As its worst, I think, this kind of questioning is a way of avoiding, of mentally needing every duck in a row before committing to something (and there are always ducks not in their rows, yeah?). As its best, though, it’s an appreciation of the whole, of beginnings and endings mirroring each other, and existing co-dependently.

That’s my long introduction for what’s below: a one-page letter I just wrote to give to my first, and subsequent, graduates of a KMI Structural Integration series. So even though it’s not a letter to you per se, if you haven’t gone through a full SI series, it’s for you if it offers any more insight into this process.

Thoughts for Departure

“Tell me, what is it you plan to do

With your one wild and precious life?”

—Mary Oliver

Cheers on completing your Structural Integration series! Perhaps take a moment to reflect upon the you who walked in my door months ago, and the you who is reading these words now.

Like any good graduation, this is of course an ending, though just as certainly a beginning, and in many ways now is when the real change begins. By that I mean, the task now is to live into your new structure and its new pattern, expansional ability, limitations and all.

Here are a few guidelines I’ve found helpful in this process.

• Listen for what’s next.

You may find your patterns in daily life have naturally shifted, either subtly or dramatically. In terms of movement, this may look like you not feeling as drawn to an old sport or way of moving as you once were, maybe as you “have always been.” Tune into your internal listening for what’s next, how your structure wants to move and express now. Don’t worry, it’s not permanent; it never is.

As a rule of thumb: movement in general, and especially more multi-planar movement, will help reinforce and develop an expanded posture. Think yoga, dance, tai chi (though the same principles can certainly be found in more typically-linear sports like running, or lifting weights). Again, start by noticing what you’re feeling drawn to now.

• Reinforce positive change.

As with anything in the body, good nutrition, hydration and enough rest will continue to serve you well. Especially now.

• Rest assured.

Changes in the fascial web would last for months untouched. And, of course, they’re not untouched. The openness is reinforced every time you stretch your arms above your head in the morning, or walk in a more balanced, expanded way.

• More bodywork …

… may indeed be in your future. As a rule of thumb for more structural bodywork, live into what you’ve got now for six months to a year or so. After that time, you could come back for a shorter, probably three-to-five session, “tune up” of sorts (I put this in quotes because in some ways it’s a tune up, and in some ways it’s actually working with deeper structures that weren’t available to us originally).

As for if and when, this goes back to listening for what’s next. You’ll know.

May all this allow you to serve the world well.

In partnership,

Liam Bowler, LMP, BCSI

Dynamic Alignment Bodywork

2. We change. We sometimes tend to think of this mostly as a negative thing, no? Like oh, I’m getting old so I’m changing for the worse. Or that we’re basically the same, only just skinnier or fatter, stronger or weaker, than we used to be. All that can be true, and … the very foundational shape of who you are is subject to change. In fact, that’s what structural integration is all about. I’ve experienced this change now quite remarkably in my own structure, and with a growing number of clients.

3. I love being up in front of crowds. I taught and co-taught with Brian Crosier, PT, two really awesome Functional Anatomy clinics. Here’s one poster. Two more coming up this spring: one for skiers on January 18th and another for climbers in March. Check back for details, or contact me to be put onto the DAB mailing list.

4. The body and the mind tend to be expressions of one another. I can’t help but to have seen this to be true. I don’t think this implies we should try to force positive thoughts into our heads, or wear dippy smiles all day and pretend to be unaffected by our lives. I do think this means that work on the body tends to affect the psyche, and vice versa.

5. Posture and movement are likewise interrelated. As in, if we’re thinking of good posture as something static to achieve and hang onto, we’re largely missing the boat. That said, if you feel like your stridge is a little off, you may be in good company here.

6. Research shows lots to be wary of with the use of NSAIDs, like ibuprofen. This is the topic of my next post after this, so stay tuned, but the short for now is: if you can not take them it’s probably best not to, especially prophylactically (i.e., before an event that you think you will likely make you really sore) or long-term.

7. Our world is rapidly changing. Need we any more evidence than to look around? Here’s to our good fortune thus far, even and especially in its most disguised of forms.

Happy New Year, y’all. Peace, Liam

Get out a pen to jot down your answer. Got one? Great. Now please, stand up, arms relaxed at your sides. From here, lift one of your arms straight out to the front, palm down, up 90 degrees (that’s straight out from your shoulder).

The pop quiz question: what was the first muscle to engage in that movement? You don’t need to know technical anatomical language for your answer to count, as in, you could say “the front of the neck.” And I’ll give you a hint: it’s not the brain, but an actual, tangible, everyday muscle (even though yes, it’s a conscious movement so there’s neural activity).

Probably some muscle in the front of the shoulder, right? That was my guess when I took this quiz. Or, if you were super savvy and had a sense of where this was headed, maybe you answered some part of your abdominal core, like the deep transversus abdominis.

The answer: the soleus, one of the deep muscles in your calf that connects to your Achilles tendon.

The reason: to begin the process of lifting your arm out front, and thus moving your center of weight more forward, your unimaginably intelligent body begins with an ever-so-slight movement of plantar flexion, or the ball of your foot pressing into the earth (or, if you’re driving a car, on the gas pedal).

Another visual that might help if you’re still feeling confused: recognize that the plantar flexion, if left unchecked, would push everything above your feet backwards. And that’s where your arm moving forward comes in as a sort of balance, so only your arm actually moves.

Can you feel it happening? (I can’t, but kudos if you can!)

Amazing, no? Imagine the implications. It seems so obvious to think raising an arm happens at the joint right next to the arm, which is does, but that’s not the whole story, or even the first part of the story.

Now, pass your papers to the front of the class …

You are a marriage counselor. Deb and Brian come to your clinic, seeking help for their recently troubled relationship.

Sure, you say, tell me your story. Well, they say, they’ve been happily together for almost ten years. Then, in a conversation to decide where to celebrate their tenth anniversary, Brian said some passive comment about how Deb always wants to go to the beach and just sit around. Deb got defensive, and said something about how Brian can’t just relax sometimes. This escalated into a full-blown shouting match, and several have followed since.

What do you, as the therapist, focus on? Probably not the “anniversary vacation” conversation itself, right? We’d be foolhardy to think Deb and Brian’s relationship troubles started with that conversation, or that they’ll go away if we created rules that they can never talk about tenth anniversaries, or maybe anniversaries in general if we wanted to be a little more holistic about it.

As in: the problem isn’t the content, or the proverbial straw that broke the camel’s back. The problem, in this case, is something underlying that might show up as an argument about a vacation, or just as easily as one of infinite issues couples can argue about. It probably won’t resolve until we get more fundamental … unless you as a counselor want to keep putting out small fires, which is a great way to stay employed.

You probably see where I’m going with this.

Is it so different to see the internal relationships of the body in a similar light? A system under physiological stress can adapt and cope and deal … until it can’t, not as well at least.

Interestingly, though understandably I suppose, seeing our health in this way is not really the norm in medicine. There is a certain logic that this one thing is the problem so it’s this one thing that needs to be fixed, because it’s only this one thing that hurts and is grabbing all of our attention.

It’s a classic and oft-told story: “I bent over to pick up whatever, when wham, my back went out.” So we go into someone to work on the back, concluding that we must’ve just really picked up that box in a weird way (which may well be true). We mend the damage done, analogously, by the anniversary vacation argument.

But what then?

Please don’t take this to suggest we should all be paranoid that imbalances in the body will eventually lead to pain and disease (an interesting article on this here), or that finding the deeper source of pain is hopelessly holistic and therefore vague and untrackable. That’s not particularly helpful, either.

This is an invitation to look at your own experience with your own health.

Is it really that crazy to say neck pain is a whole-system issue? Or that the causes of plantar fasciitis, or carpal tunnel syndrome, are not isolated to the tissues displaying the symptoms?

Are you interested in putting out small fires, or in finding out what’s with everything being so combustible?

I’ve been working on this one line for awhile now: KMI Structural Integration is a powerful and system-oriented method of balancing the body, improving mobility and freeing stagnant, chronic pain. It is deep, lasting, significant bodywork.

Another, even simpler, description of what it’s all about could be making peace with gravity.

Let’s start with logistics: a Structural Integration series consists of 12 sessions (in KMI, which is my particular school of SI; Rolfing® is an example of another). The work addresses freeing and balancing the whole of the body in an intelligent, progressive and holistic way. The vehicle for this change is the myofascia. That’s a clinical, though most accurate, term for your soft tissues, so including your muscles, your tendons and ligaments, and the ubiquitous net of fascia surrounding and investing your musculature, your guts, your nerves … everything, quite literally.

Also a big part of a series is a re-education of the body’s movement patterns. These patterns can deeply sustain our energy (think the eternal poise and alignment of the dancing Fred Astaire), or rob us of it (think the head-forward, more compressed position of the oft-cited office worker).

It’s hands-on and movement-oriented, meaning my hands are helping to open, balance and re-integrate your tissue—you!—and your movement is a big part of that.

Goals of an SI series will vary from person to person (patients and practitioners alike), though a few overarching themes, and in general the things that KMI Structural Integration is exceptionally good at:

• Freedom from pain, especially chronic, stagnant pain (as opposed to the kind where you just sprained your ankle or something and it hurts now; this work would more address both the possible predisposition to and the implications following that sprain).
• More optimal ranges of motion, for couch potatoes and athletes alike.
• A better internal kinesthetic map, your felt sense of where you are, quite literally. This one is huge in its implications.
• Ability to discharge “stuck” thoughts and emotions, also called somato-emotional release. For some people, this part of their series is very profound; for others, less so.
• Increased vitality and adaptability in engaging with the gazillions of potential stressors that will continue to occur in your life, unless you’re planning on sitting in a cave for the rest of it (and even then …).

There are four noteworthy stages in a full 12-session series.

1. Sessions one through four address opening the “sleeve” myofasciae (more superficial).
2. Sessions four through eight address opening and balancing the “core” myofasciae (deeper, both anatomically and, in my experience, energetically).
3. Sessions eight through 12 are the integration sessions of core and sleeve. These sessions fine-tune your daily movement, and the ability of your whole structure to move, and simply be, in concert.
4. After session 12 … that’s it for your work with me, at least for a year or so when you may wish to come back for a tune up. Your integration will very much continue for months and even years after you’ve left my office. The closed-ended nature of this therapy is an important piece of this work and, as far as I know, unique to SI as a field.

That’s what happens, to the best of my ability to articulate it. More detail here on KMI’s website if you’re interested.

Of course, though, it’s much more than any of that. It’s kind of like saying coffee is a mildly bitter caffeinated beverage commonly drunk in the morning. While true, this would not begin to describe what it’s like holding a warm cup of java in your hands, the first sip, the mild caffeine rush, the associations you have with mornings like this … not to mention just the complexities of the taste. Or as a Zen teacher of mine in California used to say, “You can’t eat the menu.”

So while I could write ad nauseam about living in more aligned, freer body … it’s something else entirely to know that for yourself. In my experience, an SI series can be a really helpful tool in unearthing that alignment.

If you’re interested in directly experiencing a KMI Structural Integration series, feel free to send me a message, either with questions or comments, or to setup your initial appointment.

To being at home in your own skin, cheers, Liam

Sometimes the change is obvious and even a bit mind-blowing. Other times, the subtleties of experience begin to work their way in, a certain nuanced way of feeling and seeing deeper than gross motor experience, more refined.

The interesting thing about all this to me is that at the molecular level, switches are either on, or they’re off. The muscle cells are either firing, or they’re not. A neuron is either making the connection, or it’s not, across the synapse. A chemical receptor in the blood is or isn’t acting as a catalyst for a reaction. There is no such thing as a partially contracted muscle fiber, nor a partially fired neuron, nor a subtle variance of a reaction.

What we’re feeling, even in the most subtle of changes, then, is not a change in quality per se, though we certainly interpret it as such. It’s really a variance in quantity. As in, the amount of muscle fibers firing can change; the fibers themselves, though, don’t speak the language of gradation.

On or off. The most subtle changes are there in the very tissue of us, clear as day, on or off, this way or that. Interesting, then, that our experience often feels so different than this black-and-white reality, no?

Though out of the many fundamental difference between us and machines as a whole (you can hopefully name lots), it seems one important distinction often gets only lip-service, even in the world of health care.

That is: we’re not assembled from parts.

Embryologically speaking, we have grown as seeds grow. From the initial zygote in the fallopian tube to the unimaginably complex organism reading this post now, you have grown as one continuously dynamic and interrelated system. Your heart developed on the top of your embryological head, detaching as your form unfolded in the uterus, cells increasingly complex and specialized taking on the jobs of forming nerve tissue, connective tissue, muscle tissue, organs, eyes, bones, dimples …

A car, on the other hand, is made of parts put together. It’d be weird if there were little baby cars scooting around.

Does it not seem a bit surprising, then, that we talk about our bodies like they were piecemeal? “My shoulder hurts.” Of course, it’s convenient; the statement “my shoulder” makes a great pointer for where the pain is being felt.

But how much does that statement reflect the reality of the tissues in what you call your shoulder? Things tend to get a little more complicated, and our answers a bit more ponderous, when the statement becomes more dire: “Your shoulder is shot; you need a new one.”

We can challenge this kind of thinking. Instead of asking “what’s happening in this shoulder that’s making it hurt so much?” try this question: “What’s happening in this entire body that’s not allowing this shoulder to heal properly?”* Do you get a different answer? Do you know the answer?

In a car, we can replace a part without affecting the whole. In the human body, in us, our reality is not so convenient. A worn-out hip will be seen again soon enough if the whole system isn’t addressed (which, in terms of physics and kinesiology, could be stated that nothing will ultimately change if the forces acting on the hip don’t change).

Thankfully, it’s not entirely true that we’re not made of parts, either. A brother can donate his kidney to save his sister; strangers can give others in need tissues, blood, organs, all amazingly safely with the phenomenal progress of medicine the past 100 years. These things are true.

And yet, if we’re seeing ourselves as piecemeal little bits somehow held together, we’re not seeing our body as it truly is.

It’s been said that a very talented healer can read the state of your whole system by testing/feeling any part, even your pinky. Try as you might, I wouldn’t suggest diagnosing your engine troubles by putting your hand on the tires. As for you, however …

*Thanks to Tom Myers for posing this beautiful distinction at a Kinesis training last week.

I remember well that pain being a sort of badge of honor, like we had all pushed it so hard and suffered together. Another badge of honor, weird as it feels to write it now, was ibuprofen. As in, I felt like a real adult athlete needing to pop an NSAID (non-steroidal anti-inflammatory drug) multiple times throughout the day for knee pain.

Fortunately for me, that phase passed pretty quickly (as I started to get a little smarter and question why I had knee pain in the first place; ultimately, my technique got better and that helped 95%). And good thing, too. I’m just starting in on this research, and will keep you posted, but for now: there’s a fair amount of research out there on anti-inflammatories and tissue health.

Here’s one article on NSAIDS and rotator cuff injuries (which plague lots and lots of us): http://www.shoulderdoc.co.uk/article.asp?article=295

I’d like to write a short article with my findings within the next few months. I’ll pass it on when I do!

Take care out there, and think twice about popping ibuprofen if you don’t

LB

I’ve had an aching, tight shoulder injury—left shoulder—for nearly ten years now. It’s an old climbing accident. I’ve had lots of work done on it that has helped tremendously, though safe to say it’s never fully resolved.

I’m seeing a huge change in that now. A little background …

Part of my thus-far-incredible KMI schooling requires that I complete a Structural Integration series myself. (This is one of those things I’d want to do anyway in becoming a practitioner, aside from the fact that, of course, receiving bodywork is great in general! Like being required to eat ice cream or something.)

My series is with an outstanding practitioner, Dan Christofferson. Our series is under the banner of Hellerwork, which along with KMI is a school of Structural Integration based off of Ida Rolf’s contribution (her original “recipe” is still known as Rolfing).

Back to the main story … even with my working knowledge of and respect for the intricacy and interconnectedness of the human body, turns out I’ve been way off on some of the roots of my aches and pains. Dr. Rolf often said, “where you think it is, it ain’t.” That’s turning out to be quite true for me in this instance.

My left shoulder especially flares up, pain and inflammation, when I’m doing a lot of rock climbing. Certain stretches feet good, and all the direct work done on the shoulder girdle and rotator cuff musculature has helped tremendously in healing from an old injury (and re-injuries).

But the pain was never gone gone … like it was always lying dormant, waiting until I really started using my body in that familiar pattern.

Turns out, as we’re getting into the part of the series that deals with releasing and reorganizing my myofascial “core” (as opposed to more superficial myofascia, or the “sleeve”), well away from my shoulder, the actual sight of tension and pain … I’m seeing and feeling huge changes in this near-ancient injury site. It feels fantastic!

This core work, in turn, is churning up what feels like pretty old, fundamental emotional stuff, too. I feel like I’m directly experiencing the overlay between bony structure (the ribcage, for example) and the soft tissue (the pericardium and the heart) and energetic centers (the fourth chakra) and meridian lines that intersect there.

Call that overlap what we will, I suppose, but … to paraphrase Tom Myers, it just goes to show that whoever and whatever God is, s/he has little concern for how we divide and label the world. A shift is a shift is a shift.

Just a quick update from the front lines

I’m glad and honored to be sharing this work with all of you (which right now is the KMI 3-series, and I’ll be offering the full Structural Integration KMI 12-series in the new year after our program wraps up).

To our true, lasting, and dynamic health,

LB

Let’s start with a little anatomy review. (If you’re all savvy on this, see you at the next paragraph that starts with a few stars *****): our physiology demands of our knees both stability and mobility. The knee, the tibio-femoral joint (the meeting of the femur of the thigh and the tibia which, along with fibula, are the bones of the lower leg), is known as a modified hinge. This means that it’s primarily a back and forth hinge (standing and sitting, jumping, anything linear), but also must have a little rotational ability (think the ability to turn your body while your foot is planted, like a quick turnaround while playing soccer; this rotation isn’t completely carried out through the knee, but certainly enough where it’s got to be able to turn a bit).

To accomplish this, we see a really stunning arrangement, both in its thoroughness of territory covered and in its elegant relative simplicity. On the outside “shell” of the joint we have the dense ligaments LCL and MCL (you may’ve heard of the MCL before, usually relating to some accident). This shell keeps the knee not only from dislocating if someone tugs on your leg, but also from approximating (read: grinding) the femur and tibia.

Inside this shell live the cartilaginous discs, the menisci, that further aid in this easeful glide of movement of the knee. Also, an “X” inside the joint capsule is comprised of two more ligaments, the PCL and ACL (the latter of which most people have heard, usually in a story that makes wince anyone who’s even mildly tweaked a knee).

Also, bathing all of this connective tissue is the synovial fluid, which serves to lubricate and nourish the poorly-vascularized articular surfaces and connective tissue. The kicker is: if there was fluid everywhere, ballooning against every surface inside the knee, we’d have no mobility. Thus, there’s less fluid than space available. This is a key we’ll be back to shortly.

For now, we’re going to stay zoomed inside the joint capsule, where things are going to get even more interesting as we introduce motion …

*****Okay, we’re back! All this connective tissue needs to be very dense by design and thus lacks much notable blood supply. We don’t really think about this with an un-injured knee. We’ll probably think about it a lot if we wind up with a torn meniscus, as it’s blood supply that’s going to be your primary healing agent (side note: this is part of the philosophy behind an anti-inflammatory like ibuprofen: less inflammation = more blood flow possible).

So we have this very dense, and in many ways quite vulnerable tissue, essentially buried inside a joint capsule with little or no blood supply to heal it.

So, what’s a knee to do? Or, thinking evolutionarily, how can our form and function work most harmoniously?

Dig this: the synovial capsule extends under the patella (the kneecap) and travels back between the little nobs on the ends of the femur to the back of the knee. And so … when you take a step, the knee straightens as the quadriceps tighten, which pushes the patella against the fluid underneath, which squeeeeeezes all the fluid toward the back of the knee, and past and into all the connective tissue;.

In the next phase of your step, the push off, the musculature in your calf contracts, which squeezes the fluid back, again past all of these otherwise-never-touched cartilages. This continues all the way through the joint capsule until, again, the fluid rests behind your patella, awaiting your next step and flush of restorative fluids through the knee.

What’s cool to note, too, is that this most efficiently happens while walking, more so than running or biking or rollerblading or whatever …  We’ve had a long, long time to make this most basic of exercises work for us, and us for it.

Walking! Awesome. I’d say your knees would thank you if they weren’t you

*This article largely informed by Tom Myers’ article “Body^3: the knee and thigh” in Massage Magazine, Nov/Dec 1997. Also available as part of the textbook Body^3: A Therapist’s Anatomy Reader