Cupping Therapy

Cupping therapy, a form of alternative medicine that dates back to ancient Egyptian, Chinese, and Middle Eastern cultures, involves placing cups on the skin to create negative pressure or suction. The suction facilitates healing with blood flow, and while it’s considered pseudoscience with questionable efficacy by the mainstream medical community, many people claim to benefit from the practice. 

I have found very profound benefits over my years of experience using a variation of cupping called Myofascial Decompression developed by Chistopher DaPrato, DPT, SCS, CSCS, MFDc.  I had the great fortune of being able to learn this technique from Chris.  It is different from standard cupping in that it uses active movements performed by the patient using the cupped muscle group.  This technique is VERY much more effective than stationary cupping.  Then I developed an even more effective technique with patients achieving an even greater positive response as part of my Silan System.   

There have been very few studies conducted on the subject so that may be why it is still perceived as pseudoscience and I summarize one below.  I have seen tremendous results but like every technique that exists, it only works for some people and never ALL.  There is no single technique that can fix all bodies!  That’s why it’s important to have an arsenal full of effective techniques and have the creativity to tailor treatment specific for each unique body and presentation!  That’s what I love about what I do-it keeps me having fun, and learning every day!!

Here are some of the advantages often attributed to the cupping method:

1. Pain Relief

One of the most touted benefits of cupping therapy is its potential to reduce pain, a claim supported by both historical anecdotes and some modern practitioners. It's believed that the suction from the cups can penetrate deep into the tissues, stimulating the body to release endorphins and other pain-relieving chemicals. People have sought cupping therapy for relief from headaches, migraines, dental pain, muscle pain, and rheumatic diseases.

2. Promotes Tissue Change

The process of cupping can be painful for many individuals. But the benefit to your tissues can be powerful!  I always re-test after every intervention to ensure it’s effectiveness.  The overall relaxation response of the tissues can help reduce stress and tension, which is a significant contributor to a variety of health issues.

3. Enhances Circulation

By pulling blood to the area where the cups are placed, cupping therapy is believed to enhance circulation. Improved blood flow can facilitate healing and reduce muscle tension, leading to healthier skin and muscles, faster recovery from muscle fatigue, and reduced inflammation.

4. Detoxification

Advocates for cupping therapy suggest that it can help detoxify the body. The theory is that by drawing blood and fluids to the surface, the method aids in removing harmful substances and toxins from the tissues. It’s recommended to drink plenty of water post-session to help flush away these substances.

5. Skin Health Improvement

Cupping is often said to improve skin health by increasing blood flow and possibly improving the efficacy of the body's natural methods for skin rejuvenation. It has been used to treat acne, eczema, and cellulite, with the increased circulation purportedly aiding in nutrient delivery and toxin removal.

6. Relief from Respiratory Conditions

Historically, cupping has been used to help with respiratory conditions such as the common cold, pneumonia, and bronchitis. The theory is that cupping helps improve immune function by moving blood and lymphatic fluid, thereby aiding in the removal of pathogens.  I have had asthma patients noticeably breathing better after many kinds of myofascial release including cupping with movement.

7. Stimulation of Digestive System

Cupping therapy applied to certain areas of the body can stimulate the digestive organs, potentially improving digestion. It may help alleviate symptoms of common digestive disorders, including irritable bowel syndrome (IBS) and bloating.

In the research: ACUTE OUTCOMES OF MYOFASCIAL DECOMPRESSION (MFD, or CUPPING THERAPY) compared TO SELF-MYOFASCIAL RELEASE ON HAMSTRING PATHOLOGY AFTER A SINGLE TREATMENT

In this study, researchers compared two forms of hamstring treatment including cupping therapy. The results found that “A significant difference was found in favor of the MFD group”.

Conclusion

While cupping therapy offers several potential advantages and has a long history of use in various cultures, it's important to approach it with a critical eye and consult healthcare professionals before trying it, especially if you have skin conditions, blood disorders, or are pregnant. Scientific research on cupping therapy is limited, and its effectiveness and mechanisms are still under investigation.

People around the world find relief and benefit from incorporating cupping into their wellness routines, especially when used alongside conventional medical treatments. Plus, it has the added bonus of self treatment: you can get yourself a set of cups and continue the therapy at home once you learn for it’s done!

Unlocking Self Soft Tissue Mobilization with a Tennis Ball: Your DIY Massage Solution (Part 2)

Glutes and Hamstrings Edition

In the realm of self-care and fitness, the use of props for self-massage and soft tissue mobilization has gained immense popularity. From foam rollers to massage balls, these tools offer a cost-effective and convenient way to relieve muscle tension, improve flexibility, and promote overall well-being. Among these tools, one humble item stands out for its versatility and effectiveness: the tennis ball.

While primarily known for its role in sports, the tennis ball can serve as an excellent tool for self-soft tissue mobilization against a wall. Whether you're an athlete recovering from a tough workout, an office worker battling postural stress, or simply someone seeking relief from everyday aches and pains, incorporating tennis ball massage into your routine can work wonders. Let's delve into how you can harness the power of this simple yet effective tool for self-care.

Understanding Soft Tissue Mobilization

Before we dive into the techniques, let's briefly understand what soft tissue mobilization entails. Soft tissues include muscles, tendons, ligaments, and fascia, all of which can become tight, knotted, or restricted due to various factors such as overuse, poor posture, or injury. Soft tissue mobilization techniques aim to release tension, break up adhesions, and improve blood flow to promote tissue health and flexibility.

Benefits of Tennis Ball Self-Massage

• Targeted Relief: Tennis balls allow you to apply targeted pressure to specific areas of tension or discomfort, providing localized relief.

• Cost-Effective: Tennis balls are inexpensive and readily available, making them a budget-friendly option for self-massage.

• Versatility: You can adjust the intensity of the massage by varying the pressure you apply and by targeting different muscle groups.  You do this by either standing more upright to provide less pressure or leaning into the wall to get more pressure!

• Convenience: Whether at home, in the office, or on the go, all you need is a tennis ball and a wall to perform these self-massage techniques.

Techniques for Tennis Ball Self-Massage

GLUTE (buttock) RELEASE

• Place the tennis ball between the back of your hip and the wall.

• Lean against the ball and move your body to roll it along the muscles of your lower back.

• Focus on areas of tension by swaying side to side on the ball and bending and straightening your knees to move up and down on the ball.

• Make sure to rotate to get the side of your hip glute muscles as well.

• Go right up to the bone that sticks out on your pelvis in the front right and left sides.

Gluteus maximus and Gluteus medius

• Hamstring Release

• Sit on a chair with a tennis ball positioned under one hamstring.

• Apply pressure by pressing down on the ball with the weight of your leg and roll it along the length of the muscle by moving your knee in and out. 

• Make sure to place the ball first toward the middle of your leg starting at the just down your leg from the sit bone and move your knee side to side for as long as feels appropriate. 

• Move the ball down and towards the inside of your leg just an inch or so for as long as feels appropriate once you feel that you are on a ropey muscle. 

• Follow the muscle down the leg by bringing the ball down in about one inch increments then moving the knee side to side, causing the ball to go from one side of the ropey muscle to the other for as long as feels appropriate. 

• Adjust the ball to the outside portion of your thigh where you will start at the top near the sit bone, and work your way down the outside of your leg in one inch increments until you run out of chair or get to your knee.

Hamstrings

Precautions

• Moderation: Avoid applying excessive pressure, especially if you're new to self-massage. Start with gentle pressure and gradually increase as needed.

• Avoid Bony Areas: Avoid placing the tennis ball directly on bony prominences or sensitive areas.

• Listen to Your Body: If you experience any sharp pain or discomfort, stop immediately and reassess your technique.

Conclusion

Incorporating tennis ball self-massage into your routine can be a game-changer for your physical well-being. By targeting specific areas of tension and discomfort, you can alleviate muscle tightness, improve flexibility, and enhance overall relaxation. Remember to start slowly, listen to your body, and adjust the pressure as needed. With regular practice, you'll discover the therapeutic benefits of this simple yet effective self-care tool. So, grab a tennis ball, find a chair, and treat yourself to the soothing relief of self-soft tissue mobilization massage. Your body will thank you for it!

Transversus abdominis training - your core activated!

The transversus abdominus muscle acts as your body's natural corset. It extends from your sternum to pubic bone in the front, all the way along the bottom of your ribcage and the top of your pelvis in the front. It wraps around both sides of your torso along the bottom of your ribs and along the ridge of your pelvis and blends into a super strong, girdling connective tissue structure along both sides of the spine at the mid and low back called the thoracolumbar fascia. 

This offers tremendous support for your spine-as long as you can make that muscle fire when needed! But if you are experiencing back pain, your corset muscle is inhibited and disengaged-unable to work for you through your movements throughout the day. Let's wake it up!

In a sitting position, bring your fingers to the bones that stick out in the front of your pelvis. Bring your fingers in towards your midline an inch and an inch down towards your pubic bone. Allow your fingers to gently rest on your abdomen and put your feelers on, you want to sense what is going on in the tissue underlying them. 

Envision the area below your belly button and above your pubic bone. Think about those muscles just under your skin and the tissue lying just under your skin drawing in away from your fingers. You are trying to tighten those muscles underneath your fingers in such a way that you feel your abdominal contents drawing in away from your fingers. 

You may feel, simply, a tightening of your abdominal muscles and not an actual retreat away from the fingers. If you feel your abdominal muscles tightening under you and or a drawing away from your fingers, you have just engaged your transversus abdominis (TA)! But if you feel the abdominal contents pushing out, or, the abdominal muscles pushing out against your fingers, you are engaging your abdominal obliques muscles and NOT the TA. This contraction will not be helpful to stabilize your low back and can even be detrimental to your bladder. This contraction can cause undue pressure on the bladder. It is critical that you feel the abdominal muscles drawing in. 

If you are having difficulty feeling this drawing in contraction of the muscle, please let me know so I can help you engage the correct muscles!

Now try engaging your TA while standing. See if you feel the same thing happening. If you are feeling your abdominal contents / abdominal muscles pushing out against your fingers, let me know so we can learn how to engage your TA instead of your obliques. 

Here's the best part of being able to recruit your natural corset, the TA. You now can engage this muscle for support for your spine when you need it! You just draw in, contracting those TA muscles just before you move, say, when bending down to get something off the floor, rising from a chair, getting in/out of a car, or making a reach out to the side of you for something, any transition or movement that you think may or usually does hurt as you do it. Use this as the valuable tool that it is. 

Practice it often so it becomes natural for your body to do before attempting these movements!

There was an important study performed a long while ago that I often mention to my low back pain patients. Scientists took a study group and divided them in half, low back pain patients in one group and non low back pain people in another. They fitted them with devices in order to read what muscles were working. They then threw them a ball and in the non low back pain group, the very first muscle to engage was the TA. Not the arm muscles that we sense as having moved first. Instead, it was the protective and supportive TA! In the low back pain group, the TA NEVER came in. 

Using this study and many others Physical Therapists came to understand that low back pain inhibits the TA muscle. It is essentially taken off the brain's radar. Your natural corset is no longer engaging when you need it most! So the TA does not need so much strength as it does activation and engagement to help you. “Strengthening” your core is not as important as ENGAGING your core or ACTIVATING your core. If the TA comes in when you need it, it will keep your spine supported. 

Perfect practice makes perfect: never assume it is engaging correctly. Check yourself using the above method every now and again in the future, more often, many times per day as you are trying to get the brain to engage it! 

It doesn’t take any extra time out of your day, it just requires a little attention throughout your day as you go about your regular activities. It can be performed every time you go to the bathroom or take a drink of water in your day! It can be performed in any position, and should be, to make sure it engages in all positions you are in in your day! You need to RE-TRAIN your brain to muscle pathway and reinforce it often so that firing your TA becomes part of the way you move. Use it as the powerful game-changer that it is!! 

What fires together, wires together!

Unlocking Self Soft Tissue Mobilization with a Tennis Ball: Your DIY Massage Solution (Part 1)

Lower Back and Hips-Hip Flexors Edition

In the realm of self-care and fitness, the use of props for self-massage and soft tissue mobilization has gained immense popularity. From foam rollers to massage balls, these tools offer a cost-effective and convenient way to relieve muscle tension, improve flexibility, and promote overall well-being. Among these tools, one humble item stands out for its versatility and effectiveness: the tennis ball.

While primarily known for its role in sports, the tennis ball can serve as an excellent tool for self-soft tissue mobilization against a wall. Whether you're an athlete recovering from a tough workout, an office worker battling postural stress, or simply someone seeking relief from everyday aches and pains, incorporating tennis ball massage into your routine can work wonders. Let's delve into how you can harness the power of this simple yet effective tool for self-care.

Understanding Soft Tissue Mobilization

Before we dive into the techniques, let's briefly understand what soft tissue mobilization entails. Soft tissues include muscles, tendons, ligaments, and fascia, all of which can become tight, knotted, or restricted due to various factors such as overuse, poor posture, or injury. Soft tissue mobilization techniques aim to release tension, break up adhesions, and improve blood flow to promote tissue health and flexibility.

Benefits of Tennis Ball Self-Massage

• Targeted Relief: Tennis balls allow you to apply targeted pressure to specific areas of tension or discomfort, providing localized relief.

• Cost-Effective: Tennis balls are inexpensive and readily available, making them a budget-friendly option for self-massage.

• Versatility: You can adjust the intensity of the massage by varying the pressure you apply and by targeting different muscle groups.  You do this by either standing more upright to provide less pressure or leaning into the wall to get more pressure!

• Convenience: Whether at home, in the office, or on the go, all you need is a tennis ball and a wall to perform these self-massage techniques.

Techniques for Tennis Ball Self-Massage

Lower Back 

• Lower Back Release: Place the tennis ball between your lower back and the wall.

• Lean against the ball and move your body to roll it along the muscles of your lower back, focusing on areas of tension by swaying side to side on the ball and bending and straightening your knees to move up and down on the ball. 

• Spend however long feels right and relieves your tension then move the ball down your back. 

• Then, work on the other side.

• Hips-Hip Flexors

• Hip Flexor Release: Lying on your stomach, place the tennis ball under one hip flexor.

• Apply pressure by leaning your body weight onto the ball and gently roll it along the length of the muscle from the bones that stick out in the front of your pelvis to the bones that stick out on the sides of your hips. 

• From there it can feel very intense to switch to a sidelying position so I recommend coming back to the wall. 

• Stand against a wall with a tennis ball placed between your outer thigh and the wall. 

• Rotate around to keep the ball in place and get all of your iliotibial band-the dense tendon along the outer thigh.  

Precautions

• Moderation: Avoid applying excessive pressure, especially if you're new to self-massage. Start with gentle pressure and gradually increase as needed.

• Avoid Bony Areas: Avoid placing the tennis ball directly on bony prominences or sensitive areas.

• Listen to Your Body: If you experience any sharp pain or discomfort, stop immediately and reassess your technique.

Conclusion

Incorporating tennis ball self-massage into your routine can be a game-changer for your physical well-being. By targeting specific areas of tension and discomfort, you can alleviate muscle tightness, improve flexibility, and enhance overall relaxation. Remember to start slowly, listen to your body, and adjust the pressure as needed. With regular practice, you'll discover the therapeutic benefits of this simple yet effective self-care tool. So, grab a tennis ball, find a wall, and treat yourself to the soothing relief of self-soft tissue mobilization massage. Your body will thank you for it!

Un-do from your day

There’s a law proposed by a guru in Physical Therapy, Shirley Sahrmann that explains how low force over a long time creates strain.  Think about a “half full glass example” though not your standard one.  All of you can hold a half full glass with an outstretched arm in front of us for a moment, a minute perhaps, right?  But if we had to hold it all day?  That’s a different story!!   

So consider this scenario: we can all tolerate putting our heads forward to, say, look at the fine print on our computer or phone screen BUT if we end up in this position all day, every day due to poor posture then that’s a different case entirely.  That means anytime of day, all of the day, there is strain on those poor neck muscles and joints!  No wonder so many people complain of tension in the traps (the muscles between the neck and the shoulder)!  

So, the low force in above equation is the weight of our heads and sitting with our head forward will create considerable strain on the muscles around our necks.  The strain leads to one, or both, of two things: one, the muscle becomes shortened in that position of dysfunction, or two, the muscle creates abnormal restrictions within it, or tautness/thickness, within the muscles.  The abnormal shortness and/or restriction within the muscles eventually leads to injury and pain.  

Think about a typical desk job.  We sit at the desk, arms out in front of us on a keyboard for hours at a time, except for at our lunch hour when we move for a few minutes before we sit down again. When we get home, many of us choose to sit and watch TV, play on our phones, read or study.  We are depriving our bodies of the much needed movement needed to keep our tissues healthy throughout the day, then deprive it for more time with what we do when we get home!  

What we ALL need to do is UN-DO from whatever postures, positions and repetitive movements that we spend the day doing.  So, to un-do from a desk job, it may be that you take a walk on your lunch hour for 15 minutes, and when you get home for another 15mins. Then,  lay on your back over a big sized 55 or 65 cm therapy ball with your arms outstretched above your head to reverse the forward reaching of most activities that we do during our day.  Try it!  It feels delicious!!  

If you don’t have a therapy ball, you can at least stretch out the fronts of your shoulders, and get your arms back behind you, if you lie on your back with your head in the corner of your bed (works better with Queens or Kings) with outstretched arms overhead or, out to the sides, or, better yet, both!  Along with the position of un-doing, add some deep breaths and you may find yourself in a little bit of Heaven!

For those who are up moving around while at work, un-do by lying down when you get home with your legs bent or place them on the couch, or, over a bolster/roll/ball under knees and do some deep diaphragmatic breathing (if you are unclear on how to do this see my previous newsletter).  This is especially helpful for relieving low back pain! Your disks (the spongy stuff in between your vertebrae) can rehydrate in about 15 to 20 minutes according to a study I read years ago.

Plus, you experience the added bonus of this position creating very gentle decompression of the spinal segments of your low back!

Breathing for Better Health

Diaphragmatic breathing has been clinically proven to reduce blood pressure and promote relaxation but it can also soothe your nervous system!  One thing I have found in my years of clinical practice is that many people have difficulty recruiting their diaphragm and require some re-orientation and re-education to engage this vital muscle.  

This process is most easily performed in sitting. Are you in a relaxed and comfortable sitting position? Place one hand covering your lower ribs, one hand up at the top of your chest, and you're going to just take a deep breath.  And then think about where you feel that breath. Is it underneath your lower hand on your lower ribs? Or is it more or all felt with the hand that's at your chest?

Now on your next breath try to minimize the movement up at the top of your chest, and maximize it into the hand down below at your lower ribs. When you feel your breath movement at your only lower ribs and just a tiny bit or none at all at the top of the chest, YOU HAVE DONE A DIAPHRAGMATIC BREATH!!

That means that you are engaging the diaphragm muscle. You are taking in breath with your diaphragm muscle rather than using the muscles up around your neck and that attach onto your upper chest.  Those muscles around your neck and upper chest do NOT like to do someone else’s job-just like any of us!  The neck muscles attaching to your rib cage only want to be called in during breathing if there is a wild animal chasing you NOT with every breath you take in a day!  And they revolt!  If you find yourself with daily tightness in the muscles of your upper chest and neck, this may be why!  

If you can feel your breath only at the chest, try this PT trick: use both hands at your lower ribs and apply gentle pressure to the ribs.  Then release that pressure and at the same time try to breathe into your lower ribs with your hands still placed upon them. Often this will allow you to activate and engage your diaphragm.  

Once you have mastered the diaphragmatic breath, there's a little trick to the end of your exhale that will get you to fire your most important abdominal muscle, your transversus abdominis. Try another deep belly breath in.  Then exhale through pursed lips. and then I want you to go that extra little bit and just try and get it out with a little tuck of the belly and just try and bring your belly button towards your spine.  So you want to engage that as often as possible. 

It does take practice, but practice makes perfect, and perfect practice will make it so that you get relaxation, lower blood pressure, calming of your nervous system, and there's many other benefits. Those benefits are all very helpful things for you to heal! 

But if you can only feel your breath in the top of your chest, even after the trick I gave you, your diaphragm is disengaged from your brain, what we call in the Physical Therapy “business inhibited”.  It might be time for you to see a physical therapist so that you can work on muscle re-education since it is very important for your health to engage that diaphragm in so many ways! 

There are many ways to re-educate muscles and I find the process very fun!  So schedule today if you have trouble with your deep belly breath.  Your body will thank you!

Remember, your body has its own innate ability to heal, you just need to learn how!!

Rules of the Rep

In my 30 years of physical therapy, one of the most frequently asked questions is how many reps, or repetitions, should I do? And I've got the answer.

First of all, you should perform two to three sets of any given exercise to fatigue in order to get optimal strengthening. Rather than going by a count, a certain number of reps, you should work your muscle until it is giving you a signal that it has tired. Performing a certain number of repetitions may not offer as much challenge as is needed to produce a strengthening response, or it may present too much challenge and could lead to strain. Going by fatigue as your indicator for the number of reps you should do, takes into account how your body is feeling at THAT particular moment. Have you just performed a bodyweight exercise that pre-fatigued the muscle? Are you fighting off a virus and your immune system is BUSY healing you that day making you fatigue more quickly?

The rule goes like this: If the number of reps you are able to perform before your muscle fatigues are under eight repetitions, lower the weight or resistance. If the number of reps you are able to perform before your muscle fatigues are over 15, increase the weight or resistance. This way you progress your weight appropriately and over time increased strength happens!

Also, keep in mind the timeframe for strengthening: you can get some neurologic strength improvements within the first couple of weeks. For instance, an increase of muscle fibers being recruited because your brain “reconnects” with more fibers contributing to more weight being able to be moved. Actual muscle hypertrophy, or growth, happens more slowly, over six to eight weeks. Then, with steady progression of resistance, your muscles continue to become larger.

And always, always, always stay HYDRATED! I believe most injuries occur due to dehydration. Dehydration puts all of your tissues at a disadvantage and can place too much strain on the muscle tissue itself or on the neighboring joints and lead to injury! You won't necessarily feel thirsty right away and so you won’t feel the need to drink perhaps until it’s too late. We always need to hydrate before we need it! So it’s best to keep sipping frequently from your water bottle, especially before, during and after workouts. This is KEY for injury prevention! Keep in mind that it is rather difficult for us to drink too much water but it CAN happen and it’s fatal!

Pain Relief Seminar 2/29/24

Suffering from pain? Come find out how you can receive some relief with Therapeutic Connection's Carolyn Silan, PT, CEO, CEAS, CSCS (R).

What: Pain Relief Seminar

When: 2/29/24 5:30-6:30pm

Where: OHANA ROOM, 68-1792 Melia St, Waikoloa HI 96738. Ohana Room is located in the front of Johnny's Restaurant

Please RSVP on Facebook or use the button below. This will be an interactive seminar with proven methods to get relief of your pain without needing to rely on medications.

Therapeutic Connection offers Physical Therapy In-Home and in the clinic in Waikoloa. In-home Personal Training and Aquatic Therapy are also offered. We are experts in multiple specialties.

Find out more at www.TherapeuticConnection.com

Stretching for Results!

I just found the Hyperbolic Stretching program on Facebook. On his website you can see impressive results with people of all ages having gone from super inflexible in their “before” videos to “in the splits” in their “after” videos! Turns out, the founder, Alex Larsson, uses the same method for stretching in order to gain flexibility as I do with my patients.  

Over the past few years I started using this method of stretching for myself, found out how effective it was, and restarted using it with my patients with very good success! 

I had learned it years ago but it is time-intensive to instruct someone about how to perform it. I stopped using it as Physical Therapy evolved into patient visits becoming shorter and shorter (this is part of the reason Therapeutic Connection has hour-long, one-on-one sessions with the Therapist-I want more time with my patients so I can teach and help them more!).  

The method is called contract relax stretching and, also, erroneously, called PNF stretching. PNF stands for Proprioceptive Neuromuscular Facilitation. PNF is much more than just contract relax stretching!  It is a rich and effective therapeutic approach that uses nerve impulses to recruit muscles through stimulation of The receptors in your muscles and tendons in addition to other sensory stimuli (tactile, visual or verbal).  

I love using PNF techniques, including contract-relax stretching, with my patients to gain strength, flexibility and greater motor control. 

Text Neck Syndrome

You could be destroying your neck one text, or video/post/reel/etc at a time!

If you are looking down at your phone like the photo above, you are placing undue strain on your neck joints!!! If you are holding your phone as shown in the photo below, it will place strain on your bicep tendon but that tissue is designed to handle the workload (unless you are currently experiencing tendonitis in your bicep and then it will hurt to do this-and it’s time for some Physical Therapy). Even better for your neck and bicep is to place your forearm on a padded, supportive surface or use a phone holder of some sort when you will be looking at your phone for extended periods of time!

Our craniums weigh about 10-12 pounds when in a neutral posture position. But with every 15 degrees of forward bend at your neck the weight placed upon your neck joints goes up and up: 27 pounds at 15 degrees, 40 pounds at 30 degrees, 49 at 45 degrees and a whopping 60 pounds at 60 degrees which is about all that most necks can bend. How often do we see teenagers at the bus stop with fully bent necks looking at their phone? Their poor necks! Especially since they often assume this position while also slouching in their mid-back worsening the strain on their necks.

So, be KIND to your SPINE and keep a giant bouquet of helium filled balloons attached to the top of your head instead of a sack of stones! Good posture is key for neck health! No one likes a pain in the neck!

My opinion on PT “Science”

I came across this article from the New York Times “What to Look for in a Physical Therapist,” and love this line:

When compared head-to-head, active exercise-based therapies are both less expensive and more effective than passive ones. In some instances, exercise is even as effective as surgery.

I encourage you to take a look at this article though I disagree with it in important ways!  The science that has been done historically was very flawed and to some degree I disagree with the premise of all research involving bodies. 

It is presumed that all people move in the same way and all people respond to treatment interventions in the same way and this is simply not the case.  What works for one person often does not work for the next.  Or even different areas of one body will respond to specific interventions differently. 

Take ultrasound, for example.  I have used it throughout my 30 years of practice.  If ultrasound is used when there are very dense areas of myofascial restrictions it CAN work extremely effectively.  I know from personal experience as well as professional experience since I always test the tissue feel before and after.  Some of my patients have been helped A LOT by it!  Ultrasound, or any other intervention for that matter, will not be effective 100% of the time.  That is why PTs need a host of interventions to be truly effective.  If ultrasound is used without first evaluating that there is need for it, as was often done in research studies, and continues to be performed as a matter of course, rather than need, in many PT clinics (the ones using "anecdote" as the article suggests). 

Take studies done on the "effectiveness" of specific exercises for strengthening specific muscle groups.  Here to, there is so much variation in movement patterns between people and there is so much affecting movement patterns such as habit/muscle memory, posture,  muscle inhibition and weakness, short muscles, joint mechanics, environmental constraints, etc, to have one specific exercise be effectively strengthening a specific muscle in all cases. 

If you are not looking at the bigger picture of what a body is subjected to over and over again, day after day, and evaluating how that particular person is moving in their unique way, then PT will be limited in effectiveness even if you are using evidenced-based practices. 

Fascia Care 101

Have you heard about fascia? As a Physical Therapist, many of my patients have never heard of fascia and don’t realize how important it is to relieving their pain. I recently read this great article in the New York Times and I thought…FINALLY…fascia is getting the attention it deserves!  If you are experiencing PAIN, read on!  This quote particularly spoke to me and the work I do with patients: 

““When you’re sedentary for a long time, fascia can shorten, become overly rigid and congeal into place, forming adhesions that limit mobility, said David Krause, a physical therapist at the Mayo Clinic…Fascia can also become damaged from repetitive movements, chronic stress, injury or surgery — becoming inflamed, overly rigid or stuck together. And it stiffens with age.”

The article explains what fascia is and how it becomes restricted with inactivity, but there’s much more to the fascia story that I want to share with you here.

Fascia is the spider-webby stuff that holds us together and covers our muscles. This connective tissue lies within our muscles as well. And it can get gunky like the oil in your car.  And here’s the great news: you can get that oil changed just like in your car.  That’s where myofascial release techniques enter the picture (among other things)!

Myofascial restriction is responsible for a lot of painful conditions in our bodies. Myo- refers to our muscles and fascia refers to the connective tissue that lies within and surrounds our muscles.  Restrictions within this tissue often come about due to inactivity but can also stem from overuse, injury or disease processes. 

These restrictions can be painful in, and of, themselves but also can cause muscles to become inhibited rendering them weak when, in fact, they may have simply been taken off the brain's radar so to speak. Our brains are designed to use what is strong and ignore what is weak. When too much myofascial restriction “strangles” a muscle, it can become incapable of functioning normally and it performs weakly.  Then, it doesn’t get used because the brain chooses to use muscles that are strong, not those muscles that are weak, and so the cycle goes.  This process forms the cornerstone for my unique approach to treatment.  

When you combine a host of myofascial release techniques, as I do when I treat my patients, you have a good start for a recipe for healing and getting past pain.  When fascia becomes restricted, stretches are rendered ineffective.  Your muscles may still gain something from stretching but your fascia does not respond as well to stretching as your muscles do.  Fascia does, however, respond very well to techniques like Myofascial Decompression (T symbol here)(cupping with movement), Kinesiotaping, ultrasound, and Trigger Point Therapy.  But, further complicating matters, sometimes the lack of movement in the area of myofascial restrictions causes your body to develop stiffness in your joints from them not moving normally.  Your Physical Therapist needs to get them moving again using joint mobilization in addition to myofascial release techniques to get you feeling your BEST!  

You can get relief from both myofascial and joint restriction with the right Manual Therapy treatment techniques, properly applied.  Even if pain and stiffness have been a problem for you for years! The combination of myofascial and joint mobilization when combined with movement is the perfect recipe for healing most painful conditions and then well-chosen exercises will help keep the tissues moving smoothly.  Relief is expected even with seemingly unrelated conditions such as pelvic health issues, headache, vertigo, even visual disturbance can all be helped, if not fully resolved, with Manual Therapy and Therapeutic Exercise.  Sometimes myofascial restrictions can even cause nerve entrapment and be the cause of altered sensation.  For example, carpal tunnel syndrome is typically the result of the median nerve being hung up as it makes it’s way through the many muscles and joints from the neck through the arm, not simply just at the carpal tunnel. This is why symptoms often persist even after Carpal Tunnel Release surgery.

If you’d like to learn more about your fascia and see how Physical Therapy might help you, contact us today!