Trigeminal nocicpetion

Can a bad smell create pain, dysfunction and weakness?

Over the last few years I have found that nothing ceases to amaze me when it comes to the human body. As it becomes possible to dissect systems and assess interactions of specific stimulus, observing the input/output relationship between stimulus and body.

Pain is observed to be chemical, thermal or mechanical in nature. Please bear with the technicalities before I explain the simplified mechanisms or skip to the last part of the blog, if you get bored!

There are many factors that contribute to a patient’s perception and physical feeling of pain. Pain is the central nervous systems response to an event that has the capacity to injure the tissues of the body. Nociception or pain can be qualified from the following pathways.

The ‘First’ pain is usually a withdrawal mechanism (Nociceptive Withdrawal Reflex or NRA) mediated by the neurotransmitter glutamate and utilises the neospinalthalmic (new pain) tract in the anterolateral system or ALS. This typically lasts less than 0.1 of a second and the signal, suggested to be dampened in the substantia gelatinosa, an area found in the dorsal aspect of the spinal cord. Think about that sharp initial pain experienced causing you to move away from a stimulus, which has been detected by free nerve endings.                               Trigeminal nocicpetion/pain pathway

The ‘Second’ pain is also part of the ALS but is part of the paleospinalthalmic tract (old pain). It typically takes over from the initial first pain/neo. It is mediated by the compound substance P and can be associated with that long, lingering pain experienced from an injury.

In addition to pain, we have the capacity to assess many other features of mechanical distortion such as pressure, stretch and touch. The Dorsal Column Medial Lemniscus or DCML, allows the nervous system to provide adequate feedback to tasks and environmental stimulus.

Another part of the pain detection system is the trigeminal chemosensory system, which has nociceptive/pain and temperature pathways that feedback to cranial nerve five, called the Trigeminal nerve (CNV). When a noxious or toxic substance is processed by the neurons in the mucosal areas of the nose, mouth, eyes and lips it is relayed into the thalamus. The VPMN (or ventral posterior medial nucleus) relays signals to the sensory cortex and provides responses, such as watery eyes, sneezing and withdrawal

When we inspire air with small particles of pollutants, they pass from the lungs into the blood stream. Although the blood brain barrier is supposed to prevent any unwanted chemicals, crossing from the blood to the brain; the Circumventricular organs present an area that does not have the capacity to restrict compounds that can create dis-organisation of neurological signals entering and leaving the brain. The area postrema, also has a chemosensory role to initiate vomiting to deal with exposure to harmful compounds

So let’s have something a little easier on the eyes and brain to read now. For example:

Perhaps you are walking across the road in heavy traffic. Sucking up all the pollutants such as benzene, carbon monoxide and other waste products of burning fossil fuels into your lungs as you find your way from one side of the road to another.

For a few seconds your brain, exposed to the onslaught of pollution, has a hard time processing the compounds that have made their way into areas such as the pineal gland or chemoreceptors that can induce vomiting in response to a noxious stimulus.

You are in a rush and bump into someone, his or her shoulder hitting you firmly in the chest. It was slightly painful but you don’t really notice it, the pain pathway, along with pressure, stretch and touch receptors provided some form of feedback. The brain, perhaps still not capable of processing this feedback due to the short exposure of increased pollutants, is just trying to get on with the milieu of everything else that your body demands of it.

Meanwhile the pectoralis muscle, which is being used with each step that you take, has been exposed to increased pressure, a state of contraction or small window of pain that necessitated a withdrawal reflex. The intrafusal muscle fiber that monitor both stretch and contraction now have increased signal towards sustained contraction due to the chaos of external compounds that entered areas of the brain.

So now we might have some level of muscle dysfunction. We probably don’t even know about it. That level of muscle dysfunction now increases and decreases tension demands to receptors found in the ligaments and tendons. The joint mechanoreceptors have a different signal. The skin exteroreceptors perhaps have a different signal. There’s no pain to remind us of the event. In fact we have now gone to the gym and started doing a bunch of push-ups or gone shopping for food and simply carrying the bag home with that hand and shoulder. This doesn’t create pain, but simply sets the foundation for increased areas of dysfunction from distorted neurological signalling.

The concept of this neurological/chemical chaos is often referred to as ‘brain fog’. It seems to be in the literature for many reasons, blood sugar issues, gluten, estrogen (PMS and menopausal females are particularly susceptible) and other factors. It’s also possible that brain fog can be created from specific food stressors, once again eliciting the same response, proposed in the heavy traffic.

Some might say, how can the body be so fragile? Surely we are more robust than that? But it is possible to create these specific dysfunctions but they can be unravelled. Understanding specific stimulus can give us a solution to what dysfunction exits. We might never find out how it came about but a thorough history taking can help to influence where we assess and how to treat it. This is where a technique like P-DTR or Proprioceptive Deep Tendon Reflex, developed by Dr Jose Palomar is unique and effective at uncovering specific neurological dysfunction.

If emotions, visual, auditory, mechanical, chemical and pain factors perpetuate dysfunction, then using those stimulus can pose an effective form of assessment and treatment.

  1. Palomar, J. Proprioceptive Deep Tendon Reflex: Course Notes.
  2. Purves D et al Neuroscience 5th edition. Sinauer Associates 2012
  3. http://www.neurology.org/content/77/12/1198.short
sleep neurotransmitters

How to improve sleep-wake cycles.

Do you need to improve sleep? Why is it that sometimes, with the best intentions of going to bed early, we either find ourselves struggling to enter a sleep cycle, or wake up, deep in the hours of darkness? The prominent stress researcher Robert Sapolsky (Why Zebras don’t Get Ulcers) writes fondly of his near death experiences, of little sleep from the arrival of his newborn child.

It’s no surprise that security and intelligence operatives use a lack of sleep to disorientate prisoners. Just one nights lack of sleep from me and I will tell you anything! Despite the will to nod off, why is it that many people suffered from poor sleep, or struggle to enter sleep cycles?

Before I delve into some brief hormonal issues that can be manipulated to ensure a deeper sleep it’s worth noting that darkness itself is a stressful experience and we produce many restorative hormones during sleep to combat the metabolic stress of darkness. Therefore one essential component of adequate sleep is exposure to sunlight on a daily basis. This ensures uptake of vitamin D and exposure to the deeper penetrative orange and red lights, which help to restore metabolism and healing of cells. An old blog on light therapy.

Over the years I have found the following issues associated with poor sleep.

  • Low blood sugar levels
  • Increase in compounds of wakefulness
  • Exercise late at night
  • Excessive work stress/blue light exposure
  • Exposure to EMF-electromagnetic stress and Wi-Fi
  • Poor sleep and its vicious cycle
  • Emotional Stress

There are several models to be aware of when it comes to sleep theory and the phases of sleep are categorised as

NREM – Non rapid eye movement- pre REM sleep.

REM – Rapid eye movement- this is the deep restorative part of sleep
Active wake

Neurotransmitters and hormones associated with sleep:

Acetylcholine – AcH is the neurotransmitter associated with Rapid Eye Movement or REM sleep.

Serotonin – 5HT this neurotransmitter along with HA is associated with wakefulness.

Norepinephrine/Noreadrenaline – Ne – Hormone of wakefulness.

Gammaminobutyric Acid – GABA. GABA’s role in sleep is well documented but levels vary depending on location of the brain. It’s role is known in decreasing wakefulness and also decreasing deeper REM sleep and involved in producing wakefulness.
Histamine- HA involved in wakefulness.

Hypocretin Orexin- PCT /O Involved in wakefulness.

Adenosine- AD involved in entering NREM sleep.

Here is a rough depiction of key Neurotransmitters of REM and NREM sleep. Other neurotransmitters of wakefulness such as Histamine, Serotonin and noreadenaline (hormone) are not depicted but are elevated in waking state and should be lower during sleep cycles. It’s worth noting that the use of serotonin in mood related disorders such as depression is a key agent in insomnia like states.

sleep neurotransmitters

 

Common sleep disorders

Insomnia:  The inability to sleep restfully and I would categorise a good nights sleep from 6-9 hours depending on your own needs. The ability to enter deep sleep is dependant on many factors such as hormones, neurotransmitters, stress and available energy. It’s worth noting that the regenerative aspects of REM sleep and brain function have been shown to use as much glucose as when awake. Maintaining adequate available energy is key to getting sound-nights sleep.

Sleep apnoea: inability to enter REM sleep due to issues associated with optimal breathing. Obesity and sleep apnoea do seem to correlate and there is a suggestion of structural abnormalities in a small section of people.

The role of sleep in disease prevention

Sleep’s role in psychiatric disorders, depression, metabolic disease and addiction are well documented. A key feature of a lack of sleep, besides on-going fatigue and failure to regenerate is the elevation of adrenalin and cortisol. Elevated levels of cortisol are well known to decrease thyroid function, which can have a significant effect on levels of circulating thyroid hormone and energy production (key to regulation of sleep). The mechanism can tie in with its pervasive actions on management of blood sugar levels. Another noted effect from sleep loss is that we tend to overeat more when tired, which could impact weight gain (and if thyroid is part of the vicious cycle, weight loss becomes increasingly difficult).

Lack of quality sleep can therefore be responsible for an increasing amount of deleterious conditions, such as hypothyroidism, diabetes and obesity, other hormone dys-regulation and cardiovascular disease. Ascertaining whether the issue initially stems from a hormone imbalance can be key in resolving sleep wake issues.

Drugs

There are a variety of drugs on the market that help to improve onset of sleep, however if you seek to improve the biological mechanisms of sleep and perhaps look to the list suggested below, you may find that your sleep improves, without the need for medication.

Cognitive behavioural therapy

The role of CBT in reducing Insomnia has shown effective results even more so than prescriptive medications. Whilst the treatment is not determined whether it effectively targets the mechanics of insomnia its success suggests provides a more desirable approach than long term insomnia medication.

What can you do?

  • Understand the link between production of inflammatory neurotransmitters such as Histamine and Serotonin and seek to lower them. This may be through diet adjustment or exposure to problematic chemicals/hormones.
  • If you get to sleep but wake up, this may be due to poor available energy. Maybe from a low carb diet, low thyroid function and poor production of energy. You may find having something light like a glass of milk with honey, or fruit juice with gelatin may help out. Salt also helps to decrease adrenalin production
  • Wi-Fi, blue light exposure, electromagnetic stress all play their part in interfering with stress and how the cells function. Stopping their use several hours before sleep can help. Do turn off Wi-Fi in house and no phones or electric devices by your bed.
  • Avoid stimulus such as caffeine or exercise in the evening, if you have sleep issues. Caffeine decreases production of adenosine.
  • If under emotional stress, a slow walk before bed may be a useful idea combined with ensuring adequate blood sugar levels are met.

References:

Neurobiology of Sleep. Course notes. Duke University. 2015.

Peat, R. From PMS to Menopause. Female Hormones in Context. 1997

Sapolsky R. Why Zebras don’t get Ulcers. St Martins Griffin. 1998

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2941414/

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3443758/

http://www.ncbi.nlm.nih.gov/pubmed/27091535

 

Thyroid pic

Muscles, pain, hormones and other stuff.

As a therapist who works within the fields of pain, movement, energy and digestion I have seen my share of pain and muscle dysfunction in clients. As my exposure to these situations increase, I realise more than ever, that the muscles are very rarely the problem.

Specific muscle dysfunction usually boils down to spindle cell

Thyroid pic

Muscle pain and thyroid hormone

dysfunction and notably Nuclear Bag Fibres (NBF) and Nuclear chain Fibres (NCF). The primary roles of these structures are related to stretch and contraction of muscle function. There can be other factors involving neuro transmitters, involved in nocicpetion such as glutamate, utilised in the withdrawal reflex and often referred to as first pain, (also known as Neospinalthalamic tract located in the Anterolateral system or ALS) and lasting, less than a tenth of a second. Problems can arise when the following pain pathway, called second pain (or Paleospinalthalmic tract also part of the ALS) has problematic feedback with first pain, this is mediated by Bradykinin.

Further complexities arise with serotonin and other structures associated with pain such as the Amygdala and Peri Aqueductal Gray (PAG) that are beyond the scope of this short blog. However a common, over looked feature of pain, may arise with hypothyroidism .

Low thyroid function can be classified effectively with assessment of a basal temperature test and a reading of between 36.6 and 37 degrees. Most blood tests designed to measure thyroid hormones such as TSH, T3, T4 and others, often do not reflect accurate function of thyroid hormone. This is often due to feedback loops between cellular function and the Pituitary gland. Some of the regular hallmarks of hypothyroidism are poor energy, weight gain, poor sleep, hair thinning, digestive dysfunction (constipation and also alternating loose stools), cold hands and feet and pain. Here’s an old blog on thyroid and adrenalin issues.

Another assessment of thyroid function is the Achilles return reflex. When stimulating the myotactic reflex a hammer hits the Achilles tendon stimulating, the dorsi flexors or calf muscles. The response should be a quick return of the foot to it’s resting position but with low thyroid the foot returns slowly. Low thyroid output equals low ATP (Adenosine Tri Phosphate – the energy used by the mitochondria/cells). This low energy state does not allow for optimal contraction and relaxation. This is where we can see specific issues with NCF and NBF’s within the muscle spindle cell.

Muscle tendons and associated ligaments provide a feedback loop via the Golgi Tendon Organs or GTO’s. There’s potential for pre-existing GTO dysfunction to drive muscle dysfunction and vice versa. As far back as the 1960s symptoms associated with muscle disorder from low thyroid were.

* Weakness

* Cramps pain and stiffness

* Hypertrophy

* Myotonoid features.

A well-documented feature of hypothyroidism is muscular hypertrophied calf muscles and despite their size may often test weak to stimulation.

Muscle pain, may indeed not be muscle related, it may be due to many factors, suggested above and these may even be related to hormones and neurotransmitters. Many people often deal with muscle aches and pains by constantly focusing on mobility work but these structures continually return to their pre mobility work status (although this could also be an underlying stability issue). In reality there can be many factors that create dysfunction such as crude touch, vibration, nociception, Golgi, Pacini-pressure related structures and many more. But even after seeing a skilled therapist, these still don’t appear to get better, then addressing the chemical aspects of pain and function might be the next sensible thing to do.

References:

Armour Laboratories. The Thyroid Gland and Clinical Application of Medicinal Thyroid. 1945.

Ramsay I. Thyroid disease and Muscle Dysfunction. William Heinemann Medical Books. 1974.

Purves, D. et al. Medical Neuroscience. 5th Edition. Sinauer Assocates Inc. 2001

Starr, M Hypothyroidism Type II. Mark Starr Trust 2013.

http://raypeat.com/articles/articles/hypothyroidism.shtml

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Dubai Eye: Eye on Health – Hormones & Thyroid

Suzanne Radford and Keith Littlewood delve into the world of hormones, thyroid, they take a look at the environment and how it can affect our well-being, and as always, they discuss how to improve your digestion and your energy levels

Listen now

 

Why you really shouldn’t be giving up sugar in the New Year.

It’s that time of year again, the silly season is upon us and plenty of people using inaccurate words such as detox are thrown around like Christmas wrapping paper.

For many, the New Year is associated with dietary restrictions, born out of a period of over consumption from the festivities. May of those decisions such as stopping sugar or in particular fruit, as part of the so-called ‘detox ‘ is probably one the poorer choices that people do during this period of fad dieting. So it’s time to put the record straight on how to detox, or more appropriately how to maintain detoxification processes efficiently.

Detoxification and its suggested three phases, like most of the processes in the body is energy/nutrient/hormone dependant. Therefore the ability to detoxify efficiently is regulated by the amount of energy available and influenced greatly by how well your hormones function. The thyroid gland for example, is key to maintaining energy and this means energy for the liver to function. Detoxification is just one of the many functions of the liver, which also include glucose production and storage and the maintenance of adequate cholesterol.

The CDR or cell danger response suggests an evolutionary response to insults that affect the human body (and in particular cellular function) from a variety of sources. These can include:

  • Viral
  • Bacteriological
  • Chemical
  • Parasites
  • Electromagnetic stress
  • Physical and psychological trauma.

The net effects of the CDR can be suggested as a protective mechanism that stiffens cell membranes, perhaps to protect other cells, a decrease in processing of many nutrients and other compounds such as metals, and a decrease in metabolism. Whether this down regulation of function is protective or a result of the damage inflicted remains to be answered. Increased oxidative stress to how the body’s cells function can decrease the ability to generate energy using oxygen. Cellular respiration (ability to use oxygen to provide energy) using oxygen and carbohydrate remains the most efficient system for generating energy. Increased stress decreases the ability to utilise carbohydrate as a fuel. Other compounding factors with the CDR are a change to the gut bacteria, which can increase the fermentation of carbohydrates. So called beneficial bacteria such as Lactobacilli can produce lactic acid that disrupts the cells of the digestive system and increase the amount of gut damaging endotoxin.

For many the over indulgence will increase factors such as endotoxin, making them feel low, irritable and poor energy and sleep. An increase to neuro- transmitters such as serotonin and histamine, will exacerbate these issues and decrease sleep quality. The New Years resolution brings about a restriction of calories and eating less, burdening the digestive system less. People often make the assumption (one of many) that cutting out sugar has caused this miracle change but it may simply be the decrease in food itself. Perhaps it’s the lack of calories and the increase in adrenaline, much like the runners high, which makes people feel great?

For some, the equation of increased movement with less calories that is often employed at this time of year will have a good effect. For many others, and in particular, those who have a cell damage response, that is being resolved, this equation seems to have little effect. The decrease in available energy, to a cell that struggles to maintain adequate energy output, will find the move more, eat less, scenario a challenge.

Ketogenic diets often have great short-term effects for weight loss. In the long term a ketogenic remains a stressed energy state requiring the need for more cortisol, a decrease in carbon dioxide (decreasing the amount of available oxygen for use) and a less efficient form of energy production. Those who have a large amount of weight to lose, potentially expose the metabolic system to increased stress by oxidising fatty acids.

The stressed body requires carbohydrate. Low blood sugar states require a balance of carbohydrate (with fat and protein), to maintain optimal detoxification you need carbohydrate. Unfortunately with the fear mongering on social media you can often observe the following.

  1. Sugar feeds and causes cancer.
  2. Sugar is addictive

Here’s the thing. There is not any scientific proof to validate those statements. The primary fuel for any cell is glucose, even in cancer cells, if sugar is not available, it will generate energy from protein. Otto Warburg’s research has often been misinterpreted to suit inaccurate memes. Damage to the respiratory function of the cell is often the source of mutagenic aspects of cellular/mitochondrial (energy producing cells) that potentiates the growth of cancer.

The sugar is addictive study; well if you look closely at the study you will see that sugar activates the same reward centre of the brain such as sex, exercise and receiving gifts. The science of addiction is beyond the scope of my expertise, however if you have someone that cannot regulate energetic processes that well, they may seek out adequate energy, with sources of easily processed carbohydrates. It would appear that insulin sensitivity becomes an issue when there is an excess of energy.

Are you eating too much? Or is it simply that you cannot process the energy available? Well, if you eating less and moving more but weight, energy, sleep, libido or emotional balance aren’t improving. Then you know which one it is.

I am not suggesting here is that you should over eat sugar and carbohydrates. Much like, I wouldn’t NUTRITIONsuggest overeating broccoli, or drinking too much water.

Either way removing the protective capacity of carbohydrates to create balance is probably not the way to go.

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Pain and Dysfunction – Dubai Today – Eye on Health Radio Interview

Suzanne Radford is joined by Rehabilitation and Performance Coach Keith Littlewood of Scandinavian Health & Performance AS. They discuss pain and dysfunction, why skin and other tissues can be overlooked factors in people, why popping supplement pills isn’t the answer to resolving health issues and why metabolic issues do not simply come from over-eating, particularly so if damage occurs to the way we process energy.

Orange and red rays

Sunlight, Low Level Laser Therapy and Photobiomodulation

Sunlight, Low Level Laser Therapy and Photobiomodulation

I first became interested in the healing qualities of light about 5 years ago after reading From PMS to Menopause: Female Hormones in Context by Ray Peat. The obvious connotations to improved health during summer compared to a so- called Seasonal Affective Disorder or SAD was well known. The mechanics were intriguing but not limited to the obvious features of Ultra Violet light and the production of Vitamin D.

UV has been known to be problematic and excess, increases ageing of the skin but the mechanisms and links to cancer are misunderstood. An incomplete overview of other potential mechanisms that might promote mutogenic or cancerous processes are often left out of the explanation. The business of sunblock marketing, like many other fear mongering industries, continue to warn us of too much sunlight, yet often we often lack the right amount. An old blog highlights some points relating to this. The qualities of the healing properties of light are often glossed over instead of promoting the optimal rays of the sun..

The light which penetrates deeply into our tissues (mainly orange and red light) is able to improve the efficiency of energy production, and to suppress the toxic free-radicals that are always being formed in cells. “

Consideration of the healing properties of certain wavelengths of light is a must for health, metabolic and rehabilitation promotion. The useOrange and red rays of light therapy for improving pain, healing and many other issues has been used for decades. In 1903 a Nobel science prize was awarded to Niels Finsen for ultraviolet-phototherapy.

Low Level Laser Therapy and Photobiomodulation

The use of light therapy for improving pain, healing and many other issues has been used for decades.

Here are just some of the issues that have seen great improvement using LLLT and Photobiomodulation.

  • Pain reduction
  • Improved hormone function
  • Swelling reduction
  • Increased healing
  • Neurological issues
  • Improved cellular function
  • Promote recovery from exercise
  • Rehabilitation of injuries
  • Decreased inflammation
  • Improved hair follicle stimulation

The use of infra red heat lamps have been used for decades and often been recommended in rehabilitation or in the beauty world as an anti-aging protocol. I have used heat lamps with myself and clients for several years but it is clear that many gains can be had without the use of heat and just focusing on the use of light alone.

There are many factors that can make the use of light more effective and these illumination parameters include:

  • Wavelength
  • Fluence
  • Power density
  • Pulse structure
  • Timing

For many, even finding these variables may prove a difficult task. In fact even using the word Photobiomodulation becomes problematic! I think the exposure of bright light during the day through incandescent or LED lights is important to offset the lack of natural daylight and healing properties of various waveforms, (unless of course you do work or spend much of your day outside) with the use of red light after sunset to decrease impact to circadian rhythm.

One of the most prevalent mechanisms that appears to offer an explanation as to LLLT’s effectiveness is by increasing cytochrome c oxidase which improves mitochondrial function, increasing cell efficiency and function and improving energy production.

The wavelength of 600-950nm or optical window is a general guideline and appears to be where most of the research and the effects of LLLT has been conducted on. The toxinless website listed below has some great recommendations for the use of light and ideal set ups, which are very cheap to set up at home.

The use of LLLT for improving hormones and in particular thyroid function has gained a greater following of late. It’s worth noting, that in some studies which can be found on Valtsu’s website (a great resource for thyroid) , the use of LLLT improved thyroid function without the need for thyroid medication. Additional studies corroborate the effectiveness in reducing the need for thyroid medication and addressing autoimmune thyroiditis.  Therefore I think the use of LLLT for improving energy, digestion, mood and sleep is validated.

References:

Peat, R. From PMS to Menopause : Female Hormones in Context. 1997.

http://www.ncbi.nlm.nih.gov/pubmed/22747309

http://www.ncbi.nlm.nih.gov/pubmed/12804422

http://www.ncbi.nlm.nih.gov/pubmed/26048721

Online resources:

http://valtsus.blogspot.fi/2015/09/hypothyroidism-could-it-be-treated-with.html

http://www.toxinless.com/red-light

http://www.photobiology.info/Hamblin.html

 

 

 

 

walker-clipart-baby_in_walker

Why baby walkers are a disaster for the growing child.

Why baby walkers are a disaster for the growing child.

It was the fourth client in the space of two weeks that prompted me to write this quick blog. Four teenagers all aged 14 with pain and compromised movement. Where did it all start? How does this happen? The parents enquire, looking for a definitive reason.  walker-clipart-baby_in_walker

As with all aetiologies of pain and movement dysfunction it can be hard to determine exactly what drives an individual’s problems. But when you can observe the way that a young person breathes you can, in most cases determine whether they have been placed in a baby walker, without any other form of assessment.

A rough overview would reveal that, within the first 9 months of movement and prior to the process of standing (verticalisation) there are many key stages of development that need to occur.

These include.

  • Lifting the head
  • Stabilising the back line between neck, chest and pelvis
  • Rotation via rolling
  • Quadra pedal or four point stance
  • Crawling and cross patterning of shoulder to hip.

So why is it that the baby walker is such a problem?

Consider the actions that a baby needs to achieve before it stands, let alone walks. Crawling develops hip, trunk and shoulder musculature. Due to the reciprocal relationship between the neck and the lower back, which counter rotates to the direction of the thoracic spine, optimal conditioning of reflexes, muscles, tendons and ligaments should occur. If a child is placed into a walker, the challenge is then geared towards locomotion and gait, rather than rolling and crawling. This is where the problems start and it presents several issues to consider.

  1. The ability to stabilise using the diaphragm is decreased due to in an early standing position, that is not conditioned enough from crawling. (observation can be made by the upper breathing pattern, using chest and neck muscles)
  2. The lower leg muscles are stressed to create movement and in particular the calve muscles are strengthened and may contribute to excessively to actions such as hip and knee flexion and extension (as well as many other movements. (look for those over developed calve muscles)
  3. The lack of rotation created by a lack of motion in the spine, decreases essential loading of the spinal ligaments, which will decrease recruitment of the muscles needed for optimal gait. (you can see poor movement and stability from the most basic movements)

Another insult added into the equation is the constant use of flip-flops. This previous blog breaks down why flip-flops are disastrous for athletic and day-to-day performance.

To develop optimal movement that progresses throughout childhood into adult life, rolling, crawling and walking patterns should not be supported with baby walkers or bouncers. It might be hard to believe but the walker does play a significant part to why younger clients present with pain and movement issues. There’s no doubt that technology has significant benefits it many aspects of life. But when it comes to human movement, the brain already has it optimised, you just need to let it of its own thing.

Thankfully with a little work, the problems can be unravelled but don’t get me started on the use of iPads and mobile phones!!

References:

Kobesova, A., Kolar, P., Developmental kinesiology: Three levels of motor control in the assessment and treatment of the motor system, Journal of Bodywork & Movement Therapies (2013),

Kolar, P. et al. Postural Function of the Diaphragm in Persons With and Without Chronic Low Back Pain. J Orthop Sports Phys Ther 2012;42(4):352-

 

Appreciating surroundings

Are you using nature to regenerate?

The more clients that I see, I realise that some are very in touch with their bodies and some have no idea what is going on with it. The same rationale can be applied to those who feel the immediate value of being immersed in nature and others who are blissfully unaware of the subject matter. I often remember the change that my body used to experience as I drove out of London towards the Yorkshire Dales; as I edged past the M25 into the countryside and the journey terminated in a swathe of greenery and granite rock, the stress meter had dialled down to a zero.

OLYMPUS DIGITAL CAMERA

So why is nature important to human body? The escalation of urbanised environments is ensuring that humans are packed into industrialised, colour lacking, banal developments, that do little to stimulate the eye and increased tension with hustle and close knit streets that people rush to and from work. This dense packing of people also accumulates a large amount of industrial pollutants, be it Benzene from car fuel, Wi-Fi (of which there is an increasing amount of literature to support it’s negative effects to hormone and cellular function) and many other factors that test the body to its limits.

There is increasing research that suggests that urbanisation is a prominent factor in rumination/negative thinking and decreasing mental health. To deal with managing aspects of mental health, exercise is often touted to be helpful as a distraction hypothesis and I don’t dispute the effectiveness of exercise training to help in this situation. A distraction is positive and exercising is essential for good health. However, how many people actually use, quiet appreciation in exercise to regenerate? We often so concerned with pushing ourselves in professional life that exercise often becomes wrapped up in the same goal setting schedules that people religiously stick to. Walking, boating, hiking and taking time to appreciate nature, take in the colours, slowly breathe in the less polluted air, listen to the birds sing, or simply sit on the beach and absorb the endless horizon of water. To often we don’t stop to take in these natural beauties as we are trying to beat those personal bests.

Studies are showing that walking for 90 minutes in a natural environment fares much better than walking in urban settings; The effects showing additional decreases in negative thinking and activity of the brain. I am a firm believer that running and cycling in built up areas may make you fitter but probably less healthier. Increased oxidation of pollutants in urbanised areas, contribute to health issues and mortality rates are on the rise. Training efficiently and smart would warrant that we should aim to exercise less in this manner. Walking in green spaces and utilising the stress decreasing mechanisms of nature, may have more impact to your health than running or cycling on by without appreciating the spaces surrounding you.

Life seems to be whizzing by faster than ever, isn’t it time we slowed down to appreciate it more? Train for strength, walk for health?

References:

skin copy

Skin deep? The role of skin in motor control and dysfunction.

Many people are aware that dysfunction can occur from many different areas. Scar tissue, joint and ligament/tendon receptors, muscle fibres and many more factors contribute to pain and movement issues. The role of skin in providing feedback is not so prevalent in literature or discussed as a source of a client’s motor control, pain or dysfunction issues.

Whilst muscle and joint receptors are well known as proprioceptors, the skin contains a large amount of feedback from exteroreceptors originally proposed by Sherrington. These include:

Meissner – vibrationskin copy

Pacinian- vibration

Ruffini – pressure response

Krause – pressure in mucosal tissues

Merkel – pressure/touch to skin

Free nerve endings – nociceptive/pain stimulation

The skin provides feedback from external stimulus, adjusting steps and movement. Damage to the skin can be one of the many areas that clients often forget and for that matter, surgeries such as appendectomies, c –sections and kidney removal are just a few of the ‘small’ procedures that have not been mentioned in an initial session.

Deep abrasions on young tissue, which heal and visually, present little to see on an adult body, are common. A recent finding with a client was a certain amount of dysfunction between a deep unseen scar from falling from a bike 20 years ago playing havoc with the scar tissue and stability of   the same knee from a later ACL reconstruction. Using techniques such as PDTR (proprioceptive deep tendon reflex) and NKT (neuro kinetic therapy) it is possible to assess the impact of scars, seen or unseen on stability and motor control of muscle and ligamentous tissue.

Another common issue is the role of deep coloured tattoos and their impact on surrounding muscle tissue via skin receptor dysfunction. Usually dysfunction between quick pin tracts (Neospinalthalmic tracts) and slower pain (Paleospinalthalamic tracts) are prevalent with tattoos but depending on depth and other factors, dysfunction can present via the receptors suggested above.

Tattoos can create dysfunction in underlying and other tissues

Tattoos can create dysfunction in underlying and other tissues

 

Addressing muscular dysfunction can be useful and effective as part of the treatment but in addition to assessment of joint, ligament, tendon and pain pathways; assessment of the skin and its associated receptors should be an integral part of the client’s treatment.

 

References:

Palomar, J. Proprioceptive Deep Tendon Reflex. Course manual.

Purves D, Augustine GJ, Fitzpatrick D, et al. Neuroscience 2nd edition.

Sinauer Associates 2001.