Massage & Bodywork

July/August 2012

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breathing pattern in which the lateral movement of the ribs and the upper chest compensate for abdominal holding. The abdominal area is held tight, and no expansion occurs with inhalation. This often happens in people who must maintain a fixed posture in their work, such as ballet dancers and military personnel. Breathing can also be informally assessed at any time during the massage. A resting or holding stroke used to open the massage provides a perfect opportunity to track the client's movement of air and notice where breathing may be limited. At this point, you may be wondering, "What am I supposed to do with this information? I can see that there is something happening on the right side, because the muscles in the neck on the right side get tenser than the muscles on the left side when the client inhales—but what does this mean? How should I change my massage to help the client?" Begin by just noticing it and experiencing it. When you see such a pattern, place your hands on the structures on either side of the neck and feel what happens when the client inhales. Do your hands confirm what your eyes noticed? Where else do you see tension? How rhythmic is the client's breathing? Where does the air flow as it moves into the client's body? Where does the air stop? Continue to palpate and observe. Trust that as your skills progress, you will soon learn how to base the client's treatment plan on your observations and palpation findings to best support the client. 2 Diaphragmatic Breathing 1 Diaphragmatic breathing is used with the client in a supine position. It works well to use this technique at the beginning of a session. Communication skills are key because you will coach the client into a functional breathing pattern. Focus on ensuring that the client's breaths are slow, rhythmic, and relaxed. Keep the exercise short enough that the client does not become concerned about losing time from the massage. 1. After obtaining permission, place your hand on the client's abdomen and ask the client to lift your hand with each inhalation up to three times. 2. Place one hand on each side of the ribs and ask the client to move your hands outward with the breath up to three times. 3. Place the fingers of one hand on the lower section of the sternum and ask the client to lift your hand with each breath up to three times. 3 4 4. Have the client put the breaths together by cueing your hands. Ask the client to inhale, first filling up the abdominal area, then laterally expanding the ribs, then allowing the chest to rise. Touch each area in order as the client inhales and pace the client on a full, even breath. As the client exhales, it can be effective to gently massage any areas of the upper neck that look tense, such as the shoulders, which may tend to pull forward or up during breathing. Repeat the cueing and coordinated breathing up to three times. Photos courtesy of Lippincott Williams & Wilkins. Celebrate ABMP's 25th anniversary and you may win a refund on your membership. 101

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