Tag Archives: physical therapy

Orthotics: Help or Harm?

Interesting article in the NY Times at http://www.nytimes.com/2011/01/18/health/nutrition/18best.html

Orthotics changed my life when I was 14, from a daily routine of pain whenever I stood to no pain whatsoever in my feet. One day, out of high school, I quietly set them in my closet and never looked back …


Mind Asleep, Body Awake

I had an interesting session today in which my client wasn’t actually there. I mean, he was there in that his body was there, but my client as I knew him was checked out, in dream-land. And I was left to have a conversation with his myofascial system.

I’ve never had anyone fall asleep on the table. Either the sensations of the work are so intense, or I’m asking them to engage specific muscle groups, or something … no one’s fallen asleep until today. Today I was left to work entirely with the body—Karl’s body, in this case (not his real name)—devoid of any consciousness of what I usually think of as this entity called “Karl.”

The interesting part, for me, was what a conversation I had with Karl’s tissues, the systems underneath my fingertips, my forearms. In particular, while working his right hip abductors, I found his musculature doing things that I had always been certain were informed by the conscious mind: actions like prolonged guarding and pulling back.

As I sank slowly into a trigger point in Karl’s gluteus medius, I felt a familiar slight recoil of the tissue (meaning “too much!”). I backed off completely for a moment, then began slowly to put slight pressure on the same trigger point, only to have the whole structure pull back and guard again, like you might envision a jellyfish pulsing in the ocean under a false attack.

I had always been sure that this stuff was conscious mind stuff, like “okay, it’s too much because he’s anticipating my next move, thinking about how he’d better guard that area” … but Karl, indeed, was snoring away quite loudly throughout this whole “conversation” I was having with his hip. He was gone.

The body seems to have a personality of its own, wisdom aside.

Anyone else who’s had this experience, please comment or shoot me an email. I’d love to hear it, as this is all new stuff for me.

Anatomy Pop Quiz!

Get out a pen to jot down your answer. Got one? Great. Now please, stand up, arms relaxed at your sides. From here, lift your arm straight out to the front, palm down, up 90 degrees (that’s straight out from your shoulder).

The pop quiz question: what was the first muscle to engage in that movement? (You don’t need to know technical anatomical language for your answer to count, as in, you could say “the front of the neck.”)

Probably some muscle in the shoulder, right? Like the anterior deltoid. (That was my guess when I took this quiz.) Or, if you were being super savvy and had a sense of where this was headed, maybe you answered some part of your core, like the deep transversus abdominis.

The answer: the soleus, one of the deep muscles in your calf that connects to your Achilles tendon.

The reason: to begin the process of lifting your arm out front, and thus moving your center of weight more forward, your unimaginably intelligent body begins with an ever-so-slight movement of plantar flexion, or the ball of your foot pressing into the earth (or, if you’re driving a car, on the gas pedal).

(Another visual that might help if you’re still feeling confused: recognize that the plantar flexion, if left unchecked, would push everything above your feet backwards. And that’s where your arm moving forward comes in as a sort of balance, so only your arm actually moves.)

Can you feel it happening? (I can’t, but kudos if you can!)

Amazing, no? Now, pass your papers to the front of the class …

Is Ida Rolf’s 10-series too formulaic?

A great question that I’ve wondered many times, answered is his latest blog post by Tom Myers here : http://www.anatomytrains.com/blogs/tom-myers

(As a quick refresher: Ida Rolf’s 10-series is the foundation, if not the protocol, of the school of bodywork called structural integration. SI works with the body’s 3D shape through the fascial network—the all-pervasive connective tissue covering literally everything in the body.)

‘good’ pain vs ‘stop that’ pain

Jeremy asks, “How do we tell the difference between the pain of injury, and the pain of correcting an injury in the context of exercise and rehabilitation?”

A fine question, good sir.

In my experience, there are a few key concepts to help guide us.

1. Change usually carries some kind of discomfort with it. Not always, but often … you know this already, as it’s what you point towards when you talk about ‘pain of correcting an injury.’

2. Correcting an injury is often a series of well-planned micro-injuries. An example of this is unfreezing a ‘frozen shoulder,’ or rehabilitating an broken-then-casted ankle, or even just working out. We’re often micro-tearing the soft tissue (muscles and connective tissue), re-aligning it, and bringing in just enough inflammation that our body ‘sees’ this area again and brings nutrition, and even better neurological pathways.

Too much of this micro-injuring and we’ve re-injured ourselves. Think of running stairs for an hour off the couch … too much too soon (for most of us, anyway). It takes forever to recover, much more time than it would’ve taken to, say, split that workout up into two sessions over a few days.

3. Pain, even a pleasurable sensation of stretching, does not necessarily equal rehab. As in, you could spend plenty of time stretching out the ligaments in your otherwise-healthy and normal-ROM ankle, and it would have that rehab-stretch kind of pain feel, but would certainly do you no good. You would increase mobility in an area that doesn’t need it, which would actually increase risk of injury like a sprain.

In other words, whatever exercises you’re doing should be intelligent ones, corrections that make sense and not just shots in the dark.

4. In general, any sudden or sharp pain means ‘stop doing that.’

5. You’re the best one to understand your own body in a subjective way.

Put all those together and I think you’ve got this: Correcting an injury should should be part of a well-thought-out process, and happen within the limits of what your body can effectively deal with. Just enough so there’s an increasing range of motion or fiber re-alignment or whatever … not so much that your body’s inflammatory response brings you back two steps. If you’re not recovered from whatever kind of workout in a few days, it was probably too much.

That’s my take … keep me posted!

And, to anyone else reading this, I’d love your two cents.

Static and Dynamic Stretching

Check out the attachment for a pretty simple one-sheet pros-and-cons list of static (holding) and dynamic (moving) stretching.

Dynamic and Static Stretch

This from a good friend and an excellent physical therapist who helped me figure out some knee pain I was having when training for my first marathon a few months ago. Part of his recommendation was a dynamic stretching warmup routine, which I immediately questioned, as I’d always heard warm up first, then slow, static stretching for five or ten or however many minutes.

So he sent me this, along with his routine, all of which ended up treating me really well.

More questions on this? Shoot me a line, of course, and I’d also be happy to pass on my friend’s work information if you’re looking for an awesome PT.