Articles in Category: General Health

Fascial Dysfunction and Treatment

on Monday, 03 July 2017. Posted in Massage, Newsletters, General Health

Fascial Dysfunction and Treatment

By Luke Attkins

Diploma of Remedial Massage, Certificate IV of Massage Therapy

Member: AAMT, SCA, CAA, CA.

 

Fascia is commonly described as a 3D spider’s web that runs underneath a person’s skin and attaches, stabilizes, encloses, and separates muscles and internal organs.

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A common problem that arises between fascial tissues is adhesions that are caused by the shortening and tightness of the muscular units that surround that area. Fascia that surrounds muscle compartments or is in broad superficial sheets has a tendency to shorten in areas of stress, causing problems in mobility and joint function.

 

Professor Vladimir Janda, characterised myofascial dysfunction into two categories; upper cross and lower cross syndrome. These two syndromes are classified as postural syndromes causing shortening and weakening of specific muscles, leading to postural dysfunction. 

 

Upper-cross syndrome is described as rounding of the shoulders and forward carrying of the head. This postural syndrome shows the tightening and shortening of the pectoralis muscles and upper trapezius whilst simultaneously weakening the rhomboids (middle trapezius).

 

In lower-cross syndrome postural signs are anterior pelvic tilt and accentuated lordosis of the lumbar spine. This is caused by the tightening and shortening of these muscles: hip flexors, tensor fasciae latae (thigh) and erector spinae group whilst simultaneously weakening the abdominal and gluteal muscles.

 

Things that are associated with these two postural syndromes can lead to chronic pain through the back, legs, neck, shoulders, and chest and if left untreated it can start to affect the diaphragm causing problems with breathing.

 

 

 

 

 

 

 

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Myofascial release (MFR) is a physical therapy technique that involves applying gentle pressure into the connective fascial tissue releasing muscular shortness and tightness which in turn helps eliminate pain and help with restoring motion.

 

Techniques that are used in the release of fascial tissue are: skin rolling, fascial stretching, and fascial separation (lifting and rolling of the muscles). The benefits of this treatment are diverse.  Direct bodily effects can help improve flexibility, function, ongoing back, neck, shoulder, hip or any type of pain that is affecting an area containing soft tissue.  MFR is commonly used as an approach to work with tissue-based restrictions and their two-way interactions with movement and posture.  

 

This style of treatment usually goes for 30-60 minutes a session. Recommended amounts of treatment sessions are 4-6 but that may vary across the board as each person responds differently to treatment. 

 

If this sounds like something you may be suffering from or are finding hard to correct, give us a call and book in with Luke Attkins as he is trained in MFR treatment.

Herniated Disc

on Thursday, 03 March 2016. Posted in General Health, Chiropractic

Herniated Disc

By Jakob van Vlijmen

M Chiro, DC

 

A Disc herniation is a protrusion of an intervertebral disc. These shock absorbing discs are situated between 2 vertebra and they allow for more elasticity and mobility of the vertebral column. The anatomy of an intervertebral disc is comparable to that of an onion; multiple layers on the outside and a gel in the centre of the disc. Through repetitive incorrect loading of the disc (i.e. prolonged bad posture or faulty lifting mechanics) the inner gel can press on and partly rupture the outer layers.

 

The back or spine consists of 24 vertebras, the sacrum, the coccyx (tailbone) and two hip bones. To be able to move smoothly our spine has little shock absorbing discs in between the vertebra, we have a total of 23 intervertebral discs.

A hernia in the lower back often causes back pain and always causes pain down one or both legs. A dull ache, pins and needles or a catching pain are common symptoms, when the symptoms worsen there is a possibility of loss of strength or numbness down the leg. Because the intervertebral discs aren't connected to many sensory nerves it is possible that the location of the herniation itself isn't painful meaning that even though the problem might be in the back, the only location where pain is felt is in the legs.

 

There are two possible causes for this. One is that the herniated or bulging disc is pressing against a nerve that travels into the leg, causing it to become irritated and producing a signal to the brain which the brain translates as pain in the leg. Another reason for the nerve to produce a signal is not physical compression but a build-up of chemicals in the area due to overuse and irritation of the IVD. These chemicals inflame the nerve and surrounding tissues resulting in the feeling of pain similar to that of a mechanical compression of the nerve.

 

Symptoms of a disc herniation can be very different from case to case depending on which nerve is being compressed and how severely. Lumber (lower back) disc herniation cause symptoms down the legs such as pins and needles and numbness. A disc herniation located in the neck is called a cervical disc herniation and can cause pain in the neck, pain towards the shoulder blade or into the arm.

 

Usually the disc bulges on the side, however it is possible that the bulge is pressing straight back which can, depending on the location, cause a ''Cauda Equina Syndrome''. This is a medical emergency as compression of the spinal cord in this manner can cause the loss of many bodily functions. Such as muscle control over the legs, bowel and bladder control and sexual function. The chiropractor is excellently equipped to recognise and act on such an emergency.

 

A disc herniation is a common injury to the back, which in only 50% of cases causes any pain at all. As people age the IVD lose their elasticity weakening the IVDs. The average age to have a disc herniation is between 20 and 45 years of age. Men are slightly more likely to have a disc herniation than women. 

 

The ruptures in the IVD happen over time caused by bad posture or incorrect movement patterns. Having a static posture (which is the case with many jobs nowadays) increases your chances to develop a disc herniation as does lifting, repetitive bending and twisting the spine. In rare events a disc herniation can be caused suddenly due to severe trauma. 

 

The chiropractor will be asking you questions about your back pain and general health to determine which factors contribute to your pain. Subsequently the Chiropractor will perform an extensive physical examination in which orthopaedic and neurological tests are used to determine which nerve is compressed. The results of these tests are combined with the information gathered during the interview to create a complete and comprehensive picture. There may be times when the chiropractor might deem it necessary to request further imaging most likely an MRI. This is the image modality of choice to asses a disc herniation, as it does not show up at all on an X-ray.

 

A Disc herniation can be a frightening diagnosis, it is important to know however, that research has shown that in 95% of the cases a disc herniation resolves spontaneously within 12 months. However, as this is quite a long period of time the chiropractor endeavours to shorten it by improving spinal function and helping patients return to optimal health as soon as possible. The Chiropractor uses many different techniques which are all focussed at optimising spinal function and taking some of the pressure off the compressed nerve. Not every disc herniation responds well to chiropractic care and for some of them surgery might be a necessity. If this is the case, your chiropractor will help you asses your additional options.

How Long will it take to Get Better?

Written by Don Williams BSc, MChiro, ICSSD. on Wednesday, 23 September 2015. Posted in Massage, General Health, Sporting Injuries, Acupuncture, Training and Performance, Chiropractic

How Long will it take to Get Better?

By Don Williams

B.Sc., M.Chiro., ICSSD., PG Dip. NMS Rehabilitation Cert DNS. Memb: FICS, CEA

 

One of the most common questions that we get asked every day in practice is, “How long will it take to get better?” Unfortunately there is no short answer to this question, however, in this article I will try to outline some of the contributing factors and delineate some guidelines and ideas which may help answer this question for you.

 

Everyone is an individual, and in that sense, how different people respond and heal from different injuries does vary somewhat, some injuries are particularly unpredictable, shoulders are particularly problematic in identifying how well or how quickly they will respond to treatment. However with most injuries, there are general time frames in which most healing will occur.

 

Most people who have ever had an injury and minor procedure which required stitches will remember that the stitches generally come out in around 7 days and this time frame is a good indication of how long a cut or trauma takes to “bond” back together, however, the general healing process generally takes around 21 days. This is the timeframe for the body to lay down a “callus” or matrix of fibres around the injury and develop new connections and bridges to stabilise the injury and repair. But this timeframe is dependent on good blood flow and environment for repair, additionally, just because the injury is stabilised, does not mean that it is fully healed and fully function. This healing process and time frame is specifically relevant for muscle and skin.

 

Areas of the body that receive poorer blood supply take longer to recover. Tendons and particularly joint cartilage and ligaments receive a lower direct blood supply and take longer to heal. We normally expect that tendon and ligament injuries will take 6 weeks to start to repair well and 3 months to be stable.

 

Bones fractures also take longer to heal. Interestingly, the ratio of cortical bone (the dense outer “shell”) to cancellous bone (the “spongey” inner core) also affects the healing rate. So when we look at bones like the tibia (the larger of the two lower leg bones) they take a particularly long time to heal (up to 4 months).

 

The other interesting thing to note is that an injury is not always something that is readily assessable via an x-ray or scan and often, the severity of the pathology on the scan can be very unrelated to the amount of pain. For example, someone with severe degenerative changes noted on an x-ray may not have any pain, and in contrast, someone with very severe pain may have really good looking x-rays.

 

It is also important to note that many people use pain as a guide to where they have a problem or not. This is a situation which has been reinforced with dodgy advertising commercials by big pharmaceutical companies suggesting that all of our aches and pains can be targeted and resolved with a little tablet.  At times pain killers can be helpful, but it is important to realise that, contrary to the advertising campaigns, and the statements of the celebrities fronting these commercials, these drugs do not “target” the source of pain. They work globally in the system to mask the pain. In fact anti-inflammatories drugs can actually slow the healing process and all of these drugs have potential for complications and side effects, some of these can be severe.

 

But pain is only the tip of the iceberg. Pain exists as an indicator that something is going wrong in our system. We have an area that is under duress or load which is unhappy or injured. Sometimes there are weaknesses or imbalances or inappropriate actions which have caused this problem to develop. Getting rid of the pain is a good start, but addressing the underlying dysfunction or causative factors is also important to reach a good long term outcome.

 

Part of our goal in assessment at Institute of Sports and Spines is to try to assess the contributing factors which caused your problem to develop in the first place and help you to eliminate or address these issues.

 

Another complicating factor as eluded to, early in the article is the individual nature of response.

Sometimes we will see muscle spasm problems which are very severe and painful, which is not related to severe pathology. At times these issues will respond very quickly to treatment and at other times they will be a little stubborn and take a little longer. Generally, the response to treatment gives a more accurate prediction of how quickly the issue will settle. Further to this, if you have had previous episodes of the same problem, the previous response rate is generally a reasonable indicator of the response rate for future episodes.

 

So as a general time line for healing rates:

  • Early tissue healing occurs in around 7 days

  • The majority of soft tissue healing takes around 21 days.

  • Early bone healing takes 6 weeks (up to 4 months so large, long bones)

  • Cartilage and Ligament issues take around 6 weeks to 3 months

  • Re-education and retraining takes a minimum of 3 months

  • Remodelling can take up to 1 year.

 

In a perfect world things can progress more quickly. The addition of complicating factors can drag these times frames out.  The better that problems are managed and treated increases the probability of a good resolution and good long term outcome.

 

Later in this newsletter and over the next few additions we will outline more specifically injuries of the neck, back, knee, hip, shoulder and tendonopathies.

 

If you have any further questions then talk to the team and we will help you out with more specific advice.

 

Fracture Healing -

 

Fracture Healing

 


Wound Healing -

 

Wound Healing