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Orthotics? No, thanks.

Patients who visit us quite often hear from their doctors and therapists that one of their legs is shorter, which results in uneven weight distribution in one of the feet. Basically, that’s all that they hear. (However, if the problem lies strictly in platypodia, and not in differences in limbs length, the orthotics as a completion of the therapy can come in handy).

Usually, the shorter leg is also discovered during our examination, but with one major difference. Whereas, we state that it’s just part of who they are, others may prescribe wearing the orthotics.

It’s an interesting course of action, because it is highly unlikely that the leg shrank while taking a cold shower, it’s not like the patient left part of it at home, or lost it on the way.

Therefore, if the leg isn’t shorter as a result of difference in bones length, then it means that some mechanism in our body must have failed. This mechanism needs to be identified and repaired. What can orthotics do? Give temporary relief, but in the long run it will worsen the problem.

If the problem was developed throughout life, then it is a result of impaired biomechanics, more specifically impaired musculo-fascio-visceral chains, and not of not wearing the orthotics.

Musculo-fascio-visceral chain is a combination, or rather interdependence of the movement between a muscle, fasciae, and an internal organ.

For example: fascial tension of the right leg’s adductor muscles causes pelvic blockage in one position. Pelvis contracts the iliopsoas muscle, which in turn affects the slide of the right kidney. This leads to the contraction of the liver which causes the diaphragm contraction. From there, linea alba will be contracted, and then pectoralis major muscle which have impact on the tension in sternocleidomastoid muscle resulting in contractions in the temple and aural channel areas, which may lead to migraines, tinnitus, neck and ear ache.

Unfortunately, now we have to enter the fantasy world as the major part of medical environment, including physiotherapists, treat musculo-fasio-visceral chains as if they were a fantasy. They don’t believe that they exists, but all they have to do is take a look into an anatomy book.

Slide and quality of the fascia have a defining influence on the behaviour of the muscle and the organ that it is located in. Musculo-fascio-visceral chains also determine how the body behaves in motion and at rest.

It means that every human organism uses the same connections for specific activities.

For example, while running, the proper movement of the foot cannot take place without the proper movement of the organ, head and hand. Therefore, all muscles and internal organs which take part in this motion create a musculo-fascio-visceral chain, meaning that every disturbance in this connection will have its impact on the whole mechanism.

The best way to present this notion is an example of a musculo-fascio-visceral chain therapy based on an original conception of CRH team.

Pelvis calibration was achieved, which gradually evens out the angles of knees and feet. Thighs and shins has been unrotated and the lower limbs length has practically levelled out. There’s still a lot of work ahead of us, but the current effects are more than satisfying.

Manual Therapy in Respiratory System Diseases

We were visited by a patient whose main problem was shoulder pain with a sporadic radiation to the hand. While describing the pain, the patient pointed out the feeling of heaviness in the shoulders as if he “ had an armor on”, simultaneously he complained about constant pain sensations between shoulder blades. The description alone suggested that the cause of the problem lies in the respiratory system rather than shoulders or hands. When asked about respiratory problems, the patient admitted that he has been being treated for asthma, and simultaneously couldn’t stop hawking for months. There was no doubt that we were dealing with respiratory system dysfunctions.

Hoarseness, frequent clearing of the throat, coughing, shortness of breath, need for swallowing, the feeling of having something stuck in the throat, or even chronic throat irritation not necessarily are of bacterial, viral, or chemical origin. It can be the respiratory system giving us a sign that there are some blockages and that it’s trying to deal with them by trying to even out the incorrect contractions by contracting back.

After working on the soft tissues, sternum fascia, sternocleidomastoid joints, costochondral joints, costotransverse joints, and after the manipulation of the sternum the symptoms felt in the shoulders disappeared, and respiratory function has been restored. The patient told us that he has reduced the intake of asthma medication by half.

We discovered that ribs and sternum were blocked in the exhalation position which caused respiratory problems incorrectly diagnosed as asthma. Because the cause of the problems wasn’t treated properly the tensions spread further, consequently resulting in the symptoms in hands.

This situation shows how important it is to base the diagnosis on the level of human biomechanics. Unfortunately, a question of how many asthmatic conditions are a result of disturbed biomechanics and do not need pharmacotherapy arises.

Manual Therapy in Internal Organs Diseases

Mobilisation of the kidneys and renal fascia with the gastrosplenic ligament in holistic approach.

Recently, we were visited by a patient diagnosed with an autoimmune disease of a gynaecological origin. She struggled with this problem for over three years. Normal functioning was impeded by frequent headaches, thoracic and lumbar spine pains, and also constant states of weakness, somnolence, and exhaustion.

The interview revealed that the problem arose a few weeks after acute pyelonephritis. The patient was hospitalized and underwent pharmacotherapy (5 antibiotics in the span of 3 weeks). Lumbar pain subsided, but the gynaecological problem, and the rest of symptoms only started to develop.

The patient described the three-year-long therapy, including pharmacological treatment with the use of steroids, as well as the gynaecological treatment, i.e. laser therapy, Platelet Rich Plasma (PRP), and modern photodynamic therapy. None of the mentioned methods of treatment caused significant improvement.

During the conducted tests and observations I realised that the patient’s neck is in protraction, she also had hunched position and protruding right costal margin, or to put it simply – scoliosis. While diagnosing the tongue, I observed deviations responsible for kidney disturbances, dehydration, and increased mucus production.

The overall dryness of the organism and strain of the renal fascia, as well as past inflammation led me to work on this structure.

The whole area was quite tender and very painful during palpation. I started the treatment from stretching and mobilising the renal fascia. Having worked on the right side, I found a new symptom, more specifically – a lateral displacement of the ribcage relative to the hips (pseudo-scoliosis), and dizziness which subsided after few minutes. Afterwards, I started working on the left kidney (more painful), which changed the position of the right costal margin.

It’s incredible how internal organs can influence our posture!

After this part of treatment, the patient was a little bit disoriented, she felt dryness in her mouth, and slight vertigo. It was caused by the increase of capacity of particular structure when the blockage was removed, which triggered the chains to work and “calibrate” the system.

We had some time left, therefore I started working on the gastrosplenic ligament and the bladder on which there was significantly less tension than at the beginning of the examination. Why this particular ligament?

During the interview the patient mentioned immune suppression. Illnesses and colds were frequent, up to couple times a year. The patient had low level of erythrocytes, and disturbances in adrenal system in the past, for which spleen may be responsible.

I advised the patient to drink big amounts of water for her organism to be able to normalize hydration. As a result of the therapy, the patient doesn’t experience any gynaecological problems, although the treatment isn’t finished yet.

„Side effects” of the therapy were straightening the hunched position and reduction in the tension of the sternocleidomastoid muscle, and also eliminating the protraction position.

Back pains subsided, headaches – although rarer – are still present. Rest of the symptoms will be taken care of in further stages of the treatment.

As the aforementioned case proves, sometimes the best solution for complicated health problems is the simple solution.

Headaches – where to look for the cause?

Nowadays, more often than not, work is related to spending long hours in front of the screen of a computer, and straining the eyes. Deadlines are hanging over our heads, we’re constantly in a rush, stressed, and there’s never enough time. All of this contributes to the occurrence of various, unwanted conditions. Headaches are one of them, they affect major part of the world’s population and are more frequent than asthma, diabetes, or even congestive heart failure.

Headaches are often accompanied by the upper back pain. In this case, it is necessary to understand the cause, examine the tissue functions – which can be involved, although not necessarily located in the head and neck area – and to introduce the proper treatment.

Insightful interview will enable the physiotherapist to correctly understand the issue, and will also enable him to start a best suited treatment for the given organism.

The treatment is non-invasive, so it is a good alternative for pain medications, which only suppress the real cause of said pain sensations.

Headaches and upper spine pains are caused by stress, increased muscle tension, disbalance of a chemical nature, or the intake of medication (as a side effect). Oftentimes, dehydration is also the creative factor.

Those causes, mentioned above, are partially responsible for impeding normal functioning.

To understand a given problem we have to delve into the case and determine what kind of pain is bothering us.

We can divide headaches into two categories:

  • Vascular – pulsing pain located inside the skull, caused by increased pressure of bodily fluids; the so-called migraines. During these headaches, changes to the blood vessels, inside and outside the skull, take place. Vascular headaches can be a result of serotonin metabolism disturbances (hormonal problems). Usually, the pain is located on one side of the head.
  • Tension – generally speaking , it is a kind of headache caused by increased muscle tension of head and/or neck, which leads to the compression of sensory nerves. It is the most common kind of headaches, since about 75% of people affected by headaches is diagnosed with it. It is usually located outside the skull, and is accompanied by the stiffness of neck and shoulders.

Vascular and Tension headaches alike can have their roots in the muscles.

The most common case are the problems concerning the sternocleidomastoid muscles, scalene muscles, and suboccipital muscles (Rectus capitis posterior major and minor, and obliquus capitis inferior).

If those structures are the cause of pain, then radiation and occurrence of symptoms are located in the ear area, and often pass into temple, forehead, and temporomandibular muscle areas. Those structures are also co-creators of tinnitus (ear buzzing).

Another piece of the puzzle are the muscles responsible for straightening the head and neck. Their dysfunction is caused by the long hours spent in a sitting position, which becomes a hunched position over time. This order of things influences said muscles’ attachments on the spine, which are located in the places where the humps are most often created during sitting. This causes pain felt simultaneously under the head from the neck side, between shoulder blades, and in the middle of the back.

Those muscles are::

  • Semispinalis capitis, cervicis, and thoracis
  • Longissimus muscle
  • Splenius capitis, and splenius cervicis
  • Quadratus femoris muscle

From the previous article concerning vertigo you could find out that vascular pains may be caused by the aforementioned structures, which influence how much blood flows through the arteries surrounding the head.

Nowadays, because of the sitting lifestyle, we encounter those problems very often. Working in front of the computer makes us tilt our head in the direction of the monitor which entails constant straining (overloading) of said structures.

Tensions within internal organs area may cause headaches. Persisting tension in the dura mater, respiratory muscles, and oesophagus will cause neck tension. The neck, in turn, will cause tension in suboccipital, scalenus, and sternocleidomastoid muscles which will result in a headache.

As a physiotherapists we encounter the cases of episodic headaches accompanied by constant, tiring neck pain on a daily basis. Thankfully, the progress and development of physiotherapy in the recent years allow us to use many techniques and methods of dealing with such problems. So, instead of being dosed with pain medications it’s better to visit a physiotherapist. 

Tennis Elbow, part 2 – The victim screams, not the culprit

Body pain is the signal of system disturbance. The cause may lie directly in the area of the pain, or it can be located much further. That’s why therapies focused only on treating the area of the pain are often ineffective. One of the mottos of holistic medicine is the saying ‘the victim screams, not the criminal’. That’s why we will focus on finding the ‘bad guy’ whom we will call the Hot Spot.

Each of the systems responsible for transporting or transmitting the energy in the human body has its own Hot Spots. They are places in which, due to their structure, decrease of capacity may occur. If the compression on nerve, vessel, or fascia will occur in a Hot Spot, then the pain can spread further.

Let us begin with circulatory and nervous systems. The first Hot Spot, in which blockages often occur, is the area of scalene muscles. Those muscles go from cervical transverse processes to the first and second rib.

Their task is to assist the inhale by pulling the ribcage upward. Muscles, like every other human tissue, adapt to the environment they are in. Sitting in one position for long periods of time (usually with the head tilted in the direction of the screen, book, or phone) leads to the muscles being stuck in one position. Additionally, majority of our population don’t know how to breathe with the use of diaphragm.

We overuse chest breathing, which introduces additional stress to the already overloaded scalene muscles and tightens it even more. Additionally, the gap between scalenus anterior muscles and scalenus medius muscles is even narrower. As a result of the muscle blockage, there occurs narrowing of the subclavian artery and brachial plexus. As a consequence, there is less blood in the brachial artery and the compressed plexus will give symptoms from all the nerves in the hand. From the holistic medicine perspective, the pain is caused by the amount of system disorders, i.e. the disorders of: circulatory system, nervous system, fascia system, digestive system, lymphatic system. From this perspective we will analyse every case.

Tennis Elbow – why medicine is so bad at dealing with it.

Tennis Elbow – extremely tiring condition with which normal usage of the arm is impossible, and which prevents us from performing even the simplest daily tasks.

Traditionally, in conventional medicine, every elbow pain located in the area of lateral epicondyle of the humerus (clod-bone) is diagnosed as tennis elbow without further consideration. Most frequently, we hear that the fault lies in an inflammation. Therefore, every kind of treatment will consist of anti-inflammatory and regenerating actions. As a consequence, we will be prescribed with the anti-inflammatory medication, anti-inflammatory physical therapies, and prohibition of heavy lifting, because it may cause worsening of the inflammation.

Now it gets interesting: since 1992 it is common knowledge that inflammation don’t occur in this condition (Regan et al. 1992; Potter et al. 1992; Cawston et al. 1994).

Every therapy focused on epicondyle are ineffective as there can be many causes of the problem. In the next article, we will prove that epicondyle is only the victim, and not the source of the problem

Regan W., Wold L.E., Coonrad R., Morrey B.F., 1992: „Microscopic histopathology of chronic refractory lateral epicondylitis”, Am. J. Sports.

Potter H.G., Hannafin J.A., Morwessel R.M., DiCarlo E 18. .F., O’Brien S.J. Altchek D.W, 1992: „Lateral epicondylitis: correlation of MR imaging, surgical, and histopathologic findings”. Radiology, 1995, 196, 43–46.

Chard M.D., Cawston T.E., Riley G.P., Gresham G.A., Hazkeman B.L., 1994: „Rotator cuff degeneration and lateral epicondylitis: a comparative histological study”. Ann. Rheum. Dis. 1994, 53, 30–34.

Intestines – frequent source of back pain conditions.

Did you know that intestines consist of about 200 million nerve cells? It’s more than all of the nervous system, but less than the brain. That’s why enteric nervous system is called „second brain”. What’s more interesting, the complexity of this system causes the scientists to attribute it intelligence of a dog, or a cat.

Numerous musculo-fascial connections are spread through the abdomen, they connect our arms with our legs.

Blockages of this area often result in pain sensations interpreted as:

  • Discopathy
  • Sciatica
  • Hip pain
  • Groin and knee pain

Blockages of this area cause swelling of the legs, calves, and ankles.

A lot of our patients diagnosed with discopathy or sciatica after therapy went home without any symptoms.

Average weight of the bacterial flora ranges between 2 kilograms. It gives us around 39 billion (39 000 000 000 000) of alien cells in our organism, with average quantity of human cells being around 30 billion (30 000 000 000 000). Therefore, sometimes the bacterial flora controls us, and not the other way around, forcing us to supply appropriate nourishment.

In the intestines, lymphatic tissue is located. It is connected with mucosa of digestive tract which contains over 70% of lymphocytes of the whole organism and creates complex immune system, the so-called GALT (Gut-associated Lymphoid tissue) system; therefore, over 70% of our immunity is strictly connected to the state of our intestines.

Over 90% of serotonin produced by the human organism is created in the intestinal cells, so it’s easy to say that the state of our intestines is responsible for our well-being.

From all the nerve impulses passing through vagus nerve, 90% goes from intestines to the brain, and only 10% takes the reverse path. It looks like our brain is outright bombarded with information from intestines, therefore, a large part of our emotions is closely connected to intestinal nerves work. Therefore, anxiety and fear may be caused by the blockage in abdominal fascia system.

Thankfully, we have a very efficient cure for that – a visceral therapy, i.e., specialised abdomen massage.

Vertigo – why neurologist and laryngologist couldn’t help us?

When we exclude the causes of neurological nature, by getting clear vestibular imaging and brain MRI scan, full arterial flow, and also by the absence of borreliosis or tetany, it is worth to proceed towards biomechanics and some characteristics of suboccipital muscles’ muscle tissue, and the specificity of the suboccipital area and scalene muscles area.

First of all, to explain the cause of vertigo, I must explain what is happening in our body.

The suboccipital muscles are a group of small, deeply seated muscles connecting the first two vertebrae – Atlas C1 and Axis C2 – with the occiput. (Pic. No. 1)

Characteristic feature of these muscles is their vast innervation and fibre density per every gram of muscle mass. They have over 36 spindles per 1 gram. In comparison, gluteus maximus has only 0,7 spindle per 1 gram. This indicates that these muscles fulfil the function of proprioception, i.e., they are a part of the sense of balance.

They are an aspecific extension of the inner-ear outside the body.

From this perspective, their task is the calibration on the sight – skull line; meaning, that if one of these muscles will become constantly contracted, or “frozen”, it will inform the nervous system that the skull is in completely different position than it really is. The muscle system on the demand of the nervous system will want to calibrate the system by changing the alignment of eyes, which in consequence can lead not only to the symptom of vertigo, but also to nystagmus.

Another element is that those muscles, along with scalene muscles (Pic. No 3) control the vertebral artery ( Pic. No. 1 – right side, Vertebral artery; Pic. No. 2), therefore, their contraction will reduce its capacity, too. Consequences will include increase in the cervical muscle tension, limiting the nutrition of the dura and spinal cord, and what’s more, ischaemia of cerebellum which is responsible for inter alia: sense of balance, planning and coordination of movements, eye movement, and muscular tension.

Solution to this problem is manual therapy adequate to the aforementioned areas.

Shoulder problems – Is it possible to solve the 4-year-long problem in 40 minutes?Holistic treatment has the solution.

Shoulder problems – Holistic treatment has the solution.

Is it possible to solve the 4-year-long problem in 40 minutes? Holistic approach in pain treatment.

Holistic approach is the only form of work with human body which guarantees a solution to the dysfunctions causes. Pain and restrictions are only the symptoms, this awareness makes us wonder why in a specific area of our body the problem surfaced. Modern medicine operates by focusing the treatment on the area where the symptom exists, and not by looking at the rest of the body.

We were visited by a patient with shoulder pain radiating through the biceps, and with a amplified pain sensations at nights. The problem has been present for over 4 years, and surfaced after motorcycle accident. He had broken ribs and blocked shoulder joint. The open-access medicine focused only on diagnosis on the level of the shoulder joint. Afterwards, when the pain was still present after conventional therapy, the diagnostics and treatment of the cervical area were applied. This area of the spine is responsible for the nervous supply of the shoulder. However, the problem still existed, that was when he heard that he suffers from the joint degeneration and has to live with it.

Our physiotherapist in barely one session was able to bring back the mobility of the shoulder and liquidate the pain. The success was so immense that on the next session tha patient wanted to focus on other ailments.

What was the source of shoulder dysfunction in this case? The patient hadn’t been adequately treated for over 4 years as the problem wasn’t connected to the shoulder.

Cause of the problem lied in the blocked joints of the previously broken ribs and in the abdominal muscles superficial fascia slide.

Now, let’s take a look on this problem from the perspective of the Holistic approach. What influences the shoulder dysfunction?

First of all, there are many possibilities.

It can be a problem of the given joint, but also of the rest of the organism.

Also the conditions like discopathy, degenerative changes, cartilage loss, chondromalacia, osteophytes, and cracking usually aren’t responsible for the symptoms, more significant are the mechanisms, which caused their presence.

Mechanisms influencing work of the shoulders are:

• superficial fascia slide in all muscles, from the skull to the fingers of the particular shoulder

• deep fascia slide of all muscles from the skull to the fingers of the particular shoulder.

• increase of the muscle density of all muscles from the skull to the fingers of the particular shoulder.

• decreased slide of the radial, median, and ulnar nerves in-between muscles.

• decreased slide of the blood vessels.

• decreased slide of the respiratory muscles

• increased density of respiratory muscles

• mobility of the intervertebral spine joints on the level of the cervical and thoracic areas

• mobility of the respiratory system joints (all costal joints, especially sternum joint)

• diaphragm blockage

• shallow breathing (lack of abdominal breathing)

• blockage of the liver slide on the ribs

• blockage of the renal slide on the lumbar muscles

• blockage of the abdominal muscles’ superficial fascia slide

• blockage of the abdominal muscles’ deep fascia slide

• blockage of the intestines mechanical functions

• wrong hip position

• gluteus muscles and leg muscles weakness

• gastrointestinal factors (diet, stimulants)

Sprained ankle – what is the key to quick recovery?

Sprained ankle joint vs. holistic approach

Recently, we were visited by a patient with a second degree sprain of the ankle joint. Orthopedist recommended wearing a splint on the limb for two weeks. For such a small injury wearing a splint can contribute to creating blockages in another joints. Because of that, unfortunately, we’re dealing with a couple of problems, instead of just one. Pain sensations in the joint are also caused by the blocked musculo-fascial chains, which are always blocked by the nervous system just in case, as it’s not aware of the level of damage.

In the attached file we present the consequences caused by the splint. Additionally, the patient had knee and hip joints dysfunctions. Thanks to the hard work of our physiotherapist, she said goodbye to this burdensome problem. Our physiotherapist needed only two sessions whereas the standard rehabilitation requires about 2 to 3 months.

Dear patients, remember that not every injury needs a splint. It is important to listen to the opinion of more than one specialist.