Acromioclavicular Joint

Happy New Year!!

Christy Cael’s article (from last edition of ABMP’s Massage and Bodywork) (latest edition had an article that I chose not to write about but take to my office for any possible future reference) was as timely as ever! I’m reminded a lot that the shoulder is a complicated structure; it has several complementary joint and much other soft tissues and such. Normal movement in this area needs coordinated efforts of the ball-and-socket glenohumeral joint, gliding motions of the acromioclavicular and sternoclavicular joints, and relative movements of the scapulothoracic joint. Ms. Cael emphasized that the soft tissues (plenty of which are stabilizers) must be addressed in assessment and treatment. As always, thank you for reading!

Healing the Hip’s Rotator Cuff: Assessing Hip Bursitis and Tendinopathy

Erik Dalton, PhD’s article (from last edition of ABMP’s Massage & Bodywork) was a wonderful reminder to me! The femoroacetabular joint is one of the largest, strongest, and most flexible joints in the body; hip pain in this area can occur because of trochanteric bursitis, wear and tear of the gluteus medius and minimus tendons, and/or wear and tear of the IT Band. Researcher Thomas Bunker and his team were the 1st to compare this condition to rotator cuff bursitis because both conditions are caused by friction, which ultimately results in inflammation. He solidified his assessments of treatments, most of which are founded in the central nervous system!

Gastrocnemius

From my last ABMP’s Massage and Bodywork, Christy Cael wrote about a very complicated muscle! It’s the largest and most superficial muscle of the calf and extends from the posterior knee to the heel and 1 of the 3 triceps surae (“calf”) muscles; the other 2 are the plantaris and soleus. The group converges into the calcaneal tendon and inserts on the posterior surface of the calcaneus. The bulk of the muscle is more proximal than the other 2 and is divided into 2 large, symmetrical segments or “heads”. Individuals with large heads and a very short calcaneal tendon tend to have a greater propensity for explosive power (and vice versa). The gastrocnemius performs knee flexion and ankle plantar flexion (mostly the latter); also, it has minimal ability to stabilize the ankle due to its posterior orientation and the narrow attachment of the calcaneal tendon. The soleus is a synergist to the gastrocnemius for plantar flexion; which of these 2 is most active during this movement is mainly driven by the position of the knee. If it’s extended or extending, the gastrocnemius is more active (and vice versa). This is because the muscle is pre-stretched or placed under tension, maximizing mechanical advantage. Thank you, as always, for reading!

Bicipital Tendonopathy

Whitney Lowe’s (from Institute for Integrative Health Care’s latest newsletter) article was most informative! The malady is an overuse pathology of the biceps brachii tendon and is a common cause of anterior shoulder pain; it’s most common in active populations that involve repetitive overhead shoulder motions. BT usually refers to the long head; it’s more vulnerable to chronic degeneration due to friction in the humerus’s bicipital groove. Lastly, he relayed that the condition could also be bicipital tenosynovitis, which involves an inflammatory irritation and potential adhesion between the tendon and its surrounding synovial sheath. Thanks, as always, for reading!

Uncricking the Neck

Ian Harvey’s article, from ABMP’s latest edition of Massage & Bodywork, was timely and informative! Waking up in the morning with a sore neck’s normal; a “crick” is a condition related to spasm of the neck muscles, usually discovered upon waking, that tends to last hours or full days. Often, 1 shoulder’s affected; this often feels hard and, of course, can make the next night’s sleep even worse. The author, through his clinical experience, says there seems to be 1 major player, the levator scapulae. When we therapists palpate an active neck crick, we’ll often find that muscle stays in a state of partial contraction, becoming more rigid as the client rotates toward the point of complete restriction. As this happens, other neck muscles, such as trapezius, scalenes, and erectors, will also contract in a guarding response; this prevents further movement. He’s found, also, that his people prone to cricks often “have other conditions that predispose them to spasm, which often include forward-head posture, rounded shoulders, upper back pain, and even jaw tightness and dysfunction”. He reinforced that “releasing the levator scapulae “should” probably be done by the reciprocal inhibition of the proprioceptive neuromuscular facilitation fame and “prevention too!””.

Enhancers in Action: Movement Cues Engage Clients, Improve Outcomes

From my last edition of ABMP’s Massage and Bodywork, Erik Dalton, PhD’s article was so very strong in keeping with “the body’s central nervous system is flabbergasting!”! A study published in Proceedings of the National Academy of Sciences found that because our brain attempts to predict sensory consequences of EVERY action, it attaches less significance to self touch, as this is predictable touch; thereby, it pays more attention to NOVEL touch, touch by others. Erik says that we therapists should usually assume to be able to take that further and say, since the patient’s ACTIVELY engaged, “shouldn’t that lead to even better outcomes”? In myoskeletal alignment techniques (MAT), we use “enhancers” to do this. A MAT’s a therapist-directed movement cue that neurologically boosts, intensifies, and heightens a therapeutic outcome; they serve 3 primary purposes: retrain the brain using graded exposure stretching techniques, relieve protective muscle guarding and nerve compression syndromes, and reward the patient through proprioception and body awareness. Thank you, as always, for reading!

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