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Massage & Bodywork The following article was "reprinted" with permission from
Massage and Bodywork, April/May 2001
CTM connective tissue massage
by John Latz
Skillful manipulation of fascia is an effortless art — at least, it can be. Throughout my 20-year career in bodywork, I've seen that true fascial artistry lies in appropriate body mechanics. This is the basis for Connective Tissue Massage (CTM), a system I developed and now teach to massage practitioners and other health care providers. Elegant in its simplicity, CTM allows every stroke to be delivered with power, efficiency and ease.

I first became intrigued with fascial work early in my training when I heard accounts of dramatic changes reported by recipients of Ida P. Rolf's method of Structural Integration. Curiosity compelled me to receive the 10-session series myself, an amazing and landmark experience. Structural Integration was far more dynamic than any other bodywork I'd received, and I'd never felt myself respond and change so profoundly. My chronic tension was relieved, my energy increased and I achieved a greater sense of self-awareness and empowerment.


Author John Latz (shown here) developed Connective Tissue Massage to offer fascial manipulation through simple body mechanics.
As a result, I came to believe that fascial manipulation is the most powerful and effective means of bodywork. This led me to the Rolf Institute, where I began training in 1985. However, I didn't "come into my own" until a year after graduating when I studied with Emmett Hutchins, one of the first practitioners chosen by Dr. Rolf to teach her system. I was deeply influenced by our Structural Integration sessions, and recognized that each time I received fascial work, my own work changed. I became increasingly grounded, powerful and connected with my clients.

In fact, my greatest understanding of fascial work came from my personal experience of receiving it. I became acutely aware of how fascia changes and what level of energy a body needs to facilitate its change. I realized I had a gift — the innate ability to learn and translate fascial contact. In other words, whatever I felt in my body I could immediately utilize with my clients.

At the same time, I recognized that not everybody learns this way. I also knew I had another gift — a natural ability to teach and share this work with others. In 1989 I decided to formalize CTM into a system to share with other practitioners, knowing how much it would benefit them and their clients.

When I began teaching, however, I found students didn't fully grasp what I was doing when only watching my hands. I realized it wasn't just the way I used my hands that made my work effective, but rather the way I used my whole body which allowed me to contact and manipulate fascia. From this realization, I drew upon Ida Rolf's genius, extrapolating her principles of body alignment and movement into a specific system of body mechanics. Having already embodied her concepts in my own work, it was easy for me to present them in an organized and understandable way. In its present form, CTM is the culmination of 10 years of continuous evolution, and is a system which offers mastery of fascial manipulation through simple body mechanics.

Some Facts about Fascia


CTM requires the practitioner to remain relaxed, even while working deep fascial layers.
When I introduce CTM to clients, I explain that all of the structures in the body are surrounded, protected and supported by connective tissue. It is the ubiquitous matrix which connects, or binds together, the body's organs and systems, and at the same time provides compartmentalization between them. As you know, fascia is a continuous elastic sheath which provides structural support for the skeleton and soft tissues (muscles, tendons, organs, etc.). This tissue changes readily, softening and lengthening when energy is added through deliberate contact.

Dr. Rolf's original research on the characteristics of fascia identified its different biochemical states. She referred to these states as "gel" and "sol." She described the gel state as having a low hydration level, in which fascia often shortens and becomes adhered to surrounding layers of tissue. When I'm working, tissue in this state feels thick and dense to my hands. With my conscious touch, the chemistry of the fascia changes, and within seconds it begins to "sol." In its sol state, fascia is better hydrated, more elastic, and more easily stretched and lengthened. This new quality of tissue feels supple under my hands. My goal in working is to facilitate the gel-sol change to most effectively manipulate the client's fascia.

Another significant characteristic of fascia is the way it organizes the body through an extensive webbing of layers. Weaving around and through all of the structures in the body, fascia creates a complicated, contiguous three-dimensional network. Within this network, I endeavor to touch a single layer at a time, sequentially addressing the fascial layers from superficial to deep. I work only on the most superficial layer of resistance, adding energy through my contact until I sense a melting sensation under my hands. This melting signals the accomplishment of the sol state, during which the softened tissue is stretched and lengthened. Once this happens, it is appropriate to work on the next, deeper layer.

CTM POSITIONS
Key to the practice of Connective Tissue Massage is its application of the principles of Ida P. Rolf to the body mechanics of the practitioner.
FRONT POSITION

— practitioner uses fingertips or heel of hand
SIDE POSITION

— only the forearm or elbow is used
1. Reaching through top of head into space (at approximately 45-degree angle)

2. Shoulders relaxed

3. Arms spanning forward from torso, elbows slightly flexed

4. Straight plane from hand to wrist through forearm

5. Lumbar spine reaching posterior

6. Pelvis squarely in direction of work, moving forward with the stroke

7. Grounded foot parallel to direction of work, pushing up on to toes with stroke
1. Top of head reaching into space, looking forward (not at client)

2. Chest open

3. Elbows extending out of ribs

4. Forearm parallel to direction of stroke

5. Palm up

6. Direction of pelvis forward (i.e., perpendicular to client)

7. Grounding through inside arch of back foot, extending through foot and leg with stroke
THE FIVE BASIC PRINCIPLES OF CONNECTIVE TISSUE BODY MECHANICS:
1. Leaning controlled body weight into the client

2. Maintaining alignment

3. Movement through the alignment

4. Using oblique angles of contact

5. Contacting with soft and relaxed hands and body

These principles comprise a specific practice which is the optimal way to affect the fascial body of the client.

It is a violation to touch the deeper layers of fascia without first having worked the surface layers. Otherwise, the body shuts down to the energy input, armors its defenses and the client will likely experience the work as harsh or painful. Without honoring the fascial layers, practitioners may try to "muscle" their way through resistant tissue, without achieving any positive results. In contrast, the fascial matrix changes readily when energy is added with a clear and conscious intention.

Principles of CTM Body Mechanics


The first principle of CTM Body Mechanics is leaning controlled body weight into the client.
The first principle of Connective Tissue Massage Body Mechanics is leaning controlled body weight into the client. Using controlled body weight ensures contact with the appropriate layer of fascial resistance, and is therefore painless for the client. It is also effortless for me, because I am utilizing the force of gravity. As I lean, gravity literally pulls my weight into the client; this involves no muscular effort on my part.

This controlled leaning is done in a particular alignment. Alignment is the second principle of CTM Body Mechanics, and refers to the vertical line around which a body is organized in the Structural Integration model. This line runs from the sole of the foot through the ankle, knee, hip, shoulder, ear and top of head. I maintain my line regardless of whether I'm working in a front or side position.

The third principle of CTM is movement, which is elongation along the alignment. It's like doing yoga; nothing shortens in my body while I'm working. When I move in CTM Body Mechanics, I lengthen in a vertical dimension through the bottom of my feet and out the top of my head, extending through my arms. I make my body bigger and longer, and my fascia expands in all directions simultaneously. This expansion continues into the fascial body of my client, whose fascia lengthens and expands as though it is a continuation of mine.

The next principle of CTM Body Mechanics is the use of oblique angles of contact. Fascia lies in broad, continuous planes in the body. In order to lengthen a broad sheet, we need to contact it from an oblique angle, which takes the downward thrust out of the contact and puts in a more forward, stretching movement. While a downward thrust would immobilize the tissue, the oblique angle mobilizes the tissue so it can be lengthened. This process maximizes the transmission of my body weight into the client, while minimizing any invasive or compressive contact.

The ability to stay soft and relaxed in my body and hands comprises the final principle of CTM Body Mechanics. This ability to be relaxed and open while working ensures I remain noninvasive, even when contacting deeper layers of tissue. My effectiveness is improved because my client is able to remain open to receive the work. In addition, I am able to listen through my hands to the proprioceptive information I receive. Intuitively, I understand the force and direction necessary to best respond to my client's needs.

When I apply all of these principles, I use my entire presence to promote change in a client. Working this way is effective for the client, and virtually effortless for me. This is because the experience of true fascial contact is one of "letting go" — for my client, as well as myself. I am able to let go because I am working with the gravity field, and my client's fascia responds to my intention by softening and lengthening. This allows the liberation of long-held patterns of shortening and restriction.

Spanning and Energetic Resonance


Shown in side position, Latz maintains the vertical alignment crucial to proper CTM Body Mechanics.
When I lean and move in the CTM alignment, I lengthen and open my body in several directions simultaneously, an experience referred to as "span." Spanning actually expands my energy field. In this way, CTM Body Mechanics are similar to t'ai chi or other martial arts, in which specific body postures enhance one's energetic presence.

By spanning, I provide a more ordered and energized energy field than that of my client. A resonance is established between us, through which my client's fascia is nourished and energized. As with other resonance phenomena in nature, the more ordered system prevails, and the client's connective tissue begins to resonate with mine. Through this vibrational exchange, the client's fascial body is transformed to a new level of openness and integration.

Within this dynamic, a new boundary is defined. This boundary requires I stay present in my own expanded energy center, while at the same time affecting my client's energy system. CTM Body Mechanics keep me centered so I am able to accomplish this balancing act. The boundary created is safe and appropriate, not forced upon my client. Rather, it is welcomed, with clients often remarking my touch feels "just right" or "just what I need."

My use of energy is deliberate and conscious, and applied through a physical act. CTM Body Mechanics constitute a specific system which is the optimal way to transfer energy into the fascial body of the receiver. This is my practical approach to bringing concepts of resonance and energetic exchange into the practice of bodywork.

Structuring a Session: Fascia is the Guide

Central to Connective Tissue Massage is the premise that fascia is the guide for the application of the work. In CTM, the sequence and progression of a session are determined by fascial relationships. The goal of the work is to lengthen clients' fascia so their bodies become longer and more open. A session doesn't necessarily dwell on a localized area of pain or discomfort, nor does it focus on symptomatic release strokes as its primary goal.

Typically, I begin a session by palpating the area I wish to address in order to determine where fascia is shortened. Rather than having a preconceived notion about clients' tissue, I let their fascia show me what it needs. I am guided by proprioception, and open to intuition. In areas where I encounter particular resistance from the tissue, I adjust my body alignment to modify the depth, speed or direction of fascial contact. Within the subtleties of these modifications lies the creative art of fascial manipulation.

This work is challenging and exciting in its application. Maintaining all the CTM Body Mechanics principles, I am able to meet the individual needs of each client. When I discover specific restrictions that require attention, I expand my awareness to consider and address more distant areas which might relate to those restrictions. I already know and teach many of these relationships. Others become apparent through palpation, and from clients' (verbal and nonverbal) response to the work.

For a moment, let us go on a fascial exploration in the body. For example, a common complaint of neck pain could be addressed first with the hand. The fascial pathway might lead us from the palmar fascia into the flexor compartment of the forearm, traversing the brachialis and biceps fascia, continuing into the deltoid fascia, and becoming part of the scalenes fascia. We affect the neck before working directly on it.

Thus shortened fascia, like a wrinkled sheet, can be stretched from distant points and directions. We can, for instance, immediately apply this same approach to address the path from the leg through the hip to the sacrum, etc. It deserves emphasis that the individual muscles are not our focus. Instead, our primary considerations are the relationships of long, broad fascial planes to one another. This allows us a creative and effective means whereby fascial work in one area affects the entire body.

Sharing the Work


The oblique entry of contact in CTM work ensures the fascial manipulation is both comfortable and effective for the client.
Virtually everyone can receive connective tissue work and experience its many benefits. CTM helps relieve chronic tension, increases ease of movement, improves posture and enhances self-awareness. A session can be organized to focus on a particular client complaint, e.g., neck tension, carpal tunnel syndrome, sciatic pain, etc. It can be helpful in preventing, as well as rehabilitating from, many types of injuries.

Fibromyalgia, arthritis, multiple sclerosis and other disorders affecting the neuromusculoskeletal system can also be addressed with connective tissue work, as well.

CTM is useful as a full-body session, addressing the entire superficial layer of fascia. This balancing approach leaves clients feeling longer, lighter and more open throughout their bodies, and still allows specific concerns to be addressed within its context. CTM clearly stands alone as a modality, but can be integrated with other techniques, depending on the training and background of any given practitioner.

Using CTM, manipulating fascia is effortless. Applying this approach has the potential to revolutionize any single practice. Among the community of connective tissue practitioners, the revolution is already underway.

John Latz is the founder of the Institute for Structural Integration and the developer of Connective Tissue Massage. Experiential classes in CTM are available through the institute. Founded in 1992, ISI is the exclusive organization offering CTM training. ISI offers four-day workshops in basic and advanced CTM, as well as a complete program of Structural Integration. For more information, contact Latz at 305/754-0983.

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Institute for Structural Integration
7700 Center Bay Drive
North Bay Village, FL 33141
Phone: 305 754-0983
Email: john@johnlatz.com

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