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Copyright © Alastair McLoughlin 2015 Revised © Alastair McLoughlin 2019 and 2022
The right of Alastair McLoughlin to be identified as the original Designer, Developer and Author of the Work has been asserted by him in accordance with the Copyright, Design and Patents Act 1998.
All rights reserved. No part of this text may be reproduced, stored in a retrieval system, or transmitted in any form or by any means without the prior written permission of the publisher, nor be otherwise circulated in any form of binding or cover, or reprinted in any physical or electronic manner without the written consent of the author.
The ideas and concepts explored within this text are those of the author. For educational purposes only.
No diagnosis is being offered nor any cure promised by the application of this information.
Alastair McLoughlin cannot be held responsible for any injury arising from the application of this work by the practitioner to any third party however caused.
This work is not a substitute for medical attention. Please seek your physician’s advice if in doubt.
Respiratory illness continues to rise across the world due to pollution and infections.
Therefore beneﬁts for the improvement in respiratory function and oxygen intake can’t be underestimated.
The practitioner only has to contemplate these beneﬁts to realise what a huge improvement in health and wellbeing this AoB procedure can produce.
INDICATIONS FOR USE
- Repeated chest infection - especially in the elderly
- Tightness in chest
- Any restricted breathing
- Persistent cough
- Lethargy and tiredness
- Pale complexion
This AoB procedure can also help to improve athletic performance especially with endurance athletes.
You cannot assume that because they are fit athletes they do not have restricted breathing.
Due to the release of superficial fascia, improvements in thoracic rotation (for example) and mobility may be noted.
Whether you’re working with athletes, old people or children, the assessment to determine if the work is necessary is the same.
CAUTIONS OR CONTRAINDICATIONS
Do not use during an asthma attack.
Do not use if there is a risk of any broken ribs.
Seek the permission of female clients when working around the breast tissue.
Refer for medical diagnosis if you are unsure about any undiagnosed medical condition.
Position of the patient:
The AoB for Respiration is performed in two sequences - prone and supine.
If the client can lay prone, start with them in that position.
Once you have completed that part of the procedure, turn the client supine on the treatment table.
If the client is elderly or infirm and cannot lay comfortably in the prone or supine positions, due to persistent coughing or immobility, then you can perform this work with the client in a seated position.
Using the ﬂat of your hand gently compress the sides of the ribcage as shown.
Ideally the ribcage should be ‘springy’ and moveable.
Any restriction of the ribcage using this test needs to be noted by the practitioner.
This work can be applied all over the ribcage to facilitate a widespread release - even when the ribs may seem to be quite moveable.
The same test can be applied to the client prone, supine or even seated.
Simply sit them forward to test the ribs posteriorly and then lean them back in a chair to test the ribs anteriorly.
The same positions apply for carrying out treatment when the client is resting in a seated position.
Application of the AoB procedure PRONE:
Identify the last (12th) rib. Palpating that rib helps you determine the angle the ribs.
Then palpate the intercostal spaces as they sweep across the body as shown in (a).
Using the the tip/s of the ﬁnger/s apply the work in the intercostal spaces as shown in the video presentation (b).
Work patiently through each intercostal space - usually from medial to lateral as this has a better ‘feel’ to the work from a client’s perspective.
Working laterally is preferable to ‘pushing’ the move medially.
You obviously have to omit the spaces where the scapula is overlying the ribcage as show by (!).
Release the thoracolumbar fascia as shown in demonstration (c) using the flat of your hand - moulding your hand to the contours of the back.
When the work is completed wait two to ﬁve minutes for relaxation of the area to continue.
Reassess for restrictions as described in and demonstrated in sequence (d).
Reapply the work if there are still some areas that feel restricted, tight or lack ﬂexibility.
Sequence (e) compares post-treatment (left) and pre-treatment (right) assessments.
Note the amount of ﬂexibility and movement in the ribcage after treatment.
After another pause of a few minutes repeat your assessment of the area.
If you have completed the work to what you would consider to be the best eﬀect during the session (based on any improvements you may have felt or seen) turn the client supine.
Application of AoB procedure SUPINE:
Assess the ribcage in this position as described in sequence (i)
Apply the AoB procedure in the intercostal spaces using the ﬁnger tips as shown in sequence (ii) or a single ﬁnger as shown in sequence (iii).
There will be anatomical ‘obstacles’ such as scapulae (prone) and breasts (supine) which do not make it possible to cover the entire ribcage with this method.
However there can be immediate and great beneﬁts from the areas we can access.
Seek the permission of female clients when working around the breast tissue.
Don’t forget that ribs can be palpated in the upper chest/pectoral area and that the ﬁrst rib is located just superior of the clavicle - so don’t forget to check that area too.
It can be very relevant with the asthmatic patient.
Re-assess as shown in (iv).
A client who cannot lay prone or supine (perhaps due to persistent coughing) can be treated in a seated position.
Lean the client forward in their seat to assess and palpate the ribcage posteriorly and allow the client to sit back into their chair to assess and placate the ribcage anteriorly.
The work is applied in the same way as described above.
You will have to adapt your own hands and body position to accommodate the seated client.
The work can be very eﬀective, even in a seated position.
Help the client to a seated position:
Pause and check the client experiences no dizziness or light-headedness.
If they are dizzy or light headed then wait for a minute or two to allow that feeling to clear itself.
Only then may the client step down from the couch (a) placing BOTH feet on the floor at the same time to allow even weight-bearing into both hips to occur.
If the client continues to be dizzy after waiting two minutes then lay them in a foetal position (b), cover them with a blanket and wait for the dizziness to pass.
Ask them to return to a seated position and check any dizziness has subsided.
Ask them to stand - placing BOTH feet on the floor at the same time to allow even weight-bearing into both knees and hips to occur.
The client may need to sit for a few moments before dressing and leaving your office.
How it works:
In respiration there should be an expansion of the ribcage with inhalation.
The ribcage should move in all dimensions as it rises and expands during inhalation. Often that is not happening.
Using the work as shown, it is not diﬃcult to see that we are releasing the fascia, intercostal muscles, and even perhaps a stimulation of the intercostal nerves.
This will usually give immediate improvements in breathing.
The client may experience cool air rushing into their chest.
They may feel the ‘tight band’ around their chest has been released.
Their facial complexion can also change - from being pale, to pink and rosy.
Nagging headaches can also be treated as low oxygen intake will create persistent and daily headaches in some cases.
The endurance athlete may also notice an easier breathing pattern. (Imagine extra oxygen intake fuelling muscles!)
The ribcage acts as a ‘pump’. I have noted that with persistent chest infections the area of ribcage restriction tends to harbour the infection due to the body’s inability to ‘pump’ away the infection.
Once you apply this work the persistent chest infection can clear much more quickly.
Patients who have been prescribed antibiotics or other medicines by their physician should continue until they are advised to stop by their doctor.
This work may be repeated every few days (or daily) with someone with serious respiratory illness or ﬁnal stages of life, in cases of terminal illness.
You will ﬁnd this a very valuable addition to your work - especially with the elderly.