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 Manipulist 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 invloves 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.
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 heart beat, 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(Hyperthermia).
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 make 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 sent 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 effected. 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 protech 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 todays 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.
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 rectus 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.