Trevor Todd, PT

It is no secret that among the keys to good health are proper nutrition, exercise, a stress-free lifestyle (to the extent that is possible) and steering clear of harmful habits—elements dependent largely upon outside factors and behaviors.  But what about that aspect of health that originates from inside, within our internal self-healing system?  We know that the body is designed to defend us from disease and assist in healing, as evidenced every time a cut heals or we “fight off” a cold. 

What we may not be aware of are the innovative hands-on techniques available to facilitate that process. Here at Manual Therapies of Gresham, I focus on problems that seem resistant to other forms of therapies.  Chronic pain and dysfunction syndromes due to repetitive injury, trauma, illness, diseases, and even syndromes of mysterious or unrecognized causes can often evade progress unless a whole body approach is taken. 

My tendency to succeed is rooted in this whole body/whole person approach combined with extensive training in a wide array of hands-on techniques. 

Among the methods used are Myofascial Release, CranioSacral Therapy, Strain and Counterstrain Technique, Muscle Energy Technique, Functional Indirect Technique, Mobilizations with Movement, Visceral Manipulations, and others.  A brief description of each of these techniques follows.  What they all have in common is the goal of making therapeutic change by following subtle cues from the body itself instead of attempting to force it to do one thing or another. 

Each individual has different needs and no one technique or sequence of treatments will help everyone.  Each treatment session is tailored to meet the needs of that body at that moment.  While the focus of treatment is to uncover the deeper causes of the problem, symptom relief is also a major objective.  The number of sessions needed is extremely variable and depends on, among other factors, the complex layers of injury and trauma that may mask the original cause of the problem.

MYOFASCIAL RELEASE

Fascia (also called connective tissue) is a system of the body to which relatively little attention has been given in the past.  It is a continuous web of connective tissue that extends without interruption from the top of the head to the tip of the toes.  It surrounds and invades every other tissue and organ of the body, including nerves, muscle, bone, vessels, and viscera.  The tough white membrane seen on butchered meat is an example of thick and dense fascia.

When fascia becomes less elastic due to injury, repetitive use, or postural considerations, it tightens down and restricts movement, blood flow, or nerve conduction.  And because it is continuous throughout the body, symptoms may be located far from the problem area and may be resistant to treatment using traditional methods. 

Myofascial Release is performed using various techniques of sustained pressure by a highly trained therapist to restore normal elasticity and function.  Since fascia is a whole body system, Myofascial Release is a whole body treatment.  It may be very effective on its own or in combination with other methods.  The results are commonly very impressive.  Long standing problems frequently fade over a series of treatments.

CRANIOSACRAL THERAPY

The CranioSacral Therapy practitioner works with the patient to assist the body’s self-correcting mechanisms.  The craniosacral system plays the vital role of maintaining the environment in which the central nervous system functions.  It consists of the membranes and fluid that surrounds and protects the brain and spinal cord as well as the attached bones -- including the skull, face, mouth, and spine.  Since the brain and spinal cord are contained within the central nervous system, the craniosacral system has a powerful influence over a wide variety of bodily functions.  The CranioSacral Therapy practitioner essentially helps the body release restrictions – which it has been unable to overcome on its own – restrictions that inhibit the body’s normal, self-correcting tendencies.

STRAIN AND COUNTERSTRAIN TECHNIQUE

In many situations of injury, joint and muscle length dysfunctions are due to a strain pattern set up in the nervous system which mistakenly tells a muscle to be the wrong length.  This tight/strained muscle pattern may persist for weeks, months, or even years and proves to be resistant to treatment through stretching, massage, or exercise.  Utilizing strain and counterstrain technique, the therapist positions the body in such a way that the neurologic input to the problem area is shut off for a period of time which resets it back to normal.  In this process, the therapist will frequently monitor various tender points that specify muscle or joint dysfunction.  These points are often distant from the problem area.  The technique is gentle and often very subtle yet extremely effective when administered appropriately.

MUSCLE ENERGY TECHNIQUE

Muscle Energy Technique can simply be considered as an effective and gentle form of joint mobilization.  The therapist will first assess and identify specific joint restrictions.  Then he/she will place the patient into a position that brings the joint closer to proper alignment – this is similar to what is done to “crack” or “pop” a joint “back into place.”  The difference is that the force causing the actual change is generated by the patient contracting specific muscles for a brief period instead of by the therapist. The two main advantages to Muscle Energy Technique over manipulation are that the gentleness will not harm the patient and that the muscle contractions help to balance the change with the adjacent structures.

FUNCTIONAL INDIRECT TECHNIQUE 

This complex and sophisticated method of resolving dysfunction in the musculoskelatal system utilizes a combination of position and pseudopassive movements to guide and at the same time follow body tension patterns enacting a sequence of releases.  With the client usually sitting or laying on the back, the therapist will monitor specific locations and move body parts into ranges of ease.  He/she will be following subtle movements and shifts that occur naturally.  By following these movements, not only is the desired body segment mobilized but it is also integrated with the rest of the body above and below that segment.  The result is lasting functional improvement.

MOBILIZATION WITH MOVEMENT

This effective technique combines two standard treatments with a result that is far greater then the sum of the two.  In this technique, the therapist aligns joints and tissues until the painful movement can be performed without pain.  The motion is then repeated several times, which creates a lasting change in the balance of tissues and/or joint position.  Dramatic improvements in pain and/or motion are common.

VISCERAL MANIPULATION 

It may be difficult to picture initially, but the internal organs (also called viscera) can have a great influence on the musculoskelatal system.  Much like joint surfaces must slide properly in order for bones to move, organ surfaces must also slide in just the right sequence and without resistance.  Additionally, just like joint restrictions can create misalignment, internal organ adhesions can pull the body out of alignment causing dysfunctions that may seem unrelated.

A second method of influence from the internal organs is through complex neurologic reflex arcs, which run between muscle and organ. This is why it is common to see a combination of visceral and skeletal problems such as irritable bowel syndrome and low back pain.

Visceral manipulation is a manual therapy consisting of specifically placed forces that encourage normal mobility, tone, and inherent tissue motion of the viscera and their connective tissues.  These manipulations have the potential to affect physiological function of individual organs, the systems they function within, and the structural integrity of the entire body.

MANUAL LYMPH DRAINAGE 

The proper functioning of the lymphatic system is critical to our body's ability to operate at peak performance. This system drains fluids, detoxifies tissues, filters out toxins and foreign substances and helps us maintain a healthy immune system. Stagnated lymph circulation causes toxins to accumulate and compromises cellular functioning, which opens the way to physical ailments. Lymph Drainage Therapy (LDT) is a highly efficient approach to working with the lymphatic and other fluid systems.  The practitioner is manually attuned to the specific rhythm, pressure, quality and direction of the lymph flow by using a combination of precise anatomical science and distinct manual techniques. Techniques are performed with hands and fingers simulating gentle, wave-like movements that activate lymph and interstitial fluid circulation as well as stimulate the functioning of the immune and parasympathetic nervous systems.

NEURODYNAMICS

This relatively new approach to states of pain and dysfunction focuses on the physical mobility and sensitivity of the nerves of the body.  With precise assessment utilizing anatomy and physiology, the practitioner gains extensive insights into conditions such as carpal tunnel syndrome.  Treatment uses the various approaches discussed above as well as innovative exercises and education.

Each of the techniques described above are gentle techniques that work with the bodies own capacity to heal.  Therefore, they are uncommonly safe.  It is, however, considered normal that some people will feel discomfort between one and twenty-four hours after the treatment session and occasionally right after the session.  This discomfort can come in many forms such as soreness, pain, fatigue, or even sadness. These sensations can be in the region of where the treatment took place or in other parts of the body.  This discomfort is likely due to the body adapting to significant changes.  If discomfort occurs, it usually lasts between 6 and 8 hours but can last up to three days.  There are a few exceptions to these time frames.  If symptoms occur from the treatment, it is reasonable to use heat, ice, medications (as advised or prescribed by a physician), rest, or positioning for comfort.  It is also reasonable to simply allow the process to resolve itself.  If there are concerns, contact the Physical Therapist or doctor.