Health and Healing

Greetings all; my name is Chris Jurak, PT; some here already know me from "the other" (ahem) forum...

Anyway, finally got around to posting here after reading some of the threads - it really seems like this forum has developed into a neat outlet!

While I am not so much geared towards the combat aspect, I am somewhat well-versed in the health / healing piece, which I think is relevant to combat insofar as it keeps fighters able to do what they want to do. That said, if people have questions about things like biomechanics, physiology, injury rehab, various therapeutic approaches, etc., I am happy to discuss.

The only thing I will NOT do is diagnose and prescribe treatments for individuals on here, because, obviously, there's no way I can accurately assess you in an internet forum (one of my biggest peeves on "the other" forum was folks who would opine as to what they thought would work therapeutically for others writing in about their issues - I would frequently point out to these people that they really had no way of reliably diagnosing and therefore should not be making any statements regarding effects of what they were recommending - of course, I would then be derided for being a control-freak or having a closed mind, lol).

As such, if anyone has any questions about a specific issue, I will discuss it and offer general thoughts and suggestions as to what I think might be useful, based on my past experience with patients I believe have had similar issues.

Nice to be here, in what appears to be a mature and productive environment.

Hi Chris.

I have a nagging ache in my lower back from lifting people up in San shou training. It is not painful or even sore, but it gets nagging. I been using ice 10 min. then moist heat for about 20 min. then i may use Biofreeze at times. Anything else you can suggest?

Admin wrote:Hi Chris.

I have a nagging ache in my lower back from lifting people up in San shou training. It is not painful or even sore, but it gets nagging. I been using ice 10 min. then moist heat for about 20 min. then i may use Biofreeze at times. Anything else you can suggest?

that's easy - stop lifting people up in san shou training...

seriously tho...

there are numerous things you might do; however, obviously, as I haven't examined u, I can't say anything specific about ur situation; which leads me to my first suggestion:

run; don't walk; run;

run and find someone, anyone, who is skilled in movement assessment, manual therapy and prescriptive exercise; when I say skilled, I mean someone who, when u tell them that u have back pain, especially in the absence of direct trauma, they look everywhere else - and I mean everywhere - feet, knees, hips, pelvis, ribs, shoulders, neck, and everything in between; they shud watch u move in general, watch u replicate the movement(s) that cause pain, assess muscle funtion of ur core and extremities in gravity and out, and then basically poke / prob / try to mobilize every joint that u hav (this shud take 45 m to an hour - no quickie screenings by chiros on the street); and one they hav looked u over thoroughly, they shud b able to hav a strong working theory as to why u get the pain u get; and then they shud treat u and (gasp) u shud notice a difference pretty much immediately, both in terms of some range of motion / strength in the clinic and functionally when u train; u also shud walk out of there with 3-5 highly specific movement-related things to do at home (and I don't mean generic exercises circled on a sheet of paper...)

this is evidence of a skilled practitioner; notice, btw, I said nothing about putting u on machines or using any hot / cold, elec stim, ultrasound - this stuff is, IMPO, essentially a waste of time: there is nothing u can't get done w ur own two hands and nothing the pt can't do exercise-wise that requires those things (well, mayb once in a while, but in general, no, as I see it, at least);

the reason I say to run, btw, is to have them assess you when u r NOT in an acute flair up; this is important for 2 reasons: first, it means that the practitioner will hav a sense of ur baseline status - they will know how u r, what u r capable of, etc. when u r not symptomatic; thus, if u do come in w acute sx's, they hav a baseline comparison - it's not that they necessarily need this, but it makes it a lot easier for them, and the overall treatment will b more efficient;

the second reason is even more important: let me ask you - do u want to go c a practitioner for the first time when u r in a normal frame of mind, or when u r dying of pain? at which point will u b more discerning about who u go to c? people in acute pain will do / believe anything if they think it will help their pain - and so might end up w someone who is lousy, and not b able to ascertain this adequately;

so, go find a skilled practitioner - especially as a martial artist, u shud hav sumone who is "in ur corner", as part of ur team, to take care of u; now, as far as licensure: I don't care - they cud b a PT, an ostepath (DO), chiro (DC), acupuncturist, athletic trainer, licensed massage therapist, or even an unlicensed bodyworker w a certification such as Rolfing or a movement therapist certified in something like Alexander Technique or Feldenkreis (and of course, u may find sum combo of people who cover these bases as well); the point is, license ≠ skill - personaly, I wudn't let 99.9% of PT's near me w a 10' pole (don't get me started); meaning that u hav to shop around, try different people, and don't b surprised if it takes a while to find sumone who is skilled and with whom u work well;

so, that's one very general answer: that u shud find sumone to work with, and sum advice on how to find sumone skilled;

Admin wrote:Hi Chris.

I have a nagging ache in my lower back from lifting people up in San shou training. It is not painful or even sore, but it gets nagging. I been using ice 10 min. then moist heat for about 20 min. then i may use Biofreeze at times. Anything else you can suggest?

ok - answer #2;

here is a very GENERAL guideline for self-treatment of those nagging aches and pains;

it's a very simple principle, called Indirect Technique, and it refers to the direction u move when u have pain / loss of movement; meaning that, when u have pain / loss of range, u hav two choices: u can move in the direction(s) that increases pain / tightness, or u can move in the direction(s) that decrease / eliminate pain and / or have the greatest range of motion;

so here's an example: if u stand up and bend forward as if to touch ur toes, and then do the opposite - bend backwards (don't actually do it, it's just an example); u shu notice pretty readily (most people w symptoms do) that one of those movements is relatively easier / preferable to the other; similarly, u can try bending to one side then the other, or twisting at the waist in either direction; usually, u will note at least one of those three movements has a greater degree of relative asymmetry and sometimes all of them have a discrepancy from one side to the other, to varying degrees; for example, u may notice u don't like bending backwards, bending to the left, and turning to the left; u can also combine those three movements (backbend, left sidebend, left rotation) and see if that is a movement that u really don't like; then, u can try the opposite: forward bend with sidebending and rotation to the right - usually, the combined moves in the opposite direction is the direction of maximal ease (there are, of course, exceptions that crop up not infrequently, so if u did try this and it didn't conform to what i described, don't freak out)

so, Indirect Technique would advocate going where the body wants to go, into the direction of ease; it's kind of like the "anti-stretch" (u know, when something is stuck, we try to stretch it out, right?); also, there r various types of IT, but u can generally break them up into Active Indirect and Passive Indirect; Active means u move there by ur self and while in the ease, actively contract to stay there; passive means u find a comfort position and hang there without any muscle contraction; there r times to do both, and different people also seem to respond more to one or the other, for various reasons;

anyway, in a very general sense, this can be done by anyone on a regular basis, esp if they have chronic nagging pain that comes and goes, bec Indirect Technique is generally very safe - u r not pushing against any barriers, so u shudn't hav to worry about irritating something;

so how do u apply this principle?

well, of course, finding a practitioner who does it and can teach it to u would b one option; in that case, looking for someone who does Strain / Counterstrain, which is a form of passive indirect, is a good start (usualy PT's and DO's, but occasionally DC's and LMT's); u can try the website for Jone's Institute to search their practitioner database: http://www.jiscs.com/FindTherapist.aspx

other similar varyingly types of passive indirect would include Facilitated Positional Release and Myofascial Unwinding; of course, a given practitioner may use these more or less, and of course integrate them in with other approaches, so u need to ask; the value of this treatment is that, altho u r manuevered into the position by the practitioner, u can typically replicate the most "releasing" ones on ur own at home;

another option is something called Total Motion Release or TMR - this is a more active indirect approach, and pretty much only PT's r doing this, as it's a relatively recent method - not so much the indirect part, but the methodology used to apply it; u can check their website for two things: practitioners, and, actually, if u took the time, u could pretty much learn how to do it on ur own from the videos up there (which is actually one of the goals of the guy who developed it); u want to look for something called the Fab 5 (or Fab 4 - he may hav changed it recently); these r a sequence of 5 (or 4) movements that u can use to isolate asymmetries pretty easily and treat them - using this method, u probably can markedly improve ~80-85% of the aches and pains u usually c w people (the other 15% or so is more complex stuff that requires a more in depth approach); the website is : www.totalmotionrelease.com

so, in a nutshell, Indirect Technique is an approach to finding where the body wants to go, and letting it go there; doing this is a safe and relatively efficient manner of dealing w all sorts of diffuse aches and pains - and at times, distant from the source: meaning that u may get neck pain, and find that u have a large asymmetry in lower trunk rotation - if u treat that properly, ur neck pain will probably go away...w low back pain, a lot of times the issue is in the hips or the ankle(s), so treating those areas may hav significant impact on the back...

anyway, food for thought; enjoy...

If I may ask, do folks ever recover from a torn ligament (wrist in my case, but I'm curious in general) without surgery? Perhaps not doing martial arts stuff that aggravates it would help lol.

I have found that the stuff that we train for fighting works for healing, which is quite awesome. The purpose I started martial arts with was for the health aspect, but was drawn to teachers with the fighting aspect (makes more sense and is more fun). Amazing stuff.

Athena