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Why do so many therapists avoid "belly work"?

I've found many workshop participants are uncomfortable performing hands-on abdominal work, i.e., pelvic and respiratory diaphragm releases and sometimes even superficial belly techniques. This seems particularly true when working with pregnant clients/patients. Do you feel belly-work is under-emphasized in bodywork trainings? Does the area hold too much emotion or possibly too intimate for some? I've written a short e-newsletter & posted a video showing some basic, but useful structural integration techniques @ http://erikdalton.com/NewslettersOnline/Sept_09_Newsletter.htm

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Comment by Erik Dalton, Ph.D. on October 31, 2009 at 2:24pm: I agree Felicia. Many therapists will continue to avoid performing belly work...even those formally trained in the techniques. So what does one do when she encounters an extremely fibrotic iliopsoas that refuses to be released via assisted-stretching? This is where good one-on-one supervised training is essential.

I cringe when I think of some of the psoas work I've done on clients over the years. Once you begin advanced study in abdominal and pelvic anatomy or attend visceral manipulation classes, you realize just how important it is to know exactly where your hands are what your intent is when performing direct manual therapy procedures to structures such as the iliopsoas.

Anybody want to offer any favorite tips on performing effective and safe psoas work?

Comment by Felicia Brown on October 29, 2009 at 7:38pm: Great video! As I've matured in my practice, I've become much more comfortable in providing or suggesting abdominal work. Once you see how much it can affect other areas of the body in terms of pain and restriction - and have experienced the benefit of someone doing the work well on you - it is so much easier to perform and recommend. Of course if receiving abdominal work is scary or overly emotional to someone as a client, my guess is that they as a therapist will continue to be hesitant to provide it.

Comment by Lisa on October 27, 2009 at 11:24pm: we were taught abdominal work as part of our routine. i have always included abdominal work without a second thought. although lately, i must admit i haven't used it in my sessions. i have found that i spend so much time working out areas of knots and tight muscles that by the time i get to the abdomen, i'm "running out of time". poor excuse though. i need to get back to making it a staple in my work.

i have to say i'm a little shocked to hear 2 references to abdominal work causing an erection. not ONCE did that ever happen on any of the clients i worked with through school OR my fellow MT colleagues.

i have also noticed not everyone works the face muscles. they work the head and neck and completely leave out the face. anyone notice that?

Comment by Gloria Coppola on October 27, 2009 at 6:47pm: Yes, abdominal work is even rarely covered in most basic massage courses. I hear it from therapists/students all the time. I am "amazed" how few know how to do any 'belly work'. Most are afraid or have their own personal issues so won't touch it.

While it does hold a lot of emotion it is our center of being! It is beneficial for all sorts of problems, including low back pain. It holds the space for a majority of our organs.

We need to educate therapists in basic training - but many instructors down play it or tell students males will get an erection. Like geez. Where do they get their information! I have personally heard instructors say these things and even say "clients don't like it".

Thanks Erik, for starting this discussion. Hopefully more will start studying and practice integrating abdominal work into all their sessions. After all , are we not contributing to postural distortion if we don't include it?

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