19

For Bodyworkers: How to Do This Work

THE TECHNIQUES outlined in this chapter are very advanced techniques; they are based on the assumption that you already have studied massage, shiatsu, Structural Integration, or physical therapy extensively. These particular techniques are for professionals, and I would recommend studying them with a bodywork practitioner who knows them before practicing. Then you can use these descriptions as a reminder.

Bodywork can be invasive and deep. As you work, the client must be very comfortable or she won’t relax fully. Sometimes people aren’t aware, or are too polite to tell you, that they are not quite happy in the position they are in. Ask them. Do whatever you need to do in terms of massage/bodywork to make the body relaxed and open.

Move very slowly. Wait for the shifts in the deep body tissues as a cat waits at a mousehole.

Don’t slide on the skin or hair. Aim for the center of the body. Don’t overwork. Stop and change course at a 70 or 80 percent shift. Let the body complete the work.

THE CRANIUM

The skull is not just a hard, immobile, protective casing for the brain. It’s a springlike system of interlocking joints—sixty-seven in total. The skull functions as:

When we work the cranium, we are influencing all these aspects of function and structure.

Craniosacral Work

All cranial work I use originates from cranial osteopathy, a school of cranial work that was developed mostly in Europe at the beginning of the nineteenth century by Dr. William Sutherland. Craniosacral therapy focuses on restoring the natural rhythm of cerebrospinal fluid, which moves through the membranes of the spine, the brain, and other parts of the nervous system, especially the sacrum. The sacrum is as important as the cranial structure in this work, hence the name. Under the aegis of osteopathy, two main schools developed, both of which are still evolving today, and each of which takes the theories of Dr. Sutherland in an opposite direction.

One you are perhaps familiar with already is the CranioSacral Therapy of John Upledger, M.D. This technique uses cranial releases that are extremely gentle and subtle; about five grams of pressure, the weight of a nickel, is recommended. My experience of CranioSacral Therapy is that it is very effective for babies and young children, before the cranial bones have fused. After that, there is less effect, especially if the bony structure is extremely locked up. The cerebrospinal rhythm seems to be hard to change in any lasting way if the cranial joints themselves are restricted.

In this case, the second school of craniosacral work, NeuroCranial Restructuring (NCR), a dramatic opposite to this gentle work, may be of use. NCR adjusts the sphenoid bone by insufflating a secured finger cot up the nose. Since the sphenoid is so internal, there is no practical way of influencing its movement manually, at least not directly. The technique was originally called Bilateral Nasal Specific Technique, which dates back to the 1920s or so. Dean Howell, N.D., refined the process to its present day form in the late 1980s.

This is a much more controversial treatment and, in my opinion, much more effective in correcting structural problems. It obviously could be dangerous if used incorrectly. In this book, we are mainly interested in it because NCR recognizes the primary importance of the sphenoid bone.

How to Do Cranial Fascia Work

Cranial fascia work, which is what we are going to study, is closer to NeuroCranial Restructuring, at least in intention, than to CranioSacral Therapy. We are aiming for structural shifts in cranial mobility, especially in the deeper cranial bones. You can use cranial fascia work to correct any condition where you find some locking of the cranial bones. It would be contraindicated with recent fractures of the skull, including brain surgery (wait six months before treating the cranium). You can use very gentle cranial fascia work on babies whose skulls are still open.

Our focus will be on mobilizing the sphenoid, the sphenobasilar joint, and the occiput through the cranial soft tissue structures. The distortions of the spiral rotational movements of the spine, and the balance between the pelvic bones, may be corrected in this way. At least they will be greatly helped.

image  Work the Outer Cranial Bones (Skull)

  1. Work the entire surface of the head as one unit, paying special attention to any changes of angle in the skull, which indicate sutures in the bone. Observe areas of locking in the sutures. You can use either elbows or knuckles to “roll” over the head. Make sure you don’t slide—you’ll pull the client’s hair, entirely the wrong kind of pain! The technique is to fix the knuckles or elbow on the surface of the scalp and then move the skin of the scalp over the deeper tissue structures. There will probably be a crunchy, grinding type of noise that the client will hear, and you may too. This crunching noise seems to indicate the presence of some toxins (lactic acid? calcium ions?) in the fascia itself, since it is more pronounced in the restricted areas of the cranium.
  2. After working the whole head, making whatever observations you can about the reflex points, the jaw structure, and the spine, return to the individual blocked sutures and work them separately.

image  Work the Inner Cranial Structures

The closest we can get to the deep cranial bones that govern the movements of the outer bones (primarily the sphenoid) just by using our hands is by access through the nose and mouth.

image  Work Inner Cranial Structures via the Mouth

We can create a surprisingly large movement in the sphenoid if we approach it correctly. Once the outer cranium is loosened, get your gloves on, and go to the mouth. The movements you use are scooping and widening, as you move the flesh away from the center of the head.

  1. First, go back as far as you can between the back teeth and the inner cheek. You will feel a ridge—part of the inner structure of the mandible. You want to start inside the ridge, moving up toward the top of the head first, and then scooping down. There may be no space to go that far back. Do not force. Work the rest of the mouth first, and come back.
  2. Next go to the upper part of the jaw where it abuts the inner cheek. Scoop out the flesh gently, avoiding pulling at the lip. You can support the head with your other hand. Repeat on the lower jaw and inner cheek surface of that side. Pay attention to the chin area, where occipital tensions are reflected. Repeat on the other side.
  3. Now go to the pterygoid muscle and the hard and soft palate, where you can influence the sphenoid (see figs. 10.1 and 10.2). Start at the hard palate in the centerline with both index fingers and move them to the outer edge to widen. Go back into the soft palate if you can. You may feel the atlas behind the palate if the gag reflex is quiet. But don’t force!
  4. Now, one side at a time, go to the upper part of the pterygoid and the soft palate (the anterior of the muscle). Scoop and lengthen down. Repeat on the other side.
  5. Now come back to the first position, way back inside the temporomandibular joint (TMJ), the outside of the teeth. Use both fingers, one on either side, if there is enough space. If not, don’t force. Instead, noticing the rotational distortion of the mandible, bring your index finger inside the tighter joint, and very gently move the mandible from the lower portion to create a more ideal space. If there is no movement, do not do this adjustment. Focus instead on the soft tissue restrictions.

This work inside the mouth is most helpful for visible structural distortions of the TMJ.

image  Work Inner Cranial Structures via the Ears

Distortions of movement, when the jaw zigzags from side to side as the mouth opens and closes, are helped more by working the TMJ from the earholes.

  1. Using both index fingers, go into the earholes about ¼ to ½ inch. Have the client open the mouth slowly, a 10-second count—just to a comfortable point—and close much more slowly, a 20-second count. Ask him to imagine little magnets attached to the teeth and visualize evenness of the bite without trying too hard to create it.
  2. You, the practitioner, assist the bite correction by exerting very gentle pressure on the side that moves outward. This may change during the process of mouth closure.

This will correct the bite if the problem is restricted to the soft tissues and bones of the jaw. If there is no change, there may be an issue with the TMJ meniscus, which is not within our field—time for the dentist or oral surgeon.

image  Work Inner Cranial Structures via the Nose

We can also approach the sphenoid through the nasal cavities.

  1. With a gloved index finger, go in to the level of the first bony ring—no farther. Work one side at a time, widening the bone slightly. Support the nose if necessary. You will find most restrictions on the outer lower corner of the bony ring. Press firmly here—this is a part of the large intestine meridian, which influences sinus function.
  2. You will probably discover that one nostril is much tighter than the other. See if you can equalize the relative size and strength of the nostrils. If you can, you create a significant shift in the parasympathetic/sympathetic dominance of the nervous system. Breathing though the left nostril affects the right side of the brain and the parasympathetic nervous system; the right side affects the left brain and increases the dominance of the sympathetic nervous system (see chapter 9, Breathing).

THE ANTERIOR SPINE AND ITS ATTACHMENTS

Very little of the spine can be accessed from the back. Most of the spinal process and the muscular attachments are accessible only through the front of the body, so this is the best way to access and work with back problems, especially if there is pain or inflammation in that area. Of course, the one part of the anterior spine that can’t be accessed this way is the thoracic area. Too bad—it’s one of my fantasies to be able to get in there. However, you can still influence the spine by working the appropriate ribs.

image  Work the Anterior Spine

The client can be lying on his back with knees up or, especially if there is gas or other stuff in the intestines, lying on his side. The lumbar spine is extremely large and easy to find relative to the abdomen.

  1. Starting at the bottom of the spine, penetrate through the layers of tissue very slowly until you feel a bony knob. When you have a bony knob (spinal process), gently scoop the muscle attachments of the psoas away from the central spine, as though cleaning it.
  2. Work both sides of the abdomen, from pubic bone to diaphragm, in this way. Notice the rotational torsions of the spine. See if loosening the muscle attachments to the anterior spine changes any of the rotational torsions.

image  Work the Rib Cage

  1. When you reach the diaphragmatic tendons (crura) that attach to the spine (see fig. 4.2), have the client breathe into the rib cage, not the belly. Ask him to focus on widening the lower ribs on the inhalation and keeping the ribs lifted away from the hips on the exhalation, so the exhalation will come from the lower abdomen (transverse abdominis).
  2. Some people have a lot of trouble doing this and will not be able to widen the ribs at all. To help them, and to work the thorax area in general, release the adhesions in the intercostal muscles (see fig. 9.3). Press into the space between each rib as they inhale (more or less—it’s useful if they can widen the ribs, but you can press anyway to stimulate the breath), and open up the rib spaces.
  3. Work any conjunct or even overlapping ribs this way to release the area of the spine adjacent to them. The very sidemost portion of the rib cage will influence the back the most. Work the entire rib cage, not neglecting the armpits and including, as much as you can, the underlying breast area, avoiding any overly sensitive breast tissue. Remember the top rib, and release the upper ribs from the collarbone.

image  Work the Cervical Vertebra

As you work the anterior spine of the cervical vertebra, pay special attention to C6 and C7 and the occipital area. Side position will get you in the farthest—and with the client’s chin pressed up you can approach the top vertebra. Prone position with the head hanging down and supported (chest raised from table) will be relatively painless. Work the edges of the hyoid cartilage very gently to free the larynx.

THE ORGANS

Organs are as much a part of structure as muscles, bone, and other tissues. Back pain and other structural problems can be caused by disease—but it can easily be just a misplaced or malfunctioning organ. It’s important that you, as a practitioner, have some awareness of this so you can recommend a medical checkup if you sense a possible problem. Meanwhile, you can correct many of these problems.

The most common system to cause structural trouble is the digestive. This makes sense when you think of it as essentially a long, somewhat bunched-up tube of muscle loosely attached to the connective tissue around the spine. I find more individual variation in the intestines and stomach in terms of shape and length than other organs.

The stomach and the transverse colon are the usual culprits (see fig. 19.1 below).

The most common organ correction you will need to do is to pull down the stomach to correct a sliding hiatal hernia. The hole the esophagus goes through in the diaphragm can easily weaken with repeated insults in the form of large, indigestible meals, lying down right after eating, or even athletic activities. Part of the stomach then can push above the level of the diaphragm, causing reflux, as the stomach acids are forced through pressure into the esophagus. One reason antacids are so bad is that the problem is almost always a sliding hiatal hernia, not high stomach acid (see Reflux section in chapter 14, for more in-depth discussion).

image

Fig. 19.1. Stomach, intestines, rectum

image  Pulling Down the Stomach

To correct the stomach, have the client lie on her back and breathe into the rib cage, while she visualizes the sides of the ribs widening. This will open the diaphragm and make your job much easier. You then pull the stomach down with your fingertips, either from below the xiphoid process or to the left and under the rib cage.

  1. Scoop first, then pull. Start off lightly and increase the pressure until you hear a gurgling sound or feel the stomach drop. Indications that the stomach is correctly placed are rumbling, gurgling sounds; release of pressure in the solar plexus; and the client taking a deep breath.
  2. If you are not successful, try releasing the rib joints around the sternum or working in the psoas.
  3. Or you can have the client stand with her back against the wall and try working the area that way. This position will drop the transverse colon out of the way, making the stomach correction a little easier (but less comfortable for the client).

image  Pulling Down the Transverse Colon

The transverse colon varies in length a lot. Sometimes it gets “bunched up,” and pockets of gas get stuck there.

  1. Palpate the colon clockwise, from the ileocecal valve to the rectum, pulling down the transverse colon as you go.
  2. Then come back to the ileocecal valve, which is usually halfway between the navel and the edge of the pubic bone (see fig. 19.1). Push your fingertips down into the valve, which may be jammed shut or too open. Either way, find the opening of the valve and continue pressing it; eventually you will feel a sensation around your fingers as though a small mouth is opening and closing around them. If that happens, the flexibility of the valve is restored.
  3. Then go to the hepatic flexure (see fig. 19.1), simply massaging that area with variable pressure. This can correlate with back problems on the right side and is prone to congestion and toxicity.
  4. Then check the transverse colon again, and go back down to the descending colon. The Houston valve (see fig. 19.1) gets stuck as often as the ileocecal and can be treated the same way.

Almost all abdominal pain is gas, fortunately. Hard pockets of gas can put pressure on the internal organs and even the psoas, causing much pain. Pockets can be broken up by light tapping (strumming) on the abdomen.

Umbilical hernias can’t be corrected through bodywork, but I have helped mild inguinal hernia by working the associated muscles around the inguinal ligaments.

PLACEMENT OF THE NAVEL

According to Chinese medicine, the navel should be evenly placed, central and perfectly round. You can check yourself for this while standing; you can check a client when she is either lying down or standing. Some people have injuries on one side of their body only. Notice if the navel is displaced to that side or the other. The muscles involved in pulling the navel off center are all the spinal muscles, particularly the psoas. However, I’ve found that working very gently (at first) around, but never in, the navel in a clockwise circle about six inches in diameter can help place and center the navel more correctly.

THE PELVIC FLOOR

The “floor” of the upper cranium perfectly echoes the pelvic floor—the sphenoid, sphenobasilar, and occiput repeat the formation of the pubic bone, pubococcygeus, and sacrum. You could think of the spine as an intermediary between these two balance points.

image  Pelvic Floor Work

The key to successful pelvic floor work is to go very slowly and work a long time in each place. Prepare the client well before entering the anus for pelvic floor work. Describe what you’re going to do and what kind of sensations the client might feel. It is definitely an end-of-session maneuver.

  1. First, have the client lie on his or her back, with legs up, feet on a table. Work under the pubic bone gently, especially paying attention to the attachments of transverse abdominis on the sides of the bone. When the pubic bone moves well, have the client lie, unclothed, prone, with one knee up toward the hip (fig. 19.2).
  2. Standing diagonally across from the raised leg, insert a gloved, lubricated thumb in the anus. Do not insert farther than the first sphincter, about 1 inch on most people. Bring the thumb down and outward into the pelvic structure, working the internal rotators of the femur and anus levator. You will feel the bottom of the pelvis. Notice the distance from the centerline of the pelvic floor.

image

Fig. 19.2. Pelvic Floor Work

3. Then have the person straighten both legs, and move to the inner edges of the sacrum, supporting the exterior of the sacrum with the other hand. Free up the line of the sacrum carefully.

4. Then have the client raise the other leg, and work the pelvis as you did on the other side.

Much energy can be freed up by pelvic floor work. You are, after all, touching the seat of kundalini and stimulating that upward movement of energy. Structurally, your aim is to free up any restrictions in deep pelvic movement and equalize the space between the right and left segments of the pelvic floor.