Massage & Bodywork

MAY | JUNE 2019

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READER FORUM Let us know your thoughts about the magazine! Email PRAISES I wanted to let you know I love that Ian Harvey is now contributing to your magazine. I have been watching him via his YouTube channel for years. He is great and really cares about the massage industry. I hope to see more of him in future editions. ANDREA TIFFIN GRAND JUNCTION, COLORADO Editor's response: We love that you love The Massage Sloth, Andrea! And good news! Ian is a regular columnist now for Massage & Bodywork, so look for him in every issue! Nice work channeling the zeitgeist of the moment! Great editor's note ["Model Behavior," March/April 2019, page 8]. All of M&B looks super great. JOHN T. GELB RIVERSIDE, CONNECTICUT RECIPROCITY REVISITED An article in the magazine ["Massage Reciprocity," by Ivy Hultquist, January/ February 2019] states on page 80 that Oregon requires a practical exam. It does not, nor has it for several years. Unfortunately, the practical portion was phased out and although I can do a Google search for the phrase "Oregon Practical Exam" and come up with what appears to be an old Oregon Board of Massage Therapy web page, I am unable to locate anything on the current website that states that Oregon currently has a practical exam. Incorrect statements/mistakes such as this cast doubt upon the entirety of the information that this article strives to provide. AMY BENNETT PORTLAND, OREGON Author response: There seems to be confusion regarding my inclusion of a practical exam as a route to licensure in Oregon. The practical exam was removed as a requirement for Oregon applicants as of 2016. This does not mean the practical exam no longer exists or cannot be used as a route to licensure in some instances. A copy of current Oregon Board of Massage Administrative Code can be found on the Oregon Board of Massage website at OBMT/Pages/lawsrulespolicies.aspx. Here is a direct link to the 2019 edition: Effective%2001.01.2019%20OAR.pdf. The rules state … 334-010-0008 Practical Exam for Indorsement (2) Health Indorsement: The Board may grant a license by health indorsement, after successful completion of practical and jurisprudence examination, to any applicant currently holding an active Oregon license in good standing in a Board approved health related fi eld who can document curriculum that includes a minimum of 300 hours comprised of Massage Theory & Practical Application, Clinical Practice, Business Development, Communication, Ethics, and Sanitation. Kinesiology and Hydrotherapy may be included as part of the 300 hours. 334-010-0010 Practical Exam for Indorsement (1) The examination must be held at least twice annually or as requested. Reciprocity can be confusing as the requirements are not always the same for every applicant. The intent of my article was to show that our profession has a long way to go in terms of license reciprocity. I encourage readers who feel this article contains incorrect information to read through the administrative code and laws of the state in question. In my years of experience reading through massage laws and rules and assisting people with obtaining licenses, I have learned that just because a route is not commonly used, does not mean it is wrong, incorrect, or misinformation. Sometimes, these rarely used options help a massage therapist obtain a license when traditional routes to licensure are diffi cult or not possible. IVY HULTQUIST While it can be tempting to dig into the masseter and try to blast those painful points to pieces, I fi nd that approach can just lead to more tightness and sensitivity. Instead, we're trying to gradually convince the client's nervous system that so much tension and sensitivity isn't necessary. This can take a number of sessions, so set expectations accordingly. WHERE TO GO NEXT Once you've seen how prevalent jaw pain is, and how effective a little work there can be, there are a lot of useful directions to explore. Start by getting more specifi c with the muscles of the anterior and lateral neck. The sternocleidomastoid and scalenes, for instance, can have an interesting relationship with pain in the area, and are worth investigating. From there, think broadly about muscles that affect the neck, shoulders, and posture. Look for tight trapezius and pectoral muscles, and even the rotator cuff. The more I try to pick apart "where pain comes from," the more I realize how interrelated it all is. There are some other muscles, like the pterygoids, that can only be accessed intraorally. That can be worthwhile (and it's a useful skill to learn via continuing education), but I get excellent results from the noninvasive technique above. I fi nd that working broadly can have deep effects, all without having to get too specifi c. Ian Harvey specializes in myofascial-inspired techniques that are kind to client and therapist. He produces free massage tutorials on YouTube under the name Massage Sloth, and his blog can be found at When's the last time you really spent some time on a client's jaw? It can seem like a distraction when you've got plenty of other work to do, but what if it could be the key to solving a constellation of problems? What if it could make your practice stand out in a sea of other practitioners? The technique I'm about to describe is based on myofascial release, but don't let that term worry you. It just means we're going to move slowly and consider the tissue broadly rather than focusing on any individual muscle. But fi rst, when should you use it? THE WHY I ask about the jaw any time my client describes neck or head pain, especially if there are multiple components involved. For instance, if a client tells me they have neck pain, and further investigation reveals headache and neck stiffness, my next question will be, "Is there anything going on with your jaw?" I'll also jump immediately to jaw work if a client reports having headaches that are primarily in their temples. That's based on my own clinical experience, but studies do indeed show a strong correlation between jaw disorders and headaches in general. Jaw problems will vary widely from client to client, but don't feel like you need to have the answer to why their jaw pops, or be able to recognize any specifi c dysfunction. We won't be changing any muscle in particular or trying to force a new confi guration of the joint. Instead, we're going to approach this from a myofascial perspective and let the client's body make the change for us. Note: If a client mentions new or unusual jaw pain or dysfunction, refer them to their doctor or dentist for evaluation. THE HOW For this technique, start by envisioning the course of the masseter muscle. This thick, two-headed sheet of muscle runs from the zygomatic arch (the cheek bone) down to the angle of the mandible. Now, think of the temporalis: starting with a wide, fanlike origin along the side of the cranium, it dips down through the zygomatic arch to latch onto the coronoid process of the mandible. Got those in mind? OK ... now mostly forget about them. The point here isn't to go from origin to insertion, or to work with attachment sites, or anything like that. Instead, we're going to work with the broad sheets of fascia these muscles are embedded in. Start by sitting at the head of the table with your client supine. Use clean hands to avoid introducing more oil (and to prevent breakouts!), and go through this sequence: 1. Place your fi ngertips along both sides of the bottom of the jaw, applying minimal pressure. 2. Draw your hands up toward the top of the client's head, dragging the tissue superiorly. 3. Wait patiently, allowing your contact to slowly make the journey up the face and into the scalp. This should take 1–3 minutes. 4. (Optional) Repeat, this time with the client slowly opening and closing their jaw. Ask them to use a small, pain-free range of motion. What we're doing here is taking the tissue along the sides of the face and displacing it upward, then waiting for movement to happen. If you use no oil or lotion (which I recommend), this can take a while! No need to press hard or force anything; think of it as slowly ironing out the fascia. 96 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 9 Yo u r M & B i s w o r t h 2 C E s ! G o t o w w w. a b m p . c o m / c e t o l e a r n m o r e . 97 technique THE MASSAGE SLOTH Ironing Out the Jaw By Ian Harvey Watch Ian's video by scanning the QR code or go to this page in the digital edition to view it. Ta k e 5 a n d t r y A B M P F i v e - M i n u t e M u s c l e s a t w w w. a b m p . c o m / f i v e - m i n u t e - m u s c l e s . 13

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