SIMON JAMES – Registered Massage Therapist – Victoria, B.C.

I just took a great course a couple of weeks ago that focused on the position of the pelvis and it’s involvement in low back pain. The course provided a great way to assess the position of the pelvic bones (hip bones) and the sacrum (bone between the pelvic bones just below the lowest back vertebrae. It is important that the pelvic bones and sacrum be level as that is the position that the low back spine will continue upwards. So imagine that the hip flexor that attaches to the front of the right pelvic bone is tight and pulls the front of the right pelvis down and tilts the whole pelvis so it is facing more forward and to the right, that is how the spine will start going up. That means that your torso will be also more forward and leaned to the right. The body will immediately recognize this and tighten your left low back to pull your torso so it is back upright. This will cause pain in the left low back as it is chronically tightening.

The course I took covered over some really simple effective comfortable methods to reduce tightness of certain muscles that are pulling the pelvis out of alignment therefore reducing the need of back muscles  to tighten to pull the body back into alignment. Being able to identify the causes of pelvic misalignment allows me to give exercises that will hold the correction so that the client is able to keep up the changes over longer time for long term effects.

Identifying what postures or biomechanics can be contributing to the issue in the beginning are also reviewed to help hold the changes for longer term. It goes to back up that the pain you feel is often in a different area from where the cause is. Working in the area of discomfort is necessary to provide relief but would only be helpful for a short term and must be followed up with exercises at home and awareness of posture and biomechanics that, as describe above, can be contributing.

Here is a picture of the pelvis from the front and slightly above. The Sacral Promontory is where the L5 (lowest back vertebrae) sits and starts the spine upwards.

I wanted to discuss my Fascial Release treatment today as one of the most important modalities that I use. It is quite a deep subject and I could go on for hours about it but just the basics I think will do and how it ties in with my treatment philosophies and how it is helpful for my patients is what I will focus on. Fascial, essentially, is what helps to create the structures in our body (bones, tendons, muscles, nerves, organs ect.) but it also helps to hold these structures together and is the reason for the shape that we are.

I thought that Wikipedia had a good definition so I hope they don’t mind if I borrow from them.

Fascia (făsh’ē-ə), pl. fas·ci·ae (făsh’ē-ē), adj. fascial (făsh’ē-əl) (from latin: a band) is the soft tissue component of the connective tissue system that permeates the human body. It interpenetrates and surrounds muscles, bones,organs, nerves, blood vessels and other structures. Fascia is an uninterrupted, three-dimensional web of tissue that extends from head to toe, from front to back, from interior to exterior. It is responsible for maintaining structural integrity; for providing support and protection; and acts as a shock absorber. Fascia has an essential role inhemodynamic and biochemical processes, and provides the medium that allows for intercellular communication. Fascia functions as the body’s second line of defense against pathogenic agents and infections after theskin. After injury, it is the fascia that creates an environment for tissue repair. So a fascial adhesion which occurs post injury, can affect the repair of that same tissue.

Where I come in to all of this is that if there is a discontinuity or change to the function of the fascia, it can effect the body in many ways, including the functions stated above. I concentrate more on structural fascial and myofascial (fascia that surrounds the muscle) in the way that they affect movement and posture and balance, which is what I see come into the clinic quite often.

Another groups of conditions that has begun to trickle into the clinic are conditions arising from disfunction to the fascia surrounding the organs. The organs that I traditionally deal with are the liver, gall bladder, stomach, lungs, large and small intestines, bladder, prostate, uterus. This form of treatment is very non-invasive (for those of you who saw the bladder/prostate and cringed). The bladder/prostate work can be accessed in the lower abdomen area just below the belly button. With their respective attachments, each organ has a movement is must be allowed to do during both it’s functions and during general body movements. Clients have come in with complaints attached to digestion such as reflux, gas, constipation, diarrhea, dry stool which can all be attributed to adhesions somewhere along the course of the digestive system. Constipation, for example can be a spasm causing the valve between the small and large intestine.  It’s a newer approach to adhesions causing trouble with the functions of organs.

As example as what can happen with tight abdominal fascia, think what would happen if you had some of those full body pajamas on and you’re sitting in a chair. You spill some sticky glue on your front but you stay there for a while, until the glue hardens. When you go to sit up, the now inelastic fibers of the front of your pajamas  will make it difficult to stand up straight because they won’t stretch. It also affects the way that the rest of the pajamas pull to compensate. This is an extreme example, but shows how restricted fascia can affect a local area and also affects the chain of fascia around the rest of the body.

Again, I could go on for a long time about different effects of dysfunctional/adhered fascia, but in a nutshell, Fascial adhesions don’t let things happen that need to happen and puts the body into a state of imbalance and dysfunction. My job is to locate the adhesions and release them so that the normal function and movement occurs and allows the body’s natural balanced position occur easier. It is an interesting process as often the best approach is a much more gentle approach. I hold the pressure to release the adhesion and often it won’t move for at least a minute, then slowly, the adhesion begins to unwind, producing a significant release allowing movement of the structures surrounding it. Often I combine other modalities with fascial release including trigger point release, muscle energy techniques, joint play to name a few. With fascial release, toxins are always released so I always flush out the area to return the venous circulation to the heart to be expelled.

Carbon dioxide is the waste product of the respiritory system, and of several other chemical reactions in the body, such as the creation of ATP. Pure carbon cannot be transported in the body, so CO2 is one form it takes that is water soluble. Levels of CO2 also tell the body when it needs more oxygen.

In the human body, the oxygen is absorbed by the blood stream in the lungs, being then transported to the cells where an elaborated change process takes place.

Oxygen plays a vital role in the breathing processes and in the metabolism of the living organisms.

Probably, the only living cells that do not need oxygen are some anaerobic bacteria that obtain energy from other metabolic processes.

I’ve wanted to write about this for a while. It’s never fun when you first feel a cold coming on and you wonder what you should take, so I thought I would pass on what seems to have always worked for me. It is pretty simple too. When I feel it coming on I take a couple of grams of Vitamin C (2000 mg), chop up some fresh ginger root and put as much in hot water as I can and just drink ginger tea with honey all day. Since I have done that, I have never felt anything settle in. Maybe it’s just the Vit C, but Ginger also has very potent anti viral properties that are good for colds and flus.

Click here for more infomation on ginger. It’s really good stuff.

I was treating at the Ironman in Penticton in August and being there is always an experience. Essentially, the meat of it is that in 30 degree celcius temperature, 2800 people or so swam 3.8 km, rode 180 km and 42.2 Km run. To regular Joe and Joettes like that, this seems inconceivable, but to an Ironman/woman, this is the result of training, often from short runs, to 10 km, to half marathons, full marathons, half thiathlons, full triathlons to the Ironman races. We worked with the athletes for the days upcoming with preparations to help them to get ready then helping them after the race.

A significant part of all this was helping them was just after the race when they came in. Many of them were so tired that they had trouble getting on the table. The treatments were mostly limited to flushing out the muscles and helping to bring blood to the muscles to aid in repair and reducing pain. Many of them wanted to lay down to rest after but my suggestion to them was, if they were able to, to go down to the lake and move about in the water. The best thing that you can do after heavy exercises, whether it be running/biking/swimming or a weight workout, I have found that a good cool down with low intensity exercises or movements. Moving about in the water allows the body to move circulation around better and helps it get rid of Lactic Acid and CO2, which is a cause of Delayed Muscle Soreness, that you feel a day or two after. Essentially, muscles short contraction and lengthening from simple movement provides the pump necessary to bring in circulation. Shortening brings in the blood, drops off the oxygen, picks up the carbon dioxide (waste byproducts), then lengthening pumps out the CO2 rich blood out to the lungs to be breathed out.

When I do a long bike ride, I ensure that I spend 5 minutes at low intensity high reps before stopping my bike ride and I have noticed that the day after I am much less sore and noticed less fatigue, that allowed me to go biking the day after.

Another thing that I do, of course is an Epsom Salt Bath, which floods my muscles with magnesium, that in turn, remove calcium from the muscle cells allowing them to relax. Take a look at a good movie explanation at http://www.youtube.com/watch?v=5guQwhRhV60

I’ve just installed some 7″ disc brakes. I had a thought that maybe I would like to get the hydraulic brakes, that uses hydraulic pressure as opposed to cables, but opted to get  the Avid BB7 mechanical disc brakes and would recommend them to anyone. They are very efficient brakes in the dry or wet weather.

One recommendation from the bike dealer was the importance of keeping the discs clean. Often things like grease and oil can get on the disc and get on the brake pad and it can be very difficult to clean. So each ride I wipe down my brake disc when I get home. It takes two seconds (margin of error of 1 minute) with a clean cloth and some plain-jane Isopropyl alcohol.

Neck pain is one of the more common reasons that someone may come in for therapy. Often it is the dull, achy general pain that occurs more at the end of the day. When I hear that, I think that it may not be a disfunction in the structure of the body, but simply that the muscles have been working hard all day and they are a little tired and sore. If a muscle is contracting constantly, it has a reduced capacity to bring in adequate Oxygen and ability to remove the muscle waste byproducts, which in turn does not allow the muscle fibers to repair themselves. Having this occur over a long period of time can cause many issues which ultimately result in symptoms like neck pain, headaches, dull achy pain to the arms, nerve compression and joint issues and sharp pain between the shoulder blades.

I have talked in the past about the importance of adapting your environment (work or home) to your balance position. For example, when sitting in front of a computer, having feet in front, good pelvic balanced position, finding the center of your torso balancing (so that you’re not falling forward or back), then doing the same with the head (making a nodding movement to find the point when your head does not fall forward or back). When you find this general balanced position, then you place your computer screen in a position where you can see your screen comfortably. Often this involves raising your screen up to eye level and about 2 feet or so away from you (a glare protector is good as well) so that you can see the screen and the font easily. Then you can place the keyboard at belly level so when you type, your elbows are back allowing the shoulders to stay back and open.

Like any position change, this will feel weird at first, but trusting that you have a good balanced position will make a huge difference in the amount that your neck and back muscles need to work, allowing them to bring in oxygen and get rid of the CO2 so they are healthy and happy. The important thing to be aware of, is the reduction of pain and other symptoms.  That is the ultimate reward for the body, and the body needs rewards to stay in a new position.

I find more and more that the pain is never where the original dysfunction is. I find that the pelvis is the center of the universe posturally. At least 8/10 times, when some has neck pain or similar it is simply because the muscles are working hard to correct the head position. For example, many times, a client’s pelvis may be raised on the right side, the body will attempt to corrcct that by pulling the torso to the right when sitting or standing. If you try leaning to the right, you will notice that your left shoulder raises and your head falls to the right. There is a sensor in each ear that ensures that if this occurs, muscles will tighten to make sure that the head is (as close as possible) rebalanced so it is level with the horizon. As above, when you are leaning to the right, your left neck muscles will tighten to pull your head straight. Very often you can’t tell that this is all going on because all that the brain is concerned with is that the head is now straight, no matter what unbalance and compensation is going on farther down in the neck and low back.

These are all side to side compensations. Now imagine that you are leaning forward on the computer working. Now your back neck muscles are working as you head is in a forward position and they are attempting to level your head on a side to side orientation. If they are doing this all day, they will become very tired and cranky causing the neck pain/headaches/arm aches/upper back pain.

So when someone comes in with neck pain, I often start by checking to see if the pelvic bones are balanced and getting an idea of the whole picture, then working up. Sometimes a person can get away with this for a while, but something very simple like a move in the wrong direction or sleeping in a strange position can set it off.

Good posture, balance, flexibility, and strength are the key to avoiding a lot of pain and dysfunction. It’s good to start from the bottom and work up to the top. To cap it all off, our heads are extremely heavy and we’re not doing out neck muscles any favors by making them hold up our heads in bad positions.

On my bike rides I was feeling like my back was really tightening up 2/3′s or so into the ride so I decided to go and get my bike fitted to make sure that everything was where it should be to make my rides more comfortable and efficient.

I went to see Bill at the Trek Store in the Songhees, just across the Johnson Street Bridge near Spinnakers (?) in Victoria. Having your bike fitted is really not something that you can do on your own. Bill pointed out that my setup needed to be changed in two ways:

1) That I need to move my seat a little more forward so the down stroke  was more over the pedals and therefore will produce more power

2) That I needed to reduce the “tilting back” of my seat as it naturally opened up my low back subjecting it to unnecessary strain and weakness.

So we made the changes and my first initial thought was that it felt really weird, which is normal as I had it in the other position for pretty much years and years. With these sorts of things, you really have to trust the math and the position will feel more normal over the period of a week or so with constant riding.

We also curled the brake levers and gear shifters more forward so that my wrist are not extended too much which can manifest their own issues over a long period of time.

My initial feeling is that maybe there is too much body weight forward on the handlebars but that may be just something to adapt to. I’m going back in a week and we can go over things like that.

It is something that I should have done a while ago and recommend that people that ride 3 – 7 times per week should absolutely do, so call and set up and appointment with Bill Fry at The Trek Store at 250-380-7877. It is quick, easy and will save a lot of grief in the future.

Check out their website at http://www.trekbikesvictoria.com/    as they have lots of great information and clinics available and fantastic inventory.

Carbon dioxide is the waste product of the respiritory system, and of several other chemical reactions in the body, such as the creation of ATP. Pure carbon cannot be transported in the body, so CO2 is one form it takes that is water soluble. Levels of CO2 also tell the body when it needs more oxygen.

In the human body, the oxygen is absorbed by the blood stream in the lungs, being then transported to the cells where an elaborated change process takes place.

Oxygen plays a vital role in the breathing processes and in the metabolism of the living organisms.

Probably, the only living cells that do not need oxygen are some anaerobic bacteria that obtain energy from other metabolic processes.