SomaSimple Discussion Lists  

Go Back   SomaSimple Discussion Lists > Physiotherapy / Physical Therapy / Manual Therapy / Bodywork > General Discussion > Try it, Use it or Lose it!
Albums Quiz PubMed Gray's Anatomy Tags Online Journals Statistics

Notices

Try it, Use it or Lose it! Hands-In approach to forget pain, useful tips

Reply
 
Thread Tools Display Modes
Old 20-03-2004, 04:41 PM   #1
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default Low Back Pain

A simple exercise for low back pain

Examination; often thoracic breathing, tight and sore low back, tight gait with reduced arms balance. Decrease or absence of voluntary motion on low back and abs.
pain: often in low back, also legs problems (hip, knees).
Behaviors: fear of movement because all motion is felt as painful.

position; Patient is lying back on a table, knees bent comfortably.

Begin with abdominal breathing.

Then I continue with a leg, gentle moving like walking and say to patient again to feel movement from a first person experience (focused and attentive to movement). Then I mobilize the other side. Patient ever relates a major difference already between the two sides; more supple. They almost begin to sense their back, a kind of ability to move?

Then, knee bent and grasped with my arms close to my chest, I say to patient to push me, as they wanted to put their feet on the table. They must sense all the slow movement in each direction. 4/5 times.

Advise: neurodynamics come there. Some of important injuries may have engaged nerve lesions and after a session, patient feels better and is now pain free at rest but feels some pain while moving and uniquely in a few degrees of motion.
Nerve lesion demands time to relieve.
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 29-03-2004, 09:35 PM   #2
emad
Forum Moderator
 
emad's Avatar
 
Join Date: Mar 2004
Location: The Earth Planet
Age: 39
Posts: 2,067
Thanks: 2
Thanked 2 Times in 2 Posts
Default

Hi Bernard:

Good practical session ,
Bernard
uasually , i lead pateint to rest pain free status , but usually , all consumers have yellow flags , i mean thier work , they can not decrease work effort /its time , so to go withe work...
i will put this a new topic .
cheers
emad :lol:
emad is offline   Reply With Quote
Old 03-07-2004, 09:05 AM   #3
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,521
Thanks: 1,805
Thanked 558 Times in 400 Posts
Default

Bernard

Your Rx plan sounds great.

Education, neurodynamics, information to the brain that legs, pelvis and spine can move without pain - and the various stations change signals.

Write it up for future reference -and for others to note.


Nari
nari is offline   Reply With Quote
Old 06-07-2004, 07:40 AM   #4
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Nari,

Quote:
Originally Posted by Nari
Education, neurodynamics, information to the brain that legs, pelvis and spine can move without pain - and the various stations change signals.
The big surprise for me is that almost all patients can't do this movement actively before my intervention! It hurts them badly and of course they are afraid of this kind of action.

Ian would say that is placebo, Nari would say that is neurodynamics, Diane would say that is brain?

I'm focusing attention of patients to the fact that they are the directors of the movement and they control it totally. If they move slowly, they'll be warned if something may fail!

More they do it with strength, more easily the pain disapears!

In my view, the movement erases the anticipation component of pain?
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 06-07-2004, 09:28 AM   #5
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,521
Thanks: 1,805
Thanked 558 Times in 400 Posts
Default

Bernard,

To your last sentence re anticipation of pain - Yes.
Overcoming anticipation of pain is an important aspect of movement.
In a way, that is education - controlling fear of pain, and even thought of pain (which is a very strong pain inducer).

Nari
nari is offline   Reply With Quote
Old 07-07-2004, 12:15 AM   #6
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,521
Thanks: 1,805
Thanked 558 Times in 400 Posts
Default

Doesn't that make one cranky - the GPs who hang onto patients but are not able to do as much for them as PTs?

We have that problem, on a big scale too. They often have difficulty deciding who is appropriate for PT and who is not, and we do not know what their criteria for referral is - it is very inconsistent.


Nari
nari is offline   Reply With Quote
Old 13-07-2004, 06:45 AM   #7
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Somasimplers,

Here is the realization of the movement. The blue arrow shows the force applied by the patient, the resistance is of course in opposite direction.




flash version
html version

You can enlarge the view by clicking on flash version!

Hope it help some to try it?
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard


Last edited by bernard; 05-08-2005 at 07:30 AM.
bernard is offline   Reply With Quote
Old 01-08-2004, 05:29 PM   #8
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

I tried during my holidays to make some little statistics about this exercise.
It was tried on 86 patients since January.
All had an improvement over pain and they feel all an enhancement during the daily life.
In this group, I had one patient which could not perform the requested movement (concurrent knee problem).
The majority of patients were painfree with 3/5 sessions.

Total average (VAS scale) actually is 1.37 (n=86)

Poor results n=11
Average (VAS scale) is 5.0

Within these 11 patients, there was

1 victim of sexual abuse
2 non cooperative patients (one of them prefer pills!)
1 divorcing woman
3 aged patients (> 92 yo)
2 polyarthritis
1 fibromyalgia (scared by her GP)
1 associated problem (knee)

So we can say that I had 75 good or excellent results 87%
VAS score is under 1.5 for all these patients.

I treated indifferently chronic or acute problem in the same manner.
Those whom have a little pain have frequently roots problems since a long time. But they all say that if the discomfort remains like that, it is not a problem for them.

I will, now, collect VAS score at every session.
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 01-08-2004, 08:40 PM   #9
emad
Forum Moderator
 
emad's Avatar
 
Join Date: Mar 2004
Location: The Earth Planet
Age: 39
Posts: 2,067
Thanks: 2
Thanked 2 Times in 2 Posts
Default

hi Bernard :

very good ideas and statistics , yes the more important , the end overall outcome for the technique which is used.

I think u have used in conjunction with ,teaching :arrow:
pain
relaxation
using assurance.

cheers
emad
emad is offline   Reply With Quote
Old 14-10-2004, 08:57 AM   #10
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

The beginning of movement

__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 14-10-2004, 08:58 AM   #11
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Then patient moves isotonic contraction.

__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 14-10-2004, 09:00 AM   #12
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Then patient moves until this position.

__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 14-10-2004, 09:01 AM   #13
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Then patient relaxes slowly to the rest position.

__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 14-10-2004, 09:02 AM   #14
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Then patient relaxes slowly to the rest position (she is pushing against me, less and less).

__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 14-10-2004, 02:55 PM   #15
Diane
Human Primate Social Groomer and Neuroelastician
 
Diane's Avatar
 
Join Date: Mar 2004
Location: Weyburn Sask.
Posts: 22,569
Thanks: 2,942
Thanked 6,070 Times in 2,745 Posts
Default

Bernard, nice pictures. In Somatics, that sequence would be called "pandiculation of the erector spinae muscles."
Cheers,
Diane
Diane is offline   Reply With Quote
Old 14-10-2004, 03:01 PM   #16
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Diane,

It is derivative from the Somatics Book.
THe important thing is to avoid legs extension. It hurts in that cases.
This exercise is a perfect revelator of scars on nerves (it hurts only on a centimeter).
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 14-10-2004, 06:32 PM   #17
fapt
世界の中心で、愛をさけぶ
 
fapt's Avatar
 
Join Date: Oct 2004
Location: Taiwan
Age: 33
Posts: 181
Thanks: 2
Thanked 0 Times in 0 Posts
Default

Quote:
Originally Posted by bernard
Diane,


This exercise is a perfect revelator of scars on nerves (it hurts only on a centimeter).
Why?
I don't understand....
This exercise can correct the spine position which is caused by weakness of lower abdominal muscle.
__________________
Lin Chih-Chung, PT, MS, Taiwan
fapt is offline   Reply With Quote
Old 15-10-2004, 06:38 AM   #18
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Hi Somasimplers,

Quote:
Originally Posted by Lin
This exercise can correct the spine position which is caused by weakness of lower abdominal muscle.
1/ No, the exercise is not intended to correct a spine position but much more a imbalance in muscle activity. (It reduces/suppresses the anticipation factor of activation).

2/ The abdominal muscles are not actived in this trial and have not to to contracted.
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 15-10-2004, 11:54 AM   #19
nari
NeuroNut Evangelist
 
nari's Avatar
 
Join Date: Mar 2004
Location: ACT Aust
Posts: 8,521
Thanks: 1,805
Thanked 558 Times in 400 Posts
Default

Good visuals, Bernard.
Sounds an interesting way to retrain, in a way. an otherwise simple movement.

Nari
nari is offline   Reply With Quote
Old 15-10-2004, 11:58 AM   #20
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Nari,

Thanks,
visuals are necessary to brain and words are visuals too!
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 15-10-2004, 12:28 PM   #21
fapt
世界の中心で、愛をさけぶ
 
fapt's Avatar
 
Join Date: Oct 2004
Location: Taiwan
Age: 33
Posts: 181
Thanks: 2
Thanked 0 Times in 0 Posts
Default

[quote="fapt"]
Quote:
Originally Posted by bernard
Diane,


This exercise is a perfect revelator of scars on nerves (it hurts only on a centimeter).
Why?
I can't figure out?
__________________
Lin Chih-Chung, PT, MS, Taiwan
fapt is offline   Reply With Quote
Old 15-10-2004, 01:58 PM   #22
bernard
Admin, Moderator...
 
bernard's Avatar
 
Join Date: Mar 2004
Location: France
Age: 57
Posts: 12,304
Thanks: 661
Thanked 405 Times in 206 Posts
Default

Lin,

After a nerve injury and also in many LBP, the muscles are very tight in all the lumbar area. This exercise is a good one to release these tight muscles and then, while moving the legs passivly, the patient can feel if a high spot remains while moving (the scar is hurting something).
__________________
Simplicity is the ultimate sophistication. L VINCI
We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. I NEWTON

Everything should be made as simple as possible, but not a bit simpler.
If you can't explain it simply, you don't understand it well enough. Albert Einstein
bernard

bernard is offline   Reply With Quote
Old 04-08-2008, 08:59 PM   #23
canuckpt
Junior Member
 
Join Date: Jul 2008
Location: Canada
Posts: 7
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Bernard,

Interesting technique. Are you taking the knees into flexion during this technique? Are you finding a point of restriction into flexion and then applying a hold relax stretch? Are you attempting yo achieve further flexion each rep?

This reminds me of a bent SLR that Mulligna recommends for highyl sensitive LBP patients with positive SLR less than 30 degrees. Perhaps the Mulligan bent SLR works since the patient realizes they can move their leg into a flexed position pain free?
canuckpt is offline   Reply With Quote
Old 06-03-2011, 06:36 AM   #24
sillewater
Junior Member
 
Join Date: Jan 2011
Location: Oregon
Posts: 13
Thanks: 0
Thanked 0 Times in 0 Posts
Default

Would you say this movement is similiar to the Cat/Camel stretch? I know there's different ideas as to why this movement works. Why do you think it works?
sillewater is offline   Reply With Quote
Old 06-03-2011, 06:21 PM   #25
Yannick
Senior Member
 
Yannick's Avatar
 
Join Date: Nov 2009
Location: Hérault
Age: 33
Posts: 334
Thanks: 46
Thanked 14 Times in 6 Posts
Default

Bernard what was the average VAS scores before your treatment ? Tell us more about your protocol : I suppose that you use others exercises with these patients or was it really the only one in a session? How long did you take in order to realize 4-5 repetitions? Did you use a transposition of this exercise in a more functional situation (position)?
__________________
« Guérir parfois, soulager souvent, écouter toujours. »
Louis Pasteur
Yannick is offline   Reply With Quote
Reply

Bookmarks

Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Forum Jump

Similar Threads
Thread Thread Starter Forum Replies Last Post
Low Back Pain and Heat Wraps Diane PPP Management 18 24-01-2006 09:46 AM
The natural history of idiopathic low back pain bernard General Discussion 2 25-03-2004 08:02 AM


All times are GMT +2. The time now is 02:59 PM.


Powered by vBulletin® Version 3.8.8
Copyright ©2000 - 2014, vBulletin Solutions, Inc.
SomaSimple © 2004 - 2014