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Williams & Wilkins, 2008), as well as numerous other publications. She is the 2008 recipient of the AMTA Jerome Perlinski National Teacher of the Year Award. The work described in this article is adapted from portions of the author's textbook Deep Tissue Sculpting (Body Therapy Associates, 2002). For these books and information about her certification program, Pre- and Perinatal Massage Therapy, call 800-856-8322 or visit www.bodytherapyassociates.com. NOTES 1. Carole Osborne-Sheets, Deep Tissue Sculpting, 2nd ed. (San Diego: Body Therapy Associates, 2002), 39–44. position.6 As pain subsides, encourage him to improve balance and strength in the iliopsoas, abdominals, erector spinae, quadriceps, and hamstring muscles. Practice pelvic tilting in lying, standing, and on all-fours positions. This uses the iliopsoas for pelvic positioning on the frontal plane and strengthens this muscle unit. Knee-to-chest stretches elongate lumbar and the hamstring myofascia.7 Another option is to actively stretch the quads and hamstring muscle groups after 2–5 seconds of muscle use against resistance.8 Healthy backs can benefit from more strenuous exercise and stretching, including yoga and movements that twist, rotate, flex, and extend the spine.9 You may need to evaluate the daily activities of low-back pain clients, as well as their environments and habits, to eliminate other factors contributing to their pain.10 While lumbar pain is a physical experience, most somatic psychologies suggest that tightened pelvic muscles reflect a need for control. These areas can harbor fear—of life, vitality, and sexuality. Nerves emerging from the lumbar spine activate the sexual and eliminative functions, as well as the legs and feet. Rigidity and imbalance here can block the pelvis from free movement, thereby inhibiting fluid walking, dancing, and sexual expression. Since lumbar alignment is a function of balance between the anterior and posterior musculature, consider some abdominal correlations too. Issues of nourishment and assimilation of emotions, as well as food, can settle here. Thus, lumbar tension might more fully resolve if a client is willing to explore his unexpressed emotions concerning nurturance and sexuality.11 REDUCING DISCOMFORT Low-back pain ranks second to acute respiratory illness as a cause of time lost from work.12 2. Carole Osborne-Sheets, Pre- and Perinatal Massage Therapy (San Diego: Body Therapy Associates, 1998), 12–16. 3. Ibid., 36–38. 4. Ibid., 135. 5. For another insightful look at myofascial lengthening in the low-back area, see Doug Alexander, "Lengthening Stereotypes," Massage Therapy Journal 38, no. 2 (Summer 1999): 40–54. 6. Maggie Leavin, Maggie's Back Book: Healing the Hurt in Your Lower Back, (Boston: Houghton Mifflin Co., 1976). 7. For a Feldenkrais approach to low-back care, see David Zemach-Bersin, Kaethe Zemach- Bersin, and Mark Reese, Relaxercise, (New York: HarperCollins Publishers, 1990). Some surveys estimate that 80 percent of all people will be affected by back pain some time during their lives, and it appears that massage therapy can help them.13, 14, 15 Your next week's client list will likely include several low-back pain sufferers. With this overview of the condition in mind and this hour-long protocol of deep- tissue techniques in your hands, you'll be ready to reduce their discomfort in a penetrating, yet sensitive way. Perinatal Massage Therapy (Body Therapy Associates, 1998), and a contributor to the textbook Teaching Massage (Lippincott Carole Osborne is the author of Pre- and 8. Aaron L.Mattes and Suzanne T. Mattes, Active Isolated Stretching: The Mattes Method (Aaron Mattes Therapy, 2006). 9. Oscar Ichazo, Psychocalisthenics: Master Exercise (Sequoia Press, 1993). 10. Leavin, ibid. 11. Kenneth Dychtwald, Body/Mind (New York: G.P. Putnam's Sons, 1986), especially Chapter 5. 12. Postgraduate Medicine Journal, 1981. 13. C.M. Godfrey, P.P. Morgan, and J. Schatzker, "A randomized trial of manipulation for low-back pain in a medical setting," Spine 9 (1984): 301–4. 14. Tiffany Field, Iris Burman, et al., International Journal of Neuroscience 106 (2001): 131–45. 15. D. C. Cherkin, D. Eisenber, K.J. Sherman, W. Barlow, T.J. Kaptchuck, J. Street, and R.A. Deyo, "Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low-back pain," Archives of Internal Medicine 161 (2001): 1081–8. visit massageandbodywork.com to access your digital magazine 69