by Andreo Spina
"Why do I have this pain?" -
It is commonplace in manual medical practice to be faced with the question “why do I have this pain.” The way in which this question is answered can represent a pivotal moment in the lives of the patient as the answer provided can shape their concept of musculoskeletal health for the duration of their lives.
Commonly, when faced with this scenario, manual therapists resort to the standard answer, which often involves producing a sequence of events that would, or so they believe, predispose one to the presenting injury. Common answers include muscle imbalances, anatomical variants (ex. short leg), cumulative trauma/repetitive strain, etc. The common theme amongst all of the suggested answers is that there is “something wrong” with the patient that requires “fixing.” Further to this, it is common for the therapist to continue care even in the absence of the original symptomology under the guise of “preventative maintenance.”
This description is riddled with problems. What if the patient does not perform repetitive tasks that can explain the problem? What if the patient is a well-tuned athlete that doesn’t have “imbalances” (what ever that means)? What if they do not have any overt anatomical variants, etc. This “problem” is often overcome by the practitioner by claiming/inventing an overly complex reasoning that is unfounded by science. Your ‘x’ muscle is ‘inhibited’ which is leading to the ‘facilitation’ of ‘y,’ causing pain in ‘z.’ Whilst this ‘x+y=z’ explanation may indeed be causative (of course there is no real way to know in absence of evidence…especially as many of the utilized ‘buzz’ words have very, very poorly understood explanations at best), there is an easier, more accurate answer that can be used. Namely….because you are human.
Possibly unknown to some, the process of evolution is not believed to be directional towards an optimal state. It is not the best traits that survive; it is only those that conferred advantage against environmental pressures that are present. The bi-pedal posture for example is believed to have come about from an energy conservation standpoint. Humans were able to get more travel out of less energy demand. Never in this equation was factored what standing upright would do to ones musculoskeletal well being. Further to this, most recent innovations such as chairs, shoes, cars, laptops, desks, etc., were never factored into the physical evolutionary process. Thus while the species is still getting used to this new development (‘new’ from an evolutionary sense) of bipedal locomotion, the rapid implementation of these types of innovations means that the body really has no idea how to deal with them.
What does this mean in terms of our original question of “why do I have this pain?” It means that it is most accurately answered by re-phrasing the question and directing it back at the origin…. “what have you done to prevent this pain from occurring?” How have you physically prepared your injured tissues to withstand the stress of sitting in a chair, working on your computer for hours on end, driving a car, etc.
I do not mean to pass blame onto to the patient seeking advice. If anything, I am questioning how we as manual practitioners, who are supposed to experts in musculoskeletal health, are not more active in informing our patients, and the population as a whole, as to the various predispositions that we have to painful conditions (low back pain, neck pain, headache, plantar fasciitis, patelofemoral pain syndrome, etc.). Further, why are we not in the habit of prescribing exercises to mitigate these problems (notice I didn’t say ‘prevent’ as this is often not possible) even in absence of symptomatology?
IMO - conferring this understanding that “it is not our right to live pain free” would also do well to encourage life long physical activity as truthfully, our physical bodies still think they are in the forest hunting and gathering food. In this context, patients begin to understand that the body desires constant motion and physical activity, and although not possible, perhaps they will realize that they need to actively, and consistently work to decrease pain and maintain function.
In addition to the 3-day hands on instruction, the seminar also includes a significant online lecture component covering a variety of topics...
ONLINE LECTURE TOPICS:
- Cellular Anatomy/Histological basis of the FR® system
- Molecular Biophysics
- Progressive tissue adaptation
- Functional Anatomic Palpation Systems (FAP)™
- Tissue Tension Technique
- Progressive/Regressive Angular Isometric Loading
- Tissue Layering Technique
- Neurological Drive assessment
- Mobility Rehabilitation & Development
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"If a practitioner cannot define what they are feeling for in any realistic, scientific manner, then what is the outcome measures guiding their treatment? By this I don’t mean the outcome measure used to define success in the eyes of patients such as pain or range of motion. I mean what is the tactile finding that, on a moment-by-moment basis, guidance the practitioners treatment? How does one know when soft tissue ‘release’ procedures are appropriate vs. passive modalities? How does one know the needed amplitude and direction of force to apply? How does one know when the treatment is over? These and many other questions require that the practitioner is able to palpably distinguish between normal and abnormal anatomic structure, and further that they have a working definition/understanding of what they are looking for."
- Andreo Spina
Interview by Patrick Ward, http://optimumsportsperformance.com
1) Thanks for taking the time out of your busy clinical and teaching schedule to do this interview, Dr. Spina. Can you please give the readers a short overview of your background??
I studied Kinesiology at McMaster University in Hamilton, Ontario, Canada. I later graduated with summa cum laude and clinic honors from the Canadian Memorial Chiropractic College as a Doctor of Chiropractic and subsequently completed the two-year post-graduate fellowship in sports sciences. During my time studying Chiropractic, I became the first pre-graduate student to tutor in the cadaver laboratory in the department of Human Anatomy, a position that continued throughout my post-graduate fellowship program.
Stemming from my passion of studying and teaching anatomy, in 2006 I created Functional Anatomic Palpation Systems (F.A.P.)™ which is a systematic approach to soft tissue assessment and palpation. Following the success of F.A.P. seminars, I later created a follow up system of soft tissue release and rehabilitation called Functional Range Release (F.R.)® technique which is now being utilized by manual practitioners around the world including the medical staffs of various professional sports organizations. I then combined the scientific knowledge gained during my studies with my 29 years of martial arts training in various disciplines to create the third installment of my curriculum, Functional Range Conditioning (FRC)™, which is a system of mobility conditioning and joint strengthening.
Aside from my work teaching seminars, I also own a sports centre in Toronto, Ontario where I practice and train clients. I am a published researcher, and I have authored chapters in various sports medicine textbooks.
2) You approach to soft tissue therapy is extremely comprehensive and, after having attending one of your courses before, it is obvious that you have spent a lot of time reading research in order to develop your thought processes and theories about what may be taking place when we apply contact to another person’s body. The fascial system is a big part of your approach and the concept of the fascial system and how the body is connected has gained a lot of popularity in recent years. Can you please explain your approach and this concept you refer to as “Bioflow Anatomy”?
To say that the Functional Range Release system has a sole focus on fascia is not entirely accurate actually, although it might have been in the not so distant past. Further examination of literature has led/forced me to be more inclusive of other tissues, which together constitute the most abundant type of tissue in the human body, namely Connective Tissue (CT). Examples of other tissues inclusive in CT other than fascia include bone, cartilage, tendons, ligaments, blood vessels, lymphatic tissues…and even 80% of nerve structure. When contemplating the effects of manual therapy ‘inputs,’ or even training inputs for that matter, we must be inclusive of all of these tissue types as each of them will equally adapt to applied inputs. To say that with a particular soft tissue technique application I am affecting one tissue vs. another is as inaccurate as claiming that any particular exercise targets a single tissue, which is in fact impossible. This line of thought stems from literature examining the effects of load inputs on cellular/subcellular processes…a topic that we dive into deeply in the FR Release curriculum.
Continue to read the rest of this article by clicking HERE
Thanks to Patrick Ward for this interview!
They say the early bird gets the worm, but at BSMPG there are no worms - just the best sports medicine and performance professionals from around the world! See speakers such as Mark Lindsay, Joel Jamieson, Charlie Weingroff, Stu McGill, Adriaan Louw and Marco Cardinale all under one roof followed by our incredible social Friday night and the best sports science, equipment and nutrition suppliers in our vendor area throughout the two days.
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When it comes to developing the highest level of athletes, few professionals understand what this actually means like Marco Cardinale.
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Learn from the man that led Britian's Sports Science activities for the Olympic preparation at the Beijing 2008, Vancouver 2010 and London 2012 Olympic Games at the 2013 BSMPG Summer Seminar. As if your time at our annual seminar with Dr. Cardinale and other leaders in sports medicine and performance isn't enough, you'll also be entered to win win a copy of his book,
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Click below to see highlights from our 2012 BSMPG Summer Seminar featuring Keynote Speaker, Irving "Boo" Schexnayder.
More highlights are set to come in the next few weeks so stay tuned!
Save the date for the 2013 BSMPG Summer Seminar - May 17th & 18th in Boston MA.
Keynote Speakers include: Dr. Stuart McGill, Dr. Marco Cardinale, Fergus Connolly, Adriann Louw and Marvin Chun. Individual learning track speakers will be announced shortly.
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The Fusion Event Track at BSMPG
May 19th 2:30-3:30pm
The fusion of sports and medicine becomes a more potent mixture each day. Using tools that gauge performance with a high degree of accuracy allows us to quantify our results in almost any fashion imaginable. Tracking minute changes in the body such as heart rate, function, mobility and mechanics provides us information on our athletes that we can rely on to develop customized programs for each athlete. Real-time reporting functions provided by today’s latest technology make it simple and efficient to make evidenced based decisions in any setting.
Doctors, physicians and trainers are all working closely with one another to bring the most comprehensive care an athlete can hope for. Student athletes are among the top demographic to benefit from this union of sports and medicine where coaches and trainers regularly evaluate hundreds of students regularly. Coordinated care breeches team practices in addition to advising on lifestyle choices and curriculum.
Outside of institutions, merging is evident in private facilities where athletic development is the number one priority. Through the eyes of Dr. Thomas Lam, Director of Athletic Development at FITS Toronto, an environment focused on sports-science and coordinated care is a premier destination for training and therapy. Located in the hub of Canada, Dr. Lam’s two Toronto locations service every level of athlete, each equipped with a sports science lab. Tracking manipulations to the nervous system by evaluating the results in through changes to the biomechanical system, Evan Chait of Kinetic PT brings his discussion to OptoSource’s Fusion Track workshop.
For attendees of the Boston Sports Medicine & Performance Group, the Fusion Track will be the ideal chance to learn about incorporating data collection into sports performance planning and get a look at the best tools for managing all of the streams of information sports performance programs rely on today.
Speakers for this presentation include:
Dr. Thomas Lam of FITS Toronto on integrating objective analysis into an existing sports performance and medicine program.
Evan Chait of Kinetic PT will discuss The Chait Neuropathic Release Technique (CNRT), a multidisciplinary diagnostic and treatment process that focuses on 3 tiers of health. The 3 Tiers include the nervous system, biomechanical system, and the movement pattern system.
What to expect:
- Using the cloud to safely and efficiently manage data.
- Incorporating multiple streams of objective analysis into existing programs.
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Visit OptoSource for more information!
See this track along with 22 other lectures to choose from during our 2 day event this May 19th and 20th. A few seats remain - sign up before the last one goes!!!
Basketball is a multifactorial sport where recovery, nutrition, training, technical & tactical aspects, mental preparation and innate conditions are involved. As S&C coaches, our ultimate goal is to enhance the team performance by optimising each player´s physical condition and helping them stay away from injuries.
Profiling athletes is an important part of the training process that helps me to decide what is the most appropriate strategy for each of the players I coach.
The image below represents the average results of 3 pre-season assessments to determine the % of Type I muscle fiber (Slow Twitch). It is an example of two different football players, both of them playing for the same team but with a different muscular profile.
The player on the left seems to have lower predominance of slow twitch as every muscle group except Semitendinosus (very postural muscle) is within 30-45% of slow muscle fibres.
The player on the right seems to have higher predominance of slow twitch, especially on key muscle groups like Biceps Fem (59,8%) and Gluteus Max (62%).
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See Jose and other internationally known speakers at the 2012 BSMPG Summer Seminar May 19-20th.
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