About stacyliddle

Licensed Massage Therapist and Physical Therapist Owner of Austin Body Therapeutic Center

Nuts and Bolts of Fascia and Movement

Passion I’ve been doing bodywork for 23 years now.  It sounds like a long time, but it always feels like there is so much more to learn.   Just as I peel away the layers on soft tissue issues, I feel closer to the awe that is the human body.  To me, it is like getting a fireworks show every time I think about its amazing power and resilience.

Currently, the two things that inspire me most are fascia and movement.  And though both have been around since I started my journey, there is a thrilling amount of new information and study coming from each of these fields.  My mentors are everything to me.  I wouldn’t be where I am today without them.  So in order to further explore my ideas about the resolution of hip pain, I think it is important to look at the sources I have found to be of benefit.

Fascia        deep_tissue_1Despite the fact that fascia was first described over 100 years ago by, the founder of osteopathic medicine, Andrew Taylor Still, MD, the first international fascial conference was held only five years ago in 2007.  With the advances in research methods and technology, most of what Dr. Still hypothesized about fascia, is now being proven.

What is fascia?    Fascia is a very densely woven covering that interpenetrates our organs, muscles, bones, nerves, and blood vessels. Of great significance, it is actually one continuous structural support that exists from head to toe without interruption.  So truly an ankle sprain that doesn’t completely heal, can lead to headaches in your future if the fascia gets tight enough.  Medicine prefers to look at the body in its parts, not in its connectedness.  This is why as a bodyworker; fascia explains a lot of the clients that have fallen through the cracks in our healthcare system.

It took me until 2010 to have my own break out moment about the power of fascia.  It was during a yoga workshop that I was introduced to the work of Tom Myers, the man behind Anatomy Trains.  Leslie Kaminoff, of the Breathing Project, showed us a video dissection of the ‘deep front line’.  And yes, just like in the movie Jerry Maguire, Tom Myers work had me at “hello.”  It just tied together a lot of those loose ends. albinus-front-view-4th-order-150x150

Movement  Let’s move on to the new concepts in movement.   Every time I turn around there is a new functional movement guru.   Currently I am drawn to the work by Gray Cook and Kelly Starrett.  My thought on why functional movement is sticking now vs. previously is because we are using these tools with our professional sport teams and getting results.  They are showing that by doing a functional screening on these well paid athletes that they can predict their probability of injury. It’s funny how managers seem to prefer to pay for athletes that can stay in the game at their top performance vs. on the sideline.

Fascia and Movement relating to hip pain     When I do an assessment on my clients with hip pain, I usually find a combination of both fascial and movement dysfunctions. The key for me is to address them in the proper order.  If you don’t have the movement due to fascial tightness, I work to get rid of the restrictions before retraining their movement.  If I find an unstable joint, I get it supported with tape or bracing and start strengthening at whatever level they can manage without pain.  Even if I find fascial restrictions around this instability, I must be careful as taking any more stability away from an area may hinder my client more.

Hip pain Alignment check     Here I find that the pelvis, sacrum and low back may be impacting the hip.  Now I have to decide if the change is due to a one time trauma that has altered the position, or that a constant postural tension with fascial restrictions has led us to where we are today.  Or the truly challenging and most common is a combination of both.

balancing-skeleton-150x150Hip pain Movement Patterns     The second biggest finding I have with hip pain is muscular imbalances in the hip, abdominal and pelvic floor muscles.   My job is to figure out if the tissue is short and fascially restricted, or overactive and just on all the time and needs to be relieved of its overactive duties, or truly just weak.

“Maybe we are all cabinets of wonders.” ~ Brian Selznick

 That’s it in a nutshell.  I sense more details on hip rehab next time.

 

The Hip in More Detail

Finally Hip pain Part 1 is posted!  Please take a look 🙂

Hip pain: Part II will be coming up next.  I’ll get into more details about the bodywork side of things as well as add some details to the rehab side of things.

If you have specific questions you would like answered, send them!

Thanks and stay cool!  Stacy

 

Hip Pain is Currently Hip!

Hip Pain- Part 1bones

I’m not sure if I would go so far as to say that hip pain is the new black, but over the past decade its popularity has been on the rise due to innovative arthroscopic surgeries.  These techniques are similar to those used for years to help knee and shoulder problems.  The major exception is that the hip is a much deeper joint, and by nature built for stability.   It has taken a little bit longer to figure out how to do a less invasive procedure which includes an exterior camera and weighted traction.  The huge plus is that many things that weren’t treated by the open procedure surgeries are now able to be corrected.

Why would a bodyworker be so excited about the advancement of hip surgery?  It is quite simple -research must support the things we do in medicine.  Twenty years ago, as a new physical therapist, the only hip problems referred for rehabilitation were bursitis, and post-operative care following hip fracture and hip replacement.  Today we have a much better understanding of what is happening if you have hip pain. This improved system of differentiation, offers more treatment options and the ability to screen those that may be at higher risk for more severe hip problems later in life.

Let’s consider hip anatomyhip-150x150

Here’s what you want in terms of having a good hip.  Nice congruent and well aligned surfaces between the thigh bone (femur) and the pelvis (acetabulum), and normal cartilage spacing between these two bones that make up your hip socket.

What if you don’t have these things?  Here is where the biggest questions live.  Are you more prone to develop hip arthritis?  Will performing arthroscopic surgery to help improve the contour and alignment of your hip joint today, prevent a hip replacement later on in your life?  Since this is all pretty new, the jury is still out on the final answer, but I believe things are looking pretty hopeful for the future of our hips.

So you have hip pain what do you do?

I recommend getting a consult with an orthopedist that specializes in arthroscopic hip procedures.  You will have to do your homework as this training is still relatively new.  For instance, in Austin, at the time of this blog, we have only two physicians with this expertise.  They will rule out if you have a true joint problem, a muscular problem, or a combination of both.  Once you know this, the options are pretty well laid out, and include medication, corticosteroid injection, soft tissue mobilization, rehabilitation and/or surgery.

Rehab Perspective- A good assessment is imperative!

An individual program should be designed to support your hip alignment and correct movement dysfunction.  Common findings are functional pelvis asymmetry, decrease in hip range of motion and muscular flexibility, and neuromuscular imbalances which include both weak and overactive muscles in the hip, abdomen and pelvic floor.  It is important to pick someone skilled in these areas of assessment to assist you in figuring out a corrective program you.

          hip-muscles

Your biggest job is to figure out and stop the irritating factor(s).   A good rule of thumb is any pain brought on during or after an activity or exercise should be discontinued or modified for the time being.  With this effort and putting a knowledgeable team in place, you should have the best opportunity to return to doing all the things you liked to do before your hip started to hurt.

“The obstacle is the path.”- Zen proverb

Hip pain: Part II will examine hip injuries and treatment in more detail.

 

 

Life’s Little Surprises

Since my last post that I would get back to you about hip pain, I have been completely sidetracked.  Symptoms are divert, alter, and change. Digress, switch, and veer.   Deviate, shift, and redirect.  And yes, since I last wrote all these things happened.

The first Saturday in May started out innocently enough, like any other, but unfolded into the unexpected.  Mid-afternoon, my neighbor called to see if I could entice a kitten out from beneath her Toyota Tundra.   “Sure,” I said.  After all, how hard could it be to coax a tiny creature out of its hiding place?  An hour and a half later, I finally had the smallest, gray fur-ball, I have ever seen, extracted from its perfect spot on top of the snug fitting spare tire.

2013-lil-lion-009-smaller-150x150It was hard for me to believe that the pair of lungs that brought her to our attention came from this teeny creature.  All fur and protruding ribs, she clearly didn’t weigh a single pound.  And plenty scared, as she tried to adjust to her new surroundings.  But who wouldn’t be- the high pitched cries for help had been for her mother and clearly not for the nine pairs of human eyes that had shown up instead to lure her out of her safe haven.

024-email-sizeAwaken your capacity to be delighted.Everything is new and exciting to this kitten.   Every inch of her environment must be explored.  New noises stop her in her tracks.  Big brother’s tail is a complete preoccupation.  Just watching her find delight in nearly everything she does reminds me to view my everyday tasks a little differently.  In these crazy, busy days that encompass most of our time, remember to do something you truly enjoy doing each and every day.

Since life has a way of constantly bringing on the unexpected, here is what this itty-bitty thing made me ponder this month.

Active Release Techniques

I’m off for a 4 day workshop and will be back to write more about what this means to me as a body worker and to you as a client.

It’s been quite a journey just to get to this place and I know in the next few days I will have plenty of aha moments, and plenty of times when I’m not really sure what point they are trying to make. It’s all part of being back at the beginning.

Let’s Start with a Clean Slate

clean-slate-3 “How you do anything is how you do everything.” I, for one, can’t believe it is the end of January- already. Everywhere I go people are talking about their New Year’s resolutions. I have long stopped this practice, but still find it fascinating to listen to others participation. Personally, I like to look at each year as a clean slate. It is both frightening and liberating to me; a time with nothing specific planned and no big goals to master. It won’t last long as life has a way of giving me plenty of tasks to handle. However, during this time, I like to notice if any of my own bad habits have shifted over the past year.

As a body worker, I see many different personalities on my table, but the most trying is the driven client who, despite all the body’s careful warning signals, continues to disregard them and to push through any type of pain. He/she only knows the quest of pushing further and further. Not until their body completely fails or their nervous system literally freaks out, will they maybe see the harm of this cycle. I hope that the time spent on the table will bring awareness to this destructive path before they take their body over the edge. If I am not careful, this can be me.

This brings me to the yogic concept of samskara. It is defined as a pattern deeply ingrained in our subconscious that causes us to act out variations on the same theme again and again. Samskaras are our individual actions, ideas, or thoughts. Lumped together, they become all of our many patterns. These can be physical patterns of holding tension or postures that keep things in a constantly stretched position, as well as mental patterns harboring our fears, needs, and beliefs.

“How you do anything is how you do everything.” I have tried to find the source of this quote to no avail. But the gist of it is that your true nature will handle everything in your life in a pattern that you are not even aware of. It’s important to realize that our patterns are conscious choices to make. It’s up to us to choose them. If we aren’t aware of this, we are strengthening the old default muscle. Yes, we are creatures of habit, but it is important to see that we have a choice in our habits.

So how do we create healthier patterns? It doesn’t happen by accident, we have to call attention to it. The massage table is the perfect place to notice our habits. To start, I ask my clients to try using breathe instead of gripping, and a mental scan of the sensations they perceive as they receive the work. With only these two intentions, change is started just by their heightened awareness. These tools are then taken off the table, back to everyday life, where conscious choices can be made.

I know when my clients retain this awareness by the way that they communicate with me about their body. If they just want to hand it over to me for me to figure out, we won’t achieve the same results. If they can tell me a little bit about their pain’s behavior, together we are more successful. If they can give me insight about their body, I know they have taken the time to slow down and listen. This input they are learning to access is more valuable for their overall health than anything I can offer. This will serve to create healthier patterns.

Awareness is what helps us see our thoughts, behaviors and movements as patterns. It allows us to ask if these habits are working for us. Instead of wondering, ‘Why is this happening to me?’ Ask yourself, ‘What does this pattern have to tell me?’ And then you can act on it. On the table, I ask my clients to envision the change they are looking for. When we step out of our patterns, we can restore our bodies to more optimal health.

Are you open to the idea of a clean slate, to get out of the deep groove of a pattern made by year’s of endless repetitions? Remember it is your choice.

“These pains you feel are messengers. Listen to them.”― Rumi