Thursday, June 23, 2011
Evolve Restorative Therapy: Article on how to work with torn hamstring
Evolve Restorative Therapy: Article on how to work with torn hamstring: "If you cannot view this newsletter... please visit daltonarticles.com/Hammy Treating Torn Hammies By Erik Dalt..."
Article on how to work with torn hamstring
If you cannot view this newsletter... please visit daltonarticles.com/Hammy 
Treating Torn Hammies
By Erik Dalton, Ph.D.
The Freedom from Pain Institute
In a study of one NFL team from 1998-2007, the occurrence of hamstring pulls accounted for 85 injuries, second only to knee sprains, which came in first at 120 injuries (1). Hamstring injuries often plague competitive and weekend warrior athletes for years, giving the illusion that the initial injury never healed (Fig 1). But recurring problems are commonly due to re-injury rather than a single isolated episode. When a disorganized web of scarred collagen tissue creates a chemically toxic environment at or around the ischial tuberosity, blood, nutrients and neurology are disturbed. Connective tissue that replaces normal healthy collagen is weaker than normal muscle tissue and more susceptible to the risk of re-injury with even less intense activity. Statistics show that re-injury to the hamstrings occur in about one-third of athletes, most commonly within the first two weeks upon return to play (2). This places extreme importance upon evaluation of the severity of the injury and the resultant manual and movement rehabilitation program to ensure that the athlete is strong enough to return to competition without the threat of re-injury. Hamstring rehab can take anywhere from 2-6 weeks or longer depending on severity and therapeutic delivery methods used.
Obviously, the role of the hamstrings is important because of their unique ability to stabilize the pelvis in the transverse and sagittal planes during trunk flexion and rotation, i.e., three-dimensionally. Anatomically, the hammies are capable of producing both internal and external rotation as well as hip extension. The balance of musculature across the hip in all three planes is critical to successful functioning during all sports and work activities. Disruption of normal force coupling in either the sagittal or transverse plane will have tremendous effects across the lumbar spine, pelvis, and lower extremities. Figure 2 shows fascial force coupling between the biceps femoris, sacrotuberous ligament, glute max, thoracolumbar fascia and contralateral latissimus dorsi. Weakness in any of the Posterior Spring System (PSS) structures causes the biceps femoris to overwork and lends it to injury.
Typically, when a biceps femoris is injured during running, one end of the muscle is trying to shorten while the other end of the myofascial unit is lengthening; the muscle is in effect trying to stabilize at one end and produce substantial force at the other. Adding to the problem is the dual (tibial and fibular) innervation at the proximal bifurcated heads. If one branch fires late, the uneven pulling can place unbearable stress on its partner. In the absence of proper flexibility, the incidence of injury increases (Fig. 3). Initially, the emphasis of treatment is on restoring and keeping the range of motion. However too much stretching and movement can result in more dense scar formation, limiting the muscles' healing ability. When an athlete is told to move the leg only in pain-free motions, the brain begins to re-map a new neurological motor pattern and compensations develop. The injured player consciously or unconsciously alters movement patterns to avoid re-stressing the damaged connective tissue.
Stretching & deep tissue… good?
It may seem during this last stage that the hamstrings simply will not loosen up. Modalities such as NMT, structural integration, orthopedic massage, active isolated stretching, myoskeletal alignment and functional movement training are often used to help restore length-strength balance in the musculo-fascial kinetic chain. Once all the neurological components of the hamstring injury have been addressed, the therapist may need to mechanically separate adhesive fascial hamstring bags and untangle cross-linked scar tissue allowing the collagen to heal and function better (see attached video).
Functional training goals during this period may include improving running coordination of the trunk and pelvis (neuromuscular control), sport-specific activities such as quick starts and stops, and improving strength. Exercises will continue to be used from the previous phases, but their intensity and focus on quality of movement is increased. Some movements that have been shown to help strengthen and reduce re-injury include high-knee marching, quick running drills, forward-falling running drills, explosive start drills, and eccentric muscle actions (muscle is lengthened while it is activated).
More research is needed to better assess the causes of hamstring injuries, i.e., muscle imbalances, neurological weakness, SI joint inhibition and myo-kinetic kinks. More and better strategies are needed to prevent occurrence and reduce prevalence. No matter the sport or the method of delivery, this injury is one that causes a multitude of problems and time away from competition. More knowledge on prevention and rehabilitation of hamstring injuries is a focus of many pain management, orthopedic massage and sports medicine practitioners.
References
1. Heiderscheit B, et al. Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention. J Orthop Sports Phys Therapy. 2010 February; 40(2):67-81
2. Hammer, Warren. Functional Soft-Tissue Examination and Treatment by Manual Methods. Sudbury,
Treating Torn HammiesBy Erik Dalton, Ph.D.
The Freedom from Pain Institute
In a study of one NFL team from 1998-2007, the occurrence of hamstring pulls accounted for 85 injuries, second only to knee sprains, which came in first at 120 injuries (1). Hamstring injuries often plague competitive and weekend warrior athletes for years, giving the illusion that the initial injury never healed (Fig 1). But recurring problems are commonly due to re-injury rather than a single isolated episode. When a disorganized web of scarred collagen tissue creates a chemically toxic environment at or around the ischial tuberosity, blood, nutrients and neurology are disturbed. Connective tissue that replaces normal healthy collagen is weaker than normal muscle tissue and more susceptible to the risk of re-injury with even less intense activity. Statistics show that re-injury to the hamstrings occur in about one-third of athletes, most commonly within the first two weeks upon return to play (2). This places extreme importance upon evaluation of the severity of the injury and the resultant manual and movement rehabilitation program to ensure that the athlete is strong enough to return to competition without the threat of re-injury. Hamstring rehab can take anywhere from 2-6 weeks or longer depending on severity and therapeutic delivery methods used.
Obviously, the role of the hamstrings is important because of their unique ability to stabilize the pelvis in the transverse and sagittal planes during trunk flexion and rotation, i.e., three-dimensionally. Anatomically, the hammies are capable of producing both internal and external rotation as well as hip extension. The balance of musculature across the hip in all three planes is critical to successful functioning during all sports and work activities. Disruption of normal force coupling in either the sagittal or transverse plane will have tremendous effects across the lumbar spine, pelvis, and lower extremities. Figure 2 shows fascial force coupling between the biceps femoris, sacrotuberous ligament, glute max, thoracolumbar fascia and contralateral latissimus dorsi. Weakness in any of the Posterior Spring System (PSS) structures causes the biceps femoris to overwork and lends it to injury. Typically, when a biceps femoris is injured during running, one end of the muscle is trying to shorten while the other end of the myofascial unit is lengthening; the muscle is in effect trying to stabilize at one end and produce substantial force at the other. Adding to the problem is the dual (tibial and fibular) innervation at the proximal bifurcated heads. If one branch fires late, the uneven pulling can place unbearable stress on its partner. In the absence of proper flexibility, the incidence of injury increases (Fig. 3). Initially, the emphasis of treatment is on restoring and keeping the range of motion. However too much stretching and movement can result in more dense scar formation, limiting the muscles' healing ability. When an athlete is told to move the leg only in pain-free motions, the brain begins to re-map a new neurological motor pattern and compensations develop. The injured player consciously or unconsciously alters movement patterns to avoid re-stressing the damaged connective tissue.
Stretching & deep tissue… good?It may seem during this last stage that the hamstrings simply will not loosen up. Modalities such as NMT, structural integration, orthopedic massage, active isolated stretching, myoskeletal alignment and functional movement training are often used to help restore length-strength balance in the musculo-fascial kinetic chain. Once all the neurological components of the hamstring injury have been addressed, the therapist may need to mechanically separate adhesive fascial hamstring bags and untangle cross-linked scar tissue allowing the collagen to heal and function better (see attached video).
Functional training goals during this period may include improving running coordination of the trunk and pelvis (neuromuscular control), sport-specific activities such as quick starts and stops, and improving strength. Exercises will continue to be used from the previous phases, but their intensity and focus on quality of movement is increased. Some movements that have been shown to help strengthen and reduce re-injury include high-knee marching, quick running drills, forward-falling running drills, explosive start drills, and eccentric muscle actions (muscle is lengthened while it is activated).
More research is needed to better assess the causes of hamstring injuries, i.e., muscle imbalances, neurological weakness, SI joint inhibition and myo-kinetic kinks. More and better strategies are needed to prevent occurrence and reduce prevalence. No matter the sport or the method of delivery, this injury is one that causes a multitude of problems and time away from competition. More knowledge on prevention and rehabilitation of hamstring injuries is a focus of many pain management, orthopedic massage and sports medicine practitioners.References
1. Heiderscheit B, et al. Hamstring Strain Injuries: Recommendations for Diagnosis, Rehabilitation and Injury Prevention. J Orthop Sports Phys Therapy. 2010 February; 40(2):67-81
2. Hammer, Warren. Functional Soft-Tissue Examination and Treatment by Manual Methods. Sudbury,
Saturday, June 18, 2011
Tuesday, June 14, 2011
Monday, June 13, 2011
Friday, June 10, 2011
Revive Therapeutic Massage: A Great way to deal with problems
Revive Therapeutic Massage: A Great way to deal with problems: "I had a small, five-minute meeting with a very wise man named Jeffrey Jacobs Christakos about the financial well-being segment of 'Wake U..."
A Great way to deal with problems
I had a small, five-minute meeting with a very wise man named Jeffrey Jacobs Christakos about the financial well-being segment of "Wake Up To Wellness," and he told me something that was huge. Most people's downfall comes from doing what they think is right, rather than doing what is in their best interest, for life. He called this "looking at the whole picture of the puzzle box," I believe.
For example, in my case, I was planing to buy a house as an endgame. What this would do, however, is give me a huge monthly payment, which will take me away from my life goal of being a business owner and entrepreneur. So instead, he said I should do my life goal first, and that the house will fit itself into my life, as the house is a part of the puzzle, and not an endgame. Furthermore, he told me that to see the whole puzzle and realize the endgame is actually not what it is about--it is about the journey. Enjoy how you got there, and the rest will be a celebration.
This lesson also parallels an e-business course that I am taking as we speak. This course shown me that it is easy to see and fix problems. When you set a system to find and understand a problem, then you have the wherewithal to deal with it. Its very easy, as the course teaches: "treat work, life, and/or business (ie. the problem) like a client." Here's the rundown:
I have been implementing this method for a very long time with all my clients, but I am now putting it into my personal life as well, and I have noticed that huge changes are happening. It basically entails you just looking at the truth of the matter and dealing with it accordingly. Try it out, and it will surprise you how simple it really is!
For example, in my case, I was planing to buy a house as an endgame. What this would do, however, is give me a huge monthly payment, which will take me away from my life goal of being a business owner and entrepreneur. So instead, he said I should do my life goal first, and that the house will fit itself into my life, as the house is a part of the puzzle, and not an endgame. Furthermore, he told me that to see the whole puzzle and realize the endgame is actually not what it is about--it is about the journey. Enjoy how you got there, and the rest will be a celebration.
This lesson also parallels an e-business course that I am taking as we speak. This course shown me that it is easy to see and fix problems. When you set a system to find and understand a problem, then you have the wherewithal to deal with it. Its very easy, as the course teaches: "treat work, life, and/or business (ie. the problem) like a client." Here's the rundown:
| 1. | Assessment: Determine what's wrong with the patient and decide on what ultimate goal or outcome the patient would like to achieve. |
| 2. | Plan: Put together an action plan for the patient by asking yourself: "what do I need to do to move the patient from where they are to where they want to be? What things do I have to do to get improvements for the patient in the short-term, and what things will I have to do to reach the long-term goals for the patient?" |
| 3. | Implementation: Implement your plan. You have to take some action if you want to see some results. Try various techniques that you feel are appropriate for the patient and that fit into your plan. |
| 4. | Reassessment: This is an important and often neglected step. Look at what results were achieved for the patient. If you didn't reach your goal, then think back through the process to determine what worked and what didn't. Did you fail to assess the problem properly? Was the outcome unrealistic? Was there a problem with your plan or approach? Did you take the necessary actions or did you try to take shortcuts? Go through the process again from Step 1 with this new information. |
I have been implementing this method for a very long time with all my clients, but I am now putting it into my personal life as well, and I have noticed that huge changes are happening. It basically entails you just looking at the truth of the matter and dealing with it accordingly. Try it out, and it will surprise you how simple it really is!
Monday, June 6, 2011
Revive Therapeutic Massage: How Body Workers Get Defeated
Revive Therapeutic Massage: How Body Workers Get Defeated: "The greatest enemy to massage therapists and all body workers is themselves. We could be the best at what we do, but if we execute it withou..."
How Body Workers Get Defeated
The greatest enemy to massage therapists and all body workers is themselves. We could be the best at what we do, but if we execute it without grace it will backfire on us all the time. The body is hardwired to defend itself and governed by a super-computer; so, we have to understand that we can not beat this system. Instead, we must try to understand this system, and get it to realize what is going on inside--not giving it a beating just because that “works.” Every therapy works, but the majority of them will get recycled into a better defensive cycle of the system. So the next time you try that same trick you forced on it before, it will probably not yield the same positive result.
We must understand this reality to get the body to cut us some slack and stop staying in a highly protective state. Understanding this should be our first objective--not finding trigger points and pressing as hard as we can because it makes the client squirm, or asking to be beat up in a deep tissue session for ourselves. This type of behavior makes the defensive pattern worse. For example: think about the body of a small child. He needs to be guided, and sometimes given a small push to learn something; he can never be forced to do anything! If forced, he will resent you for a very long time, and this resentment comes in the form of self-protection. Where you suspect that the body is doing something protective but are unsure if it is, chances are that it is. An example of this is when a client is unaware that she is holding up her leg as you ask her to drop it. These examples are signs of auto-protecting and/or child abuse.
We must understand this reality to get the body to cut us some slack and stop staying in a highly protective state. Understanding this should be our first objective--not finding trigger points and pressing as hard as we can because it makes the client squirm, or asking to be beat up in a deep tissue session for ourselves. This type of behavior makes the defensive pattern worse. For example: think about the body of a small child. He needs to be guided, and sometimes given a small push to learn something; he can never be forced to do anything! If forced, he will resent you for a very long time, and this resentment comes in the form of self-protection. Where you suspect that the body is doing something protective but are unsure if it is, chances are that it is. An example of this is when a client is unaware that she is holding up her leg as you ask her to drop it. These examples are signs of auto-protecting and/or child abuse.
A while back I had a client that had no clue how his body was feeling when he laid down on the massage table. During the session, I would be on a spot and ask him how it felt, and he would respond: “fine.” Moments later, the muscle I was holding began to recoil into a tight ball, and I asked again “does this hurt?” He said “no,” so I asked him, “do you see how your body is running away from me?” He blinked and said, “Huh, wow. It is doing that.” This is the body protecting itself without the client being aware. Therefore, we need to stop diving in and making people squirm just because you can. Yes that way works, but produces a short term gain in exchange for a long term loss.
So where can we go from here? What we can do is play with that area. Let’s take a trigger point, for example. The muscle with a trigger point can refer pain somewhere else, but we need to resist the temptation to grab at it. Instead, we should back off, feeling lightly on it to look for when that specific muscle begins to push back, and then wait or stop because that is it for now. The feeling we are looking for is very subtle push back. Imagine the muscle is a damp sponge. The correct massage technique feels like this to you: you want to push gently on the sponge to the point when the water starts to trickle out of it. When you learn that push, you will be able to get an area of the body and/or a particular muscle to clear so much quicker and with less backlash.
Revive Therapeutic Massage: Revive Therapeutic Massage: Silence Is Bliss
Revive Therapeutic Massage: Revive Therapeutic Massage: Silence Is Bliss: "Revive Therapeutic Massage: Silence Is Bliss : 'The answer to the last question was that I need to realize that if I am that driven or cont..."
Saturday, June 4, 2011
Revive Therapeutic Massage: Silence Is Bliss
Revive Therapeutic Massage: Silence Is Bliss: "The answer to the last question was that I need to realize that if I am that driven or controlled by my thoughts, then my ego is in play an..."
Silence Is Bliss
The answer to the last question was that I need to realize that if I am that driven or controlled by my thoughts, then my ego is in play and is taking over.
I realized this at 5:00 AM during meditation, where I heard words that gave me clarity.
DO YOU KNOW YOUR EGO
By the end of the day mind was much more at ease, and now I just have to practice do this.
I realized this at 5:00 AM during meditation, where I heard words that gave me clarity.
DO YOU KNOW YOUR EGO
By the end of the day mind was much more at ease, and now I just have to practice do this.
Friday, June 3, 2011
Doodoo Brown Cauliflower
So the day began with a sudden eye opening experience with a group I call the masterminds. This lovely group of men brought to my attention that I am a train wreck when it comes to writing using proper English grammar. As they proceeded to teach me how to properly write a blog, the experience turned into the scene in The Matrix 2 where there were a whole lot of people saying a bunch of different things all at once--but there was no cursing. (By the way, that movie was not that bad, everyone!)
I also realized that it is much harder controlling my thoughts with friends than with strangers. Why is that? Is it the first impression jitters, or is it just my comfort level? Or maybe it is like being able to fart in front of an old girl friend?
This conundrum preoccupied me so much that I found my self stud-daring with a client like a kid on prom night! Later on, I got a lovely text message from my wife stating: "Maybe you should blog about not paying any attention to anything... Way to buy doodoo brown cauliflower."
So the question I put out is this: How do I stay present and be fully aware of my thoughts without letting them spill out?
I also realized that it is much harder controlling my thoughts with friends than with strangers. Why is that? Is it the first impression jitters, or is it just my comfort level? Or maybe it is like being able to fart in front of an old girl friend?
This conundrum preoccupied me so much that I found my self stud-daring with a client like a kid on prom night! Later on, I got a lovely text message from my wife stating: "Maybe you should blog about not paying any attention to anything... Way to buy doodoo brown cauliflower."
So the question I put out is this: How do I stay present and be fully aware of my thoughts without letting them spill out?
Thursday, June 2, 2011
Revive Therapeutic Massage: Verbal Vomit
Revive Therapeutic Massage: Verbal Vomit: "Revive Therapeutic Massage: An experiment for empowerment and self improvement... : 'The problem came to my attention plenty of times from m..."
Wednesday, June 1, 2011
Verbal Vomit
Revive Therapeutic Massage: An experiment for empowerment and self improvement...: "The problem came to my attention plenty of times from my wife saying I speak to her in a way that makes her go crazy. In my head I just thou..."
Verbal Vomit
The problem came to my attention plenty of times from my wife saying that I speak to in a way that makes her go crazy. In my head I just thought I had made a point, but as time goes on and I started to watch and hear myself and it started to get clearer. I sounded kind of conceited, but that's not what I had intended. See I have a gift for seeing situations from a different angle and perspective. Usually these unique angles come true so I began stopping second guessing myself going with my first instinct. Now, as great as a gift this may be it goes really has the potential to go wrong when verbal vomit arises.What happens is I spit out everything in my head at once, and truth be told everyone is not ready to hear all of it at once! Here is where my experiment comes to fruition.
Experiment: Begining with one week to a month, posting to you everyday
1 Only speak when spoken to.
2. When I must speak has to be in a form of a question, no statements.
Both of these rules force me listen and elaborate only on topics that the client is ready to here. The goal here is to acclimate them to my thought process and not scare them off with loads of information.
Day One: As a massage therapist I have spent a great deal of time in my head planning for for the future. Problem with this is that all my thoughts hit me like a ton of bricks. I had three sessions today which went great therapy wise, but when it came to keeping my mind in check it was so damn hard to quiet my brain and speak with my hands. The toughest part of me bettering my self is allowing my self the time to slow down and present my information with a clear present direction.
So when is the right time to tell someone the answer their questions? Do I tell them as I move through my protocol, or do I wait till the end of it treatment and illuminate the changes in their body from the beginning to the end? Can I do it in a question form so that person understands what is going on better because he figured it out. That is what this is about folks I feel I am a power robber instead of helping people figure things out I just vomit it out at them. People learn ten times better when the experience it, if it is handed to them they are more likely to let it fall or forget it.
Any suggestions for day Two?
Experiment: Begining with one week to a month, posting to you everyday
1 Only speak when spoken to.
2. When I must speak has to be in a form of a question, no statements.
Both of these rules force me listen and elaborate only on topics that the client is ready to here. The goal here is to acclimate them to my thought process and not scare them off with loads of information.
Day One: As a massage therapist I have spent a great deal of time in my head planning for for the future. Problem with this is that all my thoughts hit me like a ton of bricks. I had three sessions today which went great therapy wise, but when it came to keeping my mind in check it was so damn hard to quiet my brain and speak with my hands. The toughest part of me bettering my self is allowing my self the time to slow down and present my information with a clear present direction.
So when is the right time to tell someone the answer their questions? Do I tell them as I move through my protocol, or do I wait till the end of it treatment and illuminate the changes in their body from the beginning to the end? Can I do it in a question form so that person understands what is going on better because he figured it out. That is what this is about folks I feel I am a power robber instead of helping people figure things out I just vomit it out at them. People learn ten times better when the experience it, if it is handed to them they are more likely to let it fall or forget it.
Any suggestions for day Two?
Revive Therapeutic Massage: Do People take better care of their cars than thei...
Revive Therapeutic Massage: Do People take better care of their cars than thei...: "Do People Take Better Care of Their Cars Than Their Bodies? Do people take better care of their cars than themselves? In order to ke..."
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