Lateral Pelvic Tilt

Postural Dysfunction on November 3rd, 2010 No Comments

Lateral Pelvic Tilt (LPT) is a common postural dysfunction that is seen in clinical practice. The typical symptomatic complaints presented by someone with this dysfunction is Sacroiliac Joint pain, hip pain and midback pain. This postural dysfunction often reveals two other common dysfunctions: rotoscoliosis and a fallen arch or hyper-pronated foot. As always it is hard to know which problem occurred first – did the arch collapse resulting in (LPT) and resultant scoliosis or did the spine twist (rotoscoliosis) resulting in an (LPT) and then the arch collapsed? Regardless of the order the elevated hip causes adaptive shortening of the QL, ES, Multifidi, Obliques, Rectus Abdominis, Iliopsoas and hip Abductors on the high side. The overlooked and under treated muscles include all the Adductors on the depressed side of the (LPT). The Adductor muscles are infrequently touched and are located in a sensitive and somewhat vulnerable area of the body. Confidence and skilled palpation technique is required to effectively treat this important muscle group. What are some great treatment approaches to help correct the shortened and tight adductors on the depressed side?

Forward Head Posture

Postural Dysfunction on October 31st, 2010 No Comments

Forward head posture (FHP) is a common problem seen in clinical practice and experienced in our society, this problem is driven by the specific and repetitive tasks of everyday work and leisure. The typical pain complaints associated with this postural dysfunction includes but is not limited to headaches, neck pain, neck stiffness, temporomandibular dysfunction and visual disturbances, just to name a few. The basic anatomical explanation for what happening is that the lower cervical vertebra are moving into flexion and the upper cervical vertebra are moving into extension, whereas the body attempts to keep the eyes on the horizon. This structural shift creates changes in the position of the muscles associated with this region, the primary neck flexors adaptively shorten and the primary neck extensors stretch weaken. Muscles that are adaptively shortened often house active trigger points and muscles that are stretch weakened become dense and fibrotic. What happens to the four suboccipitals on each side of the spine in this scenario?

Types of Muscle Contractions

Uncategorized on October 28th, 2010 No Comments

There are basically three distinct types of muscle contraction.

1) Isometric 2) Isotonic Concentric 3) Isotonic Eccentric

An isometric contraction is defined as a muscle contraction without joint movement. A good example of this is when a bodybuilder is posing for a contest and he holds the arm up to contract the arm muscles displaying the biceps brachii and triceps brachii.

An isotonic concentric contraction is defined as a muscle contraction with joint movement and is where the attachment sites are moving closer to each other. A good example of this is the classic biceps curl, the barbell, hand and forearm move closer to the shoulder. This is a concentric contraction of the  biceps brachii, brachialis and brachioradialis.

An isotonic eccentric contraction is defined as a muscle contraction with joint movement where  the attachment sites are moving farther away from each other. A good example of this is the down phase of a squat, the body is being lowered towards the ground as the knees and hips go into flexion. This is an eccentric contraction of the quadricep muscles, although the Rectus Femoris is a multi-joint muscle therefore the Rectus Femoris is probably not be changing length since the hip is flexing simultaneously.

In order to perform an isometric contraction you need to know the primary action of a muscle. Then you can provide resistance and this is a great way to help isolate and outline the distinct location and borders of muscles, assisting in accurate palpation technique.

Cyriax Cross Fiber Friction

Uncategorized on October 26th, 2010 No Comments

I learned Cyriax Cross Fiber Friction in a Sports Massage course up in Seattle, WA back in 1990. My teacher at the time loved sports and sports massage. He taught us the exact treatment protocol outlined by James Cyriax minus the corticosteriod injection. Personally and professionally I think this is one of the most effective soft tissue techniques used by massage and manual therapists. The effects are immediate and no other technique creates the kind of muscular tension release and reduction of muscular pain. The only problem is that most therapists lack the physical strength and stamina to perform this technique through numerous layers of dense and fibrotic tissue. So the incorporation of this treatment protocol is seldom used, mainly because it is simply fatiguing and difficult for the average practitioner. One of the main features of this technique is knowing the fiber direction of the muscle or ligament that you intend to treat. This is just another example of where knowing your muscular anatomy is a critical aspect of effective technique application. An interesting finding published in the International Musculoskeletal Medicine journal Sept. 2010 Vol. 32 #3  - found the use of transverse friction superior to ultrasound for Supraspinatus Tendinopathy. It is unclear whether the methods used in this research study followed the Cyriax protocol.

The Importance of Palpatory Anatomy

Palpation Tips on October 25th, 2010 No Comments

I’ve been thinking alot about the importance of Palpatory Anatomy as it relates to any practitioner who is involved in healthcare and fitness. The human body is a vehicle in which we all drive around in and perform our daily routines from. We dont really appreciate all the unique features and functions of the body until something goes wrong – like we break a leg or injure our back. Then it is becomes completely clear how important this amazing vehicle is and how important it is to take care of it. As a bodyworker I take pride in knowing as much as I can about every fascial sheath, muscle, tendon, ligament, joint, disc and bone in the human body. For me this knowledge translates into confidence and confidence allows my clients to trust me to do the best that I can to help them recover from an injury or to just plain relax and de-stress. So the combination of confidence and trust creates an environment where therapeutic exchange is possible, no matter what technique,exercise or procedure is being perform. If there is good intention and the client is receptive then the result should be positive. That, I realized is the ultimate goal of MyoFinder – to be a facilitator of  anatomical knowledge that will ensure positive outcomes.

Palpation Tips for Latissimus Dorsi, Teres Major, Teres Minor & Deltoid

Palpation Tips on October 24th, 2010 No Comments

Here is a simple way to access the Latissimus Dorsi – find the inferior angle of the scapula and move lateral a couple of inches. Using a pincer palpation technique pick up the central belly of the Latissimus Dorsi, if you move superiorly you will find the Teres Major which is aligned at about a 30 degree angle from the orientation of the Latissimus Dorsi. The Teres Major is not as easy to get ahold of, if you passively abduct the shoulder to about 90 degrees it will make it easier to access the main portion of the muscle belly. Transition by using reinforced thumbs move just slightly above the Teres Major and slide under the Posterior Deltoid to find the small tube like muscle belly of the Teres Minor. You can use a light cross fiber friction to feel the borders of the muscle. Superficial to the Teres Minor is the Posterior Deltoid it is easy to lift and squeeze this muscle with a pincer palpation technique. At anytime if you are not sure which muscle you are on have the client perform the primary action of the muscle to help differentiate between muscle bellies. Remember the Latissimus Dorsi and the Teres Major create the same actions at the shoulder. Let me know if this helps you isolate these important muscles of the shoulder region.

Whiplash Injury

Pain & Injury on October 23rd, 2010 No Comments

The most  common form of Whiplash is typically associated with a motor vehicle collision (MVC). The scientific literature explains that even low speed impact can have lasting effects upon the health of the cervical spine as well as resulting psychological consequences. The top three  factors which determine the severity of injury from a (MVC) are the following: 1) Rear end impact 2) Head rotation 3) Element of surprise. Muscle, ligament, disc, bone and joint injuries can result from this type of hyperextension/hyperflexion trauma. Most manual practitioners do a pretty good job addressing the large muscles involved in a (MVC) which include the Upper Trapezius, Sternocleidomastoid, Splenius Capitis, Levator Scapulae, and Scalenes. The most overlooked muscles involved in a Whiplash injury include the Sternohyoid, Geniohyoid, Mylohyoid, Thyrohyoid, Longus Capitis and Longus Colli. I would love to hear some discussion on how practitioners are approaching the treatment of the these overlooked muscles.

Tension-type Headaches

Pain & Injury on October 21st, 2010 No Comments

Tension-type headaches (TTH) are the most prevalent of headache disorders seen in clinical practice. This condition can be divided into two subgroups or categories: episodic and chronic their definition is based the upon frequency of the attacks. Episodic (TTH) occurs fewer than 15 days per month and chronic (TTH) occurs 15 days or more per month. Stress is commonly seen as the biggest trigger for these headaches and as we know with stress comes increased muscular tension. There are three muscles that should be treated when someone presents with a tension-type headache the Upper Trapezius, Sternocleidomastoid and the Temporalis. Can you name two other muscles that refer pain into the head??

Quadratus Lumborum The Mimicker of Low Back Pain

Pain & Injury on October 20th, 2010 2 Comments

When someone comes into my clinic with Low Back Pain (LBP), I was always taught and continue to hear in advanced seminars that you should check out the Iliopsoas as a potential contributor to the persons (LBP) . After 20 years of practice I can hardly recall a case where the person would say – that is my low back pain as I was palpating or treating the Iliopsoas. Oh, I know there has probably been a few cases where the Iliopsoas was causing referred pain into the low back but not that many. On the other hand I cant tell you how many times that I have been palpating or treating the Quadratus Lumborum (QL) and the person says – that is my low back pain right there you found it. Janet Travel says the (QL) is the most overlooked muscular source of low back pain, so I guess my experience is not unique. I would love to hear other practitioners experience regarding the number of cases where the person’s (LBP) was related to the Iliopsoas versus the (QL).

Decreased Range of Motion for Rotation of the Cervical Spine

Pain & Injury on October 19th, 2010 No Comments

How many times have you awakened in the morning and were unable to turn your head from one side to the other?  Sleeping on your stomach with the head rotated to one side is a common cause of decreased rotation of the cervical spine and neck stiffness. Prolonged cervical rotation decreases blood flow through the vertebral artery on the contralateral side of rotation, starving the neck muscles of oxygen and nutrient rich blood, and decreasing venous return. The primary muscles involved in this problem are the Levator Scapulae and Sternocleidomastoid. What other muscles might be contributing to this problem??