Issue link: https://www.massageandbodyworkdigital.com/i/68009
THE FORGOTTEN CORE WHY ABDOMINAL BODYWORK? During my 34 years in general massage practice, I have seen many clients with bothersome conditions for which abdominal massage was the most appropriate treatment. I often found deep muscular tension, adhesions, myofascial trigger points, shallow or dysfunctional breathing, myofascial restriction, and/or musculoskeletal pain in the abdomen. There were many different causes: trauma to the abdomen, forceful vomiting, undergoing a painful manipulation of the abdominal wall to turn a breech baby, improper exercise of the abdominal muscles, sexual abuse, adhesion-forming abdominal operations, rib sprains, and pelvic fractures. Even a normal pregnancy and delivery left many women with abdominal issues, such as myofascial pain, abdominal muscle trigger points, and dysfunction of pelvic joints.Lifestyle factors such as postural habits, exercise regimens, repetitive stress at work, anxiety, depression, and emotional stress also led to abdominal tension and pain. There are other reasons why abdominal massage truly does matter. A relaxation massage that neglects the abdomen misses a critical place where tension—perhaps the deepest tension in the body—is stored. The abdomen is more than just a muscled cage for the internal organs: it is a primal area of emotion. How does the abdomen come to carry so much stress? Ron Kurtz and Hector Prestera, founders of Hakomi Bodywork, believe humans have two different, often opposing, drives. What they term the belly mind contains our non-rational consciousness of hunger, satiation, sexuality, and intuitive awareness of our environment and of other people, whereas the head mind specializes in more rational and logical thoughts and plans. According to Kurtz and Prestera, conflicts that arise between the two are 74 massage & bodywork july/august 2009 Incorporating the Abdomen • Ask questions during the intake process about abdominal issues and conditions such as irritable bowel syndrome, gastro-esophageal reflux, and chronic constipation. Note any previous abdominal surgeries so you can check old incisions for adhesions or trigger points. Diarrhea, gas, and bloating are common symptoms of abdominal trigger points. • Safeguard your client and yourself with firm boundaries. Be sure to ask if abdominal massage is acceptable. If so, establish a clear draping line and explain what you plan to do. If the client declines, begin your session by laying a warm pack over the abdomen. At the point that you would normally massage the abdomen, simply lay your hands there gently, have the client breathe into your hands for a few breaths, and move on to another part of the body. • Explain the importance of working with the abdomen to help release nervous tension and how emotions affect the functioning of the gut or the relationship between tension in the diaphragm and esophageal reflux. • Tune in to the client's breathing. Explain to the client how deeper, more relaxed breathing can help a person cope with chronic tension. • Use the abdominal strokes you know more often. There are some abdominal massage strokes in every major style of massage. A basic massage of the abdomen generally requires only 5–10 minutes. • Study a type of bodywork that focuses on the abdomen. Visit Massageandbodywork.com to learn more about techniques. • Educate clients on the relationship between the abdomen and musculoskeletal aches and pains. Give the client homework: teach self-massage of the abdomen, show how to stretch abdominal muscles, and teach simple breathing exercises to release tension. Visit www.massageandbodywork. com for an abdominal self-massage routine handout for your clients. usually expressed by the emotions of the heart and chest: "Chatter and static fill the organism, the heart begins to pound, and the respiration may become shallow and rapid, or suspended. The belly mind, in the face of this raging turmoil, attempts to protect itself by contracting the diaphragm and the belly muscles, thereby cutting down on the emotions flooding it."3 Neglecting abdominal massage denies clients the chance to experience their bodies as a whole. This sensation of connectedness has been called "perhaps the single most pleasant sensation of a complete massage."4 ABDOMINAL ANATOMY The abdominal muscles are critical to efficient movement, intimately interwoven with the digestive and respiratory functions, and are prime repositories of emotional stress. The outer abdominal wall consists of the rectus abdominis, internal and external obliques, and the transverse abdominis. Together, these muscles create various movements, support the trunk against gravity, and help hold the abdominal organs in place. At the top of the abdomen, the wide, sheet-like diaphragm muscle performs respiratory movements and separates the abdominal and thoracic cavities, while the back of the abdomen is made up of three very important muscles: the psoas, iliacus, and quadratus lumborum. The abdominal viscera are surrounded by and intimately connected with the abdominal muscles, and the viscera may be powerfully