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.

 

Advertisements

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.

 

 

The Power of Looking Deeper

One of my favorite teachings reminds us that we already have everything we need to heal within us. This is not to say that modern or alternative medicine isn’t necessary. However, just hold this thought, tangibly in your hands, for a moment and think about how powerful it really is.

As a body worker, I would be out of a job if we were always capable of figuring out exactly what it is we need. My observation, over the years, is that many people need a clearly definable and fixable injury or illness for them to move forward in their recovery.

But what about the thing that just hurts sometimes, or despite a diagnosis and sound treatment plan, it remains present and quite annoying in your life. What if that tension you hold is deeper than your annoying boss, your daily grind or a past physical trauma?

We start our patterning really early. Some believe from the day that we take our first breath. I don’t know about you, but I can’t remember how easy it was or wasn’t to breathe, or to crawl, or to walk. But all of those skills initiate our internal wiring. It is completely subconscious, but still there never the less. Based on our life experiences, we learn to keep certain muscles chronically tight, and our joints compensate around this imbalance. Luckily, given the right attention to detail, this can be restored.

“Life is the sum of all your choices.” ~Albert Camus

It’s your Choice, Mountain or Molehill?

Lately I feel a need to remind folks that hate is a very strong word, especially when used in reference toward your own body. Just like people, I think your body is sensitive to this dialogue and has a difficult time not taking it personally. This self judgment of ill will can only safeguard a very personal sense of deficiency. So rather than becoming quick to anger at your body’s communication style, try instead to have a little compassion for yourself, even in times when it feels like ‘not this again.’

Just remember when your body hurts, it is only trying to tell you something is amiss. Your body gives you information as an early warning signal, so that you won’t end up in a mountain of discomfort when a mole hill will do. It wants desperately to put the ball in your court so that you can be proactive and figure out an appropriate solution.

So seriously, the next time you feel a minor ache or pain, don’t just ignore it. Ask yourself what you could do to make a difference today. Does your body want ice, heat, rest, movement…? If you stop for a moment and really listen, your body will tell you what it needs. And if the interpretation isn’t loud and clear, pick up the phone and call someone for advice. Now, instead of hating the body part that hurts, you can start the healing process, and get back to doing all the things you love.

‘Don’t wait for your mood to change; take action despite it.’ ~ Terri Trespicio