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BASIC RELAXATION MOVE 2 (BRM 2) - Upper Back Procedure Minimum Prerequisite NONE. When performing both BRM 1 & BRM 2 always begin with BRM 1. Move 1 Stand at the client’s left side to move the left erector spinalis thoracis medially. Spinalis thoracis is the medial continuation of erector spinae and lies medial to and blends with longismsus thoracis in its lower part. Position both hands pronated with fingers extended, the palmar aspect of both thumbs laying tip-totip on the crest of the left erector spinalis thoracis 1 finger-width below the level of the inferior angle of the scapulae. BRM 2 - SUMMARY Moves 1 & 2 - Medial moves over the left (1) then right (2) Erector spinae at a level 1 finger-width inferior to the inferior angle of the scapulae. Moves 3 & 4 - Medial moves over the left (3) then right (4) Erector spinae at a level 1 finger-width superior to the inferior angle of the scapulae. Pull skin laterally over the left erector spinalis thoracis on exhalation and without sliding to the lateral border of the left spinalis thoracis. Sink the thumbs beside the lateral border of the left spinalis thoracis PAUSE Moves 5 & 6 - With the thumb pad placed 1/3 from the top of the scapula take move supero-medially and then supero-laterally in a boomerang pattern (5). Stop at the medial border of the scapula. Draw skin slack inferiorly with your spare hands finger as you lift the thumb pad off the skin. Replace the thumb and angle the challenge obliquely and move supero-laterally over the Rhomboideus minimus and Levator scapula (6). Moves 7 & 8 - Repeat moves (5) & (6). 6 8 PAUSE 5 7 Moves 8 (a) & 8 (b) - Optional if the shoulders are tight perform 2 posterior moves over the tendonous fibres of Latissimus dorsi superior to the inferior angle of the scapula and level with the back of the arm. PAUSE Moves 9 - 16 - 4 pairs of ascending moves between Moves (1) & (2) of BRM 1 and Moves (1) & (2) of BRM 2. The pairs of moves alternate in each direction and the thumbs perform all the moves away from you and the fingers perform all the moves towards you. PAUSE 26 Copyright © BTC Canada Ltd. 3 4 1 2 15 16 13 14 11 12 9 10 1 2 by Jonathan Damonte for The North American Bowen Teaching College Inc. apply gentle pressure medially to its lateral border to create challenge. Wait for an exhalation and move over and through medially while maintaining the same comfortable depth and pressure to lightly release the tension created. Move 2 Move over the right erector spinalis thoracis medially as in Move (1) but using the palmar aspect of both hands 2nd fingers. Move 3 Move over the left erector spinalis thoracis medially as in Move (1) with the palmar aspects of both thumb on a line 1 finger-width above the level of the inferior angle of the scapulae. Move 4 Move the right erector spinalis thoracis medially as in Move (2) with the palmar aspect of both hands 2nd fingers on a line one finger-width above the level of the inferior angle of the scapulae. Provide A Minimum 2 Minute Pause Moves 5 & 6 Made over left trapezius, rhomboideus major, rhomboideus minor and levator scapulae in a boomerang or shallow semi-circle. Move (5) affects the deeper muscles including: rhomboideus major, longissimus thoracis and iliocostalis lumborum and Move (6) affects rhomboideus minor and levator scapulae. Position the palmar aspect of the left hands thumb adjacent to the medial border of the left scapular and at a point one-third below the superior border of the scapula, measured between the inferior angle and the superior border. (This can also be landmarked by defining a point one finger-width inferior to the spine of the scapula). To have the best hand position for these moves it is best to rest the back of the 2nd & 3rd fingers gently on trapezius, to support you're hand during the move, and place the palmar aspect of the right hands 2nd finger tip-to-tip with the left hands thumb. Push the available skin slack inferiorly along the medial border of the left scapula to its limit. Apply gentle challenge supero-medially with the thumb only. Move the thumb pad over and through rhomboideus major and the deeper iliocostalis muscles to the limit the skin allows without sliding. While maintaining depth and challenge adjust the angle of the thumb to move supero-laterally to the medial angle of the scapula, stop. Elevate the thumb pad slightly and pull the excess skin-slack, that has bunched superior to the scapula, from the trapezius inferiorly. Replace the thumb in its last position and challenge anteriorly. Turn the wrist supero-anteriorly over the trapezius whilst challenging rhomboideus minor and levator scapulae antero-laterally with the palmar aspect or tip of the thumb. The rhomboideus minor and specifically the levator scapulae are challenged and released as the thumb moves supero-laterally adjacent to the medial angle of the scapula. Lower Stoppers Moves 7 & 8 As per Moves (5) & (6), Moves (7) & (8) are performed over the right trapezius, rhomboideus major, rhomboideus minor and levator scapula in a boomerang or shallow semi-circle. Copyright © BTC Canada Ltd. 27 Modules 1-2 Bowen Therapy Instruction Manual Provide A Minimum 2 Minute Pause Note: It is easiest to stand on the left side of the client to perform these moves but if preferred it is acceptable to stand on the right side to perform Moves (7) & (8). Optional Moves If there is little response in the rhomboideus major, rhomboideus minor or levator scapular. Or, if these muscles are particularly tense ‘Optional Moves’ (8a) & (8b) can be applied followed by a minimum 2 minute pause and an optional repetition of Moves (1 - 8) with no obligatory pause between Moves (4) & (5). Note: Angle the challenge supero-medially. The palmar aspect of both thumbs can aslo be used to perform the move. Another way to landmark the starting point is to divide the 2 points between the inferior angle of the scapula and the axilla. Provide A Minimum 2 Minute Pause Latissimus dorsi Moves 8a & 8b Place the palmar aspect of the fingers of the left hand on the belly of the latissimus dorsi at a level approximately 1 finger-width superior to the inferior angle of the scapula and midway between the inferior angle of the scapula and triceps tendon. Push the skin with the proximal finger joints anteriorly till the fingertips reach the anterior border of the latissimus dorsi, challenge latissimus dorsi posteriorly and move posteriorly releasing the challenge to latissimus dorsi as the move is made. Levator scapulae Rhomboideus minor 6 8b Trapezius 8 7 5 1 3 4 1 2 8b Latissimus dorsi 15 16 13 14 11 12 9 10 1 28 Copyright © BTC Canada Ltd. 2 2 by Jonathan Damonte for The North American Bowen Teaching College Inc. Moves 9 to 16 Stand on the left side. All the moves away from the therapist are performed using the thumbs pushing away and all the moves towards the therapist are performed with the fingers pulling towards. The direction of the moves alternates after each pair is performed. Note: The medial moves are relaxing and the lateral moves are stimulating to the system. The moves are performed using the palmar aspect of both hands fingers and thumbs and consist of 4 pairs of moves over the left and right erector spinae and are positioned equidistant and superiorly to Moves (1) & (2) of BRM 1 and inferiorly to Moves (1) & (2) of BRM 2. E.g. If the focus of the client’s problem is in the neck it is important to have an idea of sectioning the effects of the treatment to that area to maximize the benefit to it. Bowen Therapy can be powerful in its effect on the manner the body has dealt with the problems and where it has built defense that protective state can be pulled apart and can leave the area in more pain for a short time. It is as if the body will re-visit how it has dealt with the problem in the first place. It can feel as if the problem re-occurred to the patient and can be quite alarming. It is for this reason we focus an area of treatment to the area of concern and using the concept of 'Stoppers' will keep these potentially strong reactions comfortable and manageable for the client. Moves 9 & 10 Medial. (Thumbs - Fingers) Moves 11 & 12 Lateral. (Fingers - Thumbs) Moves 13 & 14 Medial. (Thumbs - Fingers) Moves 15 & 16 Lateral. (Fingers - Thumbs) Provide A Minimum 2 Minute Pause The purpose of a "Stopper' is to segment the body into parts and thereby section off an area being worked on and importantly to section off the effects of the work. In the beginning of treatment with Bowen Therapy the effect desired is to influence specific areas of the body in an orchestrated manner and this is important as the overall benefit of these first procedures is a resetting of the body's blueprint. It is a re-boot of the way it has accommodated itself for all the old injuries, diseases and stresses of life. To achieve the most effect it is best to have a focus of influence to an area. Copyright © BTC Canada Ltd. 29