Archive for the ‘Anatomy & Health’ Category

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so you think you have a sprain

Monday, November 30th, 2009

You think you have a sprain, huh. I know every pain seems severe, especially when it first happens. The initial shock to the system can turn into a great story and suddenly you’re like a fisherman after a big catch. It just gets bigger and more severe, any minute you your whole ankle could fall off, or at least feel as though it could.
What’s the difference between a sprain and a strain? Basically a strain is to tendon(muscle) as sprain is to ligament(bone to bone connectors). If you think you have either follow the RICE method, Rest Ice Compress Elevate.
If you are able to put pressure on it, and yes there may be some difficulty/pain in doing so, it is likely a strain. The pain of a sprain can be excruciating, your body knows that the best thing to do is stay off it for a while. A sprain also often comes with less subtle symptoms, bumps, bruising, extreme sensitivity to touch, etc. Patience is one thing, however, do not be too hasty before seeing a professional (including your doctor). WebMD is not a doctor, while they do have a plethora of information, having this information at your fingertips does not make you a doctor either, or a PT, or a massage therapist, or anything unless you actually have a license.

Take the signals from your body seriously, like the old joke “Doctor, it hurts when I …” “Don’t do that!” A better understanding of your own body is something that can be achieved from exercise, yoga, meditation, massage therapy and all of those things which require focus on the self.

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Sciatica, for real

Friday, November 13th, 2009

I have had quite a few clients that have told me they have sciatic pain, a few have even claimed to have Sciatica.  In truth Sciatica is generally caused by the compression of lumbar nerves L4 or L5 or sacral nerves S1, S2 or S3, or far less commonly, by compression of the sciatic nerve itself, and it’s truly debilitating.    Those that have “sciatic” pain often suffer from piriformis syndrome or related conditions.

Sciatica is debilitating, it doesn’t just hurt, or cause a bit of tingling and loss of feeling.  It makes movement very difficult, extremely in fact.   Think having to move your leg with your hands.    This whole walking upright thing is quite complex.  The low back and especially the hip are quite prone to dysfunction.   Take a look at an anatomy chart sometime.  There are quite a few muscles with many different actions to be a part of.  Oh and there’s a pretty vital nerve running through or close to the aforementioned piriformis which makes this little guy one of the top five seeds of trouble in the body muscle wise.

I do not mean to dismiss those who have pain and want to name it.  Often, being able to just name your pain is beneficial on many levels.   Anything that brings us towards a better understanding of our bodies is a good thing.    Any information you can provide your massage therapist about your pain can benefit your massage session.  Simply knowing where the pain is coming from and what effect it has on your activity and mobility helps with any treatment you may get. Getting informed about different conditions can be helpful, but claiming you have a condition that has not been diagnosed by a doctor can impede your treatments.   WebMD or answering a few brief questions about your condition does not a diagnoses make.

If you have pain, see a practitioner that’s comfortable for you, whether it be acupuncture, massage, chiropractic or your medical doctor.   If the pain is truly symptomatic of a particular condition any of the first three should recommend you consult your physician for a medical evaluation.    Try to find a practitioner that is familiar with other specialists,  every one in the health field who is concerned about health often knows the other practitioners in the area.

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Low Back Pain

Tuesday, October 27th, 2009

I was talking to a physical therapist the other day about her own troubles with low back pain.   While we agree, as do most, that the human body is a greatt feat of engineering, we both concluded that there are areas that could use some re-engineering, a 2.0 if you will.   Unfortunately, evolution takes quite a bit of time, though it does seem to be working.

Our main focus would be the low back,  specifically the quadratus lumborum and the piriformis or maybe a complete overhaul of the hip.     You see low back pain is more related to the muscles of the hip than it is to the low back itself.  Why?  The muscles of the low back in a general sense, have issues because they are compensating for the lack of work that the hip and core muscles do on their own.   The body is neverendingly trying to remain in balance.    In order to stay upright, whether in a seated or standing position the muscles have to work well together.

Often, when people complain of low back issues and say things like, “Ireally need to strengthen my low back, do you have any recommendations?”  My response is usually,”Really, what you need to strengthen is your CORE.”     Instead of thinking of the body as segmented at the crest of the pelvis, really there’s about 6-8 inches more that should be thought of.   Imagine the split just above the navel, instead of at the waist.   THis then takes into account all of those core muscles and how they interact with the hip and low back in a much better way.

The pain information received from the low back is more from the strain of carrying all of the load, and therefore past the point where it needs to grow, what it needs really is for the other muscles that should be helping to start activating more and helping with some of the work.    It’s like a tandem bike with one weak rider and one strong rider,  eventually the stronger will fatigue and need rest, while if both riders are nearly equal in stamina and the amount of effort they put into the pedals, then the ride will last much longer and both will fatigue at a similar time.  This is what the body wants, in essence,  homeostasis, a balance between everything.

Instead of blaming the area that hurts, think of the other areas and how they could be helping.   If you lived with 6 people and felt like you were the only one doing the dishes, would you do more dishes?

How massage helps…  The goal of massage for the low back is to loosen the over-worked muscles and allow them to recover from the strain they have been under.    Typically, a good massage therapist will work the low back as well as the hips and glutes.   Strengthening of the core muscles is highly recommended and a personal trainer or physical therapist can make recommendations on this.   There are also vids on YouTube like this one

The Best Pilates Core Workout Video it’s only six minutes, and really great info,  all you need is a floor.    Pilates is great for core work.

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Head, shoulders, ….

Monday, October 19th, 2009

This weekend I had quite a workout followed by some yard work. Not having any forethought I decided to do a shoulder workout, which was followed by use of a scythe. This was part of a cooperative effort in our neighborhood to clear some invasive plants. The scythe is an effective tool, however, it’s very shoulder-heavy in terms of work. You have to hold it and cut across your body, like sweeping in a way but much heavier in terms of work load.

The shoulder is such a magnificent feat of engineering. The scapula is actually not as attached to the body as one might think, being held in place more by muscle than any bone to bone contact.

The reason I title this head, shoulders …. is because shoulder pain can often refer to muscles in the neck such as the scalenes. The infraspinatus in particular runs along the top of the scapula and attaches underneath the deltoid. Thus the pain can be thought to be more in the deltoid and along the top of the shoulder. The pain can feel as though it comes from movements of the head, as when you bring one ear to your shoulder or when you raise the shoulder up toward your ear.

Frankly, the moral of this post is think before you work out, what will you be doing next. This is really where overuse injuries present themselves. Doing too much of a similar action for an extended period can lead down the path of pain. Try to break projects up and if you’re going to say ride your bike for a few hours, you might want to do so a day or two before the big hike or climbing up quite a few flightss of stairs. Keep your muscles happy by breaking up the work.

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So much for the Psoas

Tuesday, October 13th, 2009

The psoas - one of the best performers in your body.  It does so much for you without you even realizing it.   It forms part of a group of muscles called the hip flexors, whose action is primarily to lift the upper leg towards the body when the body is fixed or to pull the body towards the leg when the leg is fixed.   It is deep, so deep that it inserts along the spine.   It’s a major contributor to our ability to stand upright.

Strongest of the hip flexors (rectus femoris, sartorius, and tensor fasciae latae), iliopsoas is important for standing, walking, and running.   It is, however, a typical posture muscle dominated by slow-twitch red type 1 fibers, and is therefore susceptible to pathological shortening or contracture, especially in those with a sedentary lifestyle) and requires regular stretching to maintain normal tone. Such shortening can lead to increased anterior pelvic tilt and lumbar lordosis (unilateral shortening), and limitation of hip extension (bilateral weakness)

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The Back and your bicycle

Monday, July 20th, 2009

I recently started taking long rides.   I moved recently and we have the ability to just get on our bikes and headd for great rides.   I’ve found that Chesterfield, Westhampton, Northampton, and even Deerfield aren’t as far as I once thought.   I’ve taken to riding somewhere in the range of thirty to fifty miles.   It’s a few hours of bliss, but I’ve noticed some things in my travels other than the scenery.

Back pain could be caused by poor cycling posture. Good posture on a bicycle is separate from good posture while sitting or standing.  Correct cycling posture must enable the pedaling action, while the rider is allowed to cope with the jolts that result from bumps and potholes.

When riding, the back should be arched slightly, not slouching forward between the hips and the shoulders. If the back is properly arched, bumps will cause it to flex slightly in the direction the curve created. If you ride swayback, bumps will force the back to bow farther in the forward direction, which can lead to severe lumbar pain.    A straight spine has no way to “give” when the bike hits bumps. Road irregularities will jam the vertebrae together, often aggravating existing back pain.

As with all activity, taking time to be mindful of your body will help a great deal.    Take a ride and take time to feel just what’s going on, tune your attention to the vertabrae and muscles in the back.  It’s easy to notice the hamstrings or quadriceps, but the more delicate muscles of the back are very important to pay attention to.

I’ll be posting some routes and perhaps even a picture or two in the future.   Ride Safe.

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