Neuromuscular Therapy - Pelvic Angles for Pain Relief

Pelvic Angles

Ensuring that a pelvis is in the proper position when standing is the first thing I check when seeing a patient. The pelvis, being at the proper angle, can help alleviate much back pain.

Checking the posture is of the utmost importance (see Posture PDF Newsletter) when my patients come in for treatment. This is because the center of gravity, or our balance point, centers in our pelvis. If the pelvis is not on the proper path, all therapy is for not. We become a wobbly top.

The proper angle for a male pelvis is 0-5 degree tilt, and women typically 5-10 degree tilt. Most patients I see come in with a forward tilt (flexion) although on occasion (about 3%) have a pelvis in a backward rotation (extension). A simple pelvic stabilization technique using the St. John Method requires about 4 minutes to realign the pelvis to the proper angles. This does not involve high velocity adjustments (chiropractor) but a simple leg movement and a gentle rotation. Then two easy exercises will help to “seat” the pelvis in it’s new and proper position (Egosque Method).

Pelvic angle and stabilization is one of the most important things any and every therapist should be looking at. Making sure that you are in proper alignment will go a long way to help alleviate pain and discomfort. The St. John Method of Neuromuscular Therapy is one of the most effective ways to do this. If you have any questions please do not hesitate to contact me.

In Health,

Peter Roach, RMT, CNMT, Laser Therapist

Let There Be Light - for Massage Therapists

Does using Low Intensity Lasers (LILT) in a Massage Therapy practice in B.C. fall within our scope of practice? This question has been posed many times during my use of LILT for the last 4 years. The short answer - yes!
I had the nod from our College (CMT), then president Doug Fairweather, in 2007, after  making a presentation to the Board defending my use of LILT. Although my presentation was a lengthy one, with Power Point and all, I will extrapolate and present to you my letter to the board.

Novemeber 11, 2007

Dear Ms. Rigby,

Re: Continuing Education and Professional Development (CE/PE)

Enclosed please find my submission for CE/PD accreditation for a Meditech seminar and more recently a conference held in Toronto for Low Intensity Laser Therapy in the Treatment of Athletic Injuries.
It is my understanding that recently Mike Berger, RMT was refused credits for this because “these courses are outside our profession’s currently applicable scope of practice.” With all due respect to the Quality Management Committee, I wish to dispute this decision and request that these hours be credited.
Under the current Health Profession Act – Massage Therapists Regulation under the heading Definitions – “massage therapy means the kneading, rubbing or massaging of the human body, whether with or without steam baths, vapour baths, fume baths, electric light baths or other appliances, and hydrotherapy …” Clearly by this definition electric light baths are acceptable under our scope of practice. The definition continues – “…or any similar method taught in schools of massage …”. I draw your attention to a course outline taken from the Okanogan Valley College of Massage Therapy, an accredited school. Under the heading Term 2: Hydrotherapy/Spa: “You will be introduced to actinotherapy. Actinotherapy is defined as the use of "rays of light" for therapeutic benefit. This brief course presents the theory of ultraviolet and infrared light and their application in a massage therapist’s practice.” Clearly light, ultraviolet to infrared is taught as a therapeutic tool to be used in a Massage Therapy practice.
I am aware of the report by George K. Bryce, Hazardous Energy Reserved Act for Physical Therapists – Implications for Massage Therapists and Other Health Professions. As far as I can find, these recommendations have not been implemented.
However, having said all this, let us draw our attention to the word “Laser” which could  be the issue.  The word “Laser” has a superior marketing appeal because of its cool, interesting and mysterious nature. It conjures up the images of Star Wars, Laser light shows, and medical surgeries performed with this light.
Therapies currently available for the treatment and stimulation of soft tissue repair include the application of light and forms of phototherapy that utilizes the electromagnetic spectrum in and beyond the visible range. Used in addition to best clinical practice in the management of soft tissue injuries, there is considerable evidence that phototherapy can help improve tissue repair. The main types of phototherapy are Lasers and LED’s (light emitting diodes).
Electromagnetic radiation in the form of photons delivered in either laser or non-laser form has been applied to wounds as a means of stimulating healing for over 30 years. The technique is now referred to as phototherapy, photon therapy or as photobiomodulation, the use of photons to modulate biological activity.
The Meditech International Inc. group provides seminars and workshops covering the therapeutic values of light and the application in a clinical setting. Unfortunately, the word “Laser” is used in its marketing and certification course, however a closer look at the contents and the use of Laser in the course amount to less than 10%. The major source of light used, discussed and recommended in their workshops is administered by LED’s. This is based on countless research papers presented through the entire course.
LED’s produce light consisting of those wavelengths both in the visible spectrum and that in the infrared spectrum, as that of sunlight, halogen lights, light bulbs or infrared heat lamps. Exposer to the red light and/or infrared spectrum can stimulate the healing of chronic wounds (Mester et al 1985) and acute wounds (Dyson & Young 1986). It is also important to note the classification standard governing the safety of electric modalities. LED’s used and recommended for therapeutic value are Class 1 – “This class is eye-safe under all operating conditions”, under the US. Food and Drug Administration (FDA) and Health Canada.
Lasers, however, unlike light from non-laser sources, produce a light are coherent, that is, in phase, the troughs and peaks of the waves coinciding in time and space. Also the light from lasers is collimated, i.e. it’s rays are non-divergent.
As a former educator of post graduate Neuromuscular Therapy (St. John Method) of 15 years, I taught, discussed, and/or demonstrated intra-oral, intra-nasal, intra-rectal and intra-vaginal methods of treatment for musculoskeletal conditions. I am aware that in the province of BC, some of these methods may be beyond our scope of practice. However full credits were given even though a part of the lecture and workshop may have been beyond our scope of practice for this province but remained part of the course content as it was applicable in other provinces or states. As with the Meditech seminars and certification, some therapies may be beyond our scope of practice in this province, do not overlook the overall course content of actinotherapy.
In conclusion, I strongly disagree with the Quality Management Committee decision that the use of light does not fall within our scope of practice, as laid out by the Health Professional Act, and as taught in our BC Colleges. I’m also adamant that if workshops such as Hot Rock Therapy (research?) and other such workshops be included for CEC, surely a workshop that provides up-to-date scientific research on the physiological effects of administrating low level light to tissue and cells would also be recognized for it’s therapeutic value in a clinical setting.
I feel it’s important the Board recognize that the potential of technology, and collaborating with scientists advances our therapy as Massage Therapists, yet does not take away or diminish our sense of touch and the power of healing.  Consequently, furthering ourselves within our scope of practice, or for that matter, understanding therapies that are available outside our scope should be encouraged by our College and Board. This can only enhance our ability to direct our patients to the best available treatments to meet their needs. As a result, we obtain further acceptance by the mainstream medical community and public alike, that we are well-informed, educated and capable practitioners.
In Health,
Peter J. Roach, RMT

Featured Guest

Featured Guest

Featured Guest

Each month I will profile a patient whom I believe has shown outstanding qualities in their particular field. I’m excited to share with you a dear friend from high school who has made such a difference in numerous lives. Ruth Andermat.

Andermatt Consulting: Personal Development Sessions

“There is a voice that doesn’t use words. Listen.” Rumi

Each of us has the ability to tap into our inner wisdom, our intuition, and our ‘gut feeling.’ But not all of us listen. Cultivating intuition can provide a deeply satisfying connection to the guidance so many of us seek – particularly when needing support through challenging chapters in our lives such as job loss, divorce or the death of a loved one.

Ruth Andermatt is a Life Coach committed to helping people build inspiring lives. She creates the space to guide people toward understanding their inner truth, which helps them align with their purpose in life. She’s familiar with this challenge. Ruth earned a physical education degree from the University of British Columbia then climbed the corporate ladder for 15 years before accepting that this was not her life work. She started Andermatt Consulting in 1998, so she could integrate her intuitive gifts and Reiki training with helping others reach their potential.

To create a life that inspires you,

Contact Ruth E. Andermatt

P: 604.307.7955

E: ruthandermatt@yahoo.ca

Blog: http://lifecoachingwithruth.blogspot.com/

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Rolling Your ITB

Rolling Your ITB

Rolling Your ITB

Rolling your ITB (iliotibial band) between treatments will be a huge benefit. I often discuss this with my patients. Here’s how to do it.

ITB rolling – click here

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Core Performance Videos

Core Performance Videos

Core Performance Videos

This web (Core Performance) site offers lots of information, but the best thing I like about it is that it shows us how to perform an exercise with video. As many of you know, we only have so much time in the office to perform our treatment ie: Neuromuscular therapy, Laser, taping, and some basic core exercises. We can now direct you over to this website that can show you after you leave the office how to perform a particular movement. Check it out. We will come back to this often as more discussion around posture and gait is introduced.

I See Your Pain

I See Your Pain

Thermal Imaging

Fever was the most common condition observed in early medical history. In the early days of Hippocrates, mud was used on the skin to observe fast drying over a tumorous swelling, thereby indicating the rise in temperature.

These days non-invasive imaging techniques are emerging into the forefront of medical diagnostics and treatment monitoring.

Medical thermal imaging is a non-invasive imaging procedure that helps in detecting diseases and physical injuries.

Every person has their own “thermal image” much like a fingerprint. Changes over time in your ‘fingerprint’, or differences from one side of your body to the other can indicate potential issues.

Some of the conditions and injuries that a thermal scan can help detect include:

• back injures
• arthritis
• headache
• nerve damage
• unexplained pain
• fibromyalgia
• RSD
• TMJ dysfunction
• carpal tunnel syndrome
• inflammatory pain
• spain/strain
• soft tissue injuries
• cancers

Thermal scans can be taken of the whole body or just areas being investigated. The digitized images are stored on a computer and can be sent to your MD, specialist, or healthcare practitioner for further interpretation and reporting.

Unlike most diagnostic tests, thermography:

• is non-invasive
• requires no contact with the body
• uses no radiation
• is completely painless

Standard region of interest scans take approximately 15 minutes while full body scans take approximately 30 minutes. Your report is normally completed within a week.

Please do not hesitate to talk to me.

Thermal Imaging

Thermal Imaging

Thermography has been used effectively as an objective test in the assessment of pain. Cutaneous temperature at rest is largely controlled by the sympathetic nervous system (vasoconstrictor nerves) which closely parallel the somatic sensory nerve distribution. Therefore, when pain syndromes are present they affect the sympathetic nervous system, changes in cutaneous blood flow reflects the physiologic response to pain, creating an altered skin temperature that is recorded by the infrared imaging device.

Thermography has been found to be a useful tool for the objective documentation of sensory and sympathetic dysfunction in peripheral nerves with cutaneous projections, as malfunctioning areas can be reliably demonstrated and documented. While the skin provides clues to diagnose systemic diseases, it is also a window that allows us to monitor the health of our blood vessels and nerves.

The sympathetic system is largely responsible for the control of surface skin, innervating all tissue including muscle, the ligament, synovium, tendon, fascia, dura, disc & peripheral nerve fibers, interosseous membrane neuro-lymphatic sphincters. Diseases affecting the vascular system, nerves and connective tissue will result in temperature changes detected by thermography.

Identifying areas of pain with thermography has traditionally been performed by the comparison of one side of the body to its corresponding site on the contra lateral side, using the side without pain as the patient’s “control”. Body areas are then determined to be symmetric or asymmetric to each other with regards to temperature.
What is important from a thermographic perspective is whether the resultant vasomotor response is great enough to create a change in skin temperature of greater than 1 ° C compared to the contra lateral side or to the surrounding tissue (dermatome, sclerotome or vasotome)

Sensitivity and specificity of thermography in the assessment of pain has been reported within the 80 percentile range.The more we know, the better we can treat you. Simple as that. But gathering the information is an art.

Understand simply, that we are not diagnosing conditions with thermography. In the same way that thermography cannot see cancer, it cannot see nerve or muscle. It can, however, determine the physiologic presence of abnormalities associated with these anatomically-based factors. Thermography is adjunctive, reliable and should be used whenever possible to help patients receive the best analysis of their condition and the best treatment directed at that condition.

Low Level Laser for Arthritic Knees

Low Level Laser for Arthritic Knees

Arthritis of the knee is usually one of three basic types;

• Osteoarthritis (OA) is the most common form of knee arthritis. It is usually slow progressive degenerative condition in which the joint cartilage wears way.
• Rheumatoid Arthritis (RA) is an inflammatory type that destroys the joint cartilage
• Post-traumatic Arthritis develops after injury to the knee, and is similar to OA, and may develop years after the injury.

If you have osteoarthritis of the knee, you can take advantage of a wide range of treatment options. Only one in four people with osteoarthritis of the knee need surgery, but the effectiveness of different treatments varies from person to person. The choice of treatment should be a joint decision between you, your physician, and any other health care provider.

The purpose of treatment is to reduce pain, increase function and generally reduce your symptoms. Patient satisfaction is a fundamental goal in treating osteoarthritis of the knee. In its early stages, arthritis of the knee is treated with nonsurgical measures. Nonsurgical treatments fall into four major groups: lifestyle modifications; exercise; supportive devices; and other methods such as Massage and Laser Therapy.
I have had many patients in which within 3-6 treatments, we have been able to reduce pain and increase function. After that, a treatment every so often keeps the pain in check.