Journal

A Story about Shiatsu and Spinal Cord Injury

By Kate Burford FwSS

FIRST PUBLISHED AUTUMN 2022 IN SHIATSU SOCIETY JOURNAL

When my son Finn was very small, I had his Birth Chart read. I remember at one point the astrologer became very confused and commented that ‘something happens to Finn as he becomes an adult’. I immediately asked if he died, and she told me quite clearly that no he didn’t - she couldn’t quite read the chart but it seemed to disappear in some way. A couple of months before my son’s 19th birthday I remember looking at him and really seeing him as a man for the first time as he stood tall, fit, strong and handsome after a day of gardening work and I thought, ‘we made it, he got there’. Two weeks later he fell off a high Cornish cliff (drinking at night with a couple of other lads outside a festival). During the two-hour drive to the hospital - where he lay in the Intensive Care Unit (ICU) with no idea of the extent of his injuries - that experience with the astrologer came back to me and I thought ‘ahh, this is what that was about, we didn’t escape it.’

Extremely lucky to survive, he suffered various traumas but his main injuries were totally life-changing, fracturing T10 and L2 and severing his spinal cord in both places. In Spinal Cord Injury (SCI) terms he is a T8 complete paraplegic. This means he has no sensation below T8 but he still has good use of his arms.

In this article I will write a bit about working with SCI but mainly it is about the skills I have as a Shiatsu practitioner which have enabled me to support both of us through the challenges of this experience. I realise that all my training and work had in some ways prepared me for this.

Finn was well resourced, having lived a privileged, healthy life. A lot of this is luck but also the gifts of a Shiatsu informed lifestyle. This meant he had grown up eating balanced, homecooked food, he had received therapies and had required very little conventional medicine, he was fit, and he slept well. All this has held him in great stead as he has adapted on all levels to this trauma.

I study Zen Shiatsu but I never feel very Zen with my busy human mind! However, the practice of ‘staying in the now’ has been helpful for all of us as a family; we can’t worry about what may happen and there is no point spending time on the ‘what ifs?’ and the ‘shouldn’t haves’. It is what it is. The ICU doctor who skillfully gave us the news of Finn’s paralysis used the phrase, ‘it is shit’ and it certainly is - but we make the best of it. 

Starting at the Feet

In the month that Finn was in hospital I spent every day with him and found myself working his feet a great deal, particularly Kd 1 and Kd 3. Feet are easily accessible in hospital room, ward or trolley! The grounding aspect felt crucial and I always felt working the points was easing the shock from his body.

Working his feet started the long adjustment to the new landscape of my son’s hitherto perfect body. Legs that were flaccid. Legs that didn’t respond. Legs that were becoming smaller. For Finn it must have been the start of the huge adaptations he was making psychologically; seeing me working his feet but not feeling it. I worked his feet when he was asleep, when he was awake and I worked his feet to help him get to sleep.

Now when I work his feet and lower legs I like to give them a lot of extra love and care because they get such a hard time. Finn really inhabits his upper body and has a tendency to chuck his legs into the car when transferring and they also get knocked around in general daily living and during sporting activities.

Kd 3 is a point I know well, being particularly valuable in the menopausal work I do - it promotes bone health, regulates the uterus, promotes vaginal tone, supports bladder health, poor memory, insomnia. And many of these functions are equally important for working with SCI. It is the ‘Yin within the Yin’ and on looking at my battered handbook of points I see it is also indicated for paralysis of the lower extremities. It is good for constipation and (along with Kd 4) it tonifies the Kidneys, lifts the spirits, strengthens the back and dispels fear - so it’s no wonder I spent so much time there!

Being a bodyworker, I could watch the physios and quickly pick up what they were doing - a great skill to have on understaffed and underresourced wards. Because the feet rest in plantar flexion when there is no muscle tonus in the calves, mobilising the ankle and creating dorsiflexion is important. When on bed rest, creating flexion helps with the pumping of the body fluids and was something I was able to do frequently. These days Finn uses a standing frame which puts the feet into dorsiflexion. It also reduces spasticity occurring in the muscles as well as benefiting the spine, blood pressure and bone health through weight bearing. Joint rotations and working tsubos at the joints are particularly important as the joints get either overused or underused.

After an SCI the nerve pathways between the brain and bowel are damaged or severed. Peristalsis still occurs but is less effective (it can also go backwards) therefore stools take longer to pass through the large intestine. In able-bodied people colonic transit time is 31.5 hours and after SCI an average of 86.6 hours - this leads to a high risk of constipation. In the hospital, perhaps because he was in spinal shock, the high levels of medication or maybe due to poor bowel management, Finn at times experienced extreme pain in his upper large bowel. Medication didn’t seem to help and Ampuku was too painful but LI 4 was always worth working and often used alongside LI 10 and 11. I frequently worked St 36, which promotes normal peristalsis, to help with the constipation, pain relief and to bring energy into his legs.

Simply Holding, Simply Breathing

Being able to hold Finn’s hand and work LI 4 felt like a gift in these moments even if it didn’t really relieve the pain. Simply focusing on the point helped me. I felt so grateful to have the life skills I embody from Shiatsu - I could be of use - especially when I observed relatives of other patients seeming to be totally at sea.

I have encouraged Finn to include the percussive techniques of Do-In, self-Ampuku and self LI 4 treatment in his ongoing bowel management and self-care routines. I have also given him a warming blend of oils which support digestion (this includes Anise, Caraway, Peppermint, Ginger and Fennel) and is applied to CV 12, CV 8 and/or LI 4.

I was so grateful for all those years of Shiatsu, Yoga and working with breath. Not only could I teach Finn breathing techniques for pain and emotion management and how to use visualisation, in those pain-filled days in hospital, but I could also use my walks to the loo to breathe into my own hara, swing my arms and open my shoulders.

Knowing how to hold space, work with the energy of a room and the people in it are skills we develop as Shiatsu practitioners and teachers, and these also proved invaluable in the hospital setting. Having given Shiatsu in hospitals, supporting women through labour and birthing, I felt well prepared for the moments I needed to be assertive. It also felt easy for me, as a care provider already, to step into an active role rather than just being a visitor on a severely understaffed neuro ward. This meant that I was able to support the staff, not only in my attitude to them but also by taking on nursing duties for Finn.

Other Healing Modalities?

However, bringing other healing modalities into the space was tougher. Asking for permission to use homeopathy was never going to work, but luckily as I was the one constantly refilling Finn’s water jug, it was easy for me to add his remedies without detection. Discussing possible herbs with the pharmacist went nowhere, and the dieticians never understood my refusal to let them give Finn their sugarfilled supplement drink. Reading the label, I couldn’t detect any beneficial nutrition in it and I knew he wasn’t dangerously underweight and that he had plenty of other options. Healing diets and hospital food is another essay entirely, but it was easy for me to bring him what he fancied - daily smoothies or juices, and his friends brought him dhals and soups.

Essential Oils

However, the pure Essential oils I work with - potent plant medicine - were accepted without question! And the constant comments about how nice it was to go in and turn Finn because the room always smelt so lovely, or how they felt calmer when they left his room, always made me smile because on some levels the physiological effects of the medicine were being acknowledged even if they believed they were just nice smells.

I used pure Essential oils on many different points and in many different ways. As already mentioned, oils that warm and move the Qi are helpful for digestion so were applied on LI 4 and St 36.

Bergamot has a beautiful sweet lemony fragrance. It promotes emotional stability and insight and so is good for mental confusion, disorientation, distressed feelings and possible brain damage support. Finn had hit his head so I used Bergamot on Ear Shen Men, on GV 20 and GV 16. Physiologically it is an autonomic nervous system regulator, nervous system relaxant, a restorative and it Regulates the Qi and Harmonises the Shen, so inhaling it or massaging it on the feet always felt soothing and beneficial. It is also helpful for digestion as it activates the Qi, reduces Stagnation and harmonises the Middle Burner.

Helichrysum is the most wonderful oil and one I wouldn’t be without. It comes from a plant sometimes called Everlasting and the oil is known as ‘liquid stitches’ so powerful is its ability to heal the skin. Skin care needs ongoing monitoring in life with a SCI. There is a high risk of pressure sores which occur if a person sits in the same position for a long time, in wet clothes or on a seam of a trouser leg and often if they don’t have sufficient flesh under the bony protuberances of the ischial tuberosity, sacrum or coccyx. Finn is lucky to have youth and a good diet on his side so his skin is good at present, but if he happens to call me to check a red mark - and if it blanches - Helichrysum is the oil I apply. The results are remarkable.

It is also the number one oil for trauma recovery, so holding some on CV 17 (mine and his) was a regular practice. Its essential TCM functions are to Activate Qi and Blood, settle the Heart and harmonise the Shen. In ‘Aromatica Vol 1’, Peter Holmes says of this oil: ‘Experience demonstrates its peerless ability to heal all irritated itchy skin conditions. It is also the premier remedy, aromatic or otherwise, for trauma care - bar none.’

Frankincense has so many uses that it is called The King of Oils. Being a tree oil it grounds and calms. It is wonderful for supporting cellular health so is perfect on scars. I used it on Finn’s feet daily in the hospital.

I used a blend of oils, including Helichrysum, Frankincense, and Lavender - which are good for the skin - on his head stitches, spinal scar and on the chest scars for pneumothorax drainage. In ongoing care this blend is helpful for burns and the scrapes on bashed toes and feet.

Learning to Live with SCI

After a month in hospital and two major operations (one to decompress and put rods in his back and one to revise the placement of some of this metal work) Finn left to spend nearly three months at a specialist spinal care unit. Although the physios on the neuro ward were brilliant, the general care there wasn’t specialist so he had to start again with treatment, but this transfer was the beginning of his new life: learning about SCI and how to live with it.

Although Finn has travelled since recovering (he is currently in a van in Sardinia) when he’s been at home Shiatsu plays a key role in our relationship. I frequently give him quick shoulder treatments as they are easily accessible to me when he wheels into the kitchen. They are frequently sore as they get so much use - transferring in and out of his van takes huge effort. The dispersal of Jitsu in his GB meridian (an issue for him before his accident) instantly helps release shoulder tension and relieve headaches and pain in his upper back. Again, I remember what a gift I have - to be able to connect with him this way as we chat for a few minutes and disperse the stuck Qi in his shoulders before we go about our business again.

I don’t get to give him full treatments as often as either of us would like – it’s that tricky thing about treating family – if I don’t put him in my clinic diary it doesn’t happen because both of us get busy and are not in the right space at the same time. When I do get to treat him on the mat I work from diagnosis, with what is coming up in that moment and I always work on his back. It feels important to work Bladder meridian as the organ needs support (spasms are common) and his nervous system will of course always benefit. Working the muscles, the fascia and the Qi of the back through Governing Vessel, Bladder and Kidney always feels important. It feels like making as much connection as possible is worth it even if the nerves aren’t connected and communicating.

The main issues for people who are living with SCI are psychological, skin issues, bladder and bowel function, joint issues, autonomic dysregulation and living in an ableist world. Shiatsu is fantastic for managing pain and improving mobility - wheelchair users often suffer chronic musculoskeletal pain from constant use of upper extremities for transfers and wheelchair mobility. Improving blood flow to the skin of the lower body helps prevent and treat pressure ulcers. We all know that Shiatsu is helpful for people living with insomnia, depression, and sluggish, disrupted digestion. I find rebalancing Qi in the LI and SI meridians in the arms, mobilising and bringing Qi into the Middle Burner, Hara work and rotating and stretching the legs all to be helpful.

‘My Paralysed Body has Not Fallen Silent’

Giving Shiatsu to someone whose body is paralysed is invaluable. The profound healing touch allows a sense of embodiment that, importantly, enables a connection with the parts of the body that can be seen as either constantly problematic or silent. Deep healing can occur as we acknowledge the continued value of the whole being. Matthew Sanford, an American Yoga teacher who was paralysed at 13 years old, describes his first experience of bodywork:

‘Carole shows me that my paralysed body has not fallen silent. It did not die. Rather, it changed its voice, speaking now on a subtler frequency but still offering keys to its inner experience. Carole radically affects how I view my body and bodies generally. She sets the groundwork, the framework for my future yoga practice. She teaches me to listen inwardly to energy, to its movement. She gives me my first access to my whole body again. I am forever grateful.’

Finally, in our clinics and in our wider social spheres, becoming more aware of our ableist bias is valuable practice and we can make more of an effort to make our spaces wheelchair friendly.

I hope, if you need it, that this story of mine gives you confidence if you get the opportunity to work with someone paralysed by a spinal cord injury or if you find yourself spending long hours beside a loved one in a hospital bed.

REFERENCES

Journal of Acupuncture and Meridian studies Vol 11 Issue 4 Spinal Cord Injury: How could Acupuncture Help?

Aromatica Volume 1, Peter Holmes

Waking: A Memoir of Trauma and Transcendence, Matthew Sanford