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ARE YOU OUT?

How many times I’ve heard a client say: “I have one leg shorter than the other,” I can’t count.

Or there’s, “my hips are out and the therapist tugs on my leg to fix it.”

What exactly are us therapists doing when we pull your leg? What we’re up to is actually a form of manipulation that’s supposed to target the sacroiliac joint (SIJ), where the tailbone (sacrum) meets the pelvis, wing-like bones (innominants). 

I will admit this was a technique I used frequently to help correct my client’s pelvis misalignments. 

I’ve even had it done to my own. The trouble with this is when clients tell me they need to keep having it done, because it keeps going out. 

WHY ARE YOU OUT? 

The pelvis (sacrum or tailbone and the pelvic bones or innominants) has two forms of stability. 

1. STATIC STABILITY, which comes from the shape of the bones and how snugly they fit together as well as the tough ligaments like duct tape holding them firmly in place.

2. DYNAMIC STABILITY, which comes from the muscles and how they pull on the pelvic bones. 

WHAT MUSCLES?

Muscles can have an effect on your pelvis including the muscles at the front of the thigh (quadriceps, tensor fascia lata), the inner thigh muscles, the back of the thigh muscles (hamstrings), the buttock or gluteal muscles, the back muscles, and even some of the shoulder muscles (the lattissimus dorsi, which is a huge muscle coming from the front of the shoulder down into the lower back). 

CHECKING THE PELVIS

I check the alignment of the pelvis on most of my clients who come in for an assessment. 

I had one client who came in for a calf strain as she was training for a half-marathon.  After releasing the calf tightness and following the line of muscle tension up the hamstring to the pelvis, I soon discovered she had significant muscle tightness and stiffness in the left upper thoracic spine (mid-back between the shoulder blades). 

The stiffness was one-sided, so I asked if she had ever been in a car accident (one where because of the shoulder strap crossing over one shoulder only, there may have been a twisting trauma). 

In fact, she had…20 years ago. 

IS THE PELVIS STUCK OR IS IT JUST MUSCLE?

One of the things I learnt from physiotherapist Dianne Lee http://dianelee.ca/ (be sure to check her website for more educational information) is how to better determine what muscles might be contributing to the problem at the pelvis.

Why are you out? This is the question I ask myself. So, I feel how the joint itself is sliding and gliding. Sometimes I feel a stiffness like I am pushing against a brick wall (the joint itself is stuck). Other times (which is actually most of the time) I feel a resistance that resembles trying to push against a mattress spring. This to me is indicative of a tense muscle causing the joint to lose its mobility. In any case, the treatment technique is different. 

With the stiff joint, I will manipulate it (which might be tugging on your leg). With restriction from muscles, I use Intramuscular Stimulation (IMS) http://istop.org/.

COMMON TRAINING ERRORS

One of the biggest training mistakes I see is over-working of the quadriceps (front thigh muscles).  People run, bike, play hockey, then go to the gym and blast the quadriceps more with squats, squat jumps and lunges. 

Tension in the quadriceps builds and has the tendency to pull the pelvis bone (wing innominant) forwards. This then puts strain on the back opposite (antagonistic) muscles, the hamstrings, which can then contribute to a hamstring strain or pull. 

You can see what I’m getting at. It’s all about muscle balance.

DO I NEED STABILITY EXERCISES?

In my honest opinion, everyone can benefit from exercises that focus on stability around the pelvis. It connects the lower half to the upper half. 

There are people who have injured the strong ligaments (after childbirth is one example) that support the pelvis and need to work on regaining the muscle stability. 

There are specific tests we can do to determine if you will benefit from these exercises and if you need extra support (core shorts are what I use).  

When retraining the pelvic muscles, PT Dianne Lee distinguishes the inner core from the outer core. 

Hold tight for more on this in my next blog entry.

So for now, if you are someone who continually needs to have his/her leg tugged on to re-align the pelvis, it’s time to look at whether the SIJ is too loose and needing extra stability or whether it’s a matter of muscle imbalances around the hip and pelvis (or up at the shoulder) that need to be released and stretched. 

It’s time to look for the why (see my earlier blog on our “bullies”) rather than treating the symptom (victim).

IF YOU’RE MOTIVATED:

Read more from physiotherapist Dianne Lee: http://dianelee.ca/

Find out more about IMS: www.istop.org/

Read Wendy’s earlier blog on discovering our bullies: http://bit.ly/qjUCY0

We’re online in every place imaginable! Surf our website www.startlinephysiotherapy.com, then be our friend by moseying on over to our Facebook or Twitter sites by hitting the link there. To book an appointment at Start Line, call the clinic at 250-746-7463.

I was out kayaking yesterday morning bright and early from 6 to 8 a.m. 

One of the things that happens when I’m out without anyone around on a calm day is my mind will think. But it’s not the wounded up thinking that happens when I’m at work, trying to keep to a schedule. It’s more a meditative type.

WINDING UP

We live in such a fast-paced society now a days. We get up and rush to get ready for work. You have to get your children ready for school before getting yourself ready. Some mornings I’m just getting myself out the door on time, so it’s hard to imagine adding children to the equation. I’d have to get up earlier ( isn’t 4:30 a.m. early enough?) or substitute journaling and meditation (which contradicts my self care plan). 

So maybe you do what my friend did and consider home-schooling your children. 

She doesn’t have to rush in the mornings unless she’s scheduled an appointment. 

UNWINDING

Kayaking slows things down. It’s meditative in nature (pardon the pun) but it’s nature that I love the most. I listened to the seagulls rising with the sun. I had two sea otters pop up in front of my kayak and stare inquisitively. I sat still for over 10 minutes and watched a heron patiently wait for its breakfast – waiting patiently (very Tao). 

The rhythmic nature of the paddling got me thinking about an information session I just listened to on pain management. It’s about 45 minutes, so only follow the link (at the bottom of this post) if you have 45 minutes. 

IF YOU DON’T, HERE’S A SUMMARY

1. We can change pain by shifting our beliefs and attitudes towards pain and people suffering with pain (by removing the barriers).

2. Learn self management.

3. Pain doesn’t always mean damage to the body (it hurts but there is no harm).

4. Pain changes everything (tissues, body chemistry, cells, emotions, thinking, breathing, posture, sense of self and relationships).

5. Number one treatment according to scientific evidence is combined cognitive behavioural therapy and exercise.

6. Chronic pain conditions are closely related to hypersensitive nervous systems.

7. Treatment programs need to take advantage of neuroplasticity.  

8. With chronic pain, the nervous system develops a Learned Helplessness.

9. The body’s image becomes distorted with chronic pain.

10. Desensitizing the nervous system, with the altered body schema/image, through visualization, meditation, rhythmic activities, breathing, yoga, touch, and/or hot or cold application.

11. Breathing: a very powerful way of calming the nervous system – practise five minutes, five times daily for four to six weeks.

12. SET GOALS – so you have something to work towards. These should be achievable with a timeframe to achieve them.

It is possible to change the nervous system

It takes time, persistence and consistent practice

IF YOU’RE MOTIVATED:

Pain management session: http://www.vimeo.com/28165279

 Neuroplasticity: http://en.wikipedia.org/wiki/Neuroplasticity

A great book on neuroplasticity: The Brain That Changes Itself by Norman Doidge, MD: http://www.normandoidge.com/normandoidge/MAIN.html

We’re online in every place imaginable! Surf our website www.startlinephysiotherapy.com, then be our friend by moseying on over to our Facebook or Twitter sites by hitting the link there. To book an appointment at Start Line, call the clinic at 250-746-7463.

Have you ever wondered why some people heal from an injury and why someone else might not? 

Have you ever wondered why you’re experiencing repetitive injuries or pain in certain areas of your body?

Wendy has been doing more and more reading on the mind-body connection. 

Some of her favourites include Carolyn Myss’s Anatomy of the Spirit, Bruce Lipton’s Biology of Belief and most recently, Louise Hay’s You Can Heal Your Life.  

MOVERS AND SHAKERS

In June, Wendy attended a Mover and Shaker’s workshop put on by Cheryl Richardson and Hayhouse. Part of the homework was to put together a book proposal and/or a 5-7 minute video with a message. 

Wendy focused on the mind-body connection in a video. To have a boo, go to the video section on our blog or search for it on YouTube under ‘Start Line Physiotherapy.’ 

Remember we are more than just our physical bodies. Our feelings and emotions can be reflected through our bodies. If we don’t listen, the volume (pain you experience) gets turned up.

I’ve recently been having to explain to clients the difference between having joints that are nice and snug versus joints that are too loose. A joint is where two bones come together. Most joints are surrounded by strong collagenous tissue called a capsule. There are also ligaments supporting the two bones that make up the joint. 

THE CUP VS SAUCER

For the average person, joints are like putting a ball into a cup. The ball can move around but is relatively stable. Some people’s joints are like the ball in the saucer that moves around too much. These (sometimes lucky) people tend to be great at stretching (head right down to the floor) and are likely into ballet or gymnastics. 

These are the loosey-goosy type people. 

OUT OF JOINT?

What I’ve noticed clinically is  with clients like me with joints snug in the socket, the tight muscles compress the joint, but they don’t seem to get pulled or pushed “out of joint.” 

I can have tight muscles and discomfort, but I’m still able to function. And as far as treatment goes, as soon as I loosen off the muscles (IMS, manual tissue mobilizations, and of course stretching), the pain goes away and it’s all good.

However, when someone has a looser joint, a single muscle that is tense, it seems they’re able to push or pull the joint out of position and mechanically move it the way it should move. 

A great example is a client who had inner knee pain for over six months before seeing me. There was no evidence of ligament damage (both knees moved too much in my opinion, which is called hypermobility). 

What I discovered was a tense ropy sartoreus muscle (longest muscle in the body coming from the front pelvic bone to the inner knee).  Once the satoreus muscle was released (with IMS) during our first session, the client experienced huge improvement and was back to normal activities (with a core and knee stability program). 

LETTING GO OR HANGING ON

For those of us with normal to tighter joints, once the ropy, reactive muscle is released, we should be stretching to help the mobility in our joints and muscles. For those who are too loose, you’ll need to commit to stabilization exercises on an ongoing basis.

Your ligaments and joints require good support from your muscles. Just ask my sister. She has spondylolithesis (one bone in her back slipped forwards on the other).

If she doesn’t do her Pilates stability exercises on a regular basis (stops for more than two weeks), her discomfort increases. 

BALANCE

An equation for success. What’s desired (=) is  MOBILIY (+) STABILITY (-) LESS PAIN and (+) FUNCTION.

IF YOU’RE MOTIVATED:

We’re online in every place imaginable! Surf our website www.startlinephysiotherapy.com, then be our friend by moseying on over to our Facebook or Twitter sites by hitting the link there. We’re now on Twitter too! To book an appointment at Start Line, call the clinic at 250-746-7463.