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CHILDHOOD ORIGINS OF ADULT MUSCULOSKELETAL ISSUES To incorporate this understanding into your practice, begin by asking more questions about childhood problems during your intake process. spinae muscles can also be activated by pediatric kidney stone pain.33 CONCLUSION Being informed about the childhood origins of adult musculoskeletal conditions can help you understand not only how a single event can have a body-wide impact, but give you a deeper understanding of how the body operates as a whole. This can make you more effective at identifying and "unwinding" old patterns. In addition, this can help you explain these patterns to your clients, and convince them (like Mark) to let you explore farther afield rather than at one limited area. To incorporate this understanding into your practice, begin by asking more questions about childhood problems during your intake process. Ask about anything unusual during birth or infancy, any chronic discomfort (such as growing pains), where stress was expressed in his or her body as a child, and any episodes of severe pain. Did the client have any postural issues as a child, such as turned-out feet or a high hip? You may obtain important clues as to deep, long- standing problems, and in addition, may be able to explain to clients why these long-standing problems might need long-term massage. massage therapist in Oregon for 35 years, and is the author of Pediatric Massage Therapy (Lippincott Williams & Wilkins, 2004). She has Marybetts Sinclair, LMT, has been a taught massage for both infants and children in many different settings, including special programs for children with disabilities in the United States, Ecuador, and Mexico. For more information, visit www.marybettssinclair.com. NOTES 1. J. Mackova, "Impaired Muscle Function in Children and Adolescents," Journal of Manual Medicine 4 (1989): 157–60. 2. A. Michele, You Don't Have to Ache: Orthotherapy, (New York: M. Evans and Co., 1971). 3. P. Wasserman et al., "Psychogenic Basis for Abdominal Pain in Children and Adolescents," Journal of the American Academy of Child and Adolescent Psychiatry 27, no. 2 (1988). 4. W. Lovell et al., Lovell and Winter's Pediatric Orthopaedics, 5th ed. (Philadelphia: Lippincott Williams & Wilkins, 2001); V. Pai, E. Tan, J.A. Matheson, "Box Thorn Embedded in the Cartilaginous Distal Femur," Injury Extra (2004): 35. 5. G. Null and H. Robins, How to Keep Your Feet and Legs Healthy for a Lifetime (New York: Four Walls Eight Windows Press, 1990), 132. 6. J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual, 2nd ed. (Baltimore: Lippincott Williams & Wilkins, 1999). 7. A. Gedalia et al., "Hypermobility of the Joints in Juvenile Episodic Arthritis/Arthralgia," The Journal of Pediatrics 107, no. 6 (1985): 873–6. 8. W. Lovell et al., Lovell and Winter's Pediatric Orthopedics. 9. A. Michele, You Don't Have to Ache: Orthotherapy. 10. W. Lovell et al., Lovell and Winter's Pediatric Orthopedics; M. Turner, "The Association Between Tibial Torsion and Knee Joint Pathology," Clinical Orthopaedics and Related Research (1994): 47–51. 11. R.L. Schulz and R. Feitis, The Endless Web: Fascial Anatomy and Physical Reality (Berkeley: North Atlantic Books, 1996), 14–15. 12. A. Michele, You Don't Have to Ache: Orthotherapy. 13. T. Bates and E. Grunwaldt, "Myofascial Pain in Childhood," Journal of Pediatrics 22, no. 4 (1952). 14. L. Staheli, Fundamentals of Pediatric Orthopedics (Philadelphia, Pa.: Lippincott Williams & Wilkins, 1998), 22. 15. J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. 16. G. Martin, "Trauma and Recall in Massage: A Personal Experience," Massage Therapy Journal, Winter 1985, 35–6. 17. Ibid. 18. D. Cheek, "Maladjustment Patterns Apparently Related to Imprinting at Birth," American Journal of Clinical Hypnosis, 18, no. 2 (1975): 390. 19. J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. 20. W. Proffitt, Contemporary Orthodontics (St. Louis: Mosby, 2000); J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. 21. W. Lovell et al., Lovell and Winter's Pediatric Orthopedics. 22. L. Koch, The Psoas Book (Felton, California: Guinea Pig Publishing, 1997). 23. W. Lovell et al., Lovell and Winter's Pediatric Orthopedics; B. Prudden, Pain Erasure (New York: Ballantine, 1982); J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. 24. S.D. Imahara et al., "Patterns and Outcomes of Pediatric Facial Fractures in the United States: A Survey of the National Trauma Data Bank," Journal of the American College of Surgeons 207, no. 5 (2008): 710–6. 25. J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. 26. W. Lovell et al., Lovell and Winter's Pediatric Orthopedics; J. Ogden, Skeletal Injury in the Child (Philadelphia: Lea and Febiger, 1982). 27. M. Crouchman, "The Effects of Babywalkers on Early Locomotor Development," Developmental Medicine & Child Neurology 28, no. 6 (1986): 757–61; I.B. Kauffman and M. Ridenour, "Influence of an Infant Walker on Onset and Quality of Walking Pattern of Locomotion," Percept Motor Skills, 45 (1977): 323–9; A. Michele, You Don't Have to Ache: Orthotherapy. 28. M. Turner, Clinical Orthopaedics and Related Research. 29. L. Koch, The Psoas Book. 30. J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. 31. W. Lovell et al., Lovell and Winter's Pediatric Orthopedics. 32. S. Aftimos, "Myofascial Pain in Children," New Zealand Journal of Medicine, (1998): 440–41. 33. J. Travell and D. Simons, Myofascial Pain and Dysfunction: The Trigger Point Manual. connect with your colleagues on massageprofessionals.com 55