Research
From the early years of using ECTT with people with complex chronic conditions Kate was so inspired by the outstanding effects and benefits experienced by the clients that she designed and completed a clinical trial that would be foundational to further research. This was completed in 2009 with a long term follow up of the subjects pain levels and wellbeing in 2016.
Esoteric Connective Tissue Therapy and Chronic Pain- A Clinical Trial
Kate Greenaway, BApp.Sc (PT) and Danielle Loveless, BBiomed.Sc, BExSci (hons), Phd (ExsPhys)
Abstract.
Aim: To investigate whether six weeks of Esoteric Connective Tissue Therapy influences subjective measures of pain levels, general wellbeing, functional capacity, and the craniosacral pulse (cycles per minute).
Method: From 2006-2009 fifty one adult men and women with a moderate level of musculoskeletal pain, had six treatments of Esoteric Connective Tissue Therapy, one treatment per week. The Craniosacral pulse (cycles per minute) was measured throughout the treatment, both at the beginning of every session (pre-treatment) and the end of every session (post-treatment). Subjective measures of general wellbeing via the General Well being Scale, functional capacity of daily activities via the Quebec Back Pain Disability Scale, and pain levels via the Visual Analogue Pain scale were assessed at week-1 of treatment, week-6 of treatment and 6-months following the completion of treatment. Participants were asked to make no changes to their usual treatment (medication or counselling) throughout the duration of the program. Esoteric Connective Tissue Therapy consisted of six gentle hand techniques placed on various parts of the body, (e.g. ankles, skull and jaw). Identical techniques were performed in each session.
Results: All measures of general wellbeing, functional capacity and pain levels were significantly improved following six weeks of Esoteric Connective Tissue and were maintained after 6 months. The craniosacral pulse increased in the subjects from 1-3 cycles after six treatments of ECTT.
Conclusion: This study indicates strongly the potential benefits people with chronic pain could receive from treatment programs of ECTT. Further research is needed to confirm the long-term benefits for people with chronic physical and emotional conditions from treatment programs of esoteric connective tissue therapy.
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ECTT Treatment Case Studies
Pain after a car accident
Physiotherapist: Kate Greenaway
Maureen 39 year old
Maureen (not her real name) is a 39 year old woman who was involved in a car accident in late 2014. She was driving her car at 60km/hr and was hit from the right side with a moderate impact.
She said her body was wrenched from side to side and she was in shock afterwards.
– She had headaches of 7/10 pain level,
– She had upper thoracic pain of 7/10 and
– Low back and bilateral hip pain that extended down the outside aspects of both legs to the ankles that was a 9/10 pain level.
The same day she went to her local GP who prescribed NSAID and mercendol pain killers. She had an X-ray two weeks after the accident that was normal.
Maureen presented to me in October 2014 – 5 weeks after her accident.
On examination she had 50-60% flexion – limited by pain. Eighty percent extension and 80% and left side bend range of motion.
Maureen had tense and tender low back muscles and sacro-iliac joints and gluteal muscles. She was very stiff in her walking and when she changed postures – there was a big fear of more pain and chronic pain that would never go away.
She had 6 treatments of ECTT with gentle massage and a progressed gentle connective tissue and strengthening exercise program.
Maureen was keen to help herself and she did the CT movements daily and looked after her posture at work.
Her last treatment was 2 months after the initial accident.
Moreen stated she had constant low back pain of 1-2/10 with constant outer shin pain of 2-3/10. She had stopped all medication and felt she was overall 90% improved.
She was walking intermittently and gently exercising, after that last treatment, it was recommended that she walk more regularly for longer distances and do regular water-based exercises.
Final Year High School Student
ECTT Practitioner: Francisco Clara
Jane 18 year old
Jane (not her real name) was 18 year old. Her mother Joanne (case study 4) recommended her to have Esoteric Connective Tissue Therapy (ECTT) sessions as she was experiencing a lot of stress leading up to completing her final exams for high school. She was also having some digestive problems, headaches, and bouts of depression and low self-esteem.
On her first visit Jane shared she was stressed out with school, part time work and home as her mum was recovering from cancer. She was feeling anxious, and exhausted with a lot of tension around her neck.
On examination her upper back, neck and shoulders and arms felt very tight and she was holding a lot of tension in her face especially around her jaw. Her range of motion through the neck and upper thoracic spine (chest spine) was very restricted.
Jane had 4 consecutive weekly ECTT sessions and then 2 more fortnightly sessions.
Her first session was on 25-09-14 and it focused mainly on ECTT to her legs, shoulders and head/ face, she was deeply relaxed by the end of the session and she commented on how she hadn’t experienced that level of deep relaxation for a long time.
The following 3 sessions focused on ECTT to similar areas with the intention of releasing the excess nervous energy in her body and each time Jane would go to a deeper level of relaxation and stillness. On the fourth session 23-10-14 there was much less tension in her whole body and her face was so relaxed it looked significantly different, she was sleeping much better and feeling more vital.
The following two ECTT sessions focused on upper body, arms and face. There was a significant difference in her body as she was holding far less tension. We were able to discuss different tools that she could start to implement daily to not get affected by the demands of life.
She completed her HSC in 2014 and is currently attending university with no problems.
Right Shoulder Pain
ECTT Practitioner: Francisco Clara
Martha 50 year old
Martha works as a graphic designer and presented with right shoulder pain on the medial (closer to midline) part of scapula. Martha had been experiencing pain for about 5 months and was receiving treatments with other modalities which alleviated it but the pain kept coming back within days mainly because of the workload she was doing that required her to sit at the computer for long periods of time.
Upon examination, Martha had a forward head carriage and also tight pectorals muscles which rotated her shoulders forward more on the right and she was holding a lot of tension in her wrists and arms. Her Thoracic (chest) spine felt very congested and locked up in the upper region (T2-T5). There was limited range of motion on flexion and abduction (sideways elevation) of her Right (R) shoulder and R rotation of her neck with a pain level of 6 out of 10.
Martha’s first session on 11/11/14, focused on Esoteric Connective Tissue Therapy (ECTT) releases to her shoulders both on prone (face down) and supine (face up) position, also of her arms,wrists, and occipitals (base of skull bones). On the second visit her shoulder was feeling better but she still experienced pain whenever she was in a sitting position for a long time, her treatment consisted of:
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ECTT to her upper body,
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Demonstrations and education on correct her posture when sitting and standing and gentle connective tissue exercises were shown and recommended for her to do them daily.
Martha’s third session was on 24/11/14, her shoulder was feeling much better with a pain level of 2/10 ( 0 being no pain,10 being extreme) She also shared how she was noticing that when she reacted to any circumstance she could feel the tension starting to build in the same location on her shoulder. This new awareness and understanding of her body was helping her to identify factors contributing to her pain and problem.
Her last session was on the 16-12-14, she was pain free and she was given connective tissue exercises which she introduced into her daily routine. She plans to continue with sessions soon.
Old Football Injury
Physiotherapist: Kate Greenaway
Brian 55 year old
Brian is a man in his 50s who does Lawn Maintenance and Gardening work.
As a young man Brian played Ruby League for many years with several injuries to his Right knee.
“It has been a problem off and on ever since and changed the way I walk and do all my manual work. For example, squatting on my right knee is something that I have not been able to do for a very long time.
I have been having ECTT periodically over the last 6 months, and more intensively in the last few months. I have been doing my connective tissue exercises for my back and legs daily - they are just part of my every day now.
They really help when I get home from work and my body is tired and my knee is aching.
As a result of these sessions and the connective tissue exercises there has been a change in the amount of movement that I have in my knee.
So now I can do a squat, it makes a huge difference to how I do my manual work, everything is easier to do and it is something that I thought I would not be able to do again.
These types of injuries are supposed to get more difficult to manage as we age. This really is fantastic as I am 55 now and have more movement in my knee now than I did when I was 40.”
Pelvic Injury
ECTT Practitioner: Francisco Clara
Joanne 52 year old
Joanne, (not her real name) was a 52 years old
woman who presented with an acute lower back pain, she had injured herself whilst exercising and had also been experiencing stress at home with children whilst recovering from a hysterectomy 10 months before. She was diagnosed with a sacroiliac joint injury ( the main weight bearing joint with side of the sacrum). Joanne was experiencing a lot of pain when she presented for treatment, movement was very restricted and she had to use a support belt at all times to be able to walk.
Joanne’s pain was initially an 8+/10 (0 being no pain ,10 being extreme), and radiating down the right side of her buttock, the pain was also radiating up to the right side near to her arm pit.
Upon assessment she had a fwd. pelvic tilt on the right and some light inflammation around the right side of her sacrum (the lowest bone of the spine between the big hip bones). She was very tender upon palpation with very tight hamstrings, gluteals and adductors (inner thigh) muscles more on right leg, she also had limited range of motion on back extension.
Joanne was on a treatment program for 7 weeks which consisted of weekly ECTT treatments.
Her first visit on 10-09-14 focused on ECTT to the lower body and alignment of the hips, afterwards she felt a lot more relaxed and was able to walk more freely. On her second visit the pain had reduced to a scale 4-5 and she no longer needed to wear the support belt, she shared that she experienced a lot of pain around her hips and her lower back after that initial treatment.
Her third treatment was on 03/10/14, she was still experiencing some discomfort of a 3 /10 mainly when driving. We also discussed lifestyle choices she was making prior to the injury and how that might have contributed to her problem. Joanne’s treatment consisted of ECTT focussing on her hips, low back and legs.
By week 4 - 16/10/14 she could move with a scale 1/10 pain and rarely felt any discomfort, she expressed she was feeling a lot calmer and more connected to her body. The following sessions focused on ECTT with gentle massage focusing on her upper body as well as her lower back and legs. She felt ECTT was helping her to address underlying emotional issues she had been facing for the last 2 years.
Wrist & Shoulder Pain
ECTT Practitioner: Francisco Clara
John 38 year old
John is a self-employed carpet and upholstery cleaner, who had been doing a painting job for 3 consecutive weeks. He presented experiencing pain in his shoulders mainly the right and also wrist pain on the same side with a pain level of 6/10 (0 being no pain,10 being extreme). John stated that his pain would worsen as the day went by.
He attributed his condition to working long hours, doing repetitive movements for long periods of time. He was also experiencing stress in his personal life due to a recent relationship separation.
On examination there was a large amount of hardness in his upper body mainly T1-T7, his upper right hand side torso and arms were holding a lot of tension, his chest was sunken in with both shoulders rolled forward, also his neck was very tight with a limited range of motion both sides.
John was on a program of weekly ECTT sessions for 8 weeks. His first session on 03-10-14 was focused on ECTT releases to his upper body mainly his shoulders and arms after this initial session he experienced soreness in both arms for a few days. He found it challenging to relax his body and let go during treatment and was surprised by his initial level of resistance.
On his second visit on 17 -10-14 his muscle tone had improved and there was more movement in his thoracic (chest) spine. He was experiencing discomfort at a 4/10 by the end of a working day. During treatment he was able to let go more easily and felt deeply relaxed by the end of the session. John was introduced to some connective tissue exercises and other tools to assist him to connect more with his body. The following sessions continued focusing on John’s upper body and legs as there was still a considerable level of hardness in these areas.
On his fifth session 31-10-14 he was pain free in his right shoulder and wrist. On his last visit 19-12-14 he shared how beneficial his ECTT sessions had been in order for him to understand how his lifestyle choices had a direct impact on his body, he continues to practice the CT exercises on a daily basis and is in tune with his body more than ever before.
ECTT is a complementary treatment to mainstream medical practice. Although clients have reported improvements in their condition from the connective tissue exercises and ECTT treatment techniques there is currently no formal research evidence for the efficacy of ECTT. In my clinical experience with over 25 years - client responses to ECTT have been very positive. As a qualified physiotherapist I offer ECTT as an adjunct to gentle physiotherapy treatment techniques and exercises. Kate Greenaway 2024.
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