Orthopedic Muscle Sculping Relieves a Patient from Undergoing Knee Replacement Surgery – A Case History

The following is an example of how a good bodyworker can address a serious condition in a client, in this case primarily with regular deep tissue or orthopedic muscle sculpting sessions.  Orthopedic muscle sculpting has been used to help relieve people of refractory joint pains, especially when associated with stiffness, limiting the range of motion, and movement in general.  Muscle sculpting, in addition has also been used successfully to prevent the need for knee joint replacement surgery.

Eventually, the protocol to be presented here in greater detail, including case history and treatment plan, was successful.  This success did not come easy, though, as it took almost one year to complete the full treatment, with an interval of two months after six months, and forty orthopedic muscle sculpting sessions in the course of the first six months alone.  And it took more than just the bodywork.  The treating therapist in this case also happened to be a general physician, and she therefore integrated other therapeutic modalities into the treatment plan.

The patient, whom from now on we shall refer to as Deepika, was a sixty year old housewife and mother of five who when she first consulted the therapist voiced the following complaints:

• Pain and swelling in the right knee for the last 5 years
• Not able to squat
• Not able to walk for more than 100m without support
• Not able to climb stairs
• Persistent stiffness & pain in the knee after waking in the morning and in the evening after completion of the day’s chores
• Heavy pain for the last six months despite regular intake of heavy-duty painkillers and wearing a splint
• Suffers from chronic fatigue & depression
• Has been suffering from heartburn & hyperacidity for the past 12 months
• Was advised to undergo knee replacement surgery a month ago

Deepika had been a homemaker all her life, with very little contact to the world outside the framework of family.  She had never smoked, and never consumed alcohol.  Her diet was mostly non-vegetarian, with an intake of 3-4 glasses of water per day, and plenty of sugary chai.  With 88Kgs at 5 feet of height, Deepika was also seriously overweight.

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Cursory observation revealed that she walked with the help of a stick, putting most of her weight on the left knee, as the right knee remained constantly guarded.  The right knee was swollen.  The leg was kept in a flexed position even while standing.  Deepika’s mostly maintained a stooped posture.  With this and other body language signs, she gave the impression of being emotionally insecure, quite frightened actually of everything. 

Through palpitation it was further discovered that the swelling was of the same temperature as the surrounding skin, except for the part right over the knee joint.  The muscles of the knee joint felt hard like stone.  This hardness extended into the thigh and the gastrocnemius; upward also further into the gluteus, the pelvis and lower back; as well as downward into the Achilles tendon, ankle joint and the foot.

Specific orthopedic tests confirmed that flexion and extension of the right knee were limited in range, and quite painful for Deepika to attempt.  The left knee was found normal in its range of movement.  X-ray of right knee showed changes typical to osteoarthritis, i.e.: decreased joint space, sclerosis of the articulating ends of femur as well as tibia, etc.

The following treatment plan was offered, with the foal of avoiding knee replacement surgery, if at all possible:

• Orthopedic muscle sculpting sessions 1 ½ hour each twice a week, for a minimum of 6 months
• One ozone injections per week for ten weeks into the right knee (2cc at a concentration of 20 microgram per milliliter)
• Infra Red Heat therapy on the right knee after every treatment session
• Daily supplementation with active calcium and magnesium salts, as well as capsules containing chondroitin sulphate and glucosamine
• Initially use of two walking sticks instead of one, in order to also relieve the left knee of the extra burden.
• Weight management through a diet plan with the intention to help Deepika achieve a more ideal weight for her height of 50 Kgs to 60 Kgs.

And these were the results:

1. After 4 sessions or two weeks of treatment, the pain in Deepika’s right knee decreased.  The muscles started to get loosened up, facilitating a smoother movement of the knee joint.  Deepika found it easier to walk.
2. For the first time in years, Deepika could put some weight on the right knee after 12 sessions, or six weeks of treatment.  She also could walk for longer stretches than before.  The swelling around the knee joint was considerably reduced by then, too.
3. After 20 sessions Deepika was able to flex the knee to 90 degrees and could keep that posture for 10 to 15 minutes.  At this point in the development, she started to use a bicycle for about half an hour per day, at low speed.  The swelling in the knee had disappeared altogether. Deepika also felt energetically and emotionally stable and stronger that before.
4. After 40 sessions or six months of treatment Deepika was able to walk without the support of a stick. She had also lost 18 Kgs and now weighed 70 Kgs.  She suspended the treatment for a while, however continued following the established diet plan.

When she consulted the orthopedic surgeon, he told Deepika that according to present clinical signs and symptoms she did not need knee replacement surgery any longer.

This is a textbook case of good bodywork in conjunction with other treatment modalities.

T’ai Chi Movements as a Useful Tool for Bodywork

In her recent interview Gagori mentioned that during her own training she learned to practice some basic T’ai Chi movements for better posture.  From the point of view of posture the value of practicing T’ai Chi with regard to improving a therapist’s performance during bodywork, springs to the eye as simply obvious. In this context, two benefits stand out in particular: T’ai Chi teaches the practitioner to move in a flowing, water-like manner, and to always permit the movements to originate from the body’s inherent center of gravity. 

It is clear that when your movements are flowing naturally and through the power of gravity also effortlessly, that the treatments that you give will be more enjoyable to the client.  Your flowing movements translate into the experience of a natural flow in the client.  They may jumpstart his or her own ability to be in and express life through his or her own genuine natural flow.  Whereas your freedom from belabored effort due to going with the power gravity, frees him or her from stress and allows for a deeper and more complete letting-go.  Natural power brings forth natural grace.  Flowing with gravity frees one from being the victim of its downward pull, or fall. 

The same dynamic applies to your giving a treatment.  When your movements flow out of your belly rather than being forcefully set in motion by will from your shoulders, arms, wrists and hands, you will encounter no resistance that makes it difficult to continue.  Rather than being burdened by giving a treatment, you may feel enriched, even empowered and gently exhilarated.

And then of course, you observe the secret instruction (which is not a secret at all) of always keeping your knees slightly bent in the typical basic T’ai Chi stance, while giving a treatment.  This makes sure that you remain grounded in a flowing way, and allow all negative energies to move through you and out.  Were your knees to remain locked when giving a treatment, these same negativities set free by the treatment would remain trapped in your system, your body and your mind, and instead of feeling invigorated after giving a session, you would feel drained.

As present-day master Hua-Ching Ni states, “ In all your movements, whether as a exercise or in daily life activities, the key to success is naturalness.  Nothing about T’ai Chi [or about giving a session of bodywork to a client] is artificial or superficial.  They are deeply related to your natural physiological structure, and how your energy flows through that structure…. Each movement of T’ai Chi describes a circle.  There are no abrupt or radical changes in direction, speed or style.  You just keep making circles: small ones, large ones; horizontal, vertical or slanted ones, in all directions.  All movements can be considered as one movement, because they are connected.  Whether you reach out or gather back. The pattern is cyclical.  Some circles are too small to observe, but in terms of energy flow they are a whirlpool.”

What Master Ni presents as an overall instruction as to how to practice T’ai Chi, can also be read as a perfect instruction for giving a massage or a session in another type of bodywork.  T’ai Chi and bodywork are a perfect marriage, a perfect match.

Pregnancy Massage

The following is an excerpt from Mirka Knaster’s book Discovering the Body’s Wisdom, published in 1996 by Bantam Books, which is a comprehensive guide to more than fifty mind-body practices that can relieve pain, reduce stress, and foster health, inner peace and spiritual growth.  The main goal is to help consumers and health care professionals to become savvy about the numerous Eastern and Western body/mind disciplines, or forms of bodywork now available. It also can reveal different approaches to the readers, as to how they may befriend their own bodies, provided they read the text with an open mind ready to receive new input.

In India, massage during pregnancy and after delivery has a long history.  It is practiced even today in traditional form in many villages among the members of extended families. The claim of some website that “massage therapy during pregnancy is one of the most recent and trendy health trends” only shows a bit of ignorance of Indian medical and health care tradition.  Be it as it may, old or new, pregnancy massage is a good tool, and Mirka Knaster’s presentation demonstrates, why.

“Pregnancy is a time to be pampered.  Just being pregnant demands a lot of physical effort.  All of a woman’s body systems are working twice as hard to sustain another being.  When you’re pregnant, the extra and unevenly distributed weight keeps shifting your center of gravity, creates aches and pains in different parts of your body (especially in the lower back, neck and shoulders, and legs and feet), and makes it more cumbersome to move and harder to rest for long.  The major changes that pregnancy generates in your body and psyche call for special attention.  Prenatal massage can help reduce these difficulties as well as comfort and affirm you during this significant life transition.”

“Even when there are no specific aches, massage acts as an overall tonic.  It increases body awareness and gives you a chance to learn how to relax in preparation for labor.  In sedating your nervous system, massage facilitates the release of endorphins, leading to a state of deep relaxation, which also affects your baby in utero.  Focusing on your body in a positive way can engender self-acceptance at a time when it would be too easy to think of yourself as ‘fat and ugly’.”

“Massage can also have a rejuvenating effect if you work during your pregnancy.  By increasing both blood and lymph circulation, it brings more nutrition to all parts of your body, including the placenta, and aids in the removal of waste products.  This can translate into greater energy, less fatigue, and reduced swelling.  If moving about is limited or impossible because of a medical condition, massage is an alternative for stimulating circulation, stretching muscles, and keeping joints flexible.”

“There was a time when [according to western doctors] pregnancy alone was considered a contraindication for massage, but doctors now agree that massage can be beneficial, unless it is administered aggressively.  For example, slow, gentle circling of the abdomen and at the lower back and sacrum is soothing, but there should never be any vigorous rubbing.  Nor is deep pressure acceptable in any other part of the body if it causes pain.  Beginning in the second trimester, lying supine may not only be uncomfortable, it can also be dangerous.  In this position, the baby’s weight could compress major blood vessels (such as ascending vena cava) against the spinal cord and result in a marked decline in blood pressure.  In the later stages of pregnancy, when the hormone relaxing loosens the joints in preparation for childbirth, only careful handling – no yanking or jerking of the joints – is safe.”

“Around the world, postpartum massage is as much a time-honored tradition as pre-natal massage.  It helps relieve the fatigue and tension incurred by the strenuous effort made during labor and delivery.  It also aids in ‘figure control’ and toning the uterus.  Massage can strengthen muscles and prevent weakness due to inactivity, particularly if you’re confined during pregnancy and in need of convalescence afterward.  As you face the challenge of mothering, you can appreciate the physical and emotional reassurance and nurturance you can get from postpartum massage.”

For those of our readers who want to find out more about Mirka Knaster and her work, go to: www.mirkaknaster.com.  If you want to read up on pregnancy massage, there are a number of excellent books on the market; there is also quite a bit of information available on the net, of course.

The Red & Green Light Reflex: Or the Sum of Neuromuscular Stress, as the Source of Stiffness, Chronic Pain, Chronic Fatigue & Chronic High Blood Pressure

Everybody knows that modern city living, office routines and too much sitting on couches and chairs, at home and behind the steering wheel, are anything but a healthy way to be.  The human body wasn’t meant to be so static or frozen in one spot as modern life often demands of us.  By virtue of the way it evolved, the body was and still is made to be mobile: to move and express itself through movement.  Therefore, lack of movement, lack of relaxation, lack of joy, lack of communicating in a friendly way with others while instead communicating impersonally mostly with and through computers, all of these factors produce opposing muscular patterns that immobilize the body even further. 

Most often these patterns evolve over time through repetition; or they can arise through trauma from physical or emotional injuries.  Independent of the causes, however, painkillers and most often, even surgeries are of little help.  They cannot take care of the problem.  Only two things can help: get up from your couch and get moving and/or receive some form of skilled bodywork that will set the process of recovery in motion and accompany it for a while.  Even then, bodywork in itself is not the cure but only the beginning of it.  The cure is in getting the body to move.

But what are these destructive muscular patterns that need releasing?  Body psychology characterizes them as ‘green light’, ‘red light’ and ‘trauma reflex’, a term coined by Thomas Hanna PhD.

According to Hanna, “The green light reflex is the reflex involved in forward movement. All the large muscles of the back contract to move your forward in walking, running and standing. The back muscles stay overly-contracted, pulling the back into an exaggerated arch.  You could think of this reflex as an ‘arching reflex,’ like a soldier at attention. When running for the train, sitting at the computer for many hours, picking up a child, or standing all day long, these ‘green light’ muscles are working to help you ‘get the job done.’ If this reflexive response to stress becomes habituated, conditions such as herniated disks, neck pain, shoulder pain, and sciatica can develop.”


As to the red light reflex Hanna says, “More commonly known as the ‘startle response,’ it involves the all the muscles on the front of the body, which tighten to pull you forward. This ‘slumping reflex’ presents itself with rounded shoulders, depressed chest and the head thrust forward.  It is a protective reflex found in all vertebrate animals and is a response to fear, anxiety, prolonged distress or negativity. A loud noise, unexpected sound or emotional trauma (or long hours hunched over the computer) can cause the muscles of the front of the body to contract suddenly as the body pulls inward in a slumping posture. An habituated red light reflex can lead to chronic neck pain, jaw pain (as with TMJ), a ‘widow’s hump,’ hip pain, mid-back pain and shallow breathing. The inability to breathe deeply deprives your brain, blood and muscles of the oxygen they need to function properly. This in turn can cause fatigue, depression, anxiety, sleep problems and exacerbate allergies.”

Finally, “The trauma reflex occurs involuntarily in response to accidents and injuries and the need to avoid further pain as one compensates due to an injury. This reflex involves the muscles of the trunk rotators, which, when contracted, ‘hike’ the hip on one side and twist the spine slightly.  Examples of this would be the repetitive task of holding a young child on one’s hip, a sudden fall of any kind, limping on one side in response to a twisted ankle on the other side, falling on one’s tailbone in a fall or suffering from appendicitis. This reflex presents with side bending and rotations in the pelvis/trunk/shoulder/head. This postural compensation may be slight, or very noticeable, but its effects can be devastating. In many cases scoliosis is an example of an habituated trauma reflex, creating a curve and tilting in the spine and trunk.”



This is the sum of neuromuscular stress, a state of muscular immobility caused by the gradual build-up of chronically opposing contractions.  The powerful contraction of the spinal muscles in the green light reflex continues its pulling of the lower back and neck into a curve.  But the equally powerful pull of the abdominal and shoulder contractions in the red light tilts the entire trunk forward, rounding the back and the shoulders and projecting the head forward.  The diagrams in this post illustrate these opposing contractions, which are often observed in the body postures of people living according to the dictates of today’s stress ridden culture.   

When prolonged, this neuromuscular stress often leads to the following six typical pathologies.

1.      Stiff and limited movement: As the Red or Green light reflexes close in on each other, the human skeleton becomes imprisoned within its own musculature.

2.      Chronic pain: Chronic (long-term) muscular contraction causes chronic pain.  The glycogen, which is stored within the muscle for the energy of contraction, is constantly being burned up.  The combustion of glycogen creates contraction, and the glycogen is then turned into lactic acid, and the more acid there is, the muscles sensory cells become irritated

3.      Chronic fatigue: The two overlapping contractions of the two reflexes cause an enormous expenditure of energy.

4.      Chronic shallow breathing: Shortened rectus abdominus and contracted diaphragm are immobilizing the chest.  When O₂ intake is down the result is depression, listlessness and loss of mental alertness and flexibility.

5.      A negative self-image: When the above 4 conditions are predominant in any individual low self-esteem naturally ensues.

6.      Chronic high blood pressure: When the red light reflex restricts breathing and therefore triggers hyperventilation, it also suppresses the normal variable heart rhythm and sinus arrhythmia.  This means that two things occur: a) Dominance of the sympathetic nervous system over cardiovascular functions, which causes the smooth muscle walls of the vascular canals to contract; and b) the up-and-down variation of blood pressure no longer occurs so that the vascular walls are not kept supple, and therefore adaptable to blood pressure changes.  When we reflect on the collision of the Red and Green light reflexes in the senile posture and their statically opposing contractions, we suddenly realize the potential fatality of the senile posture.  The body’s two major muscle groups are opposing one another involuntarily in a static, isometric contraction – a dark vise that causes chronically high blood pressure.

Many medical professional see these problems as structural in nature, when in fact they are functional.  Improved function of the muscles improves the structure, or posture.  Therefore, in practice, these problems need to be resolved through a process of cultivating awareness of the ‘amnesic’ muscles first, then retraining the brain to retrain the muscles to release and relax back to a new length. This process results in better balance, coordination and improved overall functioning of the musculoskeletal system. Ultimately one becomes more self-reliant.

“According to my own experience, a combination of bodywork coupled with NadiPrana (Tibetan yoga exercises) and the simple beginners Tai Chi movements that I learned for better posture in my profession did do the trick.  They changed my posture not only physically, but mentally and emotionally as well,” says Gagori Mitra-Gupta.  Whereas Thomas Hanna developed his own system of simple movements, called Hanna Somatic Education.

For those who want to find out more about the subject, go to: http://www.essentialsomatics.com/index.php?/hanna-somatics-learning-center/about-hanna-somatics/

Training Is the Key: An Interview with Gagori Mitra-Gupta

ABA-BLOG: In the previous posts, the importance of in-depth all-round training for bodyworkers was addressed, especially in between the lines in Ken Dychtwald’s overview of what good bodywork can achieve.  Only someone very well schooled in the field would ever be able to accomplish what Ken is pointing to.  What about your training?  Was it encompassing?  Did it enable you to do some of the things Ken is talking about?

GAGORI: YES, it was; and YES, it did.

ABA-BLOG: I mean, not just by enabling you to give a good massage, which is a pleasant enough experience although the pleasure doesn’t last, of course. What I want to know is, if through your bodywork, were you able to coach someone to the point that his or her own life changed for the better?  Not for a moment, but for good? 

GAGORI:  YES, again.  Such things happened and continue to happen.

ABA-BLOG: You don’t elaborate much.

GAGORI:  May be, because if I get warmed up to the subject, I won’t stop talking for a while. 

ABA-BLOG: Be my guest.

GAGORI:  Well, what I had the good fortune to receive through the people with whom I trained, turned out to be much more than a solid schooling in bodywork; it was more like a complete education.  It changed my life.  It did not only give me the tools for a career.  It gave me self-knowledge, self-assurance, broadened my horizons, and enabled me to become a self-made woman.  That’s some development.

ABA-BLOG: It is hard to believe that taking a course could bring that about.

GAGORI:  As I said, it was an education, not a course.  It started with a 300-hour course or training in a variety of forms of bodywork, body psychology, tai chi for better posture, treatment etiquette and so forth, taught in four modules.  These were followed by a 2-year apprenticeship, so to speak, when I was invited to serve as an assistant to the trainers in three more 300-hour courses and learned so much more.  In addition I took part in several 5-day retreats in Tibetan yoga and attended seminars in self-inquiry all with the same trainers, very traditionally Indian in some ways, especially the self-inquiry part, but very modern at the same time.  So, if you add all of this up, I must have spent 2400 hours on my training and would not want to miss a minute of it.  Really, not even one of the bad minutes when I felt lousy, or inadequate, or was hurting because I had run into the brick wall of my own mind, or preconceived ideas; or felt challenged, because it appeared that my instructors demanded so much, or did not appreciate me or my needs nearly enough. 

ABA-BLOG:  Would you recommend that everyone follow your example and take such a long training?

GAGORI:  It depends on what people aim for.  If you want to work as a masseur or masseuse in a hotel, or beauty parlor here in India and earn an average salary, then you don’t need to go to such great lengths in terms of training.  You take an 80-hour course in some form of massage, and a 60-hour course in another.  We will even help you find a placement.  But if you want to be an authentic therapist, able to genuinely help people through your work and call yourself a true bodyworker, then, yes, a long and comprehensive training is what it takes. 

ABA-BLOG:  What made you persist?  What made you forge ahead and do it?

GAGORI:  I started without much of a plan.  Actually, I was just curious.  I originally had graduated as a B Com.  Then I passed my post graduate degree in Human Resources at Symbiosis in Pune, after which I was hired on the spot by some multi-national company, for a decent enough entry remuneration package even.  My family was elated.  They figured that now I had it made and would rise along the corporate ladder.  Me, on the other hand, I became depressed.  I found the situation depressing, or claustrophobic.  

ABA-BLOG:  I don’t understand.  Why?  But then, unlike many you probably weren’t the security-minded type.

GAGORI:  I said to myself, “So now you’re set.  You’ll get promoted until you reach but one notch above the level of your incompetence, or you’ll get married, raise a family and die?  Is that really all that there is going to be?  Is that really all you want?”  Obviously it wasn’t.  I wanted more.  I did not want to get stuck in a rut at age 25.  Then, when I heard through a friend about a unique bodywork training given by an American psychologist and her German partner somewhere in South India, I made sure that I got the contact number, and signed up the next day.  I wanted to satisfy my curiosity.  After the first week of training I quit my job.  That is also something I never regretted. -  But, to come back to a previous point in our discussion, if you want to get that independent, a very comprehensive training is absolutely needed.  Western bodywork or massage schools only offer courses of 500 to 1000 hours minimum, when some of certification becomes part of it. And I understand why, just to learn and understand human anatomy as it applies to massage takes quite a bit of time.  As a bodyworker you also need a few years to mature.  You are not only acquiring some professional skills.  You become a therapist.  And being a therapist means that you need to get to know yourself in ways other than those, according to which you mistakenly believe you already know yourself.  You only know the surface.

ABA-BLOG:  In the trainings that you give, you do take these different needs into account, though?  I mean in your academy, you train people for their future job and help them find one, and you offer additional courses and seminars along the lines of the things that you went through. Is that how it works?

GAGORI:  In a manner of speaking, yes. We are presently restructuring the Aithein Bodywork Academy, and it seems that after some time we will be able to deliver the full package: professional training in different forms of massage and bodywork; advanced bodywork courses; plus trainings in different forms of self-inquiry and yoga and tai chi.  We want to be in the position to deliver what according to my own background and experience, I consider the full package.

ABA-BLOG:  Thank you.  I am sure we’ll pick up the discussion under from a different angle at a later date.

Ken Dychtwald on What Good Bodywork Can Achieve for Our Lives

In 1977 a young psychologist, Ken Dychtwald, burst on the scene and wrote the ultimate easy to read summary on the topic, titled Bodymind. The book became a classic.  It is still available, still receiving raving reviews, and continues to be considered the definitive overall presentation of the subject. This is probably because Ken has the gift of the broad stroke that allows him to describe the heart of the matter in terms that any lay reader can follow. No one has succeeded to define the benefits of bodywork as clearly and succinctly as he, when he states:

“Without adequate tactile input, the human organism will die.  Touch is one of the principal elements necessary for the successful development and functional organization of the central nervous system, and is as vital to our existence as food, water, and breath.”

“Our genetic blueprints are only the starting points of our individual development.  The kind of conditioning we receive and the kinds of conscious choices that we make play tremendous roles in our physical growth, our acquisition of skills, our health and maturity, and our aging.”

“All of the body’s tissues are, then, a great deal more “plastic” and responsive to change and improvement throughout our lifetimes than we normally assume.  Far from being “fixed” and “determined” by our biological inheritance we are still “works in progress”.

“There is no sensation or emotion that is not translated into muscular response of some kind; these feeling states are the primary bases of our habitual postures and our individual patterns of behavior.”

“Bodywork, by using tactile input, can actually re-educate and re-program the organism into becoming more coordinated, more flexible, and more appropriately responsive – literally more “intelligent”.  A body/mind system that is integrated in this fashion will be more able to resist depression or disease, more able to attend to and repair itself in times of stress or injury.”

“Various ancient and contemporary forms of bodywork go far beyond temporary pleasure or relief and actually alter conditioned responses, chemical balances, and structural relationships.  That is, bodywork has the potential to deeply change and improve the given state of an individual.”

“Nothing is more essential to lasting positive change than self-awareness; it is the prerequisite for self-control. Bodywork is a direct and effective way to increase this awareness within an individual.”

In other words, bodywork is good for health, good for happiness and good for deeper understanding of self and others – and thus intra- and interpersonal harmony.

Bodywork? Is It Any Different from ‘Massage’? – A Choice of Words That Defines What We Do

At present, much of our work at Aithein is spa focused.  Usually, people visit spas to receive massages, and a variety of other kinds of spa treatments.  Most everybody working in the industry, as well as most young women and men who aspire to become spa therapists in India and South Asia may not have even heard the word, let alone can associate any content with the term ‘bodywork’.  Why then, do we use it?

We use it, in order to broaden horizons, to include other forms of physical therapy in our presentations, and to provide a shift in focus.  We use it because we want to make it a point that ours is a professional therapeutic approach, covering the full spectrum of manipulative and movement therapies.  The word ‘massage’ would be too narrow to cover all of these, whereas the term ‘physiotherapy’ has too medical and clinical a ring to it, to evoke the rich, even limitless inner landscape of healing and emotional balance that good bodywork can facilitate. 

In 1987, Deane Juhan wrote a handbook for bodywork that became a classic in the field, which by now also is required reading in many certification programs in massage or bodywork schools in the US. In the introductory matter to his 500 page whopper of a text he explains, why he uses the term bodywork, rather than ‘massage’ or ‘physiotherapy’, “Throughout the book I will use the term ‘bodywork’ to refer generally to a wide variety of manipulative therapies… The word ‘massage’ covers a number of styles – Swedish, Esalen, Sports Massage and so on; but it does not include many approaches, such as Trager, Rolfing, Feldenkrais, Alexander Technique, Craniosacral Manipulation, Zero-Balancing, Reichean, and Neo-Reichean work, to name but a few, which are quite different from ‘massage’ in any of its guises. And the term ‘massage’, alas, still seems to be tainted in many quarters by its common associations with touchy-feely parlors… The term ‘physical therapy’, or ‘physiotherapy’ avoids these associations, but it is also too narrow in the scope of its normal usage. It refers to an official medical discipline,… prescribed only by physicians, and applied through fixed procedures… In particular ‘physiotherapy’, typically eliminates a good deal of the intuitive element, which seems to be such an important of other approaches, and which in fact many physical therapists have confessed to me that they wish they could use more freely in their clinical practice.  So I have settled upon the term bodywork because it seems to include fewer of the elements I wish to avoid and exclude few of the elements which I wish to consider.”

This describes almost all of it, except for the one meaning that all practicing bodyworkers/massage therapists also know, and only too well from everyday experience: for the serious professional practitioner bodywork is hard work, no matter how rewarding it also may be.