BODYWORK AND PAIN

Can Bodywork Help?.

The answer is both yes and no. Appropriate bodywork can bring relief from pain and stiffness, increase mobility, assist balance and blood pressure control, or simply make us feel better. Bodywork that is too vigorous, or misdirected, may create more pain and discomfort, or even cause injury to our frail body.

During my illness phase, and during the many years leading to my illness, I tried many types of bodywork for many reasons. We have included a brief look at my journey below as it may reflect yours, or allow you to make better decisions. We’ve also included information on Bowen Therapy and how it works. A little later, we’ll give more information on the physiology of bodywork (knowledge brings understanding and power), plus specifics on what therapies to use and how to find therapists. In the meantime, continue with all the strategies detailed earlier and make sure that your water intake is now up to 1.5 litres (3 pints) each day).

BODY WORK – PLEASURE AND PAIN

A significant symptom of Parkinson’s disease is muscular stiffness, rigidity and pain.  During my long prodromal period of over thirty years (that is, the time when I had mild but unrecognised symptoms), I had sought therapies to alleviate and/or cure these symptoms, which were progressing slowly.

Chiropractic seemed to be a logical choice as most of my pain and stiffness was blamed on posture, work injury or car accidents and chiropractors were gaining credibility among many branches of medicine.  I persisted with chiropractic treatment for over 20 years with little success.  Certainly, I almost always gained some symptomatic relief after each treatment, but it did not “hold”.  Within two or three days, the symptoms would return, rapidly reaching the pre-treatment severity.  I sometimes had three or four treatments close together to try and consolidate benefits, but the result was the same – a rapid return to pre-treatment status.  A number of chiropractors told me that I was a “lifetime chiropractic patient”.

I tried massage on several occasions over the years and enjoyed the experience but, as with chiropractic, gained only short-term alleviation of pain.  Neither massage nor chiropractic could do more than lessen the pain level for a short time; they could not take it away.  Acupuncture and cupping were also tried at various times and were successful in easing specific symptoms at specific sites, but, again, brought no long-term relief.

By the time of my collapse with Parkinson’s disease symptoms in August 1995, I had been in escalating pain, with associated rigidity and stiffness, for over thirty years.  In fact, in June 1998 (after my recovery), I celebrated my first pain-free birthday in 35 years.

I visited a Craniosacral Therapist regularly for two years. My CT and MRI scans had eliminated the possibilities of MS, stroke, infarct, lesion and tumour, so the symptomatic diagnosis of Parkinson’s disease seemed logical.  The only contentious issue was whether the Parkinsonian symptoms were caused by head injury during my very early years (caused by having my head banged on the floor often) or were idiopathic as believed by my neurologist.

Craniosacral Therapy (CST), like other extremely gentle bodywork techniques, is a comprehensive, holistic therapy which can be used as a stand-alone therapy or in conjunction with any other allopathic, alternative or complementary modality.

There were three major aims as a focus for my CST:

• free up the cranial suture lines and allow normal movement again;
• improve the flow of cerebrospinal fluid (CSF) throughout the central nervous system (CNS);
• improve the vascularity, plasticity and vital strength of the bones in my skull damaged by repeated impacts – especially the left temporal bone.

Conventional wisdom accepts that it is normal for the skull’s suture lines to become immovable in some adults, especially older adults.  CS Therapists disagree.  In their view, the sutures need to remain free to make extremely small, but palpable movements in order to allow the CSF to flow freely.  The sutures can be felt to move in a rhythmic way, independent of cardiac and respiratory rhythms, which coincides with the production and flow of CSF.  If the sutures are completely immovable, the movement of CSF is inhibited, causing nerve dysfunction.

The brain is covered by the dura mater, part of the continuous fascia that surrounds all subcutaneous parts of our body.  Lymph and cerebrospinal fluid spread throughout the craniosacral system via channels in the fascia.  Inhibition of movement in the skull’s sutures also impedes flow of CSF through the fascia.  As this is continuous throughout the body, this inhibition can have detrimental effects far from the cause.  Areas of particular concern are the tentorium cerebelli and falx cerebri, folds in the dura mater that extend into major brain fissures – the cerebrum/cerebellum fissure and the longitudinal fissure respectively.  These folds may be damaged during birth (too fast, too long in the birth canal, or forceps delivery) and are particularly far reaching in their effect on all body systems.  Injuries similar to birthing injuries are likely to cause similar detrimental effects.

Early in my adventure, a colleague gave me fortnightly deep massages.  We theorised that the significant muscle movement which occurs during massage would ease rigidity and enhance the work done by CST.  We were wrong.  While I felt invigorated and encouraged after each massage, my body rebelled within twenty-four hours by giving me dreadful cramps and pain in all the muscle groups massaged. I persisted for a few weeks hoping that my body would get used to the procedure as I was in the habit of “making my body obey me”, but had to give up, as the pain was too great.

I later received some gentle relaxation massages from another colleague.  While these did little for my rigidity and pain, they definitely increased my sense of well-being and helped me reconnect my poor old body with the “real person hiding inside”.

Greg Morling (a massage instructor) has written a useful article on massaging Parkinson’s disease patients and emphasises the need to be aware of the frailty of the Parkinsonian body.  I am convinced that there is a significant place for careful, aware massage in the treatment of Parkinson’s disease.  Massage will not cure any of the Parkinsonian symptoms, but will enhance the ability of the Person With Parkinson’s to pursue their goal of recovery.

Feldenkrais is a bodywork modality developed by Moshe Feldenkrais to facilitate the “integration of the skeletal, developmental, environmental and neuromuscular systems”.  It offers a framework in which the patterns of movement, thought and feeling can be explored.

Moshe Feldenkrais said of his method, “What I’m after isn’t flexible bones but flexible brains.  What I’m after is to restore each person to their human dignity.”

There are two processes in working with Feldenkrais.  Awareness Through Movement (ATM) sessions involve the therapist verbally guiding their client through a series of movements, drawing attention to how they move and encouraging them to use their attention, perception and imagination to discover more efficient and effective ways of moving.

In Functional Integration (FI) sessions, the therapist moves the client, or uses their hands to guide the client’s movement in patterns that will help restore awareness and balance.

I commenced a series of Functional Integration sessions with a practitioner I had contacted through my work as a masseur.  At each session, I lay supine on a low padded table while the practitioner moved quietly around me gently stretching or rearranging my limbs, pushing or just touching head, hands, face, hips.  With each move, she tried to bring some balance back to my distorted, frail body while I entered a state close to trance and felt a “connection” develop between my spirit, mind and body.  I often felt quite euphoric as I left a session and had to be particularly careful while driving as it was easy to “go off with the fairies” until I grounded myself again.

I enjoyed my FI sessions but the results were always temporary.  Within a day or two, the sense of wellbeing and reduction in pain would dissipate and I would be back to square one.  I was referred to Basil Glazer (a prominent Feldenkrais teacher) during his visit to Melbourne in 1996.

Basil’s treatment was much stronger than my practitioner’s.  He pulled and stretched my body in ways that seemed right and balancing at the time and, because of this, I did not object to the pain caused by the treatment.  At the end of the session, I felt taller, stood straighter and moved with more assurance.  I thought we had achieved a breakthrough.  However, twenty-four hours later, I was in agonising pain.  My whole body seemed to be cramping, aching and burning with deep, deep pain.  My body had rebelled again.  Some three days later, I was back in my pre-treatment state; very disappointed.

I decided not to pursue Feldenkrais as a therapy.  This may have been a mistake.  Had I persisted with my practitioner’s gentle treatment, I may well have made progress like “Elizabeth” who recovered from stage I Parkinson’s disease using Feldenkrais as a major therapy.  However, I was short of money and tired of pain, so gave up.

Late in 1997, CST seemed to have achieved all it was going to achieve.  I had made good progress in flexibility and mobility but had “plateaued”.  I took a short rest from bodywork, then looked around for “the next step”.  I had trained in Bowen Therapy sometime earlier but had never seriously pursued it as a therapy for myself.

I began fortnightly treatments with my Bowen teacher.  My major physical problems were a persistently locked and painful right shoulder with consequent restriction of arm use (I had been unable to fold my arms for two years), nagging pain and restriction of my right hip and continuing stiffness of most back muscles, more on the right side.  Other than my shoulder, these symptoms were greatly reduced from my condition in 1995, but I was determined to be completely well, not just better.

The Bowen technique is simple and minimalistic in its approach.  Very gentle, rolling moves are made across specific points of soft tissue to encourage energy flow – a concept similar to that of acupuncture where needling is used to encourage the flow of Qi.  The Bowen technique includes pauses where the therapist moves away from the client and may leave the room.  This allows the client’s body to respond to the therapist’s touch in its own time, rather than having the “therapist’s will imposed”.

After several treatments from my teacher, my stiffness and pain were reduced and mobility increased but the pain and restriction in my right shoulder persisted.  My teacher took me to Kevin Ryan in Geelong, one of Tom Bowen’s original students.  Kevin’s treatment lasted about twenty minutes and, as I sat down afterwards, I folded my arms without thinking.

This was a moment of great celebration; I had been frustrated by the pain and restriction in my right arm, and now, at last, I could fold my arms with only a little stiffness.  My condition improved rapidly as I re-commenced regular Bowen Therapy treatments with my teacher.

Can Bowen Therapy Help?

Bowen therapy is very gentle bodywork developed by Thomas Ambrose Bowen in Geelong, Australia during the late 1940s and early 1950s.  It consists of gentle, rolling movements across muscles, ligaments and tendons to relieve pain, spasm and stiffness of movement.

Tom Bowen was intuitive in his diagnosis and could often correct dysfunction with a single treatment or, at the most, three.  He was extremely busy, often seeing 14 patients per hour; this equated to approximately 13,000 patients per year.  He successfully treated all sorts of conditions ranging from intractable pain, muscle spasm, sporting injuries, respiratory problems to arthritis and other chronic disorders.

Bowen therapists today do not see patients at the same rate as Tom Bowen during his busiest years.  While some therapists may have two rooms in operation at once, many see one patient at a time and spend from half an hour to one-and-a-half hours in treatment.

A Bowen therapy session consists of light movements across the bellies of muscles, tendons or ligaments, then pauses for two or more minutes to allow your body to make adjustments.

There are a number of theories concerning the way Bowen therapy works.  Current research indicates that there are probably two major effects created by the therapist’s moves during a Bowen therapy session.  The first is the movement of water through the fascia.

Fascia (a substance rather like fresh egg white) covers all parts of our body including organs, muscles, bones, tendons and ligaments, and the brain (the dura). See later for more detailed information on Fascia. This fascia carries fluids, immune system cells, and other elements vital to our wellbeing.  During times of illness, fatigue or stress, fascia can become thick/sticky (“cook”) and firmly attached to the muscle or bone it surrounds, and no longer allow free movement of fluid and nutrients.  This can create discomfort, stiffness or pain and inhibit our return to wellness. It may impinge on nerves where they emerge from the spinal column, thus creating pain distant from the site of fascial “cooking”.

Bowen Therapy effectively frees the fascia through a process called thixotropy, and allows free movement of fluids again, thus reducing pain and mobilising joints.  At the same time, the therapy enhances the work done by the Aqua Hydration Formulas.  The Aquas help us to absorb water into our cell structure, while Bowen Therapy circulates that water around the body.

The second major effect of a Bowen therapy treatment is a movement of electrical energy throughout the body.  This can be thought of as electrical current, Qi, Prana or life-energy depending on your personal philosophy.  However we view (and this electrical flow has now been measured by western scientists) it, it is vital to have a balanced electrical energy flow throughout our bodies for us to feel well and satisfied with our life.  The moves in a Bowen therapy session serve to remove blockages, correct imbalances, and restore free flow of electrical energy over the whole body, even though the moves are made in only specific points.  This is similar to the work done in acupuncture or acupressure.

Bowen therapy is very powerful treatment for pain, injury and a number of illnesses.  However, I have found in the treatment of neuro and autoimmune disorders, it works best with the Aqua Hydration Formulas.  While some improvement in neurological disorder symptoms can be obtained by using only Bowen therapy, the results are generally slow and unsatisfying.  Using the hydration effect of Aqua Hydration Formulas, plus the hydrating and balancing effect of Bowen therapy is very powerful medicine indeed.  All those who have come to me with neuro and autoimmune disorders, and persisted with this therapy, have made great steps forward in returning to wellness PROVIDED they are diligent in all the self-help and other recovery strategies detailed in earlier classes.

You may already be trying some form of bodywork. Continue with this for now if you feel that you gain benefit. If you feel little improvement, perhaps some of the explanation above will help you understand why.

Homework

This week, write some notes about all the forms of bodywork you have experienced, with an assessment of gains or lack of gain for each. Think about the process of each type – did the treatment hurt or was it pleasant? Did you feel immediate benefits, or was there a delay of a day or so before you felt better? Did you find the therapist supportive or “offhand”?

FASCIA AND BOWEN THERAPY

The notes on Fascia below are extracted from Wilkepedia, the online encyclopedia. You may not want to read through all of this information, although I believe that the more we know, the greater power we have to create health. The most important words are shown in bold green towards the end of the article. Please read this as it shows how fascia plays a significant role in stiffness and pain while we exhibit symptoms of Parkinson’s disease, and how this relates to our explanation of the development of Parkinson’s disease.

Fascia (făsh’ē-ə), pl. fas·ci·ae (făsh’ē-ē), adj. fascial (făsh’ē-əl) (from latin: a band) is the soft tissue component of the connective tissue system that permeates the human body. It interpenetrates and surrounds muscles, bones, organs, nerves, blood vessels and other structures. Fascia is an uninterrupted, three-dimensional web of tissue that extends from head to toe, from front to back, from interior to exterior. It is responsible for maintaining structural integrity; for providing support and protection; and acts as a shock absorber. Fascia has an essential role in hemodynamic and biochemical processes, and provides the matrix that allows for intercellular communication. Fascia functions as the body’s first line of defense against pathogenic agents and infections. After injury, it is the fascia that creates an environment for tissue repair.

Three layers of the fascia

• Superficial fascia is found in the subcutis in most regions of the body, blending with the reticular layer of the dermis. It is present on the face, over the upper portion of the sternocleidomastoid, at the nape of the neck, and overlying the sternum. It is comprised mainly of loose areolar connective tissue and adipose and is the layer that primarily determines the shape of a body. In addition to its subcutaneous presence, this type of fascia surrounds organs and glands, neurovascular bundles, and is found at many other locations where it fills otherwise unoccupied space. It serves as a storage medium of fat and water; as a passageway for lymph, nerve and blood vessels; and as a protective padding to cushion and insulate.

• Deep fascia is the dense fibrous connective tissue that interpenetrates and surrounds the muscles, bones, nerves and blood vessels of the body. It provides connection and communication in the form of aponeuroses, ligaments, tendons, retinacula, joint capsules, and septa. The deep fasciae envelop all bone (periosteum and endosteum); cartilage (perichondrium), and blood vessels (tunica externa) and become specialized in muscles (epimysium, perimysium, and endomysium) and nerves (epineurium, perineurium, and endoneurium). The high density of collagen fibers is what gives the deep fascia its strength and integrity. The amount of elastin fibers determines how much extensibility and resiliency it will have.
• Visceral Fascia suspends the organs within their cavities and wraps them in layers of connective tissue membranes. Each of the organs is covered in a double layer of fascia; these layers are separated by a thin serous membrane. The outermost wall of the organ is known as the parietal layer, whereas the skin of the organ is known as the visceral layer. The organs have specialized names for their visceral fasciae. In the brain, they are known as meninges; in the heart they are known as pericardia; in the lungs, they are known as pleura; and in the abdomen, they are known as peritonea.

Fascial Dynamics

Fascia is a highly adaptable tissue. Due to its elastic property, superficial fascia can stretch to accommodate the deposition of adipose that accompanies both ordinary and prenatal weight gain. After pregnancy and weight loss, the superficial fascia slowly reverts to its original level of tension.

Visceral fascia is less extensible than superficial fascia. Due to its suspensory role of the organs, it needs to maintain its tone rather consistently. If it is too lax, it contributes to organ prolapse, yet if it is hypertonic, it restricts proper organ motility.

Deep fascia is also less extensible than superficial fascia. It is essentially avascular, but is richly innervated with sensory receptors that report the presence of pain (nociceptors); change in movement (proprioceptors); change in pressure and vibration (mechanoreceptors); change in the chemical milieu (chemoreceptors); and fluctuation in temperature (thermoreceptors). Deep fascia is able to respond to sensory input by contracting; by relaxing; or by adding, reducing, or changing its composition through the process of fascial remodeling.

Deep fascia can contract. What happens during the fight-or-flight response is an example of rapid fascial contraction. In response to a real or imagined threat to the organism, the body responds with a temporary increase in the stiffness of the fascia. Bolstered with tensioned fascia, people are able to perform extraordinary feats of strength and speed under emergency conditions.

It has been suggested that manipulation of the fascia by acupuncture needles is responsible for the physical sensation of qi flowing along meridians in the body. As explained above, allowing fascia to become more “fluid” during Bowen Therapy is one reason for its effectiveness.

Why Bowen Therapy?

During 1999 and 2000, I conducted an informal trial of Aqua Hydration Formulas and bodywork combinations.  Therapies included Craniosacral Therapy, Remedial Massage, Feldenkrais, Reflexology and Bowen Therapy.  Over a period of eighteen months, I observed that those using Bowen Therapy made better progress. This does not mean that the other modalities were not useful. All the therapies included, provided they were administered by an empathic, loving practitioner, gave many benefits. My judgement of “progress” focused on reduction of symptoms and long-term ability to function with less medication or not require medication for a longer period.

We explained last week that Bowen Therapy produces a thixotropic effect on fascia, allowing fluids to flow freely again. The explanation of fascia above shows us that fascia extends around our brain and central nervous system (CNS). We can see, then, that better fluid flow through fascia may bring improved hydration of brain and nerve cells.

This has many other benefits; for instance, Bowen Therapy can help move accumulated waste products out for adipose (fatty)) tissue as the fluids flow more freely; drugs that have been accumulating in tissue (and this does happen in tiny quantities over long periods) may be expressed into the blood stream and become available for absorption into cells – thus making medication more effective at lower doses; blood pressure may be stabilized within normal range; joints may become freer in movement with reduced stiffness and pain.

There are also specific Bowen Therapy sequences that can help with bladder control, bowel function, digestion, respiration, headache, and many other symptoms.

However, not all Bowen Therapy is the same.  There are many Bowen Therapists who believe that firm or hard touch is required. We must remember that, even in the early stages of Parkinson’s disease, we have many fragile cells and a degree of constitutional frailty that needs to be respected. Because of this, we may respond painfully or negatively to bodywork that is too hard, rough or vigorous.  Bowen Therapists using hard touch can diminish the chances of recovery for those with Parkinson’s disease because of the discomfort caused.

On the other hand, there are a growing number of dedicated Bowen Therapists learning as much as they can about the process of degeneration and recovery, and working with loving gentleness to assist their patients on a healing journey.

Beware of claims that a practitioner knows “original Bowen”. There are some schools and practitioners who claim to be the “guardians” of Tom Bowen’s original technique. The truth is that nobody practices like Tom Bowen any more. Tom’s genius died with him. What we now have is a marvelous healing technique that is used, interpreted, taught and received in many countries.

There are many schools of Bowen, often operating under different names to make it clear that this is an “interpretation’ of Tom’s work. In truth, all Bowen taught and used today is an “interpretation” of Tom’s technique.

If your Bowen Therapist treats you with respect, and respects the power of the technique they bring to you, you will receive benefit from their work, no matter what it is called. Bowen is Bowen and comes from the heart.

If your chosen Bowen Therapists has any doubts or questions about how to treat someone diagnosed with Parkinson’s disease, we can direct them to experienced therapists who can give guidance and reassurance. Just contact us at  our contact email address or ask your therapist to make contact with an email addressed to John – Bowen Therapist Enquiry and we will follow up.

PLEASE NOTE:         Do not undertake any other form of bodywork within four days of a Bowen Therapy treatment.

                                    Do not use any artificial heat, such as electric blankets, hot water bottles or heat packs, on your body until the day after receiving Bowen Therapy. In fact, you should never use excessive heat on your body, or hot water bottles or electric blankets, as this can “cook” fascia very quickly.

Finding a Bowen Therapist near you

In Australia, information and practitioner contact numbers can be obtained from the associations below.

I have conducted seminars for many practitioners to help them better understand how to help you so you may find someone who has personally experienced my work or teaching. If not, don’t be disappointed, the vast majority of Bowen Practitioners/Therapists are skilled and willing to help.

BOWEN THERAPISTS FEDERATION OF AUSTRALIA

Email: info@bowen.asn.au

Website: www.bowen.asn.au

NEUROSTRUCTURAL INTEGRATION TECHNIQUE (World Wide)

www.nsthealth.com

INTERNATIONAL SCHOOL OF BOWEN THERAPY (Australia and Europe)

www.bowen-therapy.com

BOWEN THERAPY ACADEMY (International)

www.bowtech.com

Phone:  +61 (03) 5572 3000

Fax:  +61 (03) 5572 3144

Email:  bowtech@h140.aone.net.au

U.S.A. CONTACTS

www.usbowen.com

U.K. and EUROPE CONTACTS

www.thebowentechnique.com ,  www.bowentherapy.fsnet.co.uk

INFORMATION FOR BOWEN PRACTITIONERS AND THERAPISTS

Please print the letter below and take it with you when you visit your chosen Bowen Therapist, especially the first time, and ask them to read the directions below.  I do not claim to be an expert in Bowen Therapy, but have unique experience in treating neurological disorders, and offer the advice below from that experience.

PLEASE NOTE: Do not undertake any other form of bodywork within four days of a Bowen Therapy treatment.

                              Do not use any artificial heat, such as electric blankets, hot water bottles or heat packs, on your body until at least a day after receiving Bowen Therapy. Electric blankets and hot water bottles are never beneficial to your health.

Dear Bowen Therapist,

Neurological disorders are difficult to treat for three reasons.

1. The skeletal and muscular dysfunctions we observe are neurological in origin and do not respond to Bowen in the same way as physical injuries and skeletal imbalances.
2. The symptoms occur as a result of damage to, or destruction of specific brain cells and/or dysregulation of specific neural pathways. Therefore, long-term or permanent improvement can only result from repair, replacement or regeneration of these brain cells and neural pathways.
3. Repair, and consequent resolution of symptoms, takes a very long time, and cannot be hurried.

Each Bowen session serves a number of purposes. Each of these purposes is equally important, and it is vital that we do not concentrate solely on the physical manifestations of the disorder. 

Each time you see your patient, you bring to them the following gifts:

1. Contact with a professional health practitioner who believes they can become well.
2. Contact with a health practitioner who gives them time to speak and listens to what they have to say.
3. The knowledge that they are complete, beautiful human beings, worthy of your undivided care and attention.
4. The healing touch of Bowen Therapy.
5. The certainty that they will receive the comfort you give them on a regular basis.
6. An assessment of their current condition and progress over time.

Even though there are a number of Bowen Therapy schools teaching different interpretations of Tom Bowen’s work, all are valid; all can help people with neurological disorders move toward wellness.  There are, however, principals of treatment which should be observed closely:

• If it hurts, it’s too hard. The purpose of Bowen Therapy in treating neurological disorders is to pump water, balance energy and encourage regeneration/reactivation of brain cells and neural pathways. Therefore, the therapy does not need to be hard or deep.  In my experience, digging too deeply into muscles that are rigid, locked and painful is counter-productive; it causes the muscles to become even more rigid, creates pain, and operates on a physical, rather than a neurological level.
• All treatment should be symmetrical, except for the coccyx move, specific brain-balance sequences and extraordinary circumstances. Two of the purposes of using Bowen Therapy are to encourage symmetrical energy within the brain and symmetry of physical movement.  Therefore, the therapy needs to be symmetrical.  The coccyx move is, of its nature, asymmetrical and serves to promote symmetry of energy along and around the spine.  Occasionally, there is a need to treat a specific asymmetrical condition such as a frozen shoulder or asymmetrical back pain.  Asymmetrical treatment is appropriate here, but it needs to be understood that this is simply treating the physical symptoms of a neurological condition.
• Bowen Therapy can’t do it alone. It is tempting to think that persistent use of Bowen Therapy will eventually create a healing pathway without recourse to any other therapy.  In my experience, this is not possible with neurological disorders.  Bowen Therapy is a critical, integral part of a synergistic recovery programme.  It helps give mobility and peace as well as the benefits described above.
• Many of our patients are old, frail and rigid. All are very sensitive.  It is very important to move each muscle group or limb only as much as is comfortable for the patient.  The rigidity, pain and/or slowness of movement shown by our patients is neurological in origin, and we must be patient in “re-educating the brain” to allow freedom of movement.  It has been my personal experience that attempting to create freedom of movement by challenging muscle groups is painful, depressing and inclined to set us back or discourage us from trying to get well.

Bowen Therapy is one way to gain a real appreciation of the progress toward health each person is making.

IS THERE A STANDARD PROTOCOL?

Following the first one or two treatments, I find it most effective to give my patients a “complete” treatment at each visit.  I do not intend to describe specific moves to use during any one treatment, rather I wish to set down principles of treatment I have found to be effective over the last twenty years.  Because each interpretation of Tom Bowen’s work names moves differently, I will give general descriptions only.

Each practitioner should assess his or her client on each visit as you do now.  Treatments may need to be varied from a set routine because of particular stresses, accidents or changes in your client’s condition.

On the first two visits, I suggest that basic moves only be used covering the back, neck and legs.  On the second visit, it may be useful to introduce the TMJ move if your client is robust enough.  This can assist with balance and mobility.

 From the third visit, I like to do a “complete” Bowen treatment each time.  This includes the basic back moves (sometimes freeing the erector spinae muscles) and, often, extra hip moves where mobility is a problem, plus sacrum and hamstrings while prone.  I almost always include either a coccyx balance or, when supine, the pelvic/psoas moves.  In the supine position, I use abdominal moves, neck, knee, ankle, shoulder, elbow and wrist (carpal tunnel) and, almost invariably, the TMJ.  I work slowly and very lightly, with long pauses, to let each client relax and gain full benefit from the treatment.

If you are skilled in any form of foot or cranial work, you may wish to incorporate some individual moves into your routine.  However, people receiving basic Bowen Therapy from a loving practitioner who uses a very light touch make good progress.  I cannot emphasise enough how important it is to use EXTREMELY LIGHT touch.  Firmness of touch will only result in discomfort and aggravation of symptoms.

Following testing during 2001, we have been able to estimate that Bowen Therapy constitutes about 25% of the physical recovery process (remember, at least 80% of healing comes from within the patient).  It works synergistically with the Aqua Hydration Formulas that do about 60% of the physical work. Bowen can be vitally important to people recovering from neurological disorders, but will give greatest benefits when used with hydration therapy.

Remember, you are the practitioner your client sees most often.  Therefore, you have a unique opportunity to join them on their great adventure.  I encourage you to participate fully and enjoy the experience.

Please contact me at parkinsonsrecoveryprogram.com if you have any questions about Bowen Therapy for neurological disorders, or wish to discuss the progress of your client.

Thank you for your care,

John Coleman, ND, MANPA, MBTAV

WHAT IF YOU CAN’T FIND A BOWEN THERAPIST NEAR YOU?

While Bowen Therapy is a most helpful and healing modality, People with Parkinson’s can and do recover without it.

So why do I spend so much time talking about it? Because we have evidence that Bowen Therapy can assist in the healing process. However, we have also seen excellent results from other bodywork modalities that can help enhance your road to wellness.

Craniosacral Therapy and Feldenkrais have been discussed above, and both have been shown tio be healing and helpful for People with Parkinson’s when provided by an empathic and aware practitioner.

Alexander Technique: a body “re-education” technique developed in Tasmania, Australia during the first half of the 20^th century. There is some useful information on this website: https://www.alexandertechnique.com/at.htm.

There have been some small trials of Alexander Technique for People with Parkinson’s and these have shown useful benefits for those participating. Here is one: https://alexandertechnique.co.uk/research/randomized-controlled-trial-alexander-technique-for-idiopathic-parkinsons-disease

As with all bodywork, Alexander Technique will only be of long-term benefit when you, the patient, employs all the self-help strategies discussed in these classes as well as the Alexander Technique.

I made enquiries about becoming an Alexander Technique teacher some years ago, only to find that the training was enormously expensive (prohibitive for someone like me on a limited income). This means that some Alexander teachers charge high prices for sessions. However, there are some who have managed to defray the cost of their training to the extent that they can offer sessions for patients/clients at reasonable cost.

Clinical Pilates: I included Pilates as a preferred exercise modality in class 8. However Clinical Pilates, that is one on one sessions with a teacher, can be very valuable and helpful in repairing mobility and balance issues while gaining strength in weekend muscle groups.

While the Pilates teacher does not necessarily need specific training or experience in treating Parkinson’s disease (although this could be useful), they do need extensive experience in treating fragile and debilitated patients and access to a wide range of Pilates equipment for best results.

This is an informative article on treating Parkinson’s disease with Pilates: https://www.pilates.com/BBAPP/V/pilates/library/articles/pilates-for-people-with-parkinsons-disease.html.

This is a very small study on including Pilates as an adjunct to other physical theory modalities to help People with Parkinson’s: https://clinicaltrials.gov/ct2/show/NCT03294031.

In summary; if you have access to an experienced Pilates teacher with a range of equipment, and can afford individual instruction weekly or each two weeks, you will gain benefits on your journey to wellness.

Reflexology: is a modality using pressure on specific points on the sole of the foot (although the practice can be used on hands and head as well) to effect organs, muscles and nerves throughout the body. Reflexology is related to acupuncture and acupressure in its principles and benefits.

Reflexology does not, and cannot, treat the causes of symptoms of Parkinson’s disease directly, but can bring benefits by improving function of detox organs (liver gall bladder, bladder, spleen, etc), calming or balancing nervous systems and relieving discomfort in major areas of the body.

A reflexology treatment may not be comfortable as it may be necessary to use firm pressure on points that can be sensitive, but the results can be quite dramatic if the Reflexologist is highly skilled. Sciatic pain may be relieved, sinus congestion cleared, headaches relieved and general wellbeing enhanced.

Here is a useful article on Reflexology: https://www.spafinder.com/blog/healing/reflexology-101-treatment-benefits/.

If you have access to a qualified and skilled Reflexologist, you may wish to consider one or more treatments to help with specific challenges and/or general wellness.

Massage: There is significant literature on the benefits of massage for general wellbeing, physical recovery and, in some cases, People with Parkinson’s. Some Parkinson’s blogs and newsletters suggest massage as useful and supportive.

There is little to suggest that massage can, in any way, reverse the symptoms of Parkinson’s disease. However, appropriately applied, massage can improve quality of life by improving mobility, calming “overheated” nerves, helping us relax, and temporarily increasing the output of “reward” neurotransmitters like dopamine, serotonin and anandamide.

My personal experience, as related in “Shaky Past” (https://www.returntostillness.com.au/shop.html#!/Shaky-Past-paperback-236-pages/p/53882379/category=14192205) shows that vigorous therapeutic or sports massage is often counter-productive when we are so fragile. However gentle relaxation massage can have many benefits. My subsequent clinical experience supports that view.

If you are feeling stiff, sore and a bit sorry for yourself, relaxation massage may be one useful technique to support your path to wellness.

Acupuncture: is an ancient Chinese modality ion which very fine needles are inserted through the skin at set points to stimulate organs and nerve pathways related to “meridians” (energy or Qi/Chi pathways in ancient Chinese anatomical philosophy), thus assisting the body to correct imbalances and mitigate symptoms.

Conservative Western Allopathic Medicine practitioner often discount acupuncture as “pseudoscience”, but quality studies and meta analyses show otherwise.

A meta-analysis published in “Medicine” (Baltimore) in 2017 shows “significant positive effects” for People with Parkinson’s (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5279085/), while other sources indicate that acupuncture “could be” beneficial for People with Parkinson’s.

Once again, the benefits of acupuncture depend heavily on the skill of the practitioner and whether it is worthwhile depends on our expectations. Acupuncture will not cure or reverse Parkinson’s disease, but can be useful in improving energy and mitigating symptoms.

You may find acupuncture useful as an adjunct to self-help and lifestyle strategies on your path to wellness.

Yin Tuina: is a Chinese modality that is well over 5000 years old. There are no independent studies on the benefits of Yin Tuina for People with Parkinson’s, but one long-term project has claimed significant results.

Tuina has been used and notated by Chinese physicians for several thousand years, and has been taught in Chinese Universities and Colleges of Traditional Chinese Medicine since the mid twentieth century.

While Tuina is a subtle, deep and variable modality, it can be approximately divided into two styles – Yang Tuina which is vigorous and, often, painful but extremely effective in the right circumstances (I was trained in this during the 1990’s) and Yin Tuina which is extremely gentle but very powerful.

I introduced Yin Tuina into my practice in the year 200 as an adjunct to Bowen Therapy after being made aware of its possibilities by a patient. I found a variety of references and trained for some months before experimenting with a combination of Bowen Therapy and Yin Tuina on the feet only for People with Parkinson’s.

While there were no “Eureka” moments, Yin Tuina, properly applied, did seem to assist balance and mobility in many, and helped calm “overheated” nervous systems.

There are claims that using full-body Yin Tuina can completely reverse the symptoms of Parkinson’s disease, but I have not found any evidence or case histories confirming this. That is not to say that it can’t work, but there is simply no independent evidence supporting the claims and those I know who have tried this protocol have not succeeded in reversing their symptoms.

That being said, if your Bowen Therapist is trained in Yin Tuina (or would like to contact me for information), you may gain benefit from its regular inclusion in Bowen Therapy treatments.

References

• MORLING GREG; “Parkinson’s disease and massage therapy”, International Journal of Alternative and Complementary Medicine, Vol 16 No 3, March 1998, pp 24-25
• CHAITOW LEON “Muscular Influences on cranial dysfunction”, International Journal of Alternative and Complementary Medicine, Vol 16 No 2, February 1998, pp 31-33.
• “Craniosacral Therapy”, Craniosacral Therapy in the Canary Islands, a brochure prepared by the College of Craniosacral Therapy.
• BAKER JULIAN “Less is more”, International Journal of Alternative and Complementary Medicine, Vol 14 No 12, December 1996, pp 16-18.
• STAMMERS GLENN “The Bowen Technique”, WellBeing Magazine, International Edition, No. 65, pp 88-89.