It’s possible to have a session that is within one service for the entire time, or to combine them depending on what your body would benefit from the most.  In general, it’s best to open and balance the system before asking it to reeducate or retrain what it’s been doing.

Beginning with a softer approach, even within the same session, will help your body to open more into the deeper layers that may be the source of the issue.  Once your body has allowed itself to trust the process and include more of the dimensions that it functions on, it’ll be much easier to create a change on the surface where the pain or tension reflects the issue.

Starting out with Brain/Spine integration or Biodynamic Cranial Sacral Therapy is recommended for long-standing or deep-seated issues. Otherwise try a combination of the softer styles with Manual Therapy that focuses on joint mobilization and soft tissue release.  If you want to prevent issues or enhance performance, include a couple of sessions in NeuroMuscular Reeducation and Awareness Through Movement. If you’re not sure or it’s your first exposure to some of these modalities, request a 25-minute Assessment to get a better idea of what would best fit your system. The Assessment will determine which layer or which system most of the symptoms are presenting on and better guide the direction the session should take.

Manual Medicine

shutterstock_side-lying Manual Medicine is an osteopathic approach that works directly on a particular structure to encourage it to reset itself, whether it be a joint, nerve, blood vessel, muscle, tendon, or ligament.  The pressure is very light, about the weight of a coin, since that’s all that’s needed for the sense organs to respond.  There is more precision in this method, as the information given by the practitioner is targeting a specific system in order to have an effect on a particular area, for example opening the pressure on a particular nerve to release a certain muscle group, or stimulating a particular tendon to release the compression on a specific joint.

Everything in the body is alive, responsive, and intelligent. The more dense parts of the body like soft tissue or bone are all collagen, forming along a continuum from very soft, pliant types of tissue, to the more stiff forms of support like bone.  Bone can easily become compressed with heavy use, especially the bones of the hands, feet, sacrum, and legs. Fluids can become sluggish or stagnant and lead to restrictions, soreness, or tension. Freeing up blood flow, interstitial, lymphatic, and cerebral spinal fluids can greatly improve a sense of pain-free motion, energy, and lightness in your system.

With the right type of contact and ‘conversation’, even compressed fixation within bone can soften, broaden, and lengthen. There can also be a great  effect on the spaces between the bones, no matter how small and limited the space for articulation may be. Because of the way the body is interwoven with itself whatever is given even marginal degree of motion is interdependent with its neighboring joint and tissue for that motion to happen freely.

shutterstock_armIf you’ve ever had a jammed sacro-iliac joint or metatarsal joint, you know how important it is for these tiny areas to be able to move freely.  If not, the neighboring areas will also begin to limit their motion, which is one of the causes of what we notice as ‘stiffness’. There are many subtle, small connections between the ribs and the spine that can easily become compressed by the work that we do with our arms.  There are so many small muscles adjacent to the spine that can often be triggered to tighten when a small joint nearby has become fixated.

Because they wrap around to the front of the body and have numerous muscular attachments, fixation at a rib head or intercostal compression can effect many areas simultaneously. These types of triggers may perhaps be more quickly and more easily addressed directly by manual therapy.

Brain / Spine Integration

This method, also known as NeuroTherapeutics, was developed by a French physician who is also trained as an osteopath, Dr. Bruno Chikly.  It is gentle, non-invasive (involving almost no pressure), and profoundly relaxing. Along with listening for subtle rhythms in the brain and spine, it helps to calm or open nuclei of the brain and spinal cord that may show signs of stress or imbalance which are also responsible for homeostasis within the system.  Once the systems responsible for maintaining balance are calmed and restored, it’s much easier for the symptoms there or anywhere else in the body  to dissolve.

For example, there are specific nuclei in the brain that are activated in the stress response and muscular tension in the back, neck, and shoulders can often be connected to stress.  If the areas of the brain that are involved in the stimulation of chemicals that provoke the stress response are settled, then the corresponding muscular tension will very naturally ease off and will be much more responsive to massage techniques.

In this way there won’t be double messages in your body, with one set of messages from your brain telling it to be excited and tense, and another set telling it to relax before the brain has relaxed.  This method goes hand-in-hand extremely well with the biodynamic cranial work.


Headaches, post-concussion syndrome, neck tension, chronic hyper-arousal, agitation, inability to focus, difficulty sleeping, certain types of trauma or PTSD, balance related to spatial integration, and vertigo can also be helped by this approach. It’s not commonly known that an early injury can have an effect on a person’s entire life.

Scans of even young men or women who’ve had an early accident, like being ear-ended by a truck can change a personality causing depression, irritability and memory loss.  The left prefrontal and temporal lobes were impacted in one scan I saw, causing reduction of brain tissue in those areas without change in the symptoms for 14 years.

In another case where the same lobes in the brain were impacted, the symptoms were very different.  A 79 year-old man who ran into a pole in his 20’s had been irritable and aggressive ever since.  We often only consider the physical ramifications of an accident and aren’t as familiar with the emotional and cognitive aspects of post-concussive syndrome or whiplash. Even in the physical realm, the forces can land in the neck, spine, sacrum, or anywhere the descending pathways of the nerves travel, including setting off trigger points in the subcutaneous nerves. Cognitive after-effects can include dyslexia, aphasia, stammering or halted speech, loss of balance, and spatial disorientation.

Some of the more common temperament characteristics of brain injury are anger, irritability, and poor impulse control. If left untreated or misdiagnosed and not attributed to the head injury, the mood and  temperament of the person can be altered for their entire life. There are many places where forces of stress, injury, surgery or emotional trauma can land in the body; the brain is just one area where the undischarged force can be reflected.


Senior Female Doctor Reviewing Xray Results With PatientIt’s difficult to see soft tissue changes without a SPECT (Single-photon emission computerized tomography) scan, but a sensitive practitioner can detect changes in motion, heat, latency, rhythm, and charge. Brain changes can happen with just one incident for some people, even if the trauma is emotional, like for the survivors of the Twin Towers collapse on 9/11. Nonetheless, these changes need not be permanent, and it may be a wise choice to address the influence that the brain has rather than attempting to overcome symptoms without addressing the shock and trauma physically.

Biodynamic Cranial Sacral Therapy

The Biodynamic method was developed by A.T. Still in the late 1800’s and made popular in this country by his protege’, Dr. William Sutherland, who began introducing his concepts to the greater osteopathic community in the 1930’s.  It differs from the structural approach in that it doesn’t attempt to make direct, manual adjustments to the musculo-skeletal system.

Instead, the biodynamic approach waits for the inherent intelligence of the system empowered by the life force instilled in everyone by a higher power to open, balance, and correct itself.  Still and Sutherland saw the fluids in the body as carriers of this life force, the original blueprint of the body’s dynamic design, and the organizing principle that knows what to do with it since it built it originally.

Water can permeate just about everything, and there is evidence to support the fact that it can also give shape to the form as well as carry forces, imprints and information that shape the form.  A simplistic example is comparing it to when a boat is trying to reach harbor in a storm, it’s much easier when the waters are calm, and in the same way it’s also much easier for the body to acknowledge and address the changes that need to happen if its fluid systems are calm and balanced.

Biodynamic Cranial sessions involve a touch and a way of relating to the system like that of handlMother massaging the belly of her four month old baby in bed at home, top viewing a small infant – with delicacy, loving presence, and clear support. In that relationship, the child knows it can open and relax. From a space of safety and support, clarity and knowledgeable intention, there can more easily be a recognition of where the system needs to act on itself. With that understanding, the forces holding the symptoms in place can more readily be contacted and resolved.

Neuromuscular Reeducation

NeuroMuscular Reeducation is the means whereby the somatic educator sends messages to the body’s tactile and kinesthetic communication system so that these cells can tell the brain to change the muscle. Numerous proprioceptive sensory cells communicate with the brain about the moment-to-moment status of their surrounding tissue. The brain uses this information to create appropriate changes, but responds to the practitioner’s input as part of the reeducation process.

Skin anatomy and Sensory receptors in the skin. Skin anatomy in the round shape.
There are three main phases of a neuromuscular session. The first phase is a mirroring phase whereby the tissue is brought to neutral by mirroring what it’s already doing.  

This releases shock and guarding and opens the system to something new.  The second phase is passive motion whereby the somatic educator introduces touch and movement that stimulates the sense receptors that awaken the brain to the activity there and gets it to notice the area.

The third phase is the active motion portion when the client participates by using conscious movement to both awaken the brain and to overcome the inability to feel or control the muscle.  It also helps mobilize muscle cells to increase the numbers of nerves firing to the muscle to increase strength and coordination. Stretch sensitive spindles become activated and their signals enable greater length in the muscle. An important part of what happens in the feed-forward process during the active movement phase of the session is that the change in the position of the joint signals the brain to change the length of the muscle in order to maintain the joint position.  

shutterstock_neckLike driving a car, the body can follow a map if you assist in removing the road blocks, let it know the current location, establish the route to the target location, and direct traffic along the way. Once it’s forgotten it’s way, you have to act like it’s the first time in order to learn again how to get there. In a similar fashion, as your body travels that route enough times, it knows how to get there and will store the route and get there without much attention to it in the future.                                         

For change to happen in the body, it needs to know where it is and to know where it’s going. Part of how that information is transmitted is via the positioning and placement of the bones. The other part is sensing movement or the change in its position. As the practitioner moves the body with the intention of changing the length of a muscle group, the body is told where to go and how to reset the muscles in order to get there.  Repetition helps to reinforce the path of action and store the change.

For the brain to be able to notice changes and store them, the body must be in motion, or the awareness must be keen and sensitized enough to move to the area and activate it by touching it with awareness alone.  Otherwise the brain will simply recruit the muscle patterns that are already filed and override the desired change. The retraining process is easier with a therapist or somatic educator because when you try to lengthen a muscle on your own, the body automatically excites a stretch reflex where it’ll pull back against your stretch to protect the joint. Including passive and active motion to lengthen instead of just pulling on the muscle to stretch it is more effective.

NeuroMuscular Reeducation techniques and principles combine well with any other method of bodywork. It’s tremendous for pain patterns, to alleviate spasm and inflammation, and to open and awaken numbed out areas while training them to work in concert with the rest of the system again.

Perceptions in Motion

Sportswoman having a leg stretching

Movements in somatic education are designed to reinforce positive changes in your body related to joint mobility, released muscle tension, integration of all parts working as a whole, and maintenance of the awake, responsive state in your body. They happen in two ways. One is during the table work after clearing and resetting your system, whereby there may be several client-assisted movements so that the brain registers the changes actively as well as passively. The other way is through movement patterns guided during the session and used as ‘homework’ to prevent imbalances from catching hold again.

The concept here, is that information from the outer environment has quite an effect on the organism as it adjusts itself based upon whatever is presenting – which is in this case, input from the practitioner. The other side of that equation is the feedback loop within the system itself that happens when the client exerts a conscious movement that reinforces the desired outcome internally. This helps to lock in the changes that happened passively in the muscle during the active phase. At times it also helps to change the speed and angle of the movement so the brain learns to retain that desired changed at different speeds or trajectories.


Gift Certificates

If you know someone who would benefit from this work and want to offer it as a gift to them, please visit the Gift Certificate page, choose a design you like and personalize it with your own message before you print it out. Many options are available to choose from to fit the needs of that someone you care about. It’s also possible to offer the books as a gift for support in doing exercises at home using mindfulness. Those steps to accessing and generating change from within are invaluable. Just visit: