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education classroom to client | Pathology perspectives | body awareness | functional anatomy | somatic research Find a Position of Strength Proper Alignment Aids in Deep Work By Barb Frye 1 When your treatment plan calls for deep work, or when your client requests it, you want to feel confident in your ability to succeed. Bringing awareness to your postural alignment reduces your risk of injury and makes all the difference in applying force effectively. Many therapists believe their lack of muscular strength prohibits them from effectively applying deep pressure. Often, however, the problem is not one of muscular strength, but rather weak positioning. If you are working from a place of misalignment, then attempting to deliver deep pressure could lead to joint weakness in the area of the body where your alignment is compromised. Image 1 shows a therapist applying pressure to both sides of a client's back. Take a moment to identify the points of misalignment and weakness in this example. As you can see, the therapist's choice to apply pressure bilaterally while working at the side of the table forces him into an asymmetrical position. From such a position, the therapist must lean into the table, misaligning his upper and lower body, especially his trunk. Consequently, he cannot work with gravity or generate force from his center of weight; rather, he must use his shoulders and back with extreme effort. Applying dynamic, gliding pressure from this stance is almost impossible because the therapist has "fixed" himself to the table. Furthermore, he is required to use the table and client for support, as his self-support is nonexistent. Is this a posture that you have used in the past? If so, consider the fact that the risk of low-back disorders is greater among therapists who work with an asymmetric trunk position, as seen in this example. A better approach for applying deep pressure to the client's back is to work with one side at a time; that is, unilaterally. This allows you to center your body over your work so that your alignment is symmetrical. Working in this way transfers force effectively by taking advantage of gravity and your center of weight. In Image 2, you can see how the therapist has changed his alignment so that he can deliver both static (direct) and dynamic deep pressure effectively. He can use 46 massage & bodywork september/october 2013 2 gravity to his advantage, using his feet and legs to transfer the force from his center of gravity to his area of focus. His hip joints, knees, and ankles are aligned so that his movements can be fluid, and he is self-supported. Now, there is no question regarding strength—his body is in a position of postural strength, allowing him to work effectively, yet effortlessly.