Whiplash 101

 By Richard DonTigney

The lack of movement in the sacroiliac joint is a myth. When walking the pelvis moves obliquely to the line of travel, to increase the length of the stride. The sacrum moves on the asymmetric pelvis to drive counter rotation of the trunk to decrease loading forces. Pelvic dynamics has profound effects on normal gait.  

The joint is vulnerable to injury through minor trauma only in anterior rotation of the innominates on the sacrum.  Idiopathic low back pain is a commonly overlooked, reversible dysfunction in anterior rotation, usually bilateral.   A diagnosis of dysfunction can be made simply by identifying a single painful point at the posterior inferior iliac spine that is caused by a vertical shear on the conjoint origin of the piriformis muscle and tearing of the capsule at S3. See pain patterns here. The anterior rotation will loosen the iliolumbar ligaments, destabilize L4,5-S1 and increase shear and torsion shear to the disks.  Correction restores stability.

Full correction in posterior rotation will provide immediate relief of pain.  More than three treatments are seldom necessary.  Stabilization of the unstable SIJ can be obtained with five to six sessions of prolo specifically to the long posterior sacroiliac ligaments.  Prolo to the iliolumbar ligaments without correction of the SIJ first can tighten the joint in the uncorrected position and may prevent correction.

Anyone not properly treating dysfunction of the sacroiliac joint is perpetuating chronic low back pain.  X-rays of innominate movement on the sacrum are published on-line at www.thelowback.com/how.htm#movement

Pool Spine Workout

By Amy Price PhD

Chronic pain and balance can be improved with water exercise. Exercise releases feel good chemicals in the brain that are powerful mood booster and pain fighters. These neurochemicals help balance mood swings and the other benefits are looking better and having a body that burns fat more effectively. Many spinal patients can’t get the exercise they need because they find exercise painful torture so they lied down on the couch with a snack until feelings (mostly guilt) about exercise go away. This perpetuates the cycle as muscles and joint get stiff and lose flexibility, loss of muscle means less fat is burned and guilt and low energy levels steal that feel good feeling.  

Water provides a safe medium for joints and working in water improves balance. Be sure to choose a warm place for your water workout to avoid muscle spasms.  Afterwards a hot bath with a couple of cups of epsom salts included can provides an inexpensive muscle soothing experience. The NCPAD  has some great information on how to get started and exercise in water safely. Here are more aquatic exercises   . If you are a swimmer add some power to your water workout with swim fins for the feet and  hands.  

The buoyancy of water reduces the “weight” of a person by about 90%, (at least while in the water!) which means that the stress on weight bearing joints, bones and muscles is lessened. That’s why aqua exercies are good for people with arthritis or back problems. You still get a great work out, it just doesn’t hurt! Water exercise can encompass all of the components of fitness: cardiovascular fitness, muscular strength and endurance, and flexibility. And, when done regularly, water exercise can help reduce body fat 

Need some help with diet too? Check out this information on diet for pain relief and clear thinking here 

Be Nice To Volunteers...They Live Long Lives!

DAVID FAWCETT, PhD, LCSW

                Did you know that giving your time and effort on behalf of someone else can actually improve your mood and overall health?  Although it sounds too good to be true, that is the conclusion of a number of studies on a variety of populations from around the world.  Scientists are still unraveling the specifics, but there are some intriguing clues documenting the health benefits of volunteering.

                First, there are positive physical health effects.  Volunteering was associated with reduced mortality risk in a number of studies, especially in persons aged 60 and over, although the benefits appear to hold true for all ages.    Simply put, persons who consistently give their time on behalf of others lived longer than those who did not.  More surprisingly, the health status of the volunteer didn’t matter.  Even if they had a serious medical condition themselves, volunteering provided a protective factor for their own physical wellbeing.

                Volunteering was also associated with increased positive emotions and a significantly-improved  sense of purpose.   It increased access to social and psychological resources which countered negative moods such as depression and anxiety.  People who volunteered reported a greater degree of overall happiness, with improved social support and cohesion that benefits both the individual and the community.  Finally, volunteering has been shown to improve self-satisfaction and mastery of new skills, both of which reinforce a positive self-image.

                These studies also reveal interesting ways to maximize the positive effects of service work.  The total number of volunteer hours per week was not as important as consistency and length of service.  That is, just one hour a week was more effective at promoting the health and wellness of the volunteer than lots of hours, as long as it was consistent over a period of months or even years.    Studies also revealed that there are health benefits even if the service work is informal and privately arranged, such as spending time with a homebound neighbor each week.  Volunteer work doesn’t have to be “official” to benefit, just consistent.

In the end, these studies showed that “mattering” was the crucial link between volunteering and wellbeing.  By moving beyond our own needs and helping others, we begin to make a difference and “matter” to both our community and ourselves, and we get the bonus of being healthier and happier.    

              This article was used by permission of Dr Fawcett  and originates from The Fusion group  

Richard Don Tigny , used by permission

Richard DonTigny SI Solutions used by permission

This  SI Joint information was graciously supplied by  Richard DonTigny, a well known leader in this field from Havre Montana.  Many individuals constantly go to a chiropractor to have them adjust this area but it can be very effective to learn how to gently and accurately self correct with the advantage of bringing almost immediate pain relief. Richard DonTigny has a great website where you can get detailed well explained  information and even purchase  video materials on how to get these corrections working for you.  

On the right are basic  techniques to reset the SI area. The first one will look familiar to those of you familiar with post-isometric relaxation or muscle energy technique. This series of images, shows different positions in which to do the same basic exercise. They can even be done standing up in an airplane corridor! 

 The instructions are to bring your leg up to the chest, grasp the leg with both arms, and push outward with the leg against resistance. DonTigny recommends pushing outward hard for five to 10 seconds, then alternating legs, doing each side three to five times. Note that this can be done supine, sitting, standing using a chair, or in a doorway 

 The next offering is a self traction correction.  I like this one as it can even be done lying in bed. When doing any of these exercises in the supine position be certain to hold your abdominal muscles tight when raising or lowering your leg to prevent anterior rotation of the pelvis.  There is a first class video  available for Richard Don Tigny with print out exercises which is available from the  Dynamic Core Program CD for patients. 

 Richard DonTigny  makes excellent additional  seldom heard points regarding SI dysfunction.1)Periarticular injections are superior to intra-articular injections for diagnosis of SIJ dysfunction.(2) Murakami Fukushima (3) found that many times cervical strain will not release until the SIJ is corrected. (I have certainly found this to be accurate) 

 The last form of correction is in the color photo on the left hand side. You can  self-correct any time during the day no matter what position he happens to be in at the time. Just by pulling the knee into the axilla or bringing the axilla down to the knee. Stretch firmly several times on each side, alternating sides each time. Remember to hold those abdominals tight as you raise and lower your leg for protection against an anterior pelvis rotation. 

  Stretching the psoas is usually counter productive as a dysfunction of the SIJ will cause the psoas to become tight while correction of the dysfunction will loosen it.  If you stretch the psoas you will increase the dysfunction in anterior rotation of the psoas. Similarly the SIJ dysfunction will cause a vertical shear on the piriformis at the S3 segment. Correction of the dysfunction corrects and relieves the vertical shear.  The piriformis, the G. max and the iliacus all have origins on both the sacrum and the ilia.  The shear is the cause of the piriformis syndrome.   Similarly the sacral origin of the G. Max will tend to separate from its ilial origin and the ilial origin of the iliacus will tend to separate from a small slip on the sacrum. 

 References: 

 1.DonTigny, RL: A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the implications for lumbopelvic function and dysfunction.  In Vleeming A, Mooney V, Stoeckart R: Movement, Stability& Lumbopelvic Pain: Integration of Research and Therapy. 2nd edition. Edinburgh, Churchill Livingstone, 2007, Chapter 18, pp 265-278 

 2.  Murakami E, Tanaka Y, Aizawa T, Ishizuka M, Kokubun S: Effect of periarticular and intraarticular lidocaine injections for sacroiliac joint pain: Prospective comparative study.J of Ortho Science  12(3):274-280, May 2007 

 3.  Fukushima M: Radiographic findings before and after manual therapy for acute neck pain. International Musculoskeletal Medicine, 30(1): 1-19, 2008

By Amy Price PhD

SI Pain is often caused by sacroiliitis (inflammation of the SI Joint) and can cause low back pain which often hurts on one side. The pain can be extreme aching sensation which is referred to the low back, buttock or thigh.  This is called  sacroiliac joint (SI) dysfunction The reason it hurts is because there is too much or too little movement in the joint which  causes strain because the bones are not adequately supported and the anatomy becomes  asymetrical. It is estimated this area is painful for as much as 15% of the population at any one time. 85 % of us will experience significant back pain in our life times

The sacroiliac joint or SI joint is the joint in the bony pelvis between the sacrum and the ilium of the pelvis. The joint is a strong, weight bearing synovial joint. These joints are shaped much like kidney beans.The joints are covered by two different kinds of cartilage; the sacral surface has hyaline cartilage and the ilial surface has fibrocartilage.  Prolotherapy is often used to strengthen the cartilege and provoke a healing process, it is important that the joint is mobilized and positioned correctly before prolotherapy and that prolotherapy be guided by flouroscopy so that treatment is accurately placed. The dermatome map can show pain patterns   Cortizone  injections are sometimes used to treat this area but release can be short lived unless the structural problem is addressed.

There are other conditions such as disk herniations, lumbar nerve compression,  hip degeneration or sensory  motor  proprioception deficits that can mimic this difficulty so it is important to be examined and treated by a qualified medical professional.  With an SI joint dysfunction present it is not a good idea to do psoas stretches as this can increase movement and instability.

 Richard Don Tigny has developed some excellent methods for treating this problem through correct positioning and strengthening exercises. I have personally found this method very beneficial. I was erroneously treated for piriformis syndrome and other things for years before I finally found relief using these simple effective corrections I could do myself. I know of several individuals who were recommended for surgical procedures, tried this method instead and became pain free without surgery. Don Tigny has validated his method with research. There is a video available for purchase by patients and professionals which is well worth the investment. He has granted permission to show three corrections and there is also a link  supplied to his website. He has made available multiple materials, research links, explanations and solutions. A link to his site and some useful corrections are available here.

Retrain Your brain and Increase Joy and Thinking Skills!

By Amy Price PhD

  Do you need to get your life back and restore relationships after trauma? Extensive research indicates our brain needs to overcome the negativity bias ingrained through the fight/flight response produced by trauma or social rejection to operate at maximum potential. It is more than positive thinking as the mind has a specific ratio of positive to negative input it accepts plus the input must be genuine to release the feel good chemicals that promote brain learning and healing.  Many people involved in an auto crash must fight for insurance rights and social acceptance during an era of limited capacity and chronic pain. All these aspects take a critical toll on the brain and promote inflammation cascades that lead to long term functional loss. The great news is that with targeted brain training in small manageable steps you can get back the edge taken from you though trauma, bad relationships, or serious illness. Your brain wants to work for you!

Clicking on Train Your Brain , Save Your Mind here will take you to a fascinating short video on the power of personal brain optimization and contains a clinically validated assessment tool. This video is presented by Dr Evian Gordon of Brain Resource Company  and speaks about the highly acclaimed wellness program My Brain Solutions. It is well worth investigating, in less than 15 days I showed improvement on several measures of cognition. If you would like to sign-up for MyBrainSolutions please email me ….read on for why training your brain matters…Our minds and brains become so starved for approval and acceptance that we accept input and relationships that are harmful and not genuine.

 Your own brain even when it is damaged can pick up emotional cues in 1/20 of a second  which will determine how we respond to others.  How can you tell the difference between a forced and genuine smile? For a smile ask your self if the eyes crinkle slightly and the pupils enlarge, smiling with only the mouth is not genuine expression. Interestingly this insight has been validated by multiple behavioral, FMRI, GSR and QEEG studies, yet like many insights it is rooted in wisdom passed down from successful individuals who are at peace with themselves. Dr David Whitehouse, an eminent Harvard trained Psychiatrist put is this way  ”PEOPLE NOT ONLY SEEK AN EMPOWERING MIND, BUT ONE THAT IS AT PEACE WITH ITSELF”.  My Brain Solutions can help you learn to discern emotion and train your brain from a negative to a positive bias and offers a clinically validated personal assessment with a presonalized prescription to increase your brain function. Dr Evian Gordon states in his book ‘The Brain Revolution’ that  “THE DIFFERENCE BETWEEN AND EXPERT AND A NOVICE LEARNER IS A MODEL” One critical component of cognitive skill is one’s ability to speedily reframe or re-appraise the circumstances that surround you. People that successfully reframe have better life satisfaction and long term survival rates than those who are fixated on negative events, this ability can be trained.

Research on cognition that shows transfer of training and increase in quality of life is dependent on carefully assessing individual differences with  clinically accepted tools which provide personalized training to meet these perimeters[1,2,3,4,]

Learning and novelty are partners yet many brain fitness programs offer rote repetition of weak areas without variation in task or content in a bid to target learning, However research shows us this is not the way meaningful learning occurs. Tasks must be individually challenging to hold engagement and yet structured enough to be doable. Ideally tasks will adapt to changing learning curves to build neuroplasticity. The best learning capitalizes on emotional and intellectual strengths already present while strengthening areas of weakness in a positive atmosphere. For example, teaching a university student mnemonics and concept mapping may make the memory more efficient however teaching an individual with organic damage or early dementia how to remember names and faces with a mnemonic is an exercise in futility.

Specific training alone can lead to plastic changes in the brain as demonstrated by expert Braille readers who show an enlarged hand area and smearing of finger representations in the somatosensory cortex. This result was observed in expert, but not in novice Braille readers suggesting that the training and not the blindness which leads to the changes in cortical representation [5]Similar domain specific results were noted in London taxi drivers and expert violinists. Kramer et al [6] states recruitment of additional brain regions helps performance only if the recruited area complements processing of the task in question. This is likely why rote memorization fails to increase working memory whereas training that targets attentional networks and processing speed increases working memory limits. We are incapable of processing in depth what we have not attended to and our capacity for material attended to is limited by the speed at which we process stimuli.

My Brain Solutions has an inviting Dashboard where you can  Empower Your Own Life….See you at the Dashboard!

References:
1. Posner, M., & Rothbart M. Educating the human brain. Washington, DC US: American Psychological Association.; 2007:189-208. doi:10.1037/11519-009

2. Jaeggi SM, Buschkuehl M, Jonides J, Perrig WJ. Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences of the United States of America. 2008;105(19):6829-33. Available at: http://www.ncbi.nlm.nih.gov/pubmed/18443283

3. Willis SL, Tennstedt SL, Marsiske M, et al. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA : the journal of the American Medical Association. 2006;296(23):2805-14. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17179457

4. Gordon E, Arns M, Paul RH. Research Report THE INTEGRATE MODEL OF EMOTION, THINKING AND SELF REGULATION: AN APPLICATION TO THE “PARADOX OF AGING”. Thinking. 2008;7(3):367-404.

5. Greenwood PM. Functional plasticity in cognitive aging: review and hypothesis. Neuropsychology. 2007;21(6):657-73. http://www.ncbi.nlm.nih.gov/pubmed/17983277

6. Kramer AF, Bherer L, Colcombe SJ, Dong W, Greenough WT. Environmental influences on cognitive and brain plasticity during aging. The journals of gerontology. Series A, Biological sciences and medical sciences. 2004;59(9):M940-57.: http://www.ncbi.nlm.nih.gov/pubmed/15472160

cold light laser

 By Amy Price PhD

Laser  therapy has been reported helpful in wound healing and chronic pain. It is a fast, painless modality which can be administered by a medical professional or self administered in some localities by a patient trained and licensed in laser protocol. The light that the laser uses is not visible to the naked eye and special laser light spectrum goggles are needed. They are sensitive to the spectrum of the laser used. According to the Cochrane report results for wound healing and chronic pain relief are evident however more study is needed to determine protocols for effectual wave lengths and time exposure 

What is a cold light laser?

Low-level laser light is compressed light of a wavelength from the cold, red part of the spectrum of electromagnetic radiation. It is different from natural light in that it is one precise color; it is coherent (it travels in a straight line), monochromatic (a single wavelength) and polarized (it concentrates its beam in a defined location or spot). These properties allow laser light to penetrate the surface of the skin with no heating effect, no damage to the skin and no known side effects. Rather, laser light directs biostimulative light energy to the body’s cells which the cells then convert into chemical energy to promote natural healing and pain relief. 

These are ways laser treatment has been found to help

Speeds Up Tissue Repair:   Increased energy to the cells means increased cellular activity for all of the cell’s components that rely on this energy including collagen formation. Speeding up tissue repair  means less scar tissue formation. 

Increases Endorphins: Endorphins can  produce analgesia (pain relief) and feelings of well-being. They are known as the bodies natural  pain killers. 

Increased Lymphatic Drainage:  Studies have shown that cold laser therapy can increase the size of the lymphatic ducts thus facilitating protein waste removal. 

Increased Blood Flow: to the tissues because of increased capillary formation. This helps healing. The laser affects deeper tissues as well including  muscles and tendons. 

It appears Laser can generate  relief for chronic pain treatment

Relieve nerve pain and trigger points without surgery or chemicals

By Amy Price PhD

IMS is similar to acupuncture except that the treatment does not rely totally on meridians but is based on a physicians training in anatomy. trigger points and the central nervous system. It can be treatment orientated as well as a useful minimally invasive diagnostic tool for neuropathic muscle pain.

Trauma and chronic pain often produces muscle shortening. These shortened muscles can press on and irritate the nerve. Even though this pressure may seem slight and be difficult to measure it can be the source of excruciating pain. This pressure builds up over time causing all kinds of problems like making the nervous system super sensitive. This can cause sensitivity to pain in other areas of the body. To get an idea of how this works think about wearing a pair of slightly snug shoes. At first you feel nothing but as the day goes on that slight pressure becomes something that can not be ignored. With the shoes you can rip them off and toss them into the trash, but when pressure mounts inside the muscle pushing on the nerve there is nowhere for it to go.

IMS works on the premise that supersensitive area can be desensitized. IMS releases muscle shortening by dry needling the sensitive areas with tiny acupuncture needles. Penetration of a normal muscle is relatively painless however an afflicted muscle responds to the needle with a slight cramping sensation. This stimulates a ‘stretch receptor’ which produces a reflex relaxation response resulting in a lengthening of that muscle fiber. The needle also causes an electric potential which travels to the nerve and potentially resets it to normal function. The other thing that happens is the needle produces a minute wound which causes increased blood flow to the area to enhance circulation and initiate healing. For FAQs about IMS or research links click here Does it work? The answer seems to be that for some people it does. For research links  New treatments with prolotherapy and adult stem cell treatment may produce results. Diet can help with pain Specific supplements can help ligaments and tendons heal to take the stress off overworked muscles

Psoas Muscle Location

By Amy Price PhD

 

Stretching Psoas can alleviate back and hip pain

                                       

The psoas muscle starts in the lower back at which point the paired psoas muscles act as anchors on either side of  the spine. These muscles wrap around the pelvic area attaching at the knobby part of the hip with several strong tendons. The psoas muscles are considered to be crucial among the hip flexor muscles. Hip flexors allow people to bend their bodies into their hips and to pull their hips into their bodies. Low back or hip pain can come from  contracted psoas muscles which fail to provide  support. They can gently stretch to elongate their muscles and make them more flexible, as well as seeking medical attention if the pain continues, grows worse, or changes. Engaging in a regular physical fitness routine which includes stretching such as Pilates or Yoga will help to keep the psoas muscle aligned, strong, and flexible, along with other vital muscles of the body.

  A gentle psoas stretch, involves lying on your back on the floor. Make sure that your pelvic position is neutral, your shoulder blades are flush with the floor, with your spine and head aligned, forming a straight, smooth line. Gently bring one knee up to your chest while extending the other leg along the floor, breathing deeply and evenly. Hold the position for 10 breaths before switching sides, and repeat 3 times. You should feel a gentle stretching action but not pain

 For a deeper psoas stretch, adopt a lunging position with one knee forward, forming a 90 degree angle, if possible, between the hip and the calf. Extend the other leg behind you, kneeling slightly, and lower yourself slowly into the stretch, which you will feel in the front of the hip. Make sure you don’t increase the curve in your back as you come forward (the Psoas connects the back with the front of the hip).  Sometimes it helps to tighten the stomach muscles as you come

Please Consult Your medical professional before stretching the psoas, In some cases psoas stretches can be counterproductive

Richard Don Tigney  referenced below states,  “Stretching the psoas is usually counter productive as a dysfunction of the SIJ will cause the psoas to become tight while correction of the dysfunction will loosen it.  If you stretch the psoas you will increase the dysfunction in anterior rotation of the psoas.

Similarly the SIJ dysfunction will cause a vertical shear on the piriformis at the S3 segment. Correction of the dysfunction corrects and relieves the vertical shear.  The piriformis, the G. max and the iliacus all have origins on both the sacrum and the ilia.  The shear is the cause of the piriformis syndrome.   Similarly the sacral origin of the G. Max will tend to separate from its ilial origin and the ilial origin of the iliacus m will tend to separate from a small slip on the sacrum.(1)

Periarticular injections are superior to intra-articular injections for diagnosis of SIJ dysfunction.(2)Murakami

Fukushima (3) found that many times cervical strain will not release until the SIJ is corrected.”

References:

 1.   DonTigny, RL: A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the implications for lumbopelvic function and dysfunction.  In Vleeming A, Mooney V, Stoeckart R: Movement, Stability& Lumbopelvic Pain: Integration of Research and Therapy. 2nd edition. Edinburgh, Churchill Livingstone, 2007, Chapter 18, pp 265-278

2.  Murakami E, Tanaka Y, Aizawa T, Ishizuka M, Kokubun S: Effect of periarticular and intraarticular lidocaine injections for sacroiliac joint pain: Prospective comparative study.J of Ortho Science  12(3):274-280, May 2007

3.  Fukushima M: Radiographic findings before and after manual therapy for acute neck pain. International Musculoskeletal Medicine, 30(1): 1-19, 2008

Nerve Glides can help relieve chronic spinal pain

Amy Price PhD

Nerve Glides can help release a lot of the pain that comes from trauma and even arthritis. A lot of the pain may be originating from the nerves in a cascading effect which inflames surrounding soft tissue. The peripheral nerves in your arms and legs are mobile structures  that can stretch when elongated. Injury and scar tissues can trap them but you can do special stretches called nerve glides to release these areas.

To see how your nerves move try this.  Take your finger and touch your nose.  Then bring your hand all the way out to your side and stretch it out as far as it will go.  Next tilt your head away from your outstretched hand (if it’s your left hand, bend your head right).  You will likely notice a pulling sensation in your hand and arm with your head bent.   Now try to bring the head towards the hand, does it go away?  This is a demonstration of  nerve tension. 

 There is no muscle that goes  all the way from your neck to the hand.   Since bending your head away from the hand tightens the nerves that go from your neck to your hand, you feel pulling. If you feel pain, numbness and tingling, this is a problem you should tell your doctor about. Nerve glides can be used in multiple body areas not just the hand and neck. Nerve pain is referred to other body areas and you can get an idea of the patterns  by looking at a dermatome map

Another example  is that the nerve when inflamed looks like a thick lumpy rubberband, but as you stretch and glide the nerves, they thin out making an easier passage through the channels they move theough. If you stretch a rubber band it “thins” out.

The nerves in your body have a normal range of motion like the joints.   Nerve glides are stretches that help get back that normal movement.  Nerve glides must be done gently and should never increase pain. The goal is to  free the area up and not to inflame it so in this case pain is not gain.  Technique is critical. It is best to have an occupational therapist that specializes in neural education who can show you how to do these nerve glides. They will give you a sheet with the instructions on how to do these right and you can watch as you perform the nerve glides in the mirror to make sure your form is correct. Nerve glides are also known as nerve flossing or nerve stretching.