July 2006 Dalton Newsletter
Erik Dalton, PhD,
Certified Advanced Rolfer
JULY NEWSLETTER
Before delving
into this month’s feature on upper extremity disorders, I must share
a brief synopsis of last week’s memorable and delightful Florida
State Massage Therapy Convention in Orlando. My wife Teri and I
vastly enjoyed the camaraderie shared with such dedicated and
inspirational bodywork leaders who’ve had such a profound influence
on our work—from colleagues and mentors to massage therapists in the
field—all devoted, all passionate about their work and all combining
forces to elevate the consciousness and expertise in the manual
therapy community. For the past four years I have had to hustle
around like a nervous bumblebee preparing to teach at this
conference but this year was solely dedicated to performing
demonstrations at the Biofreeze booth and generally having fun with
all my old friends.
It is such a
wonderful experience interacting with past students, teachers and
exhibitors. I am grateful to have the opportunity to not only share
my ideas and techniques but to also learn from others….something I
will never get enough of. Hopefully, there will never come a time
when I am not a “working” teacher. For the past 27 years, my clients
have always come first. Working with them presents new challenges
that allow me to keep my teaching fresh and new ideas flowing.
Recently a convention billed me as “A teacher’s teacher”. When I
heard this, I objected saying that I consider myself more a
“Learner’s learner”….always a therapist first and that’s how it
shall always stay.
Okay, enough
philosophy…let’s get down to the fun stuff. This month we will begin
an adventurous tour through the body’s upper extremities.
Theory of
shoulder girdle function
The shoulder girdle functions to position the hand,
provides stability for hand use, lifts, pushes, elevates the body,
assists with forced inspiration and expiration, and even weight
bearing as in crutch-walking. The hand performs a significant range
of functions. It is an organ of touch, an extension to the brain
that provides information to the visual system about the
environment, and it is an important organ for expression and
nonverbal communication. The hand can grasp with forces exceeding
100 pounds as well as hold and manipulate a delicate thread.
Unfortunately, optimal hand functioning is often jeopardized by
problems occurring in the shoulder girdle, elbow and wrist.
Most Myoskeletal seminars begin with assessment and treatment
techniques aimed at restoring length-tension balance between tonic
and phasic (tight-weak) muscle groups of the torso. Typical
imbalances between these two muscular systems lead to aberrant
strain patterns such as Vladimir Janda’s upper and lower crossed
syndromes and scoliotic (torsional) asymmetries. Tension, trauma,
and repetitive movements combined with gravitational exposure alter
the position and function of associated joints. Mobilizing joints
through muscle manipulation is at the heart of the myoskeletal
method. Therefore, soft tissue maneuvers have been developed to
release osseous fixations and help create joint-play in all the
body’s synovial joints.
Those
of you who have taken my Advanced Shoulder, Arm & Hand
workshop or viewed Volume III, Myoskeletal Techniques videos
are aware that the assessment and treatment order is reversed when
dealing with loss of range of motion and stability in the upper
extremities. In my personal experience, I have found that many
painful shoulder, arm and hand conditions do not fully recover until
each articulating joint surface (sternoclavicular, acromioclavicular,
glenohumeral, radioulnar, and carpals) is addressed in a precise
order. Most massage therapists are unaware of the precise range of
motion options that must be present in each joint so fluid movement
can travel smoothly down the shoulder girdle’s kinetic chain and
into the hand. When active stretching techniques are properly
applied to a joint and its associated soft tissues via muscle energy
(contract-relax) techniques, many cases of tendinitis, nerve
impingement and referred pain suddenly disappear.
Active
movement psychologically reinforces to a client that she can move
the arm through a greater range of motion. Physiologically, active
movement assists the healing collagen tissue to align itself along
normal stress lines and aids in restoration of normal strength.
Active movement also nourishes articular cartilage and enhances its
repair. Active exercises, such as scapular plane elevation and
external rotation, facilitate muscular strength and endurance while
augmenting the joint mobilization intervention with regular
stretching. This is important because musculotendinous structures
return to their resting length within a few minutes following active
isolated stretching.
For
example, when testing the sternoclavicular joint, the medial heads
of the clavicle must drop down during shoulder elevation and must
move posteriorly during horizontal extension of the arms. The
acromioclavicular joint has three motions that can become
dysfunctional, the glenohumeral ten, the elbow three, and so on down
the arm. When performing upper extremity work, I first take my
clients through a systematic 15 minute mobilization routine
beginning with the sternoclavicular (SC) joint, and proceed with
assessment and correction of all bony articulations in the shoulder,
elbow, wrist, and hand. Any remaining soft tissue restrictions
and/or pain sites are then evaluated using the acronym ART:
-
Asymmetry;
-
Restriction of Motion; and
-
Tissue Texture Abnormalities.
Mobilization techniques apply distraction, compression, rotation,
and/or translation forces to bones to restore normal accessory joint
mobility. Continual reevaluation of motion progression is valuable
to provide clients with short- and long-term goals. This also gives
the clinician feedback about compliance with the home exercise
programs which includes Thera Band® strengthening tools and specific
stretching modalities.
Pelvic
& Trunk Stabilization
Of
course, pelvic and trunk alignment and stabilization routines as
presented in Myoskeletal Techniques Volumes I and II must
precede any upper extremity work. This is obvious to most structural
integrators and sports therapists. During a tennis serve for
example,
the
power generated by the shoulder must follow a kinetic chain
beginning with power produced by the legs, trunk and back. Since the
muscle mass of the shoulder is relatively small, if inadequate
momentum is generated by the preceding links in the kinetic chain,
the shoulder has to play 'catch-up' and generate power rather
than acting as a force regulator. Improving muscle/joint
function in the server's legs, lumbars and trunk stabilizers, allows
reduction of the incidence of rotator-cuff injuries during the
tennis player’s serve. Biomechanical analysis of specific joints is
not difficult and can help rule out suspected soft tissue injuries.
In skilled hands, joint mobilization through assisted stretching is
a crucial and effective element in injury prevention.
Summary
The
reflexogenic relationship of muscles and joints is at the heart of
the Myoskeletal Method.
Any alteration of
joint function influences muscular function, thus producing a
self-sustaining chain reaction. To understand the fine control of
motion, the separate activity of individual muscles is not as
important as their coordinated activity within the different
movement patterns. The proper understanding of this concept appears
as the best basis for rational treatment and good long-term
therapeutic results in the general population, along with clients
presenting with functional joint problems.
In closing, enjoy
the summer—it’s going fast and I hope to see many of you in my Boca
Raton or Reno workshops in August.
|
August 4-
6, 2006
Boca Raton,
Florida
Advanced
Myoskeletal Certification Workshop
Advanced Low Back/ Neck/
Shoulder
24 CE hours
(Call Michael at
800-766-1942)
Register online at
www.takemyregistration.com
|
August
26-27, 2006
Reno, Nevada
Freedom
From Pain Institute Seminar
Neck, Shoulder, Hand &
Back Pain
16 CE hours
(Call Michael at
800-766-1942)
Register online at
www.takemyregistration.com
|
Make plans now for
next year’s big “2007
5th Annual Costa Rica Retreat” with special guest,
Mr. Anatomy Trains himself…Tom Myers.
www.erikdalton.com Sponsored By:
