Corrective

Pain Series Part 3: Top 7 Corrective and Restorative Therapies for Chronic Pain

Pain Series Part 3: Top 7 Corrective and Restorative Therapies for Chronic Pain


Movement-based therapies such as yoga, tai chi, qigong and more mainstream forms of exercise are gaining acceptance in the world of chronic pain management. Many pain clinics and integrative medicine centers now offer movement-based therapy for pain caused by (dis)eases; like cancer and cancer treatment, rheumatoid arthritis, fibromyalgia, multiple sclerosis, and other (dis)eases and conditions.

Here I offer you seven of my top therapies that I have used  on and off to manage injuries, back pain, IBS and intermittent colitis, as well as coached clients through or referred clients, which has resulted in better movement, overcoming pain and restoration of their well-being.

In my own practice I am able to pull from a gambit of tools; where , Yin Yoga, deep breathing, NLP guided brain wave work and corrective transitional movement are part of my weekly pain management regime. Apart from what I can guide myself through, we all know that a support system and integrated teach is key. You can’t do it all yourself. Therefore, many of the therapies listed below I cycle in every 4-6 weeks. The first step is to always remember to honor the process and have patience as you progress. The second step is to ensure you keep moving. Humans are made to move, we are not meant to be stagnant. The less you move the more you will “feel” pain, your fascia will stiffen and you will lose strength. Train smart, not hard and take time to re build the trust in your training. The third step is understanding that there will be obstacles, detours and pit stops along the way. Like all things in life – unpredictability is a constant, so be prepared to have feedback from your body. In the beginning, your pain may increase, but this is a natural response, a protective response. If you keep your pain as an observer and your goal of living pain free as your driver, your body will respond as such, just give it time. Every step you take makes you stronger and brings you that much closer to the well-being you wish to achieve.

 

Yin Yoga & Deep Diaphragmatic Breathing:

Yoga and the art of pranayama are ancient systems developed in India that address the physical, mental and spiritual aspects of the individual. Studies have shown its positive effect on stress through a decrease in serum cortisol levels and increase in brain alpha and theta waves. It may also be of benefit by increasing self-awareness, relaxation on physical and emotional levels, respiration, and self-understanding (Nespor, 1991). Decreased stress may positively influence the emotional component of pain. On this basis, it has been advocated as part of a multimodality program for back pain (Nespor, 1989). In clinical studies, yoga has reduced the pain of osteoarthritis and carpal tunnel syndrome (Garfinkel, 2000), and promoted stress reduction and positive mood (Kerr, 2000; Schell, 1994). These are just a few of the many studies that show Yoga as an instrumental benefit to anyone living with chronic pain.

Committing to a regular practice of deep breathing is the first place to start. Learning how to train the body and mind to move with breath will help, not only to break down that protective “turn on” of our auto stress response, which leads to contraction and “tightness,”  deep breathing will help release and relax tissue, as well as work to supplies every organ with necessary oxygen and blood to help restore function.

YogaFORM: http://sarahmjamiesoncoaching.wordpress.com/yogaform/

Scott Sonnon, Intu-Flow and Prasara Yoga: www.prasarayoga.com 

NLP Integration and Somatic Healing:

The power of language goes beyond words. Combining the methods of NLP and Yoga; two powerful schools of thought; you can experience the transformational tools that can lead you towards breaking down barriers that hold you back from greater potential. A private yoga setting is the perfect space to connect the body and mind through practiced, sequential postures; while utilizing the power behind guided meditation and language to encourage your consciousness to overcome obstacles, de stress, restore and rejuvenate.

Meditation is proven to have a huge influence on brain activity and physical response. Meditation produces significant increases in activity in the prefrontal cortex, the part of the brain responsible for positive characteristics like optimism and resilience, as well as “higher” executive functions. By tapping into the mindfulness of meditation and focused movement, you can reduce stress levels, by reducing the production of cortisol and regulate your adrenal glands (the organs designed for fight or flight). This in turn encourages your immune system to function in optimal levels.

Somatic education emerged during the twentieth century, but has been practiced in Eastern traditions for centuries. Western science classifys somatic healing and somatic education; a term used interchangeably, as an internalized learning process which is initiated by a teacher who guides the client or student through a sensory-motor process of physiological change.

When we speak of self-teaching, self-learning, self-healing, and self-regulation, we know that this is a somatic process, and as coaches and teachers we must guide our clients to the understanding that these are genetically-given capacities intrinsic to all human beings. When we combine guided meditation and yoga, the body can undergo a transformation.

NLP Integration: http://sarahmjamiesoncoaching.wordpress.com/nlp-somatic-healing/

Corrective Movement:

Repetition in movement and altered movement patterns through compensation can cause imbalances in the body and increase the high sensory stress response in clients with chronic pain. This can lead to changes in the elasticity of the tissue. And as most of us know when we feel pain, we tend to do less; which leads to the body getting weaker and the tissue getting tighter. This fear of movement is the number one cause that continues the viscous cycle of pain.

There is evidence that if you perform slow paced movements with regular breathing and slow the heart rate, you can calm or quiet the autonomic nervous system. Slow paced, corrective movement can ensure a client’s success towards moving away from pain and moving into a more stable and pain free existence. This tempo and focused intention can target the pathways by shutting off or diminishing the inflammatory response that causes chronic pain. Many of my clients who suffer from chronic pain show better movement and reduced tightness, tone and neuropathy after 12 weeks of consistent corrective movement 2 times per week.

Functional Movement Systems: Understanding Corrective Movement  Video: http://graycookmovement.com/?p=76

Tai Chi  (Taiji) and Qigong:  

are gentle movement practices that have been used for centuries in China for health. As a form of exercise and relaxation they have been used to improve balance and stability, reduce pain and stress, improve cardiovascular health, and promote mental and emotional calm and balance. In the area of pain management, scientific studies have shown their benefit in reducing stress, as evidenced by alpha and theta brain wave increases, increases in B endorphin levels and drop in ACTH levels (Ryu, 1996). Effectiveness has also been shown for complex regional pain syndrome, fibromyalgia, and chronic low back pain when combined with education and relaxation training (Creamer, 2000; Berman, 1997). Studies continue to clarify the mechanisms of action, benefits and applications of these movement practices for health maintenance and disease management.

Shou-Yu Liang (SYL) Wushu Taiji Qigong Institute: http://www.shouyuliang.com/index.shtml

KMI Structural Integration

KMI is expressed in two parallel through awareness of movement and Structural Integration; which is a hands-on form of tactile, kinesthetic communication. This technique allows the client and practitioner engage in precisely structured movement explorations that involve sensing, moving, energy work and relaxation. The design of KMI is to unwind the strain patterns and compensations residing in your body’s locomotors system, restoring it to its natural balance, alignment, length, and ease. Common strain patterns come about from inefficient movement habits, poor posture habits, and our body’s response to our external environment. Individual strain patterns can come from imitation when we are young, from the invasions of injury or surgery or birth, and from our body’s response to traumatic episodes. Compensation begets compensation, and more symptoms. KMI is designed to unwind this process and reduce structural stress. The method depends on a unique property of the body’s connective tissue network.

Structural Integration attempts to make one aware of his/her habitual neuromuscular patterns and rigidities and to expand options for new ways of moving while increasing sensitivity and improving efficiency without increasing in pain.

Sherri Leigh Iwaschuk:  http://www.sherrileighrmt.com/Sherri_Leigh_RMT/Welcome.html

Acupuncture:

Millions of people worldwide use acupuncture to ease a variety of painful conditions. Ever since the 1970s, when this ancient Chinese tradition debuted in the U.S., Western researchers have sought to understand the phenomenon of acupuncture. Even though there is still some controversy surrounding the scope of this ancient treatment; many swear by it’s healing powers and how it can be an effective tool towards reducing pain. What happens when a needle is inserted into “Acu-points,” the needle stimulates pain-sensing nerves, which trigger the brain to release opium-like compounds called endorphins that circulate in the body. There are some who believe that acupuncture works through a placebo effect, in which the patient’s thinking releases endorphins.  As for myself, I have seen Mon Jef Peters, with Fit to Train and I can say that it has worked wonders for me.

Fit to Train Human Performance Systems: http://fittotrain.com/About/team

Osteopathy:

Osteopathy is a well-established branch of complementary medicineIt is a gentle hands-on treatment that aims to adjust your body’s structure (the alignment of bones, joints and muscles) so that you can function at your best, physically and mentally. The osteopath uses physical manipulation, stretching and massage to correct imbalances in the joints and muscles. Osteopathic treatment can also help problems that seem to have nothing to do with joints. Chronic fatigue, asthma and Irritable Bowel Syndrome (IBS) have all been successfully treated.

Correcting joint imbalances and postural problems allows your body to heal itself, freeing blood circulation and trapped nerves.

Roderia Ostepathy Wellness Art: http://www.rodieraosteopathy.ca/

Additional Articles and Links:

Corrective Movement Un Covered: Primitive Patterns, Myths and Strategies

Corrective Movement Un Covered: Primitive Patterns, Myths and Strategies

Corrective movement is a modality within the health and wellness realm; which we like to call the “transition zone.” Corrective movement opens the door for coaches and professionals in the fitness industry to screen, assess and correct breakdowns in a client or athletes movement mechanics.

In my practice I use this style of training to either (a) pre screen a client who may need to see a physiotherapist or medical professional or (b) the client has been referred by a physiotherapist or medical professional and thus, my role is to “transition” the client from the clinical to the coaching again.

The following video selections are favorite videos I have chosen from the FMS library for you to be become more familiar with Corrective Movement, common mistakes and myths in the industry and the written portions of the article is direct excerpts from Gray Cook’s website and movement book.

 

CORRECTIVE MOVEMENT MECHANICS:

“Movement Competency: The ability to employ fundamental movement patterns like single-leg balance, squatting, reflex core stabilization and symmetrical limb movement.  This can also include basic coordination with reciprocal movement patterns like crawling and lunging. The central goal is not to assess physical prowess or fitness, but to establish a fundamental blueprint and baseline of quality not quantity.

Physical Capacity: The ability to produce work, propel the body or perform skills that can be quantified to establish an objective level of performance. If movement competency is present at or above a minimum acceptable level of quality, deficits in physical capacity can be addressed with work targeting performance. If movement competency is not adequate, it would be incorrect to assume that a physical capacity deficiency could be addressed by working only on physical capacity.

Growth and development follow the path of competency to capacity, but how many fitness and athletic programs parallel this time-honored gold standard of motor development? If screens and standards for movement competency are not employed, we are programming on a guess. Furthermore, if our testing does not clearly separate movement competency tests and physical capacity tests, we exchange a guess for an assumption.

In the Movement book we emphasize the importance of movement competency through screening and assessment, and we further separate movement categories to help the exercise and rehabilitation professional categorize movement deficiency in clients and patients.” – Gray Cook

COMMON MISTAKES & MYTHS:

Exercise professionals too often overlook the fundamental movements because highly active individuals can often perform many high level movements without easily observable deficits. The Functional Movement Screen was first introduced to give us greater relative insight into primitive patterns by identifying limitations and asymmetries. The FMS screen is a way of taking it back to the basics and recognizing that these patterns are fundamental; a key factor is that they are common during the growth and developmental sequence, and thus taking it back to primitive movement, we may be able to overcome some of these common compensations.

 

VIDEO 1: Gray Cook:  Common Mistakes Made in Corrective Movement vs Strength Movement

Video – http://www.youtube.com/watch?v=75-c_xYHZHQ&feature=colike

 

PRIMITIVE PATTERNS: BACK TO BASICS

Consideration of primitive patterns can help make you a more intuitive, and intelligent exercise professional. Very often we become experts in exercise without considering growth and development, which is where the fundamentals of movement were first established. As explained in this video, these fundamental movements include rolling, pushing up, quadruped, and crawling. This foundation is often neglected in the approaches we take to enhance function and/or performance through exercise programming.

The first rule of functional performance is not forgetting fundamentals. In order to progress to movement we first learned to reflexively stabilize the spine, in order to control movement more distally in the extremities, this happened naturally during growth and development. However, many individuals lose the ability to naturally stabilize as they age due to asymmetries, injuries, poor training or daily activities. The individuals who do this develop compensatory movements, which then create inefficiencies and asymmetries in fundamental movements.

VIDEO 2: Gray Cook and Lee Burton: Secrets of Primitive Patterns http://www.youtube.com/watch?v=qxRy55CeoQg&feature=share&list=PL77D5203810F6A356

 

THE FMS SCREEN UNCOVERED:  

Here Gray talks about how to do a self movement screen. It can be done and assesed by a Pass or Fail marking scheme. It covers 7 important movement patterns, which are the Deep Squat, In-Line Lunge, Hurdle Step, Rotation, and Active Straight Leg Raise, as well a 2 clearing tests to asses spinal extension and flexion in a fixed position.

Modern fitness and training science has bestowed upon us the ability to create strength and power in the presence of extremely poor dysfunction. This dysfunction means that fundamental movement patterns are limited, asymmetrical or barely present. Just because we can make people bigger, faster and stronger on top of this does not make it right. Seated, fixed-axis equipment perpetuates the illusion of fitness without enhancing functional performance. Utilize all of your tools to uncover an individual’s dysfunction and then work to correct it. The result will be an individual who moves more efficiently, thereby creating a foundation for more effective strength, endurance and power training.

VIDEO TWO; Gray Cook: Self Movement Screen:

Video: http://www.youtube.com/watch?v=h8G6jkEf1uI&feature=related

Here are a couple quick techniques you can utilize to observe primitive movements, checking for asymmetry and limitation in rotary stability and how to learn to fire the core!!! Everyone’s favorite:

 

The “Core” is the Foundation to Primitive Patterning: We call it Trunk Stability

Gray Cook; Sequence of Core Firing

Video: http://youtu.be/gEIHeaNmSok

 

Sources: The Importance of Primitive Movement Patterns

Gray Cook, MSPT, OCS, CSCS and Lee Burton, PhD, AT

Website: http://graycook.com/?m=201104

Somatic Healing Meets Corrective Movement

Somatic Healing Meets Corrective Movement

Soma – The word soma describes the everlasting constantly flowing array of sensory feedback and actions that are occurring within the experience of each of us. A somatic experience is when we viscerally feel connected usually brought on by movement. Even in meditation and states of rest our body and internal experience is always moving. It is an internal representation of our energy force.

Movement – Movement is the language that the nervous system understands very well. Gently guiding a client through a series of small movements allows the body to highlight muscular and systems integration on the voluntary level. It is a communication portal that showcases integration from the muscles, fascia and bone to the client – when the client is open to listening.

Lineage of Somatic Education:

Somatic education emerged during the twentieth century, but has been practiced in Eastern traditions for centuries. Western science classifys somatic healing and somatic education; a term used interchangeably, as an internalized learning process which is initiated by a teacher who guides the client or student through a sensory-motor process of physiological change.

When we speak of self-teaching, self-learning, self-healing, and self-regulation, we know that this is a somatic process, and as coaches and teachers we must guide our clients to the understanding that these are genetically-given capacities intrinsic to all human beings. As practitioners our roles are to merely offer the means to help “turn on” the ability to self manage somatic healing on and off the mat. In essence the client actually teaches themselves, we merely aid in offering the verbal and sequential tools.

Somatic healing is much like corrective movement in this way. When there is a break down in movement or movement patterning; much like in an athletic injury, there can be trauma and compensation patterns that take over proper and once efficient patterns. When this happens the client feels as if they do not have control over their body’s responses, contraction and control over that particular area of their body, muscle group and to an extent this is true because the body’s protective response is to contract and quite frankly.. protect. In somatic medical terms we call this somatic trauma and/or SMA (sensory motor amnesia; which is the worst case scenario.

This somatic trauma can pull the body into what we call somatic reflex. It is the reflex of pain avoidance. Cringing, for example, is the overt manifestation of this reflex. For instance, in boxing when blows occur to one side of the rib cage, the muscles traumatized will go into chronic contraction. Prolonged pain can attribute to chronic contraction, which we see in runner knee and a myriad of load responsive micro trauma. This alters the body’s ability to recover and to properly manage movement.

The internal compensation process is to selectively dis-engage that sensory input and motor control of muscle function and then establish a compensation pattern.

“Pain is impressively humbling. Your regular ambitions and thought processes come to a grinding halt. Emotional factors creep in and generally exacerbate matters. It can even become difficult, if not impossible, to make decisions in your own regard. Yet in this human community, we are never truly alone. Family, friends and professionals come to our aid. And, short of that, or in addition, in my system of belief, we are constantly ministered to by intelligences and forces of orders beyond our normal frames of recognition. Lean into these resources no matter how bad it gets. Relief will come.” ~ Gil Hedley (Integral Anatomy Series)

 

Primitive Patterning and Somatic Healing:

We know that somatic trauma can occur from injury or prolonged discomfort, but somatically we can also harbor emotions within the tissue well after the injury has healed. Depending on the nature of the injury and the emotional context from which the injury was viscerally felt can still be present at the soma level. Sometimes these somatic reactions are linked to our childhood many years or decades earlier. These visceral triggers can creep up over time and continue to cause bio mechanical breakdowns in the future.  This is one fundamental reason why somatic healing and corrective movement are so closely linked.

When we talk about corrective movement there are two pillars that FMS coaches will focus on (1) Primitive Movement Patterns and (2) Foundation Movement Patterns.

Primitive movement patterns are used to describe those movements most humans explore during growth and development. When we look at pediatric development this includes movements that are supine, prone and hand and knees (all fours).  As we begin to learn how to crawl, then squat and stand and then walk we form foundation movements. The development of fundamental movement is the foundation that leads to effective functional movement.

Somatic education can include taking the client back to these primitive and foundational movements to better break through somatic trauma and or related visceral connections that still hold negative movement and reactionary patterns.

Gray Cook, co-founder of the Functional Movement Systems, looks at corrective movement is very similar way; which is much like describing somatic re patterning and healing. They are very closely related in the foundational thought and intention process …

“Patterns and sequences remain the preferred mode of operation in biological organisms. Patterns are groups of singular movements linked in the brain like a single chunk of information. This chunk essentially resembles a mental motor program, the software that governs movement patterns. A pattern represents multiple single movements used together for specific function. Storage of a pattern creates efficiency and reduces processing time in the brain, much as a computer stores multiple documents of related content in one file to better organize and manage information. Common strengthening programs applied to muscles with the stabilization role will likely increase concentric strength but have little effect on timing and recruitment, which are the essence of stabilization.” ~ Gray Cook, FMS

In order for the client to regain pattern control it is an internal process; where new sensory information is introduced into the sensory-motor feedback loop through specific movement sequencing and pattern re training, allowing the motor neurons of the voluntary cortex once again to control the musculature fully and to achieve voluntary relaxation and contraction properties.

We see forms of this somatic trauma in today’s corporate world, but it is masked by “stiff muscles”. 80% of those over the age of forty have pain and stiffness from spines that are chronically contracted from the pelvis to the neck and naturally have spent decades in this compensation pattern.

Therefore, understanding the connection between somatic healing and corrective movement can greatly affect your health and wellness and longevity of your chosen sport – even if you classify yourself as just a weekend warrior.

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