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Zhao Yuan Uchida-Pichon's Thai Massage for Sciatica course notes
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Zhao Yuan Uchida-Pichon
France
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August 8, 2018 - 8:06 pm
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Module 1
Thank you for the very informative introduction to this course in this module. I downloaded a picture of the skeleton of the human back and was trying to refer to it as you were talking about the L4, L5 and S1,2,3. I tried to locate these area on my back and I tried to locate them on my husband's back as well, to get a general idea of where we will be dealing with.

I have had a few clients who were complaining to me about their sciatica and true enough, usually it was only one sided. I took this course because I want to add something to my normal massage to help clients with sciatica and hopefull, to stand out from other massage therapists here.

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Shama
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August 9, 2018 - 12:29 am
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Welcome back to another course. The fact is that almost all Thai Massage schools only teach a typical sequence and nothing about specific therapeutic applications. What makes Thai Healing Massage Academy's courses unique is that they cover very specific therapeutic work for many areas like sciatica, knees, back, shoulders, feet, and hips. This will definitely help you to distinguish yourself from other therapists since you will have specialized knowledge which is not easily available - not even in most Thai Massage schools in Thailand.

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Zhao Yuan Uchida-Pichon
France
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August 9, 2018 - 2:37 am
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Module 2
Thank you for the comprehensive video on various methods to diagnose Sciatica, it is definitely useful to start the massage especially for new clients. I have a few questions.
1. For the techniques to diagnose Sciatica, do we conduct all 3 types of tests or do we only need to do one of them? This is because assuming we are allowed to do this massage for Sciatica on pregnant women, the F.A.I.R test may be a little difficult for them due to the big tummy.

2. And if the massage is not suitable for pregnant women, how long after giving birth should they start to have the massage?

3. Also for the tests, do we continue doing leg raise test and F.AI.R test on the second leg if the client already experienced pain during the tests on the first leg?

4. How long should a massage for Sciatica last usually? Can it be done as a massage on its own or can I use it with another massage for example, the Thai massage for back?

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Shama
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August 9, 2018 - 11:51 pm
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1. This is a very general question. There are several possibilities. The lower back pain might actually be sciatica, but there is a good chance that it is not. Pregnant woman often get lower back pain which can easily be confused with sciatica, but is actually not caused by the compression of the sciatic nerve. It might be pelvic girdle pain instead. Pregnancy generally does not cause sciatica. If a woman has had sciatic problems before the pregancy, then she might actually have sciatica. But if the problems started during the pregnancy, then chances are good that it is not sciatica, but pelvic girdle pain.

Both pelvic girdle pain and sciatica can benefit from similar lower back treatments. You can try to do a sciatica test, but only if the woman has had sciatica before the pregnancy.

2. Thai massage is suitable for pregnant women, but not all techniques. It also depends on the stage of pregnancy. You can work on the feet, the legs, the arms and hands, neck and face, and the back. Prone position is not good obviously, and back work should be done in the side-lying position. Don't do any stretches which affect the midsection. This is a little bigger subject than I can address in this forum post.

If the woman had a natural birth, you can start massage within a few days of delivery, as soon as she feels okay about it.

3. Once one test confirms sciatica, you don't necessarily have to do all tests. It is quite rare that sciatica happens on both sides of the body. However you can do tests on both legs anyway. If someone experiences pain on both sides, then there might actually be another problem which might not be sciatica at all. It is important to get a good description of the pain and its location from the client, aside from doing the tests. Keep in mind that sciatica is not the only possible cause of pain in the hip and leg area. There are other possible causes like arthritic problems in the spine or sacroiliac joint dysfunction.

4 Sciatica massage does not necessarily have to be a separate kind of massage. It can be combined with massage work on other parts of the body, just with more emphasis on the sciatica techniques. So yes, it can easily be combined with back massage, for example.

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Zhao Yuan Uchida-Pichon
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August 20, 2018 - 5:24 am
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Module 3
The rocking massage technique is very soothing, both for the giver and the receiver. May I know if we can do this technique if the receiver is lying on his/her side as well? The alternative method of using the heel of the foot is very interesting. I remember my father asking my sister and I to step on his back to massage it when we were little kids. I noticed that doing massaging using feet is not that strange in asian culture but here in France I often get a lot of raised eyebrows when I tell my clients that for example, Thai massage, use a lot of feet and legs. I also think that I will need a longer time to master the method of using the heels of my feet because I have a bit of difficulty doing this movement without having something to hold onto for balancing, and I find it a bit difficult to gauge my strength at first using the heels of my feet.

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Shama
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August 20, 2018 - 4:59 pm
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I never tell clients that I will work with my feet, to avoid the raised eyebrows. I just do it. When I am in the middle of the session, nobody questions what I do. Smile

It is clearly easier to do rocking techniques in the face-down or face-up position. In the side position, you can do smaller motion movements like wiggling with fingertips or the heel of your hand.

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Zhao Yuan Uchida-Pichon
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August 21, 2018 - 6:28 am
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Module 4
I tried the elbow in the groove rolling down technique on my husband and he adores it! He has a sciatica problem and when I did this movement on him he said he could feel the instant relief on his sciatica nerves. However his feedback is that I should not do this movement too fast because there will not be enough time for the feeling of the movement to 'sink in', so the slower I roll my forearm down, the bigger the impact, according to my husband.

In general, all the techniques taught in this module are very manageable for the giver and soothing for the receiver. My husband needed a while to get use to the percussion because personally he is never a big fan of percussion massage, but that is just personal preference.

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Shama
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August 21, 2018 - 9:11 am
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If he likes it slow, by all means, do it that way. Try it on a few more clients and see what feedback you get. In general, except for rocking movements, I have always found that slower feels better than faster for many techniques. A fast Thai Massage feels hurried and not very relaxing.

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Zhao Yuan Uchida-Pichon
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August 22, 2018 - 6:38 am
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Module 5
For the rocking sacrum and the SI joint, does it mean it will be quite impossible to do it on a massage table with the 'spider man' transitioning technique, or can we do one direction first and then go over to the other side of the table and do the other direction?

The forearm leaning, rolling and rocking is very efficient and they really help to preserve the hands so much, especially when we have to work on big and heavy clients. The knee is great for working on the floor too.

May I know for all the techniques introduced, how long do we do them in general? When do I know it is time to go on to the next technique?

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Shama
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August 22, 2018 - 12:46 pm
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With the 'spider man' transition (I love that name, maybe I will make it the official name for this move Smile) it is a bit more elegant and flowing, but you can definitely do it on a massage table and just walk around to the other side. You obviously have to interrupt the flow to do that, but this is not really a big deal.

Regarding the time you spend on each technique: If you want to work out an issue, it is obviously better to stay with a technique longer. But there comes a time when even the best technique feels oppressive if you do it for too long.

I have found that when I work on real issues like sciatica, it is very useful to keep the line of communication with the client open. What I mean is this: Ask the clients how a technique feels, which techniques they feel are most helpful, and ask them to tell you when something gets too much for them.

In general it is better to use several techniques for a relatively short time, and then come back and do them again a few minutes later, than doing one single technique for a really long time.

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Zhao Yuan Uchida-Pichon
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August 25, 2018 - 5:10 am
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Module 6
The double knee leaning on buttocks and double knee rocking on buttocks are very nice for the recepient but as a giver I felt my thighs a bit tired after rocking for a while. Maybe it is due to my size because I am really small with short legs haha. I find the face cradle simulation very very helpful! I was just talking about this with another massage therapist another day. We were saying that as massage therapists we love the hole in the massage table where clients can put their face into. It makes our job easier when doing back massage because the neck is not twisted. However we also understand that some clients really dislike the hole because if they have a huge face it makes their face feel crushed on the side. We were discussing about a solution for this and we were looking around online for special kind of pillow to rest the face while doing massage on the floor, but it cost a bomb. and we were trying out different positions of towel rolls and cushions but none are that comfortable. So when I saw your face cradle simulation I was delighted. Now I just need to get a couple of good pillows with suitable thickness.

I love all the techniques that involve the forearms, it is not tired at all for the giver and it feels very pleasant for the receiver, especially the elephant steps with the forearms. For the hip rocking technique, my husband's feedback was that perhaps it will be even better to add some cushions under the clients' knees to reduce the space between the lumbar region and the mattress so that the rocking will be more effective.

For the stretching technique, I have a bit of difficulty because as I mentioned above, I have really short legs, and when I put my legs over the receiver's thigh, my foot could not touch the floor haha, so I felt a bit less confident to execute the movement because I felt I wasn't stable enough with my feet handing over the client's body. Is there another way I can pin the client's legs down without using my own legs?

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Shama
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August 25, 2018 - 11:43 am
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The double knee rocking will get easier once you find the right rhythm. I am pretty sure you are doing it with too much muscle effort instead of getting into the flow of it. It has nothing to do with your size and weight.  The trick is to find the right rhythm between the forward and the sideways motion. It should feel rather effortless. And also you are not supposed to do this for a long time, just 15-30 seconds.

Regarding the stretch where you cross over with your leg, one way to make it easier is if you lift yourself up a bit by not sitting on your foot, but by squatting on your heel while being up on your toes. This lifts your center of gravity and makes it easier to put the leg across and have some weight in it.

If someone is really big and heavy, then you just skip this technique. Not every technique works well on everybody. Remember that the techniques are options to choose from, not mandatory sequences.

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Zhao Yuan Uchida-Pichon
France
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September 9, 2018 - 4:43 am
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Module 7
I like that this module contains a lot of stretchings for the hips and lower back. It looks painful yet satisfying haha. Just a question, when we do the stretches, do we follow our client's breathing (stretch on breathing out)?

Another question, I noticed that a few of the techniques require the massage giver to move their legs close to the pelvic region of the receiver. In case some clients may feel the movement too initmate, should we check with them if they will be comfortable with the movement before we move into it or should we just do first, explain after?

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Zhao Yuan Uchida-Pichon
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September 9, 2018 - 5:22 am
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Module 8
I am submitting my course notes of Module 8 on the same day as this modules does not require any practising of new massage techniques.
For the part on advices for clients, as massage therapists, we know very well that massage on a regular basis is only good for our clients. How regularly is ideal if the client is able to afford it? How would you advise on talking our clients to get the massage as regularly as possible without sounding like we are trying to rip it off them?

Thank you for the examples of yoga moves to help with sciatica. Very often when I advises clients to take up Yoga one of their reactions was that they didn't know which movement to do, since there are so many movements. With these set of exercise homework, I can now effectively advise them on the specific movements to target their sciatica problem. I'm sorry the belly dancing movement really made me laughed, I didn't know you are such a good dancer!

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Zhao Yuan Uchida-Pichon
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September 9, 2018 - 6:01 am
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Module 9
I really agree that massage therapy is not just about physical techniques. In my centre I call it the 'massage and wellness centre' because personally, I believe that the physical techniques can be more effective when combined with other factors such as how the clients are positioned, layout of the room, energy flow etc, and together they bring about the wellness of the client.

My husband and I practise Reiki and the thing is , not everyone here is open about the Reiki methods. Already our own family members looked at us like we are crazy when we told them about energy flow and such. Some people find it too abstract to digest. However, we add them here and there during our massages sessions, some clients never asked, those who asked we then explain to them the concept of energy flow.

Another of my husband's client had this constant nagging pain in between her eyes that no doctor was able to cure. She came to our centre and my husband decided to use Reiki on her, during the sessions my husband said she was talking non stop, turns out she was feeling generally very negative about herself, she feels like she was constantly being judged etc. So along with Reiki my husband use verbal guidance to help her relax during the session. The next day she texted us to say that for the first time after so long, the pain between her eyes disappeared. One week later she told us the pain never came back.

I think there is no one size fits all method for every client, even for one client, depending on how they are feeling, they may not get exactly the same massage each time they come. And I now understand better when you say that we do not have to use every single technique you taught, we choose the one that fit our body type and circumstances.

Thank you for another wonderful course, I will be back for another course soon!

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Shama
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September 9, 2018 - 11:56 am
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Regarding the ' intimate' techniques - in my experience clients really don't care. If you have clean energy and conduct yourself in a professional way, nobody will think that something is too intimate, especially if they have sciatica pain, and you are helping them to improve the condition.

I never ask clients if I can do a particular technique, because this will only plant a doubt in the client's mind. I just do it. I generally explain to the client how what I am doing benefits their condition, but I don't think about 'intimate', and my clients don't think about it either in my experience.

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