Dermatomes are areas on the skeleton that relate directly to a specific and individual spinal segment. The areas designated on the arms and legs relate directly to a single spinal nerve and being able to palpate or pinpoint this area where a client may be experiencing pain, numbness, tingling or other type of ‘nerve pain’ can be traced directly back to that one location in the spine that corresponds to that singular nerve and where it exits the spinal column.
We do see it in the natural world where birds, bees, coral spawning, turtle hatchings and migrations of Monarch butterflies all effected by magnetic pulls on the earth. Is even said that dogs orientate themselves on a north/south axis to defecate???? These pulls of magnetism signal occurrences that create visual displays of wonder and excitement that have the likes of David Attenborough scrambling for their camera crews. It does exist - but does it exist for humans?
Most of us have a basic understanding of muscular contractions involved in simple actions. A step for example, comes from hip flexion, which usually involves the psoas or iliopsoas. However with this concept, we look at all the structures that can act on this movement that may influence the motion. When someone is in pain, its not just the one singular muscle that has to be taken into account when trying to rectify a painful action. Hence these slings become vital to understanding where the origin of certain pain in said actions can occur.
The Pelvic Floor is the main supportive base for our pelvic organs, namely the bladder and the bowel. In women the pelvic floor also supports the uterus so this is why it is perhaps more pertinent for women to be concerned with their pelvic floor than males. Women have much more awareness of the pelvic floor as it is a vital part of birth function and support. But it also presents a very valuable understanding in support of the lumbar spine when lifting. Hence we all should try and understand how to control and use our pelvic floor in various activities and movements.
Whenever we talk about pelvic floor, inevitably we begin to talk about sphincters and the defecation system. The Pelvic floor muscles control and support the pelvic floor organs. They ensure the supportive ‘trampoline’ if you like of the lower organs of Bladder, bowel and uterus. They also create openings for the organs passageways (the anus, urethra and in women the vagina) to pass through which then allows the body to discharge waste product. These openings have their own circular muscles or sphincters that control the opening of the passages for defecation but it is the pelvic floor that wraps quite firmly around the passages as the first point of muscular control.
There are other applications of the pelvic floor that relate directly to the diaphragm and internal pressure and breath control. Many singers are well aware of the control needed in the pelvic floor when involved in high notes or long breath cycles. Utilising the pelvic floor can help with using the least amount of air needed for vocal control. There is a wonderful story of a well known actor going for a note as Gaston in Beauty and The Beast where he has to quickly let the note go and then run off stage to be changed out of his costume!
The pelvic floor, like any muscle can (and should) be trained to be tight and healthy to assist internal pressure and function of the abodimno-pelvic cavity. The main concern with dysfunction of the pelvic floor is incontinence or loss of bladder control. This is more acute in women at a senior age and post childbirth as the birthing process can damage the pelvic floor and weakening it for later in life. For men the weakness can come about after surgery for the prostate. A weak pelvic floor may result in loss of bladder control in actions such as sneezing or laughing – as Jane Fonda aptly put it in context ‘I think I just peed on Ryan Gosling’
This structure also helps in supporting the lower spine and the back muscles. The pelvic floor provides the inferior border (bottom floor) of the abdomino-pelvic cavity. Imagine if you will, the pelvis is like a balloon – a three dimensional sphere that has to contract and release according to what is required in movement and bodily function. The most important aspect of this internal pressure is most obvious when involved in lifting heavy loads. The internal pressure of the abdomino-pelvic cavity creates the supportive base for the supporting muscles of the lower back and pelvis to push against.
In much the same way that the scapula acts as the base for the shoulder, so to can the abdomino-pelvic area serve as the base of movement support for the lumbar spine. The pelvic floor muscles act directly with the Multifidus and deep abdominals (transverse abdominus/obliquous) to support the load bearing of the lumbar spine. This is known as a ‘feed forward’ (as opposed to feedback) system whereby the support base engages directly in a pre-defined way under load or stress. The Pelvic Floor can thus be vital to anyone involved in lifting heavy loads or high impact exercise.
The pelvic floor has three distinct layers:
1. Superficial Perineal Layer – Bulbocavernous, Ischiocavernosus, Superficial Transverse Perineal, External Anal Sphincter
2. Deep Urogenital Diaghram – Comperssor Urethra, Uretrovaginal Sphincter, Deep Trasverse Perineal
3. Pelvic Diaghram – Levator Ani, Piriformus, Obturator Internus
These muscles span from the coccyx in the back to the pubic symphesis in the front and side to side from the ischial tuberosities. There are two openings in the ‘floor’ for men for the urethra and anus and 3 in women with an extra opening for the vagina.
There are a number of influences that can loosen the Pelvic Floor namely child birth for women and heavy lifting in the general population. High intense exercise as well as straining on the toilet and even chronic coughing can all have adverse effects on the pelvic floor. As with any muscle group, weakness requires training to tone and strengthen the muscles. Likewise you can also have too much tension in the pelvic floor, which can create pain and difficulty with bladder and bowel movement as well as pain in sexual activity.
Essentially the exercise for training your pelvic floor is the ‘Inward Up and Lift’. To identify these muscles, it can be likened to trying to stop the flow of urine. Lifting ‘up and in’ will cause the pelvic floor to contract and restrict flow of the bladder. It is not recommended to do this often, but that sensation can help to understand how to identify the pelvic floor muscles.
Once you have identified these muscles, then actively lifting ‘up and in’ for a series of 8 to 10 seconds can assist in training the pelvic floor. The trick is to do this without involving the buttocks or gluteals. It’s an internal pressure contraction and shouldn’t be a contraction of any of the moving muscles in the pelvis or hips. Performing the 8 second hold for a series of 8-12 repetitions over 3 sets whilst sitting or lying on the ground (to ensure relaxed muscles of the hip and abdominals) is advised for those who need to strengthen their pelvic floor. There are qualified professionals such as physiotherapists that can assist with instructing these exercises.
So it’s not just the women that have to worry about the pelvic floor. And it’s not just the women that can control their pelvic floor. They just might be better at it! But it is something that all of us should be aware of and understand particularly if we are involved in resistance lifting and intense exercise and be ready to articulate and train when it is necessary.
Family is an inclusive word, it’s about a sense of those that you hold dear. Far from just being the nuclear grouping of people brought together by ancestors, family has come to include those that are part of your inner circle, that trusted group of people that you hold and cling to in moments of crisis, and whom you celebrate with when you are in moments of joyous celebration. Emotional bonds and common goals can be enough to unite people in a bond that creates that sense of belonging and compassionate affection. And these come in many forms and types of relationships.
Yoga in the western world is enjoying a huge crescendo of populism with athletes and extreme sports people all praising the virtues of the restive exercise program. Far from being just physical, yoga also has a wonderfully mental balance and even a spiritual element to which it is easy to aspire. So why is this ancient practice so popular and why do we all have an impression of what yoga actually is?
I was sitting down to dinner with my dearest and most wonderful friend (who also happens to be my volleyball coach) and the conversation of ‘does yoga really have benefits’ came about, I harkened back to my days of being a yogi and pretending to know what all the jargon was and every asana’s Indian name as opposed to just calling things an English slang equivalent. Very quickly my friend/coach quickly put me in my place about being opinionated on the matter - I was pretty much forced to take my proverbial silver spoon out of my lower asana!
The mensicus are our shock absorbers in the knee. They help to create a secure and stable platform for the femur (leg bone) to connect withe the tibia in the lower leg We do everything we can to try and avoid injury to the meniscus. Sadly this is not easy as discs in our body age and deteriorate from the minute we start jumping and running and being human! Meniscus tears are a major issue for most of us who are involved in sport and primarily in squatting. That pretty much covers the entire population!
Cortisol has a vital role in the body as one of the body’s ‘stress hormones’. It is released from the adrenal glands into the body in the ‘fight or flight’ mode and it’s job is to prime the body for physical and mental stress and exertion. It downgrades systems such as reproduction and immune function in order to give the body the maximum amount of energy available to execute exertion (that is fighting the bear or running from the bear). However Cortisol can also have a negative effect on the body and when the levels are too high, it can reduce protein synthesis, decrease musculature and increase abdominal body fat.
Much research exists on neural performance and fatigue in high intensity and endurance athletes. In a nutshell, the consensus of articles tends to value that the nervous system needs more time to recover from intense exercise than does the muscular and cardiovascular systems. Pushing into fatigue on hard days in a training regimen is beneficial, only if you also have your ‘easier’ or ‘off’ days. This allows all the systems in the body the time to recover and reset before optimal output is once again attempted.
So - you’re getting tingling down your arm, you may even have some sensation in your fingers and along your shoulder. You could also be presenting with coldness in the arm and fingers and even some discolouration in the arm after or during exercise - one of the elements to consider is a condition called Thoracic Outlet Syndrome (TOS).
Clients presenting with disc herniations will usually be accompanied with numbing pain and radiating pain in their extremities. Notably the sensation affects broad areas of the legs and arms and even down to the feet and hands due to the nature of neural (nerve) involvement in a disc bulge. This neural involvement is particularly noteworthy in a cervical disc bulge due to the relatively small space between vertebral segments. Any change in the discs here is felt perhaps more acutely than in the lumbar spine as there is just less space for the body to tolerate any changes in this small opening.
Knowing what type of knee pain is important as the treatment protocols do differ for each one and understanding what the presenting issues are can help you to target exactly why you are getting the knee pain. This also determines what type of remedial activity you can indulge in and whether you can rebuild yourself back into your sports activity, or whether it is time to hang up the boots, pads, or runners.
Anatomically the shin splint is a collection of conditions that can be coined into this ‘umbrella term’. From muscular tears, inflammation of the periosteum (connective tissue enveloping bones at joints) and even hairline fractures. They are usually the result of overuse of the Tibialis Anterior, Extensor Digitorum Longus and Extensor Hallucis Longus muscles that run down the lateral part of the anterior lower leg. It can also relate to tearing of the Tibialis Posterior Muscle and soleus that lie in the posterior compartment. These muscles are connected to the tibia via a periosteum - a connective sheath that runs the length of the tibia bone and encases the muscles within it. Which is perhaps unique in the body as most muscles attach only at the ends of their tendinous insertions.
It is interesting how often I can encounter clients who come to me with history or current concerns about seizures. Perhaps the most common attribute of these complaints can often be an ‘embarrassment’ to discuss the issue. “it’s nothing… it was just a turn… I had a blackout of sorts…” Some other cases are a little more prevalent where a tremor or shake can be a social embarrassment or something to hide. But we should all be aware that these conditions should and do need to be taken seriously and discussed. It does not mean that everyone needs a CT Scan straight away but an awareness about what different types of seizures can and do entail is worth discussing so that the ‘embarrassment’ factor is not cause for non-investigation.
A Morton’s Neuroma is a thickening of the plantar nerve that innervates the sole of the foot. Rather than the neuroma being a tumour or growth (as the anatomical term implies), the Morton’s Neuroma is a thickening of the sheath (or sock) that surrounds the plantar nerve. So rather than it being a pebble in your foot, it is the surrounding tissue of the nerve that becomes irritated and creates swelling that then impedes function.
Having a heel spur doesn’t create the inflammation that occurs in an area or that radiates to the underfoot. It is documented that in some cases a bone spur of up to 1cm on both heels only illicits pain in a single foot. Some say as little as 5% of bone spurs result in inflammation and painful conditions. The issue comes about when a bony formation occurs close to or at the site of a tendinous insertion. Its not necessarily that the spur irritates the tendon, moreso it creates a bio-mechanic (the way that an articulation/joint moves or operates) that can create an inflammatory response or ask too much of a tendon/muscle to overperform. So indeed you are often not necessarily treating the spur but the condition that is being caused by it.
Bodywork can play a huge role in managing symptoms relating to both physical issues of the hypertonic contractions as well as the mental and sensory issues associated with touch and therapy. The depressive nature of the disease and the isolation of physicality is a viscious circle and is one that massage therapists and bodyworkers can directly address. It's not just about getting tight muscles to release and relax, but about getting sensory perceptions to be activated, re-firing neural pathways and getting neurons to communicate and keep their pathways communicating. Touch is vitally important in these circumstances and just having a treatment can be a great alleviator to the isolation that these people can feel.
Many factors determine how to treat a torn (partial tear ) or ruptured (complete tear) of the ACL. The severity of the tear and the degree of movement or impact that the client may be likely undertake in the future is a major concern. Is the client likely to undertake impact sports in the future or are they at the tail end of their career? This is a very real concern for those facing ACL surgical repair.
The labrum is the articular surface (the area where the ball of the arm bone or humerus connects to the actual joint surface or glenoid cavity *the socket of the shoulder). Its like looking at the Universal Joint on a car crankshaft. The surface on the inside of the socket is where the labrum forms a secure ‘cuff’ for the bony humerus to insert into. Like a ring of fibre that makes the articulation more secure, it helps to create a deeper rim. Like the rubber ring on a preserving jar.