Taiwanese odyssey - Last day. Muscle Energy Techniques

“What about its skin, what type of skin does it have?” Victoria and Kelly were keen for me to have a “mos” burger but before committing myself I wanted to know what it was made of. We had been revising the importance of asking questions when assessing a client for musculoskeletal problems so it was fitting I now had my chance to ask some. I asked a student what was in a Mos burger or what sort of skin the animal it was made from might have had. We established it was brown colour although it wasn’t clear whether that was the animal or the burger. "Does it live in the sea?”

“No”.
“Does it live anywhere near water or in water or ever been immersed in water?” The student wasn’t sure. “What does it look like?” She didn’t know how to explain it. “Could she draw one?” She laughed and shook her head. “Ok so can you tell me anything about it?” I wanted to be certain it wasn’t soft bodied with fins or suckers of any kind, lived on or under a rock or had ever had tentacles at any stage of its life cycle. She said it had horns. But wait, snails have horns. Can we just confirm that it doesn’t have a shell or been scooped from a shell or resemble the animal we call a snail but is shelless? Nine days in Taiwan and I had learned that Taiwanese delicacies were an acquired taste.

The Importance of Asking Questions

We had been practicing Muscle Energy Techniques (MET) all morning. After lunch I snapped yet another hand safety sticker and added it to my collection. The staff at Mo Mo's think I am a safety officer sent from head office to check up on them. Knowing this was the last day of the first part of their course, in between practising, the students took a great many photos of me, me with them, me with the skeleton, themselves with the skeleton, and themselves with me and them and the skeleton.

Figuring out MET to hip rotators

Group practising MET to pectorals

A fellow therapist in London very kindly went to a lot of trouble to write out all of the muscle names phonetically and email them to me. My job for next time is to learn them. I have learnt the names for some of the bones.

Patella - bingoo

Femur – goo goo

Tibial tuberosity – gingoo

Fibula - faygoo

You can imagine the fun I had explaining the assessment of patellofemoral problems such as chondromalacia patellae.

As we approached the afternoon break we continued with more MET practice and revised scapula terms. I love the way Victoria pronounces scapula “skapooola”.

The number of photos I have of the course is phenomenal. One student gave me 14 CDRoms containing her own photographs. I have essential oils, one from the 1000 year old Taiwanese tree. I was also given a packet of super heat packs which stay hot for around 20 hours. At teatime I enjoyed some popcorn tea—it has rice crispies in it!

Despite being tired themselves, after class two of the students took me to a lovely vegetarian restaurant where we sat in the dark as waiters plied us will a whole variety of dishes. Everything was small and none of it had ever had legs. My kind of diner. My soup had strange things in it. Things that looked very much like they had been used on a Stephen Speilberg set. I was assured that it was so delicious that even Buddha would eat it. “So you’re sure these are vegetables? The chef hasn’t slipped in some mollusks politely just because he thinks I’m foreign?” I was assured these were only vegetables. I picked one up on my ladle. It looked like an eyeball. “Special nut.” I eyed another. “Special mushroom”. I had tea which was a delicacy. It tasted of parsnips. And then hot vinegar which the waiter told me I should drink very slowly and in small amounts because it was very ‘dense’. It was to clean my palate. I assured him I would be sipping it in very small amounts. I liked it. The other tea tasted just like Bovril but was "Chinese medicine". I probably needed some medicine so I drank that too. It tasted like dandelion and burdock. I liked that too. “Stikkee” said Regina when we parted. “August veree stikkee. Must pack shorts.” Thankfully next trip I will have lighter clothes to bring. 

Back in my hotel room I could hardly stand. Teaching 7 days in a row is no problem when you love your subject and the people learning it, but with the added 2 hours teaching each day and the interpreting, it was very tiring indeed. I knew if I sat down I’d fall asleep. I forced myself to pack, including all the gifts the students had given me. When the alarm went off at 3am I didn’t feel so bad.

As the chauffeur drove me in the dark back to the airport at 4am I reflected on the SWOT analysis I did before leaving London.

Strengths: well, I love the topics I'm teaching and have taught them many times so feel confident in being able to deliver a great course. 

Weaknesses: not speaking Chinese. Fortunately we had Victoria and some of the students could speak a little English.

Opportunities: I'm here to help Victoria's company expand into China so that Chinese therapists can learn sports massage techniques. As everyone knows, it's the largest market in the world.

Threats: problems with travel such as plane delays. Fortunately everything had gone smoothly, the hotel in which I was staying was close to the teaching venue which, now that I've seen it, is great.

Sitting in the airport I looked at the photos on my Blackberry. The first 7 days were over. I checked the student register and all students had attended all 7 days, signing their names in delicate, florid patterns. Well, they say every 1000 mile journey starts with one step. I had been 6000 miles away and the students' skills had improved in leaps and bounds. I can't wait to return in August for the second part of the course.

MET to pecs

MET to quads

The register

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter

Day 6 in Taiwan - Sports Massage Techniques

Today was my sixth day of teaching, my eight day in Taiwan. For breakfast one of the students brought me warm oysters, a Taiwanese delicacy. I explained how full I was from my pink cornflakes at breakfast but they insisted. She and Kelly watched as I tried one. It was 8.30am.

I had left my phone adaptor back in the hotel and was low on battery so Kelly took me to Ikea in the basement but we were not allowed in with our drinks which had to be locked away.

The students all have hypermobile elbows much like in their textbooks and we discussed the problems this caused them as therapists. They practiced manual lymphatic drainage to help reduce swelling, frictioning, trigger points, and the importance of checking for contraindications. They continue to demonstrate superb hands on skills and clearly love their work. They are caring and it was a joy to watch them perform some of the gentler massage routines. They gave me more gifts, including this neck massager.

Victoria is working very hard translating. There are more questions. Its good for the students to feel free to ask them. For a special dinner we had eel and lots of other dishes. I’m starting to hallucinate from having to try so many soft bodied sea creatures.

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter

Day 5 - Sports Massage & Sports Injuries Course in Taiwan

Out of curiosity I had pink cornflakes for breakfast. They turned the milk pink so it was like having them in strawberry Nesquick. Some of the buses are pink too. When I left the hotel this morning it was raining and the moped riders were wearing brightly coloured macs as they streamed past and waited at the lights. Along with the bright yellow taxis and the pink buses it made for a colourful rush hour. The crossroad lights here are great. The green man actually moves and when you are running out of time to cross, speeds up until, when there are only 3 seconds left, he is running. Same as me. One day I shall write a thriller based in Taiwan and call it Green Man Running. The shops have super umbrella devices outside which wrap your wet umbrella in plastic for as Victoria rightly says, “its not good manners to let it drip on the floor”. 

One or two of the cosmetic sales assistants got dangerously close to lipsticking me today. I think the security guard I see on my way in may be tipping them off as to my route to the 11th floor. But I bent down suddenly as if to tie my shoe which was fortuitous because whilst in a crouched position I found another safety sticker. I couldn’t work out what it had to do with sharks but Kelly explained it was yet another reminder to keep fingers away from doors.

It was a great day and the students did brilliantly. We had been learning about knees all morning, describing and locating the different structures then getting proficient with the many special knee tests. They pick up everything so fast. Victoria is right when she says the Taiwanese are good at copying. 

Calculating the Q angle

Writing out knee structures in Chinese

Practising Appley's Compression Test 

At break I ate a boiled sweet that tasted a bit like blackcurrant but had salt in the centre when it eventually broke in my mouth. One of the students very kindly gave me a throat lozenge. It was triangular and looked like it was made from very tough black felt and tasted of menthol and mushroom at the same time. Sometimes when I try things here, they taste so different that I can't even find similar foods with which to describe them. I have forgotten what day it is. Maybe I only imagined the banana that’s lost in my room?

Learning knee structures

Student knee test notes

Sharp doors safety sign

Umbrella machine

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter

Day 4 in Taiwan

“I’m really pleased with your work today, you’re all doing really well and have excellent massage skills.” I said, waiting for Victoria to translate our first session following lunch.

“You said this already this morning. You want we tell them again?”

“Yes please,” I said, happy to give praise where praise was due. The therapists were indeed doing well, enthusiastic and hardworking they watched and video’d everything intently, many made copious notes and tiny drawings, then practiced the techniques, playing back their recordings as a reminder. It was super to see them all helping one another, sharing notes as I dotted about to answer questions. Perhaps because the couches are all really low here, the therapists all have great posture so learning to incorporate deep tissue techniques and use their forearms instead of their hands came more easily to them than it seems to when therapists use higher couches. They naturally transferred their bodyweight and applied elbow techniques with relaxed wrists. It was fun to watch them experimenting with 'soft tissue release', one the skills in which they need to be proficient, trying different applicators and treatment positions.

Practising soft tissue release on calf and hamstrings

Soft tissue release to erector spinae

For lunch I tried Korean food. The soup was full of what looked like transparent green and white pieces of tissue but it was seaweed. Victoria was making notes from her bilingual bible, reading about marriage in both English and Chinese. “It says here a woman who get divorced should get married because otherwise there will be too much passion” she exclaimed. We agreed that that would be no good at all. Better get married and put a lid on all this passion. 

The train home was packed. Lots of commuters wear face masks against pollution or if they have a cold. So its kind of like being in a carriage full of surgeons or on the set for Holby City or Casualty. But you get used to it. Its Valentine’s Day and the students were happy to finish at 5, rushing off to meet special boyfriends and husbands. I have a choice of three films: (i) something with Charles Bronson made in the late 70s where he’s in a wide car safeguarding a lady with even wider hair, (ii) Garfield, (iii) something with cheerleaders wearing a lot of makeup. The other 87 channels were all full of men with tight hair buns fixed with chopsticks who, brandishing long swords are challenging one another to duels over honor, or women in lycra wobbling on bicycles designed to vibrate fat off your bottom. I tried out the Chinese massage tools one of the therapists had given me as a gift. I still can't find my banana.

Chinese massage tools

Soft tissue release to lat dorsi

Soft tissue release to wrist extensors & flexors

Victoria bible

Soft tissue release to quads

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter

Day 3 - Hip

Monday and I’m traveling in rush hour traffic. The main road on which the hotel Fullerton is situated is thick with mopeds. Taiwanese Quadrophenia. I’m loving the Taipie transport system. On the platform are ‘train lines’ within which you have to queue on both sides of the doors, a civility everyone observes. Trains arrive every 30-60 seconds so no one pushes because they know there really will be ‘another along in a minute’. Here they like their warning signs to suggest expletives and the metro is an ideal place for such signage. Every carriage has a guard standing outside on the platform to wave a flag, blow a whistle and ensure fair play. Although the carriages are packed its somehow less stressful than back home. To board an 8am Northern Line train in London you need to have eaten no breakfast, be carrying no luggage and have a strong constitution when it comes to body odour. No one much cares if you trap your fingers.

As soon as students start arriving they ply me with coffee and a lovely bag of fruit in which I later discover the largest eating apple I have ever seen and, being free from the UK supermarkets' obsession with fruit unification, two delicious green skinned oranges.

Today we were learning to assess the hip joint and practicing different treatment positions. We managed to get through the Thomas Test, the Ober Test and the Straight Leg Raise. Then an introduction to postural analysis of the lower limb, something everyone seemed to enjoy and eagerly lined up outside to check one and others’ hip levels. As I suspected from having already observed their elbows, the therapists demonstrated some interesting lower limb postures, with half the class having hypermobility in the knee joints and many with bowed or torsioned tibia.

Practising leg massage

Practising straight leg raise

Demonstrating iliac crest levels

It was a busy morning. Students were getting more confident in asking questions and Victoria had worked her socks off interpreting. I was glad for the first break when I was unexpectedly handed a large slice of strawberry pie, another coffee and some sweets. Outside, the check in desk was covered with a selection of food. There were trays of seaweed crackers and a bag of dark cocoa chocolates that came in powdery squares a bit like oxo cubes. The Taiwanese love their food and love clothes shopping. Best of all they like shopping for clothes in shops where food is available. So the restaurant of Mo Mo’s department store is very popular. But today I wasn’t having lunch. Instead, I was taking 100 photos. I had offered to assess the posture of each student and they had all eagerly agreed to share the analysis with their fellow classmates, thus receiving not only an assessment of their own posture, but that of 21 other women. So with what until last year, was the tallest building in the world looming in the fog behind me, I sat crouched with the camera balanced on a chair back and one by one snapped four shots of each student: front, back, left and right sides.

Back in my hotel room I began downloading the photos. Its great that the students are so willing to share their images with one another, and agreed it was ok for me to include classroom shots of them in my Facebook blog (though I’m not of course posting their postures).

After downloading 100 photographs I fell asleep early and woke at 2am, hungry for carbohydrates. There’s a banana in the room somewhere but I’ve forgotten where I put it. I searched the bathroom and even my suitcase to no avail. I looked under the bed just in case it was there. Too early to shower, I made tea but couldn’t face using one of the tubs of pot noodle so ate three boiled sweets that were salty and might be laxatives but as I can’t read Chinese and the restaurant didn’t open for another four and a half hours it was a risk I was willing to take.

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter

Day 2 Stretching

This morning for breakfast was a wide selection of fish and meat, including a whole fish cut into chunks, pork knuckle, crab and carrot stew, a pile of fried ham, sausages and frankfurters, plus ham sandwiches. I had my usual melon and bread rolls, patted the bronze baby in the foyer on my way out and trotted off to the station this sunny Sunday morning.

Bronze Baby

One of the students is very small in stature, perhaps only four feet, and wears huge wedge shoes. She's energetic and has a good knowledge of muscles. Whilst waiting to get in, we showed each other photos of our children. Taking photos is pretty hot here. The students especially like it when I demonstrate or explain something theoretical, so as soon as Victoria announces that there is going to be a demonstration there is a quick flurry and I turn round to find everyone sitting cross legged at my feet like children excited to hear a story. They stand so close when I’m demonstrating that I keep stepping on them when I step back to perform a technique, but they don't seem to mind and crowd around enthusiastically, then play back their videos and copy the techniques there and then. Quick learners, they call out "teecha! teecha!" when in need of help. 

Today we were learning about stretching and the students are themselves very flexible, with at least half the group being hypermobile. So I had to modify a lot of the techniques so they did not hurt themselves when they were applying these to clients, or when receiving the stretches themselves. At least half the class have an extra 10 degrees elbow extension so I’m pretty amazed none of them have shoulder pain. Although I suspect they do, they’re just not telling me yet. There was much distress this afternoon at the death of Witney Houston so for distraction I brought out packets of stretchy toys and made a target on the flip chart. This caused much amusement and they stopped stressing about Whitney and threw small yellow men at a bulls eye.

At break time they gave me a drink made by dissolving honey into luke warm water which tastes like orange juice. And a small pastry that looked like an egg custard. They still wanted me to visit the night market with them but I'm stalling until August because I know this is going to be a long week and whilst they’re not tired now, they still have 5 more days to get through and the hours are much longer than they're used to. I don't want to offend them but need to help them pace themselves. A sign on the escalator said ‘stand firm’ so I kept that sentiment in my mind when I made my way home.

Passive Back Stretches

Finding the addcutors

Labeling Muscles

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter

Taiwan Day 1 Shoulder

"Welcome to sports injuries and sports massage diploma"

Group Photo

How do you explain to someone that you don't eat anything with tentacles before 8pm at night? Sitting at lunch downstairs in the dinning hall of the Mo Mo's department store the students were eager to join me for lunch on the first day of their course, and like a posse surrounding their fugitive, they appeared from all sides carrying bowls of various sizes, including a tray on which was a huge squid, its legs splayed out towards me like it had deliberately regurgitated itself in defiance of being cooked.

Squid Lunch

"You must try pearl tea. It is famous in Taiwan. Very expensive in America. Four dollars one cup," said Victoria.

"Ok" I said, I'd try it. "What's the pearl made of?"

"Its black," she said, making a pincer movement with her fingers, "like a pearl. You must suck it up." This was getting more dangerous by the minute but there was no way out as my host had already motioned to Kelly to get me the drink. "You want a warm one or a hot one?" Here they have three options for beverages: hot, cold and warm. I ordered hot with the intention of stalling the act of ingestion. The class were intrigued to see how I was going to suck up black pearls from hot tea. "Maybe I'll let it cool down and have it later?" I suggested when a large paper cup was placed in front of me containing a straw with a 1cm diameter. "Why's the straw so big?" I asked.

"For the pearls!" said Victoria, and everyone smiled. So with my host, her assistant and half the class watching I put my mouth to the straw and tentatively sucked. It was tolerable. The pearls are the size of small marbles with the consistency of very soft, warm jelly and ever so, ever so slightly aniseed. They stuck to my molars as I chewed them and Victoria watched intently. "Its nice yes?" she said with wide eyes. "Mmm" I replied, smiling and chewing and raising my eyebrows in a manner suggestive that I was enjoying it whilst not actually committing a reply to words. Three students approached and bowed and nervously slipped a small tub of what looked like white glue onto my table. "Special pudding!" said Victoria, "Coconut milk!"

Pearl Tea

After lunch I had to negotiate my way back to the 11th floor through a store of women intent on changing my appearance through the application of expensive creams colours. This required stealth and cunning the like of which Daniel Craig would envy. With my carefully practiced just-woken-up-no-make-up-since-the-80s look, I'm an obvious candidate for a complete makeover and sales assistants, highly skilled in customer combat, hone in on my presence from all corners of the store. Once trapped you get asked about your beauty routine but 'routine' implies you do more than one thing whereas I get up and get washed. What's there to 'routine' about it? The advantage of being in a British department store used to be that I could pretend to be foreign and thus partially extract myself from roving Revlon assistants, intent on pinning me down and smearing my lips bright red. "There, take that you unlipsticked creature. Pah!" (if you get caught the trick is not to struggle or it makes the experience worse). I could fairly easily dodge the infantry of saleswomen who, like police armed with poison gas, loitered with their perfume spritzers ready to take down passers by. An inability to speak English is no longer a safety guard now that assistants in department stores in London are likely to have a Polish mother, German father and having been schooled for 7 years in the Ukraine and with a degree in business studies from Birmingham, can probably find a language to suit you. Here in Taiwan its pretty obvious I'm not from these parts, and being a good foot and a half taller than anyone else, my powers of evasion are tested to the limit. (Their clothes rails are all really low and there are glass mirrors everywhere so potential customers have no place to hide). With the restaurant in the basement and the teaching room on the 11th floor, I have a whole 11 floors to negotiate. Its a battle of wills. Its too early for any assistants to have sussed out my route so for now I'm fairly safe and can get to the lifts unharmed. (And to stay unharmed you have to observe the elevator safety signs, presumably designed for women who have just been lipsticked and are shaken and disorientated).

Back in the teaching room after lunch the students were playing with the teaching toys and seemed to have enjoyed the first morning of their course which was spent assessing the shoulder joint. With the help of Victoria we made flip charts in Chinese and students were allowed to film everything and take photos, something they really enjoyed and did speedily and unobtrusively. Each session took longer to deliver, as Victoria had to translate not only my simple instructions but also any questions and my replies. Note taking took a whole lot longer because their symbols took so long to construct, one of the reasons I had encouraged Victoria to allow them to take pictures as well. Together, myself and Kelly are taking our own photos and making a 'collage' of the entire course to be given to the students. Each night when I get back to my room I download the 50 or so photos I have taken during the day and annotate them. My notes will then be translated into Chinese and the picture with their accompanying notes given to the students on a CD. The students all wanted me to visit one of many night markets with them but I am resisting because after a 10 hour day I need to rest and Victoria will loose her voice if she doesn't rest also. I pacified everyone by having a group photo taken. The students had survived their first day of sports injuries and I had survived the black pearl initiation. It was a promising start.

Shoulder Assessments

Springing the AC Joint

To see what we're up to in our London classroom visit us at : www.thelondonmassagecompany.com or join our monthly updates and shares via our newsletter