Sep
5
2023
Simeon Niel-Asher, The Concise Book of Trigger Points, second ed., Lotus Publishing, Chichester, England, ISBN: 978-1-905367-12-2, 224 pages.
Anita Mehrez and Peter A. Mackereth
The Christie NHS Trust Foundation Trust, UK
As massage therapists, who also offer acupuncture, this book appeals on a number of accounts. First, the author has put together a very accessible book set out in 9 chapters; the first three setting out clearly the theory and physiology of trigger points (TPs). The six that then follow are organised around distinct muscle groups. Each 2 page spread features clear detailed colour illustrations by Amada Williams, depicting each major skeletal muscle, the zone of pain distribution and exercises to strengthen, including selfstretches. Second, the author skilfully explains each muscle’s origin, insertion, function and action, with an exploration of the physiological implications of TPs in each muscle, advice for the patient and treatment techniques.
Third, in ‘Putting it all together’ (Chapter 10) the author presents 4 new ‘Laws’ to determine the ‘how’ ‘why’ and ‘where’ of TP formation and advice on developing an effective TP therapy protocol. Finally a ‘manual and selfhelp’ section describes steps and sequences in tackling some of the most common painful conditions.
Overall, this is an excellent text that would be useful to students of massage/bodywork, physiotherapy, acupuncture, osteopathy as well as an excellent resource and reference for teachers. We both recommend this book highly…it certainly pressed some points for us.
the book is available from www.terrarosa.com.au
Complementary Therapies in Clinical Practice
Volume 15, Issue 1, February 2009, Page 48
Sep
5
2023
Myofascial force transmission via extramuscular pathways occurs between antagonistic muscles
Author(s): Huijing PA (Huijing, Peter A.)1,2, Baan GC (Baan, Guus C.)1
Source: CELLS TISSUES ORGANS Volume: 188 Issue: 4 Pages: 400-414 Published: 2008
Most often muscles (as organs) are viewed as independent actuators. To test if this is true for antagonistic muscles, force was measured simultaneously at: (1) the proximal and distal tendons of the extensor digitorum muscle (EDL) to quantify any proximo-distal force differences, as an indicator of myofascial force transmission, (2) at the distal tendons of the whole antagonistic peroneal muscle group (PER) to test if effects of EDL length changes are present and (3) at the proximal end of the tibia to test if myofascially transmitted force is exerted there. EDL length was manipulated either at the proximal or distal tendons. This way equal EDL lengths are attained at two different positions of the muscle with respect to the tibia and antagonistic muscles. Despite its relatively small size, lengthening of the EDL changed forces exerted on the tibia and forces exerted by its antagonistic muscle group. Apart from its extramuscular myofascial connections, EDL has no connections to either the tibia or these antagonistic muscles. Proximal EDL lengthening increased distal muscular forces (active PER Delta F approximate to +1.7%), but decreased tibial forces (passive from 0.3 to 0N; active Delta F approximate to -5%). Therefore, it is concluded that these antagonistic muscles do not act independently, because of myofascial force transmission between them. Such a decrease in tibial force indicates release of pre-strained connections. Distal EDL lengthening had opposite effects (tripling passive force exerted on tibia; active PER force Delta F approximate to -3.6%). It is concluded that the length and relative position of the EDL is a co-determinant of passive and active force exerted at tendons of nearby antagonistic muscle groups.
These results necessitate a new view of the locomotor apparatus, which needs to take into account the high interdependence of muscles and muscle fibres as force generators, as well as proximo-distal force differences and serial and parallel distributions of sarcomere lengths that are consequences of such interaction. If this is done properly, the effects of integrating a muscle fibre, muscle or muscle group into higher levels of organisation of the body will be evident.
Sep
5
2023
The use of complementary methods (CMs) is widespread and increasing in the United States. Most literature on CM use among cancer survivors focuses on the treatment period, whereas only a few studies address use further along the cancer continuum.
This study analyzed the prevalence and the medical and demographic associations of CM use among cancer survivors surveyed 10 to 24 months after diagnosis. The study’s sample-4139 survivors of 1 of 10 adult cancers-was selected from stratified random samples provided by statewide cancer registries and surveyed by mail and telephone. Three logistic regression models examined associations between medical and demographic factors and CM use among survivors of sex-specific and non-sex-specific cancers.
The results showed that of the 19 CMs included in the survey, the CMs most frequently reported were: prayer/spiritual practice (61.4%), relaxation (44.3%), faith/spiritual healing (42.4%), nutritional supplements/vitamins (40.1%), meditation (15%), religious counseling (11.3%), massage (11.2%), and support groups (9.7%).
Among these 19 CMs, the least prevalent were hypnosis (0.4%), biofeedback therapy (1.0%), and acupuncture/acupressure (1.2%). Survivors more likely to use CMs were female, younger, white, higher income, and more educated.
Gansler T, Kaw C, Crammer C, Smith T. A population-based study of prevalence of complementary methods use by cancer survivors: a report from the American Cancer Society’s studies of cancer survivors. Cancer. 2008 Aug 4.
Sep
5
2023
Research suggests that exercises that target core muscles may reduce back pain and prevent future injury, but whether these exercises are substantially better than other structured exercise programs for chronic back pain has not been proved. And not all researchers agree on which components of the body’s core muscles are most crucial to preventing a back injury and reducing pain after suffering an injury.
A seminar on the role of core stability in reducing and preventing back pain was held at at the American College of Sports Medicine’s 12th annual Health and Fitness Summit and Exposition in Long Beach 24-27 March 2008. Presenter Marjorie King, director of the graduate athletic training program at Plymouth State University, in Plymouth, N.H., outlined the current state of the field: a need for more research and moderate support for the use of core stabilization exercises to decrease low-back pain and increase low-back function.
King thinks that some who practice core stability are missing at least part of the boat. “One of the biggest misconceptions people have about core stability is that by doing crunches, they’re getting at core stability,” she says. Crunches address the trunk, or “global” muscles, which exercisers more commonly work. But to really target core stability, she says, exercisers need to attend to the often-ignored spinal, or “local” muscles.
Local muscles include the little intersegmental muscles, the multifidi, that run along the vertebrae. These muscles don’t move a lot but are thought to play a role in keeping the spine stable during movement.
Other musculature involved in local stabilization include pelvic floor muscles and the transversus abdominis muscle, the deepest of the abdominal muscles. This muscle is horizontal in design, King says, and functions like a corset, stabilizing the spine.
Core stability training “is the standard of care, it’s what people do, in my field anyway,” says Dr. Christopher Standaert, a physiatrist (a physician specializing in physical medicine and rehabilitation) and clinical associate professor of rehabilitation medicine at the University of Washington in Seattle. But, he adds, “There’s never even been a uniform agreement on the definition.”
Among those who think — based on their clinical experience — that core training works, there are two schools of thought on exactly how it works. Some think, as King does, that local muscles such as the multifidi and the transverse abdominis are critically important.
But, Standaert says, “there are other people who . . . think it’s more about training movement patterns and broader motions and coordination of multiple muscles through your trunk to help your spine move more effectively . . . . So it’s about the whole system.”
In fact, Standaert adds, whether one is talking about local or global core stabilization, the rush to embrace core training has gotten ahead of the science. “People need to know that the scientific clinical foundation, the research, doesn’t match the extent of emphasis that trainers and therapists and all sorts of people put on it,” he says.
As back experts continue their debates and research, those who want to prevent or deal with their back pain need solutions now. Those with persistent, chronic back pain should see a physician and get a proper diagnosis, says Dr. Robert S. Bray Jr., a neurological spinal surgeon and founding director of D.I.S.C. Spine and Sports Center in Marina del Rey. A sports medicine physician or physiatrist are good places to start.
In addition, anyone who is doing exercises to reduce back pain should do so with guidance from an exercise or back-care professional, such as a physical therapist, chiropractor or certified athletic trainer.
Regardless of the state of the science, working the core’s local stabilizers won’t hurt and will probably help, King says. Targeting those muscles doesn’t even require going to the gym.
The best way to stabilize the spine, she says, is to stand up straight (stomach in while still breathing, equal weight on both feet, feet straight ahead, glutes flexed, pulling up through the pelvic floor) and sit up straight (stomach in, both feet on the ground, again, pulling up through the pelvic floor).
“Any time you sit or stand, in the line at the grocery store, stuck in traffic, brushing your teeth” is an opportunity to correct your posture, she says. “You don’t necessarily need a huge difference, you just need a bit of a difference.”
http://www.latimes.com/features/health/la-he-backpain31mar31,1,261211.story
