Thursday, 22 June 2017

Understanding Pain and Accumulative Strain

I've said it before, I'll say it again.
There are things that your brain has tagged as painful, long before you may recognise it yourself. I only started to understand this concept after studying and listening to Michael Ridgway, one of my mentors who revealed so much of what I once had no understanding of... the accumulative strain model and clearing neural irritation. 

Some of the background to catch you up. 
Stress (or strain) causes inflammation, inflammation leads to fatigue, injury and/or illness.

When we experience pain, there is usually a reason for it. Often the symptoms (pain, swelling, redness, loss in ROM, flexibility function or etc) are obvious and require some type of pain relief or treatment. The best place to start in my opinion is clearing the nervous system (as taught to me in the Ridgway Method). We do this technique in clinic, try and touch your toes --> if you get a neural sensation or pain --> book in and I'll show you why stretching aggravates you and potentially could be making your pains worse

But what about the stress/strain that we aren't consciously recognising as a problem or pain?

[This is the part I love to communicate and share with people]

That understanding, our bodies are always communicating with us. We have a language that we natively speak (our body language) but many of us have disconnected from it because of technology, behaviours and addictions that steal our attention and separate us from our inner voice and self-understanding. 

Many of us perform dysfunctional movement at work, school, sport, holiday without truly understand that those movements are causing stress/strains that eventuate in what seems like an acute injury, but actually was stress/strain building up over a long period of time. 

Michael Ridgway explains further: 
I was taught that if someone has no overt symptoms, such as pain and stiffness, then there is no musculoskeletal problem.

This seemed to make sense because my clients would always present with a problem that needed the help of a physiotherapist to resolve.

Nobody ever came in saying "I don't have any issues, can you still treat me"

So there was no need to question the apparent logic of what I was taught.

Yet when I do a whole body assessment on a client with a musculoskeletal condition (in response to Fundamental 2 "Local Symptoms often have Remote Causes"), I very rarely find a single problem such as 1 tight muscle or 1 stiff joint. I always find a multitude of problems throughout their body.

Did all of these problems occur at the exact same time as the symptom that caused this client to seek my help…or did these problems exist beforehand and potentially play a part in the appearance of the presenting symptom?

I decided that instead of only doing a Whole Body Assessment on clients who had already presented with a problem, I had to start testing by doing a Whole Body Assessment on people who apparently had no symptoms…and no reason to seek my help.

What did I find?

These apparently healthy people, with no apparent symptoms and no "reason" to seek the help of a Physiotherapist, just like my clients, had multiple problem areas of tight muscles and stiff joints and restricted movement throughout their body,

My conclusion?

That these healthy people with no apparent symptoms, suffered from an accumulation of strain (strain + resulting compensation, leading to a new strain + resulting new compensation and so on).

Just as my clients who presented with symptoms also suffered from an accumulation of strain, but that cycle of strain then compensation eventually became too much for the body to continue to compensate adequately for, and so there was a "straw that broke the camel's back" effect which resulted in the onset of more apparent symptoms, to motivate them to avoid activities that aggravate, and/or to seek help.

Why is this important for us to know?

Because if musculoskeletal conditions are the result of an accumulation of strain, then treating or removing only the presenting symptoms, and not ALL of the dysfunctions, will result in at best a short-term fix that leaves the client vulnerable to regular re-accumulation and re-aggravation.

It also helps us understand that we need to retrain the client in how to move in a more "ideal" way once the accumulation of strain has been reversed throughout the entire body, in order for the client to not immediately recommence the re-accumulation of strain and compensations cycle as soon as they complete treatment…and that they continue to get Tune-Ups…

See the image of the Accumulative Strain Model

My conclusion... musculoskeletal conditions, that are appropriate for physiotherapists to resolve, are the result of ACCUMULATIVE STRAIN.

With this understanding, there are no mismatches anymore, I enjoy my work a lot more and I get significantly better results with clients.

RM 5 Fundamentals:
1 Be objective
2 Local symptoms often have remote causes
3 The Single Best Intervention results in Resolution Of Multiple Dysfunctions
Throughout The Body [i.e. Conditions are Protective Mechanisms]
4 And result from accumulative strain
5 Behaviour change is required for sustaining the fix

These fundamentals guide the redesign of RM... making it more simple and easier for physiotherapists to understand and apply.

Actually, it's much easier for me now. Not just with simplifying RM systems for physiotherapists, but also helping me to deliver better outcomes for my clients.

* Quiroga, Q.R., Mukamel, R., Isham, E.A., Malach, R, Fried I. (2008) Human single-neuron responses at the threshold of conscious recognition. Proceedings of the National Academy of Sciences, Vol 105, p3599.
* Marras, Wm, S. (2003). The Case For Cumulative Trauma In Low Back Disorders. The Spine Journal, 3, 177.

Monday, 19 June 2017

FREE Functional Mobility Classes

Can we help you or someone you know feel better?

How: Functional Mobility Classes.

What is Functional Mobility: It’s something we all need. In fact, our bodies crave it.

We all love that feeling when our bodies just feel great. When they move really well all of the time. 
In clinic, we like to call it nutritious movement.

Essentially, functional mobility is the movements that we do every day (at work, school, sport, holiday). Movements like squat, bend, sit, stand, push, pull and lay.

These movements completed correctly will make feel confident, in control, strong and functional.

These movements performed incorrectly over a period of time can create stress on the body that later presents itself as pain. If these inefficient movements are continued and repeated in combination with:
- heavy lifting
- long periods of intensity
- high speed
- reduced recovery time —> your body will become inflamed, fatigued and injured.

If you know someone who needs nutritious movement to help:
- restore
- heal
- rest and
- recover
from the movements they do at work, school, sport, holiday, then the following movement classes will be perfect for them.

Someone who is in pain, has inflammation, stress and movement dysfunction.

Someone who wants to exercise but simply feels like they cannot. These classes are you.

The Functional Mobility classes are designed around movement but are not considered exercise. 
Exercise is for healthy people and if you have pain, inflammation, stress and movement dysfunction, you are not healthy.

When, Where and How?
The following 3 classes are available to everyone and are lead by our Clinical Pilates Instructor and Physiotherapist.

Bookings are essential - Please book online

1. Mobility Func! (This class is for everyone - Even if you struggle with pain and movement)

2. Ground Up Therapy Rehab (Area specific classes) 
- Feet to knee Class
- Hip to lower back
- Thoracic to Neck

3. Functional Movement Pilates (FMP is a pre-pilates to develop nutritious movement + before moving into higher demands of function and strength)

We believe if people feel better, then they will think clearer and do more of what they love. 
We know people are stressed, so stressed that they have inflammation in their body that causes injury and illness.

We know that if we can help people feel better by identifying their stressors, then we can begin to reduce inflammation that causes pain and discomfort and treat injury at its source.

**You must book to attend. ** 
These classes are FREE but there are limited spaces. 
To see a timetable of what's available and to book online go to