Sunday, January 20, 2013



I have noticed on Facebook a lot of comments and discussion about the properties of a specific muscle. I know we study individual muscles in school.  I even have individual muscle content in my textbooks. But—I know that in the real world there is no such thing as an individual muscle. Each skeletal muscle is an individual organ made of hundreds or thousands of muscle fibers (or cells), large amounts of connective tissue and nerve fibers, and many blood vessels. –the muscle organ!

Most daily activities require the coordination of complex neuromuscular interactions. Myotatic units are functional muscle groups. They are interconnected with fascia and networked neurologically so that movement occurs smoothly, sequentially, and in a coordinated manner. Only rarely does any muscle act independently.  All functional movement patterns involve acceleration provided by concentric muscle action, stabilization provided by isometric muscle action, and deceleration provided by eccentric action. Every so called “muscle” can perform all the actions but not at the same time. The function of the muscle organ shift just like how we can be a parent, massage therapist and spouse

Most muscles play a part in a movement pattern, just as actors do in a play. Roles can change, depending on the response required. A muscle can be the star, or prime mover, and in the next instant become one of the supporting cast.  A moment later the same muscle can assume the opposite role. Remember, three types of muscle actions exist: concentric, in which the muscle shortens producing movement (acceleration) and the joint angle decreases; eccentric, in which the muscles maintains a controlled lengthening (deceleration) response as the joint angle increases; and isometric, in which the muscles shortens but produces no movement. The terms mover (agonist), prime mover, antagonist, fixator (stabilizer), neutralizer, support, and synergist describe the function of muscles in a complete movement pattern.  .The nervous system accomplishes the fine control of muscle organ interaction over a wide range of lengths, tensions, speeds, and loads.

The mover/antagonist interaction is easy to visualize in muscle pairs such as the biceps brachii, which flexes the elbow joint, and triceps brachii, which extends the elbow joint. However, the interaction becomes more complex when we consider that the deltoid and quadriceps femoris and the adductors and hamstrings form a functional unit because of our gait, or walking pattern. The various functional units that require muscles to cooperate in producing body wide movements (e.g., walking, maintaining balance) need sophisticated reflex control by the nervous system.. Muscle units also must react proprioceptively to gravity, momentum, external forces, and forces created by other functioning muscles units.

The body functions as a linked system of interdependent segments involving the entire neuromuscular, connective tissue, articular system which is linked each segment to the next. The parts of the body act as a system of chain links so that the energy or force generated by one part of the body can be transferred successively to the next link. The optimum coordination (timing) of these body segments and their movements will allow for the efficient transfer of energy and power up through the body, moving from one body segment to the next. Each movement in the sequence builds upon the previous motion.. Connective tissue binding, joint injury, or degeneration or neurological and balance problems are causes of dysfunction. Regardless of where the problem begins, eventually the entire chain is affected.


Thursday, January 10, 2013




Each step takes a year
I had a few conversations yesterday that have made me do some thinking.  One had to do with why the entry level massage education at Health Enrichment Center (my school) takes a year.  Another involved how long it would take for an ACL repair on a knee would take to fully heal-a year.  I was also responding to a question about why I changed my advanced program at the school from a two year diploma to a one year certificate.  Then I was posting on Facebook about the Entry Level Analysis Project (ELAP) and fussing that the release of the findings were delayed until April which would be about a year since the process started so I stopped fussing.  
You get the idea.  What is it about 12 months?  I don’t have an academic or even sort of logical answer right now but the pattern is persistent.  I have been teaching massage for close to 30 years now. Over this time at the school we have had 12 month programs, 6 month programs, 10 week programs, 18 month programs, 9 month programs and 24 month programs.  In the fall we implemented the new curriculum based on licensure in Michigan and were going to offer a 12 month and 6 month format.  The 12 month program began last September and the students are doing great.  There are 500 hours in the classroom and 100 hours online. Classes are one day a week and toward the end there will be a few weekends.  Soon we will start another 12 month program on weekends.   We were going to do a 6 month program in March but I changed my mind.  6 months is just too short. 

I provide massage to many athletes and there are always injuries to deal with. Over and over I have seen the individual attempt to go back to competition too soon and end up with more problems instead of less. The demand on them is to return to practice and play as soon as possible.  That is what happens but there is usually diminished performance.  I have been involved in many rehabilitation situations and motivation diminishes as time progresses.  Rehab is repetitive, cumulative, presented in stages where the acute, sub-acute and finally remodeling phases of healing progresses. There are time of regression and frustration and well as leaps in function and then doing too much too soon with some level of re-injury or interruption of the healing.  Typically in a year function returns.
 When I analyze the massage curriculum here at Health Enrichment Center , the first six month is when the information is presented and skills are learned- the student begins as a novice and at the end of the 6 months functions as a beginner.  The next 6 months is about integration, understanding and confidence and that second six months is really important whether you are learning or healing.  This is the time period where strength, function, and tissue remodeling occurs in the healing process and for learning it appears to me that that second 6 month period Is when the students begin to get it and become ready to enter the massage profession as an advanced beginner. What the graduate really need then is to spend a year doing a lot of full body massage with the general outcome of helping clients reduce stress and feel better.

I offer an advanced course as well.  Originally it was a year long. Then I increased the time to two years.  I think the two year time frame is necessary for the student to move from  entry level skill to proficient practice and were they can truly be their own teacher in a lifelong learning process.  However, upon analysis of the program it appears that the ability to remain motivated for 24 months was difficult.  I have seen this in rehab situations as well.  I remember the first year after I have open heart surgery (triple bypass in 2006). The first six months after surgery was about healing physically and emotionally. Then during the next 6 month I was focused on continuing the cardiac rehab and ongoing lifestyle changes.  I was really good at the diet and exercise and rest and so forth during that time.  However in 2007 many other issues demanded my attention.  My year of healing focus ended. I  still  continue ( mostly) to maintain a lifestyle that supports my heart issues but not with the same focus as during that first year.  

So at this point I am working on the premise that it takes a year –whatever it is – to complete a cycle and then be ready to move on to a new cycle or a new phase of the cycle.  


Here is how I think it works for massage education—

The student begins an entry level program of 12 months and the first 6 months they function as a novice. At the end of the second 6 months-12 month entry level program they function as an advanced beginner. Now they are ready to be licensed and begin professional practice.

At this point the student is able to enter the profession and provide massage in the wellness arena.  They need to do a year of work experience refining skills for massage addressing relaxation, stress management and minor pain and mobility issues.   The franchise, spa, and other wellness environments are excellent employment options.  I believe a minimum of 500 one hour massage sessions (1000 better) is needed during this very important year after graduation to really perfect entry level skills.  

Within this year of experience I would hope that the entry level graduate would enroll in the Advanced Practice program here at Health Enrichment Center.  It is one weekend a month for 12 months that adds and refines knowledge, skills and abilities and also offer peer support from fellow classmates and mentoring from instructors.  I feel that this is an important and missing component in the development of the new massage graduate.

At the end of this year of professional experience and formal education the massage therapist should be feeling competent in their massage practice. Interestingly this is similar to the model for eligibility for the new Board Certification credential being offered by the National Certification Board for Therapeutic Massage and Bodywork.

At Health Enrichment Center I offer and encourage those who have completed the 12 month Advanced Practice Certificate the option of repeating the 12 monthly seminars at a substantially reduced fee.  I continue to believe that proficient and expert practice requires commitment to learning, mentoring and repetition.   If a student completes the second year of the Advanced Practice program then they become eligible to attend the seminars in the future for as long as they wish for no charge.

This educational plan results in three solid years of supported formal learning with year 2 and 3 occurring while the person is actually working in the field supporting motivation to remain engaged in the professional growth process from novice to proficient.  As the massage therapist continues with learning and professional practice by year five and 5000 massage sessions under their belt they are on their way to expert which they may achieve if they keep learning and keep working in the field- maybe 10 years and 10,000 massage sessions as a goal for achieving the level of expert.

Yes I think it takes a year and then another year and then another one—I am on year 34 and still practicing, learning and evolving.