WHAT IS MUSCLE MANIPULATIVE
THERAPY?
Muscle Manipulation (Muscle
Manipulative Therapy) is the alignment of muscles, ligaments, tendons,
cartilages, blood vessels, nerves and fibrous tissues to parts of the body
that have misaligned for one reason or another. After manipulation, the body
can then proceed to heal the area and within a short time a full recovery
will result. If the muscles, ligaments, tendons, cartilages, blood vessels, nerves
and fibrous tissues remain misaligned pain will be sustained and in some
instances calcium can form around injured areas making it difficult to
manipulate. The Muscle Manipulator will be able to feel the injured area and
by using either a Bio Stimulator, their own fingers or both they will be able
to perform a correct alignment. This alternative therapy can produce
remarkable results seconds after a manipulation and in some instances the
patient is completely pain free within minutes.
Muscle Manipulative Therapy
involves a sensitive feel and the Muscle Manipulator must know what they are
feeling for and when they have found it they must know where to place the
muscle, ligament, tendon, cartilage, blood vessel, nerve and fibrous tissues.
This remarkable therapy is new and exciting giving the opportunity for those
who have had injuries for years and avoiding expensive operations the chance
to be fixed at a fraction of the cost of surgery. This technique is also
available for those who have injured dogs or race horses.
MUSCLES
WHAT MUSCLES ARE AND HOW THEY
WORK?
A muscle is like its Latin
word, meaning mouse. It has a body which is the muscle itself and a tail
which is the tendon. The tendon for most purposes acts as an extension of the
muscle and is usually attached onto a bone to assist in the raising and
lowering of a limb. Muscles act like small motors that move every part of the
body. You can’t talk, eat, breathe or blink without using some muscle. All
muscles produce movement by the same method. When they shorten or contract
they pull on tendons or their attachments to bones and these in turn lift or
bring those bones towards the body. Each muscle is activated by a nerve which
relays the messages from the brain to affect every single function of the body.
HOW THEY WORK BETTER
Endurance is a basic element in
the performance of any sport. In competition winning is usually the paramount
factor and coaching and training revolves around just this. How does a coach
enhance the endurance levels of the members of his team? His training program
concentrates on getting top performance out of the muscles of those in his
charge.
PHYSICAL PERFORMANCE DEPENDS
ON:
- The capacity
of the muscles to store and burn muscle fuel,
- The ability to
get delivery of oxygen to the muscles in order that these muscles can
burn fuel efficiently
WHAT ARE THESE MUSCLE FUELS?
PROTEINS – these
are never a source of immediate energy and are a poor substitute of energy
during exercise. Proteins are a building block for the tissues in the body.
The body has no way to store extra protein.
FATS – a
secondary source of energy especially during the later stages of sports. Fat
is stored in the muscles, under the skin and around the inner organs.
CARBOHYDRATES – the
primary fuel for exercise. Your body can store carbohydrates in muscles and
the liver in the form of glycogen. Glycogen and fat are the main fuel the
muscles burn up for energy.
To burn these fuels
efficiently, oxygen is needed and this is delivered to the muscles through
the bloodstream by the red blood cells. This is why I stress the importance
of muscle toning. The toned muscles have larger blood vessels allowing more
blood to flow through them, hence taking in more oxygen to the muscles for
them to burn up glycogen and fats.
By training properly you can
improve your oxygen utilisation. In so doing you are improving the ability of
the heart to push more blood to the muscles and you are improving the ability
of the muscles to extract the oxygen from the bloodstream. Training will strengthen
your heart so that it has the capacity to pump a greater volume of blood to
each heartbeat, enlarge your arteries and blood vessels so more blood can
flow through them, increase the number of your red blood cells so that your
oxygen-carrying capacity is increased and increase the rate at which enzymes
in your muscles pick up oxygen from the bloodstream.
FACTORS LIMITING MUSCULAR
ENDURANCE
Loss of muscle glycogen – the
primary fuel of muscles.
Loss of fat reserves – a
secondary fuel of muscles.
Low level of blood sugar –
called hypoglycaemia.
Lack of oxygen.
Heat build-up in the muscles
(Hypothermia).
Accumulation of lactic acid – a
break down product of exercising without oxygen.
LACTIC ACID – for
sports persons I wish to describe briefly what lactic acid is and the effect
it has on performance.
When glycogen is burned up it
is broken down into a chemical called pyruvate. If there is enough
oxygen available, pyruvate converts it into carbon dioxide and water,
which are blown off from the lungs.
However, if there is not enough
oxygen in the muscles, pyruvate converts it into lactic acid, which
builds up in the muscles and then overflows into the bloodstream.
Lactic acid impedes muscle
contractions and makes it increasingly difficult for muscles to move. As a
result, you can feel fatigued.
A high level of lactic acid
will eventually stop the muscle from contracting altogether. When this
happens you lose all control over the muscles and they become very painful
and may cramp. As soon as oxygen becomes available again, lactic acid
converts back to pyruvate and to carbon dioxide and water and the
sports person has a feeling of a new lease of life.
Lactic acid is mentioned here
to make sports persons fully aware of the importance of proper training and
exercises so that they build up and tone muscles and ensure that these
muscles receive a plentiful supply of oxygen via the bloodstream. Tiredness
and fatigue will be prevented and the athlete will be able to perform much
better with the same amount of effort.
LIGAMENTS, TENDONS AND
CARTILAGES
A ligament is a tough,
fibrous band that is attached near the end of the bones where they meet to
form a joint. Its main function is to hold the bones together when the joint
moves.
Ligaments can hold so tightly
together that there is very little movement in the joint itself. They can
also be flexible enough to allow for a wide range of motion as with elbows,
writs, shoulders, hips, knees and ankles. Others such as the vertebrae
ligaments which hold the spine together have a very limited range of
movement.
In manipulative muscle therapy
the ligaments play a very important role as they not only hold bones together
but are also responsible for keeping the muscles in their correct position.
Ligaments are fixed at both ends, either to bones or to muscles and these in
turn have fibrous tissues (cords) that can easily tear, either away from the
bone or the muscle. These tears or ruptures are usually referred to as
sprains and are always accompanied by bleeding. In manipulative muscle
therapy these fibres or cords and ligaments are replaced as near as possible
to their correct alignment. In most cases they re-attach themselves to the
area from which they were torn or stretched and they do this by laying down
new cells which quickly grow, closing the tear and avoiding much scar tissue.
Ligaments are found in almost every part of the body holding bones, muscles
and also organs in their correct positions.
Throughout one’s life,
ligaments may often stretch and stay that way for the want of manipulation.
This is very much in evidence in women who after childbirth do not have
correct treatment or do not carry out the right exercises to strengthen the
muscles and ligaments in the groin, stomach and lower back region. The result
is continual lower back pain, trouble with sciatic nerve and lumbago. All
these ailments could be avoided with proper treatment.
My advice is to seek the aid of
a muscle therapist who can give you far more satisfactory results and save
you a lot of unnecessary pain and suffering.
Too many people have surgery
for ligament and cartilage injuries, when a simple manipulation would have
been sufficient. I have seen some of the results of such surgery, and the
patients who have been unable to participate in sport again. At the moment,
the patient has no recourse, but things will change when the public is aware
that there are other treatments available to them.
TENDONS are
strong, fibrous bands that attach to muscles at one end and to bone at the
other. They have great strength and are an integral part of the muscle
complex. They differ considerably in size, shape and feel to a ligament and
after some practice can be easily recognised by feel. In most cases you will
also be able to feel where they continue on from a muscle and attach to a
bone.
When a muscle contracts, it
draws the tendon up and with it the bone to which it is attached. For
example, when the calf muscle contracts it draws the Achilles tendon up(this
is the wide tendon that starts at the bottom of the calf muscles, continue
down the back of the leg and is fixed to the back of the heel), and it is
this action which is responsible for pulling the foot down.
Similar actions are responsible
for bending the knees, elbows, fingers, toes etc. During hard exercises, you
will find that the muscles will shorten, increasing the tension on the tendon
muscle complex. An experienced athlete will recognise this tension and either
rest or stretch the muscle. Personally, I would prefer to stop exercising,
stretch the affected muscles and then continue. I place a lot of emphasis on
stretching muscles to prevent injuries.
Tendons have a smaller cross
section than muscles, which means that the force cannot be distributed over
as much area and as a result there is more strain placed on the tendon than
on the muscle during exercises. In the structure of the anatomy of the human
body, tendons are not very well protected and can easily be damaged. When
they move, it is possible that they will rub against bones, ligaments and
even other tendons, whereas muscles are usually protected against rubbing on
other rough tissues. Some are even encased in sheaths to guard them against
damage.
Tendons are prone to separate
from the bone or muscle and occasionally they tear completely. These ruptures
are usually the result of a violent contraction of the muscles. They are
common in sprinting, football and other sports where sudden bursts of speed
are required. These ruptures occur often in athletes who have tight,
inflexible muscles, or who lack muscle toning. Again, I can’t stress too
strongly the importance I place on correct exercise and muscle toning.
You can usually hear a tendon
rupture; there is a loud ‘pop’ and the athlete usually writhes in pain,
holding the injured limb in such a position that the muscle is contracted. He
will not let it be moved as the pain is so great and the therapist has great
difficulty examining it. This is one time when a doctor can assist in muscle
therapy, because the pain killers they administer can be a great help in
allowing the damage to be assessed.
If a rupture is suspected, send
him to a hospital immediately to verify the extent of the rupture. If the
rupture is a complete one i.e. one that has snapped right through, then it
will need to be stitched back together. If it is a separation only, there
will be internal bleeding at the site of the rupture and this will have to be
dispersed as quickly as possible. This will assist the natural healing by
allowing the cords in the surrounding tissues to re-attach to the tendon or
bone. By manipulating and lining up these cords and fibrous tissues, recovery
will be hastened and within a few days the injured person should be able to
start stretching the tendon and muscle. Stretching the injury daily is the
only way to be sure that there will be no recurrence of the rupture.
In sports that involve running,
the Achilles tendon is the one that is subjected to the most force and it is
pulled or ruptured far more commonly than any other tendon in the body.
Ruptures of other tendons are very rare indeed and they only occur when there
is a sharp weight distribution change and the extra force will cause the
tendon to rupture because of it. They can become very serious when the tendon
is pulled away from the bone or muscle to which it is attached leaving it a
long way from the original site and making it impossible to re-attach
itself.
Take special care when a piece
of bone is torn off with the tendon. These cases need surgery as there is no
way that the tendon can be stretched and held in place by manipulation.
In cases of a slight tear of
strain, I find that manipulation the tendon as near as possible to its
original site and securing it there with a tight bandage is as good a
treatment as any.
It does not take nature very
long for the injured tendon to send out fibrous cords which soon re-attaches
it to the bone. Once this natural form of healing starts, it is not long
before a full recovery is affected. With the proper stretching exercise, you
will find that the site of the injury will be even stronger than it was
before because of the build-up of the new cells and fibrous tissues.
CARTILAGES are
tough, white gristle that line the ends of bones in the joints to protect
them from rubbing together and act as a cushion to absorb shocks. They
contain no blood vessels or nerves, are fairly brittle and can be torn,
chipped or mutilated by the stress that is placed on them.
Any damage could allow the
bones to rub together, as could the friction against the opposing bones which
gradually wear away the cartilage. If this occurs, each movement will be very
painful because the ends of the unprotected bones contain a rich supply of
nerves and pressure on the nerves is the most common source of pain in the
human body.
The cartilages most prone to
injury are those in the knee joint and the spinal column where they are
referred to as discs. It is a good practice to make sure that the ligaments
and muscles around the knee are exercised properly and regularly to tone and
strengthen them. This also applies to ligaments and muscles of the back which
are responsible for the correct positioning of the spinal column. All so
called slipped discs problems can be attributed to an injury to ligaments or
muscles somewhere in the back. It is my opinion that correctly placed muscles
and ligaments in the back will not allow discs to slip or be pinched anywhere
in the spine unless by a severe and sudden force.
Injuries to the spine,
vertebrae and discs are very common in today's work force. Most o these injuries
could be prevented with correct exercises and manipulation.
Lack of flexibility is the main
source of muscle and ligament stains and I must emphasise that stretching is
the most important factor in preventing injuries.
FEEL
Manipulative Muscle
Therapy involves sensitive feel. You must know what you are feeling for
and when you have found it you must know where to place the ligament, tendon,
muscle, blood vessel, cord or nerve.
I class only one of these as
dangerous to manipulate. Blood vessels do not stretch as much as the others,
and thus are more prone to rupturing. The resultant complications that can
occur are haemorrhaging and blood poisoning.
With much practice, blood
vessels can be easily recognised by feel so I will explain how they feel to
me. When feeling for ligaments, I first probe in the affected area to locate
the blood vessels. It may or may not be in the correct anatomical position so
I exercise great care in probing. A blood vessel feels spongy to me, with
tiny concertina ridges across its length. These ridges are more easily
identified in larger blood vessels, but I can feel them even in the smallest
ones.
Sometimes a throb or pulse can
be felt and it is possible to press the blood vessel against a hard surface
such as a muscle or bone. Remember in First Aid where we were taught to use
pressure points to arrest bleeding. Feeling for the pulse on the radial,
ulna, or carotid arteries is used daily by the medical profession.
Some main blood vessels do not
need to be compressed, e.g. the carotid artery, which is one of the
main arteries of the neck. By placing fingers on this artery a very strong
pulse can be felt. This is a simple way to practice feel.
You will find it easier to
recognise the feel of tendons, if you read the chapter on tendons. Tendons
attach muscles to bone or they are an extension of a muscle and you will find
them where they assist with the raising and lowering movements e.g. arms,
legs etc. they are large, feel very smooth to touch and are usually very
taut.
By pressing your fingers on a
muscle and moving down you can easily feel where the tendon starts and it
won’t be too difficult to trace it to its end. Tendons vary greatly in size
and shape.
They can be wide and flat, as
in an Achilles tendon which connects the calf muscles to the heel and
assists in pulling the foot downwards, or round and long. Some are as thick
as your little finger, and some are the size of a piece of thread. They are
very strong, non-elastic fibrous cords and can vary in length from a fraction
of an inch to more than 300mm.
Muscles are much easier to
recognise by feel. A greater percentage of sporting injuries are muscular
related, so feel plays an important role in treating them. They too, vary in
size and length.
It is essential that you recognise
the shapes of muscles as nearly all of them cross over or under other muscles
and knowing where this occurs, assists greatly in diagnosing the difference
between strained and torn muscles. Most muscles are shaped like a deflated
Aussie Rules football bladder, i.e. thinner on the ends and wider in the
middle. They consist of many fibres which usually run the length of the
muscle rather than across it and when they tear it is usually lengthwise.
The femoral (thigh)
muscles are a classic example of the shape and composition of muscles that
are frequently torn. The rectos femoris have the appearance of being
in two parts like a butterfly fillet of fish and one can easily feel the two
distinct shapes of this muscle and where it is usually torn. It is very rare
indeed that a muscle is torn in any other way than lengthwise in sporting
injuries.
With a torn muscle, you can
feel the tear once you know the direction of the muscle. Then it is only a
matter of using a very light pressure and running your thumb or fingers in
that direction – if there is a tear your fingers will go into the depression
that will always be there and you will feel the tear. Unfortunately you will
be unable to feel an injury to a deep muscle. i.e. a muscle that is covered
by several layers of other muscles.
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