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Linda Depew's Hip Therapy notes
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Linda Depew
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February 11, 2018 - 3:51 am
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Module 1

Shortly after I first watched this video, one of my regular clients was complaining about her right knee giving her a lot of pain (left knee was fine). After hearing her problem, I immediately checked her feet, was not surprised to see that they were both pointing decidedly to the left. I performed several minutes of therapy around the hip and adductors, then reassessed, at which point her right foot was pointing upward. With the result much improved (although not yet ideal), she felt some relief in the pulling on the knee. Before she left, I showed her some exercises to keep the adductors more limber. She has now been back for another appointment, and while there is still more work to be done, her right foot is starting to point slightly outward, and she has had no pain in the knee since the previous session.

While I found your discussion of cartilage and the bursae very interesting, I think that in the US, while there are some who overuse their joints (i.e. runners and those performing hard physical labor) problems arise more often from poor nutrition and lack of movement than from overuse. The diet of most Americans is highly inflammatory and the movement necessary to encourage movement of fluids through the body is lacking in our large population of couch potatoes. I am reminded of an Army physical therapist who referred to exercise as “motion lotion” in reference for the need for movement to push lymphatic and synovial fluids through the body. For this reason, I also talk to my clients about their diet and lifestyle, and often assign them exercises to do between sessions.

 

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Shama
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February 11, 2018 - 2:16 pm
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That’s a great success story – congratulations.

I have to agree with you, poor nutrition and lack of exercise are major reasons why things break down and deteriorate in the body.

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Linda Depew
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February 12, 2018 - 10:06 pm
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Module 2

Having already taken the rocking course, this module was more of a review than new information for me. I have incorporated rocking into my table as well as my THM work, and have yet to meet a client who doesn’t like the rocking techniques. The yoga practitioners appreciate the fact that with rocking I can gently take them into even deeper stretches, less agile clients like that we can loosen areas without undue stress, and my fussiest and most vocal table client often reminds me that she wants the rocking just because it feels good. It seems that rocking is a universal hit on several levels.

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Shama
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February 13, 2018 - 12:13 am
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Linda, I thought that was such a good description of the rocking techniques that I shared your post in the facebook group. Smile

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Linda Depew
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February 14, 2018 - 10:33 pm
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Module 3

As I was working through this module, I was thinking about how I often use my forearms, but only occasionally use my feet or knees. I know it has a lot to due with a balance issue. I need to be more diligent in my yoga practice to gain a better sense of balance. When I do use my feet or knees, it seems to be okay for the clients, but none of them comment how great it feels like they do with some of the other techniques. One thing I had not tried before this is reaching across with my foot to address the inner thigh. I think this move might be quite useful as I get more comfortable with it.

I do use my forearms a lot. This is something I was doing in my work even before I studied THM. I do find some advantages of the forearm over using my feet or knees. One is that I have enough experience that my forearm has become very sensitive, and I can often sense issues that some people would only find by using their fingers. Another is that being relatively short, it is easy for me to bend into a move without undue strain on my back since I really don’t have to lean over very far. I am wondering if the technique shown at minute 13 could be better adapted for a man if the arm was angled upward more. While it would hit the muscles in a slightly different way, it seems like it might still be quite effective. I often use the next technique with great success, but realize I have not been taking it all the way to the outer thigh. Even the areas of this course that are a review of the techniques I have seen before can be useful because with so many ways to work it is easy to overlook some very useful options.

P.S.  I’m glad you liked my description of the rocking techniques in my previous post.

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Shama
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February 15, 2018 - 12:23 am
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By all means experiment with modifying techniques and make them fit you better. I show what works for me and what useful modifications I can think of. However I am sure that there are many more ways of adapting and modifying techniques. Since I am in a rather tall body, I don’t encounter the same issues that someone in a much shorter body would encounter.

The truth is that I found many of those modifications just by ‘playing’ with different ways of doing it. But I have seen others use other modifications, including many of my students. I always encourage creativity.

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Linda Depew
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February 17, 2018 - 3:49 am
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Module 4

Love traction; have been using it since my early days in massage school. My clients love it, too. I have even suggested inversion tables to a couple of clients to help stretch their spines. I find your technique incorporating the rocking motion particularly interesting, providing more benefit than the straight pulling on the legs which is the original technique I learned. In fact, as you know, I like rocking for just about everything. Even though I usually do compressions on the inner thigh, often with the help of a pillow, I like to do the rocking variation, also. I like that the rocking helps to loosen the SI joints in addition to helping to stretch the adductors. The technique with the legs at a 45o angle is great for my yogis, although even with them I often need to ease into it with rocking. And with anything I do at the higher angles, I will take the stretch as far as I can until I feel resistance just to check the flexibility of the client, then automatically rock until we can get into a deeper stretch.

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Shama
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February 17, 2018 - 9:42 am
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I can really picture you doing excellent work just by reading your post! Especially the rocking/stretching combinations. Smile

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Linda Depew
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February 19, 2018 - 10:09 pm
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Thank you, Shama, for the above comment.  I really enjoy doing THM, and love the results I see in my clients.  SmileSurprised

 

Module 5

I love that Thai massage offers such a great opportunity to work the adductors, a much neglected area in standard table massage. I do a lot of forearm work in this area, but also work extensively with the fingertips to get in deeper, especially as I work closer to the tendon. Because I often hold compressions for an extended period, I have already had effects similar to your blood stop technique, but I still find it a pleasant surprise when a client tells me they had a sudden sensation of warmth or rush of energy. I don’t know anybody that I would take directly into the strongest stretches. Even with yogi types, I like to prepare them for the stretch with some circling or rocking first just to get the muscles warmed up and make sure they are loose enough for the more extreme work.

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Shama
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February 20, 2018 - 5:10 pm
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Yes, adductor work is often neglected in massage, along with sacrum work, glute work, abdominal work and chest work. Sometimes I wonder what massage therapists are actually working on with all those ‘forbidden’ areas. Laugh

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Linda Depew
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February 26, 2018 - 5:37 am
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Re your comment above, from my experience the answer for many massage therapists is “not much”.  As a professional, I admit I can be very picky but I have had many unsatisfying massages where it felt like they left most of the critical areas completely untouched (even after I’ve told them what needed work).

 

Module 6

I have had great success with the scooping and circling techniques for cramping in the groin during stretches, but until now, I have only done this after I discovered the client had a problem during the stretches rather than as a preventative. This work is something I never would have thought to do at all without your courses. The first modified technique for working with heavier people feels very awkward, and so far I haven’t figured out how it would actually give more power. The second modification is much easier, and for me much more effective. The third modification is something I have done many times. It is a favorite for both me and my clients; they love how it opens the SI joints.

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Shama
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February 26, 2018 - 9:34 pm
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I guess you are referring to the modification where you put your shoulder on the client’s lower leg, right? This is a bit tricky to get the positioning right, but you can put the weight of your entire torso into this move. Play with it a bit more.

I have had the same experience, that I told a therapist what I wanted done, and she did not do it. Actually this happened to me many times here in Thailand. And I definitely don’t want half my body skipped in a session!

The problem in Thailand is that they mostly follow a rigid routine, and if you ask them to do something a little different, they have no reference point for this – and then they just revert back to their routine. 

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Linda Depew
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February 27, 2018 - 6:45 pm
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Module 7

I love the stretch toward the opposite shoulder for my yogi types, but of course always rock into it. The first stretch in slice #7 is very interesting, but challenging for some of my clients for whom the gentle rocking is more appropriate. I look forward to summer when I can try the intense stretches at the yoga retreat on my more flexible folks. As for the rest of this lesson, I’m not sure what to say except that it is going to take a while, although I think the very last technique may come a bit easier.

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Shama
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February 28, 2018 - 1:33 am
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Working on the yogi types is generally a lot of fun because you can do so much more on them. But…working on stiff and restricted clients is often more rewarding because you can see the progress much more easily, at least in my experience. Smile

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Linda Depew
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March 1, 2018 - 2:46 am
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Up until very recently I have had a business location inside a chiropractor’s office, so I know well about the rewards of working on people who are often “broken” along with the frustrations of doing the some thing over and over on the ones who refuse to do anything to change their disastrous lifestyles.  I am looking forward shifting focus this summer with mostly clients are interested in their own well-being and with whom I can have some fun seeing where we can take things.  And  trust me, the way some people practice yoga in this countryFrown, there are still plenty of challenges.

 

Module 8

This lesson addresses yet another often neglected area. I was trying to think how often I have had a massage that someone did extensive (or any) work around the trochanter, and I honestly cannot remember much at all. I have had clients with issues with the trochanter, and it is somewhat awkward to address in standard table massage. I like the side lying position to address the area and picture myself doing this work often.

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Shama
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March 1, 2018 - 9:51 am
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You are so right, it is frustrating to work with people who refuse to change their lifestyle which causes their condition. It’s kind of like the Sisyphus story of Greek mythology. 

At one point I used to teach and practice Thai Massage at a resort with only yoga teacher training students. And I can verify your experience – there was plenty to work on and plenty of issues. I did not just find pictures of perfect health in all of them. Smile 

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Linda Depew
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March 2, 2018 - 9:13 pm
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Module 9

Another good lesson for neglected muscles. I love working with my arms, elbows and fists on the larger muscles like the glutes. The knee work doesn’t appeal to me as much (possibly because I am easily able to accomplish so much of what I need to do in other ways), but it is good to know for the larger, more challenging clients. With my work shifting more toward the yogi types, I actually have fewer of those over-sized clients at the moment. I absolutely believe in your comments about approaching an area from different sides; every change in angle can bring out different issues and yield slightly different results. I very much like the last position. I am very comfortable in a seated position, and find it provides me the leverage and adaptability I like in my work.

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Linda Depew
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March 4, 2018 - 12:45 am
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Module 10

As you know, I love all things rocking, although when I initially tried the first technique in this lesson (during rocking course?) I found the leaning more challenging than I expected. Once mastered, I love how the technique gets things moving and opens up the joints. With the sedentary American lifestyle, the flexors are a serious problem. Your discussion on this issue describes why I like to discuss general lifestyle & fitness with my clients. The stretches in this lesson are fantastic. I am going to have fun with them at the yoga retreat where I will be able to test just how far into the stretch some of these clients can go. Sometimes I am amazed at just how far I can take them, but as we’ve discussed, other times it is equally amazing how stiff yogis can be and how much they can be helped by assisted stretches such as these.

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Linda Depew
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March 4, 2018 - 12:46 am
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Module 11

I think the flow may be one of the most challenging elements in Thai massage. While I don’t have a problem with it in my table work, I am never as graceful as I would like when changing position and moving around the client on the floor. But maybe I’m a bit better at it than I think because my clients always say how relaxing the session was and talk about the energy flow they felt and how helpful the stretches were. Anyway, I always keep trying to make my flow better, and I know the longer I do it the more graceful I am likely to become.  SmileSmileSmile

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Shama
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March 4, 2018 - 1:02 am
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The longer I do it the more graceful I am likely to become.”
I would reword this to “the longer I do it the more graceful I will certainly become.” Smile

From what I read, and just the fact that you have taken about half a dozen of my courses, you must be pretty good by now. Nobody is so serious and dedicated about this unless they get good results. Smile

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