Is that your anus twitching as you run??? It may be useful!

Paul Hodges says so!
All those magnificent marathon runners in London recently will have involuntarily been contracting their anal sphincters with every step of the way. This coordinat functions requires the same muscles that are used to maintain IAP and spinal stability.

In fact Dr Hodges spoke extensively on the subject of optimal neuromotor control of the fascial system as a requirement for lumbopelvic control, with particular and unusual reference to the key elements of respiratory and the wider pelvic floor. He was a key speaker at the CONNECT soft tissues in sports medicine conference held a fortnight ago in Ulm, in Bavaria, Germany.

This depends essentially along the lines of the interaction of muscles with direct and indirect attachments, as the intra-abdominal pressure is critical to the mechanism of hoop tension (with respect to laPlace's law).

He was speaking to the points that Intra-abdominal pressure(IAP) augments intersegmental control,  and the use of preactivation and anticipatory feedforward mechanisms will provide the nervous system not only for control but for support of the lumbar spine & pelvis. The myofascial system operates to stabilise the spine in space, yet simultaneously allow dynamic movement, and the deepest portion is required for deep segmental control: too much or too little was deemed 'not useful'.

This coordination of functions requires the same muscles that are used in continence & breathing to maintain IAP and spinal stability are the same.

In walking or running gait, that much-debated muscle Transversus Abdominis is in a state of tonic activation, and never switches off.

In future blogs we will look at common running challenges prior to the Edinburgh Marathon, and other sporting performances.

And now you know a little bit more about how your insudes are all connected, and how optimum performance depends upon that connectivity!

Manipulation for back pain - more effective than drugs!

So medication for acute non-specific low back pain (or NSLBP) is not as effective as manipulation? We already know mobilisation of the spine works for chronic pain but this demonstrates improvement for acute pain!

Another hammer blow for the drugs industry? And is that physical treatment is available in Edinburgh?! Well certainly treatment rather than anti-inflamms seems sensible-and YES that treatment is right here!!!

A study of over 100 patients with back pain for over 48 hours duration were assigned treatment or medication (more of the non steroidal anti-inflammatory types of drugs such as in this case, diclofenac, alluded to in a previous blog TheEdinburghPhysioSPACEBlog NSAIDS ) or no active treatment.

Study: von Heymann et al 2013: 'Spine' Journal:HVLA Thrusts more effective than drugs or placebo

Both of the interventions made a difference on acute back pain, but the manipulation treatment group were significantly better off than the medicated group of patients with no adverse effects or harm registered.

These manipulations are essentially the therapeutic application of load to specific body tissues or structures and are broadly divided onto two categories, with one being high-velocity low amplitude, and the other low-velocity variable amplitude load.

Physios at SPACE are capable and skilled in the practice of manipulations for spinal pain here in Edinburgh's West End!

In the USA it is a different story, although there is evidence that the national physical therapy body is seeking to upskill our American colleagues to be able to add this form of treatment to their repertoire.

Dynamic Chiropractic: Warren Hammer 
This article from Dynamic Chiropractic cites an article written where manipulations can also be seen to be advantageous in the treatment of other spinal pain from the neck to the upper back, or thoracic spine ( Dunning et al JOSPT, 2012; 42(1): 5-17) and so our staff can have a significant effect on any area of your spine with manipulative techniques when appropriate, or other 'mobilisation techniques'. We have been practising them a while-and even the Cochrane Review has shown of their effectiveness in chronic as well as acute back pain as reported on our website: SPACECLINICS.com link to manips report.

Finally a study of spinal manipulation on low back pain from 2011 found that patients actually had the additional benefit of treatment of this kind in that their repositioning and body-awareness of their pelvis & lumbar(low back) area was enhanced even after 6 weeks following treatment. Even their response to sudden load was improved after undergoing treatment, as reproduced when the patient was blindfolded and subject to random loads in secure testing! Wilder et al 2011 Effect of spinal manipulation on low back pain

Don't reach for the medicines
 reach for the phone
01313133999

SO if you are in a bit of bother with your thoracic spine/mid back, have a pain in the neck, or are getting backache, lumbago or leg pain, it is sensible for you to seek expert assistance: instead of reaching for the medicine cabinet what about reaching for the phone or computer instead, and contacting SPACE for a health check and treatment that is more proven to work than drugs alone! 

Give us a call on 0131 3133999 for the good of your health!