Entries by Tobias Hall

5 Amazing Benefits Of Lion’s Mane Mushrooms

5 Amazing Benefits Of Lion’s Mane Mushrooms

Lions Mane

Introduction

If you suffer from lower back pain, neck pain, headaches, sciatic pain, shoulder pain or any other common type of pain that we often see here at the clinic you might have tried a number of ways to find some relief. But, do you think that a mushroom could help you with your pain? Often, people can be skeptical that something other than traditional over-the- counter medicines can provide them with relief. However there’s a growing body of research suggesting that one mushroom, known as the lion’s mane mushroom might hold potential to help with pain relief alongside many other health benefits.


What are Lion’s Mane mushrooms?

Lion’s mane mushrooms get their name from their long and shaggy spines that look like a lion’s mane. Also know as hou tou gu or yamabushitake, the mushroom can either be eaten, drunk as a tea or taken as a supplement. People often say it tastes like seafood, comparing it to crab or lobster.

For centuries, lion’s mane has been valued in countries such as as China, India, Japan and Korea for it’s fierce medicinal properties (1). Interestingly, research over the past decade has started to back up these observations.

While more research is needed on the effects of lion’s mane on humans, animal studies so far have been promising and make for what we think is extremely interesting reading. For the record – we don’t particularly like animal experiments. It could be considered sad that we can’t just draw from the long observed benefits of healing herbs like lions mane without devising cruel animal experiments to verify their effectiveness. But science is that it is and if we can learn from it we had might as well do so.

Now that we know what they are – let’s take a look at some of the potential benefits of taking lions mane mushrooms.


5 Potential Benefits of Lion’s Mane Mushrooms


Enhances Nerve Function

One of the most revolutionary discoveries about lion’s mane is that it can induce nerve growth factor (NGF) and repair cells quicker. (2)  NGF is a protein that plays a major role in the maintenance, survival and regeneration of neurons that are responsible for nerve function.

A 2012 study showed strong support for the regenerative properties of lion’s mane by demonstrating that consuming the mushroom can regenerate damaged cells from peripheral nerve injury. (3). In this study, rats were surgically given an injury to their peripheral nerves that severely imparied their ability to walk. After this, some of the rats were given water containing lion’s mane while others were given plain water. After a period of 14 days, the rats that had been given lion’s mane were able to walk again due to significantly better recovery to their peripheral nerves compared to those that hadn’t been given the mushroom.

What’s interesting about this study is that some rats were given more lion’s mane than others – but this didn’t change the rate of peripheral nerve recovery. That is, the improvement was seen even in smaller doses. If these findings could be replicated in humans, it may have a profound impact on the treatment of people with damage to their peripheral nerves, which can cause significant back pain, shoulder pain and neck pain.

Inflammation and Oxidation

Another powerful property of lion’s mane is it’s ability to reduce inflammation and oxidation. This has to do with the antioxidant properties of the mushroom. Although we hear the term thrown around often, not many people know what exactly antioxidants are. Antioxidants are molecules that fight free radicals (unstable molecules that damage cells) in your body. High levels of free radicals in the body are associated with inflammation.

Inflammation contributes to many medical conditions, including diabetes, heart disease, and autoimmune diseases. Acute inflammation can also cause pain of varying types and severity. Pain may be constant and steady, throbbing and pulsating, stabbing, or pinching.

A 2012 study evaluating the therapeutic benefits of 14 different mushroom species found that lion’s mane had the fourth-highest level of antioxidant activity (4). Because lion’s mane mushrooms are high in antioxidants, it’s believed that they are able to reduce inflammation and cellular damage throughout the body.

This idea is supported by a 2014 study where rats who were given lion’s mane demonstrated a significant reduction in inflammation of the brain. In fact, these same rats also showed a reduced risk of stroke (5). Another study showed mice with ulcerative colitis (a type of inflammatory bowel disease) had a significant reduction in intestinal inflammation after a period of consuming lion’s mane (6).

Anxiety and Depression

The anti-inflammatory properties of lion’s mane may also help reduce symptoms of anxiety and depression in mice (7,8). Other animal studies have also demonstrated that lion’s mane extract can also help regenerate brain cells and improve hippocampus function, an area of the brain vital for processing memories and emotional responses (9,10). It’s thought that an improved ability to process emotional responses might play a part in the reduced anxiety and depressive behavioiurs seen in mice.

In a 2018 study, mice who were given a high dose of lion’s mane mushroom for one month performed better on tests designed to measure both anxiety and depression. After treatement, mice who had been given lion’s mane spent more time exploring when placed in an open arena. They also swam for longer when forced to swim in a pool they couldnt escape. In other words, the mice felt more confident in open spaces and were less willing to give up when placed in a tricky situation – both signs of a reduction in anxiety and depression. 

Although lion’s mane’s ability to reduce anxiety and depression isn’t directly linked to pain, chronic pain is often closely associated with stubborn emotional conditions. Research suggests that patients with depression are not only more emotionally reactive to pain, but also are less able to modulate their perception of pain once it develops (11). A reduction in anxious and depressive symptoms then, might set people up to better deal with pain in everyday life. We all know how back pain, shoulder pain and neck pain can impact our mood, and have discussed how the surprising science of enduring pain in a pervious blog. Taken together, the ability for lion’s mane to not only impact nerve growth and inflammation, but mood as well makes them potentially very powerful when it comes to pain treatment.


Improves Brain Function

Lion’s mane’s impact on brain function is also seen in research suggesting it could help protect against Alzheimer’s disease.

A 2016 study suggested that lion’s mane mushroom and its extracts prevented neural damage caused by plaques that often clump together and damage neurons – causing memory loss. Indeed, the researchers also found that the extract decreased symptoms of memory loss in mice with Alzheimer’s disease (12).

Although there’s no research currently showing whether the mushroom can do the same for humans, it does appear that the mushroom have positive effect on brain function. Older adults who took three grams of the mushroom daily for four months showed improved mental functioning (13). What’s the most interesting part is that the improvement’s disappeared once they stopped taking it, strongly suggesting the improvements were due to the mushroom. 

Wound healing

The antinflammatory properties of lion’s mane may also help skin wounds heal quicker. Although further research is needed on humans, there’s evidence from animal studies to suggest the mushroom may have beneficial effects.

In a 2011 study, rats who were given a neck wound healed quicker when the wound was treated with a topical application of lion’s name extract. When the researchers looked at the wounds they found that they had less scar tissue area at the wound enclosure, fewer white blood cells (indicating less infection or pus formation) and greater levels of collagen. They also contained a greater density of new blood vessels (14).

Although they didn’t measure levels of pain in the study, it’s easy to suggest that having a wound that heals quicker means that the rats also spent less time in pain. A infected wound, or one that’s slow healing would have meant that any associated pain continued for longer.

The Take Home

The current evidence that the lion’s mane mushroom has a wide variety of medicinal properties is extremely compelling and makes for very interesting reading.

It would be unsurprising many of the findings within animal studies translate to humans. After all, the mushroom has been used in traditional medicine for centuries and it seems as if the science is now simply catching up to what people have been observing for a long time. However, to provide further clarification if there are any differences between what has been observed in animals, more research is needed in humans.

From a pain perspective, the idea that lion’s mane can help with reducing inflammation and nerve regeneration alongside improving brain function and mood means we think that they could be a powerful alternative to traditional pain and mood medications – which can often come with a bunch of side effects that impact quality of life further. Lion’s mane has proven to be safe in even reasonably large doses in rats with little side effects (22, 23), and if the same held true with humans it may provide an alternative to medicines that can sometimes come with a cost.






 

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Plantar Fasciitis Taping Vs Plantar Fasciitis Treatment

Plantar Fasciitis Taping Vs Plantar Fasciitis Treatment

Achilles Tendonopathy

Introduction

Plantar fasciitis is notoriously difficult to treat, thankfully though difficult is not the same as ‘impossible’. The difficulty in getting treated successfully is partly due to the sheer number of management options available. The number of possible ways to manage plantar fasciitis makes it tough to know which you should pursue. One of the key decisions that faces plantar fasciitis sufferer is around whether they pursue treatment or just rely on taping.

Before we weigh up the relative benefits of plantar fasciitis taping and plantar fasciitis treatment it’s worth defining these 2 terms. In many ways plantar fasciitis taping and plantar fasciitis treatment are not entirely separate topics but are interlinked. There is however a difference between the intention of plantar fasciitis taping and the intention behind plantar fasciitis treatment.

 Plantar Fasciitis Taping – The application of tape to the sole of the foot in order to stabilise the plantar fascia and provide support for the arch.

 Plantar Fasciitis Treatment – The use of tools and techniques that target the pain and scar like tissue of plantar fasciitis. 

*In this post we will ignore the important subject of ‘plantar fasciitis rehabilitation’ which stops the pain from coming back repeatedly. For now we’ll just call that part a no brainer. If you want to see the necessary exercises click here.

 Having thrown myself at treating people’s foot pain and plantar fasciitis for a couple of decades I have learned that by far the most reliable treatments for plantar fasciitis are those that break up scar tissue and increase blood flow in the sole of the foot.

The specific forms of plantar fasciitis treatment which target scar tissue (like shockwave therapy and graston technique) and blood flow make the biggest difference to the greatest number of people in the shortest amount of time. I am not the only practitioner who has come to this conclusion I can assure you! 

Weighing It Up

So out there, amongst the wide spectrum of possible ways you could manage your plantar fasciitis are the topics of plantar fasciitis taping and plantar fasciitis treatment, that’s clear. What is not clear is which you should choose, or even if you should choose either of them! 

The basic distinction to be made here is that plantar fasciitis taping and plantar fasciitis treatment have very different intentions. They are both obviously designed to help reduce your pain but the way that they go about that is very different indeed.

Plantar fasciitis taping does not seek to break up scar tissue or to promote blood flow. It does however seek to reduce mechanical stress in the plantar fascia What this generally means in practice is that plantar fasciitis taping is very useful for easing pain (especially in the short term) but that it should under no circumstances be used as a replacement for the all-important plantar fasciitis treatments that actually aim to heal the tissue.

So plantar fasciitis taping reduces strain in the plantar fascia – and plantar fasciitis treatment aims to heal the ‘injured’ tissue.

Plantar fasciitis treatments aim to create positive change deep in the tissues while plantar fasciitis taping aims to provide support by reducing stress in the tissues. So in many ways plantar fasciitis taping and plantar fasciitis treatments for blood flow and scar tissue are perfect compliment’s to one another.

What Does It Look Like

Plantar fasciitis taping techniques that aim to reduce strain in the plantar fascia and supporting the arch include a range of techniques and taping patterns.

 The plantar fasciitis treatments that aim to break up scar tissue and promote blood flow include..

 -acupuncture

-shockwave therapy

-guasha or scraping

-acupressure

-post isometric stretches

-mechanical massage machines

 If you are looking for help with plantar fasciitis treatment, plantar fasciitis taping or even help with a full rehabilitation plan for plantar fasciitis, heel pain or any other pain for that matter look no further. All our contact details are here on the site if you use one of the channels to reach out and tell us what is happening we will give you an honest indication of whether we think we can help. 

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The Surprising Science (and Non-Science)of Enduring Pain

The Surprising Science (and Non-Science)of Enduring Pain

The Science Of Pain Endurance

One of the most surprising truths about the biology of pain, is that pain does not happen in the body.

Now, before you ask for a complete refund, bear with me a moment. Just because pain feels like it’s in the body, it doesn’t mean that it is. Sensory perception and scientific truth don’t always line up.  It’s common knowledge that sciatic pain in the back of your leg doesn’t necessarily indicate a problem in the leg itself! By the same token, if you see a glowing aura around everything prior to a migraine, it doesn’t mean that your personal effects are actually glowing. 

Image depicting nerve cells involved in referred pains like sciatic pain, headaches and migraines.

The torrent of information carried within the nervous system and it’s cells can give rise to confusion over the true location of pain.

It’s only natural that we’ve always assumed pain happens down in the body. To our faculties of perception that’s exactly how it feels. It was however also natural that we assumed our earth was completely flat and the sun vaulted over the top of it once a day. Prior to the light of science being shone into the dark depths of reality for us, we often fall into cognitive traps laid by our limited sensory perception.

The truth of the pain matter is as follows… the pain we feel is created deep inside the brain – from where it is projected onto the body. 

The pain part of the brain is like a movie projector – it projects pain down into body parts that need to be ‘tended to’.  And just as there is no actual image on the projector screen in the movies,  there is no actual pain happening in the body. This analogy should help, but it has its limitations – because unlike the movie projector/screen, pain is a two way street. 

I said that pain happens in the brain, but I didn’t say the body wasn’t involved in the process, because of course it is. 

In order for pain to happen in the brain, there needs to be some incoming raw data from the body; which gets translated into ‘felt pain’. Science calls this raw data ‘nociception’. Nociception is the raw data the body generates when it is harmed. This raw data gives rise to the pain we feel, but only when the brain decides it’s necessary. If the brain doesn’t ‘tune in’ to it there is no pain at all.

If you touch a hot stove or hurt your back; nociceptor signals fire in your tissues. The nociceptive signals are sent as raw data to the brain. The brain reads that incoming raw data and translates it into finger pain or back pain, in an attempt to advise you of your mistake. Pretty simple, conceptually at least.

There are however times when things can get a little more squirly, and it is these moments that give the pain game away.

Have you ever cut or burned your finger and felt the pain an inch or more away from the injury? Or even in the wrong finger? Have you ever had a deep tissue massage or some acupuncture and felt the weird migrating ‘referred pain’ that happens during treatment? Perhaps you haven’t personally, but millions of us have. These examples are the brain slightly mis-interpreting the raw nociception that came up the spinal cord – so that you feel the pain in an unharmed part of the body.

If the brain fails to process the incoming raw data, there can be an injury with no pain whatsoever. This is why so many have reported delayed pain after being shot or stabbed unsuspectingly. The brain in shock failed to process the incoming data, so there was no pain… at first.

There are many other well known anomalies that highlight the true nature of pain. Phantom limb pain. Completely sane patients with headaches outside their head. Painless surgery under hypnosis. Painless religious ceremonies that involve stabbing ones self with kebab skewers. And many more examples besides.

Think of the raw nociception data generated by the body when it’s harmed is like radio waves. Radio waves are utterly silent, unless there’s a radio apparatus attuned into the signal. When the noise of the radio kicks in – it is all generated by the radios hardwear. Pain is generated within your brain’s hardwear – the nerve signals in the body are just like the silent invisible radio waves prior to them being received by a radio receiver! 

It’s pretty clear when you look at the true nature of pain that there is potentially scope for altering the way we manage our pain internally. If pain is really an artefact of the brain (and it is) the ‘laws’ of neuroplasticity and epigenetic influence may very well have some relevance on our journey towards a lessening of the vast physical suffering our species has always gone through. It is this deeper question of our immense suffering as a species that holds the real meaning here… far moreso than the science.

The  Human Dimension Of Pain Endurance

There’s a well known pain related spectrum that we are all part of. And it’s one that offers an important glimpse of the deep and complex nature of our pain. That spectrum is made of what we refer to as ‘pain thresholds’.

At one end of this spectrum – there are people who can endure unthinkable levels of physical punishment. ‘High pain thresholds’.

In the middle of the spectrum – there are people with reasonable pain tolerance. ‘Normal pain thresholds’.

And at the far end of the spectrum – there are people who are very sensitive to pain. ‘Low pain thresholds’.

 Normal healthy folk do all experience pain, there’s not really any question about that; because there data on rare genetic conditions that prevent people from experiencing pain indicate very clearly that you can’t stay healthy if you don’t have pain. What the differing thresholds reveal is variability in our brain function and psychology… our human experience. Our level of pain tolerance reflects how we process pain in our brains.

We are treading along an imaginary but still somehow very real line here. We are at the ethereal interface between what happens in our bodies cells and our psychology. The tendency would be to think of these 2 things separately – maybe on some level they are – and definitely on some level not. Either way, pain is not a simple on/off switch in the brain or in the body.

People with good pain tolerance tend to have a robust mindset around pain, and/or have experienced a lot of it (like experienced soldiers and athletes for example). These people manage pain well at the brain level. If you have had pain for a long time, it may have turned you into one of these!

At the other end, people with very low pain tolerance tend to be inexperienced with pain, and/or feel uncertain about the meaning of their pain. These people have often experienced very little discomfort in their lives, or alternatively have had a great deal of discomfort but failed to manage it resourcefully.  These people manage pain poorly at the brain level. 

The connection between our conditioning and how we handle pain it is not a simple one however, far from it.

Physical abuse early in life tends to polarise the pain threshold topic. Adults who were physically abused as children tend to land at the extreme ends of the spectrum; depending on how they learned to deal with what they went through. Some end up impervious to physical pain, others are are ultra sensitive 

It’s possible that not all pain thresholds come about just by chance conditioning and early childhood experience  however.

On 10 June 1963, U.S. press based in Saigon were informed that ‘something important’ would happen the following morning on the road outside the Cambodian embassy in Saigon. They were unsettled times, so in itself that was nothing unusual. But the event that followed created an emotional and psychological shockwave that was felt around the world.

The morning after the announcement, a handful of journalists turned up at the Cambodian Embassy. In due course a small procession appeared. It was lead by a sedan and followed by 350 monks and nuns marching in two phalanxes. The monks and nuns were carrying banners. They had come to protest.

At the intersection outside the embassy three monks emerged from the car. The first monk to emerge placed a cushion on the road. The second monk took a five gallon petrol can from the trunk of the car. The third monk made use of the cushion, using it to sit down in the lotus position. He continued to sit quietly as the monk holding the petrol can emptied the entire contents over his head. The sitting monk then gently thumbed his wooden prayer beads one last time, uttered a few words, struck a match, and dropped it on himself. 

After about 10 minutes the body toppled onto its back. Still in the lotus position. 

Once the heat had subsided enough to get close, a group of monks covered the man shaped block of charcoal with yellow robes. They then picked him up and struggled to fit him into the coffin and left.

The journalist who had shown up from The New York Times wrote “Flames were coming from a human being; his body was slowly withering and shriveling up, his head blackening and charring. In the air was the smell of burning human flesh. ‘I was too shocked to cry, too confused to take notes or ask questions, too bewildered to even think. As he burned he never moved a muscle, never uttered a sound, his complete composure was a sharp contrast to the wailing people around him.”

If you have ever wondered how much pain a human can endure – you now have your answer.

The monks name was Thích Quảng Đức and he was protesting the incumbent vietnamese government’s treatment of Buddhists… through ‘self-immolation’. And our basic assumption about his ability to tolerate pain should be that it was something that he cultivated over a lifetime of meditative practice. 

As well as posing sciency questions about the source of our ability to endure pain. Acts of extreme pain endurance like this reverberate within our collective imagination. Photographs of Thích Quảng Đức’s self-immolation made headline news across the entire world.  Communist China seized upon the image and distributed millions of copies, twisting it into a symbol of support for their own political agenda at the time. The Pulitzer award-winning photograph of Quảng Đức’s death became an icon in itself. And has been reproduced and referenced millions of times on merchandise, in films, television programs and music album covers.

Quảng Đức’s self-immolation didn’t just grab attention (as many extreme acts or protest do) either, it also had the intended specific effect. It was subsequently oberved to have been a turning point in the Vietnamese Buddhist crisis and a critical pivot point in the collapse of the South Vietnamese regime.

pain endurance

What are the limits of human pain endurance?

In reality though, the world need not have been so shocked by these events. Self immolation is an practice that has been undertaken by literally thousands of people in the modern era alone. Mostly buddhist and hindu monks.

To my mind, sitting in quiet dignity while every cell in your body turns to charcoal seems like an implausible feat. You are of course free to disagree, but before you do, try holding the tip of your finger in a small flame for 10 seconds with firm composure.

I manage pain for a living – bit I don’t know the first thing about the mechanics of how someone becomes willing to face that much pain. But knowing what I know about pain, as something that happens deep in the brain; it is hard not to entertain certain questions.

It’s not likely that Thich had a genetic insensitivity to pain. As far as we know he was a perfectly healthy 65 year old monk. There is also the fact of countless other instances of self immolation by buddhist monks. These clearly point to a practice rather than a freak genetic event.

In a sense the question of complete madness is neither here nor there. Whether a person reaches this level of stoicism by madness or by meditation; it still shows that it is possible for a mind to endure at this level.

In another sense, the question of madness vs meditation potentially matters a lot. Does dignified self immolation mean we (the clinically sane) have the potential to cultivate mind power to a point where we are that free? How much did he suffer? Did he have ability to switch pain off at will? Is it even possible to feel what we would feel and sit quietly?

Somewhere deep down we all want to be free of pain. Preferably by us not having any. But most of us will face scary pain at some point. Wouldn’t it be beautiful to be able to greet that without fear.

Can you and I learn to trip switches deep in our brain so that ‘raw nociception data’ doesn’t get converted into pain? That’s a life skill I for one would be keen on attaining. Although I confess the self immolation might not make it onto my list of party tricks. If it is a direction you choose to go in my job is to to make sure you can comfortable sit on your cushion in the lotus position, without a sore back and knees – prior to you merging with the Buddha as you purify yourself in the flames ;)

For me there is also a question of why one image of a burning monk would create such a profound and enduring impression on millions of people. Death and atrocity were very much routine throughout the 20th century after all.

Perhaps there is some wonder that someone could be that commited to a cause.  If you have ever thought it seemed like a hassle to sign an online petition, you’ll appreciate the commitment it takes to self immolate for a good cause. But I suspect there is more to our collective reaction than that. The pictures of Thich burning on the front of newspapers sent a seldom seen ripple of collective speechlessness across the western world.

Moments like these point again to that invisible transitional zone. Between the hard science of pain/and the profoundly un-sciency topic of human sufferingBetween what happens in our cells and what happens in our souls.

When JFK was shown the picture of Thich burning on the cover of a newspaper, his first response was reportedly “Jesus Chris”. He later said of the picture “No news picture in history has generated so much emotion around the world as that one’’. And yet another violent human death in the news was the most normal thing imaginable at that time in our recent past.

Quietly composed self immolation is a headline grabber because it heavily implies freedom – to our collective subconscious at least. Freedom from the physical struggle and suffering that come with being human. And that’s exactly what the gesture symbolises in buddhist monking circles. Caring about something bigger than yourself, enough that you are willing to sit serenely while your flesh is seared to the bone for it implies freedom from the baser physical parts of our humanity. 

The least buddhist and the most materially attached among us still seem to register this gesture of completely freedom on some level. That is why we clearly feel there is a very big difference between a monk quietly and willingly burning himself; and a monk being noisily and reluctantly burned by others.

The attention self immolation grabs, arises from our own deeper senses of the hold pain has over each of us. A hold that somehow steps over a line. This deeper sense of pain is not just a form of important biological feedback. This feeling about pain, is about something that constrains us – something that holds us back – something that scares us – something that makes life worse not better.

The ability to overcome fear and pain are ultimate expressions of strength. Especially so when they are faced as a sacrifice and not for personal gain. This points to the key traits of countless pop culture hero’s going back thousands of years. For good reason. There is something within us that see’s pains hold over us as being something limiting. So not only is there more to pain than simple nerve signals in the body – there is also more to pain than just the physical. 

The science of how the pain we experience is really generated within the body-mind is definitely interesting. Beyond simple fascination understanding may even prove to be a useful tool on the road to managing chronic pain better.

For me though it is the deeper human element that ignites my interest in this topic. Not the science itself -but what it might mean for my potential for leading a more fearless life.   If we can hack into our own brains pain centres the potential implications for how we engage with our bodies, with our fear, and even with death could be vast. We are all going to get sick, we are all going to get old, we are all going to suffer pain and loss. Is there a way we can learn to make this more okay?

I would argue that we don’t fear losing everything so much as we fear how it might feel. We don’t fear death so much as what it might feel to go through the process of dying. We dont fear pushing ourselves to the extremes of our endurance – we fear the pain we will experience as a result. For all these reasons and many more freedom from the hold physical and emotional pain have over us may be the deepest from of freedom that a human can express.

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A Surprising Sciatic/Back Pain Treatment Story

‘There is absolutely nothing I can do to help you’ I said.

The patient had lived through 3 months of sciatic pain so severe that she had barely slept in that time – let alone worked, exercised or smiled. If you know back pain and sciatic pain patients you can spot the ones with true sciatic pain before they even finish filling out their forms. People with true sciatica sit differently, talk differently, move differently and are often not even the same colour as regular pain patients. They tend to look slightly grey. All this is because true sciatic nerve pain is severe beyond belief.

For every 50 people who say they have some sciatic pain along with their back pain – only 1 or 2 actually have true sciatic nerve pain – thankfully!!!

This particular lady had true sciatic pain – I could see that from the other end of the waiting room. She had spent 3 months with sciatic pain so bad that she literally felt like there was a reduced  hot knife in her hamstring muscle – 24 hours a day. It was true blue neurological pain – caused by a large nerve being compressed. Not only that – she had an MRI scan to prove it – and you didn’t need to have any medical training to see what was the biggest central disc prolapse I have personally seen in 20 years of practice. All this is why I was telling her there was nothing I could do for her. I am not a surgeon.

True sciatic pain stemming from a lumbar disc prolapse is no walk in the park.

True sciatic pain is no joke – there sciatic nerve is a thick as your pinky finger.

The lady had met with a surgeon previously –  who ordered the MRI and he on reading it clearly instructed her that she must have immediate surgery to decompress the spinal cord. She had the worst case scenario whereby the actual spinal cord itself was being pressed upon by a disc. Not only was her immediate sciatic pain bad – the potential was that she could suffer longer term harm to her spinal cord which her symptoms clearly indicated was under huge pressure. I could not have agreed more with the surgeons assessment – which is why I was telling her I couldn’t help her – and that she should agree to the surgery immediately.

She had sought a second opinion (mine) and it was the same as the surgeons, we both felt strongly that the only possible solution to her sciatic pain was surgery. There was a however a complication that made the situation even more sticky than it might have been.

The lady had seen her husband go through 15 years of severely disabling back pain that he attributed to failed back surgery!!! She lived with someone who felt back surgery had ruined his life – a life that she herself had lived intimately with him. And as you might imagine this had left her with the most extreme fear of spinal surgery imaginable.

This lady, who was apparently in desperate need of spinal surgery for the worst back pain and sciatic pain imaginable – was more scared of the surgery than the life of searing and crippling agony she was currently living. Tricky to say the least! I spent quite some time trying to convince her that while there are always risks with surgery for sciatic pain – she really didn’t have any other choice if she wanted her life back in tact. But she wasn’t interested in what I had to say. She just kept begging me to try some form of treatment because she wasn’t getting sugery.

I sent her away and went home to sleep on it but the following day her answer was the same. So then I slept on it, and by the next morning I had figured out what I sensed was the best way I could serve this poor woman.

My plan was to offer her some safe treatments that wouldn’t aggravate the disc over a few weeks – not for pain relief though – just to prove to her that I couldn’t relieve her sciatic pain in any meaningful way. My hope was that this would act as proof that I couldn’t help her – and she would finally concede that surgery was the only option.

So we started treating her with acupuncture every second day – I felt like a bit of a fraud but I planned to refund her at the end of my sham treatment protocol to ease my guilt about deceiving her. What happened next was completely unplanned however.

When I was examining her and figuring out how to put some acupuncture needles in her back with the minimum risk of aggravating her sciatica I discovered that she had the worst muscle spasm I had ever felt in a lower back. Not surprising really, nor was it surprising that the spasm appeared to centre around her L5 0x disc.

When you have been treating pain for 20 years you can become quite compulsive about trying to ease whatever you can ease – it becomes a habit to try and ‘tidy up’ anything you think you can ‘tidy up’ – like a professional cleaner who reflexively does dishes at their friends house perhaps. So once I found this muscle spasm I thought that I might as well try and ease it off a bit for her – it wouldn’t effect the leg pain but at least she would have a bit of blood flow in her spinal tissues. No bad thing when your body is constantly trying to heal an uhealable wound UI thought.

So I used some fairly long acupuncture needles and went as deep into the muscles around her L5 0x  disc as I knew I could with stirring it up – which is actually pretty deep fyi – there is a lot off muscle in the lower back. And as part of my compulsion to help I thought while I was there I would put double the normal amount of needles i normally would – there was double the normal amount of spasm after all.

And this is where things got weird.

After my first attempt at relieving the spasm she came back the next morning and said she has slept better than she had done in months because the sciatic pain was a little less. I figured this was almost certainly a wisp of placebo, and there was no harm in her getting a little sleep – she would need whatever rest she could get with surgery on the horizon. But when I felt her back the spasm was a little less and she was moving better. So feeling happy for her to have slept better on the second day (again compulsively) I put double the amount of needles in her lower back – so she had quadruple the normal number of needles I would normally put in the lower back of a patient. And this is where things got weirder.

Needles like the ones that released this lady's sciatic pain

Acupuncture needles, a very ancient tool for treating back pain and sciatic pain – clearly useful in some instances.

On day 3 she came back and her sciatic pain was 90% gone. She had slept like a baby and walked into my office with a huge smile on her face – a face which had gone from greyish to a healthy happy pink. There was however another part of her body which had changed colour too – her lower back. She showed me her lumbar spine and there was what looked like a huge bruise covering her ENTIRE lower back – her whole lower back was bluish green. Much of the muscle spasm was gone too and she was moving normally.

After another week passed all of her back pain and sciatic pain was gone and so was the ‘bruising’ on her lower back. She felt completely normal. Fast forward a year and she sent me a message from Africa – she had just climbed Mount Kilimanjaro in the middle of a round the world holiday and was living a completely pain free and normal life. Fast forward 6 years and I sat down and had a coffee with her – she was still completely pain free and had persisted with the core exercises I had taught her to maintain stability in her lower back.

You might say she was foolish to have refused surgery knowing that disc was no doubt still damaged. But you’d be overlooking the irrefutable fact that literally millions of people have silent disc prolapses that never cause them any problems. You might think I was irresponsible for opening a door that led her away from surgery – but that was the opposite of what I was trying to do – I resolved her pain completely by accident.

In terms of explaining what might seem a little miraculous I have what I believe is a pretty solid theory about what actually happened inside her lower back. She absolutely did have a disc prolapse (and probably still does)  – but the real cause of the nerve pressure was a coffee mug worth of swelling (like a big fat sprained ankle perhaps) right around that disc. Somehow the needles triggered a release of the swelling and in an instant she became one of the millions of human beings living with a disc prolapse and no pain. The release of that swelling was so great that it showed up looking like a giant bruise that spread through the tissues of her entire lower back region.

For my part I already knew disc patients could live with no pain – it just never occurred to me that someone with severe sciatic pain and a disc prolapse as bad as hers could live without pain. I also believe that the core exercises helped bind the area and have helped prevent further damage occurring. We’ll probably never know for sure though – because she has refused to go near a hospital for her back since – even for a scan. Which is ultimately her choice.

Does it seem like an improbable event to you?

Perhaps this whole scenario isn’t as surprising and improbable as we might think… after all its not as if we know much about the science of back pain and sciatic pain yet… not in the same way understand dentistry for example.

Did you know that dental pain has not always been caused by tooth decay? It used to be caused by worms that burrow into your teeth, at least that’s what we thought up into the 1600’s anyway: and it makes a little more sense than you might think.

The little round holes in ships and furniture are made by worms. And it’s not as if we ever see those little critters doing their thing. We simply assumed that a worm wiggled into your mouth while you slept, and burrowed into the enamel.

If you know what worms do for a living, the hole in the tooth looks like a smoking gun. Then when you pull a tooth, there is a dangly little worm like structure (the root), seemingly the culprit!!

It seems a little silly to assume that the root of your tooth is a worm that burrowed in there, if you understand neurology and microbiology the way you do. But before the microscope we had to figure out things like tooth pain using ‘common sense’.

How much do we really know about pain?

Do we really know much about sciatic pain and back pain?

The worm theory is far more commonsensical than the actual ultra-weird truth about tooth decay. Hundreds of billions of tiny life forms clinging to the surface of your teeth, so small that even in those numbers they are completely invisible. Feed them too much sugar then their digestive juices melt your enamel? Compared to that bizarre fact of life, surely the worm was a perfectly sane and understandable theory?

So perhaps understandably, the myth of dental worms was a popular one for a long time. Theories on and treatments for tooth worms spanned many cultures and eras. It would appear trying to smoke the little monsters out was a popular strategy, as was tooth extraction.

Sometimes we are incredulous about an event because we have a genuinely deep knowledge base and the event was truly improbable/rare/miraculous. Other times we are incredulous simply because we just didn’t realise that it was possible -or simply because we had a lack of awareness and experience of that part of reality.

You may have a clear explanation for why my crazy sciatic pain story seems improbable. But where does your explanation come from? It’s not likely to be based on meaningful first hand knowledge of putting large numbers of very long needles into the lumbar spines. And it is just as unlikely that anyone you know, or have ever known has tried out that method with a group of ‘disc patients’.

So what specific knowledge base are you drawing from when we deem it an unlikely event? Maybe you simply assume if that type of thing worked then doctors and surgeons would be advertising it? If so I would definitely advise you against assuming your doctors know about every possibility worth considering… especially about pain.

I would argue that both you and I would tend to be a little incredulous about that lady’s recovery because we are ‘so knowledgeable about pain’. We are incredulous because we know very little about pain… yup even me the supposed expert.

If we went back to the 1600’s and told them that tooth pain wasn’t caused by worms what do you think they would have said? They has seen those worms with their own eyes, they believed in them every bit as much as we believe in injured discs compressing nerves.

You live in a world that understands the gases in distant stars better than it does many kinds of pain. Almost everything you’ve been told about your pain is incomplete at best!

Who Wrote This Blog?

The truth is, I am just someone who’s seen a lot of pain. Thanks to an army of very trusting people who I have had the honour and privilege to assist.  And yet my take on pain is just one tiny star in a literal milky way of possible perspectives on pain. Naturally though, I believe that my little pin prick of light is a fraction brighter than many. If I didn’t, why would I go to the trouble of writing about it?

If I am not deluded, and my perspective on pain does in fact shine a little brighter than some. It will only be because it drew light from many other sources over a long period of time; and condensed them into something useful.

I have been treating pain for ages!

I suck at lots of things – but I am good at roast potatoes and pain management!!

It kills me to admit this, but the truth is there are many things in life I’m unusually bad at.

All manly made sports that involve a ball, elementary DIY tasks, elemental mathematics – being vulnerable – essential IT processes, remembering to buy light bulbs – small talk – keeping on top of paperwork. Just a few examples, from the list of lifeskills my ego would rather I was good at. In many of life’s arenas I’m little more than a running joke amongst those who know me best.

Am I bad at these things just because I believe I’m bad at them? I couldn’t say. Either way, as I type this now I do objectively suck at each of them, and many other things besides.

So as you can see, I’m more than willing to consume my spiritually nutritious humble pie when required. But I can also own up to the few things I am good at.

I do not suck at making roast potatoes – I am good at drawing – I am great at looking after animals – and I definitely don’t suck at helping people out of  stubborn pain. Over a long period of time I believe I have been able to consistently demonstrate that I’m unusually good at all of the above. There is a solitary valid reason why it’s worth me talking myself up here.

The fact that I am honest about my limitations and realistic about the fact I am good at treating pain means I may be able to help you. I have helped a tonne of people feel better, move better; and stay that way –  so there’s a meaningful chance that I can help you in some way too.

I’ve spent 20 years ‘in the trenches’ treating people with really stubborn pain. I have also spent 25 years reading obsessively about pain and wellbeing. I literally haven’t read a single fiction title in 25 years. I have meditated and read on this pain thing for a long time and it has beaten me into a state of open mindedness.

My first big professional realisation about pain after escaping 6 years of college and university was that I didn’t know much about it. I remember being really despondent about that at the time. I’d expected to walk away from my education feeling like a boss, not an absolute rookie.

I had worked my arse off too. Got through 6 years of higher learning, passed with near enough top marks – and still I came out up to my neck in uncertainty about the true nature of pain. I suspect it was that harsh realisation – after all that effort – that shocked me into a permanenently open minded state regarding pain.

Either way, it wasn’t a conscious decision to play the last 20 years open mindedly. But looking back I’m so grateful I did. Because, by good fortune, it turns out open mindedness is a major asset when you’re trying to navigate and influence highly complex systems – like the human body.

Being open minded means I have always anticipated deeper understandings of the pain I see impact so many lives… and possibly as a result, they keep coming!

Fast forward 20 years of hard graft and x thousand successful missions later – I am still open to new learnings.

So… if I’m still open to new perspectives after all that, then you should be open too, even to ideas that surprise you. Cautiously open though of course!!

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Should I Wear Custom Orthotics For Flat Feet?

Should I Wear Custom Orthotics For Flat Feet?

Flat feet

Flat Feet Intro

Flat feet and the problems that go with them are the most common reason for people to seek a custom orthotics prescription.

Having flat feet can be a serious cause of pain and injury for many people, this is old knowledge. Even back in the day when they were screening soldiers for WW1 having flat feet were a barrier to entry into the military because they knew that flat footed soldiers could be an injury prone liability. Flat feet have been implicated in a host of pain and injury issues over the years. 

A great way to understand flat feet is to realise that essentially flat feet have very poor postural alignment. Imagine a person with really bad spinal posture and quite a hunched back – that situation is very similar in nature to the flat feet situation. Both flat feet and classic poor spinal posture involve the following – muscle weakness – genetic shape of bones – environment – lifestyle factors. 

Foot Misalignment & Repetetive Strain

The reason flat feet cause pain and injury problems like plantar fasciitis, back pain, knee pain and hip pain is constant repetitive misalignment of the foot and leg bones during weight bearing. If the arch collapses under weight bearing the ankle folds in, the knee internally rotates and the hip also internally rotates in an awkward way. These relatively small but unnatural movements repeated millions of times cause ‘repetitive strain’ which can eventually undermine the tissues.

Ankle sprains, plantar fasciitis, heel pain, hip bursitis, ACL injuries, meniscus tears, muscle strains, ITB syndrome and hernia’s are but a few of the issues that can be majorly contributed to by flat feet. These are also the issues that so often have people with flat feet seeking support and help from custom orthotic devices.

Environment 

In an environmental sense it could be said that having flat feet might not be as much of an issue for us if we had not invented concrete, tarmac and paving. There is no intrinsic support under our feet now, not the way there was when we still lived outdoors. The lack of shock absorption and support under our feet in the modern world is a major issue for all of us but especially for people who have flat feet but don’t wear custom orthotics. 

Since long before our direct ancestors were even in vaguely human form and still walked on all 4’s – they walked on soft, natural surfaces. A million generations of human ancestors evolved walking on soft ground. Moving around in the big outdoors is a very different life for the feet than living in the urban environment.

Hard flat ‘urban terrain’ like paving & concrete is incredibly stressful not only to the joints of the feet but to the joints in the entire lower half of the body because it doesn’t absorb shock. Imagine the feeling of jumping down off a sea wall onto the beach and letting your heels squash into the sand… now imagine the feeling of jumping that same height onto concrete heels first .. big diff !!!!! The first option can be done for fun, the second option could cause significant injury. This is a window of visualisation into what the real difference is between surfaces like concrete and natural terrain… remembering that we take millions of steps per year. 

For those with the combination of physical factors we call flat feet, the absence of shock absorption and support combined with hard flat surfaces is particularly disastrous … remembering that the the arch of the foot is a shock absorber ! 

Custom Orthotics For People With Flat Feet? 

Custom orthotics provide shock absorption for the heel and the arch of people with flat feet, they also provide a dynamic flexible surface for the arch to interact with. This combination of factors mimics the natural surfaces that your feet evolved to live on.

When a person with flat feet puts in their orthotics they sometimes feel completely different straight away. Many find that in a matter of weeks they don’t want to  go anywhere without their custom orthotics in their shoes. This is because a biological need that their body has been deprived of for a long time has finally been met. Thereafter most report a gradual reduction in the symptoms that came with their flat feet, be it foot pain, plantar fasciitis, heel pain, ankle sprains, knee pain, hip bursitis, IT band syndrome or lower back and hip pain. 

Conclusion

The truth is that the fundamental reason custom orthotics are so desperately important for people with flat feet are quality of life and basic physical freedom. Being able to move around comfortably without pain and without the threat of injury forms one of the most basic building block of our happiness.

The ability to lead a normal active life without pain and limitation of movement is a big deal … just ask anyone who has experienced the loss of this and they will let you know. . These facts are what the importance of orthotics for flat feet really boils down to. 

 

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Navigating IT Band Pain Syndrome

ITB BAND PAIN SYNDROME INTRO

The reason iliotibial pain is a worthwhile topic to investigate is on one level quite painfully obvious; pain is not fun and those of us in our right minds want it gone. Beyond the immediacy of not enjoying pain though – there are much deeper and broader reasons to learn about and resolve your ITB pain. We will take a deep dive into this and into the relevant solutions here.

Stubborn pains are nearly always signs of ‘wear and tear’ occurring in the body, that we ignore at our peril. The pains in your leg are no less of a call to action than the pain you get when you touch a hot stove. You aren’t supposed to ignore the hot stove pain because you can get burnt: and you aren’t supposed to ignore the IT band pain because you could develop wear and tear or at least significant scar tissue in your leg.

Most of the stubborn ITB pain syndromes we treat people for at our clinic are functioning as an alarm bell for broader microscopic ‘wear and tear’ that has begun to accrue in the patients lower body – and not only in the thigh and hip, but also the ankle knee and hip too.

If your IT band is under strain your whole leg is under strain. If you have IT band pain and have also noticed other pains like knee pain, back pain, foot pain or hip pain (on either side) they probably relate to the same underlying weaknesses/imbalances that cause your foot pain. If you only have iliotibial pain that’s good – but there may be stress playing out ‘quietly’ in other areas that will need attention later.

From my perspective – after 20 years in the front line of pain management the big reason to get on top of ITB pain syndrome is in reality freedom. Our entire lives are based on the ability to move, even for the most sedentary of us the ability to get around is a cornerstone of health, happiness and freedom.

I meet a huge number of young people (under 70) who are suffering desperately from a loss of the freedom to move comfortably, and I see both their health and happiness suffer as a result. Freedom to move –  freedom to stay active and healthy – and the freedom to have a choice in what we do with our lives; that’s what is at stake when we are learning about and managing pain. And no offence intended – but many of you have a bit still to learn in this area.

Up until the 16th Century people had no idea that there was such a thing as bacteria and they had no idea what caused tooth decay. Believe it or not, most people thought that the holes in their teeth were caused by a  little nocturnal worm that burrowed into your tooth.

It seems amusing to us. But if you think about it the boara holes in wood are caused by little worms, so there was definitely logic in the theory. If you don’t know that microbial life even exists (they didn’t) how could you hope to understand the underlying process behind tooth decay.

There is a good reason for the brief history lesson. Many of us these days are almost as unsure of the real causes of our iliotibial band pain, foot pain, back pain, hip pain, ankle pain and knee pain; as folks were about the causes of tooth decay back then. And not only do many not know what the cause is, most seem quite unsure as to what the steps they should take to resolve their ITB pain etc.

The lack of understanding wouldn’t matter so much, except generally our understanding of such things tends to dictate how successfully we self manage, and also how skilfully we select the right professional help.

ITB BAND PAIN TREATMENT OVERVIEW

For most iliotibial pain syndrome sufferers a very straight forward 3 step process is the best template for resolving their pain.

STEP 1 – Diagnosis and Education. Identify and understand the pain, and the cause of pain.

STEP 2 – Pain Management. Deal with inflammation and scar tissue in painful area. Relieving but also in preparation for proper rehab.

STEP 3 – Rehabilitation. Usually some combination of gentle daily strength exercises, some stretching  and custom insoles prescription. 

CAUSES OF IT BAND ITB PAIN GUIDE 

The truth is that all stubborn pains including IT band pain are complex. There is no single root cause in a stubborn case of back pain ITB pain or plantar fasciitis. Stubborn pains are more like jigsaws. The good news though is that there are usually a few key pieces of the jigsaw which fit together to make life  becomes a whole lot easier.

Let’s take a generalised look at some of the jigsaw pieces that underpin most persistent cases of IT band pain.

Genetics

The shape of the bones in your ankle was decided long before you took your first breath. The shape of these bones determines how and where you bear weight in your foot. In addition your ankle bones determine how you stand and walk but also how high your arches are and the amount of work your hip muscles need to do to keep you in alignment.

The shape of your ankle bones is a key factor in generating IT band pain syndromes’ because they influence where ‘repetitive stress and strain will tend to occur in the connective tissue of your leg Without going into unnecessary technical detail – those of us with slightly more extreme bone shapes tend to get more pain over a lifetime.

When we are helping people with ITB syndromes we use a wide range of tests and investigations to determine the shape of their ankle and foot bones. Understanding the shape of the ‘ankle bone architecture’ helps make prescriptions that take stress off your feet…but also your IT band.

Environment

The truth is that concrete, paving & tarmac are as much of a factor in instances of IT band pain as lollies/soft drinks/cake are in instances of tooth decay.

The density of concrete in particular is extremely unnatural for our bodies, compared to natural surfaces like sand, dirt and paddock. The hardness of urban surfaces like concrete creates a lot of compression and irritation in the connective tissues of our lower body – even through our shoes.

The extreme flatness of urban surfaces is also a big issue for our bodies. The muscles in our feet, knee and hips were designed for the hard daily workout that comes with living on uneven outdoor terrains; when they are only exposed to flat surfaces muscles gradually waste away over time. Muscle wasting in the hip, leg and foot is a major factor in determining who will get IT band pain and who won’t.

Lifestyle

Your lifestyle to a large degree determines the physical condition of your iliotibial band, knee and hip – and all the other parts of you for that matter.  The relationship between your lifestyle and your IT band is that familiar old story of balance.

If you play 7 hard games of basketball a week and run 10k every sunday on pavements you massively increase your exposure to stress and strain in your iliotibial band and all the structures it depends upon.

If you sit at a desk all day and lie on a couch all evening; and you just don’t have the time, interest or energy for ‘working out’ you become severely weakened through the lower limb. If we don’t mover ur bodies turn to jelly – andmuscle weakness massively  increases the likelihood of ITB pain.

None of the above is meant necessarily to judge how much or little or little activity you should choose as an individual – your own conscience can be the judge of that. I am just letting you know that if you are live life at the extremes you may be contributing to your IT band pain.

The happy news is that a significant number of the people I have helped resolve their iliotibial pain syndromes over the years were at the extreme ends of the activity spectrum and yet it still hasn’t stopped us getting them relatively straightened out in most instances.

Stress

Perhaps surprisingly or unsurprisingly (depending on your level of experience with such matters) stress has been a factor in many of the worst foot pain cases we have helped people with over the years.  We aren’t going to delve too deep here though because we don’t need to. But I am going to tidy this issue up for you in case you need to hear it.

We are physically and mentallY only designed for short periods of stress – not long periods of stress. Long periods of stress effects our bodies!!!

When we are stressed for sustained periods, those of us in vigorous health get few symptoms; but those of us with a weakness or imbalance somewhere in our body will often develop some symptoms in that area due to the effects of the stress. Those with gut problems get tummy pain, the ones with skin problems get outbreaks, those with a weak core get back pain and those with weaknesses in their leg and foot get… you guessed, it well done.

Once again though the news is good! We have treated many people over the years with IT band pain that was triggered by stress. Happily though we can usually still get a good outcome – if the patient is able to take their attention off the stress long enough to do what is necessary to heal.

Often when managing a patient with stress related iliotibial band pain we provide simple coaching on good ways of starting to incrementally reduce stress – which often helps reduce the pain   The truth is though there are no magic bullets for stress – and managing stress is one of life’s big challenges.

The maintenance thrust of our intentions is basically to help people with their physical issues. In a way that makes them more like all the millions of people who don’t get leg pain when they are stressed; this is usually a very achievable goal.

PAIN RELIEF FOR ITB PAIN

If you have plantar fasciitis or heel pain you will most likely show up looking like any other case needing treatment for IT band pain. Under the surface though you will have a pattern of inflammation, scar tissue build-up and muscle weaknesses that are unique to you!

Treatments for plantar fasciitis that increase blood flow to the plantar fascia.

Treatments that increase blood flow to the IT band can be very useful for promotion of healing and reducing inflammation. Hot and cold therapy, massage, foot rolling and acupuncture are just a few of the ways we can attempt to increase blood flow to the iliotibial band and find some relief. For better outcomes though it is often necessary to so work that attempts  to create deeper changes within the soft tissues.

Treatments for IT band pain that break up scar tissue in the foot.

Most IT band syndrome sufferers ultimately find that it is the breaking up of scar tissue and adhesions in the IT band and its associated muscle groups that brings the most releif.

Scar like adhesions create tightness and mechanical difficulty for the IT band and it will tend to generate pain signals for as long as they stick around. People who foam roll endlessly are repeatedly loosening off this type of adhesion, but rarely getting into it deep enough to get lasting relief.

Graston technique, deep tissue massage, myofascial release and extracorporeal shockwave therapy are all excellent ways of breaking up scar tissue and adhesions in the IT band and its associates muscles.

Treatments for plantar fasciitis that reduce pain signals.

Pills are great, we love them, painkillers are the 8th wonder of the world when you really need them. We should pay respect to the clever people who develop them so that we can get ourselves out of tight spots.

But let’s be honest – pain killers don’t break up scar tissue; pain killers don’t strengthen your glute muscles and prevent your arch dropping – and they certainly don’t reduce the strain of concrete on the soft tissues of your leg.

Ultimately the value of any IT band syndrome treatment is determined 100% by whether it works for YOU – both in the long and short term. That said there are some general rules to be aware of when choosing treatment options for ITB syndrome.

By far the most reliable treatments for plantar fasciitis are those that break up scar tissue and increase blood flow in soft tissues. The forms of IT band treatment that target scar tissue and blood flow make the biggest difference to the greatest number of people in the shortest amount of time. And we are not the only practitioners who have come to this conclusion I can assure you!

Understanding that there are a group of IT Band Pain treatments out there that generally work better than others; and that they all have the same broad intention, is a good way to understand the relative usefulness of the ITB pain treatments on offer.

REHAB FOR ITB PAIN

Once your ITB band pain syndrome has settled down and you are able to have fun again without paying the price of ITB pain its time to make a very big and important decision.

Do you carry on as you were, or do you try to fix the underlying problem. Fixing the underlying problem is called rehabilitation – the idea behind rehabilitation is that it prevents your IT Band pain from coming back in the longer term.

It usually takes a bit of discipline to persist with fixing your ITB pain syndrome in the longer term – and it’s nowhere near as easy to get up for your exercises when you are back to feeling invincible. But… any effort that we’re willing to put into conquering the more and lazy short sighted aspects of our personality is likely to be well worth it in the longer term.

If you want to effectively rehabilitate your IT Band Syndrome in the longer term there are 3 types of activities that you may need to look at – each of them tend to specific parts of the underlying biomechanical issues that caused your ITB issues in the first place.

Stretching & Foam Rolling 

Stretching and foam rolling form the mainstay of most peoples ITB self management and the mainstay of the prescriptions made by countless PT’s and pain practitioners. This is for good reason – the tightening to the iliotibial band is a major component in ITB pain syndromes and releasing that tension can bring a great deal of relief. Restoring flexibility to the IT band is also extremely beneficial fo0r the biomechanics of the knee, hip and ankle – because the ITB helps with the tracking of these joints and the distribution of force during periods of activity.

While stretching is an excellent tool that can be used within a broad strategy for rehabilitating ITB syndromes it should not be relied upon solely. Tighteness and stiffness in muscle and connective tissue are ‘reactive’ phenomena – they happen as a reaction to underlying strain on the body. The higher level activities required to effectively rehab IT bands is the stuff that reduces the strain in the longer term – thereby preventing the IT band from tightening up endlessly in the first place.

Strengthening 

The IT band is to a large extent involved with helping transmit muscle forces onto bone. Muscle weaknesses and imbalances mess with the function of the IT band and tend to create irritation. When the glutes in particular are not firing coherently and cooperatively with other major muscle groups ITB pain syndromes are a common result.

Stabilising the leg and the IT band by increasing the strength and supportive power of the leg and hip muscles is a major part of how most ITB pain syndrome sufferers get themselves from being stuck with ITB pain to being free of it in the longer term.

Beyond understanding their intrinsic importance in rehabilitating ITB pain – the key thing to understand about strength exercises is that they have to develop the right kind of strength.

If you use heavy weights on machines to increase the bulk in the supporting muscles it will only be beneficial if you perform those movements with good understanding. if you do the weights in a disorganised way the muscles will become strong in a disorganised manner – which can be counter productive – as can putting extra strain on the IT band during faulty heavy lifts.

On top of ‘brute strength’ work performed in a careful manner – most IT band pain sufferers also a havegreat need for better balance and ‘proprioception’. This type of strength helps ‘re-educates’ the glutes and other leg muscles – helping them re-learn how to support the leg and take strain off the IT band.

We live nearly our whole lives on hard flat surfaces – unlike our ancestors who were on constantly uneven and changing terrain for most of their lives. All this walking around on hard flat ground tends to make our leg and hip muscles sloppy – this is where balance and proprioception exercises for IT band come in handy for those who are looking to save their own day.

Orthotics

The need for orthotics also stems from the differences between an ancestrally normal existence, and a weird urbanised existence.

When you live in the big outdoors your feet tend to squish into the mud/sand/leaf litter. We call that footprints. Footprints are left when the ground conforms to the arch of the foot. In other words natural surfaces provide arch support – in other words we evolved to need arch support.

A major part of the reason for the IT band pain plague (along with the back pain – ankle pain – knee pain – hip pain – sciatic pain plagues) is the lack of ancestrally appropriate arch support we get when we move around the urban environment in fashionable footwear. Wearing custom orthotics in our shoes bridges this gap and brings massive relief to a vast number of ITB pain syndrome sufferers. The key to finding out whether you need to do the same is in depth gait analysis and biomechanical analysis of the foot – which is what we do with IT band pain sufferers at Featherston Street Pain Clinic.

CLOSING THOUGHTS

Whether you have ITB pain, knee pain, hip pain, back pain, ankle pain, shoulder pain or even pain in your pinky toe – whatever effort you are willing to put into finding resolution is likely to pay off in the end. We meet people on a daily basis who have been through 10 or more different practitioners and treatments before they find one who can help them. Their stories are the reason you should continue to strive for effective management of your IT band pain – even if you sometimes feel like giving up hope.

 

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The True Cause of Plantar Fasciitis 

Achilles Tendonopathy

Introduction To Plantar Fasciitis

The term plantar fasciitis (pronounced plantar fash-ee-eye-tis) is somewhat scientifically outdated – its literal translation meaning ‘foot inflammation’ specifically in the plantar fascia.

The plantar fascia is ligamentous sheet made of flexible, fibrous tissue –  and it stretches from the heel bone to the ball of the foot. The plantar fascia forms a stiff but elasticated arch that distributes and absorbs the daily impact of weight bearing movements – like walking, running and Zumba. 

The feet themselves are a pair of natures engineering marvels – and as such they are able to bear the brunt of the 3-5 millions steps that the average adult takes each and every year. This insanely high work rate leaves the entire foot open to injury, overuse and repetitive strain.

Living in the space between hard ground and bone the poor plantar fascia is open to damage in the form of small tears – micro-injuries & scarring.

In an effort to reinforce the fascia and it’s boney anchor points, the body sometimes even develops bone spurs which are somewhat like a callus formation. It is thought that in partularly bad cases these bony protrusions can dig into the fatty pad of your heel and exacerbate the pain of plantar fasciitis pain.  

But What Is Plantar Fasciitis Really?

Plantar fasciitis was once thought to be an inflammatory condition but on closer scientific scrutiny it is now known to be more of a degenerative disorder. This is why the term plantar fasciitis is a little outdated.

Under the microscope plantar fasciits is made up of the aforementioned degeneration – micro-tears, disorganised collagen fibres, scar like adhesions and compromised blood flow. It’s hypothesised that constricted blood flow is responsible for localised nutritional deficits that impaired healing.

Modern medical researchers including Dr. Kendrick Allen Whitney, DPM have developed a preference for the term Plantar Fasciosis or Plantar Fasciopathy instead of “Plantar Fasciitis”. This is because these medical terms more closely reflect the actual degenerative cellular changes we see in plantar pain sufferers. 

And What Causes Plantar Fasciitis?

All this is very interesting but of course. It is all the more important however that we are able to turn these insights into the underlying causes of ‘plantar fasciitis’ pain in the tissues into something that brings you lasting relief! 

There are really only 2 mechanical ways to cause degeneration in healthy tissues. Either by a single event injury – like jumping off a high wall onto hard ground and hurting your foot – or through a repetitive stress that the bodies tissues can’t sustain over time. The cause of almost every case of plantar fasciitis is the latter – repetitive strain, which is what all those changes under the microscope is really showing . 

Putting this build up of repetitive strain in context –  it is very important to be aware of how many people there are without plantar fasciitis. It is estimated that 1 in 10 of us suffer from plantar fasciitis in their lifetimes – which is clearly no the same as 10 out of 10.

So the real juicy question we might ask about plantar fasciitis is that given approximately the same mileage, same footwear companies, same environment, same hobbies, same foods – why is it that some are dealt the plantar fasciitis card and other are not? Here is a list of commonly implicated factors…


Excessive Pronation and Other Gait Abnormalities 

Pronation is a natural movement of the the foot that occurs during weight bearing. Excessive pronation however can cause problems on the theme of repetitive strain to tissues and plantar fasciits is one of them. My experience has been that excessive pronation and the factors that tend to go alongside it are a major cause of plantar fasciitis. 

Excessive pronation is caused by a combination of genetic, environmental and lifestyle factors. Some of these factors can be addressed while others are obviously non negotiable. It excessive pronation is a significant cause of your plantar fasciitis it is highly likely you would benefit in the longer term from a combination of rehab exercises and insoles both of which have the power to limit excessive pronation. 

Overuse

Failure to give your feet the amount of time they need between exercise sessions and/or long periods of standing can overload the plantar fascia and be a significant cause of plantar fasciitis. 

One classic patient who finds overuse is the cause of their plantar fasciitis is perhaps unsurprisingly the high mileage endurance athlete. Another classic would be the patient who finds the cause of their plantar fasciitis is standing all day on concrete in their retail job.

There is a subtle layer of understanding hidden within the topic of overuse that a percentage of us find is important. ‘Overuse’ to some degree is a relative concept, there are many cases of overuse in which the actual ‘mileage’ is reasonably low but the individual still finds it to be the cause of their plantar fasciitis. This is essentially due to a lack of strength in the lower limb and foot.

To a massive degree plantar fasciitis is prevented via the support provided to the foot by the muscles in the lower limb. Weakness of those muscles if they fail to provide adequate support and sustain alignment during active times can mean that a simple 10k walk twice a week qualifies as overuse and as such can cause plantar fasciitis. . 

Arch Abnormalties 

Both very high and very low arches ( flat feet ) can cause plantar fasciitis. Your ancestors walked mostly on soft ground like that you find on grasslands, in forests and sandy regions. You walk on rock solid flat ground like concrete, paving and tarmac. If you reflect for a moment on the human footprint it’s pretty self evident that there is an arch supporting nature to it. As your ancestors ran and walked they left footprints much of the time – and every time they did so they received the benefit of a nice soft arch support made of mud, sand or vegetation. 

Often in life it is those of us at the extreme ends of any spectrum who show up in the stats. When it comes to body mass for example you don’t want to be at the extremely skinny or extremely ‘unskinny’ ends of the spectrum for ideal health.

People with very high or very low arches are more dependent on natural arch support to limit strain in their plantar fascia than those with more average arch height. If you work with pain sufferers for a couple of decades it becomes very apparent that high arches and low arches are a significant cause of plantar fasciitis. 

Weak or Tight Surrounding Tissue

Weak glute muscles, reduced ankle mobility, or tightness in the Achilles tendon are all key players in many plantar fasciitis cases. The poor old human foot has an unimaginably hard life.

The heel bone hammers down onto hard ground preferably more than 10k times per day and that’s before we take into account it having to then support the entire body weight through the delicate bones of the arch. Then transition all that weight to the long Bones for the Herculean task of propelling all that weight forward. Endlessly!

Perhaps the most surprising and impressive thing about what the feet do is that they perform their task without any of their own muscle mass. If you reflect on any of the other major ‘joints’ in your body like your hips, knees or shoulders they are all wrapped up by big strong muscles that stabilise them. Amazingly the poor old feet only have very tiny muscles that are responsible for microadjustments of angle and position. 

Obesity or Rapid Weight Gain

Obesity is sometimes a major factor in cases of plantar fasciitis. That said there is a difference between ‘factor’ and ‘cause’ so it’s wise to be very suspicious of any professional who tells you that ‘you justneed to lose weight’.

The role that weight gain can play in being a cause of plantar fasciitis is fairly straight forward. The more weight that presses through the plantar fascia with each of your countless yearly heel trikes the more stress there is in the tissue. 

The key to understanding the true cause of plantar fasciitis is held within seeing that there is never a single factor. Muscle weakness in the leg and foot, fallen arches, poor footwear, scar tissue and overuse will always play their role regardless of what your body mass index is. 

Aging

When you are born your tissues are in their most supple and elastic state and the day you die they will be at their most tight and ridgid, the plantar fascia comes along for this ride. The normal aging process in combination with the type of mild neglect most of us treat our feet with can result in a loss of elasticity and play its part in causing plantar fasciitis.

The world we live in embraces the age related decline of muscle, joints and soft tissue in a way that it does not when it comes to the decline of dental health. We are very aware of the possibility of maintaining the health of our teeth but not so wise to how much can be done to maintain the musculoskeletal system. The truth is that through stretching and strengthening the stiffening of our tissue we can manage it very nicely. Age is a factor in plantar fasciitis but not the cause of plantar fasciitis for those who are willing to embrace the necessary exercises and good old fashioned hard work. 

Ill-Fitting or Old Footwear

Shoes that don’t fit right, or don’t provide proper cushioning and arch support, can play a significant role causing plantar fasciitis pain to manifest.  Running shoes should be discarded as the soles wear out and their support is depleted. 

Shoes that are narrow through the forefoot contribute to increased tightness in the plantar fascia over time, they also narrow the foot and decrease its intrinsic stability. The more we wear spacious and supportive shoes the less likely footwear is to cause plantar fasciitis. 

Conclusion 

We owe our feet alot ! The species-wide benefit of the astonishing job our feet do has been the liberation of our forelimbs from the dirt –  freeing them from the task of weight bearing.

Freedom for the forelimbs ultimately lead to us developing the trump card of all evolutionary trump cards  .. the opposable thumb. This leap from trotting around in the dirt on all 4’s to the microscopically skilful use of our forelimbs that has shaped the human world was made possible by our feet taking a hit for the team. Plantar fasciitis is juts one of the problems out feet have inflicted upon them – partly by our decision to only have 2 of them!

Plantar fasciitis like most stubborn pain conditions is complex but the solutions thankfully are often reasonably simple and easy to execute givent the right understanding. Pain relief is the necessary first step for most of us. Once the feet are more comfortable the door opens to rehabilitiation and the prescription of arch support. The health of our feet is desperately important to maintaining our quality of life as we get older, they are worth whatever effort becomes necessary to heal them and prevent further issues from manifesting later on. 

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Shockwave Therapy For Pain Management

Shockwave Therapy For Pain Management

This prospective, randomized and single-blinded study to measure the influence of shock wave therapy on patients with low back pain.

In todays world there are many ways of treating and managing lower back pain and sciatic pain. The common medical approach for lower back pain therapy is still mainly pharmacological – which definitely has its place. Physiotherapy, chiropractic and osteopathy all take a more biomechanical look to the treatment of back pain.

International guidelines for the management of lower back pain have been develop and only vary slightly from country. Treatments like spinal manipulation, core stabilisation training, cognitive behavioural therapy and acupuncture all feature. Shock wave therapy on the other hand has not been studied enough for us to know whether it warrants inclusion into guidelines for the treatment of lower back pain.

Shock wave therapy is defined as a series of high energy acoustic wave impulses that produce momentary turbulent pressure changes in the target tissue. Shock wave therapy was initially developed as a non-invasive procedure for breaking up kidney stones. This is made possible by the fact that the shock waves are absorbed by soft tissues to a depth of down to 12 cm. 

Radial shock waves (the ones used in the study) are generated by a pneumatic (ballistic) method using a device that produces compressed air, which fires a special bullet inside a short tube. This bullet, after accelerating, hits the head of the device and causes the transformation of kinetic energy into a pressure wave. This wave then propagates into the tissue. 

There has been a good deal of interesting research into the benefits and physical effects of shock wave therapy on injured and sick tendon, bone and connective tissue: and its effects on pain. There is however very little high quality research on Shock Wave Therapy’s effects on lower back pain. The researchers in this study were therefore, aiming to assess the influence radial shock wave therapy in the treatment of patients with lower back pain.

A total of 52 patients with LBP were enrolled in the study, this is not a large study group by any means – but it is enough to gather a small but meaningful amount of data – assuming the methods observed in the study are sound.

In order to study a treatment like shock wave therapy and its effects on a complaint like lower back pain you need to be a little bit tricksy. As with all research of this type you need to have a group within the study who think that they are receiving the treatment but who are actually just receiving a placebo. In this case that meant fabricating a cheeky little device that prevented the wave from leaving the device. This meant the lower back pain sufferers could receive a treatment that looked and sounded like the real thing, but wasn’t. 

A key limitation of this study was that it was only ‘single blinded’ this meant that the practitioner delivering the treatment knew themselves whether the shock wave therapy for lower back pain was the real thing or not. This allows for the possibility of subtle cues to leak out of the practitioner that impact the patients outcome – it is also entirely possible that they might deliver the treatments slightly differently whether they meant to or not. This fact does not render the data useless as such – it just leaves a small question mark over the accuracy of the lower back pain outcomes.

The study concluded that radial shock wave therapy is effective for patients with lower back pain – particularly in the long-term. The data suggested a significant advantage over a pure placebo effect as the placebo group did not see the same kind of longer term improvements in their pain. The use of this therapy has a significant influence on the reduction of pain and the improvement of the general functional state. The combined with stabilization training appeared particularly effective in the long-term and achieved a stable beneficial effect for patients with lower back pain. 

Essentially what this means is that people who received the real radial shock wave treatment for their lower back pain experienced a significant reduction in their pain – and adapted particularly well the rehab exercises which they were better at performing and experienced more benefit from.

No single piece of scientific data will ever tell us everything we need to know about the treatment of lower back pain, and especially not a small and imperfectly designed one like this. But as time goes by if these results can be replicated we will begin to get a clearer picture of whether shock wave therapy should be included in international lower back pain treatment guidelines.

For what it’s worth – my prediction is that further tests will prove successful and ultimately we will learn that shock wave therapy is a valuable treatment for certain lower back pain cases. Lower back pain is often more similar to complaints like tendon pain than you might think – and in those instances there is every reason to be optimistic about the future of shock wave therapy as a treatment for lower back pain. There will however also prove to be many instances where Shockwave Therapy does not bring any relief for back pain sufferers.

As a layperson or even as a healthcare practitioner you may very well ask how it is that delivering high impact acoustic waves to human tissues can trigger long term resolution of a complaint like lower back pain.

There are countless examples in nature of controlled stress being a healthy thing for living tissues and living systems. In the microscopic world bacteria who are fed a tiny amount of poison thrive more than bacteria who live in a completely non-toxic environment.

In human lives we need the stress of exercise and gravity or out bones and soft tissues turn to mush. These are all examples of a natural principle called ‘Hormesis’. Hormeses is a positive and fortifying response to a controlled dose of stress. This is the principle by which shock wave therapy impacts conditions like shoulder pain, back pain, wrist pain, hand pain, ITB band, ankle pain, hip pain and knee pain.

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Are Migraines Really ‘Caused’ By Issues With Blood Flow To The Brain?

Are Migraines Really 'Caused' By Issues With Blood Flow To The Brain?

The Classic Explanation For Migraine

Migraine is defined as ‘recurrent attack of headache that are commonly unilateral and accompanied by gastrointestinal and visual disorders’. 

Although I am not sure that’s the exact wording used by most migraine sufferers describe their migraines

Your average white coat type would explain migraine as  “a complex neurovascular disorder involving local vasodilation of intracranial, extracerebral blood vessels and simultaneous stimulation of surrounding trigeminal sensory nervous pain pathway that results in headache”.

This impressive wordiness highlights the fact that traditionalists investigate migraine as a ‘medical disorder’ –  they explain and study migraine as you might do so with a virus or a bacterial pathogen. And there is certainly nothing wrong with that as such.

For the migraine sufferer the vital question however is around whether looking at migraines ‘down the microscope’ is bringing us any closer to a solution.

A New Theory

According to Johns Hopkins –  the old migraine theory about fluctuations in blood flow to the brain causing migraines has been pushed aside.  Researchers have at last realised what clincians have known since day 1 – changes in blood flow and blood vessels don’t initiate the pain, at most they only contribute to it – and may in fact only be an incidental part of the far broader and more complex genesis of migraines.

Johns Hopkins article goes on to highlight the fact that newer explanations for migraine are focusing on the role of neurotransmitters  and hormones serotonin and estrogen. The updated theory see’s waves of excitable brain cell activity being triggered by substances like serotonin and estrogen being the cause of migraine. A part of the support of this theory is the fact that facial and scalp nerves are far more responsive to pain when we have low serotonin levels.

But from my perspective – which I am going to claim is a valid one having successfully managed several thousand migraine patients in my time as a clinician – is that the updated ‘neurotransmitter theory’ is really not any deeper or more insightful than the blood flow theory.

Not only do these heavily ‘physiological’ explanations for migraine continue to overlook the true cause of most migraines – they don’t lead us any closer to an ideal migraine solution – a non-toxic – no drug based – removal of / adjustment to the underlying cause. Which would constitute the healing of the migraine problem – as opposed to just managing the migraine problem through trigger avoidance and pharmaceuticals.

NB. I am not knocking the use of pharmaceuticals for ‘managing’ migraines of any other condition for that matter. I am just saying that a better option would be one that treated the migraine at its root cause! If that is a possibility…

Is There A ‘Known’ Cause Of Migraine?

So what am I claiming that the root cause of migraine is?

The root cause of migraine headaches in most cases lies in the chronic and habitual ‘emotional habits‘ of the migraine sufferer – and the ‘as yet unknown by science’ way those emotional patterns upset the function of the internal organs (mainly the liver) – the upper neck and central nervous system. The most common emotional themes in this respect with migraine sufferers is the repression of frustration and anger.

And believe it or not there is research that lends some weight to this touchy feely explanation for migraine. And the American Migraine Foundation are well aware of this important theme too. And if you take the time to read that AMF article it’s worth reflecting on the amount of anger that many victims of abuse must feel.

And as a further proof that I am not being ‘woo woo’ with you – even the good old WebMD is able to acknowledge that emotions are a factor in migraines and headaches.

Not only is there research on the connectedness of migraines and emotional stress – there is also research that sits within the realm of being able to show that management of stress can actually reduce migraine.

And did I forget to mention a study published in The Journal of Headache and Pain concluded that chronic tension headache and migraine headache patients present with a ‘significant impairment of anger control’. Not that this lack of control applies to all migraine sufferers – in fact many control their anger to excessive levels and create issues for themselves through supprresssion. Does this sound familiar to you?

Which brings us full circle to Johns Hopkins and the ‘serotonin update’. If you are an unhappy bunny it messes with your serotonin levels – we have known that for ages! So when you understand the real underlying and easily observable common patterns that cause migraine it’s not at all surprising that when we look ‘down the microscope’ there is abnormal neurotransmitter activity – that’s what you would expect in people who aren’t happy for long periods of time surely?

If you bash your knee and I take a tissue sample from your bashed knee there will be inflammatory compounds present – but the inflammatory compounds are not the problem – the bashing of the knee was the problem. Migraine is a bit like that – emotional patterns mess with the biocemistry and ’cause’ the headaches. There is a difference between ‘coincidence’ and causality in other words.

The biochemistry doesn’t just mysteriously up-end itself and cause migraines I promise you. There are doubtlessly genetic components but we know genes are not the only determinant in genetic conditions – lifestyle and stress huge influential.

Closing Thoughts

The emotional patterns and traits that classic migraine sufferers present with are super predictable – and easily obsevable if you know what to look for – but you won’t see any of that stuff if you are too busy peering down a microscope instead of looking at the whole person.

This isn’t gospel – the science has a long way to go before I can offer this view and say it has been rigorously tested in the academic sense. For now in all fairness its just my observation – and the observation of countless other ‘soldiers in the front line’ of migraine management.

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Your Soft Tissues are a Precious Gift 

Your Soft Tissues are a Precious Gift 

Your Body’s Fascial System

The bodies soft connective tissue (fascia) is an unspeakably precious gift that you received before your birth. Like most of life’s most basic blessings we tend to take our fascia completely for granted while we are in a state of optimum health. In fact we have taken fascia for granted as a culture for a long time – overlooking it in favour of caring more substantial physical structures like muscles and joints.

Occasionally I find myself able to dial up a full appreciation of how great air is when I am walking or on my bike, mostly though I can only feel that appreciation after I have been temporarily deprived air. In the same vein most of us are blissfully unaware of how fantastic our fascia is until it reminds us with pain. Although for many of us it is an unconscious appreciation –  we wish to be out of pain – without realising that what we are really wishing for is healthy connective tissue.

The full role and anatomy of your fascia and connective tissue has yet to be even superficially navigated by modern science.

We know that fascia creates structural and functional synergy between the muscles and bones of the body. We also know that fascia probably plays more of a role in organ health than you might think. A modern understanding of the fascial system has it pegged as an organ system in its own right.

In the same way we have realised that our skin is a giant organ – so too surely is the fascia?

As a collective we have a long history of overlooking some big stuff due to the limitations of our 5 senses. We once thought the universe was full of solid, dense stuff called matter because that’s how it seems to our senses, now we know  that ‘stuff’ is 99.9999% space.That’s a pretty big misunderstanding if you think about it. Fascia is not dissimilar, as we have explored the inside of the human body we totally ignored the significance of all the white fibrous stuff in between the organs and muscles, because the big lumps of tissue are the main event. 

The ‘realness’ about fascia is that it holds together your organ function, physical comfort, physical freedom and ability to move.

You could read the content of an article like this and think it’s pretty dry and in some ways it is. But you might be overlooking some of the important stuff slightly hidden from sight. The ‘important stuff’ is everything that you associate with a happy, normal, active life.

Getting out of bed and making a cup of coffee, playing a round of golf, playing with a child, going on the holiday of a lifetime, all of it dependents on connective tissue – connective tissue that creates synergy, comfort and ease of movement in our bodies… there’s nothing dry about that!!! 

Even though we don’t talk about fascia much, many of us know only too well the names of many fascial structures in the body. The iliotibial band for example is a famous fascial structure – for all the wrong reasons. A huge number of active people suffer with iliotibial band syndromes.

Caring For Your Fascial System

The best way you can deal to problems with your fascial tissue is preventatively – by exploring and pursuing healthy, varied, natural movement as you live your life. Pursuing healthy normal forms of movement can include a broad range of processes and approaches.

Breathing exercises – when done consistently and correctly stretch and nourish the parts of the fascia that create synergy between your respiratory muscles and organs. Your diaphragm does not only breathe, it massages your digestive organs and supports their ability to secrete. The subtle stressy patterns that so many of us hold in our respiratory muscles can seriously effect the function of our fascia. 

Yoga & stretching done in the right ways (like yin yoga), stretches and opens the fascia in ways that promote fascial health and wellbeing. Our lifestyles are the biggest enemy of our precious fascia. The repetitive nature of being hunched over a desk is a classic way to create fascial contractions at the front of the body for example. The way we hold stress in our bodies dictates fascial dysfunction and pain in a big way also. Yoga is a superb way to open up some of these contractions that we develop over time. 

Correcting posture is one of the greatest gifts you could give back to your amazing fascia. If you can picture the way a classic office worker with poor posture changes shape over time you can picture what happens to their fascia. If you sit a certain way – for a X no. of decades – your body adapts to that position and a major part of how it does so is through fascial contractions.

If we sit hunched for long enough  we change shape – because the dimensions of our fascia alter, and both our insides and our golf game suffer. By working quietly on postural correction over time we can prevent the unwanted facial contractures that get us all hunched up. 

Treatments are totally unavoidable for many fascia related issues.  This really for when preventative measures fail – as they often do in urban dwelling humans. Plantar fasciitis is a classic example of a condition where the body’s fascia has got itself into such a pickle that pretty much only treatment will resolve it.

Using fascial release techniques executed by a practitioner who knows what they are doing releases deep scar-like adhesions from deep within the plantar fascia. In addition to plantar fasciitis stubborn cases of knee pain, hip pain and back pain and even headaches may require hands on fascial release work. Many people find very rapid pain relief and improvements in joint function are possible once their fascia has been released.. even after long periods of pain and stiffness. 

Custom Orthotics 

In many ways concrete is to the fascia, joints and soft tissues of your lower limb what sugar is to your teeth. Concrete and paving stones are weird unnatural man made stuff that the body struggles to cope with long term. The constant stress of these hard flat surfaces on our feet, spine and legs is a major cause of unwanted changes in our fascia as the body tightens up defensively against the onslaught (I am not exaggerating honest… just look at the stats for knee back and hip arthritis in our society).

The legacy of all this strain on the joints and fascia often comes in the form of back pain, hip pain, IT band pain, knee pain, knee injuries, shin splints, ankle pain, ankle sprains, foot pain, plantar fasciitis and osteoarthritis. One majorly important and seriously easy way to reduce strain in our fascia is to wear insoles or custom orthotics in our shoes. Custom orthotics are a very straight forward way of supporting the lower limbs and providing some protection from concrete. 

Strength Training is essential for the fascia and its ability to stay healthy. Chances are you already understand that muscle tissue has a range of needs when it comes to it staying in good condition. Muscles need rest, they need to exert themselves in different ways and they need to stretch out too. All of this wisdom also applies to fascial tissue!! 

Going back to the earlier part of this post, it is very tempting to think that when we do gym type resistance training that we are just working muscle.. because they occupy so much volume and space. The truth is that when we do resistance training like lifting weights and performing body weight exercises we support, nourish, enhance and ultimately protect our tendons and fascia every bit as much as we do the muscle tissue itself. 

Closing Thoughts 

The lack of maintenance type love we tend to not give to our bodies connective tissues  is more of a question of education and conditioning more than it is anything else. The reason you most likely get up every single morning and brush your teeth without even thinking about it is that you have been brain washed to do so. From this perspective the reciprocal reason that you probably don’t do the same for your fascia by stretching every morning is that you havn’t been similarly educated as to it’s importance (salute to those of you who do – keep it up and I will strive to do the same ). 

The price we pay for failing to gently and persistently tend to the wellbeing of our soft tissues is paid in pain – plantar fasciitis, foot pain, ankle sprains, ankle pain, shin splints, knee pain, knee bursitis, IT band syndromes, hip pain, hip bursitis, migraine headaches and lower back pain

My recommendation for you is the same as the coaching I frequently offer myself .. don’t wait for stiffness, pain and discomfort to take hold of your tissues .. fight to preserve and maintain every single day!

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