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Ribbit

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

I put one foot in front of the other, stepping over roots and rocks, my hiking boots leaving little waffle marks in the soft dirt behind me.  I am surrounded by trees that reach for the sky, and dive deep into the earth.  Plants are emerging from the ground, splashes of vibrant green.  And there is a misty fog enveloping it all, a damp hug from the air.

As I have been walking, I have been thinking about connective tissue.

 

The connective tissue is also called fascia.  It surrounds every bone, muscle, organ, and vessel and connects them to every other part.  It also creates a surface for those structures to glide and slide on each other.  It is integral to the cohesiveness of the body and its movements.  Practitioners talk about everything being all connected, and this tissue is the main reason why.  It is made up of collagen fibers that give it strength and elastic fibers that give it flexibility.

As I move through the forest, I look around for the thing that interfaces with everything.  Is it the fog?  Not really.  That leaves out everything underground.  Is it the earth? Not really, that leaves out everything in the trees.  What moves between everything?

The vernal pool to my right has a wooden boardwalk that runs into the middle of the pond.  I step onto the planks, making a clunk sound, louder than I expected against the backdrop of birds and wind.  Out of the corner of my eye, I see a little frog dive underneath the surface of the water.

I think frogs are pretty cool.

They are happy to swim in the water, they are happy to settle in the mud, they are happy to climb the trees.  They can be flashy, orange or blue, characters on the cover of National Geographic, or sedately camouflaged into the green of the algae or the brown of the mud.

They can move between all the levels of the forest, in a sense connecting it all.  But as an analogy for connective tissue, they aren’t quite right.  But I want to play with the metaphor, it has potential.

I look at the water line of the pond, the interface between the air and water.  There is a layer of algae, there are also water bugs dancing on the surface of the water.

Connective tissue responds to the stresses that are placed on it physically and emotionally, the way all tissue does.  When there is stress or trauma, the connective tissue goes into a protective spasm, just like a muscle does, it tightens, and it contracts.  And sometimes, the structures around the fascia heal, but the fascia forgets to drop its guard.  These areas do not move very well.  In other words, they become “fascial restrictions”.

I watch as the frog pokes its head above the water again.  Ripples move outward to bounce off the surrounding rocks, back to the frog.

Because this system is throughout the body, areas of limited movement impact the entire body, just like the ripples in the water.  The frog pokes its head out of the water in the middle of the pond, the ripples can be felt everywhere the water meets the dirt, even three dimensionally if you really think about it, going outward and down, or until it meets another structure that stops the ripple.

If connective tissue does not move in one area, some other area needs to work harder to complete the movement.  Some people describe it like a full body nylon stocking, which connects every part to every other part, and moves with whatever movement is being performed.  If it were to get a snag, the most common fix is clear nail polish, dab a little on the snag, wait a few seconds for it to dry, and problem solved.  Sometimes the polish dries and sticks to the skin underneath it.  Sometimes the nylons had to be adjusted to fix the snag, so they are not lying in the most comfortable position when they got stuck.  That place of limited movement would be felt all over the rest of the nylons, the resting position would feel awkward, and movements might be altered to adapt to the restricted tissue.

I watch as the water bug skitters past the frog, ripples interfacing, the water amazing me in its ability to support the frog from deep below, and support the bug with the surface tension.

It occurs to me that this is just like I support the collagen and elastic fibers of the connective tissue when I work with a client.  I support the elastic fibers and take them to their end range, like the water holding the frog, and then I hold them there, as the collagen fibers dance what they need to dance to get back to mobile tissue, like the water bug.  This gentle prolonged stretch of the collagen fibers, while keeping the elastic fibers anchored, allows the tissue to change, and to regain normal tissue mobility.  Addressing the fascial restriction takes the stress off the other tissues, so that when the client gets off the table, everything is moving again, and that usually translates into more comfortable movement.

I turn around and step back onto the trail.

Frogs didn’t make a great metaphor for the connective tissue system, but I still think they are pretty cool.

Unsolvable puzzles

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

In January, I started a study group for manual therapists. That means the time that I was putting into this blog, I transferred into putting together anatomy reviews for the group. Geeky, overly detailed, three dimensional graph kinds of anatomy reviews that barely scratch the surface of how I picture the anatomy in my head and in my hands. I absolutely love putting them together.

Delving into the anatomy deeper, I started thinking about how all the parts fit together, and all the parts that make up all the parts that are fitting together. Body tissues are made of cells and fluids that are dancing around in relationship, those cells and fluids are made up of molecules that are interrelating, those molecules are made up of atoms that are relating back and forth, and the atoms are made up of…….

It was here that I contacted my physics teacher from high school for my crash course on quantum physics. Several emails later…….

Atoms are made of particles that fit into two families. Protons and neutrons that are made of quarks and electrons are in one family. The other family includes photons. Protons and neutrons are connected and the electrons dance around those guys, and that makes an atom. And when two atoms start to relate to each other, they do so by tossing photons back and forth like a medicine ball. But the bottom line, to me, is that even at this teeny tiny level, they are moving around, relating to each other.

Zoom back to the bigger picture of a client on the treatment table, with the anatomy and the emotions and the spirit that goes with being a human on the table.

I really want there to be a direct connection between these small sub-atomic particles and the anatomy that has cells that breath, walk, talk, think and feel. Rationally, it should make sense. I should be able to trace the jumps from subatomic particle, to atom, to molecule, to cell, to fluid, to organ, to system, to person.

I can do that on a physical level.

I can sort of do it on an emotional level.

Emotions are cascades of neurons firing to release hormones. These hormones are molecules. The molecules swim around our bodies and our brain receives them and interprets them. These very concrete molecules have a concrete relationship with the nervous system and the organs. Then the next jump gets murky. Somehow, the brain turns these molecules into an experience of an emotion. Like “anger”. Like “fear”. Like “love”. It’s like magic. Amazing, beautiful, unexplained magic. It’s the unexplained part that has me frustrated right now.

I can almost do it on an energetic level.

In the energetic framework that I use, the Healing from the Core framework created by Suzanne Scurlock-Durana, Suzanne ties those emotions and energy back to the body tissues. If you are in a session and have an emotion or an energy that you want to work with, the first question is always, “Where do you feel that in your body?” And once you have identified it in the body, then you can be present with it, support it, and that support gives it an opportunity to change. So, I keep coming back to the thought that energetics, as well as emotions and spirituality, should have a concrete explanation on how it relates to the physical anatomy. A lot of the last two months, I have been struggling with the belief that if I just think about it enough, in the right way, that I will find the answer. (Suzanne would ask me where I feel that in my body, and I would tell her its right at the base of my skull, where my left temporal bone meets my occiput bone and wraps around to the front of my left neck, just under my jaw. Then she would tell me to ground and fill.)

Todd said the other day, “Humans are complicated structures that exist on many levels with multiple, interrelated complex systems.” And he is right. The “truth” about the way the physical anatomy relates to the energetic and the emotional part of being human is that there probably is a “link” or multiple “links” that connect everything together. Those links may not be linear, rational, or even physically anatomical as we know the anatomy at this point. Those missing links have me thinking in circles, like the computer at the end of the movie War Games playing Tic Tac Toe with itself. Eventually, the computer realizes that there is no winner, and it calls off the nuclear missiles. I am almost ready to admit that there is no “right” answer.

But on the other hand, those missing links are also what make “life” such a mysterious and mind-boggling gift. Like a unicorn.

Oh, Christmas Tree….

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

Look closely at our Christmas tree.

I’m not sure if you can tell from the photo, but there are an awful lot of gold beads on the lower half of the tree, and the lower part of the tree has the ornaments in clumps with big areas without decoration. The really expensive ornaments and the ones we can not replace, those are on the tippy top of the tree. And if you look really closely, you might see that the felt reindeer ornaments all are “tagged” in pairs with matching balls. If you sort of squint, there are some nutcracker ornaments dangling off the end of a strand of gold beads, hovering just above the train engine on the rug.

You may or may not have guessed, but this year I had help decorating our tree. I had a very enthusiastic and creative five and a half year old helper. From where the decorations are placed, you can get a sense of how tall he is this season.

He insisted on putting the beads on himself. I am not usually one for gold, but we got a box of decorations that my mother in law was getting rid of, and he thought they were great, so I went with it and let him go to town.

When I was little my mom made the felt reindeer, and I always had to have them in order the same way the rainbow is organized. This year, I let Ryan put them on. Then he started hanging glass balls on the reindeer hangers. I asked him what he was doing. He replied, “I am tagging the reindeer. See, there are girl reindeer and boy reindeer, and the tags match, and that is how they will know that they belong together.” I chuckled at the elaborateness of his story.

Then he found the little nutcracker ornaments, and started hanging them off the end of a bead string, and he said,” Look Mommy, the nutcrackers are climbing the mountain.” By now, I was trying not to laugh out loud. He couldn’t hang an ornament without creating a back story of who the ornament was, what the ornament was doing, and where it was going. His stories were interesting, elaborate and unexpected. (I told this story to a friend of mine, and she laughed and said, “You do that too, you don’t just do something, there is always a story that goes with it.” Really? Do I really do that? You don’t have to answer.)

But I found myself struggling to let him find his own way of decorating the tree. I desperately wanted to reorganize the beads over the entire tree, fill in the holes where there were no ornaments, and, as it was starting to get late, I wanted to speed him up a bit so we could finish and get him to just put an ornament on and not get so caught up in all the stories he was telling about each one.

I am not always good about “process” when it comes to myself or my own family. I want things done now, and I can be a bit of a perfectionist. It seems a lot of my personal learning is about appreciating the “process” and all the moments that lead up to the goal. I think it’s something a lot of people struggle with, especially when they are dealing with a part of their body that is no longer working as it did.

We are all in a continual process where one minute flows into the next, one movement flows into the next, and where injury flows into wellness. The process of our bodies striving towards wellness, physically, emotionally, and spiritually, is so fluid and circular and never ending. One injury is not a separate and distinct entity from everything else in your life, past, present or future. It is all connected.

It’s hard to be patient when a body is in pain. I know first hand, I am no different from any one else in that regard. But I also know that the process of recovering also brings many good lessons with it. Struggling through a healing process gives me insights into dysfunction that I would not have learned any other way, and almost always those lessons come back around to help me help others. It may be a day, a month, or a year, but eventually, I run into someone else with similar symptoms, and I am able to help guide them through their process precisely because of the process I had to go through. Such a funny thing is this web of life.

Dr. Upledger (the osteopath that advanced CranioSacral Therapy) always jokes that when you finally have it all figured out, and the “process” is complete, then you have about 6 minutes left to live.

It seems I am stuck with “process”, as the alternative doesn’t sound that much fun.

So I tried to support Ryan’s process the way that I support the process of my clients, with openness and without an agenda. I kept my mouth shut about where to put the ornaments. I kept myself from repositioning the bead strings. I left the “tags” on the reindeer, and the nutcrackers “climbing”. In other words, I refrained from “fixing” his portion of the tree. I enjoyed the stories, and tried to appreciate the moments we were spending together instead of rushing to finish.

He is so proud of himself, proud of his contribution, and proud of his independence. I would have completely negated that if I had gone back to fix the tree. I would have been putting my agenda of how a tree is “supposed” to look onto my son. And I would have missed all his creativity, humor, and all the little moments that went along with our spending time together.

I am proud of myself too, for letting our tree be a “process” tree this year. I am making progress in my process.

Oh, Christmas Tree, Oh, Christmas Tree, how lovely are thy branches…….

Knock, Knock

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

We recently reorganized our basement.

We had three big shelving units in the little alcove at the bottom of the stairs, storing our holiday decorations, random dishes, luggage and random crap that had accumulated there. Our scuba diving dry suits were hanging in another corner of the main area with the rest of the gear in assorted bins on the floor. The air hockey table kept the air handler company, and our work out equipment was gathered in another. Dave, my husband has a workshop for woodworking and assorted house projects in the other end. And I can’t forget that my son Ryan had unpacked the train that is supposed to go around a Christmas tree and set it up amongst the work out gear, stacking all the free weights in the center as a “camp fire”.

There is a lot going on in our basement. Storage, exercise, play, wood working.

My husband was getting annoyed that there was always a huge pile of stuff (I have changed the wording here somewhat) in the area at the bottom of the stairs. He was feeling that the area for storage was too small for what we needed, so that stuff ended up on the floor and not always put away promptly. He had an idea that if we changed the storage to be more linear against the back wall, we could reorganize it to put the stuff we used most where we could get at it, we would have enough room to get boxes down and back up, and it would not longer be the first thing you see when you come down the stairs.

So we spent an afternoon taking everything off the shelves, moving the shelving units, throwing away trash, recycling what we could, and reorganizing so that everything had a place. We decided that we need to put a wall up to separate the sawdust from the rest of the basement (a project for a later date), and we moved the dry suits in front of where the wall will be, and moved the rest of the gear onto the shelving unit we freed up by throwing away stuff. The mini home gym is now the first thing you see when you come down the stairs, and the main area of the basement is open floor space and everything just functions, looks and feels better.

An instructor I had years ago used to say that he thought of a client’s body like a house, that all the different parts of the body were like different rooms. And when he would put his hands on the client, he connected with their tissues as if he was a guest walking into their house. Respectfully taking a look around, he would say, to find the areas that were not moving, and then helping them to move, the same way a nice neighbor comes over to help move furniture or help to fix a leaky pipe.

As I walk into our basement now, I think of that instructor, and how reorganizing our basement is a lot like physical therapy.

Fascial restrictions, dysfunctional joint mechanics, poor postural habits, lymphatic congestion, are all things that stack up in our bodies that impair functional movement. Just like the crap that accumulates in a basement. It’s the stuff we don’t want to deal with, or only partially deal with, like an achy joint for example, that we ignore, promising to “deal with it later”, until it’s so painful that we physically can not move anymore, and “later” becomes “now”. Then we finally decide it’s time to “deal with it”.

And just like my instructor, I see myself as a guest in the client’s house when I connect with their tissues. A guest who cleans. Systematically going through every room, helping the body organize, flush, and cleanse, until the tissues are moving smoothly again. Then I graciously say “thank you for having me, goodbye,” and I exit the house.

I find it really interesting that, now, every time I go down there, I have a brief moment of disorientation. I expect the old messy disorganized space and it takes a moment to register the new location of everything. I have clients say similar things to me. “I didn’t think I could move that way anymore,” or, “right in the middle of what I was doing, I realized it didn’t hurt anymore,” that sort of thing. It takes the brain longer to catch up, to unlearn the old ways and old movement patterns and old expectations. I could talk about neuromuscular junctions and nerve pathways and limiting beliefs and all that stuff, but really it comes down to basements and attics. The brain is in the attic and sometimes if you are in the attic you can’t really hear what’s going on in the rest of the house, so it takes a little longer to get the message if someone is having a conversation in the basement.

I have been surprised at how cleaning our basement seems to have impacted the workings in the rest of the house. I needed some paperwork, and was able to find it right away. I wanted to exercise again. My husband went to the basement for a tool, and was not annoyed when he came out of the basement. Things that are subtle, but those things really make a big difference in decreasing our overall frustration levels, and increase our enjoyment of life. Just like my clients when they no longer have pain with certain movements or limited movements. The scales are tipped towards enjoying life rather than suffering through it.

And isn’t that what living is all about?

Moving

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

Our office has moved.

It’s a little surreal, after 10 years in the old building, to be in this new space.  I never really saw the old building as “bad”, but being in this new space, that fits our clinic much better, and fits the clinicians much better, I see how dysfunctional the old space had become.

I was helping Todd unpack during the move weekend, and we were talking about his vision for how we would use the new space.  There is now a place for everything and everything has a space, and therefore should increase our efficiency.  And he said, “We were so stuck in our old way of doing things, the only way we were going to be able to change was if we moved locations.”

 

Though not entirely true, we could have completely overhauled our systems, though it would have been much harder to let go of our established patterns without moving to a new space.  The move gave us a formal time where everything’s usefulness was examined.  Things no longer useful were thrown out, recycled, or sold.  What we wanted to keep we put in a box, moved and unpacked in the new space, in a more ordered way, the treatment stuff in the treatment rooms, and the office stuff in the front office, the gym stuff in the gym.  There is enough storage for everything, enough room to move around everything, and nothing cluttering the visual lines anymore.  But we needed that proverbial kick in the pants to make the change.

Shortly thereafter, I received an email from a far away family friend.  My friend had hurt his back and was in pain.  He was asking if I had any exercises or stretches that could make it better.  He was about to leave on a trip and wouldn’t be near home or his doctor.  I tried my best to get an idea of what was going on through his oral history and to give him some exercises and recommendations that would be neutral if not helpful to tide him over until he could get to see someone.

Though I couldn’t accurately assess the specifics of his back issues, one thing was crystal clear.  He was at a pivotal place in his movement strategies.  Something in the way he has been moving has become inefficient.  Parts of his body are not moving as freely as they should, causing other parts to work harder, and when parts work harder for long enough, they break down.  It was almost as if his body was saying,” We are stuck in our old way of doing things, and it’s not working anymore.”

Just after that, I found that my cat had resumed urinating in my craft room (long story).  Now cats always use the same place, and if there is any trace of a smell left, they will continue to use it until something changes, even if it is your craft room and not the litter box.   So my cats had become, “stuck in their old way of doing things”, and the only way they were going to change was if that carpet “moved locations”.  So we spent an evening pulling up smelly, degrading carpet, stinky padding, tack strips, and staples.  When we pulled up the carpet pad, we found the expected places of urine and chemicals used to try to eliminate the urine, and three tiny spots of mildew/mold.  But we also found a huge unexpected puddle that had been underneath the steam cleaner I have been using to try to clean the carpet.  It was a 2 feet by 3 feet wet spot on the floor boards.  Bad.  Really bad.  So I sprayed the whole naked floor with bleach, opened all the windows, and said a little prayer that the room would smell better in the morning.

Do you see the pattern?  To make a change, we often need to be pushed into a corner by something so inconvenient or painful that we have no other choice but to change.  Like moving locations, like back pain, like repetitive cat pee.

And when we finally get into that corner, we need to change from the inside and from the outside to get out of it.  And rarely have I seen one change without the other.

There are intrinsic changes, changes that happen within.

Changes within a clinic, within a craft room, within a body.  Within a body, there are joint mechanics that need improvement, fascia that needs to glide again, parts not moving that need to remember how to move again.  I told the complete story of the carpet, and the big water spot from the cleaner to show that often, there are places that need attention that we are totally unaware of, (I would never have guessed that the cleaner was leaking) and that if left unaddressed, those places could lead to major damage somewhere else.  A poorly moving sacrum, if left long enough, can cause the joint above it to break down contributing to herniated discs higher up.  And that is where a good body worker comes in, someone that can figure out what is not moving, and help those places to move again.

And there are extrinsic changes, changes that happen without.

The clinic now has a new address, a craft room now has vinyl tile floor, a body now moves with less pain and more strength and range of motion.  I think that a good body worker, well, at least a good Physical Therapist anyway, will work on the intrinsic dysfunction and then work on functional movement.  Balance the movements within the spine, and then use that new relationship in getting up from a chair, that sort of thing.

Our new clinic feels better to work in, and it feels better to the clients that walk through the doors.  My friend texted me that he was starting to feel better doing some of the exercises and talking his wife into nightly massages.

And in the morning, the craft room did smell better.

Rocks and Stones

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

Picking through the pile of rocks and stones in our backyard, I start to assemble the pieces I am going to use to face the fireplace in our outdoor living room.

We saved these flagstones from the old fire place, patio, and walkways when we knocked down our old house, and have been collecting rocks every time we dig a hole.  We have moved this same pile of stones around our yard at least three times, waiting for inspiration on how to recycle them back into our new space.  These stones are heavy and solid.  Each stone has an organic personality formed from its unique shape, colors ranging from gold to grey, and the subtle differences in each grainy rough texture.

As I examine each stone, I ask myself questions, thinking about the function the stones will serve.  Is this piece too thick to put on a wall?  What shape is this piece?  I need to put my foot there, is that pile stable enough?

 

As the rocks gather in the wagon, I look at the vertical stack.  It looks just like the spinal column, the vertebrae stacked on top of each other.  I have inadvertently stacked the stones by size, the small ones at the top, gradually getting bigger as I went down, with the biggest ones at the bottom.  Now that I see the spine, I add in the triangle bone at the bottom, called the sacrum.  I couldn’t find a small enough rock for the coccyx, the very last bone in the spine, and I can’t quite figure out how to create the many parts needed for an accurate representation of a skull from the rocks I have on the ground, though I did spend way too much time thinking about it.  I can’t help but laugh at my physical therapy geekiness.

The basic function of the bones is to provide stability amongst the mush.    But in addition to the stability they provide, there also needs to be mobility between those bones to make the functional movements fluid.

There is a perceived solidness and weight to bones.  But hidden in the denseness is space, a lot of space.  The individual bones are porous, formed of cross bridges called trebeculae that are created in response to the stresses placed on the bone, reinforcing areas of greater stress.  The centers of the bones are hollow, rich caverns filled with bone marrow that produces blood cells.  It looks just like those hard loofah sponges that used to be popular a few years back.  And this space makes the bones light enough for us to move without needing muscles the size of the Hulk.

The spine itself is organized the same way as the rocks in my wagon, the bones getting progressively bigger from top to bottom.  The cervical spine is at the top (a.k.a. the neck), through the thoracic spine (a.k.a. mid back) to the lumbar spine (lower back).  The spine ends with two triangle bones, the first one is larger, roughly the size of my hand, the sacrum.  The second one is small by comparison, about the size of the end of my thumb from tip to that first knuckle, the coccyx (a.k.a. tailbone).  Each part of the spine has characteristic shapes, so just by looking at a bone you can tell where in the spine it belongs.  All of the bones stack on top of each other and there is a built in cushioning between them known as the disc.  There are also places that each bone connects to the bones above it and below it that allow them to move in limited ways, but when you add all the tiny movements together, there is great flexibility to the spine as a whole unit.  These articulations are called facet joints, and there is one on each side of the bone.  So each bone in the spine has two facet joints and a body cushioned by a disc that attach to the bone above, and two facet joints and a body cushioned by a disc that attach to the bone below.  Then you have all the things that attach to the bones: fascia, tendon, ligament, and lots of things traveling along side the bones: muscles, nerves, blood vessels, lymphatic vessels.

I do have the unique view that the skull should be seen as part of the spine, and to properly treat the spine, you need to include the bones of the skull.  Anatomically, the bone at the base of the skull, the occiput, shares many characteristics with the other cervical bones.  And so does the sphenoid bone in the center of the skull, which also articulates with nearly every other bone in the skull.  Not to get too abstract about it, the sphenoid bone connects the spine to the skull, just as the sacrum connects the spine to the pelvis.  So how can you treat the middle without treating both ends and be effective?  It’s all connected, it all works as a unit, and in my opinion, should be treated as a whole in a bodywork session.

On the yard I have created a template of the fireplace walls, sticks laid out on the ground measuring out how wide and tall the space is so that I can preplan which rocks will go where.  I drag the wagon of stones over to my template.  I start piecing together the picture of stones.  Still asking myself questions:  Should this stone go here?  How does this stone fit in that space, or is it better in that space? What happens to the picture if I move this one here and that one there?  What looks best when I take a step back at look at it as a whole?

Sometimes people come into my office feeling like the pile of jumbled rocks.  Convinced there is no longer any order left in their structure to ever be functional again, they drag their wagon of stones into my office.

I think of my education as my template.  I know what the parts look like, I know how the bones are supposed to move by themselves, in relation to one another, and the relationships they have with the surrounding soft structures.  My education also taught me how all that movement combines to create a function.

So one by one, piece by piece, I sort through the pile of stones with my client, examining each piece.  Asking the questions: Are you supposed to be stable?  How stable are you?  Are you supposed to be mobile?  How mobile are you: by yourself, with the bones above you and below you, and in relation to everything that connects to you?  Just like I am stacking stones in my wagon, I evaluate each part of the client.

Then the work begins to figure out what each part needs to help it move the way it should.  For a lot of my work, I use the bones as handles to stretch deeper tissues, and by stretching the deeper tissues, it frees the bones to move as they should, without me having to work very hard at all.  In my work, I have found that the bones tend to follow the lines of tension in the soft tissues of the body.  The same way a tall building follows the tension placed on it by guide wires pulling on it.  Decrease the tension on the bones, the bones can figure out where they are supposed to be, and then movement becomes easier.  Some practitioners push on the bones and expect the soft tissue will fall into place.  Though sometimes pushing on the bones is helpful and necessary, I find it much easier if I have untangled the soft tissue layers and decreased any swelling in the area first.

Once the structure is stable in its mobility, then we layer on the function. Testing if movement is still painful, figuring out how to hold a posture, or contract a certain muscle.  Function is how we use these bodies we have been given, and decreased function is what brings people into my office, so they should have increased function when they leave.

I look at the fire place wall taking shape in front of me on the ground.  I have found stones to fill in around the fireplace opening that won’t need cutting, and am still playing with the spacing, but for the most part it is starting to look really good.  Organic and restful, I can imagine the flames in the fireplace next to the stones, and I can’t help but breathe a deep relaxing breath.  I am getting excited to put the stones up, to finish this project, so I can relax and watch a real fire.

Sometimes people ask me why I love my job so much.  And besides the pure thrill of the puzzle, this is my answer:

I fundamentally believe that out of the rubble, something can be built that is functional, strong, and beautiful.

Tapestry

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

Inspiration hits in the most unlikely of places.

I was on the airplane flipping through the US Air magazine.  I stumbled across an article that was an excerpt from a book entitled, “Turn Left at the Trojan Horse” written by Brad Herzog.  In the passage he is talking about Greek myths and talks a little about the Morae.  The Morae are three sisters that are also known as the Fates.  Clothos, the youngest, spun the thread of life.  Lachesis, the middle one, measured it with a rod, and Atropos, the oldest, snipped it with shears when Death arrived.  They determined the time and manner of one’s death and also one’s lifelong destiny.  I vaguely remember something about Norns and Parcae, other versions of the fates described in a similar way in Germanic paganism and Roman mythology.

 

I started thinking about these three sisters, weaving the strands of life, and the different ways that life is like a tapestry of woven cloth.

An individual strand connects with another, the strings weaving together, intertwining sometimes for a short while, sometimes for the rest of time.  Each person is represented by a string, the weaving is the relationships between people.  Each connection is meaningful, and each connection influences the way the whole cloth turns out.  People come together in life, travel together for a period of time, and then branch off again.  Sometimes cycling back, sometimes not, the same way colors move in and out of a woven tapestry cloth, sometimes used throughout the entire piece, sometimes just an accent of a particular color to complete a picture detail.

My thoughts returned to the image of the three sisters holding the threads of life, weaving the tapestry.  And interestingly enough, there are three main systems that travel throughout the entire body: the nervous system, the lymphatic system, and the circulatory system.  They are all long string like tubes, weaving in and out of the muscles, bones and organs.  They bring new fluids, energy, and information to an area, and then take away the waste products and the return feedback to the central processing areas.  They all start and end at a large central core, and branch out to progressively smaller vessels until they reach the capillary beds.  They make their exchanges, and continue the cycle.  If you look at it in an anatomy book, they almost look like strings being woven together, with yellow string to represent the nerves, white string for the lymphatic vessels, red and blue string for the arteries and veins of the circulatory system.  The same way that people come together, tangle lives for a while, and then branch off again, these systems have the same fluidity in anatomy.

These three sisters rely on each other.  The circulatory system enters a portion of the brain in the nervous system that filters out fluid from the blood to make cerebral spinal fluid.  The lymphatic vessels weave around the nerve roots to absorb the waste products out of that same cerebral spinal fluid.  The lymph also weaves through the capillary beds of the circulatory system, cleaning up any fluid the veins didn’t pick up.  The nervous system innervates smooth muscle in the arteries to help adjust blood pressure.  The nerves also help control the lymphangions to milk the lymph fluid through the vessels.  Like sisters, these systems support each other.

These three systems are everywhere in the body.  And I mean everywhere.  They also travel together.  Think about the spinal cord, and then think about the aorta and vena cava, the major artery and vein of the circulatory system.  The lymphatic system also has its main collection duct just below the sternum.  They all are in fairly close proximity to each other running vertically through the trunk.  Then they all have branches to the arms and legs and head that progressively branch out smaller until they hit the fingers, toes and brain.  They have found nerves, lymph vessels, arteries and veins in the sutures of the skull, places that they now know continue to be mobile throughout life.  There are even nerves, lymph and blood in the sheath that surrounds each nerve.  Everywhere they look they find these three sisters woven into the tissue.  That is amazing to me.

And like the three Morae, the three systems can determine the fate of a body.  If they are healthy, the body can recover from illness and trauma much more efficiently.  But like anything so interwoven, if one system is faltering, it impacts everything.  And faltering systems usually mean pain and dysfunctional movement.

There are different treatment techniques to work with each sister individually, but the best treatment results are when each sister gets some attention during a session, more like a conversation, each sister talking in turn, passing the discussion back and forth.

I just marvel at these sister systems weaving their strands in and out of the body, and how they create a beautiful tapestry in the flesh.

Who knew all that would come from an airplane magazine?

Vacation

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

Sometimes, I just can’t sleep.

I’ll wake up a bit before everyone else and instead of just rolling over and falling back asleep, my brain jumps to life, and even if I try to fall back asleep, I’m awake.  So, today, I got up and started to write, not quite sure where I was going to go with this blog this week, my rhythm thrown off a bit by a break in our regular schedule.

 

We went on vacation.  And I mean a real go to another country, swim in the Caribbean Ocean, run your fingers through the white sand, and play for hours in swimming pools family vacation.  We stepped out of our normal busy scheduled lives, and we spent ten days immersed in water, our family recharging in the sun.

Water can be so powerful.

I loved feeling the thick salty water of the ocean supporting me as I floated, bobbing up and down with the surf.  I loved sitting in the surf as the tide came in, each wave a little farther up my legs, and digging holes in the sand for my kids to fill up, and how the waves would change the texture of the sand.  The dry sand soft and light, add a little water and the sand began to hold a shape, add a lot of water and the sand became fluid again, but with a density to it.  I loved finally getting to scuba dive again, totally immersed in an entire world of fluid, where all I heard was my own breath, and my husband and I reverted back to our short hand sign language as I found critters for him to photograph, and even though he didn’t bring his camera on the dives due to strobe trouble, I still fell into the habit of showing him every critter I would find.  And by contrast, I loved feeling the slippery water of the swimming pools with the waterfalls pouring over our heads, the early morning hot pool swims my son and I would take as we waited for everyone else to wake up, and the rush of fast water carrying me down the waterslide.

When I took my first Lymphatic Drainage class, the instructor talked about the fluid inside the cells and around the cells, and the pathways that lymph takes as it moves through the body.  And then it struck me that our bodies are made up off all these cells, and the cells are made up of fluid and also swimming in fluids and even the cell walls contained fluid, so really everything in the human body is made up of different densities of water.  Instead of thinking that our tissues are solid, what if we started thinking of different tissues as just containing more or less water on a spectrum of fluid density?  For me, my treatments changed dramatically after that.  It was kind of like Neo in the Matrix series when he discovers that in “the Game” he could see the code that everything was made of, and he could scoop out a bullet lodged in someone’s body in the game and thereby save their life in reality.  For me, it became much easier to move from one system to another within a treatment, since it is all fluid anyway. And since it is all fluid, it makes much more sense to treat the body as a whole unit, the area of dysfunction itself and to treat all the parts that are connected to it.  Fluid became the great connector, connecting everything to everything else.

Another thing about fluid, it likes to move.  Correction, fluid in the human body, needs to move.

When I evaluate someone’s tissues, I always say that I am looking for the places that are not moving.  But to be really specific, I am feeling for the places where the fluid does not feel like it’s moving the way it should.  Every course I have ever taken relates to movement.  The movement of the muscles and joints, the movement of the craniosacral system, the movement of the lymphatic system,  the movement of all the organs and the connective tissue around the organs, even the energy that flows through a body, all these parts of the body that have very specific ways of moving.  My training has mostly been about what each part feels like when it moves, what it feels like when it doesn’t move, and how to help it start moving again.  Each tissue has a texture, and within that texture is a fluid quality.  And when things are not moving, areas of decreased movement also affect that fluid dynamic; just like a beaver dam can alter the way a river flows.  Every cell is constantly metabolizing.  The waste products get dumped into the surrounding fluid.  If fluid in the body does not move, those waste products accumulate.  When waste accumulates, it keeps fresh fluid from getting to the cell.  When the cells are deprived of fresh nutrients, they suffer.  When cells suffer, it translates into pain, swelling, inflammation, and poor movement.  Get that fluid to flush out and the cells can get the things they need.  Cells with their needs met, work better.  When cells work better, the tissue they live in works better.  That translates into improved movement, decreased pain, swelling and inflammation.  Fluid needs to move to keep everything healthy.

So everything is connected to everything else.  And everything needs to move.  Therefore, everything needs to move in connection with everything else.

This is a simple enough concept.  Like trying to keep a family group together through an airport, you are connected, you need to move, and you need to all stay together to make it to the next plane intact and before boarding.  If you don’t move together, one of the kids gets left behind in the scary sea of strangers, or one of the kids runs ahead to crash into the woman walking with a cane, or one parent gets stuck with two kids trying to find the other parent that went off in search of food since they don’t feed you on airplanes anymore.  It’s more efficient for everyone in the family to move together until you get to the next gate.  Same is true in our bodies.  Every part needs to work with every other part to get the functional movement completed.

It was a good vacation.  Actually, it was a great vacation.

Drip, drop, drip

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

It has been raining here.  A lot.

I am looking out the window, and watching as one single raindrop lands on the glass.  Then gravity pulls it towards another drop and the two become a larger drop.  They are joined by a third, and are starting to leave a little trail behind them.  As they flow down the glass, the various trails meet up to make bigger channels, braiding together.  The bigger channels all converge at the bottom of the window, a puddle forming and growing until the water spills over the edge to create a waterfall that feeds into the large puddle at the edge of the house.  From here, the water runs with a slight current downhill towards the gutter where our yard meets the street, to flow into the tiny river that rushes to the sewer drain.

Anatomically speaking, I have also just described the lymphatic system.

 

The lymphatic system starts out as the fluid that surrounds each cell that flows through unorganized pathways, which lead to the larger collection areas, called lymphatic capillaries, and then into lymphatic collectors, then the lymphatic trunks and ducts, and eventually arriving into the nodes.  The fluid continues its migration through the nodes and ends up dumping into the aorta, the large blood vessel that enters the heart.  From here it gets pumped via the bloodstream to the different organs of the body for filtering.  And then it gets recycled back into the general fluid content of the body.

Eighty percent of the lymphatic system is superficial, living just under the surface of the skin.  The other twenty percent is around the deeper body cavity tissues.  The lymphatic system surrounds, supports, and cleanses the entire body.  It is a dynamic system having spiral smooth muscles throughout the channels called lymphangions.  These muscles contract and relax in waves, starting at one end of the tube and essentially milking the fluid to the other end, where it dumps into the heart.  It has direction, it has predictability.  It feels like a gentle moving stream, my hand drops in and gets pulled along the current.

A thin pine needle lands on the glass.  The water pools up behind it, until it finally cascades around it.

When there is too much fluid, whether it be from a trauma, surgery, chronic inflammation, or illness, the lymphangions get stretched open and then cannot fully contract, leading to more backup of fluid, more swelling.  The body tries its best to keep up, continuing to move the fluid however it can, using the normal pathways as able, and if there is overflow, it reroutes the fluid to the next open lymph node.  Just like water anywhere, when it gets blocked, it finds a way around.

This is where lymphatic drainage comes in.

The gentle massage technique locates the areas of congestion and then helps to milk the fluid through, decreasing the push on the lymphangions, and allowing them to more fully contract.  As the fluid gets milked out of the tube, this also creates a vacuum that pulls more fluid through.  As the lymph vessel begins to clear, the current under my fingers gets stronger.  Lymphatic drainage can also reroute the fluid back to the normal pathways, or if the normal pathways are permanently removed (as in some surgeries for cancer where they intentionally take lymph nodes) help the fluid find the most efficient path to take.  This sparks the body’s natural processes to kick in again, and with all the parts able to do their jobs again the body decreases any swelling.  Lymphatic drainage helps clear out the blocks to the fluid flow, opening up the rivers so they can resume their travels to the ocean.

I go outside and gently lift the pine needle off the glass.  The rain runs straight down the glass again.

I can’t help but smile and appreciate the beauty of moving fluid.

Possibilities

Written by consiliumclub on . Posted in A Little Connection, by Jen Richards Little, MSPT, CST

I am open to the possibility…..

I have been walking around the last few days, knowing I want to write another post, and struggling with what to say.  Every action I make is a half finished sentence that goes nowhere.  Then my old friends worry, fear, and judgment show up.

When I feel myself barraged by those critical voices in my head, I know it is a sign to take a step back and regroup.   I take a moment to feel my feet on the earth, the ground supporting me from below, my breath moving in and out of my lungs, the rise and fall of my ribcage.  I begin to relax.  Tuning into the details of where I am in my body right in this moment in time.  And as I settle back into myself, I begin to hear my true voice.  It reminds me that I don’t have to work so hard. Instead of reaching and grasping for what I want to say, I can just listen, open myself up to the possibilities, and the inspiration will come and the words will move through me.

 

An exercise I did in one of my earlier classes illustrates this beautifully.  There are two people, one person is sitting, the other is helping, they are holding hands, and the goal is to get from one chair to another across the room.  The first time, the helper is to lead, but it ends up with the helper pulling the sitter across the room to the other chair.  Just reading about it, I remember the feeling as the helper, so much work with so little gain, and the feeling as the sitter, the more I got pulled, the less I wanted to move.  The second part of the exercise was for the sitter to initiate the travel, which ended up with the helper waiting and waiting for something to happen, and then when it finally did, the helper was so startled that they might or might not have been able to catch up to the sitter.  That didn’t feel great either.  The last part of the exercise was for the helper to ask the sitter when they were ready to move, the sitter lets the helper know, and then they move together across the room to the chair.  This is a much softer way of traveling, for both the helper and the sitter.  The same is true for me and inspiration, and also between a therapist and a client.

A client comes to my treatment table, and I ask questions, of the client and of the tissue.  Then I listen to the answer.  I remain open to allowing whatever needs to happen in that moment in time, happen.  Whether it’s a particular technique, a verbal dialogue to process an emotional holding, or to just hold a space for a few moments of rest, it’s all ok.  I give the tissue what it is asking for in that moment in time and allow my treatments to move through me.  The treatment flows from one moment to the next like water, with very little effort on my part, as long as I keep listening and keep open.

Then when I look back on a session, I can see how the water was flowing, how all the dots connect.  Sometimes it’s like a river, with a clear direction, swirls and eddies.  Sometimes it’s like the surf, big crashing waves, and dramatic releases.  Sometimes it’s like a calm lake, dynamic in the stillness.  And sometimes, it’s like jumping from one puddle to the next, it doesn’t always make sense why you go from one place to the next and eventually, you as the therapist might figure out how it’s all connected, but sometimes not, but you get to the other side of the street, so it’s all good.

And most amazing of all is that it happens within the allotted treatment time.  Part of communicating with a client’s tissue is to let it know how much time it has to do what it needs to do.  And being open to the possibility that it will do what it needs to do, in the time you have available.  I have met many therapists who consistently struggle with holding that time boundary.  And I always wonder what they are asking the body at the beginning of the session.  Are they asking, “What do you need from me today?”  Or are they asking, “What do you need from me today in this hour (or whatever time frame your session is) that we have to work?”  I also wonder if they are listening to the ending point, that gentle pushing away and cooling off of the tissue, or are they lost in their own worries, fears and judgments.  Either way, can they take a step back, and open to the possibility that the client can get everything they need from the treatment in the given time frame?  It is amazing how being clear with your questions and intentions can change the way a session plays out.

Actually, it is amazing how being clear with your intentions can change the way a lot of things go outside of the treatment room as well.  Coming back to my struggle with this blog post, it is amazing that when I asked them to come before the week had passed, the words gathered around me, as if they were lining themselves up to flow out of my typing fingers, I just had to open to the possibility that they were there, and listen to hear what I was supposed to say.  And the blog just wrote itself.

I am open to the possibility……