Zen and the Art of (Manual) Therapy™

My sessions start like most, where there is a short interview/update, a sharing of information to tell me the present state of being. This time gives me feedback on what we've done and direction on where we need to go. Listen, then move forward into treatment. Today, one of my morning sessions started just this way, with reports of a sudden "POP" in the outer knee region during a certain motion. No apparent injury or worsening of the condition, just something needing to make itself known. My patient and I negotiated a direction for the treatment and we began.

Those of you who are familiar with my work know I have moved into a lighter brand of therapy. Myofascial release is often said to be lighter than other forms of manual therapy, but many do not practice what they preach and roll up their sleeves to bury their elbow into the body with regular frequency. Using principles of therapy based more on a sound, neurological approach has quieted me considerably during therapy. I was taught early in my MFR training not to coerce, but now I really see what this can mean.

So, I grabbed a piece of Dycem and enveloped my patient's fibular head region, moving in only as far as her body allowed, then waited for more information. 30 seconds into the technique, she asked if I practiced Zen. I suppressed a laugh, as with what little information I had about Zen, I felt myself the most un-Zen-like person I could imagine. I asked her what she meant and she went on to say that it seemed that when I put my hands on her I only move in enough to wait patiently for things to occur, rather than trying to create change by forcing my way in. She seemed to be describing zen (small Z) vs. Zen, not the spiritual/religious practice, and she thought that the way I was approaching her today was zen-like.

Forced to consult a dictionary for a better idea of what she meant, I found this on the Urban Dictionary:

zen

One way to think of zen is this: a total state of focus that incorporates a total togetherness of body and mind. Zen is a way of being. It also is a state of mind. Zen involves dropping illusion and seeing things without distortion created by your own thoughts.

No help so far.

Next, I tried Wikipedia:

Zen is a school of Mahayana Buddhism^{[note 1]} that developed in China during the 6th century as Chán. From China, Zen spread south to Vietnam, northeast to Korea and East to Japan.^[2] The word Zen is derived from the Japanese pronunciation of the Middle Chinese word 禪 (dʑjen) (pinyin: Chán), which in turn is derived from the Sanskrit word dhyāna,^[3] which can be approximately translated as "absorption" or "meditative state" (my bold).    Now we are getting somewhere.

There are times when I feel I have been absorbed into my patient's tissues, into a joined state of one-ness (did I just say that?). Not forcing, but just being; not acting, just listening.

So, we zen'd around her fibular head for most of the session and found that most of the grumpiness had dissipated. She was quite pleased.  Maybe she is on to something. Simply allow yourself to be absorbed into your patient, so that things become more clear. We have the ability to influence their nervous system, which in turn will influence all else. Try it, be absorbed, be zen-like.  Ommmmm.

For now,

Walt Fritz, PT

Foundations in Myofascial Release Seminars

A Lighter Way of Doing