Here is the latest article(s) from our friend Bernard Scully from Newcastle, Australia on Muscular Balance - A Continuing Discussion and - Muscular balance – A Continuing Discussion I

Many of you with greater knowledge and experience than mine might deplore my method of analysing and describing soft tissue structure and function, but I am an incurable explainer; texts on this topic, such as Grey’s Anatomy are hard to beat for accuracy, but they sure take some digesting.

I don’t pretend that I know more than you, or that I have made new discoveries in the field of human form and function – I like to work on a chosen topic, read the texts, study the volunteers in the clinic, listen to the stories of aches and injuries, and then re-tell the story in a simpler form; in the legal system, it’s commonly referred to as forensics.

Muscles, and their behaviour, are a major element in our profession of manual therapy; I see muscles as belonging to one of two broad groups – long fibre, and short fibre. Long fibre muscles are designed for long ranging, slow speed skeletal movements. On the contrary, short fibre muscles are better suited to short, sharp, high speed actions, to produce rapid skeletal response.

As an example, a slow, steady, comfortable walk through the park, would make use of the long muscles of the lower limbs, such as rectus femoris, and quadriceps femoris. conversely, a series of rapid movements of the lower limbs, such as those performed by an athlete, a dancer, or a martial arts exponent, would call upon the fast-response, short fibre groups, such as psoas, or piriformis.

Anyone embarking, say, on a long distance cycle ride, would eventually find that the long-fibre muscles would begin to fatigue at some point, and the CNS would call upon the assistance of the underlying muscles, so, these short-fibre muscles are also activated when our endurance is tested –so, they are not only designed for the high speed activities.

So, when next you hear a client reporting pain after a fairly simple activity, or a series of simple movements, and saying something like….” I don’t understand how this happened, I go for a walk almost every day… “,  you could gently enquire about the distance they cover, the speed they attain, and so on; stretch should also be on the list, as you all know.

As we age, our ability, and perhaps our wish, to engage in an extensive and vigorous campaign of exercise that activates all muscle groups, decreases, so this factor needs to be considered, as our client list, more and more, includes the elderly and maybe the infirm.

Bernard Scully

Newcastle, Australia, June, 2011.  

Muscular balance – A Continuing Discussion II

Preview. We have been discussing muscular performance, and behaviour, comparing parts of the skeleton, say, the spine, with a ship’s mast, or a flagpole; stability of these posts relies on the strength and the health of surrounding ropes or cables. if the supporting ropes are weak, then the post’s stability is low. If the ropes on one side have strength and good attachments, stability is still doubtful, unless the opponent, or partner cables are not equally suitable. If all supporting cables are loose, weak or have weak attachments, then at the first sign of stress, these ropes can yield – the post, or the skeleton, is not equipped to deal with...

I want to discuss with you today not the strength of skeletal muscles, but their tone. Any muscle devoid of tone is said to be flaccid, or somewhat “loose”. Returning to our analogy of the ship’s mast, if the mast is supported by cables that are loose, you can imagine that any slight change of wind intensity or direction will cause the mast to shift its position as far as the slack in the ropes will permit. Depending on the weight of the mast, this “shift”, and the sudden stop, as the slack in the cables is taken up, could severely strain the cables, or their attachments.

Tone, in a muscle, is, by my definition, a residual amount of tension, even at rest.

A muscle that possesses good tone will always exert a certain amount of “pull” on whatever joint it acts upon; that joint will experience a comfortable amount of compression, and more importantly, if the joint is suddenly threatened by something like “a sudden wind gust” or a simple fall or a stumble, the well-toned muscle is available to exert an even stronger “pull” to provide joint protection – no time would be wasted in attempting to take up any slack in the structure.

This is, as I mentioned at the opening, a discussion paper; I want to initiate discussion, I want to promote it, and I want my students and colleagues to sit back, think about the problem and devise possible solutions. Mechanical or electrical problems are best put into the hands of a technician who can visualize the circumstances and re-construct them in his/her mind. Otherwise, if we rely on techniques devised by a text book, or the guru who is currently on the top of the charts, then we might as well rely on the computer spell-check system.

So, if I still have your attention, and you are keeping up with my rough analogy, think about your wrist joint, where the forearm meets the palm. There are a few joints here, radio-carpal and so on, but : these joints. like any others in your body, rely on the tone in surrounding muscles for support – sure, the ligaments are there, but if ligaments fail, they are slow to heal, and if damaged, all we have left is muscle tissue.

Grasp the hand of your partner, and give it a good squeeze – depending on the nature of your relationship, this could be a painful experience. My point is, most of us have significant strength in our wrist flexors.

Next, make a fist out of your hand, engaging these flexor muscles; allow your partner to close their hands over your fist – now see if you can open your fist against the resistance offered by your partner’s hands. Very few of you will succeed, because of the weakness in your extensor muscles – compared to the partner flexor group.

You see the anomaly here, possums?- More next week.

Bernard Scully.

Newcastle, Australia, June, 2011.  

Bernard offers some valuable insight into muscle balance, especially the issues that result from spending too many hours in a forward flexed position, like hours bending over a massage table.  What follows is Muscular Balance, Parts 1 and 2.  Enjoy!

Muscular Balance, Part 1

(CLICK ON THIS IMAGE TO VISIT BERNARD SCULLY'S WEBSITE)

Muscular balance is not a term I have invented – it is sometimes referred to as kinetic balance, and there may be other versions; I usually explain my understanding of muscular balance in the following way.

Consider a wooden post – maybe a tent post, or a flagpole. The stability of these columns depends on the positioning and the strength of supporting ropes; each of our skeletal joints has a similar reliance on supporting structures – the tent post has ropes, while our skeleton has muscle tissue.

The vertebral column is a great example – a long, slender column, assisted by supporting muscles; these muscles are used to keep the column steady and rigid, or, to control movement in a chosen direction. let’s consider a small section of the vertebral column, say, the cervical zone.

For many of us, a significant portion of our day is spent positioned over a :

treatment table,

food preparation bench or,

computer desk.

There are many other occupations, I understand, but, unless you are, for instance, leaning back, painting the ceiling of your home, the cervical section of your spine will be in flexion, chin towards your chest. This suggests that the flexor muscles at the front of your throat are in tension, holding the head in this forward position.  This is an incorrect assumption.

The head can sit in this flexed position, under its own weight, with hardly any assistance from the anterior muscles – only the extensor muscles at the rear are active, as they pull back on the upper spine and the cranium, controlling its flexed position. This means that for a large part of your day, whether you work at a computer, or read a book, or perhaps drive a vehicle, your cervical flexors are under-used, compared to the busy extensors.

One of the results of this over-activity of one set, and under-activity of an opposing set is muscular imbalance; the extensor muscle maintain strength and tone, while the flexors become flaccid by comparison. Our imaginary flagpole is now supported by  set of ropes on one side which have strength and tension, and an opposing set that is weak and slack.

The complete flagpole assembly must be adversely affected. I ask you to speculate on the contribution of this imbalance to the injuries suffered by the driver in say, a rear-end motor vehicle collision.

Bernard Scully

Newcastle, Australia, March 2011

The following article has been sent to us by Bernard Scully from "a land down under".  Mr. Scully contributes editorial articles and massage articles such as this one that show us that the history and evolution of massage therapy in Australia is very similar to the history and development of massage in the US.  Please also check out Mr. Scully's article on the editorial page of AHSConnect.

The History of Massage in Australia

Well, while this is not so much a history, but this old man’s recollections, based on a 27 year experience; putting such memories into print would be a waste of time unless it served a distinct purpose – my purpose ? I can only hope it serves to advance our profession.

I really don’t care if the origin of manual therapy was the occident or the orient – this point could be debated for a long time, if it was something invented, instead of a skill naturally acquired, then I’m glad it originated somehow.

The first diplomas of massage were awarded in Australia in the 1930’s – I had the pleasure of meeting one of those early graduates, who proudly showed me her diploma – Number 36, as I recall. When I made her acquaintance, in about 1975, she was a founding member of the Physiotherapy Association of Australia – professionally, she was regarded as a physiotherapist, or physical therapist, yet her credentials declared; Diploma of Massage. Her training was largely based on manual procedures, (as machinery used today hadn’t been developed), and bandaging and mobilization techniques were regularly employed.

As the physiotherapy profession expanded, and progressed, machinery lessened the physical demands, and the small number of trained therapists (the great war, as it has become known) had the dual effect of increasing the need, and reducing the number of trainees entering college. The point I am emphasizing is this introduction of mechanized treatment procedures spelt the decline of manual massage as we know it, as well as accelerating the progress made by the physiotherapy profession.

Ø  In the 1960’s, two major things occurred in Australia;  the  Medical benefits system, where people with the means, can pay into a health benefits system, arrived. This was (is,) – a private insurance scheme –membership is voluntary, and members receive a rebate of some of the money they have spent consulting a medical practitioner. As with all insurance proposals, the client has to determine “is the investment worth the expense ? “ Australians are still asking themselves the same question today, and the results seem to suggest that the majority of the population doubt the worth of the medical insurance scheme.

This medical insurance system paid benefits  for a clearly defined, and restricted, list of procedures – generally based on a medical model. Non-medical therapies, such as psychology, counseling, massage, physiotherapy, dentistry, audiometry, optometry, to name a few, were outside the scope of the legislation; naturally, once it became obvious to the market that this was to become a popular insurance scheme, (at least for a short time), representatives of those professions left off the list commenced their campaign for equality.

Ø  The second thing to occur was the arrival of Chiropractic procedures; the initial graduates were from USA, later from Canada. Osteopathy was to appear much later, from the UK, and has never gained much ground. The Chiropractic profession proved itself much more adept at lobbying than the nearest rival – physiotherapy – and quickly gained accreditation with the medical insurers. Physiotherapy, in Australia, took a long time to recover from this setback, and one of their strategies, this is my personal opinion, mind you, was to become a severe critic of all other manual therapies – massage, chiropractic, osteopathy, occupational therapy, even nursing.

Where is the massage therapy business today ? Broadly speaking, we are under assault on two fronts.

v  from outside, we face regular criticism from the chiropractic, osteopathic, and physiotherapy professions. Criticism from competitors is always present, in any business venture, but in my view, our critics have largely abandoned manual massage in favor of machines, and high velocity displacements – massage takes too long, they might think. and yet they still resent the small progress we have made, and,

v  from the paying public, who are quite confused, when they seek attention for a fairly simple loss-of-mobility problem , and are offered hot stones, chanting, smelly essences, astrological analyses, drumming, or small fires lit inside their ears.

We are, I believe, at a critical point in our careers. Many, if not most, of our competitors, have abandoned manual procedures because they are too arduous, or they are time-consuming, and, without talent, they cannot predict outcomes.

Be confident that what you do is *effective, *productive, *non-invasive, and *a relatively pleasant experience, if you have the ability, the personality, and the presentation.

Bernard Scully

Australia ,August 11, 2010

This article is from Captain Ben Kavoussi, M.S., MSOM, L.Ac. (currently on active duty in Iraq) and it is a groundbreaking investigation into the real history of acupuncture.  We are copying the first paragraph below and then providing a link to the remaining paper.  Anyone using oriental medicine theory, TCM, acupuncture or acupressure needs to read this article.  Enjoy.

Traditional acupuncture – as we know it in the West – is an integral part of a system of diagnosis and treatment, commonly called traditional Chinese medicine (TCM) or oriental medicine and allegedly based on the natural philosophy and the scholarly medical knowledge of ancient and medieval China.¹,² Nonetheless, given the limited number of reliable translations and critical analyses of Chinese medical classics in English, most of our knowledge about this natural philosophy and its underlying belief system is either based on the official publications of the People’s Republic of China (PRC) or on a secondary literature published outside of PRC by practitioner-advocates who often do not have any familiarity with the Chinese language and medical history, and who have never, or at best for short periods, been to China.³ Remarkably, one of the main publications by the Foreign Languages Press of PRC explicitly states that the traditional tenets of acupuncture are ‘naive’ theories with ‘definite limitations’ that should only ‘serve as an analogy to explain some of the physiological functions of human organs’.⁴ In contrast, the majority of the publications by Western advocates of acupuncture maintain more or less that the natural philosophy and medicine of ancient and medieval China were based upon ‘an approach to health and disease, to reality and the altering of reality, completely foreign to the West.’⁵ It therefore appears that these publications foster a set of preconceived ideas and ideals about approaches to health and disease that the official Chinese publications, paradoxically, describe as ‘limited’ and ‘naive’. In addition, the all-pervasive belief among Western authors in a fundamental difference between the general approaches to reality in the orient and in the West amounts to what the critical theorist Edward Saïd (1935–2003) has called one of the four ‘principal dogmas of Orientalism’, meaning an unfounded ‘style of thought based upon an ontological and epistemological distinction made between the Orient and the Occident’.⁶

http://beta.medicinescomplete.com/journals/fact/current/fact1404a05t02.htm?q=#_hit

Our current article is from Rena Sherwood and is on migraines

According to the Migraine Research Foundation, migraines are one of the most debilitating medical conditions in the world.  In America alone, one in four people will experience migraines.  But the exact cause of migraines is a topic of considerable debate among scientists.  The theory is that if a person is born predisposed to getting headaches, then if they are exposed to certain triggers, a migraine will result.

So, what are triggers?  They are indirect causes of migraine.  The best way for a migraine sufferer to cut down on migraines is to learn what their personal triggers are.  The best way to do that is to keep a migraine journal.  Triggers are different for everyone.  Some people will need a combination of triggers to occur in order for a migraine to develop.

Food Triggers

Many with migraines find that certain foods will almost always trigger a migraine, so they need to avoid those foods for the rest of their lives.  Some migraine patients only find that the foods will bother them only if they eat them at a time when they are also exposed to other triggers.  Skipping a meal can also be a migraine trigger.

Food triggers are different for every migraine suffer, but common food triggers are aged cheeses, nitrates in preserved meats and foods, MSG, peanuts, beef, snow peas, citrus fruits and chocolate.  Caffeine can be the solution – and the cause – of many migraines. 

Some migraine sufferers are so sensitive to caffeine that even one cup of coffee can get them violently ill.  But for others with migraines, a little caffeine can help bring relief.  That's one reason why caffeine is often added to over the counter painkillers such as Excedrin Migraine.  Still others find that a migraine results from caffeine withdrawal, a person like that needs to gradually taper off from caffeine.  Over time, the body's dependence on it will lessen.

Stress Triggers

Lack of sleep or too much sleep can trigger migraines.  If insomnia is a problem, then that needs to be dealt with before the migraines will have any chance of being managed.  Always try to wake up at the same time – even on days off – to help going to sleep at a regular time.  Waking up and going to sleep around the same time helps make the body develop good sleeping habits.

When you are sleepy, even the smallest problem can set your teeth on edge.  This causes you to be stressed.  Too much stress can also be a migraine trigger.  The theory is that when stressed, we breathe shallow breaths as opposed to deep, regular breaths.  Shallow breaths do not get enough oxygen to the brain.  This is when we can get irritable, confused, and indecisive even over small decisions.  All of this makes us even more stressed out and more prone to getting a migraine.

Lifestyle Triggers

As the old saying goes, the unexamined life is not worth living.  That's certainly true for migraineurs.  Getting a migraine attack definitely makes life not worth living.  By modifying lifestyle habits, attacks can decrease and make life worth living again.  But in order to modify those habits, you need to take a hard look at your life.

Red wine is a common trigger for many migraine sufferers, but any alcoholic beverage can set some people's headaches off.  But alcoholic beverages dehydrate your body, pack on pounds with empty calories and can disturb sleep patterns.  A person with migraines needs to stop or drastically cut back on alcoholic beverages and tobacco smoke.

Hormone Triggers

Women get three times as many migraines as men.  The reason for this is thought to be due to a sudden drop in estrogen that happens during a woman's menstrual cycle and when they begin menopause.  Fortunately, migraines vanish for many of these women when they finish menopause.  In the meantime, preventative medication can be taken to help women with their fluctuating hormones.

"Menstrual Migraine" (Oxford University Press, 2008) notes that women with hormonally-caused migraine attacks are often overweight.  By losing the pounds through diet and exercise, they not only got better sleep but had a lower incidence of migraines.

Other Triggers

Certain strong smells have been known to trigger migraine attacks.  These include tobacco smoke, perfume, aftershave, new shower curtains, fresh paint, new carpeting, flowers and gasoline. 

Flashing, flickering or glaring light can also trigger migraines by causing eyestrain and stress.  Sometimes wearing sunglasses indoors can help.  Even a glare spot on a computer screen can be a culprit.  But adjusting the lights in a room or tilting the computer screen can stop the glare.

Other noted triggers include a drop in barometric pressure, sudden temperature changes (especially when walking from summer heat into a cold room) and becoming addicted to over the counter painkiller medication.  When the body wants more medication, it triggers a migraine.

Be Flexible

To a migraine suffer, it can seem as if the world is full of nothing but migraine triggers.  But over time, these triggers can be avoided.  Triggers can change over time due to hormone changes due to aging, developing other health problems or taking new medication.  If migraines return, go back to keeping a trigger journal to see what could be culprit.  Don’t waste time complaining that your triggers have changed.  Just accept that they have changed and work to discover them.

Journals are not to act as a substitute for a doctor's care and for medication.  But they sure can help you and your doctors in assisting you manage your migraines.

This months article is submitted by health author Jean Lockwood who wants to tell our readers about the importance of estrogen containing foods.  Hey guys!  Anyone want to send us an article about testosterone?  How about it Sports Science majors and Personal Trainers?

This article, Estrogen Containing Foods and Why They Are Important is from Jean Lockwood

Overview:

Estrogen is a hormone that's produced in the ovaries of women. Knowing what foods have estrogen in them, or make you produce more estrogen yourself, may be able to help you bring your levels to a healthy point. Whether you need to increase your estrogen levels, or limit them, eating food that will help you promote better health by keeping tabs on your estrogen intake may help you reach the healthiest estrogen levels for you.

Significance

Estrogen is the female sex hormone. When women reach menopause, they may experience a lack of estrogen being produced in their bodies. Many doctors believe that a lot of the problems women have with menopause, is actually caused by a lack of estrogen. With new concerns about artificial hormones, many doctors are suggesting that women use more natural ways to increase their estrogen levels, including eating food that contains estrogen hormones.

On the other end of the spectrum, there are women  who need to avoid estrogen hormone foods. Whether because of having breast cancer, fibroid tumors, severe PMS, or ovarian cysts, you might want to know what foods to avoid in order to help lower your estrogen hormone levels.

Types

There are many foods that contain the estrogen hormone. One of the most common estrogen foods is animal products. Meat, poultry, fish, and organ meats, all contain estrogen, as well as eggs, dairy. For grains, there is a number of estrogen containing foods. Oats, barley, rice and wheat all have a good amount of estrogen in them. Vegetables and fruit that contains the estrogen hormone, include  alfalfa, apples, beets, carrots, cherries, chickpeas, cucumbers, garlic, red beans, soy beans, papaya, peas, potatoes, pumpkin, tomatoes, yams, peppers, eggplant, rhubarb, soybean sprouts, and split peas.

There are also flavorings and spices that contain estrogen, including licorice, fennel, flaxseeds, olive oil, and sage.

Benefits

The benefits of knowing what is in the food you are eating will be great, no matter what your health profile. If you need to increase the amount of estrogen in your body, you will want to eat more estrogen hormone foods.

If you want to limit the amount of estrogen in your body, you will want to avoid the estrogen hormone foods. Taking care of your health is sometimes as easy as eating the right things on purpose. Talking to your doctor can help you come up with a diet plan that will help meet your estrogen level needs.

Problems

Too much estrogen can cause physical problems, and must be dealt with by lowering the amount of estrogen you are eating. One of the biggest culprits to increasing estrogen levels is too much is soy.  If you eat a lot of soy or other estrogen foods, you should know the symptoms of too high estrogen levels.

Some of the symptoms you might experience if you have too much estrogen, and should avoid estrogen hormone containing foods, are swollen or painful breasts, extreme PMS, fatigue, impatience, irregular periods, loss of sexual desire, moodiness, water retention, and weight gain.

Almost all those symptoms can also be attributed to other problems. If you think you might have too much estrogen hormone, you can try limiting the amount you get in your diet. You might also want to ask your doctor to check your hormone levels by doing a simple blood test.

Balance

Keeping your estrogen levels balanced by eating estrogen hormone foods can help you in many ways. With the estrogen hormone levels needing to be kept in balance, eating foods that contain estrogen hormones will help. Maintaining good estrogen levels as menopause approaches may help avoid some of the symptoms that many women experience due to low estrogen levels. Eating more soy, more beans, olive oil, and other high estrogen hormone foods may be what you need in order to avoid having to take estrogen supplements.

Estrogen hormone foods may help you have less hot flashes, night sweats, irregular periods, and mood swings.

Isn't it something, what a hormone can do? Knowing what foods to eat to keep your estrogen levels right, can help make you overall healthier, and happier.