Erik Dalton Bodywork Training Blog

Addressing Forward Head Posture

erik_dalton — Thu, 24 May 2012 19:27:40 +0000

Summary: Oftentimes seen as a structurally subtle body segment, the neck is burdened with the highly difficult task of supporting the human head. Because of the tension, trauma, and poor posture inherent in the workplace today, it is no surprise that head-on-neck and neck-on-thorax imbalances serve as some of the most frequent pain generators driving people into our bodywork practices.

Many injuries in America today come from on-the-job muscle/joint strain and overuse syndromes. Working in a technologically driven society has caused an explosive and expensive increase in work-related costs, with injuries occurring to categories of workers previously considered low risk for anything more serious than the occasional paper-cut.

This two-part series is excerpted from the new textbook written by Erik Dalton, entitled Advanced Myoskeletal Techniques. This segment studies the causes, conditions, and corrections associated with one of the most painful of all postural faults: forward-head postures.

The battle against gravity

Muscles are designed to glide independently neighboring myofascial tissues as the central nervous system orchestrates a complex assortment of specified movements. When observing professional gymnasts at work, one immediately recognizes the amazing quality, variety and complexity of their coordinated movement patterns. Conversely, the elderly foot-shuffler appears to have body areas frozen in time. Unfortunately, years of tension, trauma and poor posture—combined with gravitational exposure—force the human body to sacrifice complexity of movement for stability.

Today, more than ever, people are disposed to sit for hours in isometrically contracted postures without adequate physical activity. When muscles contract, fuel is burned and waste products accumulate. In time, these chemical irritants modify the muscle resting length, causing enveloping fascial bags to lose their natural suppleness. Prolonged sitting leads to slumping, as people spend innumerable hours tied to work terminals, home computers, school desks and television sets. As the heavy head eventually drops forward and down, the scapulae externally rotate and protract, increasing thoracic kyphosis and flattening of lumbar lordosis.

Worn out from battling gravity, intrinsic cervical extensor muscles such as semispinalis, longissimus, the suboccipitals and multifidus become toxic from oxygen deprivation. Extrinsic (phasic) muscles (trapezius, rhomboids, posterior rotator cuff, etc.) prefer burning glucose for fuel but the deep intrinsic support muscles require more oxygen. When tension, trauma, and faulty posture lower the amount of delivered to intrinsic postural muscles, fatigue sets in, causing the gravitational load to shift to the extrinsics.

Extrinsic muscles are dynamic and created to provide quick bursts of energy. Since phasics contain a greater number of fast-twitch fibers, they do not respond well to sustained compressional loading and quickly give out and the energy-depleted intrinsic muscles are once again made to bear the load. This decompensation cycle marks the beginning of a domino effect that structurally manifests as reduced flexibility, loss of range of motion, and an awkward forward-head, slumped-shouldered posture.

The seven deepest myofascial layers traversing the C7-T1 junction are especially vulnerable to sustained isometric contraction from forward-head postures (Figure 1). Over time, the slick lubricating fluid designed to provide smooth gliding of individual fascial sheaths dehydrates, thickens and becomes adhesive. The effect: fascial adhesions, myospasm and muscle contractures. Living in a healthy body with pain-free range of motion requires that every upper quadrant muscle maintain its own independent yet communal contribution during head-and-neck motion. When “sticky” fascial layers bond, specialized (efficient) muscle activity is lost. The semispinalis, splenius, longissimus and trapezius fasciae are frequently guilty of clinging and dragging on neighboring muscles. Myofascial restrictions not only waste invluable energy but also reduce flexibility and range of motion.

An exaggerated example of this condition is often recognized in persons forced to turn their entire trunk to look to the side. This population usually presents with protracted shoulders and forward-drawn heads evolved from decades of slumped sitting, repetitive movement patterns, trauma, and limbic system (emotional) stressors. Names such as fibromyalgia and chronic fatigue syndrome are often used to describe these achy, energy-deficient bodies.

High Heels and Postural Problems

erik_dalton — Fri, 04 May 2012 15:05:51 +0000

by Erik Dalton PhD

Summary: In a highly functioning body, the neuro-myoskeletal system hangs in dynamic equilibrium, with each part balancing the other. But when a woman chooses to wear high heels, a new dynamic equilibrium occurs. If even one body part becomes fixed, the whole system must compensate with altered movement patterns, resulting in kinetic “chain” kinks.

Last week while going through TV channels, I happened to catch some interesting gossip from a cheesy entertainment show reporting that Stefani Germanotta, aka Lady Gaga, was being treated for low-back pain at a local physical therapy clinic. This uniquely talented, five-time Grammy Award winner and self- proclaimed “high heeled queen of sheen” has definitely done more to mess up low backs than anyone since Mike Tyson. So, here she is at the ripe age of 25 suffering back spasm.

Although high heels have been in and out of vogue since Catherine of Medici invented them in Paris in the 16th century, I have always been puzzled by the strange attraction to body height— which figures, since I was always the tall one in class. I had somehow missed the point, so I decided to pose the question to my wife. She told me, “Erik, some women would grow their toenails long and walk on them if they thought it would make them look sexier.”

That answer certainly did not settle my curiosity, so I searched online for some fashion-magazine photos of high-heeled ladies, studied the postures and finally arrived at three seemingly logical visual bonuses gained from wearing high heels. Curvier hips and a more prominent buttock happen due to exaggerated lumbar lordosis, the legs appear longer and leaner as the thoracic spine hyperextends to compensate for the swayed low back, and the female chest becomes more prominent as the shoulder girdle is driven back by the hyperextended thorax.

The biomechanical effect of heels, in everything from running shoes to stilettos, has puzzled researchers and fueled controversy for about a century.

Here is an interesting experiment that will help you get a feel for the biomechanical adjustments high-heel wearers deal with every day:

Stand barefoot with the back against a wall and observe how your upright body column forms a perpendicular line, or 90-degree angle, with the floor. Slide a 2-inch wedge of some kind, such as a phone book, under both heels. Notice by keeping your body column rigid, you are forced to tilt forward from 90 to about 70 degrees.

Now replace it with a 3-inch wedge and straighten up so you are touching the wall again. Feel the intense myoskeletal adaptations that take place. Can you feel your ankles alter from dorsi- to plantar-flexion? In this standing position, the knees buckle, hips flex, low back sways, and the shoulder girdle retracts.

The brain, guided by foot, ankle and visual proprioceptors, must instantaneously make a whole series of myofascial and joint adjustments to the ankle, knee, hip, spine, and head to regain and retain erect stance and equilibrium.

But high-heeled, posturo-functional faults are not limited to the external milieu – they may also inflict compressional damage on the internal viscera, particularly the pelvic bowl contents. According to a report conducted by Canadian physiotherapist Diane Lee, in “Biomechanical Effects of Wearing High Heel Shoes,” published in the International Journal of Industrial Ergonomics, excessive lumbar lordosis causes the pelvic bowl to dip anteriorly, which raises the center of gravity and leads to reduced proprioceptive stability. So not only are we unstable on our feet when wearing heels, but the dramatic anterior pelvic tilt squashes our poor organs.

For instance, when standing barefoot, the anterior angle, or pelvic tilt, of the female pelvis is 25 degrees. On 1-inch heels it moves up to 30 degrees, on 2-inch heels it increases to 45 degrees, and on 3-inch heels it increases up to 60 degrees…

Bodywork Therapy for Bikers

erik_dalton — Tue, 24 Apr 2012 14:22:16 +0000

Summary: Like many of our popular, but abnormal, athletic endeavors such as golf, tennis, bowling, etc., cyclists bring with them a complex biomechanical downside that is frequently hard to completely fix. The “arched back” model is typically the most problematic. In an effort to level the eyes, the rider must hyperextend occiput on atlas. The cervicothoracic junction is also forced to hyperextend (neck-on-shoulders) resulting in chronically locked intervertebral joints and rib jamming.

It is incredible the money and time many elite and “weekend-warrior” cyclists devote to retrofitting racing bikes to conform to their bodies rather than first restoring function to the most critical piece of racing equipment: the body of the rider.

When muscle imbalances, faulty movement patterns, and joint fixations distort the bony framework of the body, the cyclist is led on a never-ending journey searching for that perfect bike fit.

My personal mantra: “Fit the body to the bike, stupid!”

Bodyworkers and functional movement trainers whose practices cater to amateur and elite cyclists are highly aware of the clinical and performance advantages gained by restoring optimal mobility, flexibility, and stability to the muscle/joint complex. It makes sense to first get the kinks out before sending the client off for an expensive and sometimes useless bike retrofit. Without hands-on maintenance and functional fine-tuning, they often unknowingly reinforce dysfunctional movement patterns ingrained from long-forgotten micro- or macro-traumatic injuries.

Bewilderment and controversy over this chicken-or-egg (bike-or-body) thing is primarily due to lack of understanding of the Law of Cause and Effect. For instance, let us say a bike shop performs a retrofit and Bob, the cyclist, smilingly pedals away on his newly reconstructed bike feeling secure and pain-free – Life is good… or is it?

Unfortunately, if Bob is one of many “flexion-addicted” Americans with a sedentary job that keeps him glued to the computer terminal day-after-day, gravitational exposure will gradually drag his body into a big “C” curve. In time, Bobs brain relearns this aberrant posture as normal and on weekend expeditions his “hip-flexed” desk posture morphs into a similarly distorted riding posture.

To make matters worse, stubborn pain-spasm-pain cycles often appear as the hip stiffens and the imposed stress destabilizes sacroiliac and low back structures. In the presence of lumbar spine instability, the brain may decide to lock down the low back and ribcage with protective muscle guarding. Thoracic cage rigidity not only inhibits proper diaphragmatic breathing but also sends shock waves through the thoracolumbar and pectoral fascia and into the upper extremity joints where reverberations are met with strong resistance from habitually locked hands, elbows and arms. Meantime, compensations from adhesive hip capsules also travel down through the knees, ankles, and feet searching for a weak link in the lower kinetic chain.

Cyclists who go for a bike retrofit prior to receiving manual therapy to release fibrotic hip capsules and hip flexors, soon notice a loss of endurance and may develop soft tissue or joint sprains associated with lumbopelvic imbalance. Strangely, many flexion-addicted cyclists attempt to work through the injury despite sensing a noticeable reduction of speed, power, and efficiency. “No pain, no gain” is an unacceptable working model for those pursuing longevity in the cycling sport.

Does decreased hip angle mean less power?

One of the most common cycling positions used by “flexiholics” has the hip flexors locked short and the hams and glutes overstretched and weak. This imbalance pattern as described by Vladimir Janda in his lower crossed syndrome, forces the pelvic bowl to be drawn too far forward resuting in a decrease in hip angle.

Those who consistently ride with an anteriorly rotated pelvis and decreased hip angle are subject to capsular and ligamentous adhesions and a subsequent loss of economy and power. To accommodate the loss of hip extension, many recreational and competitive racers compensate by posteriorly tilting their pelvic bowl and rounding their backs into a hyperkyphotic posture just to advance hip angle and power. The famed cyclist Andy Pruitt believes that changing the seat height by a mere inch alters mechanics and motor control patterns of every joint in the lower extremity. By reducing seat height, excessive force is transferred to the patellofemoral joint, while raising the saddle too much strains the hamstrings, low back, and hands…

Erik Dalton, Ph.D., Certified Advanced Rolfer, founded the Freedom From Pain Institute and created Myoskeletal Alignment Techniques to share his passion for massage, Rolfing, and manipulative osteopathy. Visit the Erik Dalton website for information on workshops, conferences, and CE home study courses.

The Importance of Balance in Bodywork Practice

erik_dalton — Mon, 16 Apr 2012 16:01:47 +0000

Summary: Many therapists don not realize the necessity of achieving and maintaining a sense of balance. In this article, Dr. Dalton expounds on techniques to achieve the fundamentals.

Many therapists wrestle with maintaining proper body mechanics, but some have discovered a simple exercise tool that dramatically enhances their therapeutic skills. I have found that training five to ten minutes a day on a rocker board drastically improves my balance, core stability, strength, and endurance. Since balance is the critical building block necessary for making movement possible, any exercise to improve balance will reveal itself in the quality of your touch.

Customers consciously or unconsciously sense if a therapist is centered and balanced. In the absence of dynamic body balance, therapist movements often are awkward and jerky, known as the “jiggling hands” syndrome. Conversely, a body worker with a firm and steady touch exudes confidence as body weight travels evenly through the hands, torso, pelvis, and into the legs and feet to form a stable working foundation. Many of these principals are demonstrated in my Myoskeletal Alignment home study courses.

How Do Balance Boards Work?

When the body notices a change of surface, it self-corrects to achieve appropriate positions for that particular movement. These rapid changes rely on proprioceptors embedded in muscles, ligaments and joints to detect speed and degree of stretch. The proprioceptors in the body are highly refined motion sensors, and balance boards help train these sensors. While the square rocker board allows for one plane of instability, the round wobble board provides multiple planes for the most difficult workout. Rocker and wobble boards are fun and safe, but be sure to purchase one with a tactile surface on top and nonskid surface below, such as those displayed in the photos.

Figure 2: Round Rocker Board

Technique Tips

• Always stay within your functional threshold of balance – hold on to a wall or doorway as needed.

• Strive to sustain balance in order to train the body to move efficiently.

• Pull your navel toward your back without flattening lumbar curve to activate dynamic core stabilizers.

• Contract your gluteus maximus muscles with more weight shifted to your heels and slowly rock back and forth to improve posture and restore proper hip-extensor firing order.

No matter your age or ability, daily use of a balance board boosts overall fitness, core strength, and therapeutic performance. By improving body and spatial awareness through dynamic balance board exercises, the therapist uses less energy, which promotes greater core stability, mobility, agility and touch.

Myoskeletal Alignment and Avoiding the Deadbeat Diagnosis

erik_dalton — Mon, 09 Apr 2012 19:46:00 +0000

Iliotibial band (ITB) syndrome is typically regarded as an overuse injury common in runners and cyclists. Recently, this controversial condition has gained greater attention due to recent articles that include my “IT-Band Friction Fallacy?”, Mark Charrette’s “Lateral Knee Pain and Orthotic Support“, and Whitney Lowe’s “New Perspectives on ITB Friction Syndrome“. When it comes down to it, Myoskeletal bodywork practices are the only true solution to the puzzle.

Although many researchers and clinicians are convinced that the patho-anatomy of iliotibial band friction syndrome (ITBF) is simple and understood, the jury is still out on the exact cause(s) of this lateral knee pain condition. Ignortantly following conventional wisdom may often point good clinicians to the wrong therapeutic path. The following example clearly shows how “chasing the pain” led physicians into a linear treatment protocol resulting in months of unwarranted pain and unnecessary medical interventions.

Case Study

Recently a 44-year-old orthopedist, who for our purposes will be called Dr. Smith, was referred to me complaining of eight months of debilitating, self-diagnosed, IT-band friction pain. During his history intake, he admitted suffering sporadic foot, hip and low back soreness but dismissed these issues as “unrelated.” A self-described “weekend-warrior,” Dr. Smith’s knee pain increased with excessive running or cycling. Both he and his staff (a physical therapist and physiatrist) had carefully scrutinized the painful knee and arrived at a unanimous diagnosis of ITBF based on results from Ober’s Test (determines the tightness of the ITB), Renne’s test (specifies the area of pain during weight bearing) and Noble’s test (identifies the area of pain when the leg is flexed at a certain angle). To further strengthen their diagnosis, MRI studies showed a thickened iliotibial band over the lateral femoral epicondyle. The conclusion: diagnosis confirmed as ITBF – case closed.

Dr. Smith related that his group’s initial treatment goals focused on relieving the (supposed) inflammation with ice treatments and anti-inflammatory medications followed by a series of physical therapy sessions. Unfortunately, the “series” of physical therapy slowly evolved into months of heartbreaking disappointment. Standard treatment modalities (stretching, ultrasound, electrical stim, cross-fiber frictioning and trigger point work) brought little relief. Discouraged with the lack of progress, Dr. Smith and his physiatrist partner began a more aggressive approach with corticosteroid and proliferation injections. Although many of their ITBF patients responded well to this treatment protocol, Dr. Smith did not. Desperate to get back to his biking and running regime, Smith decided to undertake a surgical release of the ITB at the posterior 2 cm where it passes over the lateral epicondyle, but still no relief. So how did eight months of aggressive treatment lead to unproductive failure? My Myoskeletal alignment home study techniques will reveal the answer.

Conventional Wisdom

ITBF is generally thought to be a multi-factorial, non-traumatic, overuse condition in which the distal aspect of the iliotibial band rubs over the lateral femoral epicondyle during repetitive knee flexion and extension movements. This eventually leads to irritation of the iliotibial band, bursa and lateral synovial recess. In this popular theoretical model, the deep posterior ITB fibers are more vulnerable to back-and-forth rubbing on the knee’s epicondyle. Several studies have described a dynamic “impingement zone” at approximately 30 degrees of knee flexion where the ITB is subject to microfiber tearing and associated inflammation.

Therapists who abide by this “conventional wisdom” often search for the sore spots around the condyle and cross-fiber friction the affected tissue in an effort to break down weak-linked adhesions, enhance fibroblastic activity and encourage tissue remodeling. Follow-up treatments usually include elbow “fascia-mashing” and manual ITB stretching routines. All of these techniques can be effective if ITB fibers truly are damaged.

Erik Dalton, Ph.D., Certified Advanced Rolfer, founded the Freedom From Pain Institute and created Myoskeletal Alignment Techniques to share his passion for massage, Rolfing, and manipulative osteopathy. Click on the Erik Dalton website for information on workshops, conferences, and CE home study courses.

The 42 Pound Head

erik_dalton — Mon, 26 Mar 2012 15:27:10 +0000

Erik Dalton, Ph.D.

as published in Massage Today Magazine May 2010

It’s not unheard of to have clients walk into your office sporting a 12-pound head that has migrated three inches forward off their shoulders. You are aware prior to palpation that their cervical extensors (semispinalis, splenii, longissimus and upper traps) are in a losing battle, attempting to isometrically restrain 42 pounds against the unrelenting force of gravity.

Rene Cailliet M.D., former director of the department of physical medicine and rehabilitation at the University of Southern California wrote:

• Head in forward posture can add up to thirty pounds of abnormal leverage on the cervical spine. This can tug the entire spine out of alignment.

• Forward head posture (FHP) may result in the loss of 30% of vital lung capacity. These breath-related effects are mostly due to the loss of the cervical lordosis which blocks the action of the hyoid muscles, especially the inferior hyoid responsible for helping lift the first rib during inhalation.

• Proper rib lifting action by the hyoids and anterior scalenes is vital for complete aeration of the lungs.

• The entire gastrointestinal system (particularly the large intestine) may become agitated from FHP leading to sluggish bowel peristaltic function and evacuation.

• Cailliet also states: “Most attempts to correct posture are directed toward the spine, shoulders and pelvis. All are important, but head position takes precedence over all others. The body follows the head – So, the entire body is best aligned by first restoring proper functional alignment to the head”.

The effects of poor posture go far beyond just looking awkward.

In fact, the 2004 January issue of the American Journal of Pain Management reported on the relationship of bad posture and chronic pain conditions including low back pain, neck related headaches, and stress-related illnesses. “The extra pressure imposed on the neck from poor posture flattens the normal cervical curve resulting in abnormal strain on muscles, ligaments, fascia and bones.”

Research presented at the 31st Annual International Conference of the IEEE EMBS Minneapolis, Minnesota, (2009) stated; “Over time poor posture results in pain, muscle aches, tension and headache, and can lead to long term complications such as osteoarthritis. Forward head syndrome may promote accelerated aging of intervertebral joints resulting in degenerative joint disease.”

It appears posture affects and modulates all bodily functions from breathing to hormonal production. Spinal pain, headache, mood, blood pressure, pulse and lung capacity are among the many conditions affected by faulty posture.

“90% of the stimulation and nutrition to the brain is produced by the movement of the spine.” – Dr. Roger Sperry, Nobel Prize Recipient for Brain Research

Additionally, Dr. Roger Sperry showed that 90% of the energy output of the brain is used in relating the physical body to gravity. Only 10% has to do with thinking, metabolism, and healing.

Consequently, a FHP will cause the brain to steal energy from thinking, metabolism, and immune function to deal with abnormal gravity/posture relationships and processing. The March 2000 Mayo Clinic Health Letter expounded on Sperry’s findings by reporting that prolonged FHP also leads to “myospasm, disc herniations, arthritis and pinched nerves.” Degenerative neck pain goes hand-in-hand with balance problems, often in the elderly. Sensitive cervical spine mechanoreceptors govern the ability to balance and must be acutely coordinated with the balance system of the inner ear vestibular to stabilize equilibrium in both static posture and gait…

The Miracle of Motherhood

erik_dalton — Tue, 20 Mar 2012 14:39:18 +0000

by Erik Dalton Ph.D.

as published in Massage & Bodywork Magazine

The miracle of motherhood is eloquently expressed when observing how perfectly designed the female body is to conceive, birth, and nurture a child. Following conception, a woman and her unborn baby join in an oceanic blend of energy and identity; where one ends and the other begins no one knows. However, there does appear to be an innate wisdom that uses the nervous system as a conduit to transmit electrical impulses of intelligence to all of our bodily systems that maintains mother and child in a state of homeostasis and balance. Regrettably, mechanical pressure on the central nervous system by distorted cranial bones and spinal structures can cause problems with the normal transmission of this intelligence. Since all of the mother’s systems and organs are now providing for two, it is obvious that optimal posture and functioning is critical for the healthy development of the baby.

We begin our adventure into motherhood by introducing some very intriguing theories detailing how third trimester fetal positioning in the womb may create aberrant adult postural patterns, just like the ones seen daily in our offices and clinics. Basic hands-on pelvic balancing and trunk stabilization routines taken from my Advanced Myoskeletal Techniques textbook are also included so therapists can aid expectant mothers in their pursuit for a healthy, happy, delivery. But before covering the various postural theories and techniques, a brief overview of the remarkable art of birthing requires thoughtful consideration.

Fetal Lie and Posture

The embryo pierces the pelvis in what is medically termed a left occiput anterior (LOA) or left fetal lie position. The baby usually remains in this “normal” primary fetal posture throughout labor and delivery although a variety of movements are common during the entire birthing process. In the left fetal lie configuration, the baby head is inferior, flexed and rotated left with arms and legs curled to accommodate restrictions in the uterine cavity. Figure 2 illustrates a typical vertex positioned baby with head turned left. The small figure on the right shows the left occipital ridge resting easily on the pubic bone. However, as the embryo starts normal rotational movements in the womb, the left side of the head will eventually face posteriorly. The most compact profile for the fetus is for the arms and legs to curl in opposing directions with a resultant rotation along a longitudinal axis. Some authors including Ida Rolf, PhD, J. Gordon Zink, DO, and Fred H. Previc, PhD have found this rotational fascial bias to be an important factor in determining the eventual shape of the fetus. It appears that as the baby grows from infancy into adulthood, it expands in size but still retains ingrained embryologic rotational fascial preferences.

When testing for rotational fascial patterns, bodyworkers typically find the head rotates easiest to the left at the occipitoatlantal joint and right in the lumbosacral location. Due to fetal positioning, it is likely that fascial patterning does actually commence in the womb during the final trimester of birth. Moreover, individual variations in fetal lie seem to become increasingly vital as the embryo’s body takes shape.

Cerebral Lateralization

During the typical act of walking, maternal acceleration repeatedly forces the head of the baby to translate posteriorly through a process called fetal inertia. Repeated left-sided cerebral stimulation increases neurologic activity in the vestibular (balance) apparatus of the baby. Prolonged left-sided inertial pressure is thought to cause increased secretion of connective tissue fibers resulting in early maturity and development of the left side of the vestibular system and subsequent right motor dominance…

Fibromyalgia: Fact or Fiction?

erik_dalton — Wed, 14 Mar 2012 15:17:44 +0000

by Erik Dalton, Ph.D.

as published in Massage & Bodywork Magazine

Fibromyalgia syndrome (FMS) is a common musculoskeletal pain and fatigue disorder for which the cause is still unknown. Investigations continue as medical and manual therapy offices are flooded with increasing numbers of reported fibromyalgia cases; but like the oft-quoted analogy of the blind man and the elephant, we currently know more about the components of FMS than we know about the “beast” as a whole. Now that rheumatologists have granted legitimacy by labeling and classifying this hazy and controversial syndrome, current beliefs regarding possible origins must be discussed.

Fibromyalgia primarily manifests as pain in muscles, ligaments and tendons — the fibrous tissues in the body. FMS was originally termed fibrositis, implying the presence of muscle inflammation, before modern research proved that inflammation did not exist. Some in the complementary medical community believe that fibromyalgia should be a primary consideration in any client/patient presenting with musculoskeletal pain that is unrelated to a clearly defined anatomic lesion. Conversely, many researchers question the very existence of the syndrome since fibromyalgia sufferers typically test normal on laboratory and radiologic exams.

For more than a century, medical science has continued to progress forward in its ability to recognize, categorize, and name painful patient disorders. Technological advances have made it much easier for doctors to rule out specific maladies from a variety of symptoms presented in the clinical setting. Additionally, modern testing methods have allowed researchers to become more secure in their ability to determine what is and what is not a disorder or disease.

Psychosomatic or Physiologic

Fibromyalgia has come under fire in many circles including medical, psychological, and manual therapy. There are two camps firmly separated on their beliefs as to the cause and treatment of the disorder while a third group of researchers and medical practitioners reject the existence of fibromyalgia altogether. Simply put, one camp believes that FMS is a mental health issue without a biological origin whereas the other camp is firmly convinced that it is a physiological disorder – even though researchers have yet to classify definitive diagnostic criteria. While each side squabbles over the fibromyalgia conundrum, thousands of Americans suffer diverse and sometimes disabling symptoms each year with little help coming from the medical and insurance industry.

Meanwhile, the debate as to the true reality of the disorder rages on as scientific evidence continues to gather in favor of the physiological aspect of fibromyalgia. Currently, traditional and complementary medicine success rates in treating the disorder indicate that it is primarily a physiological condition with biological origins.

In the face of the debate as to the origin of disorder, the American College of Rheumatology comprised a list of criteria for the purpose of classifying fibromyalgia. The list includes typical symptoms such as having a history of widespread pain for more than three previous months. The college went on to define a series of 18 checkpoints (tender points) for the pain sites.

A client is required to have pain in eleven or more of the eighteen sites to be considered a actual case of fibromyalgia. Since the symptoms are relatively basic to recognize, why the continued debate? Part of the trouble lies in the fact that the symptoms are sometimes vague and reminiscent of other musculoskeletal complaints.

Confusing Symptoms

From the massage therapy office to the traditional medical facility, clients and patients alike are appearing in increasing numbers with a plethora of unexplained symptoms. But there are undoubtedly some shared symptom commonalities, such as predictable tender points, extreme fatigue, poor sleeping patterns, and whole-body pain upon awakening. Regrettably, musculoskeletal pain research generally lags behind well-funded scientific projects that promise more profitable outcomes. It often takes years to definitively confirm and catalog conditions with vague, widespread symptoms like fibromyalgia. As a result, this perplexing disorder continues to be poorly understood, and clients often suffer for several years before a medical diagnosis is made.

Fibromyalgic symptoms have been described as steady, radiating, burning, and spreading over many areas of the body. The pain usually involves the neck, shoulders, back, and pelvic girdle. Clients report that pain seems to emanate specifically from muscles, tendons, ligaments, bursa, and joints. Most identify pain as their central symptom. Fibromyalgia pain seems to worsen with cold temperatures, increased humidity, weather changes, overexertion, and stress. Many clients report symptomatic pain reduction with…

Erik Dalton, Ph.D., Certified Advanced Rolfer founded the Freedom From Pain Institute and created Myoskeletal Alignment Techniques to share his passion for massage, Rolfing, and manipulative osteopathy. Visit www.erikdalton.com for workshop, book, massage home study courses and bodywork training videos.

Learn Dynamic Techniques for the Treatment of Low Back, Hip and Leg Pain

erik_dalton — Fri, 02 Mar 2012 19:54:16 +0000

The newly released Level 4 Home Study Course from The Freedom From Pain Institute teaches deep tissue massage, muscle energy techniques, and joint stretching techniques for the relief of low back, hip, and leg pain. The course gives massage therapists and athletic trainers 32 non-expiring (CE) credits.

Freedom From Pain InstituteTM has introduced a Level 4 Home Study Course that teaches techniques to relieve low back pain, hip pain, and leg pain. In this course, manual therapist Erik Dalton, Ph.D., provides a combination of deep tissue massage, muscle energy techniques, and joint stretching techniques that sports, orthopedic, functional movement, structural integration, and massage therapists can merge into their practices.

The course contains six DVDs with Dalton demonstrating and explaining the techniques for relieving low back, hip, and leg pain. The course also contains the recently released Dynamic Body: Exploring Form, Expanding Function. This 424-page textbook, which examines approaches to assessing and treating clients, contains contributions from 16 of the biggest names in structural integration, physical therapy, chiropractic, osteopathy, fascial research, functional movement training, and manual therapy research and education.

“We have been fortunate enough to emcompass lessons from some of the top practitioners and researchers in physical therapy, structural integration, osteopathy, chiropractic, and functional movement training. Reading the book, you’ll find an intriguing flow of ideas regarding structure and functional movement, presented by Judith Aston, Adjo Zorn, Kai Hodeck, Craig Liebenson, and Serge Gracovetsky, and highlighted in chapters by Aline Newton, Tom Myers, Til Luchau, and Robert Irvin.The 6 DVD set is a detailed learning program on treating back, hip and leg pain through myoskeletal alignment techniques. ” Erik Dalton, Ph.D.

The Level 4 Home Study Course offers 32 approved continuing education (CE) credits for massage therapists and athletic trainers who complete the course and pass a multiple-choice test. They receive the title “Certified Myoskeletal Therapist.” they will also receive a beautiful diploma. These home-study CE hours do not expire and can be used in any year to satisfy continuing education requirements.

The Freedom From Pain Institute is an approved provider for organizations such as the National Certification Board for Therapeutic Massage and Bodywork (#157429-00), New York State Department of Health, Florida State Department of Health (#50-790), The BOC, Board of Certification, Inc. (P8112) for athletic trainers, and most other state certifying agencies.

For a limited time, the home study course is available at an introductory price of $388, more than 20% off the regular $515 price, at erikdalton.com.

In Search of the Perfect Bike Fit… The Vicious Cycle

erik_dalton — Mon, 09 Jan 2012 22:44:30 +0000

by Erik Dalton, Ph.D.

Let's call this guy Bob.. He sits at a computer all day and his brain relearns this aberrant posture as normal. On weekend outings, his hip flexed posture morphs into similarly distorted riding posture.

Like a number of very popular, but functionally abnormal, athletic activities, such as golf, tennis, and bowling, cyclists can come in with a complex biomechanical downside that’s often difficult to thoroughly treat and fix. If you are a massage therapist, sports therapists or athletic trainer who treats cyclists it’s important to precisely target the anatomical structure at fault, and sort out any risk factors that may put the client at risk for injury.

Risk factors will be:
Intrinsic (within the cyclist – any postural, overworked, or flawed movement dysfunctions)
Extrinsic (the actual set up of the bicycle)

Therefore, as a Massage Therapist or any bodyworker, treatment is always twofold:
1. Identify and correct muscle imbalances, joint dysfunctions, and motor control issues.
2. Direct focus to the underlying causes for the injury by correcting bike setup and/or training errors.

Now for the good news. The human body is both flexible and dynamic. Now the bad news. Our cyclists often bring in with them a lot of baggage, including flexion-addicted sitting postures, old injuries, compensations, and poor training habits. Any weakness or motor control issues are intensified by traumatic shocks due to bad road conditions or repetitive bike injuries.

Dalton Techniques for hip capsule and knee work... common complaints of cyclists.

A correct bike fit to the body, in conjunction with a revitalized and functionally balanced neuro-myoskeletal system, enables joints and muscles to work at maximum levels of motor unit recruitment and synchronization. As endurance and performance is improved, so does the joy of cycling.

Cycling Biomechanics
The actual cause of ITB pain is a highly beneficial discovery for manual therapists or sports therapist who work with cyclists and runners. If the underlying fat pad is in fact the main cause of our client’s lateral knee pain, it’s probably not a the best idea to apply compressive forces over the ITB tendon, which is already compressing the inflamed fat pad. Conventional techniques, such as cross-fiber frictioning and ITB fascia-mashing, may not be a recommended treatment approach to cycling injuries.

From the New Dynamic Body Textbook featuring Erik Dalton and 16 other leaders in the Manual / Movement Therapy industry. Judith Aston, Serge Gracovetsky, Robert Irvin, Gil Hedley, Jerry Hesch, Kai Hodeck, Craig Liebenson, Til Luchau, Aaron Mattes, Thomas Myers, Aline Newton, Divo Muller, Art Riggs, Robert Schleip, James Waslaski, Adjo Zorn

For Details and to purchase go to http://daltondynamicbody.com

Click to Look Inside the New Dynamic Body Textbook