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82 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 2 0 speeds (3 centimeters per second) that can maximize the involvement of these pleasant-touch nerve fibers. 2 These slow- conducting fibers project onto the same region in the brain (the anterior insula) as other C fibers, including those that carry temperature, itch, and pain. 3 The brushing technique shown in the sidebar (this page) is an example of how we might apply these principles. Though physical therapists sometimes use brushing techniques to facilitate muscle tone and relieve pain (as in the Rood approach), our version is a bit different. Imagine that your gently brushing touch is filling in, revealing or recoloring the brain's sensate map of the hand, just like a paper rubbing or tracing reveals and recolors a hidden pattern. The therapeutic value of this approach is related to the phenomenon of cortical smudging, where the brain's body map in people with pain or movement disorders is thought to become blurred (or more accurately, to develop greater overlap between adjacent body regions) like a smudged drawing or out-of-focus picture. 4 We can use touch, then, to redefine or trace a new, clearer picture onto the brain's sensory map. This kind of light-touch approach may also have therapeutic effects on lymph function or on the fluid perfusion within the interstitium (the sponge- like layers of superficial fascia just under the skin), which are intimately As an experiment, why not use your skilled hands on yourself, with one hand refining, remapping, and recoloring the other hand's large region in the brain? they occupy in the brain. But to the extent that pain is a variable response related to protection, rather than a fixed indicator of tissue damage, pain can be modified in many ways. This suggests ways that we, as hands-on therapists, might use the outsized brain representation of the hands to our advantage—filling the brain's hand regions with benign and even pleasant signals can displace and relieve the experience of pain, not just for local hand pain, but also for pain elsewhere in the body. In practice, starting far away from a painful area is a time-tested strategy for easing pain, with the hands being particularly suited as an entry point for this approach. And parents everywhere know that gently stroking their child's hands is calming and can lull the most wakeful child into sleep. AFFECTIVE TOUCH Most any benign hand sensation can probably have a pain-relieving effect. But detailed research into affective touch, that is, "pleasant" touch sensations carried by specialized nerve fibers (C-tactile afferents), has indicted that there are particular body regions (the back side of the arm and hand, for instance); certain pressures (0.3–2.5 millinewtons of pressure—lighter than a postcard); and even particular Key Points: Brushing Technique Indications • Pain in the hand, or elsewhere in the body • Local inflammation or swelling related to injury, arthritis, etc. • Stress, anxiousness, or wakefulness Purpose • Stimulate C-tactile afferent (pleasant-touch) nerve fibers, and thereby supplant pain experience in the brain • Refine and recontextualize the sensory representation of the hand in the brain's somatosensory cortex • Calm and quiet autonomic nervous system arousal • Stimulate lymph flow and interstitium perfusion Instructions • Use your fingertips or a soft brush to stroke the fingers and hand gently, slowly, and thoroughly (Image 3). Imagine "recoloring" and refining the brain's hand-representation map. • Use your client's feedback to find the optimal pacing, pressure, direction, and duration. Watch Til's technique videos and read his past articles in the Massage & Bodywork digital edition, available at, www.abmp. com, and on's YouTube channel. Watch Til's ABMP video playlist on YouTube, where all his videos have been compiled.

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