Excerpts from Larry Kaufman's

Practitioner Training Manual

 

The Big Picture

                

My way of understanding structure (bodies) is to look at the ways people move. This book aims at helping you to see how people move, how they transfer motion through their body and how to get them to move and feel better.

 

Structural integration (SI)—the focus of this book— attempts to align the body’s structural components (head, neck, shoulders, arms, thorax, pelvis, legs) to its vertical center (core) and to support the transfer of motion through it. Like water flowing through a hose, the transfer of movement between muscles and through the body’s vertical core is significantly effected by the alignment of its structural components---twist the hose and water can’t flow through it---twist the body’s structural components and movement can’t transfer through its core.

 

Theory into Practice

 

This manual attempts to be a guide for beginning students, helping you to be more aware of what to look and feel for and offering some basic ways in which to release adhesion. Learning to feel whether a layer is mobile, free to move independently, and shift its position and elongate fully will be your initial challenge. Learning to feel the overall mobility of many interconnected layers (kinetic linkage) and the transfer of motion through the core will be your challenge throughout your career as a practitioner…….. 

 

SESSION ONE

 

Specific lessons in this chapter include:

 

Basic structural assessment, observing your client’s posture while standing, walking and lying supine

 

Basics of releasing adhesion between layers of connective tissue and how to mobilize the body’s extrinsic (outer) muscle layers

 

Basic strategies for mobilizing and shifting the side-to-side balance of shoulders and hips

 

Assessment of your client’s breathing and movement patterns and exploring how adhesion of layers affects your client’s overall posture and mobility

 

Exploring ways of working in partnership with your client, by helping them to move areas of their body that have limited range of motion, breath and motion flowing through them 

 

Overview: 

Session One begins the process of remobilizing (releasing and repositioning) your client’s thorax, shoulders and pelvis, and shifting these structural components into greater horizontal and vertical alignment. The session also focuses upon your client’s ability to breathe freely and to flex and extend evenly at both shoulders and hips. Typically at the start of this session, your client’s shoulder girdle (scapulae and clavicles) with be shifted forward (anterior) on her thorax. Releasing the pectoralis major adhered to the anterior thorax, humeral heads and clavicles, begins the process of remobilization the anterior thorax and shifting the position of the girdle…..

 

Assessment:

As you begin this session, notice your client’s breathing.  Do the upper three ribs and clavicles move upward (cranially) on inhalation? Does the costal margin widen, and the pubic bone shift slightly forward and back with the breath?  With your client lying supine shoulder flexed and arm raised over her head, assess the scapula’s ability to shift downward (inferior glide) and the arm’s ability to circumduct.......

 

Muscles needing to be released:

Release of the pectoralis major and rectus abdominis layers supports the elongation of the anterior thorax and its ability to expand with the breath. Release of the distal ends of pectoralis major and latissimus dorsi (adhered to the humerus) helps to ease medial rotation of the humerus and supports the shoulder’s ability to extend. Release of the latissimus dorsi and trapezius layers adhered to the sides of the thorax and scapulae helps to ease protraction of the scapulae. Release of adhesion between the trapezius and levator scapulae layers supports the scapula’s ability to shift downward (inferior glide) on the posterior thorax.

 

 Releasing and creating greater balance between the latissimus dorsi and pectoralis layers eases twist between the shoulder girdle and the thorax. Releasing the lower portion of the latissimus and oblique layers at the waist eases twist between the lower thorax and pelvis…..

 

Session One Goals

          

To untwist and support the mobility of the thorax and fullness of the breath

              

To begin the process of shifting the position of the shoulder girdle and arms

           

To begin the process of remobilizing the pelvis, untwisting it and moving it toward a more neutral or horizontal balance

 

Session One Practicum

 

The Shoulders and Thorax

Session one begins with your client lying supine, working to free fascial restrictions keeping the pectoralis major and rectus abdominis layers adhered to the anterior thorax.  By freeing these layers it is possible to support the chest’s ability to elongate and expand with the breath and the shoulder’s ability to extend…….

 

Release the pectoralis major adhered to the chest with your client lying supine, arm horizontally abducted (resting on the massage table) and elbow bent. Sitting on the massage table at your client’s side, anchor the pectoral fascia close to the sternum with your fingers and as your client slides her arm towards the head of the table, feel for the layer to be free to move slightly medially and superiorly. Work slowly and carefully at an oblique angle to the sternum and ribs without compressing the tissue into them . . .