Bowen Therapy

Bowen, aka, Bowenwork is a myofascial technique

Bowen therapy is a type of “myofascial technique”. Myofascia is a very thin tissue that is spread throughout your body. It lies over, under and between all layers of skin, fat, muscle, organ and bone. A good analogy is that myofascia is like a spider web.

There are many versions of spider webs that vary in flexibility and tension. For example, there are cobwebs that are floppy, silky, and extremely fragile. There are also webs made by the black widow. These are extremely sticky, randomly patterned, and tough. Finally, there are webs built by the garden spider. These webs are a good combination of both of the previous webs. They hold some stickiness, yet are still able to flex and move with the wind. They are arranged in a symmetric pattern, and tough enough to last.

The myofacia in your body that covers the muscles and nerves needs to promote smooth movement between layers. To do this it needs both structure and flexibility, like that of the garden spider web. If the myofascia is too loose and fragile or too sticky and non-flexible, proper movement is restricted and pain patterns begin. These patterns are commonly known as “entrapments” or “muscle spasm”.

Your brain and pain: Principle 1 - form a pattern, keep a pattern

Scientific evidence has proved that the term “muscle memory” exists. Anatomical evidence demonstrates we have sensors in our muscles and myofascia that communicate information to and from the brain. (They are called fancy names like Ruffini endings, Golgi tendon organs or muscle Spindle Fibers). When a signal is sent to the brain, it receives it, organizes and processes it, and then forms a stored pattern which we call a memory. Later, when we bring our attention to the pattern, the brain will send signals down to the sensors as instructions on how to perform. There is no judgement of good or bad. There are only instructions based upon your attention.

Consider when you learned to ride a bike. Remember that uncomfortable feeling of failing multiple times before succeeding? When you began trying to coordinate the ability to balance, steer and pedal at the same time, it seemed like an endless exercise in frustration. But during that time, there was a constant back and forth communication between the sensors in your body and your brain. Because of your attention and desire to make it happen, with practice and possibly some positive encouragement… Bang! It clicked! Suddenly you got it!

It was at that moment a pattern was formed in your brain. The pattern was named, “how to ride a bicycle.” Whenever you want to pull that pattern from your memory it is there; the brain never loses a pattern. Even if you haven't been on a bike for years, it is there! In fact, once established, patterns are so powerful all you must do is imagine the feeling. At that moment, micro movements occur in the appropriate sensors to prepare for the pattern. To prove this to yourself, close your eyes for a moment, and feel you are riding a bicycle. Did you feel your balance change? Did you feel some tension in your arms as if you were steering?

Your Brain and Pain: Principle 2 - normal pattern vs. chronic pattern

How do brain patterns relate to chronic pain? Chronic pain occurs because of our brain’s preference to keep patterns organized. That means one pattern typically becomes dominate over another. To be clear, chronic pain patterns become dominant because they are practiced over and over until they are more powerful than previous normal patterns.

Normal pain starts out as an injury with nerve irritation and inflammation. Communication occurs between the brain and the sensors and the body responds naturally. Tissues heal. This is followed by a peaceful confidence that you will return to normal patterns.

Chronic pain also starts out as an injury with nerve irritation and inflammation. But the communication is typically tied to an emotional shock like a traumatic event, or a consistent emotional nagging pain that started small and then continued over and over. Regardless, the tissues still heal, but they don’t return to normal. It is important to know the tissues aren’t broken…they are just angry. What follows is a new dominant pattern of sensitivity that includes muscle tension, continuous trapping nerves and continuing inflammation.

This pattern, just like the others, is then stored in the memory. Do you remember what it feels like to burn your hand on the stove? You withdraw, your arm and shoulder muscles get tight, your jaw clenches, your face grimaces in pain, etc. To prove this to yourself, close your eyes for a moment, and feel the memory of a burn.

Your Brain and Pain: Principle 3 - Stubbornness

Let’s review: Principle 1 is the brain forms patterns for everything. Principle 2 is the brain organizes patterns by dominance. That leads us to principle 3: stubbornness. Here is an example of how the brain is stubborn and does not like to replace patterns it has used often.

I am right handed. I cannot throw with my left hand without feeling totally uncoordinated and being completely inaccurate. But, if I were involved in an accident and permanently lost the use of my right arm, I would need to start using my left for many things. Otherwise, I would never learn to eat with utensils, perform basic hygiene tasks like brushing my teeth, write my name, or even play catch with my son. My brain must form a new pattern. If I were to constantly fight the new pattern by emotionally concentrating on my loss and how easy the old dominant pattern of using my right arm was, I would never learn.

Believe it or not, that is what happens with pain. People who suffer from physical pain also must recognize the connection with the emotional distress. The worry, anxiety, feelings of loss and anguish are emotional side effects of pain. The countless hours spent focusing on these negative side effects only serves to feed the chronic pain pattern, making it stronger and more dominant.

Often, when the Bowen therapy or the Biofeedback has some success, people tend to “not believe”. When one has invested so much time reinforcing a pattern of pain and suffering, it is difficult to trust anything else. The brain remains stubborn.

The stubborn brain patient is the type of patient that gets some relief and then "tests” or “searches" for their familiar pain. “It always hurts when I do this. Yep. See it’s better, but not gone.” Then, they start to think about it more and more, and naturally due to the rule of ‘never forget’, the pain pattern begins to return to dominance. In my years of practice, I have found something to be very true: "If you search for it, you will find it."

It is often an emotional challenge for chronic pain patients to trust and learn acceptance when they begin to experience some relief. While in treatment of any kind, the therapist is standing by you in a competition between your existing dominant pattern and guiding you towards something else that is healthier. To win this competition, to make your “normal” dominant again, you need to train your emotions in the normal state. What are normal states of emotions? Well, for one, not thinking about pain all the time.

How is Bowenwork effective? – the short version

Currently, there is only limited evidence of how myofascial techniques work and no definitive evidence to state one technique is better than another. That said, this is my best explanation of how the Bowen technique works:

Bowenwork gently stretches and releases the sensors within the myofascia. (Remember, these are the sensors that send signals to and from the brain). This movement starts a new back and forth process of myofascial to brain communication including processing, and reaction. But because the signals are so gentle and so direct over specific spots, the brain does not recognize them as the familiar dominant pain pattern. As a result, it becomes confused and must pause to process the information. It must dig deeper into previous patterns of the past and search for an answer.

Studies have shown when the brain receives a signal of this type it takes a minimum of 90 seconds for the brain to complete this search. That's why Bowen practitioners leave the room. During this "down time" the brain dusts off an old memory. Can you guess what that memory is called? That memory is called "normal".

This "normal pattern" becomes activated and sends the familiar signals back down to the sensors. The brain instructs, “don’t be tense, don’t be in spasm, let the blood flow, reduce the inflammation. You remember...like normal.”

Tom Bowen realized that people had forgotten “normal”. Through 30 years of practice, he attempted various light movements, and analyzed the results. He studied conditions, practiced techniques, and refined treatments, until he created a series of successful movements to counteract the various pain patterns. Put simply, he created recipes for the body to rediscover normal patterns and to make them stronger than pain patterns.

What will I experience with Bowenwork?

Everyone has a distinct experience, but here are some common comments that I suspect are due to specific physiological factors. Many people experience warmth which is the opening of previously choked circulation. Some people feel like they are sinking, becoming heavy, which is the softening of muscle spasm. Some people feel energy flows which is the loosening of tissue to allow freedom of movement between entrapped layers. Some remember old memories which occur because the brain has been examining itself like a computer searching through the archives to find the “normal pattern” again. But most all experience a profound state of relaxation. That is simply because your body and your emotions have been tense for too long. They needed a break.

How to prepare for a session

Patients are asked to dress in loose clothing such as a t-shirt, gym shorts or loose light athletic pants (jeans or thicker clothing or silky nylon material are more difficult to work with). A few tests of motion are conducted and then you lie on a table. I will then guide you through a series of specific gentle movements, applying light myofascial pressure and then gently rolling over the tissue. Each move is small, in a specific spot, and usually part of a “recipe” of moves. I then leave the room to allow for your brain and body to incorporate the instructions and achieve a state of relaxation and process the new pattern.

Treatments can be as short as 15 minutes and as long as one hour. Often, people state they are in a deep state of relaxation but occasionally some conditions are more stubborn and the patient says, “it’s the same”. In those stubborn cases, the advice is to wait for the results. The patterns of holding on to tension may be so well practiced that it requires a few sessions to start to feel the new patterns. In general, most treatments show significant changes within 6 visits. This is also why I ask to temporarily stop any other treatment therapies during this time as they intend to send messages simultaneously and the brain will return to its old patterns.

My personal history with Bowen Treatment

When people ask me this question, I typically start with a story that goes like this: As a Physical Therapist, I have been taught to stretch, push, pull, deep tissue, contract/relax, acupressure, yank/crank, etc. All of these techniques required much work from me and much enduring of pain from my patients. I found after time that tougher techniques do not work for some chronic pain patients.

One day I woke up from an awkward sleep and had a “crick” in my neck. I started treating it with my stretching, ultrasound, electrical stimulation, etc. but was still in pain at the end of the day. The next day, my Tai Chi instructor told me to check out Bowen Therapy. Being of open mind, I scheduled a session later that day with a local practitioner.

I was amazed what this person did. I was barely touched with light gentle movements. He then left the room to let me “cook” as he said. He would return after a few minutes and do a few more gentle movements and then leave again. After about 30 minutes of this I rose from the table pain free and able to move my neck as if nothing had happened. I immediately said to myself, “I have to learn this because it is easy on my patients and easy on me!”

Since that time, I have trained and used Bowen Therapy in my practice for the past 10 years. It is a wonderful complement to my philosophy of addressing both the physical and mental components to difficult conditions.