E-Magazine: Terra Rosa

Terra Rosa
E-magazine
Open information for Bodyworkers
www.terrarosa.com.au
Terra Rosa E-Magazine, No. 15, December 2014
contents
26
Fascial Training for Soccer Players , An interview

with Markus Rossman
InteroceptionSome Suggestions for Manual

and Movement TherapiesRobert Schleip
18
Report from the 2014 Fascia Summer School

Alison Slater
23
FFT Case Study: Exposed Leg FracturesRon

Alexander
26
Plantar Fasciitis: High loading strength training

improves outcome - Michael Rathleff
30
Comments on Plantar FasciitisJoe Muscolino
31
Treatment of Plantar FasciitisJudah Lyons
32
Comments on Plantar FasciitisArt Riggs
35
Comments on Plantar FasciitisTil Luchau
37
Touch is EverythingArt Riggs
40
Fascia: A Body wide Organ Paolo Tozzi
43
CORE Myofascial Therapy George Kousaleos
44
Workshop Report: CORE Myofascial Therapy &

CORE Sports and Performance Bodywork
47
Research Highlights
51
6 Questions to Paolo Tozzi
52
Featured Front Cover:

6 Questions to Jo Phee
Front Cover: Jo Phee
52
Published and made freely available by: Terra Rosa
www.massage-research.com
Disclaimer: All material provided in this e-magazine should be used as a guide only.
This information should not be took or used as a substitute for professional or medical
advice. The publisher of this e-magazine disclaims any responsibility and liability for loss
or damage that may result from articles in this publication.
Fascial Training for

Soccer Players
An interview with Markus Rossmann
Are there still power reserves remaining unused by elite athletes? Markus
Rossmann says there are. He teaches soccer coaches how to train their fascia.
Frank Aschoff spoke with him.
Golf Roll: Typical for the fascial training: The athlete is given a basic exercise and then discovers his optimal individual position, which
lets him actively stretch the areas that need stretching. At first, this might seem like an unfamiliar procedure. The shown exercise is
used by professional golfers (amongst others) to get ready for a tournament. However, it could be an interesting, effective and new
idea for the warm-up program of a soccer player as well.
Terra Rosa E-mag 1
Fascial Fitness for Soccer

Flamingo I
Goal: flexibility of the complete back of the upper leg, while including the fascial net
of the whole body
What made you pick soccer players

as your target group for fascial training?
Im an athlete myself. Ive played basketball in the regional league and in
the second division, and I have been a
youth coach for many years. I have
known for a long time that a special
training of the fasciae can boost an
athletes capacity and prevent injuries. It can also be used for rehabilitation.
Bring body weight over the leg, feel the

tension.
This well-known exercise now gets a twist:

the game with different motion vectors
begins. You can look for new, unfamiliar
tension. Once you find a position, you
should bounce lightly three or four times,
and then move on to a new position.
The boosted capacity can be explained easily: An elastic fascial network results in a smaller consumption of energy while moving, this can
set aside power reserves that a soccer player might need in the defining
last ten minutes of a game. A second
important aspect that I have experienced is that the fascial training improves the presence on the field.
Players talked about a better sense of
direction, being able to comprehend
faster where were their teammates
and opponents, and more precise
passes and shots.
How can this be explained?
A very big part of someones own
body perception, their proprioception, is influenced by the fascial systemmore than the well-known receptors near the joint which fire
when the joint is at the end-range
position. This is how you can explain
the observed effects on the field. The
fascial network is our largest sensing
organ, so it is only logical to train it.
Currently, a lot of attention is drawn
to this subject and many reports refer to the well-known international
fascia researcher, Dr. Robert Schleip.
In what way are you working with
him?
It is very important to remember the playful aspect of this (Everything is allowed): for example, changing the position of the leg or the torso, changing the
position of the arm, or changing the position of the head.
2 Terra Rosa E-mag
Everyone can discover where one feels

the tension.
He is a Rolfing instructor and was the

one that trained me as well. He also
let me be a part of his practice quite
soon. I knew that he was doing a lot
of research, and then he asked me if I
wanted to work with him on a new
concept for moving that lets you actively train your fascia. In the beginning, there were five or six of us that
worked closely together. My job is to

Flamingo II
Goal: flexibility of the complete back of the upper leg, while including the fascial net
of the whole body, but unlike the Flamingo I, more focus on the torso or the thoracolumbar fascia
turn their latest scientific discoveries

into actual moves. Its a fact that people have always been training both
muscles and fascia. Obviously they
cannot be separated. We are moving
the focus on the fascia. While people
train, we let them move in a way that
activates more of the fascial component, and therefore makes them
need fewer muscles. This way of
moving is well known to a lot of people, and yet it is somehow new to
them.
So research results are continuously
put into practice ?
Yes, we are very lucky that Dr. Robert
Schleip is close to the source and that
he regularly keeps us informed on the
latest research findings.
What have you done with the soccer
players so far?
Another well-known exercise, but with a

slight modification: bounce lightly, again
a change of vectors (directions), look for
a different position, as shown: turn to
your side.
Alternate with feet pointing towards each

other.
So far, I mainly provided training for

trainers, especially at the soccer association of Wrttemberg, at the Bavarian soccer association, but also at
the federation of German soccertrainers. Those are the ones with the
highest trainer certification. However, I am not only involved in soccer,
but in many other sports like golf,
triathlon and long-distance track. On
an occasion, I was also a trainer at a
summer camp for Norwegian biathletes.
What do you offer to soccer trainers?
First, I offer some theoretical basics
particularly concerning soccer. Soon,
we focus on practicing. The course
participants do a lot of exercises. This
way, the trainer can feel the effects
for themselves, which is important! It
then becomes clear to them: We can
change how we move in a way that
activates our fascial network more.
Point feet to the inside, combine with

turning sideways.
Feet turned to the outside.
It is no secret that many soccer players are not that flexible and often
suffer from pulled or torn muscles.
This is why I bring up the fascia roll in
courses. After the trainers have
worked with the roll for 15 minutes,
they usually feel like they are able to
move a lot more easily. Also, they
notice very quickly that the finger to
Terra Rosa E-mag 3

floor distance is reduced by a lot.
They say, I can reach further down
now! Every soccer player has areas
of struggles. Often, we can take active measures to prevent problems,
or help with a looming pulled muscle.
I have been told various times by the
players that they were able to go
back to training the very next day.
Straight Jump
Goal: Improving the catapult capability of the Achilles tendon and at the same time
preventing injuries
Another important aspect is the

fascial stretch which offers threedimensionality. When doing so called
correct axial stretches, we only
stretch a small part of the neglected
parts. Theres no impulse. It is essential, not only for soccer players, to
move on to a change of vectors
(directions). The athlete can discover
for himself: Where do I feel the pull?
Where do I feel this exercise? Thats
something no trainer can tell him,
everyone has to feel it for himself.
So, no more one-dimensionality. Its
time to move on to threedimensional stretching with many
changes of vectors.
You know, each person is an individual. Everyone has a different bone
structure, different muscles, different
fascia, and, most of all, a different
everyday life. While one person sits
behind his or her desk all day, another works physically in the construction business. Their bodies are
being formed individually. However,
when it comes to sports, everyone is
told to do the same stretches in the
same positions. It just doesnt make
sense.
Swing movements
Jump
Only once the athlete starts looking

for better ways, when he tries various vectors changes, he will be able
to activate a wide range of fasciae
and muscles, and he will be prepared
for bigger athletic challenges.
You are talking about a playful element as well.
Definitely. A basic exercise is given,
and then everyone can find the area
where he or she feels the pull: I have
potential there, I can work on that.
And then they are allowed to do continuous, soft and bouncy movements
in that specific direction exactly
4 Terra Rosa E-mag
Land like a ninja, meaning bounce silently and softly, while changing the position of your legs. For this exercise, ones
feet should point to the inside.
Land with feet turned to the outside.

Power Leg
Goal: Using the catapult effect for better movements when shooting
what we were told not to do for

thirty years.
How do you explain this new attitude towards bouncy movements to
the trainers?
Initial position with lead and trail leg
First bouncing phase: whiplash motion,

meaning a maximum of prestretching.
While the trail leg is moving back to its
initial position, your upper body and pelvis should already be moving forward.
Well, the goal is a tear-resistant, elastic fascial network. With examples

such as the Achilles tendon, science
has clearly shown that there can only
be an impulse with bouncy movements. Normal stretching, without
bouncing or pre-stretching, is not
enough for an impulse! You can look
at the tendon like a rubber band. It
can conserve energy or give it off. To
get low energy consumption, it needs
optimal elastic characteristics. To
train the Achilles tendon to have this
elastic quality, you dont have to do
any extra training. All it takes is the
inclusion of this knowledge in the
normal training. For instance, a good
exercise to improve the catapult effect of the Achilles tendon are
bouncy, teetering movements when
going up the stairs of course, after
pre-stretching.
What are the typical areas a soccer
player struggles with?
Mainly the calf muscle, hamstrings,
quadriceps, but obviously, the lumbopelvic and hip area.
Groin problems are fairly common,
too. What about those?
There is still need for more research.
If were lucky, we will have new insights soon.
How do the athletes react to the new
exercises?
Second bouncing phase
After swinging forward, you move right

on to using your own body weight for the
next movement cycle.
The majority of the prescribed exercises receive positive feedbacks, because the soccer players can feel the
improvement straight away. Also, it is
diverse and entertaining. The area of
the Sensory Refinements, or the proprioception exercises, takes sometime to get used to by many players.
Often, they smile at me oddly when I
asked them to turn around on the
floor and toll. However, once they
gave it a try, they quickly realized
that it does a lot for them, especially
Terra Rosa E-mag 5

Starfish
Goal: Improvement of the body perception, mainly of the contralateral movements, which are extremely important when it comes
to running and shooting.
Start movement
Initial position
Initiate a turn to the left, bring your left elbow and your right
knee closer together, and at the same time stretch the entire
right side of your body.
once theyre out on the field again.

The new insights about fascial training are not being used to their full
potential yet, especially in male
sports. Luckily, as an athlete, I know
how to sell these exercises. I know
that I dont need fancy instructions,
so I dont use instructions such as
Imagine you are a starfish that
were meant to stimulate the imagination.
Mr. Rossmann, what is your next
goal?
The plan is to include the positive
effects of fascial training in many different sports. Im highlighting the
word include here, because it is
extremely important for us to make
clear that fascial training is just another tool in the training and ther-
6 Terra Rosa E-mag
As soon as the centre of the body weight lies on the left side,
you change positions into the relaxed embryo position. Dont
remain in this position for too long, but instead move on to the
opposite, contrasting movement. To enjoy the full potential of
this exercise, continue doing those flowing motions for three to
four minutes.
apy tool box. When used correctly

as a part of training and therapy, I
promise a bigger capacity, faster
healing and a lower risk of injuries.
Another big goal has to be the inclusion of fascial training in mass sports.
It is simply a fact that it allows you to
do more for your health in less time
and this is a trend that fits our modern lives perfectly.
IMAGES
All photographs by Mira Hampel for
the Fascial Fitness Association
INTERNET RESOURCES
Webpage of the Fascial Fitness Association
www.fascial-fitness.com
Fascia Research Group
Last but not least, there is a byproduct of fascial training we should

not forget about: it encourages creativity and self-responsibility. Two
things that we dont get too often in
our working life or in the society.
Thank you for this interview!
www.fasciaresearch.de
Webpage of Markus Rossmann:
www.concept-rossmann.com
Webpage of the European Rolfing
Association:
www.rolfing.org
Basic principles of Fascial Fitness

Fascial Stretch
Playful, creative whole-body fascia and muscle stretching can stimulate the fascial network perfectly. A multidirectional, bouncy stretching prepares the soccer player (athlete) specifically for the extreme, three-dimensional, and
physical pressure during a competition or practice.
Rebound Elasticity
Only by pre-stretching the fascial network, the maximum of physical strength can be achieved. This training boosts the
so-called catapult effect. It supports the process where motions can be done with less muscle energy, which leads
to fewer tendon and ligament injuries.
Fascial Release
Fascial Release is a self-treatment method using a fascia roll. It lets you dissolve adhesions and soften the tissue. This
results in more flexibility and better physical ease that you can feel right away. Fascial Release should be done before
(fast rolling) and after (slow rolling) practice and competitions.
Sensory Refinement
Considering that the fascial network is our largest sense organ, the fascial system should be stimulated to its maximum capacity when thinking about our body perception. At times, this makes delicate, sensual exercises necessary.
The better the body perception, the closer to perfect will be the motion sequences. In the case of a soccer player, this
equals more precise passes and shots, as well as a more economical running style.
(See www.fascial-fitness.com)
Markus Rossmann
Markus Romann Dipl.-Sportl. Univ., a Certified Rolfer, MAT/EAP certification, fascial trainer, many years of experience as the director of motion and
health seminars, member of the European Rolfing Association.
In 1992 graduated from the Technical University Munich as a sport scientist
(rehabilitation/ prevention). After working as a ski instructor in Canada, he
became the head of medical training therapies of several ambulant rehabilitation centres in Germany. Searching for new, more efficient and sustainable approaches, he came across the Rolfing method. After completing his
training in Munich in December of 2004, he started working in Munich and
Erding.
Contact: markus.rossman@fascial-fitness.com
This article is an English translation of:

Aschoff F. 2014. Fasziales Training mit Fuballern. Im Gesprch: Markus Romann. Z. f. Physiotherapeuten 66, 6: 14-22.
Copyright: Richard Pflaum Verlag GmbH & Co. KG, Lazarettstr. 4, 80636 Mnchen, Germany
Terra Rosa E-mag 7
Fascial Fitness
Get in Shape with Elastic & Dynamic Connective Tissues
With Daniela Meinl, Sydney 31 Jan3 Feb 2015.
Based on the Latest Finding

in Fascia Research,
A new approach to train your
fascial web.
This workshop is the only training program for the development of supple,
flexible and strong connective tissue!
It consists of theory and practice and
addressing all aspects along Fascial
Fitness. Learn the latest findings in
Fascia Research and put it into practice.
Fascial Fitness Introduction: 31 Jan 1 Feb 2015

Fascial Fitness Trainers course: 2-3 Feb 2015
Yoga & Fascia: 29 Jan 2015
8 Terra Rosa E-mag
www.terrarosa.com.au, E: terrarosa@gmail.com, Ph. 0402 059 570
Interoception
Some Suggestions for Manual and
Movement Therapies
By Robert Schleip
The discovery of interoceptive receptors in human skin.

The established view is that touch is mediated by largediameter, fast-conducting peripheral nerves and there
are areas in the body that are more densely innervated
and more cortically represented such as the finger tips
and the lips. However recent findings showed that there
is another purpose to touch that is more interoceptive
than exteroceptive. Beside the well known cutaneous
receptors for haptic perception human skin contains interoceptive C-fibre endings which trigger a general sense
of well being. The connections of these slowly conducting
receptors do not follow the usual pathway of the pyramidal tract towards the proprioceptive areas in the brain.
They rather project to the insular cortex, a key player in
the regulation of interoception. This was recently discovered through experiments with patients lacking myelinated afferents. Whenever their skin was gently stroked,
they responded with an increased sense of general wellbeing, although they were unable to detect the direction
of stroking. Subsequent brain imaging studies revealed
that the touch activated their insular cortex, while no
activation was seen in proprioceptive brain areas. It is
concluded that human skin contains special touch receptors, with a slow conduction velocity, which are part of a
neurobiological system for social touch.
Terra Rosa E-mag 9
Interoception
Body Image
Insula
Thalamus
Body Awareness
Interoception
Proprioception
Figure 1. Body Image, Body Awareness, Proprioception & Interoception. Body awareness includes proprioception and interoception, whereas body image includes to some
extent information on what our body looks like when observed from without (From
Mosely 2011).
In manual and movement therapies,

we have discussed the importance of
proprioception, our sixth sense, the
ability of our body to sense our relative position in space, be aware of its
surroundings, and the sense in movement, the sense of effort, force, and
heaviness. The awareness or how we
perceive our own body can be quite
variable (Figure 1). It is mostly linked
to the external signals to the body,
such as how we look or touch our
bodies or how our body acts in terms
of biomechanical parameters. But
body awareness can also be perceived by how we feel our body as a
dynamic physiological organism from
the inside. Recently a new concept
of interoception has been proposed.
Body awareness relies on the representation of both exteroceptive, proprioceptive and interoceptive signals.
10 Terra Rosa E-mag
So what is interoception?
The current concepts describe interoception as a sense of the physiological
condition of the body, an ubiquitous
information network used to represent ones body from within. It is the
ability to detect subtle changes in
bodily systems, including muscles,
skin, joints, and viscera (Dunn et al.
2010). It includes a range of physiological sensations, including: warmth,
coolness, pain, tickle, itch, hunger,
thirst, air hunger, sexual arousal,
muscular activity, heartbeat, vasomotor activity, distension of bladder,
distension of stomach, rectum or
oesophagus, wine tasting (in sommeliers), and sensual touch.
These sensations are triggered by
stimulation of unmyelinated sensory
nerve endings (free nerve endings)
that project to the insular cortex
rather than to the primary somato-
Prebrachial
nucleus
Lamina I
of spinal cord
Free nerve endings

Figure 2. A novel short-cut route for interoception in primates. In mammals, the
main pathway of interoception starts with
free nerve endings, which project to the
lamina I of the spinal cord. From here they
project to the prebrachial nucleus in the
brainstem, and it is only from there that
they are further projected to the insular
cortex via the thalamus. In primates, however, there are additionally direct projections from lamina I to the insula via the
thalamus. Primates therefore possess as
a novel phylogenetic acquisition a more
direct route between the afferent region
for interoceptive sensations in the spinal
cord and the insular cortex (red arrow).
sensory cortex which is usually considered as the main target of proprioceptive sensations (Figure 2)
(Berlucchi & Aglioti 2010). Feelings
from these sensations not only have
a sensory, but also an affective, motivational aspect and are always related to the homeostatic needs of the
body. They are associated with behavioural motivations that are essential for the maintenance of physiological body integrity.
Interoception
Table 1. Properties of Primary Sensory Afferents Innervating Human Skin (After McGlone et al., 2014).
Sensory Afferent Nerves

Receptor Type
A Fibre Group
Low-threshold mechanoreceptors
A Fibre Group
Nociceptors
Cool receptors
C Fibre Group
Nociceptors
Warm and cool receptors
Itch receptors
Low-threshold mechanoreceptors
(CT)
Modality
Axonal
Diameter
Conduction
Velocity
Discriminative
touch
10 m
60 m/s
Pain
Temperature
2.5 m
12 m/s
Pain
Temperature
Itch
Affective Touch
1 m
1 m
1 m
1 m
<2 m/s
<2 m/s
<1 m/s
<2 m/s
Distressed interoception and altered

insular processing is associated with
conditions such as irritable bowel
syndrome, eating disorders, anxiety,
depression, alexythymia (emotional
blindness), schizophrenic disorders,
Post-Traumatic Stress Disorder
(PTSD), and possibly fibromyalgia. It
has been proposed that the neural
pathways associated with interoception may be considered as a potential
correlate for consciousness (Craig
2009). The sensory receptors for interoception are free nerve endings,
most of which are located in fascial
tissues throughout the human body.
It is helpful to understand that proprioception and interoception are
organized differently in the human
brain and that very different afferent
pathways are involved in them. Figure 3 shows some conditions that
tend to be affected by distressed
proprioception and interoception.
work better for some conditions and a

more interoceptive oriented approach
for others.
If applied with an open minded and

careful attitude, it is an appealing
thought that a more proprioceptive
oriented therapeutic stimulation may
Based on the innervation of primate

skin and on subsequent studies with
other patients it was concluded that
there is dual tactile innervation of the
Affective Touch
A recent and surprising addition to
the list of interoceptive sensations is
the sense of affective, sensual or
pleasant touch. This discovery was
triggered by examinations of a
unique patient lacking myelinated
afferents, slow stroking of the skin
with a soft brush triggered a faint
and obscure sensation of pleasant
touch, although the patient was unable to recognize any stroking direction. Functional magnetic imaging
showed that this vague sensation
was accompanied by a clear activation of the insular cortex, while no
activation was seen in the primary
somatosensory cortex (Olausson et
al. 2010).
human hairy skin: in addition to fastconducting myelinated afferent fibres, there is a system of slowconducting unmyelinated C tactile
(CT) afferents that respond to gentle
touch (Table 1). The C tactile afferents are a distinct type of unmyelinated, low-threshold mechanoreceptive receptors that are connected
with neural interoceptive pathways.
Those afferents have a slow conduction velocity (half to a second delay
from stimulus to arrival in the brain).
Since these receptors types have
never been found in the glaburous
skin (areas with lack of hair, mainly at
palm of the hand and plantar of the
foot) despite numerous micro neurographic recordings, it is assumed that
they are only present in hairy skin.
The cells are stimulated by gentle
pressure on the skin and respond
preferentially to gentle caressing
stroke. C tactile afferents are connected to specific areas of the brain:
the insular cortex, the posterior superior temporal sulcus, the medial prefrontal cortex and the dorsoanterior
cingulate cortex, which are known to
Terra Rosa E-mag 11
Interoception
PROPRIO-CEPTION
INTERO-CEPTION
Lower back pain
Irritable bowel syndrome
Phantom pain
Eating disorders
ADHS
Anxiety, depression
Complex Regional Pain Syndrome
Alexythymia (emotional blindness)
Scoliosis
Schizophrenic disorder
Whiplash
Post Traumatic Stress Disorder
Other myofascial pain syndromes?
Fibromyalgia?
Figure 3. Conditions that tend to be affected by distressed proprioception and interoception.
be activated by affective touch

(McGlone et al. 2014). It is concluded
that primate skin contains particular
touch receptors which form a system
for social touch that may underlie
emotional, hormonal (for example
oxytocin) and affiliative responses to
caress-like, skin-to-skin contact between individuals (Figure 2). The profound importance of such a system
for human health and well-being has
long been indicated (Montague 1971),
at least since the classical study of
Harlow (1958) with baby rhesus monkeys that express affection for a surrogate mother in response to tactile
comfort. This is reiterated by
McGlone et al. (2014) who suggested
the affective touch hypothesis: the
essential role of the CT system is to
provide a peripheral mechanism for
signalling pleasant skin-to-skin contact in humans, thereby promoting
interpersonal touch and affiliative
behavior.
12 Terra Rosa E-mag
Fascia as an Interoceptive Organ

In musculoskeletal tissues only a
small amount of the sensory nerve
endings are myelinated mechanoreceptors which are related to proprioception, such as muscle spindles,
Golgi receptors, Pacini corpuscles or
Ruffini endings. Predominantly, approximately 80% of afferent nerves,
terminates in free nerve endings
(Schleip 2003). Termed interstitial
muscle receptors they are located in
fascial tissues such as the endomysium or perimysium and are connected with either unmyelinated afferent neurons (then called type IV or
C-fibres) or myelinated axons (type III
or Ad fibres). Indeed 90% of these
free nerve endings belong to the first
group, to the slowly conducting Cfibre neurons. Functional magnetic
imaging studies by Olausson et al.
(2008) revealed that stimulation of
these C-fibre neurons results in acti-
vation of the insular cortex (which

indicates a clear interoceptive role of
these receptors) and not of the primary somatosensory cortex which is
usually activated by proprioceptive
input.
A surprising conclusion from this is
that the number of interoceptive receptors in muscular tissues by far
outnumbers the amount of proprioceptive endings. Quantitatively, one
could estimate that for every proprioceptive nerve ending in these tissues
there are more than 7 endings which
could be interoceptive receptors.
While some of these free nerve endings are thermoreceptors, chemoreceptors, or have multimodal functions, the majority of them do in fact
function as mechanoreceptors, which
means they are responsive to mechanical tension, pressure or shear
deformation. While some of these
receptors are high threshold recep-
Interoception
tors, it has been shown that a significant portion (approximately 40%) can
be classified as low threshold receptors, which are responsive to light
touch, even to touch as light as with
a painters brush (Mitchell &
Schmidt 1977). Most likely they are
responsive to the gentle myofascial
stretch by therapists.
Pain and Interoception
Camila Valenzuela-Moguillansky
(2012) recently reviewed the relationship between chronic pain and body
awareness. She presented evidences
that showed the relationship between pain and exteroceptive body
awareness is bidirectional: not only
does pain change the body perception, but modifications in ones perception of the body can modulate
pain. In addition, she suggested that
in order to give a full account of the
relationship between chronic pain
and body awareness it might be necessary to include the interoceptive
sensorimotor system. While augmented attentive interoceptive sensitivity seems to be associated with
increased myofascial pain perception,
a mindfulness based interoceptive
training can be helpful in the treatment of somato-emotional disorders
such as anxiety or depression
(Fjorback et al. 2013).
Pollatos et al. (2012) in an article published in Pain evaluated the relationship between interoception sensitivity and pain perception. This study
was based on the idea that enhanced
sensitivity to autonomic state is often
accompanied by increased autonomic
reactivity. As pain is made up of both
sensory and emotional components,
the authors investigated the relationship between pain and the ability to
perceive physiological changes.
To evaluate interoception sensitivity,
60 healthy participants were asked to
count their own heartbeat rate and

compared it to actual heart rate
count. Based on the data, participants were split into two groups:
higher interoceptive sensitivity more
accurate heart rate estimation) and
low interoceptive sensitivity (more
error in estimation). Then the participants were subjected to pain stimuli,
using an algometer, cutaneous pressure pain was applied to the thenar
eminence of the participants. Subjective pain intensity and unpleasantness was assessed along with heart
rate variability and respiratory activity.
They observed significant relationship between heightened interoceptive sensitivity and enhanced sensitivity and decreased tolerance to pain.
In other words, high interoceptive
sensitive participants had lower pain
threshold and tolerance than low
interoceptive sensitive participants,
they also rated threshold level stimuli
as significantly more unpleasant.
These effects were accompanied by a
more pronounced parasympathetic
decrease and a change in sympathovagal balance during pain assessment in the high, compared to
the low, interoceptively sensitive
group. The authors concluded that
better detection of internal signals
and evoked bodily changes seems to
increase pain perception for pressure
pain.
Manual Therapy and Interoception
Manual therapists when treating
muscular tissues issues are mostly
concerned with direct biomechanical
effects on non-neural tissues or with
the stimulation of specific proprioceptive nerve endings, such as muscle spindles, Golgi receptors, etc.
However, based on the above information, manual therapists could target the interoceptive receptors and
thus can trigger their related upstream effects much more effectively
than what is commonly practiced.
Some of the interoceptive nerve endings in muscle tissues have been classified as ergoreceptors; they inform
the insula about the work load of
local muscle portions. Their mechanical stimulation has been shown to
lead to changes in sympathetic output which increases the local blood
flow. Stimulation of other interoceptive nerve endings has been shown to
result in an increased matrix hydration, via an augmentation of plasma
extravasation, i.e. the extrusion of
plasma from tiny blood vessels into
the interstitial matrix (Schleip 2003).
It would be really useful for the therapist to pay attention to the autonomic responses at each moment
and to the limbic-emotional (or insular) response of the client, while
monitoring the touch direction (plus
its speed and magnitude) in such a
manner that a profound change in
local tissue hydration as well as other
autonomic effects can be achieved. It
would also be worthwhile to encourage a perceptual refinement and
some verbal feedback from the client
regarding his/her interoceptive perceptions. While proprioceptive sensations may be in the foreground during the application of strokes, those
finer interoceptive sensations are
usually easier to perceive in periods
of at least several seconds of rest
between different manipulative
strokes. Subjective sensations of
warmness, lightness/heaviness, spaciousness, density/fluidity, nausea,
streaming, pulsation, spontaneous
affection or a general sense of well
being may be such interoceptive sensations that can be triggered by myofascial tissue manipulation. From the
therapists perspective subtle
changes in the client - such as an in-
Terra Rosa E-mag 13
Interoception
PROPRIO-CEPTION
INTERO-CEPTION
Dance training (classical/modern, etc.)
Continuum Movement, Body Mind Centering
Feldenkrais method of Awareness through
Somatic Experiencing
movement
Iyengar yoga (if done with emphasis on
Yoga style with emphasis on physiological
biomechanical precision)
tingling, temperature, streaming sensations
Classical Pilates approaches
Visceral and cranial osteopathy
F.M. Alexander work
Energy work (with emphasis on subjective
streaming sensations)
Rolf Movement Education
Biodynamic bodywork (e.g. Reichian

bodywork, Boyesen work, etc.)
Postural re-education methods
Gentle affective massage methods
Figure 4. Therapeutic approaches primarily focused on refinement of proprioception and interoception.
creased local tissue hydration,

changes in temperature, in skin colour, in breathing, micro movements
of the limbs, pupil dilation and facial
expression can serve as valuable signals for physiological effects related
to interoceptive processes.
Therapists which apply mechanical
stimulation to visceral tissues, such as
visceral osteopaths, should also
profit from a larger recognition of
interoception and related physiological as well as psycho-emotional effects. Recent discoveries concerning
the richness of the enteric nervous
system have taught us that our belly
brain contains more than 100 million
neurons (Gershon 1999). Most of
these are located either in the con-
14 Terra Rosa E-mag
nective tissue zone between the inner and outer layers of the muscularis
externa (Auerbachs plexus) or in the
dense connective tissue layer of the
sub mucosa (Meissners plexus).
Many of these visceral nerve endings
are directly concerned with interoception and are connected via the
lamina 1-spinothalamocortical pathway with the cortical insula, as described above. Considering that several complex disorders such as irritable bowel syndrome are associated
with a disrupted modulation of insular responses to visceral stimuli, it is
conceivable that a slow and careful
application of manual forces to visceral tissues, if accompanied by a
sense of safety and mindfulness of
the client, could be useful if not ideal
approaches for enhancing a healthy

interoceptive self regulation.
Myofascial as well as visceral therapists should also not be surprised
when encountering psychoemotional responses or emotional
release which may include changes in
internal body perception, in selfawareness or affective emotions.
These may be triggered by their
stimulation of interoceptive free
nerve endings in the skin, in visceral
connective tissues as well as in muscular tissues.
Movement Therapies and Interoception
In competitive sports, the attention is
often focused on achieving an exter-
Interoception
nal goal, and often it also focused on
overriding internal sensations of discomfort, tiredness, etc. In contrast,
complementary or alternative practices, such as Yoga, Tai Chi, Qi Gong,
Pilates, Feldenkrais, Body Mind Centering or Continuum Movement, usually encourage a perceptual emphasis
on finer sensations in ones own
body. However, depending on the
focus of the individual teacher or respective school, the internal perception is sometimes directed almost
entirely towards proprioceptive refinement. For example, a student of
such training approaches may learn
to feel minute movements of individual vertebrae or to control their lumbar lordosis within a multitude of
loading situations. Nevertheless they
may remain an interoceptive moron,
e.g. unable to differentiate visceral
sensations from signs of an empty
stomach, of stage fright oriented
butterflies, of empathy driven gut
feelings about another persons dilemma, which may simply be an acute
gastritis.
In contrast some teachers of these
practices also include a skilled finetuning the students perception for
interoceptive sensations (see Figure
4). This may include emphasizing
sensations such as a subtle tingling
under the skin, sensation of a general
or localized warming, a subjective
sense of internal spaciousness, a feeling of aliveness, an inner silence, an
emotional home coming, or a meditation like change in general self
awareness. For example gravity oriented changes in body positions,
such as some upside-down postures
in yoga practices, could easily trigger
new and interesting (and hopefully
unthreatening) sensations in visceral
ligaments, which can foster interoceptive refinement. Given the recent
research indications for a close corre-
lation between disrupted interoception with many psycho-emotional

disorders, such as irritable bowel syndrome, anxiety or post-traumatic
stress disorder, it is plausible that
some of these movement practices
may have a strong therapeutic potential. Typically these therapeutic practices foster an attitude of inner mindfulness, of refining internal listening
skills, and they frequently alternate
brief periods of active motor attention with subsequent periods of rest
where the students pay attention to
small interoceptive sensations within
their body. Not surprisingly, some
studies already indicate a positive
health enhancing effect of such mindfulness-based therapies for a large
number of common clinical conditions (Astin et al. 2003).
References
Astin JA, Shapiro SL, Eisenberg DM,
Forys KL (2003) Mind-body medicine:
state of the science, implications for
practice. J Am Board Fam Pract 16: 131
-147.
Berlucchi G, Aglioti SM (2010) The
body in the brain revisited. Exp Brain
Res 200: 25-35
Craig AD (2002) How do you feel?
Interoception: the sense of the
physiological condition of the body.
Nat Rev Neurosci 3: 655-66
Craig AD (2003) Interoception: the
sense of the physiologically condition
of the body. Curr Opin Neurobiol. 13:
500-505.
Craig AD (2009) How do you feelnow? The anterior insula and human
awareness. Nat Rev Neurosci 10: 59
70
P (2013) Mindfulness therapy for

somatization disorder and functional
somatic syndromes: randomized trial
with one-year follow-up. J Psychosom
Res 74(1): 31-40.
Gershon MD (1999) The second brain.
Harper Perennial, New York.
Harlow HF (1958) The nature of love.
Am Psych 13: 673-689.
Montague A. (1971) Touch: The Human Significance of the Skin. Harper
& Row, New York
McGlone, Francis, Johan Wessberg,
and Hkan Olausson (2014) Discriminative and Affective Touch: Sensing
and Feeling. Neuron 82.4 : 737-755.
Mosely, L. How should we measure
body awareness? Body In Mind.
http://www.bodyinmind.org/howshould-we-measure-body-awareness/
Olausson HW, Cole J, Vallbo A,
McGlone F, Elam M, Krmer HH, Rylander K, Wessberg J, Bushnell MC
(2008) Unmyelinated tactile afferents
have opposite effects on insular and
somatosensory cortical processing.
Neurosci Lett 436: 128-132.
Olausson H, Wessberg J, Morrison I,
McGlone F, Vallbo A (2010) The neurophysiology of unmyelinated tactile
afferents. Neurosci Biobehav Rev. 34:
185-191
Pollatos, O., Fsts, J., & Critchley, H.
D. (2012). On the generalised embodiment of pain: How interoceptive sensitivity modulates cutaneous pain
perception. Pain, 153(8), 1680-1686.
Schleip R (2003) Fascial plasticity a
new neurobiological explanation.
Part 1. J Bodyw Movem Ther 7: 11-19
Valenzuela-Moguillansky, C. (2012)
Chronic pain disturbances in body
awareness. Chilean Journal of Neuropsychology, 7(1) 26-38.
Dunn BD, Galton HC, Morgan R, et al.

(2010). Listening to your heart. How
interoception shapes emotion experience and intuitive decision making.
Psychol Sci 21 (12): 18351844.
Fjorback L, Arendt M, Ornbl E,
Walach H, Rehfeld E, Schrder A, Fink
Terra Rosa E-mag 15
Yoga & Fascia

with Daniela Meinl
Explore an interesting Fusion of Bhakti Vinyasa Yoga and

latest Fascial Training and Fascia Research in an experiential Workshop to dive deep into your tissues.
Sydney Jan 29, 2015. (9 am5 pm )
More info at www.terrarosa.com.au
E: terrarosa@gmail.com
16 Terra Rosa E-mag
Clinical Orthopedic Manual Therapy

with Dr. Joe Muscolino
Sydney, November 2015
This workshop covers the major clinical orthopedic assessment and treatment techniques
for the thoracic spine and ribcage.
31 Oct, 1 Nov 2015, Sydney
This workshop covers motion palpation and

joint mobilisation of the entire spine
(cervical, thoracic, and lumbar) as well as the
sacroiliac joint and rib cage.
2 & 3 November 2015, Sydney
Terra Rosa e-magazine, No. 11 (December 2012)
"Joe Muscolino is a master of his profession! His broad

knowledge on the human body and extensive experience
made the workshops interesting and engaging. I would
highly recommend his workshops to any body-worker. I,
E-mag
17 G, North
17
myself, can't wait for the nextTerra
one!"Rosa
Zuzana
Sydney.
Report from
The 2014 Fascia Summer School
By Alison Slater
It was my pleasure and privilege to attend the recent Fascia Summer School in Germany, held at the esteemed Ulm
University. A biennial event, it offered a mouth-watering
array of internationally-renowned presenters. Part of a
small (60 or so) group, the likes of Andry Vleeming, Carla
Stecco, William Fourie, Siegfried Mense and Robert
Schleip were easily accessible and open to questions. The
program was well considered but in such company, there
was a tendency to want to see and participate in everything on the agenda! Meeting at the charming and historic
Villa Eberheim, we were allocated groups depending on
our pre-conference preferences to attend different breakout sessions , and given an opportunity to meet the other
attendees who had gathered from all over the world. It
was fascinating to appreciate the range of professions
from which they all hailed physiotherapists (like myself),
soft tissue and movement therapists, yoga and Pilates
aficionados! They were all represented.
We opened with an inspiring address by Carla Stecco, who
is soon to put to print the worlds first anatomy atlas with
the emphasis on fascia! In her relentless quest for answers and countless dissections, Carla always comes up
with something fresh and exciting. On this occasion, she
outlined and showed us the role of paratenon, and how
this structure in the Achilles area is strongly integrated
with the crural fascia and that it is this continuity of paratenon and the deep fascia which splits around each tendon
to create separate compartments. (Note: paratenon is the
fatty areolar tissue filling the interstices of the fascial compartment in which a tendon is situated according to Dorland's Medical Dictionary for Health Consumers). The differentiation of paratenon, epitenon and endotenon was
highlighted, and we were reminded of the role of these
structures and the deep fascia in force transmission. The
18 Terra Rosa E-mag
disease process of paratendinitis involves myofibroblastic

activity, thickening of the paratenon, the increase in type I
and type II collagen fibres and obliteration of blood vessels. Normalisation of fascial tensions in the early stages
could avoid damage to the tendon but chronic inflammation will dramatically alter the glide characteristics of the
tissue with devastating functional consequences; surgical
repair must aim to preserve the paratenon to nourish further repair. Preservation of the gliding between different
layers must be our aim when working on the soft tissue,
and foam rollers were lauded as a means to accentuate
this. She also touched upon more recent research that
suggests that antibiotics can increase the likelihood of

ruptures of the tendo-Achilles.
Her second lecture, delivered later that same morning,
concerned the difference between densification and fibrosis of fascia. Both represent pathologic changes to
deep fascia which may be responsible for causing pain
within deep fascia when nociceptors become enmeshed.
Differentiating between the two and understanding the
connective tissue matrix will guide treatment choice to
alleviate chronic pain syndromes. The causes of densification include low pH, low temperature, dehydration and
accumulation of waste products. Alkalisation is not a
problem increased acidity causes increased viscosity of
loose connective tissue. We were introduced to the concept of functional failure if collagen is deposited between the fascial layers and that stretching the fibroblasts
increases collagen turnover. And that the fascia of a newborn is homogeneous, and that movement dictates line-of
-force creation as the child begins to load-bear. There was
general agreement that there is urgent need to standardise the terminology were using internationally to differentiate the fascial layers, and this was highlighted repeatedly during the weeks presentations.
Boris Hinz joined us via a Skype link from the Laboratory
of Tissue Repair and Regeneration at the University of
Toronto. His presentation concerned the mechanics of
healing, including truly amazing time-lapse footage of
integrans allowing TGF-1 from the extracellular matrix to
facilitate the transformation of a fibroblast into a differentiated myofibroblast. This process is inhibited by mechanical stress and reduced oxygen levels in the blood.
William Fourie gave two excellent presentations on the
importance of working with scar tissue. This gracious and
empathetic man told of his work with paralympians and
breast cancer survivors alike, and was at pains to point
out the critical aspect of respecting the emotional aspect
of a scar and what it represents in terms of loss. His painstaking dissections demonstrated just how devastating
adhesions can be, not just in the immediate vicinity of the
scar but over vast areas of the body think kinetic chains/
anatomy trains, with the inevitable ramifications for functional movement.
Uwe Schtz gave a fascinating insight and account into
the lives of ultra marathon runners. He and his team followed the participants in the 2009 Trans Europe Footrace
covering a staggering 4487 km! He drove a pantechnicon
containing an MRI scanner to monitor the inflammatory
profiles of the runners. While some had to withdraw from
the race, others actually ran themselves back to health
through a process of adaptation. These individuals were
found to have a higher cold pain tolerance than controls.
Heike Jger walked us through the myriad of tensional
loading receptors within fascia that support our true sixth
sense, proprioception, an ideal first introduced by Andrew
T Still in 1899. Martina Zgel then spoke of her work into
how sex hormones promote skeletal muscle regeneration.
Scott Wearing, a fellow Aussie, spoke of his work into
defining the heel pad behaviour during barefoot running.
He devised an ingenious method of applying ultrasound
to a heel during impact. The findings of his study suggest
that wearing shoes decreases the vibrational loading in
the heel but significantly increases the loading within the
Achilles.
Siegfried Mense whose work we are all familiar with, over
many years, Nat Padihar, Andry Farasyn, Rainer Wirtz and
Tom Findlay all gave their insights into their current research. Dr Findlay with his myriad of knowledge and experience was on hand to offer tips and guidance for those
wishing to undertake research. Given his prolific output
over many years, who could ignore his wisdom?
We were all treated to a couple of sessions in the anat-
Terra Rosa E-mag 19
omy labs where barely-fixed specimens were available as

we observed Hanno Steinke demonstrating various fascial
connections and the overall integrity of the body. There
were a number of plastinated models as well, a methodology first developed by Gunther von Hagens in 1977. This
allowed the models to be handled with ease and safety
(both of the model and the handler!). The sections
through the trunk, about 2 cm thick allowed for easy appreciation of the layering effect that the superficial and
deep fascia affords the tissue be it muscle, an organ or a
cavity. A small group of us had the honour of a private
tutorial with Dr. Stecco who demonstrated the three distinct layers of the thoracolumbar fascia as it envelops and
divides the trunk.
Amongst the break-out sessions, Daniele-Claude Martin
offered a fascinating practical insight into biotensegrity,
something Im sure as practitioners well hear a lot more
about it in the future. As well as giving a keynote address,
Andry Vleeming demonstrated the accepted tests for differentiating pelvic girdle pain, imploring all to recognise
and adequately address the long dorsal ligament as a
common source of so much of the pain emanating from
this area. He was adamant that piriformis syndrome is
exceedingly rare other than in athletes. Instead, Gluteus
Maximus is believed to be hypertonic, even if it is atrophic.
Divo Mller (aka Mrs. Schleip) was on hand to demonstrate the methodology of Fascial Fitness. She also provided welcome relief from long hours of sitting (the natural enemy of the clinician!) with intermittent bursts of fascial stretching and bouncing between lectures! William
Fourie expounded the practical approach to scar management to avoid the pitfalls he had so graphically demonstrated in his lectures. He is apparently touring Australia
at the end of 2015 so keep an eye out for that. I can per-
20 Terra Rosa E-mag
sonally recommend his presentations. Wilbour Kelsick

who has worked on and associated with the likes of Usain
Bolt, taught us how to run, fascially, which was fun and
instructional!
I hope Ive at least given readers an insight into what was
a thought-provoking and fascinating week. One I hope to
repeat when it rolls around in another 2 years!
About the Author

Alison Slater is a highly accredited Physiotherapist, offering 28 years of Australian and international training and
practical clinical experience. A graduate of The University
of New South Wales and Cumberland College of Health
Sciences , Alison has also undertaken significant postgraduate study, including a Master of Manual Therapy
from the University of Western Australia. Upon graduation, Alison was invited to join the University as an Adjunct Teaching Fellow, a position she has retained since.
Alisons areas of special interest are fascia and fascial manipulation, and the spine, specifically, the sacrum/pelvis.
She has undertaken numerous advanced courses and
taught extensively throughout Australia and the United
Kingdom in Muscle Energy Technique. She has presented
at Soft Tissue Conferences both here and abroad. Alison
also has extensive experience in Craniosacral Therapy, Dry
Needling, Myofascial Release, Mulligan Technique and
manual therapy assessment and treatment; and is committed to being totally hands-on. She balances her holistic approach with the latest clinical research findings from
around the world.
bodybliss is a movement program developed by Divo G. Mller and incorporates latest scientific knowledge on fascial connectivity and neurobiology of movement. Special Focus will be
on the concept of embodiment - the experience of the body as a moving flow and the sensual
unfolding into the fluid dynamics of muscles, bones, fascia and the fluid systems.
Sydney
bodybliss Part I: 22-23 Jan 2015, bodybliss Part II: 24-25 Jan 2015
Daniela Meinl is a dedicated and gifted Bodybliss Trainer. She embodies strength, fluidity and sensitivity and is able to share
her knowledge with a clear mind, an open heart and a kind spirit. All aspects which are providing an opening in the field to
encourage participants to explore and discover new, yet unknown movement potentials. I highly encourage you to get introduced in bodybliss and deepen your experience in the Courses offered in Australia by her. Divo Mller
DANIELA MEINL
Fascial Fitness Master Trainer, Yoga Teacher, Advanced Pilates and bodybliss Trainer, Meditation Facilitator, Alternative Practitioner for body-oriented Psychotherapy (HPG)
Trained as a movement teacher, bodyworker and meditation facilitator I have been exploring movement and
personal growth for the past 10 years. I have been trained in Aerobics, Back Health and Pilates, Certified Bhakti
Vinyasa Flow Yoga Teacher .
My strength in teaching is in imparting knowledge in a structured way while always keeping the practical relevance
of the content in mind. I like to allow participants to explore the new aspects of movement and to experience this
directly in their own bodies. I am passionate about how movement can bring back life and connection to oneself and
each other in peoples lives. Id love to share this with you soon in one of my classes.
More Info at www.terrarosa.com.au
Terra Rosa E-mag 21
Advanced Myofascial Techniques

with
Til Luchau, Advanced-Trainings.com
Sciatica and Disc Issues: Special 1-day course

Friday, May 22, 2015, Sydney
Pelvis, Hip and Sacrum: Parts I & II
Sat-Sun, May 23-24, 2015, Sydney
More Info at: www.terrarosa.com.au

22 Terra Rosa E-mag
FFT Case Study:

Exposed Leg Fractures
By Ron Alexander
At the Functional Fascial taping (FFT)
Workshop in Rio de Janerio, one of
the participants, Julio Cesar, a Physiotherapist, suffered 5 exposed fractures as a result of being hit by a
truck whilst riding a motorbike 21
years ago. After the accident he was
placed in a leg device to lengthen the
leg, he then had a surgical fascial release of the Tendo Achilles and the
Plantar Fascia.
Before FFT treatment he had a Visual
Analogue Scale (VAS) score of 8/10
pain whilst standing and whilst sitting
putting weight on the leg and foot.
After FFT his VAS score was 2/10. The
following day he had no pain standing and walking. He still had limited
dorsiflexion which still resulted in a
limp, however his gate was better
than he had for years. We don't think
dorsiflexion will return to normal due
to the amount of damage and surgical procedures. Over subsequent
weeks and months Julio self administered FFT less frequently and then
only sporadically. Now, he no longer
requires FFT.
Julios quality of life has improved
dramatically as a result of the tape.
At the 12 month follow up he reported that he had returned to doing
martial arts including competitive
fighting, this is after 21 yrs of being
unable to participate in any sport due
to pain. His surgeon was impressed
by this but was unable to explain how
the taping could bring about this

change. In Julios case we were not
able to achieve much of an improvement to his range of motion, apart
from putting his foot flat on the floor,
which was completely achieved the
following day. However, this was
already a major improvement, his
function was much better with significant reduction in pain and he felt
optimistic about change in his condition.
The surgeons inability to identify
how change occurred is a question
that still remains unanswered. There
are numerous reasons why we experience pain. In Julios case, for the
first couple of years we can understand it as his condition involved massive trauma, mechanical repair, ongoing mechanical disruption by the
process of the lengthening and healing bones and soft tissues, followed
by ongoing disrupted biological repair. He followed the standard rehabilitation procedures for someone
with this type of injury. This is a complicated pathology that would have
many contributing factors, however,
in the end he continued to have pain
and it is the residual pain that I
viewed from a neuro-fascial perspective.
The application of FFT involves
stretching the skin and underlying
tissues in a pain-specific direction.
One plausible explanation is that the
application of rigid tape with tension

on the skin could stimulate largediameter afferent fibres and then
modulate nociceptor input (gate control mechanism). In addition to this,
stretching the skin in a pain-specific
direction with FFT may affect pain
perception or it may alter local tissue
internal architecture (Ingber 2008) as
well as stimulate cutaneous Mechanoreceptors (Grigg 2002). If we view
the body from a Biotensegrity principle where living tissue and cells are
constructed by discontinuous compression columns (bones) supported
and balanced by tension elements
(fasciae and connective tissues) resulting in continuous tension (Fuller
1961, Ingber 1998) then FFT may be
offering a strong sustained load by
tightening components of the mechanical scaffolding of the body. The
external force from the tape on the
skin may transfer to the underlying
tissue and cause multi-laminal sliding
movements under the skin, and that
could convert into an internal force
to evoke different levels and types of
mechanoreceptor firing (Chen 2012#).
In a practical sense once the tape is
applied to the body this potentially
creates sustained altered load, the
patient is then assisting the treatment by actively moving the affected
area and thereby increasing the load
provided by the tape . This is custom
made for each patient/athlete for an
Terra Rosa E-mag 23
FFT on Exposed Leg Fractures

(a)
(b)
(c)
(a) Medial side of foot. Pre-test position with limited range of motion. (b) Medial side of foot after taping. Julio is taught h ow to re-apply the tape
himself. (c) Lateral side of foot after taping and shoe on. The tape directions stayed consistent throughout the treatment.
extended and pre-determined period

of time. By removing the pain via FFT
and having the patient go about normal activity, we are potentially assisting proprioceptively by encouraging
muscle firing and restoring normal
movement patterns. The patient can
now move into this new range, pain
free which may assist with the apprehension of pain, elevate mood and reeducate the neuro-muscular system
through rehabilitation. In Julios case
FFT, walking, normal activity and then
martial arts was all that was required
to reduce his pain, possibly due to
the limited dorsiflexion.
We conducted a randomised double
blind placebo controlled study on FFT
for a non-acute non-specific low back
pain that demonstrated a significant
effect on pain and function with FFT.
Although this was conducted on the
low back, the same hypothesis of
how change occurred can translate
to other areas of the body (Chen
2012). This is the process that I used
when treating Julios condition. FFT
24 Terra Rosa E-mag
has a relative simple objective assessment procedure and tape application

that can be fast to do (not in this case
study) and is used by any therapist
treating neuro-musculoskeletal conditions.
References
Ron Alexander. Functional Fascial

Taping Practitioner [FFTP]. Director/
Founder of the Functional Fascial
Taping Institute Melbourne, Australia. Co-Investigator Randomised Double Blind Placebo Controlled Trial of
FFT for Non-Specific Low Back Pain
[PhD] Deakin University Melbourne,
Australia. Awarded the Lady Southey
Scholarship for Excellence from the
Australian Ballet Foundation. Presented FFT to the International Olympic Committee World Congress, the
Royal College of Surgeons UK. Fifth,
Sixth and Eighth Interdisciplinary
World Congress on Low Back & Pelvic
Pain and the Fascia Research Congress 2007 including an FFT workshop at the FRC in 2012.
Macgregor K, Gerlach S, Mellor R, et al.

2005. Cutaneous stimulationfrom patella
tape causes a differential increase in vasti
muscle activity in people with patellofemoral pain. J Orthopaed Res; 23: 351
358.
Ingber DE. 2008. Tensegrity-based mechanosensing from macro to micro. Prog

Biophys Mol Biol; 97: 163179.
Grigg P and Del Prete Z. 2002.Stretch
sensitivity of cutaneous afferent neurons.
Behav Brain Res; 135: 3541.
Chen SM, Alexander R, Sing KL,Cook J.

2012. Efficacy of Functional Fascial Taping
on Pain and Function in Patients with Non
-Specific Low Back Pain: A Randomised
Controlled Trial. Pub Clin Re-hab Oct 2012
Vol 26, No. 10. 924-933.
#Chen SM. 2012. FFT Thesis. Neurophysiology of the Cutaneous Mechanoreceptors.
Deakin University, Supervised by Professor Jill Cook.
Alexander R. 2014. Functional Fascial Taping and Research. Terra Rosa e-magazine,
No. 14.July. pp 24-29.
Functional Fascial Taping

with Ron Alexander
Evidence-Based Pain Relief

This workshop teaches a fast and simple way for clinicians to reduce
pain, improve function, encourage normal movement patterns and rehabilitation of musculoskeletal pathologies in a pain-free environment.
FFT has been shown to have a significant effect on Non-Specific Low
Back Pain in a randomised double-blind PhD study. FFT is a noninvasive, immediate, functional and an objective way to decrease
musculoskeletal pain.
Presenter:
Ron Alexander
A great way to encourage treatments

to hold longer
STT [Musculoskeletal],
FFT Founder and Teacher
Sydney, 14-15 March 2015

Melbourne ,21-22 March 2015
Wodonga, 28-29 March 2015
Register Now at:
Terra Rosa E-mag 25
Plantar Fasciitis
High loading strength training improves outcome
By Michael Rathleff
Most of us who have experienced plantar fasciitis know
first hand how debilitating and frustrating it can be. Every
morning resembles being forced to walk on broken glass
and you quickly become grumpy and dissatisfied. The
prevalence in the general population is estimated to
range from 3.6% to 7% [1, 2], and may account for as much
as 8% of all running-related injuries [3, 4]. The life time
prevalence may be as high as 10% which means that quite
a big proportion of us will at some point be affected by
plantar fasciitis or see these patients in the clinic.
Most previous treatment studies on plantar fasciitis have
used a combination of orthotics, plantar specific stretching or similar non-exercise intervention. These interventions have proven successful to some degree and we
know they are superior to placebo treatment. However a
large proportion of patients still have symptoms two
years after the initial diagnosis. Most clinicians who see
these patients in the clinic will agree that they can be
quite the challenge especially if they have a long symptom duration. So we definitely need to start thinking
about new effective treatments. An interesting thing is
that we are starting to realise that there are some similarities between plantar fasciitis and tendinopathy. We know
from the literature that high-load strength training appears to be effective in the treatment of tendinopathy [5].
A similar approach to plantar fasciitis therefore seems to
be relevant to test. We recently completed a study where
we investigated the effect of a high-load strength-training
program compared to a standard plantar specific stretching program in the treatment of plantar fasciitis.[6]
26 Terra Rosa E-mag
Our main question before initiating the trial

was how we could induce high tensile forces
across the plantar fascia
to resemble the loads
induced to the patella
tendon during e.g. single leg squat. Our approach was to exploit
the windlass mechanism during single-leg
calf-raises by using a
towel to dorsal flex the
toes. In theory, the
windlass-mechanism
would cause a tightening of the plantar fascia
during dorsal flexion of
the metatarsophalangeal joints while high
-loading of the Achilles
tendon is transferred to the plantar fascia because of
their close anatomical connection [7-9].
We recruited 48 patients with ultrasonography verified
plantar fasciitis. They were randomised to either high-load
strength training or plantar specific stretching. In addition
both groups received a short patient information sheet
and gel heel-inserts. The patient information sheet covered information on plantar fasciitis, advice on pain man-
Table 1. Advice given to the patients.
agement; information on how to modify physical activity;

how to return slowly to sports and information on how to
use the gel heel-inserts. On a side note, I think that one of
the key things in successful management of plantar fasciitis is to educate the patient. The advice we used can be
seen below in Table 1.
The plantar-specific stretching protocol was identical to
that of DiGiovanni (2003) [10]. Patients were instructed to
perform this exercise whilst sitting by crossing the affected leg over the contralateral leg (Figure 1). Then, while
using the hand on the affected side, they were instructed
to place the fingers across the base of the toes on the bottom of the foot (distal to the metatarsophalangeal joints)
and pull the toes back toward the shin until they felt a
stretch in the arch of the foot. They were instructed to
palpate the plantar fascia during stretching to ensure tension in the plantar fascia. As in DiGiovanni, patients were
instructed to perform the stretch 10 times, for 10 seconds,
three times per day [10].
High-load strength training consisted of unilateral heelraises with a towel inserted under the toes to further activate the windlass-mechanism (Figure 2). The towel was
individualised, ensuring that the patients had their toes
A key clinical point is that the calf-raises

need to be done slowly to decrease the risk
of symptom flaring.
maximally dorsal flexed at the top of the heel-rise. The patients were instructed to perform the exercises every second day for three months. Every heel-rise consisted of a
three second concentric phase (going up) and a three second eccentric phase (coming down) with a 2 second isometric phase (pause at the top of the exercise). The highload strength training was slowly progressed throughout
the trial as previously reported by Kongsgaard et al. [11].
They started at 12 repetition maximum (RM) for three sets.
After two weeks, they increased the load by using a backpack with books and reduced the number of repetitions to
10RM, simultaneously increasing the number of sets to
four. After four weeks, they were instructed to perform
8RM and perform five sets. They were instructed to keep
adding books to the backpack as they became stronger.
We used the Foot Function Index as our primary outcome
after three months but also did follow-ups after 1,6 and 12
Terra Rosa E-mag 27
Figure 1. Plantar-specific stretching.
months. At our 3 months follow-up we saw that patients

randomised to high load strength training had a 29 points
lower Foot Function Index.
This is far greater than the minimal relevant difference
and suggests a superior effect of high-load strength
training compared to plantar specific stretching. An important aspect is that we saw no difference between
groups at 6 and 12 months indicating no superior longterm effect. However, if you ask patients to choose between two treatments that have similar long-term effect
but one will give you a quicker reduction in pain, I am certain that all patients would choose the treatment, which
provides them with the quickest reduction in pain.
There are still lots of unanswered questions about why
high-load strength training may work in the treatment of
plantar fasciitis. One explanation could be that high-load
strength training may stimulate increased collagen synthesis which help normalise tendon structure, increase
load tolerability of the plantar fascia and thereby improve
patient outcomes. Another explanation may be that the
exercise help improve ankle dorsal flexion range of motion as well as improving intrinsic foot strength and ankle
dorsal flexion strength. When I completed the high-load
strength training program as part of our pilot studies I
developed good DOMS in the intrinsics which suggest
28 Terra Rosa E-mag
they are active during the exercise. The questions are

many and hopefully other researchers will take a critical
look at our findings and confirm or contradict our findings.
The loading paradigm for treatment of plantar fasciitis is
by no means a miracle treatment. However, it does provide us with the first evidence that high-load strength
training may be the road towards more effective treatments for plantar fasciitis. The key message to the patients is that they need to perform the exercises
(otherwise they are unlikely to work) and they need to be
performed slowly (3s up, 2s pause at the top and 3s
down) to decrease risk of symptom flaring and with
enough load starting by 12RM for three sets and working
their way down to 8RM for five sets.
This article was originally published in RunningPhysio.com.
Dr. Michael Rathleff is a researcher at Department of Clinical Medicine, Aarhus University,
Denmark. His research interest is in Patellofemoral Pain among adolescents and how
new technology can measure adherence and
quality of unsupervised home-exercises . Follow his
tweeter https://twitter.com/MichaelRathleff
Figure 2. High-load strength training.
References
Scand J Med Sci Spor 2014:n/a-n/a doi: 10.1111/sms.12313.
1. Hill CL, Gill TK, Menz HB, Taylor AW. Prevalence and correlates
of foot pain in a population-based study: the North West Adelaide
health study. J Foot Ankle Res 2008;1(1):2 doi: 10.1186/1757-1146-12.
7. Stecco C, Corradin M, Macchi V, et al. Plantar fascia anatomy

and its relationship with Achilles tendon and paratenon. Journal
of anatomy 2013;223(6):665-76 doi: 10.1111/joa.12111.
2. Dunn JE, Link CL, Felson DT, Crincoli MG, Keysor JJ, McKinlay
JB. Prevalence of foot and ankle conditions in a multiethnic community sample of older adults. Am J Epidemiol 2004;159(5):491-8.
3. Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith
DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002;36(2):95-101.
4. Lysholm J, Wiklander J. Injuries in runners. Am J Sports Med
1987;15(2):168-71.
5. Malliaras P, Barton CJ, Reeves ND, Langberg H. Achilles and
patellar tendinopathy loading programmes : a systematic review
comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports Med 2013;43(4):267-86 doi:
10.1007/s40279-013-0019-z.
6. Rathleff MS, Mlgaard CM, Fredberg U, et al. High-load
strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up.
8. Cheung JT, Zhang M, An KN. Effect of Achilles tendon loading

on plantar fascia tension in the standing foot. Clin Biomech
(Bristol, Avon) 2006;21(2):194-203 doi: 10.1016/
j.clinbiomech.2005.09.016.
9. Carlson RE, Fleming LL, Hutton WC. The biomechanical relationship between the tendoachilles, plantar fascia and metatarsophalangeal joint dorsiflexion angle. Foot Ankle Int 2000;21(1):1825
10. DiGiovanni BF, Nawoczenski DA, Lintal ME, et al. Tissuespecific plantar fascia-stretching exercise enhances outcomes in
patients with chronic heel pain. A prospective, randomized study.
J Bone Joint Surg Am 2003;85-A(7):1270-7
11. Kongsgaard M, Kovanen V, Aagaard P, et al. Corticosteroid
injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scand J Med Sci Sports
2009;19(6):790-802 doi: 10.1111/j.1600-0838.2009.00949.x.
Terra Rosa E-mag 29
Comments on the Plantar Fasciitis study

By Joe Muscolino
The research study and subsequent guest blog (reprinted
here) on the effectiveness of the treatment of plantar
fasciitis with high-load strength training was nicely laid
out and clearly explained. And the conclusion was quite
straightforward: High-load strength training is an effective treatment paradigm for plantar fasciitis, and a viable
alternative to the classic plantar stretching protocol. In
fact, as pointed out, high-load strength in this study was
shown to be more effective in the short run, three
months from the outset of the treatment program, than
the plantar stretching approach.
The blog was so clearly written and explained that I do
not feel that I have any enlightening conclusions to make
regarding the topic of the study itself. Instead, I would
like to use the opportunity to comment on this study to
make a general observation regarding the value of biomechanics compared to research.
I am a great proponent of research. At its core, research is
simply the ability to reproduce a stated result. If someone
claims that a particular treatment approach is effective
because it works in his or her practice, and as we so often
hear in the world of manual and movement therapy, that
it is a miraculous new technique that will cure the world; a
research study puts this claim to the test. And if done
well, the study is double blind and therefore without
bias.
However, in this age in which the trend is swinging harder
and harder toward all care being evidence-based, there
are times when I fear that the pendulum is swinging too
far and that we are replacing critical thinking with the
need for a research study to tell us what to think. Although I greatly respect research being applied to neuromyo-fascio-skeletal treatment, I never want it to blindly
replace critical thinking that comes about from a fundamental understanding of biomechanics, in other words,
kinesiology.
It is probably not fair that I bring this up in response to
this particular research study because it actually was
prompted by critical thought. The author of the study/
blog noticed that high-load strength training was effective with the treatment of tendinopathies, and rightly
made the correlation that plantar fascia is similarly consti-
30 Terra Rosa E-mag
tuted of the same connective tissue. Therefore, it seemed

prudent that whatever treatment protocol was effective
with one fibrous fascia would be effective with another
fibrous fascia. After all, it is the mechanics that determine
the efficacy of a mechanical treatment approach. And I
am very glad that this particular research study was done
and proved this to be true.
It just scares me sometimes when I hear people repeat a
research study result without critically thinking through
the biomechanics of why the studys results turned out as
they did. Or often just as bad, someone discredits a treatment approach simply because a study has not yet been
conducted proving it to be true, without trying to reason
through the reasonableness/logic of the approach.
I often like to joke that a research study showed that 2
dogs + 2 dogs = 4 dogs; and another study showed that 2
cows + 2 cows = 4 cows; and yet another study showed
that 2 tigers + 2 tigers = 4 tigers; and then someone proposes that we should do another research study to examine the question of whether 2 cats + 2 cats = 4 cats. What I
believe is most important when determining the efficacy
of manual therapy treatment is to understand, and then
extrapolate and apply the principles of kinesiology!
Perhaps I unfairly used the opportunity of commenting on
this study to make my plea to not lose the idea of critical
thinking based on kinesiology to work through the likely
value of our neuro-myo-fascio-skeletal assessment and
treatment approaches. I very much enjoyed this study and
applaud the authors for undertaking it. The concept of
loading the plantar fascia from both ends by extending
(dorsiflexing) the metatarsophalangeal joints (for the
windlass effect) and engaging ankle joint plantarflexion
musculature (for its connection to the plantar fascia via
the superficial back line myofascial meridian) was an extremely creative and effective approach and quite in
keeping with critical thinking based on concepts of kinesiology!
Dr. Joe Muscolino is a global lecturer and author, and has
been a manual therapy educator for more than 25 years. His
website is http://www.learnmuscles.com/
Treatment of the Plantar Fasciitis

By Judah Lyons
Plantar Fasciitis has been one of the five major
complaints that seem to have hobbled through
my practice door in the last 25 years as a Rolfer
and Craniosacral therapist. Up until this point, no
one has needed the surgery to repair the inflammatory condition. Although, if the client has been
plagued by the condition for any length of time,
and they have made it to my table as a last resort
having exhausted other approaches, I will ask
them if they have had an x-ray to determine
whether or not they have a bone spur that has
been laid down due to excessive tension at the
attachments. Because if they do have a large
bone spur, its out of the scope of our practice. (I
only encountered this condition once in my practice). But, if they are free of any spurs, then as I
have said, I have been totally successful with my
myofascial approach.
Stretching the plantar fascia, image from Plantar Fasciitis DVD by Judah Lyons.
Once I ask the tell tale question, is it very painful when you first get out of bed in the morning"?. And the answer is a
definite yes, my strategy is a simple one, and I wont bore you by naming every anatomical structure in the lower leg
and foot. But, in order to take tension off of the attachments of the foot, including the plantar fascia, we need to
loosen everything below the knee including the retinaculum. Once that has been accomplished, the muscles of the bottom of the foot, the quadratus plantae, abductor hallucis, abductor digiti minimi, flexor digiroum brevis, lumbricals,
flexor hallucis brevis can be attended to with various tools that we can employ from our own anatomy.
Essentially the protocol is to loosen planes of tissue that have been tightened due to wide assortment of activities.
Imagine a trampoline that has been tightened down too much! The springs need to be let out, loosened to remove
some of the tension. Once that has been accomplished, the pain is usually gone. That may take some time of course,
and I send them home with lacrosse and golf balls to work the tissue themselves as instructed for 5 to 10 minutes a day
to continue the lengthening process. It has never failed. Once they feel like the pain has diminished to 70-80% of the
original condition, I will have them do calf raises in a very specific manner, and only if it doesnt create a return of the
inflammatory process. I also highly recommend epsom salt baths as hot as possible daily.
Judah Lyons is a certified Rolfer and Craniosacral therapist, practising in Charlottesville. He is also a graduate of the British
Sports Institute concentrating on sports injuries. Judah shared his knowledge, passion and experience with many students
over the years. His website is http://www.lyonsinstitute.com/
Terra Rosa E-mag 31

By Art Riggs
depth comment.
First, the original article about the high load strength
training as a treatment for plantar fasciitis. Like Joe, I
found the study well conducted and worthwhile, but also
think that for bodyworkers, its importance is extremely
important in broader perspective for growing a successful
therapeutic practice. An early teacher often quoted,
You give a man a hammer, and the whole world becomes a nail. As therapists we do our most effective
work with freeing adhesions and lengthening short muscles and fascia. However, many of the problems we treat
can be greatly helped by strengthening, movement work,
and educating with home programs. I will go into detail in
the next section, but must say that for most all conditions
and injuries, adding a well-informed knowledge of other
strategies will be of tremendous help for your clients and
for separating yourself from the competition. So many of
my clients have commented that the suggestions for
other strategies are the icing on the cake and it has been a
huge referral resource.
First, I want to applaud Terra Rosa for its continuing efforts to offer such informative and thought provoking
articles. I was quite intrigued with the recent articles
about plantar fasciitis and feel that their importance transcends just that condition and has general applications to
all of our practices for both our efficacy in treatment and
for a successful practice. To understand my comments, it
will be necessary to revisit the original articles.
As an ex-runner (knees) who treats both athletes and sedentary clients with plantar fasciitis, I feel it is almost an
epidemic, and am sure that any therapist could be seeing
20 people a week for shorter sessions with a little advertising and communication with podiatrists and athletic
shoe stores. Like Judah Lyons, Ive found that soft tissue
techniques are extremely helpfulmost clients commenting that it was the key to their recovery and more useful
than a lot of the more conventional treatments offered by
physicians or podiatrists. I was also grateful to Joe Mucolino for his philosophy about how to interpret clinical
studies with critical thought and think it is worth an in-
32 Terra Rosa E-mag
I do concur that the high load exercises would be very

helpful for many people who suffer from plantar fasciitis,
especially those in which stability and lack of strength is a
factor, but do feel that the condition is extremely complex and that there are many other helpful tools, particularly stretching, so putting all your eggs in the strengthening basket is not the best approach. In comparing the
strengthening to the stretching in the article, I sensed an
either/or mentality that is often seen in such studies
(albeit necessary to control factors) and would hope that
a multi faceted approach would be used by anyone treating plantar fasciitis.
The author of the study also writes a full guest blog article
on this (reprinted here) that illustrates the importance of
taking the time to read the complete study rather than
relying upon quick summaries. Doing this will stimulate
the critical thinking that Joe Muscolino argues for in his
excellent reply. The original has very helpful photographs
that demonstrate both the stretching used in the control
group and the specific high load exercises so one could
properly instruct clients.
What grabbed me in the photographs (Figure 2, page 29)

was that the exercises are not just training concentric
high load muscle function, and are a perfect example of
the difficulty in isolating factors, possibly leading to incorrect conclusions. Although the protocol only speaks to
heel raises, since the exercises require both dipping the
heel far down below the forefoot with the toes supported
by a towel, they also perform a significant stretch of the
plantar fascia and mobilization of the transverse arch.
Possibly more important is that in lowering the heel in
preparation for the concentric contraction, the patient is
performing a slow, non-explosive eccentric contraction of
the posterior compartment as well as a good stretch.
Many studies indicate that eccentric muscle strength is an
important factor in strengthening, especially in Achilles
injuries, and this may be a large factor that is ignored in
the statistics claiming benefit from the high load heel
raises.
Again, I think the article is very worthwhile and certainly
would recommend the exercises as part of a more comprehensive treatment plan, especially including the soft
tissue techniques that Judah Lyons covers.
To me, Joes comments about statistics on controlled
studies may be more important than the specifics of the
original article. Like Joe, I am highly in favor of such studies, but think he is astute in pointing out the risks of kneejerk acceptance that may shut off the all-important critical
thinking to apply to our treatments.
I want to point out a few brief points in connection with
Joes thoughts and possibly go into more detail in a later
article covering treatment options. Most important is the
fact that that plantar fasciitis. is a very complex condition,
and although the study is well constructed to attempt to
isolate treatment factors, it is impossible to isolate the
multi-faceted causes of the condition some of which are
actually conflicting and would require very different treatment.
Hypermobility: A high percentage of plantar fasciitis. is
a result of hypermobility (and not just in the foot, but
also knees and hips). If this is the primary cause, then
by all means, stabilization and strengthening will
probably be of the most benefit. This stabilization can
be accomplished by proper shoes or orthotics, which
have been shown to be quite helpful. And strengthening as demonstrated in the article would also be very
beneficial.
Hypomobility: I actually see more clients suffering
from plantar fasciitis. having a high arched rigid foot

structure or from having shoes that immobilize the
foot having both biomechanical effects with gait, and
preventing the plantar fascia from normal stretching in
activities so it becomes short and fibrosed. A lot of
new literature, including the well known Born to
Run touts the benefits of less shoe stability so the
foot can move through the range of motion that it is
built for. For such people, strengthening may be less
effective and techniques mentioned by Judah to increase mobility would probably be more helpful.
Body Structure: In addition to the arches of the foot
and the all important talo-tibial joint that Judah treats
by freeing the retinaculum, one must consider a multitude of factors, including, forefoot mechanics, hip
function, IT band tension causing rotational strain, valgus or varus knees, weight and general health of the
client.
Causative Activities: Any treatment should consider
the activities that seem to be causative. Is the person
sedentary? Are athletic activities primarily straight
ahead running or more mobile, as in sports requiring a
lot of lateral mobility and quick explosive starting and
stopping.
In varying degrees, these difficult to control factors may
influence the outcome of studies as much as a particular
technique. So the danger of any sampling is to jump to
Terra Rosa E-mag 33
different needs as mentioned above) are equally important.

The one exception Id offer concerns heel spurs. So often
Ive had people with quite new plantar fasciitis. say that an
x-ray showed a heel spur and that the doctor said that was
the cause. My feeling is that the heel spur has probably
been there for years, and although it may be involved, until
the flare up it was also there and it should not be given as
the cause. I have excellent results working to soften
tissue around the spur along with the other areas I treat.
I also spend a great deal of time stretching and softening
the posterior compartment of the lower leg, with particular attention to determining if the gastroc or soleus is more
tight and working with lateral/medial balance since tightness in one of the two gastroc heads can cause torsional
forces on the foot. I also agree that freeing the ankle retinaculum is extremely useful to have the foot track in a
straight line. Dealing with rotational forces all the way up
the leg is also helpful. I also always check both the navicular and cuboid bones for mobility, often finding that the
cuboid needs mobilizing.
conclusions about the efficacy of treatments. This may

create an either/or myopic approach and have therapy exclude possibly benefits from other strategies or even utilize a strategy that may be counter-productive. For example, if a large sample were to show minimal differences in
results for stretching, or for strengthening, or for orthotics, one might conclude that choice of treatment really
isnt much of a factor. In reality, the sample may include
very different causes such as previously mention hyper/
hypo mobility, weakness, tight muscles and fascia. A result
showing strengthening as more beneficial may actually be
that the sample included a higher number of people with
weakness or hypermobility as their causative factor, and
conversely, an apparent larger benefit from stretching,
might actually be a higher number of people with hypomobility as a cause. The skill of the therapist lies in tailoring
the treatment to the relevant factors
I have a whole basket of golf balls I give out to clients, telling them to use several times a day, but never to the point
of pain. For stubborn cases, a night splint to move the foot
into dorsiflexion can be very helpful. Interestingly, I also
find that calf stretches, both with knee straight and flexed
are often the key to lasting recovery, even after symptoms
abate. Im always very clear to clients that just because the
pain abates, they cant forget about keeping the area
working properly with stretching and possible tune up
work.
Lastly, I strongly suggest that therapists study proper function of the foot to understand the complexity of lateral
and medial arches, the transverse arch and the differences
in how the foot responds to proximal forces such as knees
and hips. The old shin bone connected to the knee bone
definitely applies. Im extremely impressed with James
Earls new book Born to Walk. If you want to really understand how the foot works and the tremendous importance
of how it distributes gravity through the body, affecting all
the major joints through the skull, this book will change
Lastly, a few comments about Judahs thoughts on plantar the way you approach bodywork.
fasciitis. I totally agree with the importance of his treatments of specific foot muscles and also am glad that he
gives his clients home treatment options. It is unrealistic
Art Riggs is a Certified Advanced Rolfer and massage therato think that we can cure such complex issues with a
pist who has been teaching bodywork since 1988. His webtreatment every week or two. Most of my clients love the site is http://www.deeptissuemassagemanual.com/
work but say that the home programs I offer (tailored to
34 Terra Rosa E-mag

By Til Luchau
Like Joe Muscolino, I appreciated the

studys (and the subsequent guest blog
reprinted in this issue) clarity and reasoned approach. I also noted that the
authors included the plantar fascias
larger-picture relationship to the Achilles tendon in their exercise design, and
their measurements of plantar fascia
tendon thickness changes, both of
which have potential relevance to the
hands-on myofascial approaches I practice and teach.
pain despite my best efforts to further

her gains over the following weeks.
Because she was also working with a
physical therapist who had given her
exercises for her plantar fascia pain, I
gave her a copy of the study and suggested she share it with her PT. He
added the studys heel-raise exercise to
her routine. Six weeks later, she now
reports no plantar fascia pain.
Of course, her case represents just one
data point. It was also impossible to tell
if the heel-raises alone made the difference: she continued to see me for myofascial work during this time, as well as
an orthopedist who administered four
sessions of shock wave therapy (which
is thought to trigger tissue healing by
inducing microtrauma to the painful
tissues). However, it was gratifying to
see her find a combination of approaches that gave her the relief she
had been seeking.
100
90
Foot Function Index
This study, published in the Scandinavian Journal of Medicine & Science in

Sports, compared a plantar fascia
stretching routine with a strengthening
exercise (heel raises), measuring the
two approaches relative effectiveness
in reducing foot pain and disability in
those with plantar fasciitis symptoms.
Previous studies showed degenerative
changes in such patients in the connective tissue of plantar fascia where it
attaches the bone. Because similar connective tissue degeneration of the patellar and Achilles tendons has been
improved by high-load strength training, the authors of this study reasoned
that such strength training of the plantar fascia might also improve plantar
fasciitis outcomes.
It is noteworthy that although the

Rathleff et al. study showed the most
dramatic advantage to strengthening
vs. stretching after 3 months (see Figure 1), no significant differences in improvement were seen at 1, 6, or 12
months when comparing the strengthening and stretching groups, suggesting that there is value in stretching as
well. Of course, our patients and clients
will appreciate the most rapid relief
possible; having multiple approaches
and tools to employ will only increase
our effectiveness and versatility.
Til Luchau, Advanced-Trainings.com, is a

Certified Advanced Rolfer and the originator of the Advanced Myofascial Techniques series.
Shoe insert & stretching

Shoe insert & strength training
80
70
60
At the time I read this study, I was see50

ing a 66-year-old client with a history of
plantar fascia pain secondary to
40
trauma. Like many other fascial practi30
tioners, I usually see clear and lasting
20
improvement of plantar fascia pain in
10
my clients. However, the improvements in this clients plantar fasciitis
0
pain seemed to have plateaued. She
Baseline 1 month 3 months 6 months 12 months
had experienced dramatic relief in her
first sessions with me, but even though
Figure 1. Foot function index at baseline and at 1, 3, 6, and 12 months from the study by Rathleff et
these improvements had lasted to
al. (2014). FFI is is a self-report questionnaire that assesses multiple dimensions of foot function.
some degree, she continued to experi- Score of 0 reflecting no pain, disability, or activity limitations.
ence a certain amount of plantar fascia
Terra Rosa E-mag 35
Le Massage au Hamam by Edouard Debat-Ponsan (1883)

36 Terra Rosa E-mag
Touch is Everything
(Well.. At least really important)
By Art Riggs
Its more than just techniques
I remember in workshops Ive taken
through the Rolf Institute and elsewhere that when trading with different partners attempting the same
techniques demonstrated by instructors. With some practitioners I felt
profound change in my body, while
with others, very little happened. I
also notice this in workshops that I
teach; some people have had extensive training in protocols but just
dont seem to relate well to the tissue and dont get the results that
they and their clients hope for. I often mention, A stroke without intention is an empty gesture. To accomplish our goals, we need to have
a clear intention of what we want to
happen in the body (not just doing
strokes, routines, or even protocols)
and we need to work with the tissue
in a way that it releases to accomplish
our goals. This requires a two-way
communication of listening to what
the body tells us and responding,
rather than just inputting our direction.
Most massage trainings mention the
gel-sol transformation of connective tissue when skilfully applied pressure in bodywork can actually change
the stiff, short and hard gel state
to a more fluid and adaptable sol
state allowing for hydration of cells
and actual re-alignment of collagen

for muscles to work better both by
lengthening short tissue and by releasing strain patters that prevent
muscles from contracting in an efficient line to help joints work properly. In more simple terms, this softening and re-alignment, along with
voluntary relaxation by the client is
the magic melt that we look for in
release. If we work too fast, too
hard, at the wrong angle, it may feel
good, but without the melt, we often
lose the lasting benefits of massage
and elicit the frequently heard complaint, It felt good for an hour or so,
but then returned to the same state.
From most of our anatomy texts we
get a simplified and incorrect image
of our muscles being ropes pulling
our bones in a straight line as levers
of perfect Newtonian physics. In reality, our muscles look nothing like
that, and are impacted by countless
insults of injury, overuse, underuse,
poor posture, or repetitive strain that
create adhesions. Compare what the
posterior knee looks like in real life
(Figure 1). Can you envision finding
strain and restrictions with slow and
precise work with your fingers?
If someone is complaining of knee
pain, can you imagine the lost opportunity of careful and precise freeing
of restrictions if one simply per-
Figure 1. Muscles of the popliteal fossa.

Can you envision finding strain and restrictions with slow and precise work with
your fingers? Image from Trait complet
de l'anatomie de l'homme .
formed fast paced and broad strokes

sliding over the tissue using lots of
lubrication in prescribed directions?
To really restore balance and release
adhesions and tension, you would
have to slow down, sink into fibrous
restrictions and patiently wait for the
melt while thinking of proper joint
function.
Terra Rosa E-mag 37
Figure 2. A sheet that is pulled tight, we see the subtle straight lines of the fabric all going in one direction.
How can we all continually improve

our touch, not with new tricks, but a
sensitive intention and feeling for
physical change in the tissue we work
with?
Working in the non-neutral position
In this example using a sheet that is
pulled tight (Figure 2), we see the
subtle straight lines of the fabric all
going in one direction as depicted by
most anatomy drawings, but complicated by a hypothetical strain pattern
from any number of potential restrictions, possibly fascial, adhesions in
muscle tissue, or even voluntary holding patterns. To work with pain or
dysfunction in this muscle, it is necessary to release the conflicting pulls
from different tangents that interfere
with proper muscle contraction
rather than just trying to simply compress tissue or just stretch tissue in a
straight line.
I find that challenging restrictions in
the non-neutral position has many
advantages. By stretching muscles to
the end range of easy motion I can
find opposing strain patterns that
dont show up in neutral relaxed mus-
38 Terra Rosa E-mag
cle length. It is easy to find the angle

of pull that is disrupting proper function and at the same time give a lasting release as the restriction releases
and lengthens with thoughtful intention.
Different strokes for different restrictions
I love lessons from everyday life that I
can apply to bodywork. A few days
ago I was working in my garden in my
perpetual battle with encroaching
weeds, trying to pull up the weed
with the entire root system so they
wouldnt grow back. I found that
there was no simple routine that
worked for all weeds. Take a look at
the beautiful drawing Ive rendered
to make my point imagining the complex variables that exist in the human
body (Figure 3).
Notice that there are multiple restrictive factors impacting the extraction.
What I found was that with some
weeds, I could simply pull straight out
of the ground and the whole root
system would easily come out. This
would be analogous to simple lengthening strokes in a massage. However
Figure 3. An illustration of a weed and its

root system.
when the weed resisted, if I

muscled and pulled straight out of
the ground, I might just as easily
leave lingering roots to grow into
more weeds. Depending upon the
soil composition (what is the general
texture of the muscles you work
with?), the depth of moisture (are
restrictions deep or superficial?), and
especially the tangential angles of
restriction that may prevent
freeing the plant; I had to approach each plant differently.
With some weeds, I could pull right
out; with others I might need to use a
fair amount of force very slowly releasing the horizontal feeder roots
first. My suggestion with bodywork is
to try the direct and simplest approach first and see how the body
reacts and how successful you are.
Dont waste time making release
more complicated than it needs to
be. With the weeds, I might rock back
and forth between pulling vertically
or horizontally, twisting, or any number of strategies. If the soil was too
hard, I had to give up and water (the
equivalent of warm up work to tangential areas). Of particular impor-
tance was the speed and force at which I worked. If

working too fast (in bodywork this is forcing tissue and
causes pain and resistance), I might break off the stem
and have to wait for the roots to regenerate so I could
start all over. With the body, you may need to free tangential restrictions and strain patterns first before the
primary restriction releases. For example, if someone is
experiencing rhomboid tightness and pain, it might be
advisable to first free restrictions in the lateral scapular
area from subscapularis, the teres muscles, latissimus, and
lateral fascial pull (Figure 4).
My point is that, in spite of advertisements touting universal protocols as the panacea for all ills, there is no magic
formula for releasing restrictions. Some are fascial, some
muscular, tendinous or ligamental; some are protective
neurological holding that you must retrain to give lasting
freedom. Inventive experimentation is not only very effective, but also makes our work a lot more fun.
Speed and direction of intentions

I like the image of achieving the melt by visualizing pushing a heavy boat from a dock. You certainly would not get
a running start and suddenly apply all your force at the
beginning. You first need to conquer inertia by slow
steady pressure until you feel the boat begin to move.
When that happens, instead of applying more pressure
with too much intention or control, this is the time to con- Figure 4. Freeing restrictions in the lateral scapular area from
tinue to apply easy pressure, but possibly releasing inten- subscapularis, the teres muscles, latissimus, and lateral fascial
pull.
tion and letting the body tell you which direction to go.
With the boat, once it starts moving, you would continue
pressure, possibly lightening up and let the boat tell you
years of practice and experimentation. I work less hard
how it wants to move, reacting to currents in the water,
and accomplish more and have fun. My touch has evolved
the wind and the shape of the hull and keel. Although we
more in the last two or three years than in any time in my
sometimes do need to butt heads with resistance, having
practice. My work has never stagnated and I look forward
voluntary cooperation if almost always the best way to
to each client as a new learning experience.
leave a lasting lesson.
How do you achieve these skills? We all learn differently:
some visually oriented people are able to just view good
work being done, while others who are more kinaesthetic
need to experience the melt in their own bodies. I go to
my fabulous teacher Michael Salveson to receive work,
not only for the benefits to my body, but to experience
his magical touch. At times, when working after these
sessions, I feel his hands working through mine like a
muse, albeit with some loss in translation.
Happy learning!
I can say that one of the joys of doing this work is that I
continue to refine and improve my touch after over 25
Terra Rosa E-mag 39
Picture courtesy of Robert Schleip
Fascia:
A Body wide Organ
By Paolo Tozzi, MSc Ost, DO, PT
Despite some current/old trends to distinguish fascial tissue in its bits and pieces, as if it is a death tissue to be dissected and named in its components (Stecco, 2014),
nowadays fascia is always more intended from different
profession as a body wide structure that permeates, supports, suspends and connects the entire organism. The
old view of fascia consisting of different superimposed
layered, gliding on each other, is now gradually being replaced by a broader perspective that considers this
fascinating tissue in the light of the interaction of its
structure and function; as a body wide organ at different
depths of differentiation; as a single architecture at various levels of form and complexity (Guimbertau, 2012). In
other terms, fascia is finally starting to be intended as it
truly is and has always been in nature: an ubiquitous, living, dynamic, pulsating and coherent whole.
As suggested by the work of Blechschmidt and Gasser
(2012), each constituent of the connective tissue in the
body presents a functional and anatomical continuity, due
to the common embryologic origin from the mesoderm.
However, loading demands acting through and upon tissues, may determine their differentiation, influencing fi-
40 Terra Rosa E-mag
bres arrangement, length, and density. Nevertheless, despite tissues seem to specialize in response to mechanical
forces, their structural and functional interconnection is
always maintained at each stage of embryological and
foetal development. This requires an alternative architectural view of the body, than the traditional division of
muscles, ligaments and bones.
By investing each tissue at all levels, fascia displays a three
-dimensional arrangement that shapes and moulds every
body constituent, being as such referred to as an organ
of form (Varela and Frenk, 1987). In fact, it embodies the
element of structural interconnectedness in the organism,
by surrounding, pervading, and connecting all body constituents, and yet allowing sliding and gliding motions at
the same time. Interestingly, due to its phenomenological
dimension of in between the outer (skin) and the
inner (visceral endothelium) boundaries of the body, it
has also been referred to as the organ of innerness (Van
der Wal, 2014). Such body wide organ raises from the
structural continuum between the musculoskeletal and
connective tissue being arranged in series, rather than by
separated entities in parallel as traditionally proposed
Picture courtesy of Robert Schleip
(Van der Wal, 2009).

This concept of intrinsic multi-tissue continuity has been
advanced by various authors, who highlighted the structural and functional interrelationship between muscular,
fascial, ligamentous, capsular and articular components.
Such whole-body connection has been referred to as
ectoskeleton (Wood Jones, 1944), ligamentous complex
system (Willard, 1997), dynament (Van der Wal, 2009),
supertendon (Benjamin, 2009) , with subtle differences
despite the same basic principle. As shown in cadaveric
experiments and computer simulations, this superstructure is capable to elaborate information at a macroscopic scale without requiring neural processes. It appears
to play a switching function of a logic gate, by distributing
forces in a non-linear fashion independently from neural
control (Valero-Cuevas et al., 2007).
to any force introduced anywhere in the system. Thanks to

its hierarchical organization, any applying force can influence any part of the whole, from cellular to the entire body
and vice versa, through a non-linear distribution of forces.
Even at a cellular level, fascia displays an interconnected

tensegritive arrangement, through an extensively reticular
network that has found to be formed by soft tissue fibroblasts, via their cytoplasmic expansions permeating the all
body (Langevin et al., 2004). Furthermore, each fibroblasts cytoskeleton is structurally connected to the external environment, either directly with contiguous cells or
through the extracellular matrix (ECM) constituents
(Fletcher and Mullins, 2010). The entirety of this system
may indeed represent a body-wide signalling network
(Langevin, 2006), expressing through the interdependence
between cells and surrounding matrix. Signals from the
ECM are transferred through trans-membrane mechanoreThe whole fascial body network can be intended as a three
ceptors to the cell nuclei, while being transduced into
-dimensional viscoelastic matrix, balanced by an integrated
chemical information, so playing an impact on various assystem of compression-tensional forces in dynamic equilibpects of cell behaviour and metabolism via modulation of
rium (Ingber, 2008). In this vision, bones are the nongenes expression (Wang et al., 2009).
touching rods, that play the role of compression struts,
embedded in a continuous connecting system (the tension Fascia appears to respond to various physical and chemical
system), that is the myo-fascio-ligamentous continuum
forces, as a single structural continuum interacting with a
(Levin and Martin, 2012). This exhibits a balanced tension
multitude of regulatory functional properties. In health as
as well as a three-dimensional and dynamic ability to adapt well as in disease, it plays different roles, such as those
Terra Rosa E-mag 41
related to joint stability, general movement coordination,

gross and fine movement control, transmission and distribution of mechanical forces; body wide proprioception,
nociception and autonomic activity, constantly interacting
with the central nervous system, cortical organization,
including cognitive and affective components; hydraulic
pumping and fluids flow; piezoelectricity and other forms
of energy transmission; diffusion of various chemicals and
nutrients; immune, hormonal, cellular, genetic and epigenetic responses, together with a potential role in many
connective tissue pathologies, wound healing and tissue
repair (Tozzi, 2014). Such multi-potential system provides
the anatomical and physiological basis for a fasciagenic
unifying theory on the different mechanisms underlying
body function and dysfunction.
This network may certainly represents a body wide sensory organ (Schleip et al., 2014), and even more, a metasystem (Langevin, 2006) that coherently influences structure and function of the whole organism and the interaction between its constituents. Its vital function is so crucial that by its action we live and by its failure we shrink, or
swell and die (Still, 1899).
Paolo Tozzi has a degree in Physiotherapy, Doctor in Posturology and Master in Osteopathy. He is the Founder of
the First Italian School of Veterinary Osteopathy, former
Vice-Principal of the Italian Association of Posturologists,
former Treasurer of the Osteopathic European Academic
Network (OsEAN), and former Vice Principal of the school
of Osteopathy CROMON, Rome. He lectures widely on
osteopathy, biomechanics and manual therapy, and he is
a member of the Fascia Science and Clinical Applications Advisory Board of the Journal of Bodywork and
Movement Therapies, in which he has published several
articles about fascial tissue. He can be contacted
at pt_osteopathy@yahoo.it
Guimbertau, JC. 2012. [Is the multifibrillar system the structuring

architecture of the extracellular matrix?]. [Article in French].
Ann. Chir. Plast. Esthet. 57(5):502-6.
Ingber, DE., 2008. Tensegrity and mechanotransduction. J.
Bodyw. Mov. Ther. 12(3):198-200.
Langevin, HM., Cornbrooks, CJ., Taatjes, DJ., 2004. Fibroblasts
form a body-wide cellular network. Histochem. Cell Biol. 122(1):715.
Langevin, HM., 2006. Connective tissue: a body-wide signalling
network? Med. Hypotheses 66(6):1074-7.
Levin, S., Martin, D., 2012. Biotensegrity the mechanics of fascia.
In: Schleip, R., Findley, T., Chaitow, L., Huijing, P. (Eds.), Fascia:
the tensional network of the human body. Churchill Livingstone,
Elsevier, Edinburgh. pp. 137-42.
Schleip, R., Mechsner, F., Zorn, A., et al., 2014. The bodywide
fascial network as a sensory organ for haptic perception. J. Mot.
Behav. 46(3):191-3.
Stecco, C., 2014. Why are there so many discussions about the
nomenclature of fasciae? J. Bodyw. Mov. Ther. 18(3):441-2.
Still, AT., 1899. Philosophy of Osteopathy. A.T. Still, Kirksville,
MO. pp. 164.
Tozzi, P., 2014. A fasciagenic model of somatic dysfunction - underlying mechanisms and treatment - A unifying model. J.
Bodyw. Mov. Ther. under revision.
Valero-Cuevas, FJ.,Yi, JW., Brown, D., et al. 2007. The tendon
network of the fingers performs anatomical computation at a
macroscopic scale. IEEE Trans. Biomed. Eng. 54(6 Pt 2):1161-6.
Van der Wal, J., 2014. The fascia as the organ of innerness An
holistic approach based upon a phenomenological embryology
und morphology. In: Torsten, L., Tozzi, P., Chila, A. (Eds.), Fascia
in the osteopathic field. Handspring Publishing, Edinburgh. In
preparation.
Van der Wal, J., 2009. The architecture of the connective tissue
in the musculoskeletal system-an often overlooked functional
parameter as to proprioception in the locomotor apparatus. Int.
J. Ther. Massage Bodywork. 7;2(4):9-23.
Read 6 Questions to Paolo on page 55.
Varela, FJ., Frenk, S., 1987. The organ of form: towards a theory
of biological shape. J. Soc. Biol. Struct. 10(1):73-83.
References
Wang, N., Tytell, JD., Ingber, DE., 2009. Mechanotransduction at

a distance: mechanically coupling the extracellular matrix with
the nucleus. Nat. Rev. Mol. Cell Biol. 10(1):75-82.
Benjamin, M., 2009. The fascia of the limbs and back--a review. J.
Anat. 214(1):1-18.
Blechschmidt, E., Gasser, RF., 2012. Biokinetics and biodynamics
of human differentiation: principles and applications. North Atlantic Books, Berkeley.
Fletcher, DA,, Mullins, RD., 2010. Cell mechanics and the cytoskeleton. Nature 28;463(7280):485-92.
42 Terra Rosa E-mag
Willard, FH., 1997. The muscular, ligamentous and neural structure of the low back and its relation to back pain. In: Vleeming,
A., Mooney, V., Snijders, CJ., et al. (Eds), Movement, stability and
low back pain: the essential role of the pelvis. Churchill Livingstone, Edinburgh.
Wood Jones, F., 1944. Structure and function as seen in the foot.
Baillire, Tindall and Cox, London.
CORE Myofascial Therapy

By George Kousaleos, LMT
Every workshop that I have taught for the past 30 years
has dealt with creating an appreciation for the fascial tissues that surround, support, connect, and in many ways,
defend the other soft and osseous tissues of the human
body. This concern stems from a myofascial approach to
structural integration that forms the foundation of my
work. Like most massage therapists, I was trained at the
entry level to primarily consider that my palpatory skills
were focused on the musculature of the body. While I was
taught that my strokes would also improve lymphatic,
venous return, and neurological issues, I still found myself
thinking, What muscle is this, and how can I improve its
tonicity? It wasn't until I began my advanced structural
training that I was introduced to the importance of the
fascia and its integrative role with other systems. My advanced training focused on techniques that improved the
relationship between structure and function. The idea of
taking the fascial tissues through a thixotropic phase
change implied that these tissues were paramount in releasing muscle tension, improving both venous and lymphatic flow, reducing neurosensory excitability, and balancing structure and posture.
My experience tells me that chronic pain resides in these
fascial tissues, especially in the deep fascia that surrounds
the body and the epimysium that surrounds the extrinsic
musculature. Over the years I have refined the foundational technique that I use to prepare the myofascial tissues for deeper and more specific work. This technique is
called CORE Myofascial Spreading. It approaches the fascial tissues at a 45 degree angle and uses a minimum
amount of lubrication to increase tissue temperature. The
technique is applied slowly with the broad surfaces of the
palm, finger pads, or fist. This technique has allowed me
to more easily feel the improvement of thickened or adhered fascial tissues. My experience seems to suggest
that if more effort is made in working in a full-body ap-
Figure 1. Langers Lines
proach with these two outer layers of myofascia, an improvement in related systems is achieved and more easily
maintained. Application of any myofascial technique
should take into consideration the layout of the sensory
nervous system on the outermost layers of fascia. CORE
Myofascial Spreading follows the primarily horizontal layout of Langer's Lines (Figure 1), so that a minimum
amount of nerve stimulation can be maintained during
slow, but forceful strokes. This organization of stroke delivery is crucial to a balanced application of full-body sessions that promote fascial improvement.
Terra Rosa E-mag 43
Workshop Report:
CORE Myofascial Therapy &
Sydney, September - October 2014.
CORE Myofascial Therapy is a 6-day certification course
taught directly by George P. Kousaleos, founder of the
CORE Institute, from Tallahassee, Florida. The workshop
was held in a nice location tucked away in the busy Newtown area in 26 September until 1 October 2014.
The first day, George presented information on the theory
and history of structural integration, the anatomy and
physiology of fascia, body reading strategies, and specific
benefits of myofascial and structural therapies. He also
discussed the Intrinsic Spiral Theory, where most of a persons structural contour has a unique circular pattern that
often resembles a clockwise spiral. Then he described the
Neurosomatic Awareness, taught the 5-Point Standing
Awareness exercise, and full-body application of the myofascial spreading techniques. The second day George introduced arthrokinetic joint techniques, and CORE myofascial therapy from a side-lying position. The final day
George detailed cervical, cranial, and facial techniques,
and strategies for stimulating the parasympathetic nervous system while improving neurosomatic awareness.
Mic Mueller-Coons, a massage therapist and Iron Man
Champions from Townsville wrote: Getting the basic Myofascial Spreading done on my first day resulted in a dramatic improvement of my body alignment and this is without focusing on any area of special discomfort or pain. They
worked only the front and back of my body. The results
were astounding! Much greater improvement of range of
motion and Breathing freeness were achieved on the 2nd
day while working in side posture on the lateral side of the
body and the inside of the legs. Supporting the work with
moderate stretching and twisting again produced even
more astonishing results.
We then continued to the next level, CORE Myo 2 where
George presented information on somatic psychology,
client-education strategies, and specific techniques for
44 Terra Rosa E-mag
intrinsic layers of fascia and musculature. George taught

clinical protocols, include the Back Specific, a deeper
treatment plan for the paraspinal, scapula, sacrum, and
iliofemoral regions. The CORE Release was presented
to work with the pelvic floor, sacrotuberous ligament, and
related ligaments of the lumbar, thoracic, and cervical
spine. Also included is the Foot Specific, a treatment
protocol for the fascia and musculature of the foot and
ankle.
One of the participants comment: I love the systematic
way of being able to assess body type, pain areas and probable response to treatment and then be able to help in a
clear and precise manner with profound bodywork that I
would be confident to use.
Everyone is impressed with Georges approach, clear instruction and stories. Comments from the CORE Myofascial participants are a testament to the quality of
the educational experience:
I enjoyed Georges knowledge (and stories). I love it all.
The whole course made me felt very flexible while covering
a lot of content Linda, Brisbane.
George was very eloquent and articulate in explaining the
techniques and the reasoning behind them. His anecdotal
stories were great. He was approachable, patient, and

funny. Leanne, Brisbane.
Thank you so much for your CORE workshops, they were
fantastic! I learnt so much and my clients are really benefitting from your techniques. Dani, Newcastle.
One of the best workshops I have been Leigh-Ann, Perth.
The CORE Sports and Performance Bodywork is the next

in the workshop series. George has lots of experiences
working with elite athletes. He was the General Manager
for the 1995-96 British Olympic Association Preparation
Camp Sports Massage Team, and was the Co-Director of
the Athens 2004 International Sports Massage
Team. George also currently leads the CORE Sports Bodywork team that works with the Florida State University
National Champion Football Team.
In this workshop, George introduced myofascial therapy
theories and techniques that are appropriate for each
style of sport. George showed how the Myofascial system
relates to sport. He further introduced the primary concepts of the physical and psychological demands of training and performance for different athletes. A breakdown
of somatotypes and their inherent strengths and challenges was used to discuss the development of bodywork
protocols for the endurance, sprint, power, and multiskilled athlete. George then demonstrated myofascial
techniques for legs, pelvis, and back.
The second day of the workshop, George showed advanced strategies including working with intrinsic myofascial tissues of the axial and apendicular regions and strategies to balance autonomic nervous system. Advanced
protocols for the arms, shoulders, chest, neck, and head
were also taught.
The final day focused on the integration of the CORE myofascial techniques. In the afternoon, George organised
elite athletes for us to work-on in a 90 minute session. The
athletes include medal-winner runner, surfer, marathon
runner, swimmer, football player, and boxer.
work very well and I averaged 13 seconds faster than any of

my previous training sessions in Australia while doing 1k
intervals two days after the massage. I had experienced
stiffness in my legs during my time here, but after the treatment my muscles felt much more relaxed and flexible.
Thank you again for this amazing seminar, I felt welcome and I learnt heaps. The most beneficial outcome from
my side as a therapist is that I haven't been using my
thumbs as much as in the past and my back and
neck certainly like this kind of work. My clients have commented on how "light" they feel after the massage. - Myriame (Canberra).
Since I've been back at my practice I performed 95% of my
work with CORE Myofascial therapy. I had great and some
amazing results. - Mic (Townsville)
Finally, Taso Lambridis, BSc (Physiotherapy) MSc (Sports

Medicine), Sydney wrote:
Having recently attended the CORE Myofascial workshops
with George Kousaleos I would highly recommend this
course to all manual therapists who are keen to understand
and explore the amazing world of fascia. As a physiotherapist I found the material invaluable and a great add-on to
what I am already using. George was highly informative and
has so much experience to give you great insight into this
fantastic treatment method. This is one course not to be
missed and I look forward to attend any further training
with him next year.
Kip Hobson, swimming athlete, and Ranell, Masters Championship winner and athlete trainer commented: Both
Ranell and I really enjoyed the massage immensely Even
coming from myself who is an avid hater of them, I found it
to be wonderful and would gladly book in for regular ones if
a suitable location was found close to home.
Robert Alexandersson, a marathon athlete from Sweden
who experienced the massage wrote: The treatment
Terra Rosa E-mag 45
Maximise Oxygenation
CORE MYOFASCIAL THERAPY

with George Kousaleos
Sydney, Brisbane Sept-Oct 2015
"George Kousaleos was one of the most influential people in the manual therapy profession on my career and my success.
His amazing CORE Myofascial Therapy training should be the foundation of every manual therapist's practice. His incredible
knowledge of the human body, his compassion, and his kind heart, make him one of my greatest mentors in the manual
therapy - James Waslaski LMT; Author & International Lecturer Integrated Manual Therapy & Orthopedic Massage
CORE Myofascial Therapy Certification
CORE Myofascial Therapy for the Back & Neck
Sydney (Venue: 5 Forbes St, Newtown)
Sydney 3, 4 October 2015
CORE Myofascial Therapy 1: 25, 26,27 September 2015

CORE Myofascial Therapy 2: 28, 29,30 September 2015
This 2-day seminar will focus on CORE myofascial treatment Back

Specific and Chest Neck & Head protocols.
An intermediate to advanced, six-day workshop designed to give

practicing massage therapists in-depth knowledge and hands-on
experience in full-body myofascial treatment protocols. With this
knowledge and skill, you will be able to improve your clients structural body alignment and increase their physical performance.
Getting the basic Myofascial Spreading done on my first day resulted in a dramatic improvement of my body alignment Mic,
Townsville

Brisbane 9,10,11 October 2015 (venue 41 Anzac Av. Redcliffe)
This 3-day seminar will examine the basic styles of performance
inherent in all athletic disciplines. Utilizing structural integration
and myofascial therapy theories and techniques that are appropriate for each style of performance, we will focus on developing
training and event protocols for endurance, sprint, power, and
multi-skilled athletes.
George Kousaleos, LMT is the founder and director of the Core Institute, a school of massage therapy and
structural bodywork in Tallahassee, FL. He is a graduate of Harvard University, and has practiced and taught
Structural Integration, Myofascial Therapy and Sports Bodywork for the past 30 years. George has served as
a member of the Florida Board of Massage Therapy and was Co-Director of the International Sports Massage Team for the 2004 Athens Olympics.
Terra Rosa
46 Terra Rosa E-mag
Your Source for Massage Information
AMT Approved CEU Points, ATMS Approved CPE
For more information & Registration

Visit www.terrarosa.com.au
E: terrarosa@gmail.com
Research Highlights
Compiled By Jeff Tan
Myofascial Trigger Point-focused Head and Neck Massage for Recurrent Tension-type Headache
Myofascial trigger points (MTrPs) are focal disruptions in
skeletal muscle that can refer pain to the head and reproduce the pain patterns of tension-type headache (TTH).
Researchers Albert Moraska and colleagues
from University of Colorado at Denver studied massage
focused on MTrPs on subjects with tension-type headache in a placebo-controlled, clinical trial to assess efficacy on reducing headache pain.
Fifty-six subjects with TTH were randomized to receive 12
massage or placebo (detuned ultrasound) sessions over
six weeks, or to wait-list. Trigger point release (TPR) massage focused on MTrPs in cervical musculature. Headache
pain (frequency, intensity and duration) was recorded in a
daily headache diary. Additional outcome measures included self-report of perceived clinical change in headache pain and pressure-pain threshold (PPT) at MTrPs in
the upper trapezius and sub-occipital muscles.
The results from diary recordings showed differences in
headache frequency between treatment groups across
time , but not for intensity or duration. Post hoc analysis
indicated headache frequency decreased from baseline
for both massage and placebo. However no difference
was detected between massage and placebo. Nevertheless, subject report of perceived clinical change was a
greater reduction in headache pain for massage than placebo or wait-list groups. Pressure-pain threshold improved in all muscles tested for massage only.
The authors wrote: Two findings from this study are apparent:
(1) MTrPs are important components in the treatment of
TTH, and
(2) TTH, like other chronic conditions, is responsive to placebo. Clinical trials on headache that do not include a placebo group are at risk for overestimating the specific contribution from the active intervention.
Kinesio Taping to generate skin convolutions is not better than sham taping for people with chronic non-specic
low back pain
Researchers from Universidade Cidade de So Paulo, Brazil asked the question For people with chronic low back
pain, does Kinesio Taping, applied according to the treatment manual to create skin convolutions, reduce pain and
disability more than a simple application without convolutions?
The researchers conducted a randomised trial with concealed allocation, intention-to-treat analysis and blinded
assessment of some outcomes. 148 participants with
chronic non-specific low back pain were recruited. Experimental group participants received eight sessions (over
four weeks) of Kinesio Taping applied according to the
Kinesio Taping Method treatment manual (i.e., 10 to 15%
tension applied in flexion to create skin convolutions in
neutral). Control group participants received eight sessions (over four weeks) of Kinesio Taping with no tension,
creating no convolutions.
The primary outcome measures were pain intensity and
disability after the four-week intervention. Secondary outcomes were pain intensity and disability 12 weeks after
randomisation, and global perceived effect at both four
and 12 weeks after randomisation.
The results showed that applying Kinesio Tape to create
convolutions in the skin did not significantly change its
effect on pain (MD-0.4 points, 95% CI-1.3 to 0.4) or disability (MD-0.3 points, 95% CI-1.9 to 1.3) at four weeks. There
was a small difference in favour of the experimental
group for the secondary outcome of global perceived effect (MD 1.4 points, 95% CI 0.3 to 2.5) at four weeks. However no significant between-group differences were observed for the other secondary outcomes.
The authors concluded that Kinesio Taping applied with
stretch to generate convolutions in the skin was no more
effective than simple application of the tape without ten-
Terra Rosa E-mag 47
Research Highlights
sion for the outcomes measured. These results challenge
the proposed mechanism of action of this therapy.
Reference: Parreira PCS, Costa LCM, Takahashi R, Hespanhol Junior LC, da Luz Junior MA, da Silva TM, Costa LOP
(2014) Kinesio Taping to generate skin convolutions is not
better than sham taping for people with chronic nonspecic low back pain: a randomised trial. Journal of
Physiotherapy 60: 90-96.
Evidence-Based Sexual Positions for Back Pain

A lack of evidence-based guidelines on how to avoid triggering back pain during sex prompted the research, says
co-author Professor Stuart McGill, professor of spine biomechanics at the University of Waterloo, Ontario. The
findings were published in Spine jouranl.
Stuart McGill and PhD student Natalie Sidorkewicz set out
to build an evidence-based and practical atlas matching
sexual positions and styles with possible back pain triggers.
They recruited ten healthy couples who were filmed using
motion capture and infra-red technology while they had
sex. The researchers were in a separate booth where they
could hear, but not see, the participants. Electrodes were
used to record muscle activity in certain parts of the body
to get an idea of force.
Their results showed that the 'spooning' position for sex
was actually one of the worst positions for individuals
with flexion-intolerant back painback pain that is worsened by bending over forward or by sitting for long periods of time.
I'm assuming because people lay on their side, someone
thought the spine would be supported and this was good
for people, but it turned out not to be true, McGill
says. For men with that particular back pain trigger, the
study suggested doggy-style sex was far less likely to aggravate the back problem. In general, the researchers
found that the person on topwhether male or female
is most responsible for motion.
For individuals with back pain triggered by movement, the
researchers suggested there was no position that would
avoid pain, and advised instead that they should try to
move more using their hips than their back.
"The more the hinging takes place at their hip, the less the
hinging takes place in their spine, the better off [their
back is]," McGill says.
48 Terra Rosa E-mag
Researchers were also able to measure the impact of orgasm on the body, which yielded some surprises. "I had
no idea of the range; how it's basically a non-event in
some people, through to really substantial muscle contraction in others, and you could see that if they were out
of position, they would hurt themselves," says McGill.
From ABC Science.
Golden Goose Award: Massages for baby rats lead to better outcomes for premature infants
What could we possibly learn from massaging baby rat?
The answer is, a lot. Just ask the millions of families whose
prematurely born infants have survived and thrived on
account of that research.
That's why the researchers behind this work Saul Schanberg, Tiffany Martini Field, Cynthia Kuhn and Gary Evoniuk
receiveed the Golden Goose Award September 18 at a
ceremony at the Library of Congress in Washington, D.C.
The Golden Goose Award honours scientists whose federally funded research may not have seemed to have significant practical applications at the time it was conducted
but has resulted in major economic and other benefits to
society. In this case, the impact of the researchers' collective work has been momentous. The key discovery that
touch, in the form of infant massage, can vastly improve
the outcome for babies born prematurely. And it began
when researchers studying infant rats decided to rub their
backs with a tiny brush.
In 1979 Schanberg, a Duke University neuroscientist,
Kuhn, a graduate student, and Evoniuk, a lab technician,
were working with rat pups to study factors influencing
two key growth markers, ornithine decarboxylase and
growth hormone. To conduct their work, which was
funded by the National Institutes of Health, they needed
to separate the pups from their mothers. However, they
quickly found that the pups, though being fed and kept
warm, were failing to thrive and their levels of the key
growth markers were declining.
A series of experiments ruled out factors such as nutrition, body temperature and maternal pheromones. The
researchers then made the key observation: the rat mothers spent a great deal of time grooming and vigorously
licking their pups. Wondering whether the act of stimulation through licking was making the difference, the researchers simulated the mother's tongue with a small
brush and stroked up and down the rats' tiny backbone.
This was the missing link. Enzyme and growth hormone
Research Highlights
levels rose and the rat pups thrived again.
foam rolling, and control groups.
Field, a psychologist at the University of Miami Medical

School who was conducting her own research on how to
help premature infants survive and grow, learned of
Schanbergs groundbreaking work and wondered whether
it had implications for human infants. In 1986, Field published her own landmark study drawing from Schanberg,
Kuhn and Evoniuks work with rat pups. Funded by the
National Institute of Mental Health, Fields study demonstrated that using similar tactile stimulation in preterm
human infants had immediate positive effects. Premature
infants who were massaged for 15 minutes three times a
day gained weight 47 percent faster than others left alone
in their incubators (standard practice at the time), were
more alert and responsive, and were released from the
hospital an average of six days sooner than the premature
babies who were not massaged.
The authors concluded that: The results support the use of

a foam roller in combination with a static stretching protocol. If time allows and maximal gains in hip flexion ROM
are desired, foam rolling the hamstring muscle group prior
to static stretching would be appropriate in non-injured
patients who have less than 90 of hamstring ROM.
flexion ROM from the pre-measure on day 1 to the post

measure on day 6.
Reference: Williams, Christopher M., et al. Efficacy of

paracetamol for acute low-back pain: a double-blind, randomised controlled trial. The Lancet (2014).
Reference: Mohr, A. R., Long, B. C., & Goad, C. L. (2014).

Foam Rolling and Static Stretching on Passive Hip Flexion
Range of Motion. Journal of sport rehabilitation.
Paracetamol doesnt help back pain
Paracetamol, a painkiller universally recommended to treat

people with acute low back pain, does not speed recovery
or reduce pain from the condition, according to the results
of a large trial. Panadol sells a product that is dedicated to
back and neck pain, containing 500g paracetamol. The study published in The Lancet medical journal
Foam Rolling as Effective as Stretching?
found that the popular pain medicine was no better than
Many athletes report that foam rollers help release tension placebo, for hastening recovery from acute bouts of low
in their muscles thus resulting in greater range of motion
back pain or easing pain levels, function, sleep or quality of
(ROM) when used prior to stretching. To date, no investilife.
gators have examined foam rollers and static stretching.
In this trial, 1,652 people from Sydney with acute low back
Thus a study was conducted by researchers from Dept of
Sport Sciences, Iowa Western Community College to deter- pain were randomly assigned to receive up to four weeks
of paracetamol, either in regular doses three times a day,
mine if foam rolling prior to static stretching produces a
or as needed, or to receive placebos. All those involved
significant change in passive hip flexion range of motion.
received advice and reassurance and were followed up for
The study is a Controlled laboratory study. Forty subjects
three months.
with less than 90 of passive hip flexion ROM and no lower
The results showed no difference in the number of days to
extremity injury 6 months prior to data collection particirecovery between the treatment groups - with the average
pated.
time to recovery coming out at 17 days for each of the
During each of 6 sessions, subjects passive hip flexion
groups given paracetamol, and at 16 days for the placebo
range of motion was measured prior to and immediately
group.
following: static stretching, foam rolling and static stretching, foam rolling, or nothing (control). To minimize acces- Paracetamol had no effect on short-term pain levels, disability, function, sleep quality, or quality of life, the resory movement of the hip and contralateral leg, subjects
lay supine with a one strap placed across their hip and an- searchers said, and the number of patients reporting negaother strap located over the uninvolved leg just superior to tive side effects was similar in all groups.
the patella. A bubble inclinometer was then aligned on the This study indicates is that the mechanisms of back pain
thigh of the involved leg where subjects then performed
are likely to be different from other pain conditions. This
hip flexion.
study would suggest that probably the most important
thing a patient does is to resume normal activities.
The main outcome measure is the change in passive hip
The results showed that there was a significant change in

passive hip flexion ROM regardless of treatment. Subjects
receiving foam roll and static stretch had a greater change
in passive hip flexion ROM compared to the static stretch,
Terra Rosa E-mag 49
Research Highlights
Constantly looking down at your phone can cause a 27 kg force
on your neck
Erik Dalton once wrote that your head could weigh 42 Pound (or
19 kg) if you have a forward heard posture, moving 3 inches (or
76 mm) of the head forward will bear a 19 kg forge against gravity.
Kenneth Hansraj, chief spinal and orthopaedic surgeon at the
New York Spine Surgery and Rehabilitation Medicine in the
US, used a 3D computer model of the human spine to calculate
the effect of constantly bending our heads down to check our
phones. Because our heads are pretty heavy - weighing up to 5.5
kg, or 12 pounds - when we are frequently looking down for extended periods, were increasing the gravitational pull on them.
And, as it turns out, this force is pretty huge.
As the head tilts forward, the forces seen by the neck surge to
27 pounds (12 kg) at 15 degrees, 40 pounds (18 kg) at 30 degrees,
49 pounds (22 kg) at 45 degrees and 60 pounds (27 kg) at 60
degrees, Hansraj reports his finding in the journal Surgical Technology International. "The weight seen by the spine dramatically
increases when flexing the head forward at varying degrees.
These stresses may lead to early wear, tear, and degeneration,
and possibly surgeries.
Ultrasonography in myofascial neck pain

Antonio Stecco and colleagues from Padova University recently
studied the possible role of the deep fasciae in Chronic Neck Pain
and test the utility of the ultrasonography in the diagnosis of
myofascial neck pain. This is because a definitive diagnosis of
chronic neck pain (CNP) is sometimes not possible. The study
was published in Surgical and Radiologic Anatomy.
The ultrasound morphometric and clinical data of 25 healthy subjects and 28 patients with CNP were compared. For all subjects,
the active and passive cervical range of motion (ROM) was analyzed and the neck pain disability questionnaire (NDPQ) was administered. The fascial thickness of the sternal ending of the sternocleidomastoid and medial scalene muscles was also analyzed
by ultrasonography.
The results showed that there were significant differences between healthy subjects and patients with CNP in the thickness of
the upper side of the sternocleidomastoid fascia and the lower
and upper sides of the right scalene fascia both at the end of
treatment as during follow-up. A significant decrease in pain and
thickness of the fasciae were found. Analysis of the thickness of
the sub-layers showed a significant decrease in loose connective
tissue, both at the end of treatment and during follow-up.
The data support the hypothesis that the loose connective tissue
On average, were spending up to four hours a day looking down
inside the fasciae may plays a significant role in the pathogenesis
to read something or check our phones. This equates to 1,400
of CNP. In particular, the value of 0.15 cm of the SCM fascia was
hours every year of extra stress on our cervical spines - the part in
considered as a cut-off value which allows the clinician to make a
our necks just above our shoulders.
diagnosis of myofascial disease in a subject with CNP. The variation of thickness of the fascia correlated with the increase in
quantity of the loose connective tissue but not with dense connective tissue.
50 Terra Rosa E-mag
6 Questions to
Paolo Tozzi
1. When and how did you decide to become a bodyworker?
therefore, in turn, its clinical application.
At the end of my high school, I was fascinated from the idea of

working with my own hands on living bodies for relieving pain
and promoting health. At that time, I was already a Reiki practitioner, so that I had some little experience in that sense and I
definitely wanted to grow in that direction. In 1996, I started my
degree physiotherapy at the A. Gemelli University of Rome. It
took me three years to graduate and to understand that it wasnt exactly what I was looking for. I felt the need to develop
something different: the ability to feel the tissues beyond just
the skills to work on them. Because of that, I moved in the U.K.
to study osteopathy at the European School of Osteopathy in
Maidstone. Finally, I found the dimension I was searching and
the profession I was born for.
5. What advise you can give to fresh manual therapists who wish
to make a career out of it?
2. What do you find most exciting about bodywork therapy?

The most exciting part about it is that you never know what is
going to happenwhen treating a person, and when engaging a
tissue in particular, is like starting an adventure. Despite the
intention remains always the same to promote the healing
process each patient will take his/her own path, own direction
and modality. Each time is different; each way is unpredictable.
It can only be followed and we can just offer a fulcrum around
which the healing may occur. The wisdom within, between and
around tissues will do the rest. The most exciting part is being an
actively passive witness of this extraordinary healing process,
rising from an instant of emptiness and stillness up to the
branching into its full development in the patients life.
3. What is your favourite bodywork book?
Each patient is an outstanding book to read and discover at
each continuing phase of its life-lasting writing. Every time I
look at any patient of mine, I remind to myself to be looking at
an ongoing phenomenon, at a wonderful universe, being
unique in its nature, form, behaviour and development, instant
by instant. I am still searching for a book that can teach me more
than a patient in my practice.
4. What is the most challenging part of your work?
I would say to remain always intellectually questioning and
manually perceptive at the same time. To keep always alive the
intimate dialogue between the thinking and the feeling
process in each treatment session. We should avoid exceeding in
any of these two directions, since the optimal therapeutic state
occurs when the dynamic interaction between these two elements is in balance. I believe also each bodywork profession
should reflect this equilibrium: keep its philosophy and manual
application pure and free, while the knowledge coming from
appropriate research should support its understanding and
If you wish to make a career out of it, change job. This is not like
going to the office every day. We deal with human being, we
take care of living person suffering of various conditions, emotional states, mental processes, social contexts. We hold a huge
responsibility for each of them. We should guide them towards
autonomy, independency, wellness, happiness; finding their own
way to reach this ultimate goal; helping the solution within to
become fully expressed; by supporting without conditioning;
promoting without imposing. This is not an ordinary job; I would
call it a vocation instead.
6. How do you see the future of manual therapy?
I see two directions. The first one is dominated by business. I
have seen many lecturers willing to create disciples instead of
colleagues; many courses where fishes were given, rather than
fishing being taught. At the same time, I have noticed many
manual approaches being basically very similar and yet distinguished and protected by trademarks and copyrights. Some of
them have even named their application with words of common
use in the clinical and research fieldso that we are not even
free to use those words without being legally prosecuted. I believe this is just ridiculous, especially if we consider that most of
these people who claim to have invented something have just
re-discovered and re-named old methods of manual intervention instead. This direction leads to separation, division, selfprotection, self-referencing, self-maintenance and a leadercentred medicine.
The second direction is dominated by passion. Thousands of
bodyworkers in the world do their job with devotion, every day
on every patient, in both a clinical and research field. I hold a
huge respect for each of them. I believe the future for this direction will be a structured and dynamic interdisciplinary approach
for every patient. We are coming to a day when we are finally
seeing the multi-dimensional reality of each patient, the multifactorial etiology of each condition, therefore the need of a multidisciplinary intervention. We are on the edge of a radical
change leading to a shift of paradigm. Clinicians and scientists
from different fields are gathering and sharing always more their
opinions, evidences, competences and experiences. Communication of knowledge and sharing of clinical experience, under a
common scientific language, amongst different professions, will
be the foundation for this bright future. This direction is based
on and will lead to participation, sharing, inter-collaboration,
holism and a person-centred medicine. So my only question is:
which direction do YOU want to go?
Terra Rosa E-mag 51
6 Questions to
Jo Phee
1. When and how did you decide to become a yoga
teacher?
More than a decade ago, I held a corporate job as an
Event Manager and was very stressed from the corporate
work. I would visit the gym daily to unwind and one day, I
saw a yoga class taking place and I stepped in to try. I
was appalled by my inflexibility, given that I was still
young and active then. That was possibly the most painful class I had ever attended and it was pivotal to what
spiked my interest in yoga since.
In late 2000, I migrated to Sydney and, as yoga was already very popular in Australia. there was an abundance
of teachers, studios and styles to choose from. I wanted
to study yoga more in-depth beyond the physical stretching, so I enrolled into a 3-year Diploma course with the
Satyananda Yoga Academy in Mangrove (The Bihar
School of Yoga). This school offers one of the most rigorous and extensive training programs in the world and,
while I was not sure I was going to become a teacher, I
am glad I made that choice simply out of my interest for
yoga.
3. What are your most favourite yoga books?

Asana, Pranayama, Mudras and Bandhas by Swami Satyananda, and The Complete Guide to Yin Yoga by Bernie
Clark.
4. What is the most challenging part of your work?
I find not knowing how each student will react to the
practice is what is most challenging but also fascinating in
teaching yoga. No matter how much analysis or study a
teacher may have, the real textbook is the student in
front of you. And each time just when I am sure I was
correct, I am pleasantly stoked to have a student that will
prove me wrong. It just goes to show that teaching yoga
(just like teaching all other movement modalities) is a
continuous, lifelong learning journey. You can never finish learning what is to come because each individual human being is so different in their anatomy.
5. What advise you can give to fresh yoga teachers who
wish to make a career out of it?
Upon graduation and coming back to Singapore, becoming a teacher seemed the natural way to progress in my
practice.
Be authentic and teach sincerely from the heart. Teach

because you want to share and give, not because you
want to make a career out of yoga. If you are passionate
about teaching, the professional aspects will take care of
themselves.
2. What do you find most exciting about yoga?
6. How do you see the future of yoga?
Yoga challenges the body on all aspects of its being. The

stretching opens up areas of the body that are stuck from
immobility. The breathing exercises enhance the energetic body and improve the circulation of stagnant blood
and energy flow. The meditation trains the mental body
to focus and become present with the very moment and
allows us to reconfigure the mind at will, so that we may
learn to weather and cope with the oscillations of everyday life. With that mindfulness training, we become a
more aware being and we acquire insight in polishing and
refining our interactions with our inner environment, as
well as the people around us. It is truly a profound bodymind-heart practice.
It is promising to see more people practicing yoga these

days. I think yoga will continue to be mainstream like running and swimming and it will become part of our daily
exercise needs.
52 Terra Rosa E-mag
Jo Phee is a senior Yin Yoga teacher trainer, specializing in

Anatomy and Fascia studies, as well as Chinese Medicine.
She is based in Singapore but travels around the world to
conduct Yin Yoga Teacher Training programs. She will be
teaching in Melbourne, 6 - 9 March. For more info on her
trainings, visit www.yinspiration.org
The Heskiers OneTool

The All-in-one Bodywork ToolThe One Tool You Need
An ergonomically designed myofascial release tool that offers potentially effective and precise bodywork treatments for bodywork professionals. The Heskiers OneTool can be used in combination with
your existing bodywork techniques . Practitioners can use the Heskiers OneTool to open the muscles in
preparation for their respective treatments. The Heskiers OneTool can assist your hands by minimizing the pressure needed to give effective deep tissue treatments and may protect you from work related injuries to your hands, arms and shoulders.
Available at www.terrarosa.com.au
Terra Rosa E-mag 53

E-Magazine: Terra Rosa

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

E-Magazine: Terra Rosa

Uploaded by

Copyright:

Available Formats

Terra Rosa

Terra Rosa E-Magazine, No. 15, December 2014

Fascial Training for Soccer Players , An interview

InteroceptionSome Suggestions for Manual

Report from the 2014 Fascia Summer School

FFT Case Study: Exposed Leg FracturesRon

Plantar Fasciitis: High loading strength training

Comments on Plantar FasciitisJoe Muscolino

Treatment of Plantar FasciitisJudah Lyons

Comments on Plantar FasciitisArt Riggs

Comments on Plantar FasciitisTil Luchau

Touch is EverythingArt Riggs

Fascia: A Body wide Organ Paolo Tozzi

CORE Myofascial Therapy George Kousaleos

Workshop Report: CORE Myofascial Therapy &

6 Questions to Paolo Tozzi

Featured Front Cover:

Front Cover: Jo Phee

Fascial Training for

Terra Rosa E-mag 1

Fascial Fitness for Soccer

What made you pick soccer players

Bring body weight over the leg, feel the

This well-known exercise now gets a twist:

2 Terra Rosa E-mag

Everyone can discover where one feels

He is a Rolfing instructor and was the

Fascial Fitness for Soccer

turn their latest scientific discoveries

Another well-known exercise, but with a

Alternate with feet pointing towards each

So far, I mainly provided training for

Point feet to the inside, combine with

Feet turned to the outside.

Terra Rosa E-mag 3

Fascial Fitness for Soccer

Another important aspect is the

Only once the athlete starts looking

4 Terra Rosa E-mag

Land with feet turned to the outside.

Fascial Fitness for Soccer

what we were told not to do for

Initial position with lead and trail leg

First bouncing phase: whiplash motion,

Well, the goal is a tear-resistant, elastic fascial network. With examples

Second bouncing phase

After swinging forward, you move right

Terra Rosa E-mag 5

Fascial Fitness for Soccer

once theyre out on the field again.

6 Terra Rosa E-mag

apy tool box. When used correctly

Last but not least, there is a byproduct of fascial training we should

Basic principles of Fascial Fitness

This article is an English translation of:

Terra Rosa E-mag 7

Based on the Latest Finding

Fascial Fitness Introduction: 31 Jan 1 Feb 2015

8 Terra Rosa E-mag

www.terrarosa.com.au, E: terrarosa@gmail.com, Ph. 0402 059 570

The discovery of interoceptive receptors in human skin.

Terra Rosa E-mag 9

In manual and movement therapies,