Tuesday, June 23, 2009

When pain limits your motion

I have a wonderful human client--I feel like I need to clarify the species--who has extreme shoulder restrictions on one side. I don't want to write about the mechanics of the human shoulder girdle--the most complicatedly orchestrated joint complex in the body--suffice it to say if one part of the girdle isn't working properly it can reflect pain to other parts of the girdle.
In the case of this client there was/is a restriction in the soft tissue scapula on thorax portion of the shoulder girdle which prevents the shoulder from rotating when the humerus is abducted over the head--the scapula has to rotate to accommodate the deltoid tuberosity's "bumping" into the glenoid fossa. What happens is that the nervous system rather than damaging the joint causes the arm to abduct across the clavicle when the arm reaches 105+ degrees.
The client wants to raise his arm. This is his measure of success or shoulder freedom. But each time he raises his arm to test two things occur: 1. the movement is prevented by the lack of scapula rotation so the arm is abducted across the clavicle 2. the pattern of abherrant motion is more ingrained in the nervous system.
I see the same thing happening in the horse world, where riders are not happy with their horse's foreleg extension and try to stretch the leg to increase this. The problem is that the horse's gleno-humeral joint has to accomodate the greater and lessor tuberosities and rotate out of the way. When we passively stretch the leg--the only kind of stretching we can do with an animal--we are not engaging the nervous system to rotate the scapula and can impinge, during the stretch, on the gleno-humeral joint.
Often these horses with restricted movement that have been "over" stretched will have over developped and hypertonic supra and infra spinati, which are gleno-humeral stabilizers.
To increase fore limb extension we have to assure that the horse has scapula that are free to rotate.

Sunday, June 21, 2009

More danger of anthropomorphism

Those of you who read this blog--thanks for your time--know that I am concerned about how we assume that therapeutic interventions used with humans are being taken without translation into the animal therapy world. I call this "anthropomorphism".
The latest trend in this has been in the idea of "core" muscular strength as a deterrent to back pain in humans. This idea is now being promoted in the equine world. There are now such things as equine "pilates" that are pilates in use of the name only. It is a sad situation to me, that two medical professionals decided that a series of stretches, using enticements like reaching for a carrot, to get the horse to move in a non-traditional way is the same as Pilates. This is an obvious rip off of a branded name.
But beyond this there is still the problem of taking the concepts of "core" strength and equating it to something useful for the equine, when, in fact, it is still a controversy in the human context as pointed out in this NY Times Article: http://well.blogs.nytimes.com/2009/06/17/core-myths/?em
Let me get off my soap box and state that anytime we humans or our animals can be encouraged to perform non-traditional movements our body will benefit from it. Getting up from the computer and stretching, teaching your horse carrot stretches or better yet clicker, taking your dog for a swim will all tend to increase the options for movement available to the body. Increasing the movement options--or as Rolfers say "adaptive capacity"--allows the body to choose from a greater repetoire of movements to remain energetically efficient.
Any thoughts?

Thursday, June 18, 2009

Fascination

My dog, the star of my canine mfr video "Jake", has come up with a new game. He goes into our backyard. This causes the rabbits to run under the deck to get away from him. This in turn keeps Jake on the deck looking and smelling through the spacing in the decking to "chase" the rabbits. He runs from one place to another, chasing after the rabbits, as they move to avoid his scrutiny. If one of the rabbits decides that the best solution to the dog is to stay still he scratches at the deck to get them to move. It frustrates the you know what out of him but he loves it. Or should I say he's addicted to it. It's really not much different to my addiction to TV or the internet.
As I'm writing this Jake and me are outside on the deck. He's taking a break from the rabbits. Perhaps he got bored with his cure for his boredom, who knows why he's on break?

It has me contemplating how much of my time is spent in my habitual pattern. This is something we talk about in Meditation as well as Rolfing. How we become habituated to our simple activities, the easy ones, or easy way of doing things. I have taken this a little bit further to suggest that this is how we survive. Through the a minimum expenditure of energy to accomplish a task. If we habituate something than it becomes "natural" and easy. From the Rolfing body view we can say that this habituation originates in an avoidance of a restriction, which makes it easier to follow a certain movement path. In meditation we could say that each action plants a karmic seed which will come to fruition later when the same conditions arise. In other words if Jake scratches on the deck to get at the rabbits and I get mad at him this plants a seed of being mad. The next time he scratches--the condition--that karmic seed of mad can come to fruition. If through meditation I become familiar with my mind and its speed I can make a break the habit and decide if I want to get mad or ? That plants the seed of decision which eventually may over plant the seeds of mad. Complicated eh?
Back to the body's habitual patterns. My premise is that a body will not, should not change what we consider a habitual pattern if that pattern is energetically efficient, unless we propose to it one that is more efficient. We can experience this on the micro level as a guide to our work at a more macro level. We all approach our work with hoping to see a change in our client's structure, movement, etc.. This is the macro. We all have to try and translate this macro strategy into a series of smaller micro interventions that will hopefully accumulate into the resulting macro change. Unfortunately we sometimes get hooked into a habitual pattern while working with our client that is not supporting the micro.
What I am saying is that every micro intervention has to be accepted as an energy efficient change by the body to be accepted. If not than we risk depleting the client's available adaptive capacity and not getting the results we hoped for.
My suggestion to people who train with me is to make small interventions. If these are accepted--as evidenced by local tissue change--than continue with that. If they are not accepted stop and reconsider the local intervention in favor or a different one that is accepted.
This is contrary to what happens in most massage settings or anything that promotes a routine--read habituated pattern--that does not allow for local evaluation of efficacy. This is a sacrifice of the local in hopes of a larger global change--usually one where the client becomes "spaced" out. I'm advocating for local change in support of a more global one. With this strategy we are working with the body and allowing it to direct its own change, one that benefits it more energetically.
Any thoughts?

Tuesday, June 2, 2009

Where have the Innovators gone?

I've been on this tantrum about the lack of adaptation of human therapies to animals. For those of you who haven't been bored by this in the past, what I mean is that too often human therapies are applied to animals without thinking about how they may need to be changed/adapted to better work with the animal. For instance, massage therapists who are taught to keep their hands on the animal for the entire massage, similar to what occurs with human massage training, with no thought to how this affects the animal's nervous system.
There was a time when we had some pioneers in the animal world who were willing to "translate" their human therapeutic specialty to animals. For instance Linda Tellington-Jones, who pioneered the use of Feldenkreis techniques to the animal world, especially horses. Some would suggest that Jack Meagher did this with the work of Travell and Simmons and Trigger Point therapy, but I disagree that this was translated--it was simple copied over with some mistakes, like "rotator cuff"...
Recently I saw two examples of simply taking a human therapy's title and applying it to animals: Pilates for Horses, Yoga for dogs. The Pilates for horses is really troubling to me, since as a Rolfer I am concerned when someone who is not trained in Rolfing calls their work this. (It's an irrational response but one I acknowledge having.) This so called pilates therapy for horses consists of some simple stretches that are induced by using a treat--this is the only way my horses get any "finger" food, they have to work for it by stretching. (When I was first developping my equine series I videoed my horse before and after while inducing these "treat" stretches since they repeatable and the tissue response was evidently different.)
Calling these new interventions by a name associated with human therapy--pilates or yoga--is a misleading way of subsuming the reputation of the human therapy and suggesting that these animal "versions" have the same therapeutic benefit as the human one enjoys.
This use of a human therapies branding leads to a dumbing down of the therapy when it is applied to animals, which in turn leads to a dumbing down of the therapist who applys these therapies with humans. What I mean is that the animal therapist stops their critical thinking about how the animal views the world, moves through the world and is motivated. I read another article in which an equine massage therapist was qouted as saying that horses will, I'm paraphrasing hold emotional stress in their shoulders. just like humans in stressful jobs will. Huh? To me this kind of statement can only come from ignorance of the difference in how humans and horses view their environment.