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part; but don't economize too much. The living tissue of the body is a single envelope whose various parts are much more dependant upon and responsive to one another than is commonly realized. For reducing tension, and for every other aspect of massage as well, the one rule before all others is: deal with the body as a whole."29 Petrissaging the abdomen along the path of the large intestine Finally, clients complain rarely about abdominal problems, as compared to neck or back pain, and may not understand the relationships between the abdomen and other parts of the body. Also, many clients are ashamed of their bellies. The idea of a therapist touching or looking at their abdomen is quite frightening. Remarks such as "My stomach is so fat," or "You don't need to work on my front; my back is what is bothering me," or "I just don't want my stomach touched" may steer us away from treating or massaging the client's body. AS A WHOLE One of the most important messages a good massage can give our clients is that the body is interconnected. We would all do well to follow the advice of George Downing, the author of The Massage Book: "Never neglect the rest of the body for the sake of one or two areas of higher tension. Do economize, cutting down the amount of time you have spent on one part of the body in order to spend more on a more tense therapist and massage instructor in Oregon since 1975. She is the author of Massage for Healthier Children, Pediatric Massage Therapy, and Modern Hydrotherapy for the Massage Therapist. She has taught massage in special programs for disabled children in the United States, Mexico, and Ecuador and currently teaches pediatric massage and other classes at massage schools in the United States and abroad. She can be reached at www. marybettssinclair.com. Marybetts Sinclair has been a massage NOTES 1. J. Whorton, Inner Hygiene: Constipation and the Pursuit of Health in Modern Society (New York: Oxford University Press, 2000), 149. 2. E. Kleen, Massage and Medical Gymnastics (London: J. and A. Churchill, 1921). 3. R. Kurtz and H. Prestera, The Body Reveals: How to Read Your Own Body (New York: Harpercollins, 1984). 4. George Downing, The Massage Book (New York: Random House, 1972), 109. 5. J. Travell and D. Simons, Travell and Simon's Myofascial Pain and Dysfunction: the Triggerpoint Manual, second edition, Volume 1, Upper Body (Baltimore: Lippincott Williams & Wilkins, 1999), 20. 6. Ibid., 37. 7. D. Greenbaum et al., "Chronic Abdominal Wall Pain: Diagnostic Validity and Costs," DigestiveDiseases and Sciences 39, no. 9 (September 1994): 1933–42. 8. F. Rivero, "Pain Originating from the Abdominal Wall: a Forgotten Diagnostic Option," Gastroenterol Hepatol 30, no. 4 (April 2007): 244–50. 9. S. McMahon and M. Koltzenburg, eds., Wall and Melzaks Textbook of Pain, fifth edition (City: Elselvier Churchill Livingstone), 2006, chapter 30, "A Clinical Perspective on Abdominal Pain," by H. Wong and E. Meyer, 753–77. 10. E. Krane, Relieve Your Client's Chronic Pain (New York: Fireside, 2005), 27. 11. Available at www.digestive.niddk.nih. gov (accessed June 2008). 12. E. Krane, Relieve Your Client's Chronic Pain. 13. C.P. Dancy et al., "The Relationship Between Daily Stress and Symptoms of Irritable Bowel Syndrome," Journal of Psychosomatic Research 44, no. 5 (1998): 537–45. 14. D. Clarke, They Can't Find Anything Wrong: 7 Keys to Understanding, Treating and Healing Stress Illness (Boulder, Colorado; Sentient Publications, 2007). 15. P. Latimer, Functional Gastro-Intestinal Disorders: A Behavioral Medicine Approach (New York: Springer Publishing, 1983). 16. E. Mayer, ed., Basic and Clinical Aspects of Chronic Abdominal Pain (New York: Elselvier, 1993). 17. Available at www.aboutconstipation. org (accessed June 2008). 18. D. Clarke, They Can't Find Anything Wrong. 19. Available at www.digestive.niddk.nih. gov (accessed June 2008). 20. Incidence of Caesarean section and other abdominal surgeries such as hernia repairs, endometriosos, etc.: check national center for health statistics, infant and maternal health, publication titled Vital Health Stat, term "ambulatory and inpatient procedures in the United States," then by year. 21. J. Barral and P. Mercier, Visceral Manipulation (Vista, California: Eastland Press, 2006). 22. Available at www.cdc.gov/mmwr/preview/mmwrhtml/ mm5615a8.htm (accessed June 20, 2008). 23. H.K. Opoien, et al., "Post-Caesarean Surgical Site Infections According to CDC Standards: Rates and Risk Factors. A Prospective Cohort Study," Acta Obstetricia et Gynecological Scandinavica 86, no. 9 (2007): 1097–102). 24. F. Tappan and P. Benjamin, Tappan's Handbook of Healing Massage Techniques, third edition (Stamford, Connecticut: Appleton and Lange, 1998). 25. M. Braun and S. Simonson, Introduction to Massage Therapy (Baltimore: Lippincott Williams & Wilkins, 2005). 26. M. Gershon, The Second Brain: The Scientific Basis of Gut Instinct and a Groundbreaking New Understanding of Nervous Disorders of the Stomach and Intestine (New York: Harper Collins, 1998), xi. 27. M. Emly, "Colonic Motility in Profoundly Disabled People: a Comparison of Massage and Laxative Therapy in the Management of Constipation," Physiotherapy 84, no. 4 (1998): 178–83. 28. M. Emly, "Abdominal Massage for Adults with Learning Disabilities," Nursing Times 97, no. 30 (July 26–August 1, 2001): 61–2. 29. George Downing, The Massage Book. visit massageandbodywork.com to access your digital magazine 79