Maintaining body balans flexibility and stabilty.pdf

Foreword

I first met Leon Chaitow in 1988 when he taught a workshop in soft tissue

manipulation in Seattle, Washington. What I learned in that workshop changed

forever the way I would practice medicine. I was shown a set of tools that has

allowed me to be far more help to my patients than I might otherwise have

been. To this day, I use these techniques with almost every patient I see whether

their complaint is musculoskeletal or not.

The human body is a complex collection of bones, muscles, connective

tissues, nerves, and organs. It is all of these parts, working together in concert,

which make us what we are. The important part of that last sentence is ‘working

together’. When these parts aren’t cooperating, disease and dysfunction result.

In a very real sense, we are what we have become as a result of our adaptation

to stress. We may adapt well or we may adapt poorly, but we will adapt in some

way. What should be obvious is that we need to learn to adapt well.

Unfortunately, much of our adaptation is without thought and intent and

becomes maladaptation. We survive, but we don’t function well.

Stress causes us to prepare for ‘fight or flight’, but we don’t fight or fly, we

just stay tight and ready. We armor, we guard, and we never let go. Many of us

sit all day slumped in front of a computer or over a desk with our heads forward

and our shoulders up. Eventually our brain begins to think that’s the position

we want to be in and we adapt. Then we develop mid back pain and perhaps

chronic headaches. Often we begin to develop numbness and tingling in our

arms and hands that some inexperienced doctor thinks is carpal tunnel

syndrome and off we go to surgery that doesn’t help. Instead, we should be

stretching the muscles in our neck and back that are crushing the nerves to our

arms. We should learn a better adaptation to that stress.

Sitting, we allow the muscles in the front of our thighs to shorten and

tighten and when we stand up that tension pulls our pelvis forward. When that

happens, we adapt with a ‘sway back’, develop chronic low back pain and

occasionally sciatic neuralgia. And it’s off to surgery we go for a herniated

lumbar disk that isn’t really the problem.

I recently saw a patient with this very condition. He had been treated with

chiropractic. He had been treated with massage. He had been treated with

strengthening exercises by a physical therapist. He had been sent for an MRI

that showed a little disk disease, but he never got any relief from his low back

pain. A friend suggested that he come to see me.

I found that his quadriceps were tight (the muscles in the front of his thighs),

his pelvis was tilted forward, and his low back muscles were tight and short as

they adapted to the anterior tilt of his pelvis. I stretched his quadriceps and low

back extensors, adjusted his lumbar spine and pelvis, and showed him how to

vii

viii Foreword

stretch at home. After two visits he came back, said he felt better than he had

in 10 years, and asked me why no one had shown him the stretches before. All

I could say was ‘nobody who you saw knew’. With this book, no one has an

excuse for not knowing.

It is through the application of simple, straightforward techniques such as

those presented here that we learn a better way to adapt. I believe that everyone

alive today would benefit from the advice contained here. For those persons

lucky enough to have a practitioner who uses these techniques the book will act

as a reminder and guide for self-care. For anyone not that lucky, it may act as a

guide in the selection of a new (and better) practitioner.

I, and several thousand of my patients, owe a debt of gratitude to my friend

Leon Chaitow for introducing me to this work. Since 1990 I have taught much

of this material to my students at Bastyr University and it has served them well

in their practices also. I hope that you find the information contained herein to

be as useful for yourself. And I hope that you introduce the book to your

friends and families so that they might obtain and Maintain(ing) Body Balance,

Flexibility and Stability.

Douglas C. Lewis

Washington, USA, 2003

Preface

How to use this book

The most common problems we take to our doctors relate to aches and pains

and restrictions of the musculoskeletal system, the ‘machinery’ of the body.

There is a great deal that individuals can do for themselves to prevent such

problems, as well as to help in treatment and rehabilitation once problems have

occurred.

The book is not intended to be a substitute for professional attention and

treatment, but should be used to support the treatment and guidance of the

treating practitioner. It offers ways of preventing new or recurrent musculo-

skeletal problems as well as outlining first-aid options for the self-management

of aches, pains and restrictions until professional advice and treatment can be

obtained. The book also contains numerous options for self-application of

toning, stretching and mobilizing exercises which may be used as part of a

planned recovery and rehabilitation program under the guidance of a medical

doctor, chiropractor, physiotherapist, osteopath, massage therapist, athletic

trainer or other healthcare provider.

The individual exercises and techniques described and illustrated should

therefore be seen as ways of complementing professional attention, not as a

substitute for this. Practitioners may wish to recommend that their patients

refer to the book as a reminder on how to carry out the exercises and

techniques they have instructed them to use. Many common muscle and joint

problems can be eased by the use of self-help variations of osteopathic systems

of care, known as muscle energy technique (MET) and strain/counterstrain or

positional release technique (PRT). A detailed summary of these useful and safe

first-aid bodywork methods is given in later chapters. Most descriptions of self-

help exercises or techniques will contain details of the aims and objectives of the

particular method and the correct position to get into, how to perform the

maneuver and the timing and frequency of the exercise or technique.

Sometimes there will also be notes on particular patterns of breathing and eye

movement to assist in successful application of the method. Choices for helping

to prevent, or to ease, musculoskeletal problems are therefore easy to identify,

either for first aid, or as homework following the advice of a healthcare provider.

In general, if a muscle or joint restriction exists, one or other of the variations

of MET can be used to produce more relaxed soft tissues, so that stretching or

increased range of movement can follow. If muscular weakness exists, other

versions of MET can be used to increase tone and strength. Before using any of

these methods it is important to recognize that if any pain is felt while

performing them, which is more than simple discomfort, they should be

x Preface

stopped. If the correct technique has been selected, and is used as described,

then there should be no pain. Detailed descriptions of how MET works are

given in Chapter 1.

MET, when used to generally loosen muscles which have become tight,

whether through misuse or overuse, is safe and effective. However, it is

important to remember that the human body is complex, and apart from using

these methods as first aid, individuals should always seek the advice of a

qualified expert before applying MET or other self-care methods.

Traditionally, the methods used in osteopathy to release and relax tense, tight

muscles and joints have involved a variety of maneuvers in which the tissues

have been stroked, stretched, pressed and generally manipulated by the

practitioner. In recent years we have learned to better understand the ways in

which the muscles and other soft tissues work, and this has led to new methods

of treatment. Some of these are suitable for self-use because they are so safe and

gentle that it is almost impossible to cause harm.

The words ‘muscle energy’ suggest that the effort and energy of the person

or patient performing the movements provide the primary force involved in the

process, as distinct from the effort and energy of a practitioner.

The conditions which can be helped, and often completely overcome by

these methods are many, and include a wide range of joint and muscle

complaints involving stiffness, restriction of movement, pain and disability. If

the problem involves actual pathology, such as an arthritic condition in which

damage has occurred to aspects of the joint surface, then the amount of possible

improvement from use of (say) MET would be limited by the structural

damage. Even so, even with an arthritic joint in the background, MET methods

should usually be able to produce some degree of improvement in movement

or reduced discomfort, even if this is not always long lasting.

MET methods can be used to strengthen weak muscles as well as to loosen

tight ones. Not all the variations of MET are suitable for self-application, as

some require the restraining or supporting hands of another person. A family

member or friend can often provide this extra pair of hands if the method has

been approved by the practitioner/therapist. In many situations an expert is

required to control the precise directions and degrees of effort, and so in the

text of this book I have attempted to indicate just where self-use is possible, and

where outside aid is necessary.

It is recommended that anyone attempting to use any of the individual

techniques and exercises described in later chapters should first ensure that they

understand the reasons for the use of these methods and their underlying

mechanisms. There is no more certain way of failing to obtain benefits than by

wrongly using what appear to be simple methods.

The most common mistakes made when using MET are those which involve

excessive use of force, over too prolonged (or too short) a period of time. Apart

from the direction in which the effort is made, these two factors are the most

important, and emphasis will be placed on them many times.

Essential questions to ask are, therefore:

• For how long must a MET effort be maintained?

• With what degree of force?

• In which direction(s)?

• And what should be done after the contraction is complete?

These are the key elements in muscle energy technique.

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