Sep
5
2023

Facilitated Stretching

Facilitated Stretching by Robert McAtee, Jeff Charland

Facilitated Stretching, Third Edition, provides a useful overview of PNF stretching—a safe and easy-to-use method that involves stretching the muscle, contracting it isometrically against resistance, then stretching it again to a new range of motion. These steps apply whether you are isolating one muscle at a time or using the spiral-diagonal patterns of PNF to stretch groups of muscles simultaneously. The third edition contains all the great features of the previous edition, plus the following: A companion DVD that demonstrates live stretching techniques from the book for a clearer understanding New stretching routines for a variety of popular activities including running, golf, swimming, cycling, and throwing and racket sports General stretches and stretches for older participants Stretching activities with added strength work using stability balls and elastic bands Stretching and strengthening tips for dealing with—and even preventing—common soft-tissue injuries

The third edition of is now revised, reorganized, and packaged with a DVD—surpassing its popular predecessor as the best source for the latest PNF (proprioceptive neuromuscular facilitation) stretching techniques.

This book is available from: http://www.terrarosa.com.au/book/facilitated_stretching.htm

Sep
5
2023

A Guide to Using the Forearms

Auth Method of Therapeutic Massage: A Guide to Using the Forearms
A new DVD just been released showing how to massage without taxing the delicate joints of the hand and increase career longevity. Learn to give a full body massage using the forearms as the primary tool. These techniques can be used for both deep tissue work and light circulatory massage. This DVD teaches simple qi gong exercises for better body mechanics, as well as, how to use body weight to engage tissue, depth of pressure, speed of strokes and developing sensitivity in the forearms.

This 74-minute instructional massage DVD will teach therapists how to give a full-body massage using the forearms as the primary tool. By using the forearms, massage therapists will be able to work deeper and longer with less wear and tear on the more fragile joints of the hands. It covers body mechanics, how to use body weight to engage tissue, depth of pressure, speed of strokes and developing sensitivity in the forearms.

The DVD is available from: http://www.terrarosa.com.au/dvd/auth_method.htm

Sep
5
2023

Size counts – more evidence about multifidus in back pain

Size counts – more evidence about multifidus in back pain

Brett Vaughan, Lecturer, School of Biomedical & Health Sciences, Victoria University, Australia

A growing number of studies have identified that lumbar multifidus undergoes atrophy with low back pain with a predictable pattern of atrophy in an acute low back pain population. The location and the extent of atrophy of multifidus in a chronic low back pain population are still debated. Hides et al.1 investigated the size and symmetry of the multifidus bilaterally, comparing a chronic low back pain population (mean age 47 years) with a sample of convenience of people with no back pain (mean age 28 years). A secondary aim of this study was to compare the pattern of atrophy in different chronic low back pain presentations. Clinical records of 42 patients presenting to a hospital low back pain clinic were assessed with the clinical presentation data coded to indicate a bilateral or unilateral low back pain presentation. Cross-sectional area of the multifidus muscle was measured at levels L2–L5 using ultrasound imaging apparatus. Results of this study demonstrated a difference in multifidus cross-sectional area, with the chronic low back pain population demonstrating a decrease in diameter, particularly evident at the L4 and L5 vertebral levels. This result was not dependent upon the age of the patient. Unilateral low back pain patients demonstrated an asymmetry in the cross-sectional area at L4 and L5; however, this was not demonstrated in the bilateral low back pain or asymptomatic populations. The results of this study suggest that multifidus does atrophy in a chronic low back pain population and this is most evident at L4 and L5 levels indicating localized rather than generalised muscle change. Single sided pain is associated with asymmetry in patients with chronic low back pain. The authors suggest that their findings re-inforce the need for clinicians to provide exercise therapy that is designed for individual patients tailored to their impairments and that assessment should address comparisons between segmental levels and between sides.

Further research is required to contextualise the growing body of knowledge about specific muscle changes in patients with low back pain with current guidelines for treatment which suggest non-specific exercise interventions.

Reference

1. Hides J, Gilmore C, Stanton W, Bohlscheid E. Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects. Man Ther 2008;13:14–19.

International Journal of Osteopathic Medicine
Volume 11, Issue 3, September 2008, Pages 114-119

Sep
5
2023

Acupuncture Reduces Pain And Dysfunction In Head And Neck Cancer Patients After Neck Dissection

New data from a randomized, controlled trial found that acupuncture provided significant reductions in pain, dysfunction, and dry mouth in head and neck cancer patients after neck dissection. The study was led by David Pfister, MD, Chief of the Head and Neck Medical Oncology Service, and Barrie Cassileth, PhD, Chief of the Integrative Medicine Service, at Memorial Sloan-Kettering Cancer Center (MSKCC). Dr. Pfister presented the findings May 30 at the annual meeting of the American Society for Clinical Oncology.

Neck dissection is a common procedure for treatment of head and neck cancer. There are different types of neck dissection, which vary based on which structures are removed and the anticipated side effects. One type — the radical neck dissection — involves complete removal of lymph nodes from one side of the neck, the muscle that helps turn the head, a major vein, and a nerve that is critical to full range of motion for the arm and shoulder.

“Chronic pain and shoulder mobility problems are common after such surgery, adversely affecting quality of life as well as employability for certain occupations,” said Dr. Pfister. Nerve-sparing and other modified radical techniques that preserve certain structures without compromising disease control reduce the incidence of these problems but do not eliminate them entirely. Dr. Pfister adds, “Unfortunately, available conventional methods of treatment for pain and dysfunction following neck surgery often have limited benefits, leaving much room for improvement.”

Seventy patients participated in the study and were randomized to receive either acupuncture or usual care, which includes recommendations of physical therapy exercises and the use of anti-inflammatory drugs. For all of the patients, at least three months had elapsed since their surgery and radiation treatments. The treatment group received four sessions of acupuncture over the course of approximately four weeks. Both groups were evaluated using the Constant-Murley scale, a composite measure of pain, function, and activities of daily living.

Pain and mobility improved in 39 percent of the patients receiving acupuncture, compared to a 7 percent improvement in the group that received usual care. An added benefit of acupuncture was significant reduction of reported xerostomia, or extreme dry mouth. This distressing problem, common among cancer patients following radiotherapy in the head and neck, is addressed with only limited success by mainstream means.

“Like any other treatment, acupuncture does not work for everyone, but it can be extraordinarily helpful for many,” said Dr. Cassileth. “It does not treat illness, but acupuncture can control a number of distressing symptoms, such as shortness of breath, anxiety and depression, chronic fatigue, pain, neuropathy, and osteoarthritis.”

“Cancer patients should use acupuncturists who are certified by the national agency, NCCAOM [National Certification Commission for Acupuncture and Oriental Medicine], and who are trained, or at least experienced, in working with the special symptoms and problems caused by cancer and cancer treatment,” she added.

Memorial Sloan-Kettering Cancer Center (2008, May 31). Acupuncture Reduces Pain And Dysfunction In Head And Neck Cancer Patients

Sep
5
2023

Abstract from the Taks Force on neck pain paper

Here is the absctact from the article in Spine.

Clinical practice implications of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders: from concepts and findings to recommendations.

Based on best evidence syntheses of published studies on the risk, prognosis, assessment, and management of people with neck pain and its associated disorders, plus additional research projects and focused literature reviews reported in this supplement, the 12-member multidisciplinary Scientific Secretariat of the Neck Pain Task Force followed a 4-step approach to develop practical guidance for clinicians.

The Neck Pain Task Force recommends that people seeking care for neck pain should be triaged into 4 groups:
Grade I neck pain with no signs of major pathology and no or little interference with daily activities;
Grade II neck pain with no signs of major pathology, but interference with daily activities;
Grade III neck pain with neurologic signs of nerve compression;
Grade IV neck pain with signs of major pathology.

In the emergency room after blunt trauma to the neck, triage should be based on the NEXUS criteria or the Canadian C-spine rule. Those with a high risk of fracture should be further investigated with plain radiographs and/or CT-scan. In ambulatory primary care, triage should be based on history and physical examination alone, including screening for red flags and neurologic examination for signs of radiculopathy.

Exercises and mobilization have been shown to provide some degree of short-term relief of Grade I or Grade II neck pain after a motor vehicle collision. Exercises, mobilization, manipulation, analgesics, acupuncture, and low-level laser have been shown to provide some degree of short-term relief of Grade I or Grade II neck pain without trauma.

Those with confirmed Grade III and severe persistent radicular symptoms might benefit from corticosteroid injections or surgery. Those with confirmed Grade IV neck pain require management specific to the diagnosed pathology.

CONCLUSION: The best available evidence suggests initial assessment for neck pain should focus on triage into 4 grades, and those with common neck pain (Grade I and Grade II) might be offered the listed noninvasive treatments if short-term relief is desired.

http://www.ncbi.nlm.nih.gov/pubmed/18204393?dopt=Abstract