Supporting Those Whom Support Me

This post really has nothing to do with PNMT, but I have a client who supports me—I have treated all in his family but one—and I want to show him and his family my gratitude by supporting them as well.

His name is Paul Smith and he had a book published this year! The name of the book is Lead With A Story: A Guide To Crafting Business Narratives That Captivate, Convince, And Inspire. It shows the reader how to use the power of storytelling to navigate 21 of the most common challenges business leaders face, based on interviews with over 75 CEOs and executives at dozens of companies around the world.

Paul is about to embark on his first (and only) public book signing in Cincinnati, OH. If you are in the area and this subject matter is of interest to you, please support him as well by stopping by.

Cincinnati Barnes & Noble
7800 Montgomery Road
Thursday, August 9th
5-7pm

Congrats, Paul! 🙂

The Psoas Major: A Major Player In Back Pain

Have you ever had back pain or know someone who has? If so, this post is for you, my friends!

There are many muscles that could cause back issues, but today I’m going to focus on just one, that being the psoas major; mainly because I’ve come across too many new clients whom never had them treated before… And this surprises me. Another reason is because I’ve noticed that many people think that only back muscles should treated because it’s their “back that hurts”. Believe it or not though, there are muscles in the front of our body that have an effect on back pain as well. Before I go on though, let’s go over the anatomy…

THE ANATOMY (per Tortora & Derrickson, 11th edition)
Origin: Transverse processes and bodies of lumbar vertebrae.
Insertion: With iliacus into lesser trochanter of femur.
Action: Psoas major and iliacus, acting together, flex thigh at hip joint, rotate thigh laterally, and flex trunk on the hip.
Innervation: Lumbar spinal nerves L2-L3.

NOTE: Some people refer to this muscle as the “iliopsoas” because the psoas major and iliacus share a common tendon and end-point, but they are in-fact two separate muscles, which is why I’m only going to refer to the psoas; however, they do work in-conjunction, in some circumstances.

The function of the psoas is to increase flexion of the thigh at the hip. It can either bring the femur towards the spine or the spine towards the femur; just depends on what movement is taking place. An example of when it would be active—or contracting—is when you swing your leg forward during walking or running. The psoas is also a strong lateral flexor and stabilizer of the vertebral column (ipsilaterally—same side); as in when you bend to one side or the other.

How do you know when the psoas could be influencing back pain? Well, let me share a few examples—which also happen to be indicators for treatment—with you…

  • You have back pain when lying on your back; without a pillow under your knees
  • You have back pain that is vertical, but is relieved when in the reclining position
  • You have difficulty straightening after prolonged sitting

Taking it one step further, let me share some additional indicators for treatment with you…

  • An increase—or possible decrease—in your lordotic curve
  • You stand with your weight off the affected psoas side
  • You have unexplained pelvic floor pain (neural entrapment issues)
  • You have rotational distortions of the spine (Scoliosis)
  • You have groin pain

Please keep in mind that muscles have synergists and antagonists, so even though you have this information at your fingertips, there are other muscles not mentioned in this post that can cause a person pain and dysfunction in the back; anywhere in the body, really.

As always, I hope you find this information to be informative!

IMPORTANT NOTE: The psoas is a deep muscle in the abdominal area and great caution should be of utmost concern when treating this muscle. I mention this because of the possible presence of an AAA—Abdominal Aortic Aneurysm—which would be a serious contraindication for treatment, due to the fact that it could have potentially disastrous consequences.

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“Neutral balance alignment is key to becoming pain free!”™ ~ Me

Barefoot Is Better

I am engrossed in an awesome book and thought I would share some information from it. The book is called Born To Run: A Hidden Tribe, Superathletes, And The Greatest Race The World Has Ever Seen; written by Christopher McDougall. I highly recommend you check it out if you are a runner—or just happen to be looking for a good read.

I’m not a runner myself, but my husband and so many of my clients are; most of them experiencing—or have experienced—one or more problems associated with the sport. Achilles tendonitis, plantar fasciitis, knee pain, hip pain, hamstring pulls, shin splints, etc. Does any of this sound familiar? If so, please keep reading this post!

Ever since I went to massage school in ’06, I have firmly believed that running shoes have way too much cushioning and are way too technical; all of this causing, in my opinion, compensation issues, in addition to weakening the muscles in our feet. While reading the book, I was pleased when I found out that Vin Lananna, Stanford University’s head running coach, basically felt the same way. In fact, he apparently had his track team run barefoot during their practices, despite the fact that Nike sponsored them. During practice in April of 2001, Nike reps asked why they were “bare-footing” and Coach Lananna’s response was (p. 169-170), “I can’t prove this, but I believe when my runners train barefoot, they run faster and suffer fewer injuries…. We’ve shielded our feet from their natural position by providing more and more support… People went thousands of years without shoes… I think you try to do all these corrective things with shoes and you overcompensate… You fix things that done’t need fixing… If you strengthen the foot by going barefoot, I think you reduce the risk of Achilles and knee and plantar fascia problems.” Interesting, huh?

Here are some links to research that was also quoted in the book…

British Journal of Sports Medicine – Dr. Craig Richards revealed that there are no evidence-based studies that demonstrate that running shoes make you less prone to injury.

The American Journal of Sports Medicine – Dr. Bernard Marti’s study found that runners in shoes that cost more than $95 were more than twice as likely to get hurt as runners in shoes that cost less that $40.

Journal of Orthopaedic & Sports Physcial Therapy – Dr. Barry Bates gathered data that suggested that beat-up running shoes are safer than newer ones. He and his colleagues reported that as shoes wore down and their cushioning thinned, runners gain more foot control.

Here are a few other links you might find interesting:

Barefoot Ted
Tarahumara people
Barefoot Ken Bob
Caballo Blanco
Scott Jurek

Well, I don’t want to give the whole book away, so why don’t you pick one up for yourself. If you’re a runner and suffer injuries as a result, I’m sure you’ll enjoy it as much as my husband and I did.

On a side note, we just got some VIBRAM Fivefinger shoes. My husband LOVES them and I can’t wait to try them out! Here is their step-by-step guide if you’re interested in having a look-see.

7/30/12 UPDATE: Sparing the details, I just wanted to quickly mention that since I wrote this post, we have had a bad, unfortunate, and unacceptable experience with VIBRAM’s customer service department… And would highly recommend that you not deal with this company. There are other brands of this type of shoe out there and hopefully I will finally get into a pair from one of them soon!

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“Neutral balance alignment is key to becoming pain free!”™ ~ Me

Massage And Contraindications

I have found in my practice that many people are not familiar with the word contraindication, and it is an important word to know; not just when referring to massage, but when referring to any medically-related condition as well. So, taking that into account, here is some information that I would like to share.

When referring to massage, a contraindication—”contra” meaning against—is any physical, emotional, or mental condition that may cause a particular massage treatment to be unsafe or detrimental to the client’s well-being. It means that the expected treatment is inadvisable; conditions may exist in which it would not be beneficial to apply any form of massage to part of or all of the body. There are absolute contraindications and regional (or partial) contraindications; absolute meaning that massage is absolutely not appropriate and regional (or partial) meaning that massage is not appropriate in certain areas of the body.

Some examples of absolute contraindications would be:

  • Severe, uncontrolled hypertension (high blood pressure)
  • Acute pneumonia
  • Toxemia during pregnancy
  • A fever over 101°

Some examples of regional or partial contraindications would be:

  • Local contagious conditions
  • Open wounds
  • Acute neuritis or arthritis
  • Local inflamed areas

Some of those may have been obvious, but keep in mind there are many more. At the end of the day, it is the responsibility of the therapist to fully understand contraindications for massage; however, it’s a good idea for the client to have a good idea as well.

A good book that I have on-hand is Pathology A to Z: Handbook For Massage Therapists. Not only has this book helped me with conditions I’m not familiar with, but it also helped me to understand and realize that some pharmaceutical drugs can affect the outcome of massage treatments as well.

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“Neutral balance alignment is key to becoming pain free!”™ ~ Me

Types Of Back Pain And Red Flags

So many people suffer from back pain; myself included, but not nearly as frequently compared to my past. It wasn’t until 2006 while in massage school, when PNMT was first introduced to me, that I ultimately got relief—this fact being why I specialize in it today! With that said, let me start off by giving you the short version of my not-so-lovely experience with low-back pain…

My issues started when I was a freshman in high school, that being in 1990—I can’t believe I just aged myself. After many visits to different medical professionals over the years, it wasn’t until the year 2000 that I was officially diagnosed with spondylolisthesis, spondylosis, two degenerative discs, one disc “protrusion”, and arthritis; all in the lumbar spine. Oh, I should also mention that I was diagnosed with sciatica. Ugh! I couldn’t believe that I had this much going on at the young age of 25, and for me, the pain was exhausting; both mentally and physically. Anyway, back to this in a few.

Does any of this sound familiar? Assuming it does, I am going to move on to the different types of back pain and where it can stem from. Yay! The following examples could relate to the upper-, middle-, and/or low-back…

  • Pain from the disc, which is richly supplied by nerves
  • Pain from facet joints
  • Pain from muscle and soft tissue mechanisms
  • Pain from SI joint issues
  • Pain from trigger points

There are many possible causes associated with back pain, but I wanted to give you some examples where PNMT would be beneficial, since it is designed to treat pain that is mechanical related; soft-tissue in origin. But, what if back pain is not soft-tissue related? Well, it is my job to rule out other causes, and to know when it is in my client’s best interest to refer to a medical professional. So, how about I be up-front with some red flags? First and foremost, it is important to know that mechanical (musculoskeletal) pain is made better or worse with movement. If movement has no effect whatsoever, consider that a red flag for treatment, and schedule an appointment with your doctor. Some other red flags related to back pain are as follows…

  • Pain that throbs, is nocturnal, and is worsened by activity
  • Pain that is accompanied by shortness of breath
  • Pain that is accompanied by a loss of appetite
  • Pain that is accompanied by a fever or night sweats
  • Pain is accompanied by swelling that is not associated with an injury
  • If pain is like bilateral sciatica—affecting both sides—causing problems with the lower extremities, bowel, or bladder dysfunction; this could be cauda equina syndrome, a massive extrusion of nuclear material into the spinal canal, which causes an acute loss of function of the lumbar plexus.

Now, back to my own low-back issues. Despite all of the depressing diagnoses I was given way back when, I have lived a relatively pain-free lifestyle since 2006 due to PNMT, and MANY thanks go to my mentor for treating me and educating me on this awesome non-invasive treatment option for pain and dysfunction. You rock, Bill!

That’s all for now, folks! Stay tuned for whatever it is I decide to write about next, and as always, I hope you find this information informative!

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“Neutral balance alignment is key to becoming pain free!” ~ Me