SOFT TISSUE MANIPULATION

my right hand and even then only part of my right hand would do the feeling. How can you learn to feel with the whole of the hand and, indeed both hands with equal sensitivity?

Exercise one Sit at a desk or plinth and place your hands palm down on the desk surface as lightly as possible. Become aware of what bits of the hand (by this I include fingers, thumb and palm of the hand) you can feel in contact with the surface. Do your hands feel equally relaxed? Now allow the hands to rest fully on the surface of the plinth. Does one hand meld better with the plinth surface than the other? Bring awareness into each finger, thumb and palm of the hand. Notice what has to shift in you for your sensitivity and aware- ness to develop more fully throughout the whole hand. Then notice what has to shift in order for you to be able to feel more equally with left and right hand. Identify in your own body where you are tense and how that affects your ability to palpate. During all these exercises at no stage push the hands into the desk or tissues, sim- ply allow the weight of just the hands to sink into the plinth or tis- sues.

Exercise two Repeat the above exercise except now with your hands lightly rest- ing on your thighs. Once you have paid attention to what is hap- pening at your hands then start to notice what is actually under- neath our hands. Get a sense of density of the tissue, does one hand sink into the tissues more freely than the other? Swap over hands so you feel the left leg with the right hand and right leg with the left hand. How deeply into the tissues can you feel with either hand? Is there a difference? Swap hands to see if the difference is consistent. Bring your right hand back to right leg and left hand to left leg. If there is a difference on one side compared to the other what needs to shift in you or where do you need to release tension in order for the legs to feel more equal. Repeat the above with hands on the right and left side of the abdomen and the thorax.

Exercise three Place your hands on your thighs, imagine now that your hands are part of the tissues you are feeling, now traction away from the hip, then away from the knee, then back to the starting position before gliding hands to the left and the right. Describe what the tissues felt like in each leg. Repeat the above while extending your aware- ness beyond the surface to engage all the tissues of the thigh. Repeat with the hands placed on the abdomen and thorax.

Throughout these exercises your awareness of your hands will have expanded, and you may have noticed that on occasions this aware- ness was influenced by how you were holding yourself. When you were able to release elsewhere in your body your awareness in your hands was enhanced. If you did notice this, then pass on to the next exercise, if not then practice the above a little more.

Palpation and state of mind The exercise that follows will demonstrate at an experiential level the effects of how positive and negative thoughts of your client can affect the tissues you are palpating.

Exercise 1 Find a colleague or willing client to practice with. Set them the task of listing one negative thought and one positive one that they

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have on a regular or daily basis. Ask the person to stand and place your hands over the diaphragmatic area (front hand over the xiphoid process, back hand over or around the T10 area). Observe what you feel in your hands and then beyond into the tissues. Once you have a clear feeling of the tissues, instruct the person to take a deep breath in, and when they breathe out, they are to bring their positive thought to the forefront of their mind. You notice what happens at the interface of your hands and beyond into the body. After a period of 20 seconds or so, then ask them to take another deep breath in, and on breathing out to bring their focus into the negative thought, again you notice what happens.

You may well have noticed that with the different mind states came a change in what was happening at and between your hands. When ones state of mind changes then this is reflected in the tissues.

FASCIAL RELEASE TECHNIQUES There are many different ways of facilitating change within the structure of the fascial matrix, and thereby enhancing function and flexibility at a physical level. As you might expect from the light touch palpatory skills assessment, many of the techniques are very gentle, yet astonishingly powerful. However, there are some more direct techniques, such as recoil, that is more akin to some stronger therapeutic stretching techniques, which can work equally as well.

With many manual therapy techniques the role of the client can often be very passive. Fascial release work on the other hand can be very active, engaging the client in the healing process. Through working with an awareness of a client’s inner tension, it enables them to recognise and understand at an experiential level how their life stresses can influence their body. With this awareness the client is able to move forward on many different levels.

In terms of the elite athlete, no matter what sport they perform, very often the difference between winning and losing is their ‘men- tal toughness’. Their mental preparation is key to their fundamental success. The fundamental success of fascial work is due to it being a system of working that addresses not only the whole body, but it also recognises and integrates the mind body connection, as part of the body work.

The ability to palpate with sensitivity, confidence and accuracy is a fundamental and underlying basic skill to all manual therapies. Developing this skill will enhance clinical practice no matter what discipline you chose to follow.

Working with the fascial system enables any therapist to explore these palpatory skills, whilst addressing the whole, in terms of the physical body. With practice one is able to tune into how the body responds to not only physical, but mental and emotional stresses too.

THE AUTHOR

Stuart Robertson graduated as a physiotherapist and completed an MSc in physiotherapy in 1996. He teaches both nationally and inter- nationally on the facial system, and has a clinical practice in Somerset. He has broad clinical experience having worked with both international sportsmen and people with chronic pain. For further information see www.dmbem.com or email Stuart on Stuart.robert- son@dmbem.com

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