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Posted on 12-12-2014
We recently had a patient referred to us by Dr. Charles Peterson who is a sports physician who treats many professional athletes including those of the Chicago Cubs and the Arizona Diamondbacks. I met him while lecturing to the training staff of the Cubs about 18 months ago about the intricacies of Chiropractic and, in particular, soft tissue work and Fascial Manipulation.
This patient had been a nationally competitive runner but now could not even play basketball (his favorite sport) due to a chronic lower hip and hamstring pain that increased with running. I understand the feeling of frustration that can come from not being able to play at your favorite sport. For me, its martial arts with its forms and self defense techniques. This patient had tried months of physical therapy with very little result. He had seen several doctors who were unable to improve the function of the posterior leg compartment and, as can be expected, the good old chiropractic lumbar adjustment didn't touch the problem.
Now, being the professional that I am, you know that I'd approach the problem by first looking at dysfunctions in the muscle force transmission system and aberrant neuronal firing patterns................blah blah blah. (Yes, I can see your eyes an ears glazing over). Anyhow, yes, I looked at the muscle force transmission and found several painful points in the front and back of the leg, hip and even in the abdomen. At first, he mentioned that it did, in deed, feel better after the first visit.
GREAT!! That's what I like to hear.
Unfortunately, it came back. Then I treated a different line of force that included the complex spirals that can get wacky. These are the things that Janda (an old time Polish Physical Therapist) and Thomas Myers (who wrote "Anatomy Trains") tried to describe in their respective life works. These spirals have been better studied and described now by Luigi Stecco as I have mentioned before so I won't be going into that again....much to your relief.
So I treat the spirals and think, "Aha!! That'll get it. I'm bad to the BONE!!"
This patient patient came back in about three weeks later stating that he hadn't gone running because it still felt like the tightness was returning and he was afraid of aggravating it with too much activity. At this point you have to be wondering just what was happening. I mean, Fascial Manipulation is becoming known as the most powerful soft tissue chiropractic technique that has ever been developed. But, something was telling me that it may not be a matter of density but of fibrosis. I haven't written a lot about the difference in these two entities but I plan to........."Oh, Great." you say as you roll your eyes.
So I decided that what I needed to do was what I usually stay away from. I attacked the problem at the site of pain. This is not what I like to do because I've learned that most problems stem from problems far distant from the site of pain. In this case, however, it was different. The hamstring had become so fibrotic from years of heavy use and training that it WAS the problem. Fibrosis can cause different but significant alterations in force transmission and, sometimes, you have to take a chance and attack the problem directly.
So, after several minute of deep and aggressive attack to the medial and lateral hamstrings at their origin point at the "sit down bone", he reported that there was no pain upon sitting up and trying to recreate the symptoms.
Yeah, I hear you! A collective sigh of relief.
After such deep work he will be taking enzymatic anti-inflammatory therapy and doing lots of ice massage to keep inflammation to a minimum. He'll also immediately start light movement exercises to help remove the damaged tissue and assist the new tissue in proper alignment. That's the critical part and it takes discipline.
With that success story told I can close and leave you to your day wondering in awe just how amazing soft tissue work is. Don't forget to tell your friends to come in and get those nagging problems looked at by someone who knows what they're doing. There is no sense in suffering any longer.
Something to think about.
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