The Runner

He sought me out because of his severe shin splints on the right low leg, lateral to the tibia, which haven’t resolved over a period of 1,5 years despite various visits to specialists, gait analyses and physiotherapy sessions. He also complaint of occasional low back pain, piriformis syndrome and a deep pain in his groin. I was immediately suspecting psoas and iliacus including the QLs on the back to be major players in this. On palpation he had a clearly distinct line of connective tissue tightened from the base of the scapula around latissimus dorsi, the abdominals, especially the insertion points at the ribs and the oblique muscles. Further along psoas major, minor and iliacus, hence the groin pain. Gluteus medius was well developed but showed very old adhesions that connected into tensia fascia late and down the IT band to the tubercle of Gerdy. From there the line continued somewhat around tibialis posterior and into the Achilles heel to the bottom of his metatarsals.

I also noticed a lot of connective tissue restrictions around the lower ribs, probably affecting the intercostal muscles. I felt the urge to ask him about an accident, probably some time ago. He told me that he broke some ribs 10 years ago while he was working in some remote area of the world, hence he never got it checked and doesn’t know exactly which rib(s). I suspected an issue with his shoulder joint as well, as the latissimus dorsi is pulling on the scapula. He suffers from general tightness in his shoulder area from time to time and especially on the right side. I wanted to figure out if there was an emotional component to the whole situation, but even after subtle suggestions and directed questions, he didn’t want to tell me anything. The only thing he said was that he needs to run to get rid of his worries and organise his thoughts. That’s why the shin splints I guess, so he needs to sit down and actually sort it out – confront it in some way. First I thought, the tension in the hips indicate “not moving forward” and then I connected the ribs and got the impression that the incident of the rib fracture was around a time of inner turmoil which affected him more than he would give away. Whatever it was, it was his to deal with.

For 2 sessions twice per week over a period of 3 weeks I worked very deeply on these connective tissue connections to break them up and lengthen the tissue and stretch the muscle. I advised on regular stretching and very little running since his shin splints were just under control again as he was seeing another physiotherapist who applied a lot of dry needling and helped him with strengthening exercises for his gluteus mucles and adductors.

He had to leave town for one month and only did yoga for stretching, especially side bending, hamstrings and quadriceps and a bit of running during this time. When I saw him today his body felt more balanced and the connective tissue on the right side of his body didn’t feel as ropy or “harsh” under my fingers. This was a very positive finding and as he also reported that his shin splints are not near as bad as they were before the treatment and resolve much better with a few days rest. I believe that in his case it was important to work with the body and keep the conversation focused around exercise, strategies and what can be done in the future. He was a smart and rational person who understand a lot about his body and enjoyed working with it. Maybe through yoga he can find a way to better listen and feel what his body has to tell him so he can use the message to finally resolve his shin splints for good.


The Cello Player

Most of the time during my work as a body reader and therapist I open up Pandora’s boxes without having any clue beforehand what to expect. So in this case of a professional Cello player and teacher at the age of 28.

Her main complaint was a history of low back pain with and without radiation into the buttocks and upper thigh. It started a few years back during a period of intense stress and she was told that she had strained her back and needed to rest it. Due to her natural arm positioning during playing ( heavy involvement of the latissimus dorsi by lifting the left arm to play the notes on the Cello) she experienced a constant strain on her left side.

On examination I discovered not only tightness in the areas mentioned but all along her left side, following through the body like a threat. What was even worse, was the immense tension she was carrying around her shoulder, pressing on the brachial plexus and changing the way the forearm muscles were pulling on the wrist joint. Her Pisiform bone on the left hand was pulled into a flexion direction due to the hand positioning during playing but also the suffering the pulling from the upper extremities. Another item that struck me was the positioning of her C6 vertebra. It appeared completely flexed and sticking out as much as C7, the most prominent hump of the cervical spine. Due to the flexion in this region she held her head in a nearly constant chin tuck position which she also habitually assumed to relief tension in the back of her neck. Last but not least, her pectoralis muscles were in a very tense state, something you would expect in people who work out a lot doing push ups etc. but with her it was also affecting her sternum and as I believe, causing a myofascial pull on the front of her neck and possibly C6. She tends to suffer from migraines and I noticed slight fluid retention in her low back, legs and arms.

She was worried to engage in physical exercise or any type of movement that might aggravate her condition. She had tried yoga a while back but it caused her more discomfort than relief so she stopped it again. She had a good sense of body awareness and easily felt what was happening in her body and could name the sensations she experienced. This made my work so much easier since she was providing all the important clues open-handedly.

I started with releasing the tension around her shoulders, especially the scapulae as well as the left latissimus dorsi including the intercoastal and the attachment at the iliac crest. Myofascially, the whole left line from the crest of the hip to the finger tips was involved. The tissue was very fibrous and she had good muscles structure from playing the Cello, therefore her body was predominately strong and tight. I further went on to release her low back, in particular quadratus lumborum and the attachments of the gluteus muscles along the crest. Both QLs were very strong, but tight and her flanks for soft which led me to think the abdominal muscles were doing a mediocre job only. However, due to her position while playing her instrument, the right abdominal muscles were pulling slightly stronger on her left side, creating myofascial tension across her belly and possibly pulling from her shoulder blades. I went onto her front side to work the connective tissue of her tummy, pulling and rolling the skin. I also released her iliopsoas on both sides and the attachments of the rectus abdominus on the rib cage.

I spent around 1,5 hours and only started to grasp what was underneath the tip of the iceberg. I advised her on movement exercise to open up her left side and stretch the connective tissue. Gentle spinal twisting, side bends, stretching of the triceps, biceps and pectoralis. There was so much more work that needed to be done and she would really benefit from supervised yoga for the first few weeks until she could manage it by herself. On top of the stretching and lengthening and advised to strengthen the abdominal muscles, or to but it in better terms, to reconnect the brain with these muscles so her exaggerated posterior pelvic tilt could be corrected and help her position during prolonged sitting. A strong core all around would at least give her the lift from the bottom up she would need to support the upper body. Interestingly, it appeared to me that the whole problem started in the upper body and worked its way down to the low back. So the focus for me was to correct the fascia in the upper body through opening up the myofacia and creating new movement and holding patterns for this region.

Matter and Mind

“Quantum physicists discovered that physical atoms are made up of vortices of energy that are constantly spinning and vibrating, each one radiating its own unique energy signature. Therefore, if we really want to observe ourselves and find out what we are, we must recognize we are really beings of energy and vibration, radiating our own unique energy signature.” – Shubhra Chaturvedi

The realization that we are all energy and vibration helps me to understand what I experience when working with the body of my clients. I often feel the blockages in the slings and bands of fascia, the connective tissue sheaths that wrap around every single organ, bone, nerve, ligament, tendon and muscle. Fascia facilitates the transfer of electrical signals from surroundings cells and nerves. If anything is not flowing properly, it may be blood, lymph or electricity, I first check the fascia and other body structures. Very often, the location of pain, tightness or congestion provides me with a fair idea of the issue at hand. Literally, I palpate the tissue and receive information about the possible cause and process. From there I can assess based on a biomechanical hypothesis (e.g. joint capsule restriction, ligament or tendon injury, or a general medical condition requiring referral) or choose to inquire further through specific questions relating to body mind issues such as stress, relationships, perceptions and world views as well as emotions about certain situations. Sometimes these questions are not guided by me directly, they may appear spontaneously as a result of contact with the body and being able to receive subtle messages about the imbalance present. The body always thrives for equilibrium and in order to maintain the balance it creates by-passes, substitutions or simple shuts down the area.

I believe especially in chronic conditions the root cause lies in a metaphysical imbalance creating a pattern or signature in the physical body. I also noticed, that this pattern can be dis-ease specific or characteristic to the individual. I could go as far as claiming that every dis-ease has its own characteristics and matches with those of the person suffering from it.  There are various books about the meaning of certain dis-eases and health issues on a spiritual or metaphysical level and I tend to see those patterns quite frequently in my practice. And often without knowing the content of these books by heart, I often arrive at a very similar conclusion to why a person is suffering from a particular condition. The mind simply manifests itself in the body.

This is the part where it becomes interesting and more or less interactive with the client. I usually look for a dialogue with the client about what I feel within myself and sense underneath my fingers. Through exploratory narratives, stories told by the client based on my feedback, the issue at hand is further explored and uncovered from a new perspective. Change then takes place through conscious awareness of one’s reality.

The Body

The body. Our physical shell, the vesicle that takes us around, let’s us experience our environment, internal and external, through our five senses, emotions and memories. The body becomes the representative of our lives and reflects our attitude and past impressions – the older we get the more detectable the character traces. Viewed as a whole, the body is a beautiful artwork showcasing its inhabitant in full completness.

From a biomechanical perspective, the body functions in a certain way as a result of the internal interaction between nerves and hormones, all controlled by the spinal cord and brain. Just like the idea that when you push button A it will switch on device X.

The electromagnetic current within each cell makes the body a whole living entity. Communication happens along the nerves and the web of fascia that is in contact with every muscle, bone, tendon, ligament and nerve. Any change in conductivity interrupts the information exchange among the cells and may have subtle influences on our overall well-being.

The Buddhist concept of Vedana comes to mind. Vedanas are feelings and sensations that arise through our five sense organs. Sight, sound, odor, taste, idea and thoughts. Vedanas are constantly fed by the sense organs and create the waves of emotional ups and downs throughout the day. The unconscious mind reacts to the citta (thoughts) and stores these reactions as sankharas (mental formations) at RNA/DNA level. And this is where our thoughts and emotions become visible to the observers eye through manifestations in the physical body. Here it also becomes our opportunity to consciously recognize the pattern and work with them to achieve emotional balance and physical health.