Issue link: https://www.massageandbodyworkdigital.com/i/1451559
L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 27 L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 27 Watch Til's technique videos and read his past articles in the Massage & Bodywork digital edition, available at massageandbodyworkdigital.com, abmp.com, and on the Advanced-Trainings.com YouTube channel. When Twisting the Trunk, as When Looking Over One Shoulder • Do the rib cage's rings each rotate in relation to their neighbors? • Does each ring slide off to the opposite side a bit (e.g., translate right when looking left)?* • Does each ring also warp a little (rotate upward in back on the opposite side of head rotation direction, and downward in back on the same side as head rotation)?* When any of these questions reveal a more diffi cult or more sensitive movement direction, we have a variety of seated or on-the-table techniques to choose from. For example, the Barber Pole Technique (Image 2) is especially suited for assessment, mobilization, and desensitization of rib-ring rotation. Your preferred therapeutic modality and style will determine whether you take a soft- tissue, articular, movement, proprioceptive, manipulative, or other approach. It'll also infl uence your choice to stay big picture and work with the entire ring, or go for smaller joint-, ligament-, or muscle-specifi c details. Whatever your approach, just as you don't want to let the "trees" of the ribs obscure the "forest" of the rib cage, you don't have to limit your consideration of these rib-ring movements solely to the times clients complain of rib cage-specifi c symptoms per se. Other functions such as neck rotation, arm and shoulder use, seated posture, bending, walking, and stepping all require rib-ring mobility as well. One tip: A simple way to assess for these big- picture connections is to support or hold a movement-impaired rib ring into the direction of more diffi culty (that is, help it do more of what it wasn't doing on its own), and see if the diffi cult or sensitive neck, spine, or shoulder motion improves. Most of all, don't be surprised by dramatic relief from both locally stiff or painful spots, as well as improvements in big-picture functions like bending, walking, or breathing, when you help refi ne rib-ring proprioception and increase the options for rib-ring mobility. *In the list of rib-ring movements, the starred movement options are often quite small, and so the most challenging to assess. They are also the rib-ring movements with the most controversy around them. Sliding (contralateral translation) and warping (upward rotation of the contralateral rib and downward rotation of the ipsilateral rib) are thought by some 3 to be normal biomechanical movements associated with the shape of the joints involved, while others 4 debate the usefulness of the "normal" movement concept, as well as the clinical signifi cance of the smaller movements described. Personally, I have found all of these concepts useful in my own work with clients, so I have included them here. The debates are however important reminders that there are many factors involved in the improvements we see in our work, and that our ideas of what is normal or signifi cant are conceptual maps rather than objective facts. Notes 1. The thoracic ring concept, common in physical therapy, is attributed to Canadian physiotherapist L. J. Lee. Her trademarked Thoracic Ring Approach is described at https://ljlee.ca/. 2. ". . . Each ring typically has 13 bony joints within it:" This statement applies to ribs 1–10. The fl oating 11th and 12th ribs form open caliper-like (versus closed ring-like) units, since they are not connected anteriorly to the sternum. As they are connected to only one vertebra each, and do not connect to transverse processes, they have more intrinsic rib-to-vertebra mobility than the closed rings of ribs 1–10. 3. Diane Lee, Thorax: An Integrated Approach (Edinburgh: Handspring Publishing, 2018). 4. Greg Lehman, "CT The Thoracic Ring Approach: Discussion and Ectodermalizing It," December 29, 2013, www.somasimple. com/forums/forum/physiotherapy-physical- therapy-manual-therapy-bodywork/general- discussion/17118-the-thoracic-ring-approach- discussion-and-ectodermalizing-it; Reconciling Biomechanics with Pain Science, "Thoracic Rings and Integrated Systems: Paleolithic or Pathfi nding?," May 17, 2016, www.greglehman. ca/blog/2016/5/15/thoracic-rings-and-integrated- systems-paleolithic-or-pathfi nding. Til Luchau is the author of Advanced Myofascial Techniques (Handspring Publishing), a Certifi ed Advanced Rolfer, and a member of the Advanced-Trainings.com faculty, which offers online learning and in- person seminars throughout the United States and abroad. He and Whitney Lowe cohost the ABMP-sponsored Thinking Practitioner podcast. He invites questions or comments via info@advanced-trainings.com and Advanced-Trainings.com's Facebook page. TECHNIQUE VIDEO: "THE RIB RINGS" 1. Open your camera 2. Scan the code 3. Tap on notification 4. Watch!