus (upper arm). The rest of the stabilisation is done purely by your muscles. To get an idea of how mobile a scapula can be, just watch a cat sauntering along – the shoulder moves through quite a range.

When performing tasks with the arms – be that typing on a computer, cutting vegies for dinner, weights at the gym or boxing, the shoulder needs to be stabilised to ensure that the movement is precise and strong. If the shoulder isn’t stable then the arms will be all over the place. One of the key muscles for this is the serratus anterior. It ties the scapula to the ribs and helps to move the scapula forward and to the sides. Also stabilising the shoulder are the trapezius, levator scapula and rhomboids and it’s these I want to talk about today.

Many people, from sitting at a desk or from habit, use the upper trapezius (runs from the upper scapula up the neck), levator scapula (from the inner corner of the scapula up the neck) and rhomboids (inner edge of scapula, running diagonally upwards to the spine) to stabilise the shoulder blade. This has the effect of pulling the shoulder blade upwards towards the head, as well as back. These muscles are easily overloaded and can bring on headaches, shoulder and neck pains as well as nausea and dizziness in stronger circumstances. Next time you’re working away at the gym or cutting stuff for dinner, take a second to think about how you are using your shoulders. Do this throughout your day and see if you can establish a pattern of not over-engaging the upper muscles.

The thing to do if you do find yourself in this pattern is to strengthen the lower part of the trapezius (runs from the scapula down to the middle spine) and the latissimus dorsi, which runs from under the arm to the lower spine and pelvis. Teaching these muscles to engage draws the scapulae down and back and takes pressure off the upper shoulder and neck. At the gym, the exercises that immediately spring to mind are the lat pull-down and the seated row. With pull-downs, you grasp a bar above your head with the hands wider than shoulder width apart. You then raise your chest and pull the bar down towards your chest. As you do so, concentrate on bringing the scapula down and together. This will engage the latissimus but also the lower trapezius. Wide-grip chin-ups also perform this action. The seated row involves sitting and pulling a handle towards the chest. You must again concentrate on sitting up high and squeezing the scapulae together and down to engage the lats and lower traps.

Hopefully this helps some of you to establish some better muscle-usage patterns and avoid a pain in the neck. Bowen therapy and remedial massage can, of course, help turn off those over-engaged muscles.

Polishing off with Piriformis

The last mention of butt muscles for a while will be the piriformis. I see a fair few problems relating to this one muscle, and the end result is often sciatica. That’s an inflammation or irritation of the sciatic nerve that can come from the spinal outlets but also from direct pressure from a tight piriformis.

The piriformis attaches at the anterior surface (the inside) of your sacrum and the greater trochanter (the lump on the outside of your hip) of the femur. It essentially externally rotates the hip (turns your foot out) but also abducts your femur when your hip is bent.

Problems arise when the muscle becomes too tight. This can often be from poor habits that we get into, such as walking or standing with the toes pointing out. Be aware when doing exercises such as squats that the feet should point roughly forward and not be in a Charlie Chaplin stance. Tension in the piriformis can cause the belly of the muscle to put pressure on the sciatic nerve, which is quite thick.

In a small percentage of people, the sciatic nerve can actually pass through the piriformis muscle, heightening sciatic pain. It is important to also build the gluteus maximus to take pressure of the deeper muscles of the buttocks. Bowen Therapy or remedial massage should aid in reducing tension that is present.

Gluteus Medius

The last post on the gluteus maximus naturally gives way to talking about the other muscles of the area. Today I’ll discuss the gluteus medius. This muscle sits underneath the gluteus maximus, attaching at one end to the ilium of the pelvis and at the other to the greater trochanter of the femur – that’s the knobbly bit you can feel when you stick your hip out to one side.

This muscle isn’t used for standing in the same way that gluteus maximus is. This one is essential for walking. It, together with the gluteus minimus and the tensor fascia latae, supports the body upright when one foot is raised from the ground. Essentially, it stops you from falling over to one side when walking. The action of the muscle is to abduct the femur – that is, take the thigh away from the midline of the body. It also turns the knee inwards (internal rotation) when the hip is flexed (knee raised in front) and turns the knee outward (external rotation) when the hip is extended (leg behind you).

The test for this is to get a patient standing level and then ask them to raise one leg slowly. If the opposite hip drops, it suggests a weak or impeded gluteus medius. Another sign that can be observed is the tendency to scuff the inside of the shoes. A weakness in the medius can lead to the inside of the feet rubbing past each other when walking. A tight gluteus medius will often come from activities that require one leg to support the whole person, such as in soccer when you are supporting on one side and kicking with the other.

But never fear, it’s not the end of the world. If your muscle is in spasm, Bowen therapy or remedial massage can help. If the muscle is weak, then good old clams can help to strengthen it. Lying on the floor on your side with the knees bent slightly in front of you, slowly raise the topmost knee in the air while keeping the ankles together and then close. It looks kind of like a mollusc opening and closing it’s shell. Of course, you really need to get this checked professionally and not do a Google Doctor on yourself!