How to increase muscle strength?

[emad]

Hi all :

All those working in sports ,and orthopedic rehabilitaion concerns more hot to improve /increase the muscle stength.
Before
I was using resisted excersies ,from more load to more repitations .

Now
It is clear trying to use those procedurces will increase muscle tension,particulrely if performed aggressively,also thus may lead to more pain .

So how we could improve muscle strength now?
Do you think using of somatics, simple , smooth , fine exercises could increase the muscle strength?

cheers
emad

[bernard]

Hello Emad,

A simple reply may be difficult but there is absolutely no reason to do so;
1/ recover in a first time awareness and intelligence in muscles.
2/ then improve musculature if necessary in a same manner.

Be awaked does not mean necessarily to be weak?

[nari]

Hi emad

First, have a think why you want to strengthen a muscle (or two).

Is it obviously wasted (eg owner has spent a month in bed or been in plaster for two months??)

Is there pain?
(Pain is often aggravated by strengthening. Look at normalising the patient, asking what they want to do, what to achieve.)

Is there evidence of poor movement pattern?
(Poor movement does not = poor strength)
Educate the sense and feel of a 'normal' gait.

Is it a weightbearing muscle? (eg hamstrings)
Try bike riding or functional activity

Is it nonWB?
Activities of daily living, global activity, and so on.

There is now a study that has proven regular physiotherapy sessions and none at all (except a home program) are equally effective in outcomes. for anterior cruciate reconstructions. Same as for acute spinal pain, it seems. :roll:
I think we are heading into education, pain management (Drug-free!!) and stroke/brain injury rehab.


Nari

[ian s]

Nari----agree with your concluding remarks .......pain physiology usually allows for efficient processing ie seldom is it necessary to see people for more than one or two sessions ......the only people I see for any more extensive sessions are those with protracted fear avoidance or those that need a bit of psychological support ......
The strengthening obsession seems to be due to training in isolationist principles .....the body moves in purpseful ways from a central command centre ......The Feldenkrais/tai chi/ somatics people have the right idea for most people .......Functional patterns for the majority, only isolationist ex's in very early phases of learning or post trauma recovery...this however is not the norm....

Any chance of the reference for the ACL -- would love to give it to some people who make a career out of 1:1 physio for these problems!

[nari]

Hi Ian-

I will dig it out tomorrow when back in my usual workplace.

Best of all (?!) it was a study done by an Aust physio....

My tendency to avoid specific (and boring) exercises comes out of my 12 year Rehab experience where we treat holistically, work from a functional aspect only, etc...rather than a guru approach (Feldenkrais, Hanna) which I am less familiar with.


Nari

[Servaas]

Greetings,

Strengthening is very important. However, when you can move in a way the body is designed to move, you will discover that ther is strength and there is length. Even more important, there is muscular intelligence.

In certain cases, yes, there definitily is a place for strengthening exercises. Like in the VMO/Quads post op ACL. However, after 'zooming in' and giving a localized strenghtening exercise, it would be great to create a 'zooming out' perspective and integrate the new strength in the natural movement patterns of esp. transitioning from lying to sitting to standing to walking (and runnign / jumping etc).

When performing these exercising from a first person perspective, meaning your internal awareness is controlling and coordinating the mechanics of the movement while you are sensing and experiencing the process of movement, you will gain faster and more natural mechanics.

This is what the Alexander technique, Feldenkrais, Hanna Somatics, Mobilizing Awareness and Somatic Conditioning are based on. Actually, I developed Somatic Conditioning to create a more strength and length component to the gentle and often non weightbearing somatic exercises like Feldenkrais & Hanna.

In the big picture, it is all fundamental Physiotherapy that up to now hasn't been implemented yet in the curriculum of the physio schools & universities. These disciplines are developed by people who did spend hours and hours and hours and many more hours practicing movements & exercises with awareness and observe the changes it creates into their own body.

Has nothing to do with gurus.

Try it yourself and you might develop a whole new interest in the human body!

I hope that helps.

Servaas Mes
www.somatichealthcenter.com

[nari]

Servaas

I did not mean to imply that someone whose name is attached to a technique/method/approach is to be avoided!
However, that is how such methods are perceived by other physiotherapists. and always have been. Mulligan, Maitland, Feldenkrais, Carr. Shepherd, Bobath, Kabat......and each has its value and its prejudices. You may well become the Maas method -as you are in the forefront with teaching, and you have great exposure.
whether you like it or not, you are on the way to being a guru...
cheers

nari

PS You mention that post-op ACL rehab one needs to zoom in and out. What you state as your approach has been done by physiotherapists for 20 years or more. Is there anything different in Somatics?

[nari]

Hi ian

I must have dreamt about the ACLR study - cannot retrieve it!!

But here is one, which MAY be the one I am confusing with the ACLR study, which proves we aren't needed for rotator cuff 'therapy'...

I cannot access the full article - but it is from Aust J Physiother. 2004;50(2):77-83

A randomised clinical trials evaluating the efficacy of physiotherapy after rotator cuff repair.

Hayes K Ginn KA, Walton JR et al

It has nothing that I can see to 'name' it so I can't post it - maybe someone else knows how to.


nari

[bernard]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15151491

[nari]

Thank you for that, Bernard

My ignorance with such cyberspace matters is showing!!

Nari

[Servaas]

Hi Nari,

I believe there are many differences between traditional Physiotherapy and the many different somatic disciplines. First of all it is the intent of first person experience, followed by the first person experience itself. For the client as well as the practitioner. This makes therapy not therapy but a process of integrated movement education.
A process where the intent is as well on turning down the activity of the stress-response and have experiential as well as objective results within seconds or minutes.

It was Hanna who initiated 3 very important processes:
- the concept of Sensory Motor Amnesia, the kinisthetic blind spot.
- the process of getting people out of their specific reflex pattern.
- the concept of Pandiculation which instantly reorganizes a disrupted or confused Sensory Motor Feed Back Loop.

This means that we are not just doing exercises, but that there are patterns and methods behind the exercise.

It is a process that often needs to be experienced before believed.

In my carreer as a Physiotherapists I have never seen anything so powerful. The world of Physiotherapy is starting to change and is requiring interest in different methods of working the human body that have better results.

Personally, I am trying to take 'ego' out of bodywork by not naming the unique processes that I have discovered after myself. Like everybody in the field of Physiotherapy as well as Somatics has done in thepast. I am not interested in the guru position, because I believe somatic freedom belongs to all of us. It came for free when you were born. That is why I have chosen names to distinguish the work I practice and teach that have a general character: Mobilizing Awareness and Somatic Conditioning. They have their own specific characteristics and are very interested in expanding and evolving with time.

Is Somatics Physiotherapy ? My answer is yes.

Is Physiotherapy Somatics ? My answer is no. Somatics is a new language for Physiotherapists. However, as Physiotherapists we already have the ability for pronounciation. We just never learned to make sentences. And when you learn to commnicate, that is when it becomes exciting!

Servaas Mes
www.somatichealthcenter.com

[nari]

Servaas

Thank you for your response. I am pleased that you run such successful workshops and wish you continuing success.

Nari

[emad]

Hi all friends :

sorry , i have put the topic then i was feverish for the last 2 days , so i will try to read .

thanks

emad

[Diane]

Just a late comment on strengthening. Ever since I started working from a 'manual medicine' perspective (as taught by D.O.s) I've seen strengthening as less and less important. Not UNimportant, but not at the top of the pile where we were all taught it belonged.

More important, and I think most would agree:
1. Seeing the body as a functional whole
2. Being cognizant of and careful about, physical "visceral" structures that are embedded in the somatic regions, and that are inherently contractile but beyond conscious ability to lengthen because they are "in" voluntary: vessels, lymphatics, neurovascular bundles. (Any injury to any of these will make the muscle system go crazy)
3. Removing inhibition to movement will automatically increase "strength"
4. The body as a whole does better with less focus on strengthening parts.
Diane

[BB]

Hi Emad,
I am finding more and more (like everyone else here) that strengthening with the goal of just strengthening is not the optimal route.

I think that if they can move freely and with pain gone, the weak areas will strengthen on their own through daily use.

I use resistance, but now for different reasons
- to add difficulty to the control of the movement, especially eccentrically. It adds challenge and makes them have to become even better at that controlling the movement.
- confidence building. I see a lot of injured workers. Often they have the ability and the freedom of movement, they just don't know it. I'll have them lift and perform some various functional activities and I think the biggest gain is that they then see that they are able to still move without pain.

Cory