Category Archives: lower limb

Cupping

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If you have ever been to the beach and saw somebody walking around with a pattern of large round bruises on their back they have probably been treated by an acupuncturist with cupping.

Cupping is a procedure that uses suction cups to help draw the extra fluid that is present in sore and stiff muscles closer to the surface. When this happens relief is experienced because pressure is removed from the nerves in the muscle tissue. Lactic acid contained in the fluid is likely to be drawn out of the muscle tissue through this suction action also.

Bruising does not always result from getting Cupped but if you are quite fair or anemic it is likely to show more and this can put people off getting it which is a shame because when used appropriately cupping brings relief of muscle pain and stiffness.

The use of cupping is common in Chinese Medicine but cupping has been used a long time in Eastern Europe too and in recent times has been discovered by many physio therapists.

Cupping is also commonly used in TCM (and Eastern Europe) to treat colds and flu, the cups are commonly placed on the upper back to do this. The rationale that is offered for this practise is that perverse energy enters the body through wind exposure which can give you a cold. By literally sucking out the pathogenic energy the symptoms are claimed to be reduced.

Whether you are employing the use of cupping to sooth over-exercised muscles or to alleviate the symptoms of a cold the results are often quite impressive, it usually does seem to work.

As already stated Cupping can leave bruises that might not go very well with your new backless ball gown but otherwise the appropriate skilled use of Cupping is quite side effect free, non-invasive and only mildly uncomfortable (if uncomfortable at all).

Bamboo or glass cups are briefly heated on the inside then quickly placed on the skin, as the air inside the cup cools a suction is formed, this is how Cupping is traditionally performed. In more recent times small pistol-grip styled hand pumps and plastic suction cups with valves have been designed to do Cupping, they both work quite well.

It is no doubt easier for many to visualize excess fluid being sucked out from stiff muscle than it is to think about invisible pathogenic energy being physically drawn from your upper back but there are many things in health science that we are yet to learn about. Whatever the case Cupping really does seem to help people feel better.

Cupping can be easily used with other types of therapy, after a Cupping is applied for instance it is easier to make an impression on stiff muscles with massage, stretching and manipulative techniques.

Hip Pocket Sciatica

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Otherwise known as pseudo sciatica, hip pocket sciatica is usually brought about by carrying around and sitting on an object (usually a wallet) in your back pocket. Even a very thin wallet will have this effect because it is the equivalent of sitting on a chair with a bump on one side.

Men are the chief culprits of this, hip pocket sciatica can cause pain and tingling in the buttock area and cause pain to radiate to your lower back. The hard lump you sit on interferes with the blood circulation to the gluteal muscles and it tips your pelvis up on that side. This can have a kinking affect on the lower lumbar discs which in turn can be a contributing factor to the “real” sciatica that radiates down your leg from your lower back.

The prevention is simple- take your wallet (or other objects) from your back pocket before you sit down. It is even better to find another pocket to carry it in because then it won’t matter if you forget to remove it when you sit.

It is surprising how much better this simple act can make your hips and back feel, if you are reading this and thinking “I always have my wallet in my back pocket and I feel fine” take it out for a few days and see if you feel any different.

Hip pocket sciatica is also called pseudo sciatica because it feels like sciatica but it isn’t. Sciatica can make your buttock sore through pain referring along the sciatic nerve from lumbar nerve root pressure in you lower back, sciatica is an indirect cause of hip or buttock pain. Pseudo (or hip pocket) sciatica on the other hand is a direct cause of hip and buttock pain because of direct pressure from what you are sitting on.

The very act of sitting unevenly like when you cross your legs also creates uneven weight distribution on the buttock muscles and can have a pseudo-sciatica  like effect. You may get away with sitting cross-legged or on your wallet for a long time before it effects you and this is why that sitting in such a way may not be considered by yourself to be the cause of that searing pain in your butt.

Poor quality seating should be on the list of suspects for hip-pocket sciatica and lower back pain along with any objects that you my habitually carry in your back pocket. Some of us have sitting habits such as tucking a leg under your butt when sitting or maybe leaning towards one side, it is easy to do when you have been on the computer for a long time.

Hip-pocket sciatica is aptly named for more than one reason because it will end up costing you money to get it fixed.

Ankylosing Spondylitis

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Ankylosing spondylitis (AS) is a progressively debilitating disease that primarily effects the spine. The small tendons and ligaments in your spine become inflamed which is bad enough in itself but as they heal they calcify, effectively turning into bone. The flexible tissue turning into rigid bone stiffens and eventually fuses the spine, your other joints, your eyes, heart, lungs and bowel can all be effected by AS too .

AS effects three times as many men as women and the average age for the onset of symptoms is 24. The pelvis and spine are effected in all adult AS sufferers, in women the pain is less severe but their wrists and ankles are more likely to be effected than with men. Children are less likely to experience back pain with AS but their hips and knees are worse and sometimes need replacement surgery at a relatively young age.

Weight loss and fatigue are common, the symptoms are worst in the early morning and improve with exercise, night sweats and fever are common too. The body in general will be better with regular stretching but more than anywhere else the muscles in the front of your thighs and hips (lateral to your groin) need to be kept flexible. If an AS sufferer allows their hip flexors to stiffen they will not be able to stand up straight, they can develop a permanent stoop forward at the hips.

There are effective drugs that can help control the symptoms of AS but you will be even be better still if you get regular body work or manipulative therapies, not just for your hip muscles but all over. Sometimes physicians may not specifically recommend other therapies such as remedial massage or chiropractic to their AS patients but this does not necessarily mean that these therapies will not help them. If you have AS and your doctor has no specific objections to other types of musculo-skeletal therapies it might be in your interests to try them.

Climate has it’s effects too, AS sufferers usually find that cold whether much more adversely effects them than warm weather. It may not be practical for you to move to a warmer place away from family, friends and work but something as simple as the way dress can make a difference. About a year ago I suggested to an AS  client that he wear a scarf to make his neck feel more comfortable and  it worked very well for him. He had never thought of trying this before, his doctor did not suggest it and it took me while to think about suggesting it too, sometimes simple things work very well.

The lungs of AS sufferers are effected through inflammation in rib joints making breathing uncomfortable, this can be helped by being posture conscious at all times, not wearing tight restrictive clothing, not eating large meals, bodywork and most importantly learn to breath from your diaphragm not costally (deep not shallow).

Get advice from your therapist about using Self Massage and stretching to alleviate your AS.

PMR (Polymyalgia Rheumatica)

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As the name suggests PMR effects our muscles (myalgia) and joints (rheumatica). PMR is one of the 80+ auto immune diseases that can strike without warning, with no easily discernable cause and can be very debilitating. The symptoms of PMR vary from person to person although it does seem to be universally agreed that the larger joints in your body are the worst effected particularly your shoulders. Other symptoms may include a sudden inexplicable weight loss, jaw tension headaches and pain in other joints including your fingers, wrists, elbows, spine and toes. A blood test would reveal a high ESR, more women than men suffer from PMR,  50+ is the typical age demographic and the symptoms of PMR can be similar to the symptoms of other auto immune disease such as fibro myalgia or rheumatoid arthritis.

PMR tends to be episodic, for most the symptoms  start in the shoulders and are most severe first thing in the morning. Raising your arms above your head when your shoulders are acute can be very painful and restrictive, though fortunately they usually respond well to anti-inflammatory drugs…..so long as you have no high blood pressure or stomach ulcers. Corticosteroids such as prednisone can lessen the symptoms significantly though apart from being contra-indicated for hypertension and stomach ulcers you may experience weight gain using this drug aswell as severe mood swings and an inability to relax. The original onset of symptoms can last from 12 months to 4 years but if it recurs it is usually of less intensity than the first time.

Unlike muscular problems where you get a little warning before you get into a painful position, PMR can suddenly feel very intense and stop you in your tracks the moment you bend a joint even a little too far. Potentially the most serious symptom of PMR is Giant Cell Arteritis (GCA), it is this that causes the jaw tension headaches which, if left untreated can blind you.

Some PMR sufferers try an alkaline or nightshade free diet and find they do not help, others who try claim such diets definately do work. In either case you can still take your medications if you want to use both, so long as any food you eliminate from your diet has it’s nutritional values replaced by some other food. Many who get diagnosed with PMR find alot of relief from acupuncture, ice packs, massage, osteopathy and chiropractic, these therapies can be used in conjunction with pharmacuetical treatments too.

For a previously active and able bodied person the onset of PMR can be scary and demoralising, any exercise at all in the early acute stages may prove impossible, even having sex may require some adjustment. Practising meditation and relaxation techniques can help you cope with PMR as will planning what you do when you go out, if your knees are affected you might find that stairs are best avoided and getting into and out of coats can be embarrassingly difficult too. Like many other health problems that effect your abilities your facility to distract yourself and remain positive is an important part of  managing PMR.

Sprains and Strains

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The main difference between a sprain and a strain is that strains are injuries that are confined to the muscle and sprains effect the other soft tissues around the joint as well as the muscle.

Both can be painful but strains do not effect the stability of the joint where sprains do. A strain can tear a muscle and cause restricted movement but fortunately muscles have a rich supply of  blood and therefore oxygen which means they heal faster than sprains do.

Sprains by definition can not only tear muscle but also damage the ligament, tendon and cartilege, these tissues have a poorer supply of oxygen and take longer to heal. Muscle is red because it has alot of blood inside it, ligament, tendon and cartilege are white because they contain less blood.

Sprains are graded according to the severity of the damage done, a grade 3 sprain is a complete disruption of stability of the joint where the ligament is torn away completely, when this happens to your knee good early splinting may be enough to set it on it’s course to healing but if this doesn’t work surgery may be the best option. A grade one sprain on the other hand does not disrupt the ligament and can be indistinguishable from a strain. Grade 2 spraining is in between one and three, partial ligament damage causes slight instability and if you are careful not to re-injure yourself will generally not require surgery.

Sprains to the ankle are one of  the most common and although they can be severe you have a better chance of avoiding surgery than an equivalent knee sprain.

Ice packs to your freshly sprained joint or strained muscle is usually good first aid, anti-inflammatories can help too just remember that though the pain is diminished the damage is still there so an immediate return to the activity that caused it is unadvisable.

Interferential, ultrasond and laser acupuncture directly to the injured area can be effective treatment. Massage, acupuncture, osteopathy, physio and chiropractic can be used on the injury site when the inflammation fades (when redness, swelling and touch sensitivity subsides) and can be used to contain the problem in the short to medium term.

Ignoring sprains and strains will not make them go away unless it is only mild damage,  when you are limping and favouring one side the other leg joints on both sides of your body are used more and in a lop sided way. If your knee, hip or lower back starts to inexplicably become stiff or painful weeks or even months after your sprain or strain there is a good chance it could be related.

No matter what therapy you choose a practitioner who takes a “global” approach protecting your other leg joints will help you most.