Why are we not at all surprised?
If you've been using TENS for ages, noting how poorly it works for anything other than transient pain gating for neurologic pain, here's another shot againt that practice that you may want to review.
From Medscape Medical News
AAN Guideline Recommends Against TENS for Chronic Low-Back Pain
Susan Jeffrey
December 31, 2009 — A new evidence-based review from the American Academy of Neurology concludes that transcutaneous electric nerve stimulation (TENS) is not recommended for use in treating chronic low-back pain but adds that TENS should be considered to treat diabetic neuropathy.
The report, from the academy's Therapeutics and Technology Assessment Subcommittee, was published online December 30 in Neurology. Authors on the new document are Richard M. Dubinsky, MD, MPH, from Kansas University Medical Center in Kansas City, and Janis Miyasaki, MD, MEd, from Toronto Western Hospital, Ontario, Canada.
"In the highest-quality studies of chronic low back pain, there was no benefit of TENS compared to sham or placebo TENS, leaving us to conclude that it is of no benefit, and make a recommendation that it should not be used for chronic low back pain," Dr. Dubinsky told Medscape Neurology.
In diabetic polyneuropathy, some studies showed slight benefit, he added. "We concluded it should be considered in the treatment of diabetic polyneuropathy."
Systematic Review
TENS has been used to treat neurologic and other disorders for decades, the authors write. The biologic basis of its analgesic effect is not known, but it is used is based on the gate theory of pain, they note. In this assessment, the authors carried out a systematic literature search of Medline and Cochrane Library up to April 2009, looking for controlled clinical trials in which TENS was used to treat pain associated with neurological conditions.
Acute low back pain not normally seen in neurologic conditions was not considered in this review. All but 1 of the studies excluded patients with known causes of low-back pain, such as pinched nerves, severe scoliosis, severe spondylolisthesis, or obesity.
"We only found 2 conditions that had adequate rigor in the research, and that was chronic back pain and diabetic polyneuropathy," Dr. Dubinsky said.
The studies included showed conflicting results in chronic low back pain. Two class 2 studies showed benefit, but 2 class 1 studies and another class 2 study showed no benefit. "Because the Class I studies are stronger evidence, TENS is established as ineffective for the treatment of chronic low back pain," they write.
Two class 2 studies suggested that TENS is probably effective in treating painful diabetic neuropathy. The only specific neurologic cause of chronic low-back pain in which TENS was studied was multiple sclerosis, for which TENS was not shown to be of benefit.
The document makes 2 main recommendations:
TENS is not recommended for the treatment of chronic low-back pain because of a lack of proven efficacy (level A, 2 class 1 studies).
TENS should be considered for the treatment of painful diabetic neuropathy (level B, 2 class 2 studies).
The document also gives some guidance on the need for further research into TENS, Dr. Dubinsky noted. Among their recommendations were determining what the best paradigm is, in terms of current, pulse-width, and frequency, and then using it in patients who are naive to TENS so that they will be truly blinded to treatment allocation, and studying TENS in patients with well-defined neurological conditions.
Absence of Evidence
In an editorial accompanying the new document, Andreas Binder, MD, and Ralf Baron, MD, from the Division of Neurological Pain Research and Therapy in the Department of Neurology at Christian-Albrechts-Universität Kiel, Germany, write that the conclusions of Dr. Dubinsky and Dr. Miyasaki "may heat up the discussion on the usability of TENS and may be viewed as supporting the critics who questioned the value of TENS in pain therapy.
"However," they add, "absence of evidence is not evidence of absence. The clinical impact of meta-analyses is always limited by the quantity and quality of conducted trials."
TENS has had a long-standing role in pain management, is easy to handle, has a favorable benefit-to-risk ratio, and can be discontinued easily if it is not efficacious — all "desirable properties when treating pain," they write. The new document calls for further trials and even provides "clearcut recommendations for their conduction," they note.
"This updated evidence-based review is valuable in providing the limits of our evidence base," Dr. Binder and Dr. Baron conclude. "Nevertheless, it is not unreasonable to take a practical position that, in spite of the relatively weak scientific and clinical evidence, TENS still represents a valuable therapeutic alternative in neurologic pain disorders.
"Taking the favorable benefit-risk ratio when compared with other pain relieving methods into account, TENS remains a valuable part in the armamentarium of pain therapy."
Dr. Dubinsky serves on a scientific advisory board and speakers' bureau for Allergan Inc, receives honoraria from BrioMed, and receives research support from Allergan Inc, Merz Pharmaceuticals GmbH, and the National Institutes of Health, the NIAM/National Institute of Neurological Disorders and Stroke, and the National Center for Complementary and Alternative Medicine, and his spouse owns stock in Abbott. Disclosures for coauthors appear in the paper. Dr. Binder has received travel expenses for lectures and educational activities not funded by industry and has received honoraria for speaking engagements and educational activities from Grünenthal, Allergan Inc, and Pfizer Inc. Dr. Baron serves on scientific advisory boards, as a consultant, and on speakers' bureau for Pfizer Inc, Genzyme Corporation, Grünenthal, Mundipharma International, Allergan Inc, Sanofi Pasteur, Medtronic Inc, Eisai Inc, UCB, Eli Lilly and Company, and Astellas Pharma Inc; has received travel expenses for lectures or educational activities not funded by industry; serves as an associate editor of Pain and on the editorial advisory boards of Nature Reviews Neurology and the European Journal of Pain; and has received research support from Pfizer Inc, Genzyme Corporation, Grünenthal, the German Ministry of Research, and DFG, Deutsche Forschungsgemeinschaft.
Neurology. Published online December 30, 2009.
Authors and Disclosures
Journalist
Susan Jeffrey
Susan Jeffrey is the news editor for Medscape Neurology & Neurosurgery. Susan has been writing principally for physician audiences for nearly 20 years. Most recently, she was news editor for thekidney.org and also wrote for theheart.org; both of these Web sites have been acquired by WebMD. Prior to that, she spent 10 years covering neurology topics for a Canadian newspaper for physicians. She can be contacted at SJeffrey@webmd.net.
Medscape Medical News © 2009 Medscape, LLC
Send press releases and comments to news@medscape.net.
Thursday, December 31, 2009
Wednesday, December 30, 2009
What is Reflexive Antagonism?
Reflexive Antagonism
From Wikipedia, the free encyclopedia
Reflexive Antagonism is the phenomenon by which muscles with opposing functions tend to antagonistically inhibit each other. When one muscle is activated, its opposite muscle or muscle group or is reflexively inhibited or deactivated.
Reflexive antagonism is the basic original notion behind indirect muscle energy techniques. While this notion is now understood to be incomplete, the clinical mechanism of Reflexive Antagonism continues to be useful in widespread Osteopathic and OMT-derived practice. Reciprocal Inhibition is a synonym. (See Entry under Muscle Energy Techniques)
Techiques that utilize reflexive antagonism, (such as Rapid De-Afferentation Techniques) are manual medicine techniques and protocols that utilize reflexive pathways and the phenomenon of reciprocal inhibition as a means of switching off inflammation, pain, and protective spasm for entire synergistic muscle groups or singular muscles and soft tissue structures.
While widely accepted as a clinical mechanism in Osteopathic Manipulative Medicine / Osteopathic Manipulative Techniques, Reflexive Antagonism form only part of the picture of why Muscle Energy Techniques work. Among reasons cited for further investigation into MET mechanisms the following are most significant: 1. The Reflexive Antagonism phenomenon is now known to be fleeting, incomplete, and weak. By example, when the triceps brachii is stimulated, the biceps is reflexively inhibited. The incompleteness of the effect is related to postural and functional tone. 2. Reflexes in vivo are polysynaptic, with entire muscle groups responding to noxius stimuli (Nociceptive Withdrawal Reflex). A pure Reflexive Antagonism has only been demonstrated in the lab.
From Wikipedia, the free encyclopedia
Reflexive Antagonism is the phenomenon by which muscles with opposing functions tend to antagonistically inhibit each other. When one muscle is activated, its opposite muscle or muscle group or is reflexively inhibited or deactivated.
Reflexive antagonism is the basic original notion behind indirect muscle energy techniques. While this notion is now understood to be incomplete, the clinical mechanism of Reflexive Antagonism continues to be useful in widespread Osteopathic and OMT-derived practice. Reciprocal Inhibition is a synonym. (See Entry under Muscle Energy Techniques)
Techiques that utilize reflexive antagonism, (such as Rapid De-Afferentation Techniques) are manual medicine techniques and protocols that utilize reflexive pathways and the phenomenon of reciprocal inhibition as a means of switching off inflammation, pain, and protective spasm for entire synergistic muscle groups or singular muscles and soft tissue structures.
While widely accepted as a clinical mechanism in Osteopathic Manipulative Medicine / Osteopathic Manipulative Techniques, Reflexive Antagonism form only part of the picture of why Muscle Energy Techniques work. Among reasons cited for further investigation into MET mechanisms the following are most significant: 1. The Reflexive Antagonism phenomenon is now known to be fleeting, incomplete, and weak. By example, when the triceps brachii is stimulated, the biceps is reflexively inhibited. The incompleteness of the effect is related to postural and functional tone. 2. Reflexes in vivo are polysynaptic, with entire muscle groups responding to noxius stimuli (Nociceptive Withdrawal Reflex). A pure Reflexive Antagonism has only been demonstrated in the lab.
Saturday, October 24, 2009
Join us for the Fitness Professionals National Congress on November 7 and 8 2009
CONVENTION SCHEDULE
16th National Fitness Convention
“Promoting Physical Activity for Wellness”
November 7, 2009 Saturday (Fitness Managers Convention, Group Exercise Convention
& CPR Seminar),
November 8, 2009 Sunday (Personal Training Convention, Cardio Latino Workshop,
& Yoga Workshop)
THE RICHMONDE HOTEL
21 San Miguel Avenue, Ortigas Center Pasig City, Philippines
November 7, 2009 (Saturday) Fitness Managers Convention-BANYAN & CEDAR FUNCTION ROOMS
6:30-8:00 Registration
7:45-8:00 OPENING
8:00-9:00 Wellness: Mind & Body Connection
(Dr. Stephanie Fay Cagayan)
9:00-10:00 Exercise Adherence (Stella Marie Urbiztondo)
10:00-10:20 AM SNACKS
10:20-11:20 Business with Pleasure-Sustaining the Fitness
Hobby (Nicky Tsai)
11:30-12:30 Detoxify Your Mind (Rebecca Ortega)
12:30-1:30 LUNCH BREAK
1:30-2:30 Protecting your Business from Fraud - an Overview
(Steffen Minkmar)
2:30-3:30 Make Mind Your Friend (Jonathan Batangan)
3:30-3:50 PM SNACKS
3:50-4:50 International Standards of Care for Fitness Facilities
(Shirley Quejada)
4:50-5:50 Panel Discussion & Open Forum
(Fitness Leaders & Convention Participants)
November 7, 2009 (Saturday) Group Exercise Convention-REDWOOD, SYCAMORE & SEQUOIA ROOMS
6:30-8:00 Registration
7:45-8:00 OPENING
8:00-9:00 Vinyasa Krama Yoga (Mick Tibbs)
9:00-10:00 Reggaetton Ripiao (David Velez)
10:00-10:20 AM SNACKS
10:20-11:20 Hataw Pinoy/Cardio Stick Fight (Shirley Quejada)
11:20-12:20 Yin Stretch (Kitty Cooper)
12:20-1:30 LUNCH BREAK
1:30-2:30 National Guidelines for Physical Activity
(Hercules Callanta)
2:30-3:30 Tango Latino (David Velez)
3:30-3:50 PM SNACKS
3:50-4:50 Mind & Body (Wai Han Kho)
4:50-5:50 Zumba (David Velez)
November 8, 2009 (Sunday) Personal Training Convention- REDWOOD, SYCAMORE & SEQUOIA ROOMS
6:30-8:00 Registration
7:45-8:00 OPENING
8:00-9:00 Power, Speed & Agility with Balance-Workshop
(Shirley Quejada)
9:00-10:00 Yin Stretch for Personal Training (Kitty Cooper)
10:00-10:20 AM SNACKS
10:20-11:20 The Truth behind Supplements (Dra. Nina Sioson)
11:20-12:20 National Guidelines for Physical Activity
(Hercules Callanta)
12:20-1:30 LUNCH BREAK
1:30-2:30 A Presentation on Carbohydrate Loading
(Luchie Callanta)
2:30-3:30 Survivor (David Velez)
3:30-3:50 PM SNACKS
3:50-4:50 Exercise Adherence (Stella Marie Urbiztondo)
4:50-5:50 The NeuroMyoFascial System: An Overview for Fitness Professionals (Dr. Strix Toledo)
SCHEDULE OF WORKSHOPS
November 7, 2009 (Saturday)
8:00-6:00 CPR Seminar By: Philippine National Red Cross (PALM FUNCTION ROOM)
November 8, 2009 (Sunday)
9:00-12:30am CARDIO LATINO WORKSHOP
(BANYAN & CEDAR FUNCTION ROOMS)
By: David Velez
8:30-12:30nn VINYASA KRAMA YOGA 1 WORKSHOP
(PALM FUNCTION ROOM) By: Mick Tibbs
1:30-5:30pm VINYASA KRAMA YOGA 2 WORKSHOP
(BANYAN & CEDAR FUNCTION ROOMS)
By: Mick Tibbs
You may contact us at 920-2762 or text 0917-5181202 for queries.
P R E S E N T E R S
BATANGAN, JONATHAN - General Manager , Cebuana Llhuillier Insurance Solutions (September 2004- present) Mobilized agency personnel to become motivated, quality-driven, customer-focused , and results-oriented individuals. Transformed agency from dismal performer to top achiever in the PJ Lhuillier Group of Companies. Initiated cross-selling and synergy programs within the Group and strengthened the AllCare brand through product development and innovation. Instrumental in creating one of the most successful micro-insurance products in the country which has now insured approximately 6.5 million Filipinos. Increased revenues by 1,000% during first year (2005),and further doubled the 2005 revenues in 2006; Conferred with “Ambassador’s Cup” by Amb. Philippe Lhuillier, the highest honor and first-ever recipient from the PJLI Group for sales/ marketing excellence; PLIA was conferred by Malayan Insurance with the following awards in 2005 : Top Achiever Award (Special Agency Category) and Most Valuable Partner Award. On the personal side, a meditation practitioner for more than ten years and a meditation resource person of the Brahma Kumaris Meditation Center, a UN-affiliated international NGO.
CAGAYAN, DR. STEPHANIE FAY - Dr. Ma. Stephanie Fay S. Cagayan, obtained her Bachelor of Science in Basic Medical Sciences at the University of the Philippines Manila in 1990 followed by her degree in Medicine in 1993 under the Integrated Arts and Medicine Program (Intarmed), a 7 year accelerated medical course of the UP College of Medicine. She is a frequent resource speaker for seminars and special topics in obstetrics and gynecology, pharmacology and toxicology and wellness specifically dance as a form of healing. She is an advocate of holistic medicine and her practice of medicine includes the use of complementary and alternative forms of medicine for prevention and treatment of illnesses. She is a member of the Fitness Network Philippines and she also acts as director and manager of Rhythms, a wellness center and dance studio located in Manila. To date, she has published 4 books namely, Essentials of Obstetric Nursing, Pharmacology for Beginners, Sayuntis (bellydance, yoga, meditative and fun movements in pregnancy) and Glimpses (poems from a mother and daughter‟s heart). She has authored several research articles in peer-reviewed local and international journals. Aside from her academic pursuits, she also finds time to teach basic belly dance and Sayuntis (sayaw ng buntis) an exercise program for pregnant and postpartum women comprising belly dance, yoga and other meditative movements. She is a part time life coach and a stress management consultant.
CALLANTA, HERCULES - Former Dean of the College of Human Kinetics (CHK) of the University of the Philippines (UP), Diliman. Herc is one of the country‟s top strength and conditioning coaches. Certified Strength & Conditioning coach by National Strength & Conditioning Association of America (NSCA). He is also a fitness and wellness consultant for Nestle, Adidas, FNRI and Runnex, and a lecturer for several professional associations such as PASOO, PHA, PCC, PSND, etc. He also writes popular articles for Badminton Asia.
CALLANTA, LUCHIE – Masters‟ in Nutrition, Bachelor of Science in Community Nutrition from the University of the Philippines Diliman Quezon City. She also received her Certificate of Course Completion from the National Restaurant Association Educational Foundation, USA for: Principles of Professional Cooking, Professional Baking, Serve Safe Food Protection Manager Certification Examination (recognized by the International Food Safety Council). She is a member of Nutritionist-Dietitians Association of the Philippines & Philippine Society of Nutritionist and Dietitians. At present, she is a member of Board of Advisers for Men‟s Health Magazine and a Consultant for Dona Elena Olive Oil.
COOPER, KITTY – She is certified as a Group Exercise Instructor with the American Council on Exercise (ACE). She has reversed her Scoliosis by studying, experimenting on, and practicing pelvic movements based on the Franklin method. Kit has been teaching Pilates and mindful movement for the past 6 years, and is certified by Polestar Pilates Mat & Allegro certifications. She is a Level 2 Reiki practitioner, and gives Dorn spine alignment therapy and is the pioneer in Bowen Technique in the Philippines. Kit owns a Pilates & healing center in Bacolod: the Mandala Centering Place.
KHO, WAI HAN – has over 6 years of teaching experience with California Fitness Singapore. She is also involved in external events with Health Promotion Board (HPB) and other corporate classes with major companies. She is a Fitness model for SHAPE magazine article “Couch Potato Workout” from Jan-Aug 2005. Her Certifications includes: Certification in Basic Exercise Course by YMCA Fitness Industry (UK); Certification in Exercise with Music by YMCA Fitness Industry (UK); Certified SCHWINN Cycling instructor by SCHWINN Fitness Academy; Certified Les Mills BODYPUMP Instructor by Les Mills International; Certified Les Mills BODYBALANCE Instructor by Les Mills International; Certified Les Mills Pro-Instructor by Les Mills International; Country Trainer Of California Fitness for BODYPUMP and BODYBALANCE; Certified Pilates instructor with Polestar Pilates; Trained mind/body instructor with Adidas Fitness Academy (AFA).
MINKMAR, STEFFEN - Steffen, who works in the internal audit department of the Asian Development Bank, has 8 years of experience in implementing and reviewing internal control frameworks, process improvement projects, and Corporate Governance initiatives. Before joining his current employer, he had worked as an audit manager in PricewaterhouseCoopers, first in Germany and later in Hong Kong, where he served for a broad range of clients in various industries. Steffen is a frequent speaker at IT Governance conferences in the Philippines and a recognized trainer for Corporate Governance related matters. Steffen Minkmar is presently an Audit Specialist working for Asian Development Bank, Audit Division (OAGA)-Key to Good Governance.
ORTEGA, REBECCA – She is a seasoned facilitator of various prestigious organizations such as the Development Academy of the Philippines (DAP) and the Philippine Institute of Applied Behavioral Sciences (PIABS) is not only a gifted trainer/educator but an in-demand trainer-of-trainers of many client organizations. Her talent in group dynamics and facilitation encompasses a broad field of expertise in organizational and human resource development (OD/HRD). Behavioral training such as: teambuilding, positive thinking, values education, quality service, women‟s empowerment, and self-management are her forte. Equally competent in technical programs on topics related to management and supervisory development, targeted selection, assessment, recruitment and selection, performance appraisal and training management, Rebecca has created a high-level impact on all the organizations and companies she has served both here and abroad. Her lecture tours have brought her to various companies and organizations in Indonesia, Malaysia, Singapore and the United Kingdom. She is a meditation practitioner for more than twenty years and the coordinator of the National Coordinating Office of Brahma Kumaris Meditation Center, a UN-affiliated international NGO.
QUEJADA, SHIRLEY – A Founding Member and current President of the Fitness Network Philippines, she holds certifications from the American Council on Exercise (ACE) in Personal Training, Group Exercise, Lifestyle and Weight Management; Aerobics and Fitness Association of America (AFAA) in Primary Group Exercise & Kickboxing; SCW-EDU in Sports Nutrition, Mat Pilates, Pilates with Small Apparatus, Aquatic Fitness, Yoga Fundamentals 1 and 2; Resist-a-Ball C.O.R.E. Basic and Advanced Certification. She is trained in AFAA Mat Science 1 & 2 and Resistance Training; and Reebok Core Board. She is also a former National Athlete Record-holder & Asian Silver Medalist in Powerlifting and an AsiaFit Professional of the Year awardee in 2000. She is the President of ProFit Consultants “Professionals in Fitness”. She is a Bowen Technique Therapy Practitioner and is also trained in Karate and Aikido, and now mastering the Martial Arts Arnis.
SIOSON, DRA. NINA - Dr. Nina graduated Magna cum Laude in BS Biology at the University of the Philippines, Diliman. She pursued her MD at the University of the Philippines‟ College of Medicine, PGH. She is a Diplomate in Family Medicine, a Fellow in Nutrition Support at the St. Luke‟s Medical Center, pursued her Master‟s of Science in Clinical Nutrition at PWU-SLMC, a Diplomate with the Philippine Board of Clinical Nutrition and in Observation Training Nutrition Support under Dr. Mark DeLegge at the Medical University of South Carolina. Dr. Nina is an Active Consultant and Member of the Nutrition Support Teams at the St. Luke‟s Medical Center and the Medical City, where she is also a Weight Management Consultant. She is also a Medical Nutrition Consultant at The Health Cube Clinic, Greenhills, San Juan. She serves as a Faculty member at the Ateneo School of Medicine and Public Health. Dr. Nina serves as Secretary and Head of Committee on Continuing
Professional Education for the Philippine Society for Parenteral and Enteral Nutrition (PhilSPEN). She volunteers as the Medical Consultant for the Carewell Cancer Foundation, Makati City.
TIBBS, MICK - Michael Tibbs (Mickyoga) is certified from the Srivatsa Ramaswami School of Yoga as a teacher of Vinyasa Krama also is a registered member of The Himalayan Institute Teachers Association (HITA) as a Hatha Yoga Teacher and, Yoga Alliance, New York Yoga Teachers Association and I.A.B.Y.T. Loyola Marymount University in L.A., Ca., Princeton Center for Yoga and Health in New Jersey and at the Wellness Center in New York City issuing Michael certificates of completion in Vinyasa Krama Yoga taught by Srivatse Ramaswami. Michael has been studying with Ramaswami since taking a workshop at the Himalayan Institute of N.Y.C. in 2000. Michael has developed a warm teacher – disciple friendship with Ramaswami. Ramaswami studied yoga with the legendary Sri. T. Krishnamarycha for more then thirty years. Michael taught at the Himalayan Institute in NYC. He has also taught for the City of New York - H.I.P. community program, which involved teaching urban children of all ages who were not fortunate enough to have a gymnasium in their school. The classes were held at Asphalt Green on the upper east side of Manhattan. Michael currently teaches privately to all students interested, regardless of age, race, body type, or gender. Presently Michael is one of the five yoga teachers that are fortunate to teach for the United Nations Yoga Club. International yoga teaching and practice has become a passion for Mickyoga. Bermuda, Canada, Denmark, Dominican Republic, Fiji, Greece, India, Indonesia, Mexico, The Netherlands, Puerto Rico, Singapore, Sweden, Switzerland, Taiwan, Thailand, and the United States are some of the places he has enjoyed yoga. Currently he is in the process of putting a yoga & meditation retreat together in Bali with other yoga teachers.
TOLEDO, DR. STRIX - Doctor Toledo's work, while largely rooted in Manual and Occupational Medicine, is highly Integrative in its approach. His U.S.-accredited Medical practice already incorporates Manual Medicine, Acupuncture, Medical Nutrition, Medical Hypnotherapy, and Neuro-linguistic Programming. Most of Doctor Toledo's patients are gracefully aged and have heart, mental, and blood sugar concerns. A large number of them used to be chronically over-stressed. Most of his clinic time is productively occupied with limiting or eliminating muscle, tendon, or joint pain. Doctor Toledo teaches Anatomy and Physiology at a University in Manila. He is the Director of a Healthcare Provider System, and heads a team of brilliantly adaptive Physical Therapist Manual Therapists. His team has started to conduct a very warmly received series of workshop-seminars on Manual Medicine. He is currently writing his second book, which would formally introduce Rapid De-afferentation Techniques. His team is in the process of designing a certification course in RDTs.
TSAI, NICKY- He is a three time Mr. Filipino-Chinese Bodybuilding Champion, National Novice Record Holder in Power Lifting, Owner of Ensayo Gym Equipment, Head Judge-Philippine Sports Commission in Bodybuilding, Technical Director-23rd South East Asian Bodybuilding Games Manila, Business Graduate, Major in Economics, and holds certification in Athletic Training Seminars.
URBIZTONDO, STELLA MARIE - She is a graduate of Bachelor of Science in Physical Education major in Sports in 2001 at the College of Human Kinetics, University of the Philippines. She is currently pursuing a Ph D. in Educational Research and Evaluation. She is the Chair of the Department of Physical Education at the University of Asia and the Pacific.
VELEZ, DAVID - 'David has been a International Fitness Presenter, Personal Trainer and Modern Dancer for over fifteen years...He currently works in Hong Kong and Singapore for California Fitness one of the biggest Fitness Companies in Asia...David is known for his creative teaching style and where he has launched a very successful 'Salsa mania' program... David has been presenting in different conventions worldwide: USA, Spain, Mexico, Ecuador, Cayman Island, Florida, England, Bermuda, Hong Kong, Shanghai, Beijing. David's training includes AFAA certified Fitness Instructor, Polar Specialist, Bosu, Spinning, Schwinn Indoor Cycling, ZUMBA, Tango, AAA/ISMA, Yoga fit and BOSU Master Trainer '. He also has a Bachelor Degree in physical exercise from the University Pedagogica in Colombia South America and technological Engineering from the Technological University of Pereira (Columbia South America).
T O P I C D E S C R I P T I O N S
M a n a g e m e n t T o p i c s
BUSINESS WITH PLEASURE-SUSTAINING THE FITNESS HOBBY – Fitness Lifestyle: Turning your love for fitness into a sustainable yet productive career/hobby. Fitness Instructors, Athletic competitors, gym enthusiasts and even gym owners usually get anchored down with too much „fitness mentality‟ avoiding simple tasks as helping the family do home chores or spending time with love ones, resulting in inability to find income sources outside the fitness world, socially-restricting themselves to „fitness people‟, educating themselves purely on fitness related literatures. As years go by, they find themselves locked in a case. Either financially unstable or socially outcasted. We need to plan ahead, work doubly hard, diversify, multiply our abilities learned from the environment of our fitness world like discipline, integrity, patience, self worth etc. Be a capable person not only in fitness but also in the world that we live in.
DETOXIFY YOUR MIND - You are what you think. Understand this energy of the mind and learn ways to clear the clutter and fill it with healthy, positive thoughts to benefit the self, others and the workplace.
EXERCISE ADHERENCE – Worldwide drop outs in exercise programs are a reality regardless of age, race and social status. However, there are known factors that increase exercise adherence and intrinsic and extrinsic strategies to keep active people from becoming inactive. Understand ways that may aid you in membership retention for clients in your business.
INTERNATIONAL STANDARDS OF CARE FOR FITNESS FACILITIES - For Health/Fitness & Leisure facility Owners and Manager‟s-is your facility at par with international counterparts? Learn acceptable updated guidelines of international standards set by the American College of Sports Medicine (ACSM) and NFTA for facility amenities and ACE and AFAA Standards of Care for fitness professionals.
MAKE MIND YOUR FRIEND - The energy of the human mind is thought. "You are what you think". By understanding and harnessing thought energy, we can develop positive self-awareness and bring life's goals into reality. Learn tools that will help your business dreams become a reality.
PANEL DISCUSSION & OPEN FORUM – Discussion and Question and Answer on the state of Philippine Fitness Industry and its future.
PROTECTING YOUR BUSINESS FROM FRAUD – AN OVERVIEW - In 2009, the Association of Certified Fraud Examiners (ACFE) found that US businesses lose an estimated 7% of annual business revenues to fraud, and that the damage is the worst among small businesses. Companies with fewer than 100 employees experienced $200,000 more in losses due to fraud than larger organizations. In June 2009, Ernst & Young released the European Fraud Survey, which found that half of European employees believed that "one or more types of unethical business behavior were acceptable." In September 2009, International Risk reported that lack of risk mitigation policies or effective due diligence is a significant challenge facing growth of Asian businesses. In the current economic environment, it is expected that fraud will continue to increase. This presentation will highlight challenges which small businesses may face and will make recommendations for safeguarding business interests from fraud.
WELLNESS: THE MIND & BODY CONNECTION - The fact that the mind can affect the course of disease has generally been accepted as fact by both physician and patient. But proving scientifically that the mind-body connection exists took until the end of the 20th century before the knowledge and technology progressed far
enough to conduct researches. Have you heard about the relatively young science of Psychoneuroimmunology (PNI), which is now scientifically establishing the interconnectedness of the mind, nervous, endocrine and immune systems? Well, here it is from Dr. Faye Cagayan.
G r o u p E x e r c i s e T o p i c s
HATAW PINOY/CARDIO STICK FIGHT – Inspired by the Filipino Martial Art of Arnis designed by Shirley Quejada. The workshop will teach you how to use the eighteen (18) strikes in Arnis for upper body muscular endurance and cardiovascular endurance together with lower body footwork for agility and coordination. In this workshop you will learn empty hand, single stick & double stick techniques incorporating the add-on & link method in group exercise choreography. Hataw Pinoy has level 2 for blocks, level 3 for strikes & blocks and level 4 for sparing workouts which will be targeted in future workshops.
MIND & BODY - M&B an innovative and integrative practice combining principles of yoga, enhanced with explosive martial arts movements and core connection with total-body balance integration. Explosive quick movements stimulate fast twitch muscles, as well as slow twitch muscles, which increase power and reactive abilities. On the other hand, slow calming postures open and unwind the deepest realms of consciousness.
NATIONAL GUIDELINES FOR PHYSICAL ACTIVITY – Physical Activity is one of the elements of a healthy lifestyle. This is now being promoted by both the Department of Health and WHO. Most countries, including the Philippines, are already campaigning vigorously for an increase in physical activity among their citizens. Most have also produced physical activity guidelines. The Philippines, however, is one of a few who has yet to formulate one. In several gatherings of movement experts (Luigi Bercades, Hercules Callanta, Luchie Callanta, Bert Madrigal, Shirley Quejada, Josephine Joy Reyes, and Stella Marie Urbiztondo) and national health stakeholders, the Philippine National Guidelines on Physical Activity was formulated and critiqued. This is envisioned to provide simple guidelines to Filipinos in their pursuit of a healthy lifestyle.
REGGAETTON RIPIAO - Reggaetton is the mixture of Latin, Reggae and R'n'B. It's fun, sassy and everyone can join in. This class is incorporated with simple reggaetton combinations to move the ground and make you sweat to the beat.
TANGO LATINO - Hit the floor and let the rhythm move you. This is a session combining Tango and Dance Aerobics movements which allows for all levels of participants to get the chance to move their bodies and join in the party! A combination of dynamic balance, turning, initiation of movements, moving at a variety of speeds & walking forward/backwards, Tango Latino helps to increase cardio fitness, improve balance and aids in weight loss. Join the Tango Latino for a larger than life Latin experience.
VINYASA KRAMA YOGA – Introductory class of Vinyasa Krama yoga for all levels. Find out how to be healthy Physically, mentally, & spiritually through this classical yoga sadhana (practice).
YIN STRETCH - The new endurance sport where the fascial matrix of muscles and other connective tissues surrounding the pelvis are gradually “stretched” beyond the typical duration of 30 seconds. Besides physical endurance, there is also a demand for mental focus to keep one‟s self still and quiet in the yoga posture. This is based on the presentation of Paul Grilley.
ZUMBA - Zumba fuses hypnotic latin rhythms and easy to follow moves to create a dynamic fitness program that will blow you away. Achieve long term benefits while experiencing an absolute blast in one exhilarating hour of caloric-burning, body-energizing, awe-inspiring movements meant to engage and captivate for life!
P e r s o n a l T r a i n i n g T o p i c s
A PRESENTATION ON CARBOHYDRATE LOADING – Its uses and benefits. It shall include the different regimens, the dietary implications and concerns associated with it.
EXERCISE ADHERENCE – Worldwide drop outs in exercise programs are a reality regardless of age, race and social status. However, there are known factors that increase exercise adherence and intrinsic and extrinsic strategies to keep active people from becoming inactive. Learn ways to keep the clients you already have and get future business from them and their referrals.
NATIONAL GUIDELINES FOR PHYSICAL ACTIVITY – Physical Activity is one of the elements of a healthy lifestyle. This is now being promoted by both the Department of Health and WHO. Most countries, including the Philippines, are already campaigning vigorously for an increase in physical activity among their citizens. Most have also produced physical activity guidelines. The Philippines, however, is one of a few who has yet to formulate one. In several gatherings of movement experts (Luigi Bercades, Hercules Callanta, Luchie Callanta, Bert Madrigal, Shirley Quejada, Josephine Joy Reyes, and Stella Marie Urbiztondo) and national health stakeholders, the Philippine National Guidelines on Physical Activity was formulated and critiqued. This is envisioned to provide simple guidelines to Filipinos in their pursuit of a healthy lifestyle.
POWER, SPEED & AGILITY WITH BALANCE (WORKSHOP) - Power, Speed and Agility are needed not just for sports but for various types of activities as well. However, another important component of good athletic performance is often neglected – BALANCE. In activities of daily living, good balance will not only help prevent injuries but help make day-to-day activities less challenging particularly for the elderly. Let us explore the principles and try the drills that can help not only our clients who are elite athletes, but those who may be experiencing challenges from what may seem to you as a basic functional movement. (Come in exercise attire).
SURVIVOR - For “Survivor” workouts, think „group training sessions‟, think „outdoors‟ (whatever the weather and whatever the season!), and think “fun” and think “challenging”. Sessions usually last for one hour and contain a broad mix of running and bodyweight exercises, which have the aim of providing an all-over body workout. In these circuit-training-style sessions, you can expect to work hard and get hot and sweaty but also enjoy a new dimension to exercising because of the variety that the sessions bring. David will present this workshop to be adopted for Personal Training practice with use of small apparatus.
THE NEUROMYOFASCIAL SYSTEM: AN OVERVIEW FOR FITNESS PROFESSIONALS – An Introductory look at the hidden network that connects, affects, and is affected by the rest of the body. The muscular, fascial, and neural are intimately linked and connect to the rest of the body systems. The NMF system thus reflects and affects the entire body. In this session, we explore the meanings and implications of NMF Dysfunctions commonly encountered by fitness professionals. These dysfunctions offer secret insight into the current and longstanding status of the bodies we work with. Understanding common NMF Patterns enables the empowered fitness professional with the ability to customize exercise protocols. This then allows for faster recovery and better functional gains for our patients or clients.
THE TRUTH BEHIND SUPPLEMENTS - Everyday, more and more commercials pop up on television and on print ad materials urging you to purchase natural supplements. Some claim benefits in overall health and aging; others promise cures for specific conditions. How can we spot the fakes and the legitimate ones? The objective of this session is to help you understand what food supplements are, which are not to be believed and what the law has done to regulate the distribution and sale of such items. The session will explain in simple terms why some supplements may be more harmful than helpful. Emphasis is placed on seeking medical advice before embarking on long-term intake of supplements. Although many supplements are helpful at times, the bottomline to a healthy life is healthy living – good nutrition, adequate exercise and inner peace. The speaker would like to acknowledge and thank Dr. Lynn Panganiban, noted toxicologist from UP-PGH and The Medical City, for giving her permission to echo her lecture to other fora.
YIN STRETCH FOR PERSONAL TRAINING - The new endurance sport where the fascial matrix of muscles and other connective tissues surrounding the pelvis are gradually “stretched” beyond the typical duration of 30 seconds. Besides physical endurance, there is also a demand for mental focus to keep one‟s self still and quiet in the yoga posture. This is based on the presentation of Paul Grilley. Learn and try (Come in Exercise Apparel).
W o r k s h o p D e s c r i p t i o n s
CARDIO LATINO WORKSHOP – This half day Latino Workshop is for instructors who are looking for ways to create safe and fun Latin classes. Learn to move to the different Latin rhythms specific to the different types of Latin dances from Rhumba, to Salsa, to Zumba, to mambo, Tango among others. Create your own combinations! Get personal feedback and evaluation from David Velez. Different Latin, different music! (0.4 ACE CEC‟s)
CPR SEMINAR – Conducted by the Philippine National Red Cross. Learn how to administer first aid for cardiac arrest, respiratory arrest & choking. Participants may attend the workshop only, but for those who wish to be certified, you must take the written & practical exams at the later part of the workshop. FitPhil encourages all instructors to be CPR-certified and renew their CPR license every year. We believe that each family should have at least 1-2 persons in the household who know CPR.
VINYASA KRAMA YOGA 1 WORKSHOP – The art form of doing vinyasa yoga is an ancient practice of physical and spiritual development. It is a systematic method to study, practice, teach, and adapt yoga. This vinyasa krama (movement and sequence methodology) approach to yogasana (yoga posture) practice is unique in all of yoga. By integrating the functions of mind, body, and breath in the same time frame, a practitioner will experience the real joy of yoga practice. Each of the important postures (asanas) is practiced with many elaborate vinyasa (variations and movements). Each variation is linked to the next one by a succession of specific transitional movements, synchronized with the breath; and the yoking of mind and body takes place with the breath acting as the harness. Vinyasa krama yoga strictly follows the most complete definition of classical yoga. The parameters of vinyasa, the Sanskrit word vinyasa comes from a prefix vi, which means variation, and a suffix nyasa, which means “within prescribed parameters.” The parameters prescribed in classical yoga with respect to yogasanas, as contained in Yoga sutra of Patanjali, are: STEADINESS (STHIRA), COMFORT (SUKHA), and SMOOTH AND LONG BREATHING (PRAYATNA SITHILA).
Practicum in Vinyasa Krama yoga this class will be more comprehensive by introducing the class to some slightly challenging movements Asana: Asymmetric Seated Vinyasa Sequences (one leg is straight while the other leg is bent in a variety of positions); Trianagle Pose Sequence; Ding-namaskara (salutations to the directions); Supine Sequences (on the back); Seated Posterior Stretch Sequences (both legs are straight). Of course all postures will have their appropriate counter posture Pranayama: Introduction to Pranayama (breath control); Kapalabhati forceful exhalation; Pranayama Omkara lengthening the exhalation by chanting OM; Satsang; Discussion (Q&A) on yoga. (ACE CEC‟s applied).
VINYASA KRAMA YOGA 2 WORKSHOP - Practicum in Vinyasa Krama yoga this class will be an extension of the morning workshop offering more challenging asanas (postures) & introducing more subtler aspects of yoga such as bandhas & mudras (locks & gestures). Asana: Lotus Pose Sequence; Inverted posture Sequence; Shoulder stand, head stand, etc…; Bow Pose Squence; Visesha Vinyasa Kramas ; Sub routines like sun salutation, & sequences stemming from downward facing dog; Pranayama; Nadi Shodhana ;Bhastrika Kumbhaka; Satsang; Discussion (Q&A) on yoga. (ACE CEC‟s applied)
IMPORTANT NOTES:
1. Please call FitPhil office at 920-2762 or text 0917-5181202 for reservations of slots for the workshops.
2. ACE CEC‟s will be available for all. For course number and number of credits for ACE Certified Fitness Professionals there is a corresponding fee to be paid, please coordinate with Fitphil office.
16th National Fitness Convention
“Promoting Physical Activity for Wellness”
November 7, 2009 Saturday (Fitness Managers Convention, Group Exercise Convention
& CPR Seminar),
November 8, 2009 Sunday (Personal Training Convention, Cardio Latino Workshop,
& Yoga Workshop)
THE RICHMONDE HOTEL
21 San Miguel Avenue, Ortigas Center Pasig City, Philippines
November 7, 2009 (Saturday) Fitness Managers Convention-BANYAN & CEDAR FUNCTION ROOMS
6:30-8:00 Registration
7:45-8:00 OPENING
8:00-9:00 Wellness: Mind & Body Connection
(Dr. Stephanie Fay Cagayan)
9:00-10:00 Exercise Adherence (Stella Marie Urbiztondo)
10:00-10:20 AM SNACKS
10:20-11:20 Business with Pleasure-Sustaining the Fitness
Hobby (Nicky Tsai)
11:30-12:30 Detoxify Your Mind (Rebecca Ortega)
12:30-1:30 LUNCH BREAK
1:30-2:30 Protecting your Business from Fraud - an Overview
(Steffen Minkmar)
2:30-3:30 Make Mind Your Friend (Jonathan Batangan)
3:30-3:50 PM SNACKS
3:50-4:50 International Standards of Care for Fitness Facilities
(Shirley Quejada)
4:50-5:50 Panel Discussion & Open Forum
(Fitness Leaders & Convention Participants)
November 7, 2009 (Saturday) Group Exercise Convention-REDWOOD, SYCAMORE & SEQUOIA ROOMS
6:30-8:00 Registration
7:45-8:00 OPENING
8:00-9:00 Vinyasa Krama Yoga (Mick Tibbs)
9:00-10:00 Reggaetton Ripiao (David Velez)
10:00-10:20 AM SNACKS
10:20-11:20 Hataw Pinoy/Cardio Stick Fight (Shirley Quejada)
11:20-12:20 Yin Stretch (Kitty Cooper)
12:20-1:30 LUNCH BREAK
1:30-2:30 National Guidelines for Physical Activity
(Hercules Callanta)
2:30-3:30 Tango Latino (David Velez)
3:30-3:50 PM SNACKS
3:50-4:50 Mind & Body (Wai Han Kho)
4:50-5:50 Zumba (David Velez)
November 8, 2009 (Sunday) Personal Training Convention- REDWOOD, SYCAMORE & SEQUOIA ROOMS
6:30-8:00 Registration
7:45-8:00 OPENING
8:00-9:00 Power, Speed & Agility with Balance-Workshop
(Shirley Quejada)
9:00-10:00 Yin Stretch for Personal Training (Kitty Cooper)
10:00-10:20 AM SNACKS
10:20-11:20 The Truth behind Supplements (Dra. Nina Sioson)
11:20-12:20 National Guidelines for Physical Activity
(Hercules Callanta)
12:20-1:30 LUNCH BREAK
1:30-2:30 A Presentation on Carbohydrate Loading
(Luchie Callanta)
2:30-3:30 Survivor (David Velez)
3:30-3:50 PM SNACKS
3:50-4:50 Exercise Adherence (Stella Marie Urbiztondo)
4:50-5:50 The NeuroMyoFascial System: An Overview for Fitness Professionals (Dr. Strix Toledo)
SCHEDULE OF WORKSHOPS
November 7, 2009 (Saturday)
8:00-6:00 CPR Seminar By: Philippine National Red Cross (PALM FUNCTION ROOM)
November 8, 2009 (Sunday)
9:00-12:30am CARDIO LATINO WORKSHOP
(BANYAN & CEDAR FUNCTION ROOMS)
By: David Velez
8:30-12:30nn VINYASA KRAMA YOGA 1 WORKSHOP
(PALM FUNCTION ROOM) By: Mick Tibbs
1:30-5:30pm VINYASA KRAMA YOGA 2 WORKSHOP
(BANYAN & CEDAR FUNCTION ROOMS)
By: Mick Tibbs
You may contact us at 920-2762 or text 0917-5181202 for queries.
P R E S E N T E R S
BATANGAN, JONATHAN - General Manager , Cebuana Llhuillier Insurance Solutions (September 2004- present) Mobilized agency personnel to become motivated, quality-driven, customer-focused , and results-oriented individuals. Transformed agency from dismal performer to top achiever in the PJ Lhuillier Group of Companies. Initiated cross-selling and synergy programs within the Group and strengthened the AllCare brand through product development and innovation. Instrumental in creating one of the most successful micro-insurance products in the country which has now insured approximately 6.5 million Filipinos. Increased revenues by 1,000% during first year (2005),and further doubled the 2005 revenues in 2006; Conferred with “Ambassador’s Cup” by Amb. Philippe Lhuillier, the highest honor and first-ever recipient from the PJLI Group for sales/ marketing excellence; PLIA was conferred by Malayan Insurance with the following awards in 2005 : Top Achiever Award (Special Agency Category) and Most Valuable Partner Award. On the personal side, a meditation practitioner for more than ten years and a meditation resource person of the Brahma Kumaris Meditation Center, a UN-affiliated international NGO.
CAGAYAN, DR. STEPHANIE FAY - Dr. Ma. Stephanie Fay S. Cagayan, obtained her Bachelor of Science in Basic Medical Sciences at the University of the Philippines Manila in 1990 followed by her degree in Medicine in 1993 under the Integrated Arts and Medicine Program (Intarmed), a 7 year accelerated medical course of the UP College of Medicine. She is a frequent resource speaker for seminars and special topics in obstetrics and gynecology, pharmacology and toxicology and wellness specifically dance as a form of healing. She is an advocate of holistic medicine and her practice of medicine includes the use of complementary and alternative forms of medicine for prevention and treatment of illnesses. She is a member of the Fitness Network Philippines and she also acts as director and manager of Rhythms, a wellness center and dance studio located in Manila. To date, she has published 4 books namely, Essentials of Obstetric Nursing, Pharmacology for Beginners, Sayuntis (bellydance, yoga, meditative and fun movements in pregnancy) and Glimpses (poems from a mother and daughter‟s heart). She has authored several research articles in peer-reviewed local and international journals. Aside from her academic pursuits, she also finds time to teach basic belly dance and Sayuntis (sayaw ng buntis) an exercise program for pregnant and postpartum women comprising belly dance, yoga and other meditative movements. She is a part time life coach and a stress management consultant.
CALLANTA, HERCULES - Former Dean of the College of Human Kinetics (CHK) of the University of the Philippines (UP), Diliman. Herc is one of the country‟s top strength and conditioning coaches. Certified Strength & Conditioning coach by National Strength & Conditioning Association of America (NSCA). He is also a fitness and wellness consultant for Nestle, Adidas, FNRI and Runnex, and a lecturer for several professional associations such as PASOO, PHA, PCC, PSND, etc. He also writes popular articles for Badminton Asia.
CALLANTA, LUCHIE – Masters‟ in Nutrition, Bachelor of Science in Community Nutrition from the University of the Philippines Diliman Quezon City. She also received her Certificate of Course Completion from the National Restaurant Association Educational Foundation, USA for: Principles of Professional Cooking, Professional Baking, Serve Safe Food Protection Manager Certification Examination (recognized by the International Food Safety Council). She is a member of Nutritionist-Dietitians Association of the Philippines & Philippine Society of Nutritionist and Dietitians. At present, she is a member of Board of Advisers for Men‟s Health Magazine and a Consultant for Dona Elena Olive Oil.
COOPER, KITTY – She is certified as a Group Exercise Instructor with the American Council on Exercise (ACE). She has reversed her Scoliosis by studying, experimenting on, and practicing pelvic movements based on the Franklin method. Kit has been teaching Pilates and mindful movement for the past 6 years, and is certified by Polestar Pilates Mat & Allegro certifications. She is a Level 2 Reiki practitioner, and gives Dorn spine alignment therapy and is the pioneer in Bowen Technique in the Philippines. Kit owns a Pilates & healing center in Bacolod: the Mandala Centering Place.
KHO, WAI HAN – has over 6 years of teaching experience with California Fitness Singapore. She is also involved in external events with Health Promotion Board (HPB) and other corporate classes with major companies. She is a Fitness model for SHAPE magazine article “Couch Potato Workout” from Jan-Aug 2005. Her Certifications includes: Certification in Basic Exercise Course by YMCA Fitness Industry (UK); Certification in Exercise with Music by YMCA Fitness Industry (UK); Certified SCHWINN Cycling instructor by SCHWINN Fitness Academy; Certified Les Mills BODYPUMP Instructor by Les Mills International; Certified Les Mills BODYBALANCE Instructor by Les Mills International; Certified Les Mills Pro-Instructor by Les Mills International; Country Trainer Of California Fitness for BODYPUMP and BODYBALANCE; Certified Pilates instructor with Polestar Pilates; Trained mind/body instructor with Adidas Fitness Academy (AFA).
MINKMAR, STEFFEN - Steffen, who works in the internal audit department of the Asian Development Bank, has 8 years of experience in implementing and reviewing internal control frameworks, process improvement projects, and Corporate Governance initiatives. Before joining his current employer, he had worked as an audit manager in PricewaterhouseCoopers, first in Germany and later in Hong Kong, where he served for a broad range of clients in various industries. Steffen is a frequent speaker at IT Governance conferences in the Philippines and a recognized trainer for Corporate Governance related matters. Steffen Minkmar is presently an Audit Specialist working for Asian Development Bank, Audit Division (OAGA)-Key to Good Governance.
ORTEGA, REBECCA – She is a seasoned facilitator of various prestigious organizations such as the Development Academy of the Philippines (DAP) and the Philippine Institute of Applied Behavioral Sciences (PIABS) is not only a gifted trainer/educator but an in-demand trainer-of-trainers of many client organizations. Her talent in group dynamics and facilitation encompasses a broad field of expertise in organizational and human resource development (OD/HRD). Behavioral training such as: teambuilding, positive thinking, values education, quality service, women‟s empowerment, and self-management are her forte. Equally competent in technical programs on topics related to management and supervisory development, targeted selection, assessment, recruitment and selection, performance appraisal and training management, Rebecca has created a high-level impact on all the organizations and companies she has served both here and abroad. Her lecture tours have brought her to various companies and organizations in Indonesia, Malaysia, Singapore and the United Kingdom. She is a meditation practitioner for more than twenty years and the coordinator of the National Coordinating Office of Brahma Kumaris Meditation Center, a UN-affiliated international NGO.
QUEJADA, SHIRLEY – A Founding Member and current President of the Fitness Network Philippines, she holds certifications from the American Council on Exercise (ACE) in Personal Training, Group Exercise, Lifestyle and Weight Management; Aerobics and Fitness Association of America (AFAA) in Primary Group Exercise & Kickboxing; SCW-EDU in Sports Nutrition, Mat Pilates, Pilates with Small Apparatus, Aquatic Fitness, Yoga Fundamentals 1 and 2; Resist-a-Ball C.O.R.E. Basic and Advanced Certification. She is trained in AFAA Mat Science 1 & 2 and Resistance Training; and Reebok Core Board. She is also a former National Athlete Record-holder & Asian Silver Medalist in Powerlifting and an AsiaFit Professional of the Year awardee in 2000. She is the President of ProFit Consultants “Professionals in Fitness”. She is a Bowen Technique Therapy Practitioner and is also trained in Karate and Aikido, and now mastering the Martial Arts Arnis.
SIOSON, DRA. NINA - Dr. Nina graduated Magna cum Laude in BS Biology at the University of the Philippines, Diliman. She pursued her MD at the University of the Philippines‟ College of Medicine, PGH. She is a Diplomate in Family Medicine, a Fellow in Nutrition Support at the St. Luke‟s Medical Center, pursued her Master‟s of Science in Clinical Nutrition at PWU-SLMC, a Diplomate with the Philippine Board of Clinical Nutrition and in Observation Training Nutrition Support under Dr. Mark DeLegge at the Medical University of South Carolina. Dr. Nina is an Active Consultant and Member of the Nutrition Support Teams at the St. Luke‟s Medical Center and the Medical City, where she is also a Weight Management Consultant. She is also a Medical Nutrition Consultant at The Health Cube Clinic, Greenhills, San Juan. She serves as a Faculty member at the Ateneo School of Medicine and Public Health. Dr. Nina serves as Secretary and Head of Committee on Continuing
Professional Education for the Philippine Society for Parenteral and Enteral Nutrition (PhilSPEN). She volunteers as the Medical Consultant for the Carewell Cancer Foundation, Makati City.
TIBBS, MICK - Michael Tibbs (Mickyoga) is certified from the Srivatsa Ramaswami School of Yoga as a teacher of Vinyasa Krama also is a registered member of The Himalayan Institute Teachers Association (HITA) as a Hatha Yoga Teacher and, Yoga Alliance, New York Yoga Teachers Association and I.A.B.Y.T. Loyola Marymount University in L.A., Ca., Princeton Center for Yoga and Health in New Jersey and at the Wellness Center in New York City issuing Michael certificates of completion in Vinyasa Krama Yoga taught by Srivatse Ramaswami. Michael has been studying with Ramaswami since taking a workshop at the Himalayan Institute of N.Y.C. in 2000. Michael has developed a warm teacher – disciple friendship with Ramaswami. Ramaswami studied yoga with the legendary Sri. T. Krishnamarycha for more then thirty years. Michael taught at the Himalayan Institute in NYC. He has also taught for the City of New York - H.I.P. community program, which involved teaching urban children of all ages who were not fortunate enough to have a gymnasium in their school. The classes were held at Asphalt Green on the upper east side of Manhattan. Michael currently teaches privately to all students interested, regardless of age, race, body type, or gender. Presently Michael is one of the five yoga teachers that are fortunate to teach for the United Nations Yoga Club. International yoga teaching and practice has become a passion for Mickyoga. Bermuda, Canada, Denmark, Dominican Republic, Fiji, Greece, India, Indonesia, Mexico, The Netherlands, Puerto Rico, Singapore, Sweden, Switzerland, Taiwan, Thailand, and the United States are some of the places he has enjoyed yoga. Currently he is in the process of putting a yoga & meditation retreat together in Bali with other yoga teachers.
TOLEDO, DR. STRIX - Doctor Toledo's work, while largely rooted in Manual and Occupational Medicine, is highly Integrative in its approach. His U.S.-accredited Medical practice already incorporates Manual Medicine, Acupuncture, Medical Nutrition, Medical Hypnotherapy, and Neuro-linguistic Programming. Most of Doctor Toledo's patients are gracefully aged and have heart, mental, and blood sugar concerns. A large number of them used to be chronically over-stressed. Most of his clinic time is productively occupied with limiting or eliminating muscle, tendon, or joint pain. Doctor Toledo teaches Anatomy and Physiology at a University in Manila. He is the Director of a Healthcare Provider System, and heads a team of brilliantly adaptive Physical Therapist Manual Therapists. His team has started to conduct a very warmly received series of workshop-seminars on Manual Medicine. He is currently writing his second book, which would formally introduce Rapid De-afferentation Techniques. His team is in the process of designing a certification course in RDTs.
TSAI, NICKY- He is a three time Mr. Filipino-Chinese Bodybuilding Champion, National Novice Record Holder in Power Lifting, Owner of Ensayo Gym Equipment, Head Judge-Philippine Sports Commission in Bodybuilding, Technical Director-23rd South East Asian Bodybuilding Games Manila, Business Graduate, Major in Economics, and holds certification in Athletic Training Seminars.
URBIZTONDO, STELLA MARIE - She is a graduate of Bachelor of Science in Physical Education major in Sports in 2001 at the College of Human Kinetics, University of the Philippines. She is currently pursuing a Ph D. in Educational Research and Evaluation. She is the Chair of the Department of Physical Education at the University of Asia and the Pacific.
VELEZ, DAVID - 'David has been a International Fitness Presenter, Personal Trainer and Modern Dancer for over fifteen years...He currently works in Hong Kong and Singapore for California Fitness one of the biggest Fitness Companies in Asia...David is known for his creative teaching style and where he has launched a very successful 'Salsa mania' program... David has been presenting in different conventions worldwide: USA, Spain, Mexico, Ecuador, Cayman Island, Florida, England, Bermuda, Hong Kong, Shanghai, Beijing. David's training includes AFAA certified Fitness Instructor, Polar Specialist, Bosu, Spinning, Schwinn Indoor Cycling, ZUMBA, Tango, AAA/ISMA, Yoga fit and BOSU Master Trainer '. He also has a Bachelor Degree in physical exercise from the University Pedagogica in Colombia South America and technological Engineering from the Technological University of Pereira (Columbia South America).
T O P I C D E S C R I P T I O N S
M a n a g e m e n t T o p i c s
BUSINESS WITH PLEASURE-SUSTAINING THE FITNESS HOBBY – Fitness Lifestyle: Turning your love for fitness into a sustainable yet productive career/hobby. Fitness Instructors, Athletic competitors, gym enthusiasts and even gym owners usually get anchored down with too much „fitness mentality‟ avoiding simple tasks as helping the family do home chores or spending time with love ones, resulting in inability to find income sources outside the fitness world, socially-restricting themselves to „fitness people‟, educating themselves purely on fitness related literatures. As years go by, they find themselves locked in a case. Either financially unstable or socially outcasted. We need to plan ahead, work doubly hard, diversify, multiply our abilities learned from the environment of our fitness world like discipline, integrity, patience, self worth etc. Be a capable person not only in fitness but also in the world that we live in.
DETOXIFY YOUR MIND - You are what you think. Understand this energy of the mind and learn ways to clear the clutter and fill it with healthy, positive thoughts to benefit the self, others and the workplace.
EXERCISE ADHERENCE – Worldwide drop outs in exercise programs are a reality regardless of age, race and social status. However, there are known factors that increase exercise adherence and intrinsic and extrinsic strategies to keep active people from becoming inactive. Understand ways that may aid you in membership retention for clients in your business.
INTERNATIONAL STANDARDS OF CARE FOR FITNESS FACILITIES - For Health/Fitness & Leisure facility Owners and Manager‟s-is your facility at par with international counterparts? Learn acceptable updated guidelines of international standards set by the American College of Sports Medicine (ACSM) and NFTA for facility amenities and ACE and AFAA Standards of Care for fitness professionals.
MAKE MIND YOUR FRIEND - The energy of the human mind is thought. "You are what you think". By understanding and harnessing thought energy, we can develop positive self-awareness and bring life's goals into reality. Learn tools that will help your business dreams become a reality.
PANEL DISCUSSION & OPEN FORUM – Discussion and Question and Answer on the state of Philippine Fitness Industry and its future.
PROTECTING YOUR BUSINESS FROM FRAUD – AN OVERVIEW - In 2009, the Association of Certified Fraud Examiners (ACFE) found that US businesses lose an estimated 7% of annual business revenues to fraud, and that the damage is the worst among small businesses. Companies with fewer than 100 employees experienced $200,000 more in losses due to fraud than larger organizations. In June 2009, Ernst & Young released the European Fraud Survey, which found that half of European employees believed that "one or more types of unethical business behavior were acceptable." In September 2009, International Risk reported that lack of risk mitigation policies or effective due diligence is a significant challenge facing growth of Asian businesses. In the current economic environment, it is expected that fraud will continue to increase. This presentation will highlight challenges which small businesses may face and will make recommendations for safeguarding business interests from fraud.
WELLNESS: THE MIND & BODY CONNECTION - The fact that the mind can affect the course of disease has generally been accepted as fact by both physician and patient. But proving scientifically that the mind-body connection exists took until the end of the 20th century before the knowledge and technology progressed far
enough to conduct researches. Have you heard about the relatively young science of Psychoneuroimmunology (PNI), which is now scientifically establishing the interconnectedness of the mind, nervous, endocrine and immune systems? Well, here it is from Dr. Faye Cagayan.
G r o u p E x e r c i s e T o p i c s
HATAW PINOY/CARDIO STICK FIGHT – Inspired by the Filipino Martial Art of Arnis designed by Shirley Quejada. The workshop will teach you how to use the eighteen (18) strikes in Arnis for upper body muscular endurance and cardiovascular endurance together with lower body footwork for agility and coordination. In this workshop you will learn empty hand, single stick & double stick techniques incorporating the add-on & link method in group exercise choreography. Hataw Pinoy has level 2 for blocks, level 3 for strikes & blocks and level 4 for sparing workouts which will be targeted in future workshops.
MIND & BODY - M&B an innovative and integrative practice combining principles of yoga, enhanced with explosive martial arts movements and core connection with total-body balance integration. Explosive quick movements stimulate fast twitch muscles, as well as slow twitch muscles, which increase power and reactive abilities. On the other hand, slow calming postures open and unwind the deepest realms of consciousness.
NATIONAL GUIDELINES FOR PHYSICAL ACTIVITY – Physical Activity is one of the elements of a healthy lifestyle. This is now being promoted by both the Department of Health and WHO. Most countries, including the Philippines, are already campaigning vigorously for an increase in physical activity among their citizens. Most have also produced physical activity guidelines. The Philippines, however, is one of a few who has yet to formulate one. In several gatherings of movement experts (Luigi Bercades, Hercules Callanta, Luchie Callanta, Bert Madrigal, Shirley Quejada, Josephine Joy Reyes, and Stella Marie Urbiztondo) and national health stakeholders, the Philippine National Guidelines on Physical Activity was formulated and critiqued. This is envisioned to provide simple guidelines to Filipinos in their pursuit of a healthy lifestyle.
REGGAETTON RIPIAO - Reggaetton is the mixture of Latin, Reggae and R'n'B. It's fun, sassy and everyone can join in. This class is incorporated with simple reggaetton combinations to move the ground and make you sweat to the beat.
TANGO LATINO - Hit the floor and let the rhythm move you. This is a session combining Tango and Dance Aerobics movements which allows for all levels of participants to get the chance to move their bodies and join in the party! A combination of dynamic balance, turning, initiation of movements, moving at a variety of speeds & walking forward/backwards, Tango Latino helps to increase cardio fitness, improve balance and aids in weight loss. Join the Tango Latino for a larger than life Latin experience.
VINYASA KRAMA YOGA – Introductory class of Vinyasa Krama yoga for all levels. Find out how to be healthy Physically, mentally, & spiritually through this classical yoga sadhana (practice).
YIN STRETCH - The new endurance sport where the fascial matrix of muscles and other connective tissues surrounding the pelvis are gradually “stretched” beyond the typical duration of 30 seconds. Besides physical endurance, there is also a demand for mental focus to keep one‟s self still and quiet in the yoga posture. This is based on the presentation of Paul Grilley.
ZUMBA - Zumba fuses hypnotic latin rhythms and easy to follow moves to create a dynamic fitness program that will blow you away. Achieve long term benefits while experiencing an absolute blast in one exhilarating hour of caloric-burning, body-energizing, awe-inspiring movements meant to engage and captivate for life!
P e r s o n a l T r a i n i n g T o p i c s
A PRESENTATION ON CARBOHYDRATE LOADING – Its uses and benefits. It shall include the different regimens, the dietary implications and concerns associated with it.
EXERCISE ADHERENCE – Worldwide drop outs in exercise programs are a reality regardless of age, race and social status. However, there are known factors that increase exercise adherence and intrinsic and extrinsic strategies to keep active people from becoming inactive. Learn ways to keep the clients you already have and get future business from them and their referrals.
NATIONAL GUIDELINES FOR PHYSICAL ACTIVITY – Physical Activity is one of the elements of a healthy lifestyle. This is now being promoted by both the Department of Health and WHO. Most countries, including the Philippines, are already campaigning vigorously for an increase in physical activity among their citizens. Most have also produced physical activity guidelines. The Philippines, however, is one of a few who has yet to formulate one. In several gatherings of movement experts (Luigi Bercades, Hercules Callanta, Luchie Callanta, Bert Madrigal, Shirley Quejada, Josephine Joy Reyes, and Stella Marie Urbiztondo) and national health stakeholders, the Philippine National Guidelines on Physical Activity was formulated and critiqued. This is envisioned to provide simple guidelines to Filipinos in their pursuit of a healthy lifestyle.
POWER, SPEED & AGILITY WITH BALANCE (WORKSHOP) - Power, Speed and Agility are needed not just for sports but for various types of activities as well. However, another important component of good athletic performance is often neglected – BALANCE. In activities of daily living, good balance will not only help prevent injuries but help make day-to-day activities less challenging particularly for the elderly. Let us explore the principles and try the drills that can help not only our clients who are elite athletes, but those who may be experiencing challenges from what may seem to you as a basic functional movement. (Come in exercise attire).
SURVIVOR - For “Survivor” workouts, think „group training sessions‟, think „outdoors‟ (whatever the weather and whatever the season!), and think “fun” and think “challenging”. Sessions usually last for one hour and contain a broad mix of running and bodyweight exercises, which have the aim of providing an all-over body workout. In these circuit-training-style sessions, you can expect to work hard and get hot and sweaty but also enjoy a new dimension to exercising because of the variety that the sessions bring. David will present this workshop to be adopted for Personal Training practice with use of small apparatus.
THE NEUROMYOFASCIAL SYSTEM: AN OVERVIEW FOR FITNESS PROFESSIONALS – An Introductory look at the hidden network that connects, affects, and is affected by the rest of the body. The muscular, fascial, and neural are intimately linked and connect to the rest of the body systems. The NMF system thus reflects and affects the entire body. In this session, we explore the meanings and implications of NMF Dysfunctions commonly encountered by fitness professionals. These dysfunctions offer secret insight into the current and longstanding status of the bodies we work with. Understanding common NMF Patterns enables the empowered fitness professional with the ability to customize exercise protocols. This then allows for faster recovery and better functional gains for our patients or clients.
THE TRUTH BEHIND SUPPLEMENTS - Everyday, more and more commercials pop up on television and on print ad materials urging you to purchase natural supplements. Some claim benefits in overall health and aging; others promise cures for specific conditions. How can we spot the fakes and the legitimate ones? The objective of this session is to help you understand what food supplements are, which are not to be believed and what the law has done to regulate the distribution and sale of such items. The session will explain in simple terms why some supplements may be more harmful than helpful. Emphasis is placed on seeking medical advice before embarking on long-term intake of supplements. Although many supplements are helpful at times, the bottomline to a healthy life is healthy living – good nutrition, adequate exercise and inner peace. The speaker would like to acknowledge and thank Dr. Lynn Panganiban, noted toxicologist from UP-PGH and The Medical City, for giving her permission to echo her lecture to other fora.
YIN STRETCH FOR PERSONAL TRAINING - The new endurance sport where the fascial matrix of muscles and other connective tissues surrounding the pelvis are gradually “stretched” beyond the typical duration of 30 seconds. Besides physical endurance, there is also a demand for mental focus to keep one‟s self still and quiet in the yoga posture. This is based on the presentation of Paul Grilley. Learn and try (Come in Exercise Apparel).
W o r k s h o p D e s c r i p t i o n s
CARDIO LATINO WORKSHOP – This half day Latino Workshop is for instructors who are looking for ways to create safe and fun Latin classes. Learn to move to the different Latin rhythms specific to the different types of Latin dances from Rhumba, to Salsa, to Zumba, to mambo, Tango among others. Create your own combinations! Get personal feedback and evaluation from David Velez. Different Latin, different music! (0.4 ACE CEC‟s)
CPR SEMINAR – Conducted by the Philippine National Red Cross. Learn how to administer first aid for cardiac arrest, respiratory arrest & choking. Participants may attend the workshop only, but for those who wish to be certified, you must take the written & practical exams at the later part of the workshop. FitPhil encourages all instructors to be CPR-certified and renew their CPR license every year. We believe that each family should have at least 1-2 persons in the household who know CPR.
VINYASA KRAMA YOGA 1 WORKSHOP – The art form of doing vinyasa yoga is an ancient practice of physical and spiritual development. It is a systematic method to study, practice, teach, and adapt yoga. This vinyasa krama (movement and sequence methodology) approach to yogasana (yoga posture) practice is unique in all of yoga. By integrating the functions of mind, body, and breath in the same time frame, a practitioner will experience the real joy of yoga practice. Each of the important postures (asanas) is practiced with many elaborate vinyasa (variations and movements). Each variation is linked to the next one by a succession of specific transitional movements, synchronized with the breath; and the yoking of mind and body takes place with the breath acting as the harness. Vinyasa krama yoga strictly follows the most complete definition of classical yoga. The parameters of vinyasa, the Sanskrit word vinyasa comes from a prefix vi, which means variation, and a suffix nyasa, which means “within prescribed parameters.” The parameters prescribed in classical yoga with respect to yogasanas, as contained in Yoga sutra of Patanjali, are: STEADINESS (STHIRA), COMFORT (SUKHA), and SMOOTH AND LONG BREATHING (PRAYATNA SITHILA).
Practicum in Vinyasa Krama yoga this class will be more comprehensive by introducing the class to some slightly challenging movements Asana: Asymmetric Seated Vinyasa Sequences (one leg is straight while the other leg is bent in a variety of positions); Trianagle Pose Sequence; Ding-namaskara (salutations to the directions); Supine Sequences (on the back); Seated Posterior Stretch Sequences (both legs are straight). Of course all postures will have their appropriate counter posture Pranayama: Introduction to Pranayama (breath control); Kapalabhati forceful exhalation; Pranayama Omkara lengthening the exhalation by chanting OM; Satsang; Discussion (Q&A) on yoga. (ACE CEC‟s applied).
VINYASA KRAMA YOGA 2 WORKSHOP - Practicum in Vinyasa Krama yoga this class will be an extension of the morning workshop offering more challenging asanas (postures) & introducing more subtler aspects of yoga such as bandhas & mudras (locks & gestures). Asana: Lotus Pose Sequence; Inverted posture Sequence; Shoulder stand, head stand, etc…; Bow Pose Squence; Visesha Vinyasa Kramas ; Sub routines like sun salutation, & sequences stemming from downward facing dog; Pranayama; Nadi Shodhana ;Bhastrika Kumbhaka; Satsang; Discussion (Q&A) on yoga. (ACE CEC‟s applied)
IMPORTANT NOTES:
1. Please call FitPhil office at 920-2762 or text 0917-5181202 for reservations of slots for the workshops.
2. ACE CEC‟s will be available for all. For course number and number of credits for ACE Certified Fitness Professionals there is a corresponding fee to be paid, please coordinate with Fitphil office.
connective tissue mobilization tools
as requested, here's what some tools lok like, with a dvd disk for size comparison.
gold metal multi-facet tool as compared to standard DVD / CD size; polycarbonate shatterproof tool on top of gold tool.
tools are shown here unpolished. final tools will have polished edges modified for release strength and patient comfort suitable to most clinical settings.
Monday, August 24, 2009
Relfexive De-Afferentation Primer Workshop
thanks for coming!
We'd like to thank everyone who upgraded their skillset for manual medicine last sunday with us at Pasig city. We trust you'll put your newfound powers for turning pain off in seconds to good use. We'll see you again soon.
Meanwhile, eyes are pointed in the direction of the third Philippine Mind-Body Convention on 19 and 20 September.
See you then and there!
Sunday, August 16, 2009
Random Post #1
"It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better. The credit belongs to the man who is actually in the arena, whose face is marred by dust and sweat and blood; who strives valiantly; who errs, who comes short again and again, because there is no effort without error and shortcoming; but who does actually strive to do the deeds; who knows great enthusiasms, the great devotions; who spends himself in a worthy cause; who at the best knows in the end the triumph of high achievement, and who at the worst, if he fails, at least fails while daring greatly, so that his place shall never be with those cold and timid souls who neither know victory nor defeat."
- Theodore Roosevelt
- Theodore Roosevelt
Friday, August 14, 2009
PRINCIPLES OF DOCUMENTATION of MANUAL MEDICINE ENTRIES FOR CPT
PRINCIPLES OF DOCUMENTATION FOR CPT
• The medical record should be complete and legible. (Ha! Good luck with that!)
• The documentation of each patient encounter should include:
1. reason for the encounter and
2. relevant history,
3. physical examination findings and
4. prior diagnostic tests;
5. assessment,
6. clinical impression or diagnosis;
7. plan for care;
8. rationale for ordering diagnostic and other ancillary services and
9. date and legible identity of the observer.
• If not documented, the rationale for ordering diagnostic and other ancillary services should be easily inferred.
• Past and present diagnoses should be accessible to the treating and/or consulting physician. (Good luck sourcing the following:
1. the consult sheets from the Consultants and
2. getting back the charts from the Prime Attending,
3. Junior Resident, or
4. Medical Records Gophers.
• Appropriate health risk factors should be identified.
• The patient’s treatment plan documentation should include:
1. progress,
2. response to (and changes) in treatment, and
3. any revision(s) of diagnosis(es).
• The CPT and ICD-9 codes reported on the health insurance claim form or billing statement should be supported by the documentation in the medical record.
*Unadulterated Source: CMS and AMA publication BPO-B12, May 1997
• The medical record should be complete and legible. (Ha! Good luck with that!)
• The documentation of each patient encounter should include:
1. reason for the encounter and
2. relevant history,
3. physical examination findings and
4. prior diagnostic tests;
5. assessment,
6. clinical impression or diagnosis;
7. plan for care;
8. rationale for ordering diagnostic and other ancillary services and
9. date and legible identity of the observer.
• If not documented, the rationale for ordering diagnostic and other ancillary services should be easily inferred.
• Past and present diagnoses should be accessible to the treating and/or consulting physician. (Good luck sourcing the following:
1. the consult sheets from the Consultants and
2. getting back the charts from the Prime Attending,
3. Junior Resident, or
4. Medical Records Gophers.
• Appropriate health risk factors should be identified.
• The patient’s treatment plan documentation should include:
1. progress,
2. response to (and changes) in treatment, and
3. any revision(s) of diagnosis(es).
• The CPT and ICD-9 codes reported on the health insurance claim form or billing statement should be supported by the documentation in the medical record.
*Unadulterated Source: CMS and AMA publication BPO-B12, May 1997
Monday, August 10, 2009
The Original Bowen Technique in the Philippines
You just might wanna visit our friends at the Spa on Saturday!
www.manualmedsolutions.org
-------------------------------------------------------------------------------------
APPENDED BELOW IS A LISTING OF RECOGNIZED BOWEN THERAPY PRACTITIONERS IN THE PHILIPPINES.
The Bowen Association of The Philippines,
affiliated with the Bowen Therapy Academy of Australia
Catherine Cooper, Tel/Fax (6334) 7091775 Mob. (63919)455-6746
(bowentechnique.bacolod@gmail.com)
Amalia Alonzo
makati city
02-8109185, 09189275384
ama.alonzo@yahoo.com
Andrew Zoppos
Bacolod & Manila
+63-34-709-1775, +63-919-455-6746
andrewzoppos@hotmail.com,
Carla Sales
Bacolod
+6334-4952530, +639285047222
cqs_rnmn@yahoo.com
Carla Sales
Bacolod City
034-4952530, 09285047222
cqs_rnmn@yahoo.com
Dr. Arneil Chua
Bacolod City
034-4410892
Elizabeth Freeman
Manila
43003346, 09178108884
elizabethof888@yahoo.com
Femia De Suyo
Bacolopd City
09192858478
Filipinas Ganchoon M.D.
Bacolod City
+63344328645, +639209271250
fffganchoon888@yahoo.com
Jacqueline Tiu Po
Manila
02-6713198, 09209520288
jacquetiupo@gmail.com
Kit Cooper
Bacolod
+63347091775, +639194556746
bowentechnique.bacolod@gmail.com
Lisabelle C. Teng, PTRP
Pasay City
09178925611
Manuel Francis Golez
Bacolod City
034-4336440/4336441, 09173007047
francis_acp@yahoo.com
Michelle Gallaga
Bacolod
+6334-4334699, +639209223100
Nestor Evaristo
Baclod City
034-4330446/4352340, 09173000400
aboyevaristo@yahoo.com
Patricia Cooper
Bacolod City
034-4332413/4346504
Rosario Marques
Bacolod City
032-4160526/2382789, 09173203121
tigressrjn@yahoo.com
Sandro Strix Toledo M.D.
02-6464346, 09228338838;(632)2156871
strixmd@yahoo.com
assist@truecaremed.com
Shane Cooper
Bacolod city
034-433-9163, 09202739394
Vita M. Clave
Quezon City
09192448840
vvmclave@yahoo.com
Willie Villar
Bacolod
+6334-4412634, +639178171900
wqvillar@yahoo.com
Sunday, August 2, 2009
The Ultimate Mega Cure-All
"Get used to the idea right away that no single system can or should claim to have an exclusive fix on the dynamics of health."
[Mendelsohn M.D.]
It's really funny to have wonderful critics who are still stuck in the box. We're in awe. Their amazing intuition and insight allows them to judge posthaste what they have not seen before. Wow. I wish i could evaluate postural dysfunctions that fast.
[Kat, RDT Practitioner]
We won't claim to have all the answers. In fact, point us in the way of anyone who claims to have all the biostructural fixes in one system, and we'd like to meet that person. Not to shoot him down, but to shoot ourselves down. We'd love to be proven wrong. We'd love to see one thing that works for everything. Especially when everything else has not worked for you, who wouldn't love a one-stop cure-it-all shop?
Point us in that direction. We're going.
I'm bringing a notebook, a recorder, a large Java mocha, and popcorn.
[Mendelsohn M.D.]
It's really funny to have wonderful critics who are still stuck in the box. We're in awe. Their amazing intuition and insight allows them to judge posthaste what they have not seen before. Wow. I wish i could evaluate postural dysfunctions that fast.
[Kat, RDT Practitioner]
We won't claim to have all the answers. In fact, point us in the way of anyone who claims to have all the biostructural fixes in one system, and we'd like to meet that person. Not to shoot him down, but to shoot ourselves down. We'd love to be proven wrong. We'd love to see one thing that works for everything. Especially when everything else has not worked for you, who wouldn't love a one-stop cure-it-all shop?
Point us in that direction. We're going.
I'm bringing a notebook, a recorder, a large Java mocha, and popcorn.
Manual Medicine Integration WORKSHOPS and Activities Calendar
CALENDAR OF EVENTS
MANUAL MEDICINE WORKSHOP: INTEGRATION VI
AICA PASIG CITY, MM, PHILIPPINES
9 AM TO 5 PM
August 23 2009
Basic Biomechanics and Biomechanical Corrections
Introduction to Bowen Therapy using the Original Bowen Technique
Rapid De-Afferentation Technology and Techniques:
Pre-Certification Course
PHILIPPINE MIND-BODY CONVENTION
MANUAL MEDICINE: A MIND-BODY APPROACH
TO PAIN REMOVAL AND FUNCTIONAL GAINS
RICHMONDE HOTEL PASIG CITY
SAT, SEPT 19 & SUN, SEPT 20
FROM 1:30-2:30PM & 11:20-12:20AM
Sunday, July 19, 2009
What is Reflexive Antagonism?
Reflexive Antagonism is the phenomenon by which muscles with opposing functions tend to antagonistically inhibit each other. When one muscle is activated, its opposite muscle or muscle group or is reflexively inhibited or deactivated.
The phenomenon is now known to be fleeting, incomplete, and weak. By example, when the triceps brachii is stimulated, the biceps is reflexively inhibited. The incompleteness of the effect is related to postural and functional tone. Also, reflexes in vivo are polysynaptic, with entire muscle groups responding to noxius stimuli (Nociceptive Withdrawal Reflex).
Reflexive antagonism is the basic original notion behind indirect muscle energy techniques. This notion is now understood to be incomplete. As a clinical mechanism, however, Reflexive Antagonism continues to be useful. Reciprocal Inhibition is a synonym.
Techiques that utilize reflexive antagonism, (such as Rapid De-Afferentation Techniques) are manual medicine techniques and protocols that utilize reflexive pathways and the phenomenon of reciprocal inhibition as a means of switching off inflammation, pain, and protective spasm for entire synergistic muscle groups or singular muscles and soft tissue structures.
Suggested reading:
1. Fryer G 2000 Muscle Energy Concepts –A Need for a Change. Journal of Osteopathic Medicine. 3(2): 54 – 59
Fryer G 2006 MET: Efficacy & Research IN: Chaitow L (Ed) Muscle Energy Techniques (3rd edition) Elsevier, Edinburgh
Ruddy T 1961 Osteopathic rhythmic resistive duction therapy. Yearbook of Academy of Applied Osteopathy 1961, Indianapolis, p 58
Solomonow M 2009 Ligaments: A source of musculoskeletal disorders. J Bodywork & Movement Therapies 13(2): IN PRESS
Smith, M., Fryer, G. 2008 A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group Journal of Bodywork and Movement Therapies 12 (4), pp. 312-317
McPartland, J.M. 2004 Travel trigger points - Molecular and osteopathic perspectives Journal of the American Osteopathic Association 104 (6), pp. 244-249
Hamilton, L., Boswell, C., Fryer, G. 2007 The effects of high-velocity, low-amplitude manipulation and muscle energy technique on sub occipital tenderness International Journal of Osteopathic Medicine 10 (2-3), pp. 42-49
McFarland, J.M. 2008 The endocannabinoid system: An osteopathic perspective Journal of the American Osteopathic Association 108 (10), pp. 586-600
Magnusson M Simonsen E Aagaard P et al 1996a Mechanical and physiological responses to stretching with and without pre-isometric contraction in human skeletal muscle Archives of Physical Medicine & Rehabilitation 77:373-377
Magnusson M Simonsen E Aagaard P et al 1996b A mechanism for altered flexibility in human skeletal muscle. Journal of Physiology 497(Part 1):293-298
The phenomenon is now known to be fleeting, incomplete, and weak. By example, when the triceps brachii is stimulated, the biceps is reflexively inhibited. The incompleteness of the effect is related to postural and functional tone. Also, reflexes in vivo are polysynaptic, with entire muscle groups responding to noxius stimuli (Nociceptive Withdrawal Reflex).
Reflexive antagonism is the basic original notion behind indirect muscle energy techniques. This notion is now understood to be incomplete. As a clinical mechanism, however, Reflexive Antagonism continues to be useful. Reciprocal Inhibition is a synonym.
Techiques that utilize reflexive antagonism, (such as Rapid De-Afferentation Techniques) are manual medicine techniques and protocols that utilize reflexive pathways and the phenomenon of reciprocal inhibition as a means of switching off inflammation, pain, and protective spasm for entire synergistic muscle groups or singular muscles and soft tissue structures.
Suggested reading:
1. Fryer G 2000 Muscle Energy Concepts –A Need for a Change. Journal of Osteopathic Medicine. 3(2): 54 – 59
Fryer G 2006 MET: Efficacy & Research IN: Chaitow L (Ed) Muscle Energy Techniques (3rd edition) Elsevier, Edinburgh
Ruddy T 1961 Osteopathic rhythmic resistive duction therapy. Yearbook of Academy of Applied Osteopathy 1961, Indianapolis, p 58
Solomonow M 2009 Ligaments: A source of musculoskeletal disorders. J Bodywork & Movement Therapies 13(2): IN PRESS
Smith, M., Fryer, G. 2008 A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group Journal of Bodywork and Movement Therapies 12 (4), pp. 312-317
McPartland, J.M. 2004 Travel trigger points - Molecular and osteopathic perspectives Journal of the American Osteopathic Association 104 (6), pp. 244-249
Hamilton, L., Boswell, C., Fryer, G. 2007 The effects of high-velocity, low-amplitude manipulation and muscle energy technique on sub occipital tenderness International Journal of Osteopathic Medicine 10 (2-3), pp. 42-49
McFarland, J.M. 2008 The endocannabinoid system: An osteopathic perspective Journal of the American Osteopathic Association 108 (10), pp. 586-600
Magnusson M Simonsen E Aagaard P et al 1996a Mechanical and physiological responses to stretching with and without pre-isometric contraction in human skeletal muscle Archives of Physical Medicine & Rehabilitation 77:373-377
Magnusson M Simonsen E Aagaard P et al 1996b A mechanism for altered flexibility in human skeletal muscle. Journal of Physiology 497(Part 1):293-298
Thursday, July 16, 2009
Manual Medicine Integration
An Overview of Selected Manual Medicine Methods
Cranial-Sacral Therapy (CST)
The cranial-sacral system addresses bones and membranes that surround the central nervous system. Restrictions here can strain neural tissues and affect correspondingly innervated somatic areas, organs, or tissues. CST uses light manual techniques aimed at inducing relaxation responses that decrease, unwind, or remove neural tissue strain. CST, while particularly effective for treatment-resistant headaches, also have positive bearing on varied cases of unresolved chronic muscle and joint pain. Case studies show usefulness in helping resolve some digestive and neuro-endocrine disorders. Learning curves, attention spans, and memory retention are often reported improved.
Movement Therapies and Postural Re-alignment
Postural habituation and any form of trauma or sudden mal-positioning are the most common causes of tissue structure / function imbalance. Compensations include often inappropriate tissue lengthening and shortening. Somatic dysfunctions over time build up and bear heavily on joints and their surrounding / supporting structures. Muscle length / strength imbalance identification allows for both prevention and proper resolution of Neuro-myofascial syndromes. Postural and Movement Rehabilitation addresses these imbalances.
Lymphatic Drainage Therapy (LDT) / Manual Lymphatic Drainage
Trauma, physical deconditioning, lack of exercise, myofascial restrictions, and local tissue / area inflammation can cause lymph stagnation. Buildup of cellular debris and inflammatory mediators reinforce the Nociceptive cycle and somatic dysfunctions. LDT can improves circulation and helps resolve edema. Joint and soft tissue swelling can be significantly reduced. Chronic pain syndromes can be improved or partially resolved.
Neuromuscular Techniques (NMT) / Neuro-myofascial techniques (NMF-T)
Fascial restriction and muscle hypertonus are highly responsive to various NMF techniques. Major techniques include Myofascial Releases, Muscle Energy Techniques (MET), Positional Release Technique (PRT), and Trigger Point-Proprioceptive Therapy.
Reflexive De-Afferentation Techniques (RDTs) have evolved from Neuro-myofascial techniques. Pain cycles easily broken with NMF techniques include headaches, nape and shoulder pain, TMJ pain, knee and foot pain. Mechanical and repetitive strain injuries that may be addressed with NMF-T include mechanical low back pain syndromes, thoracic outlet syndromes, “frozen shoulder,” carpal tunnel syndrome, lateral epicondylitis, and plantar fasciitis. Our suggested term would be “neuromyofacial-endocrine” techniques, given the profundity of effects from working on the fascia.
Articulatory techniques (ART)
Soft tissue injury and cumulative joint trauma result in joint ROM restrictions and / or pain. These techniques involve taking joints through their restrictive and compliant motion cycles. They improve joint range or motion and help ablate joint pain cycles.
Movement with Mobilization
Movement with Mobilization (MWM) is based on Mulligan's work.
His SNAGs = Sustained Natural Apophyseal Glides involve passively (operator) introduced translation that is maintained while the patient goes toward the restricted end-range. The translatory or gliding force is typically maintained while a return to passive neutral is established.
One of the easiest and most useful techniques that can be taught to patients is the one involving a towel drawn against the nape and tugged on forward by the patient via handhold on either side. These have been called self-MWMs.
The Functional Techniques of Osteopathy appear to be the closest analogue.
1) Visceral Manipulation (VM, Ventral OMT techniques)
Trauma, lack of exercise, physical deconditioning, cumulative soft tissue injury, inflammation, surgery, or obesity can displace, restrict, tighten, or scar ligament and fascia that surround, support, or suspend organs. Fascial and ligamentous injury can result in focal strains that cause tissue or organ dysfunction and injury. Pain and inflammation cycles are facilitated. VM uses soft vectoral techniques aimed at re-engaging normal suspension or movement of internal tissues / organs.
The notion of tissue restrictions or compliance to movement extends to the viscera. Organs, fascia, mesentery, and visceral ligaments move along and in relation to each other in much the same way that we know normal fascia-muscle compartments do. This notion of mobility in relation to each other is differentiated from intrinsic organ motility. Organs are mobile in relation to each other and often possess an internal movement or motility. As all fascia moves with breathing, the lungs move as we breathe, the stomach and intestines move in relation to each other during peristalsis, the urinary bladder shifts location somewhat when we piss. Viscera also move around a bit with ambulation. Visceral mobility restrictions are thought to restrict normal fluid, solid, and impulse conduction through individual organs. VM addresses these restrictions.
Musculoskeletal conditions linked to visceral involvement include:
1. Mid to low back pain: The colon’s attachment to the back of the abdominal compartment may be strained. This can lend ligamentous tightness or displacement which, in turn, can inhibit normal spinal movement. These spinal segmental dysfunctions result in their related pain constellations.
2. Neck stiffness and pain: The suspensory ligaments of the lung and the pericardium all attach to cervical vertebrae. Ligamentous involvement here can cause cervical joint compression and flexion cervical somatic dysfunction. A forward head posture may thus actually be more closely related to a lung problem than to a thoracic spine dysfunction.
3. Shoulder restrictions and pain: Most paramedical personnel are familiar with the fact that gallbladder inflammation can result in pain that radiates to the right shoulder. Nerves that supply the suspensory ligaments of the liver stem from the spinal segment that innervates the shoulder. Liver suspensory ligament involvement may thus result in shoulder somatic dysfunctions.
4. Peripheral joint pain: Visceral compartment restrictions can transmit tension via adjacent myofascial trains into the limbs. These tension lines can cause compressive and torsional joint irritation and dysfunction.
5. Comparative Studies have found Visceral Manipulation also Beneficial for:
Somatic-Visceral Interactions
Chronic Spinal Dysfunction
Headaches and Migraine headaches
Carpal Tunnel Syndrome
Hip and Knee Pain
Sciatica
Whiplash
Seatbelt Injuries
Chest or Abdominal Sports Injuries
Visceral Manipulation has been known to improve:
1. Fatigue: Abnormal fascial tension or scarring from at the visceral suspension system may result from inflammation, surgery, and blunt or countercoup trauma. Loss of organ mobility due to restrictions of surrounding and supporting tissues have been linked to general fatigue. By example, lessened fatigue has been reported by whiplash-injured VA patients. Faster recovery rates and lower incidences of depressive symptoms have likewise been reported.
2. GI motility disorders: Ileus, constipation, and irritable bowel syndrome: Abnormal fascial tension or scarring from at the small and large intestinal suspension system may result from inflammation, surgery, or blunt trauma. This causes restrictions that negatively alter bowel motility and function.
3. Hemorrhoids: The venous drainage from the rectum toward the liver is impeded when the hepatoduodenal ligament is abnormally tight. The resultant vascular congestion can cause or aggravate hemorrhoids.
4. Incontinence: Ligament us tightness and muscle hypertonus may limit proper urinary bladder expansion and emptying.
5. Comparative Studies have found Visceral Manipulation Beneficial for:
Digestive Disorders
Bloating and Constipation
Nausea and Acid Reflux
GERD
Swallowing Dysfunctions
Women’s and Men’s Health Issues
Chronic Pelvic Pain
Endometriosis
Fibroids and Cysts
Dysmenorrhea
Bladder Incontinence
Prostate Dysfunction
Referred Testicular Pain
Effects of Menopause Pain Related to
Post-operative Scar Tissue
Post-infection Scar Tissue
Autonomic Mechanisms
Pediatric Issues
Constipation and Gastritis
Persistent Vomiting
Vesicoureteral Reflux
Infant Colic
Emotional Issues
Anxiety and Depression
Post-Traumatic Stress Disorder
Bowen Therapy in the Philippines
Bowen Therapy and RDTs
For someone so used to mind-bogglingly fast functional results with OMT and a synthesis of Manual Medicine, I have recently gained an unexpected new respect for Bowen Work (Bowen Therapy). I have also regained foothold on the concept that, yes, it also matters who you learn your techniques from.
We've had the good fortune of leaning directly from Andrew Zoppos. Andrew learned Bowen's work from "Ozzie" Oswald Rentch, who was charged with spreading the techniques by the man himself, "Tom" Bowen. Having progressed in my Bowen work studies, I can now wholeheartedly agree with Andrew -- Tom Bowen was a genius. That the work came to Tom without osteopathic or mixed manual method training is truly astounding.
Recent findings in fascia research amplify my respect for the work of Tom Bowen. The fascial system is more and more being shown to be linked intimately to the neuroendocrine system. By example, the results of fascial therapy are different when a patient is anesthetized to unconsciousness. They do not hold as well. So, yes -- There really seems to be an intelligence we interact with when we move fascia. Then again, we've always known that the human body is an incredible machine. Kudos to the Brilliance of its Creator. Now, however, we regain a no-holds-barred astonishment at how profoundly complex the human body is.
How Tom knew which points to access in order to talk to the body in the way Bowen Work appears to do is beyond me. Perhaps it truly was a Gift from God. God is closer than most people would accept, anyway.
I can now understand how important it is to learn Bowen work the way it was passed on by Tom Bowen.
Rapid De-Afferentation Techniques, as remarkable as they are, are still evolving. Unlike RDTs, Bowen work appears to have been born fully evolved.
My patients deserve to have someone on their side who knows what he's doing. Plus, I'm a curious fellow. So I'm likely to look at what everyone else is doing. Despite the proliferation of a swarm of personalities offering some form or other of supposed modification or advancement of Bowen Work, however, I'd love to master the unaltered gift first. It's amusing, as I think of it now.. I've grown up in the age that gave us the Photocopier. I love that machine. But I still rarely see a copy as clear, organically detailed and unflawed as the original.
What is Gua-Sha?
Gua Sha / Gua-sha / Guasha is a connective / soft-tissue mobilization technique commonly used in Asia by practitioners of Traditional Chinese Medicine. Gua Sha is used by TCM clinics and practitioners with the most frequent intent of restarting circulation and releasing "Sha," held by many TCM practitioners to reflect blood "trapped" in the peripheral capillaries. Gua-sha would literally translate into "releasing (the) Sha."
In Gua Sha, a scraping handheld tool is applied to skin, to fascial depth, in longitudinal strokes. This is meant to release the "exterior Sha." A stimulation of movement of lymph and blood flow occurs. This is interpreted as a means of discharging "cold negative energy" via the skin surface. Many TCM practitioners swear by Gua-sha, saying it helps cure many diseases.
In the TCM context, Gua Sha is held to be valuable in the treatment of pain, in the prevention and treatment of acute infectious illness, upper respiratory and digestive problems, and the resolution of many acute or chronic disorders.
Gua Sha is the Traditional Chinese Medicine analogue of today’s Connective Tissue Mobilization Techniques that use tools. In a strictly Manual Medicine analysis of the technique and its results, Gua-sha is a local, direct, tool-enhanced myofascial release. The body of techniques Gua-sha is thus categorized in is more popularly known now as Instrument-Assisted Connective / Soft Tissue Mobilization (IASTM / IASCTM). The more popular of the branded techniques include the Graston Technique and SASTM (Sound-assisted Soft-Tissue Mobilization).
You’ll let us know as soon as you realize you want to learn CTM / IACSTM with us, won’t you?
Stay well, evolve, and prosper.
An Introduction to (Rapid) Reflexive De-Afferentation
An Introduction to (Rapid) Reflexive De-Afferentation
Session Description
I. Ignored Anatomy: What the Medical Community usually fails to check?
Introduction:
Chronic mental stress, fatigue or burnout has been linked to - among other things - gastritis, severe headaches, and heart attack risk.
What if I were to tell you that I could tell how stressed you were by touching just a few spots on your body that most would not have even checked? What if those spots were linked to most headaches and nape pain? What if you could be pain-free without medications? What if the solutions were so simple that they have been strangely overlooked for decades?
Content:
Missed Anatomy: RDT Checkpoints
The Nociceptive Reflex
The Ignored Anatomic Landmarks
RCPM
Myodural Bridge
Nuchal Ligament
Cervico-thoracic junction
Diaphragmatic Insertion
Partially Ignored Anatomy
The Notion of 1) We don't treat what we don't know is there and 2) We don't check what we don't know how to treat
II. The Relaxation Response: Parallel Pathways
This session will explore general mechanisms of entry into the much-coveted state of relaxation. This Parasympathetic (Rest and Recovery) Response has profound mental, emotional, and physiologic effects. The usual ways to reach this state include:
1. Mind to Body = meditation techniques, prayer,
2. Body to Mind = Bodywork of all sorts (Bowen work, certain massage techniques and protocols, post-exercise, etc.)
Integration is proposed, so that both approaches / gateways are used. A powerful synergy is the hoped-for endpoint. Our work in this direction includes the application of Biofeedback techniques, Neurolinguistic Programming (NLP) Techniques, and the Revolutionary new field opened up by Rapid De-Afferentation Techniques. Since a few good breathing techniques will be covered by other speakers, I will not delve deeply into breath-work. Focus will instead be given on starting with calming the body as a rapid means of calming the mind. A Reboot Demonstration will follow.
III. An Introduction to R.D.T.s: Mind-Body Reboot in Seconds
Introduction:
What if you could be Pain-free in Seconds? What if you could reach Mental Clarity in seconds? How would that change the rest of your life?
Precursor Work:
NLP Semantics
Biofeedback without machines
An Introduction to the RDT PROTOCOL
(a synthesis of: Rapid De-Afferentation Techniques + NLP Semantics / Language + Biofeedback)
IV. Missed Assessments and Unavailable Treatments
(What once didn't know how to treat, and therefore hardly checked)
Summary of the theories behind RDT work
Reflexive Inhibition
the Nociceptive Reflex
The Path of Ease
Harmonic Response
On Reflexive Techniques and RDTs
My cat knows how to ask for food. It's simple and it makes sense. She's figured it out, and so have I. Just signals, feedback, and recalibration. If time eventually proves us both wrong, it will not stop me in the meantime from doing what we know from experience to consistently work.
My cat knows that, too. She meows. I get her snacks.
In testament to the soundness of the initial thought behind (let's generalize) reflexive techniques (or attempts at development of such), if you toss the idea around, people will say they've heard about it somewhere. I'm no genius. I'm certain someone else must have figured these things out. Perhaps a tribe somewhere has done just that. Perhaps in the same place JPB first heard of VM from. Perhaps it's just the RCTs that lag.
We have all known about reflexive inhibition and have used it as a tool in clinics for the longest time now.
Has not everyone on these forums used indirect muscle energy techniques, positional releases and lymphatic drainage and vascular restarts? If the monosynaptic reflex is so well described that no one questions its validity, how hard it to imagine that people have tried to utilize it as a treatment mechanism? Isn't that initial notion behind METs?
Do you now think it might be possible to use reflexes as a treatment mechanism?
Let's stretch that notion, then. How often do see a purely monosynaptic reflex in practice?
Programmed reactions occur in response to noxious stimuli. They are never just monosynaptic in the living organism, are they? Stick your finger in fire and watch several muscles fire off automatically. Pull off a great prank to startle someone and a well choreographed set of muscles set off a startle and guard reflex. Several muscles activate in response to one stimulus. Think about it.
Now, what if you could do specific stimuli on purpose, with the intent of reversing or stimulating established reflexes? Could you not then stimulate muscles that reflexively antagonize targeted muscle groups? Could that be a way to reverse guarding and relax even groups of muscles along synergistic patterns?
Most curiously something I say at every sharing session we've ever had is echoed in your boards: "If I have been able to see farther, it was only because I stood on the shoulders of giants."
(Sir Isaac Newton)
I'm trying to remember who said it first, but there is "nothing ever new under the sun - just a new understanding, or a rediscovery of what was lost." (My paraphrasing.)
Has anyone here ever tried to meet with the best minds they could, with the intent of solving something, of doing something better?
What happens when you do that with every single good technique you come across?
"Take what is useful, discard what is not." (Paraphrased from Mas Omaya)
Have you ever had an "a-ha" or "eureka!" moment when it all just suddenly made sense? Could not something new emerge from that moment, from that idea?
This, if anything else, is an invitation to test everything vigorously. Test what you know. Test what you don't know. The blind faith of acceptance is not much different from the blind faith of rejection. These things are so well primed and fueled by fear. Fear of the unknown. Fear of what is unfamiliar. Fear of what could destroy acceptance or the status quo. For us, it has just been a choice:
Do we keep doing what does not work, or what does not work so well? Do we keep doing something for which the evidence is so well stacked against? Do we succumb to fear, or do we choose to see what works?
Do we test everything, or are we fine with the rut we're stuck in?
Do we want better for our patients, or do we just stay in the boat we've always been stuck in?
Depends, doesn't it? Does your boat work?
The best description I’ve heard of insanity stems from the NLP community:
Insanity is when we "keep doing what we've always been doing, and then continually expect different results."
These are just thoughts.
Perhaps that is where evolution starts -- a thought.
My cat meows a certain way, motions to the shower, then to the faucet. I get her a bowl of water. She meows approvingly, assuring me I’ve got it right. I'm well trained. She trained me well. Faster than any teacher and master I’ve ever trained with.
Meow.
The science behind RDTs
You already have the science well studied.
The work of Eyal Lederman and Leon Chaitow is an excellent place to start.
Even in books you already have, there is already a wealth of material on PNFs, METs, reflexes, proprioception, mechanoception, reflexive inhibition, adaptation, facilitation, somatic dysfunctions, and higher center involvement in LMN function.
The science is out there. It’s the approach that is radically different.
There are unfortunately not yet any large-scale randomized controlled double-blinded Meta studies on Rapid De-Afferentation techniques. Mainly because there isn't anyone we've been able to compare results with. The techniques are different. The results are different. Strong multicenter protocols for dissecting this work have not been built.
Next reason is because we're clinicians. We just don't have the time yet to crunch numbers and do all the studies ourselves. If academicians want to come up and do the studies, we're open to that. Meantime, we're too busy to do paperwork explaining to the world the WHY of how we've getting the amazing results that we do get.
We can show you several gigs of info on the science of it all, but wouldn't you rather see results?
What are RDTs?
The entry I deleted From Wikipedia:
'Rapid De-Afferentation Techniques' (R.D.T.s, or RDTs) are a system of soft-tissue rapid-release techniques developed by Sandro Strix S. Toledo, M.D. These techniques have the commonality of being able to quickly break the nociceptive cycle for somatic dysfunctions. Some of the RDT methods bear resemblance to ease techniques of osteopathic manipulation. The reflexive techniques for soft tissue release appear to be unique versus references in the general medical and peer-reviewed manual medicine literature.”
What are RDTs (Rapid De-Afferentation Techniques)?
RDTs are manual medicine techniques and protocols that utilize reflexive pathways and the phenomenon of reciprocal inhibition as a means of switching off inflammation, pain, and protective spasm for entire synergistic muscle groups or singular muscles and soft tissue structures.
RDTs are a hands-on method for turning off pain and spasm and for turning on the recovery cycle and an autonomic "reboot." The reboot here is essentially a turning off of the sympathetic overload and a flooding with a good series of parasympathetic signals.
A Still point is often reached at "reboot," as is a theta brain state.
Physical therapists and Doctors
Just if you might be really interested in learning the fastest hands-on means we know to get rid of pain on the spot with long lasting functional gains, we're pre-offering the opportunity to sign up for a limited slot pilot class for Rapid Reflexive De-Afferentation Techniques (RDTs).
We're gearing to do this by August - September 2009.
Temp dates: August 15-16, August 29-30, and September 5-6, 19-20.
Location: Boracay Island
More than the certification, you go home with the chance to correct on the spot structural complaints and to resolve pain that no one else can - faster than NSAIDs, better than opiates.
We invite you to take up this challenge with us.
As soon as you get over arguing with yourself how useful this is for you, your patients, your practice, and your financial well-being, you may signify intent to join us at assist@tuecaremed.com with the subject line "sign me up for RDT training NOW, please!"
Sorry, slots will be limited to maintain heavily hands-on workshop environment.
Until more formal arrangements can be made with regard pre-requisites, we would greatly prefer that you have prior training on functional positional releases and Muscle Energy Techniques. We recommend you sign up for these with Sirs Leomil and Val (UST / SOMATIC).
See you then.
Suggested reading:
1. Fryer G 2000 Muscle Energy Concepts –A Need for a Change. Journal of Osteopathic Medicine. 3(2): 54 – 59
Fryer G 2006 MET: Efficacy & Research IN: Chaitow L (Ed) Muscle Energy Techniques (3rd edition) Elsevier, Edinburgh
Ruddy T 1961 Osteopathic rhythmic resistive duction therapy. Yearbook of Academy of Applied Osteopathy 1961, Indianapolis, p 58
Solomonow M 2009 Ligaments: A source of musculoskeletal disorders. J Bodywork & Movement Therapies 13(2): IN PRESS
Smith, M., Fryer, G. 2008 A comparison of two muscle energy techniques for increasing flexibility of the hamstring muscle group Journal of Bodywork and Movement Therapies 12 (4), pp. 312-317
McPartland, J.M. 2004 Travel trigger points - Molecular and osteopathic perspectives Journal of the American Osteopathic Association 104 (6), pp. 244-249
Hamilton, L., Boswell, C., Fryer, G. 2007 The effects of high-velocity, low-amplitude manipulation and muscle energy technique on sub occipital tenderness International Journal of Osteopathic Medicine 10 (2-3), pp. 42-49
McFarland, J.M. 2008 The endocannabinoid system: An osteopathic perspective Journal of the American Osteopathic Association 108 (10), pp. 586-600
Magnusson M Simonsen E Aagaard P et al 1996a Mechanical and physiological responses to stretching with and without pre-isometric contraction in human skeletal muscle Archives of Physical Medicine & Rehabilitation 77:373-377
Magnusson M Simonsen E Aagaard P et al 1996b A mechanism for altered flexibility in human skeletal muscle. Journal of Physiology 497(Part 1):293-298
Wednesday, July 15, 2009
The Ultimate Mega Cure-All
Wednesday, July 15, 2009
The Ultimate Mega Cure-All
"Get used to the idea right away that no single system can or should claim to have an exclusive fix on the dynamics of health."
[Mendelsohn M.D.]
It's really funny to have wonderful critics who are still stuck in the box. We're in awe. Their amazing intuition and insight allows them to judge posthaste what they have not seen before. Wow. I wish i could evaluate postural dysfunctions that fast.
[Kat, RDT Practitioner]
We won't claim to have all the answers. In fact, point us in the way of anyone who claims to have all the biostructural fixes in one system, and we'd like to meet that person. Not to shoot him down, but to shoot ourselves down. We'd love to be proven wrong. We'd love to see one thing that works for everything. Especially when everything else has not worked for you, who wouldn't love a one-stop cure-it-all shop?
Point us in that direction. We're going.
I'm bringing a notebook, a recorder, a large Java mocha, and popcorn.
The Ultimate Mega Cure-All
"Get used to the idea right away that no single system can or should claim to have an exclusive fix on the dynamics of health."
[Mendelsohn M.D.]
It's really funny to have wonderful critics who are still stuck in the box. We're in awe. Their amazing intuition and insight allows them to judge posthaste what they have not seen before. Wow. I wish i could evaluate postural dysfunctions that fast.
[Kat, RDT Practitioner]
We won't claim to have all the answers. In fact, point us in the way of anyone who claims to have all the biostructural fixes in one system, and we'd like to meet that person. Not to shoot him down, but to shoot ourselves down. We'd love to be proven wrong. We'd love to see one thing that works for everything. Especially when everything else has not worked for you, who wouldn't love a one-stop cure-it-all shop?
Point us in that direction. We're going.
I'm bringing a notebook, a recorder, a large Java mocha, and popcorn.
Thursday, June 25, 2009
On Reflexive Techniques and RDTs
My cat knows how to ask for food. It's simple and it makes sense. She's figured it out, and so have i. Just signals, feedback, and recalibration. If time eventually proves us both wrong, it will not stop me in the meantime from doing what we know from experience to consistently work.
My cat knows that, too. She meows. I get her snacks.
In testament to the soundness of the initial thought behind (let's generalize) reflexive techniques (or attempts at development of such), if you toss the idea around, people will say they've heard about it somewhere. I'm no genius. I'm certain someone else must have figured these things out. Perhaps a tribe somewhere. Perhaps in the same place JPB first heard of VM from. Perhaps it's just the RCTs that lag.
We have all known about reflexive inhibition and have used it as a tool in clinics for the longest time now.
Has not everyone on these fora used indirect muscle energy techniques, positional releases and lymphatic drainage and vascular restarts? If the monosynaptic reflex is so well described that no one questions its validity, how hard it to imagine that people have tried to utilize it as a treatment mechanism? Isn't that initial notion behind METs?
Do you now think it might be possible to use relfexes as a treatment mechanism?
Let's stretch that notion, then. How often do see a purely monosynaptic reflex in practice?
Programmed reactions occur in response to noxious stimuli. They are never just monosynaptic in the living organism, are they? Stick your finger in fire and watch several muscles fire off automatically. Pull off a great prank to Startle someone and a well choreographed set of muscles set off a startle and guard reflex. Several muscles in response to one stimulus. Think about it.
Now, what if you could do specific stimuli on purpose, with the intent of reversing or stimulating established reflexes? Could you not then stimulate muscles, that reflexively atagonize targetted muscle groups? Could that be a way to reverse guarding and relax even groups of muscles along synergistic patterns?
Most curiously something i say at every sharing session we've ever had is echoed in your boards: "If I have been able to see farther, it was only because I stood on the shoulders of giants."
(Sir Isaac Newton)
I'm trying to remember who said it first, but there is "nothing ever new under the sun - just a new understanding, or a rediscovery of what was lost." (My paraphrasing.)
Has anyone here ever tried to meet with the best minds they could, with the intent of solving something, of doing something better?
What happens when you do that with every single good technique you come across?
"Take what is useful, discard what is not." (Parapharased from Mas Omaya)
Have you ever had an "a-ha" or "eureka!" moment when it all just suddenly made sense? Could not something new emerge from that moment, from that idea?
This, if anything else, is an invitation to test everything vigorously. Test what you know. Test what you don't know. The blind faith of acceptance is not much different from the blind faith of rejection. These things are so well primed and fueled by fear. Fear of the unknown. Fear of what is unfamiliar. Fear of what could destroy acceptance or the status quo. For us, it has just been a choice:
Do we keep doing what does not work, or what does not work so well? Do we keep doing something for which the evidence is so well stacked against? Do we succumb to fear, or do we choose to see what works?
Do we test everyhting, or are we fine with the rut we're stuck in?
Do we want better for our patients, or do we just stay in the boat we've always been stuck in?
Depends, doesn't it? Does your boat work?
The best description i've heard of insanity stems from the NLP community:
Insanity is when we "keep doing what we've always been doing, and then continually expect different results."
These are just thoughts.
Perhaps that is where evolution starts. A thought.
My cat meows a certain way, motions to the shower, then to the faucet. I get her a bowl of water. She meows approvingly, assuring me i've got it right. I'm well trained. She trained me well. Faster than any teacher and master i've ever trained with.
Meow.
My cat knows that, too. She meows. I get her snacks.
In testament to the soundness of the initial thought behind (let's generalize) reflexive techniques (or attempts at development of such), if you toss the idea around, people will say they've heard about it somewhere. I'm no genius. I'm certain someone else must have figured these things out. Perhaps a tribe somewhere. Perhaps in the same place JPB first heard of VM from. Perhaps it's just the RCTs that lag.
We have all known about reflexive inhibition and have used it as a tool in clinics for the longest time now.
Has not everyone on these fora used indirect muscle energy techniques, positional releases and lymphatic drainage and vascular restarts? If the monosynaptic reflex is so well described that no one questions its validity, how hard it to imagine that people have tried to utilize it as a treatment mechanism? Isn't that initial notion behind METs?
Do you now think it might be possible to use relfexes as a treatment mechanism?
Let's stretch that notion, then. How often do see a purely monosynaptic reflex in practice?
Programmed reactions occur in response to noxious stimuli. They are never just monosynaptic in the living organism, are they? Stick your finger in fire and watch several muscles fire off automatically. Pull off a great prank to Startle someone and a well choreographed set of muscles set off a startle and guard reflex. Several muscles in response to one stimulus. Think about it.
Now, what if you could do specific stimuli on purpose, with the intent of reversing or stimulating established reflexes? Could you not then stimulate muscles, that reflexively atagonize targetted muscle groups? Could that be a way to reverse guarding and relax even groups of muscles along synergistic patterns?
Most curiously something i say at every sharing session we've ever had is echoed in your boards: "If I have been able to see farther, it was only because I stood on the shoulders of giants."
(Sir Isaac Newton)
I'm trying to remember who said it first, but there is "nothing ever new under the sun - just a new understanding, or a rediscovery of what was lost." (My paraphrasing.)
Has anyone here ever tried to meet with the best minds they could, with the intent of solving something, of doing something better?
What happens when you do that with every single good technique you come across?
"Take what is useful, discard what is not." (Parapharased from Mas Omaya)
Have you ever had an "a-ha" or "eureka!" moment when it all just suddenly made sense? Could not something new emerge from that moment, from that idea?
This, if anything else, is an invitation to test everything vigorously. Test what you know. Test what you don't know. The blind faith of acceptance is not much different from the blind faith of rejection. These things are so well primed and fueled by fear. Fear of the unknown. Fear of what is unfamiliar. Fear of what could destroy acceptance or the status quo. For us, it has just been a choice:
Do we keep doing what does not work, or what does not work so well? Do we keep doing something for which the evidence is so well stacked against? Do we succumb to fear, or do we choose to see what works?
Do we test everyhting, or are we fine with the rut we're stuck in?
Do we want better for our patients, or do we just stay in the boat we've always been stuck in?
Depends, doesn't it? Does your boat work?
The best description i've heard of insanity stems from the NLP community:
Insanity is when we "keep doing what we've always been doing, and then continually expect different results."
These are just thoughts.
Perhaps that is where evolution starts. A thought.
My cat meows a certain way, motions to the shower, then to the faucet. I get her a bowl of water. She meows approvingly, assuring me i've got it right. I'm well trained. She trained me well. Faster than any teacher and master i've ever trained with.
Meow.
Wednesday, June 24, 2009
our understanding of the mechanics of METs is incomplete
Someone asked for info on this, hence this repost.
I have respected the copyright of the author by witholding the complete text.
TITLE:
A study Investigating the effects of osteopathic muscle energy technique on the viscoelasticity of skeletal muscle
AUTHOR(S):
Ghassan Y. Al Araji, Unitec New Zealand
DOCUMENT TYPE: Masters Dissertation
PUBLICATION STATUS: unpublished
YEAR COMPLETED: 2006
NUMBER OF PAGES: 98
DEGREE: Master of Osteopathy, Unitec New Zealand
INSTITUTION: Unitec New Zealand
ADVISOR: Gutnik, Boris
COPYRIGHT STATEMENT:
Copyright restriction for articles
This digital work is protected by the Copyright Act 1994 (New Zealand). It may be consulted by you, provided you comply with the provisions of the Act and the following conditions of use:
• Any use you make of these documents or images must be for research or private study purposes only, and you may not make them available to any other person.
• You will recognise the author’s and publishers rights and give due acknowledgement where appropriate.
COPYRIGHT HOLDER: Ghassan Al Araji
• Download the Document (PDF format - 34.6 MB) - November 2007
• Tell a colleague about it.
ABSTRACT:
This study was performed to investigate the effects of an osteopathic treatment technique (muscle energy technique) on the viscoelasticity of skeletal muscle (biceps brachii). Fifteen 18-30 year old healthy non obese right handed male volunteers participated. Data collection was undertaken over four days with each subject attending two sessions separated by an interval of 1 day. On day one, three measurements of muscle viscoelasticity (stiffness, power of resistance) were taken from each individual participant’s left biceps brachii muscle. Measurements were made using a purpose designed force dial viscoelastometer. This device is designed to perform incremental compression of tissue and to calculate stress - strain data for muscle tissue during periods of controlled deformation. On day two, three measurements were again taken followed by five 10 second cycles of muscle energy technique on the subject’s left biceps brachii muscle; three further measurements were again taken post intervention. Analysis of deflection and resistance of the measuring probe was then plotted as a linear equation (y = kx +b). The deformed muscle tissue was conceptually modelled and represented using 3 subsequent springs in series, representing 3 different compartments (layers) of skeletal muscle. Indices of total compressive stiffness of skeletal muscle and specific power of resistance during tissue compression were calculated using multiple mathematical formulas. A comparative statistical analysis between pre-intervention and post-intervention data was performed with the single tailed paired samples t-test from the software program SPSS 12.0.1 for Windows. There was no significant difference in stiffness (95% CI = -0.06419 to 0.23786 degrees; t = 1.233; df = 14; P < 0.238) and power of resistance (95% CI = -0.00804 to 0.01988 degrees; t = -0.910; df = 14; P < 0.378) between pre-intervention and post-intervention states. After intervention the stiffness and power of resistance of the biceps brachii muscle did not decrease. The Cohen’s d post-hoc test showed that the effect size of the intervention was considered to be small, low, minor. No significant individual difference was demonstrated in terms of the stiffness (95% CI = -0.36715 to 0.07369 degrees; t = -1.428; df = 14; P < 0.175) and power of resistance (95% CI = -0.02503 to 0.01245 degrees; t = -0.719; df = 14; P < 0.484) between pre-intervention (baseline) trials for each subject. This study demonstrates that muscle energy technique did not decrease indices of viscoelasticity (stiffness and power of resistance) of the biceps brachii muscle. These findings encourage further research on the physiological background of MET.
PRIMARY SUBJECT CATEGORY: Medical and Health Sciences (320000)
PBRF SUBJECT CATEGORY: Other health studies (including rehabilitation therapies)
KEYWORDS: Muscle energy technique, Muscle viscoelasticity
I have respected the copyright of the author by witholding the complete text.
TITLE:
A study Investigating the effects of osteopathic muscle energy technique on the viscoelasticity of skeletal muscle
AUTHOR(S):
Ghassan Y. Al Araji, Unitec New Zealand
DOCUMENT TYPE: Masters Dissertation
PUBLICATION STATUS: unpublished
YEAR COMPLETED: 2006
NUMBER OF PAGES: 98
DEGREE: Master of Osteopathy, Unitec New Zealand
INSTITUTION: Unitec New Zealand
ADVISOR: Gutnik, Boris
COPYRIGHT STATEMENT:
Copyright restriction for articles
This digital work is protected by the Copyright Act 1994 (New Zealand). It may be consulted by you, provided you comply with the provisions of the Act and the following conditions of use:
• Any use you make of these documents or images must be for research or private study purposes only, and you may not make them available to any other person.
• You will recognise the author’s and publishers rights and give due acknowledgement where appropriate.
COPYRIGHT HOLDER: Ghassan Al Araji
• Download the Document (PDF format - 34.6 MB) - November 2007
• Tell a colleague about it.
ABSTRACT:
This study was performed to investigate the effects of an osteopathic treatment technique (muscle energy technique) on the viscoelasticity of skeletal muscle (biceps brachii). Fifteen 18-30 year old healthy non obese right handed male volunteers participated. Data collection was undertaken over four days with each subject attending two sessions separated by an interval of 1 day. On day one, three measurements of muscle viscoelasticity (stiffness, power of resistance) were taken from each individual participant’s left biceps brachii muscle. Measurements were made using a purpose designed force dial viscoelastometer. This device is designed to perform incremental compression of tissue and to calculate stress - strain data for muscle tissue during periods of controlled deformation. On day two, three measurements were again taken followed by five 10 second cycles of muscle energy technique on the subject’s left biceps brachii muscle; three further measurements were again taken post intervention. Analysis of deflection and resistance of the measuring probe was then plotted as a linear equation (y = kx +b). The deformed muscle tissue was conceptually modelled and represented using 3 subsequent springs in series, representing 3 different compartments (layers) of skeletal muscle. Indices of total compressive stiffness of skeletal muscle and specific power of resistance during tissue compression were calculated using multiple mathematical formulas. A comparative statistical analysis between pre-intervention and post-intervention data was performed with the single tailed paired samples t-test from the software program SPSS 12.0.1 for Windows. There was no significant difference in stiffness (95% CI = -0.06419 to 0.23786 degrees; t = 1.233; df = 14; P < 0.238) and power of resistance (95% CI = -0.00804 to 0.01988 degrees; t = -0.910; df = 14; P < 0.378) between pre-intervention and post-intervention states. After intervention the stiffness and power of resistance of the biceps brachii muscle did not decrease. The Cohen’s d post-hoc test showed that the effect size of the intervention was considered to be small, low, minor. No significant individual difference was demonstrated in terms of the stiffness (95% CI = -0.36715 to 0.07369 degrees; t = -1.428; df = 14; P < 0.175) and power of resistance (95% CI = -0.02503 to 0.01245 degrees; t = -0.719; df = 14; P < 0.484) between pre-intervention (baseline) trials for each subject. This study demonstrates that muscle energy technique did not decrease indices of viscoelasticity (stiffness and power of resistance) of the biceps brachii muscle. These findings encourage further research on the physiological background of MET.
PRIMARY SUBJECT CATEGORY: Medical and Health Sciences (320000)
PBRF SUBJECT CATEGORY: Other health studies (including rehabilitation therapies)
KEYWORDS: Muscle energy technique, Muscle viscoelasticity
Re the lumbar spine and joint play
Someone asked for help on these, hence this repost:
Coupling Behavior of the Lumbar Spine: A Literature Review
Chad Cook, PhD, PT, MBA, OCS, COMT
Abstract: Coupling behavior has been described as fundamental to the theory of lumbar biomechanics. Different manual therapy approaches use discrepant coupling biomechanical models. Despite these inconsistencies, coupling models have been frequently used in the management of low back pain. The purpose of this paper is to investigate evidence for the use of coupling biomechanical modeling in manual therapy assessment and treatment. The findings of this paper suggest that use of a single dogmatic lumbar spinal coupling approach utilizing a side-bend initiation may not be appropriate and could lead to unreliable findings. The use of rotation initiation needs further consideration. Coupling behavior may be more consistent if rotation is initiated first, however there is insufficient evidence to substantiate this view.
The Journal of Manual & Manipulative Therapy Vol. 11 No. 3 (2003), 137 - 145
Four Cardinal Principles of Joint Mobilization and Joint Play Assessment
John R. Stevenson, PhD, PT, CEA, Dan W. Vaughn, PT, MOMT
Abstract: The teaching and learning of fundamental principles that guide valid and effective assessment and intervention techniques in joint mobilization is a basic foundation to those health professions that make use of manual therapy. Such principles help establish the specificity of manual therapy techniques, the foremost quality of 'best practice.' However, authors of few textbooks or reference books devote space to establishing such fundamental principles for learners and practitioners of manual therapy techniques. The purpose of this paper is to present four cardinal principles that have impressed us, over our years as educators and clinicians, as the foundation for the teaching and practice of sound manual therapy techniques for either joint play assessment or joint mobilization. These principles are utilized in practice from entry-level to master clinicians, they can guide educators as to how to introduce and monitor effective manual therapy skills among students and colleagues, and they can also serve as a source of refreshment for experienced clinicians who desire continuing education for maintenance of their hands-on skills in manual therapy interventions and assessment.
The Journal of Manual & Manipulative Therapy Vol. 11 No. 3 (2003), 146 - 152
Management of a Patient with Sacroiliac Joint Dysfunction: A Correlation of Hip Range of Motion Asymmetry with Sitting and Standing Postural Habits
Phillip H. Warren, PT, DPT, OCS, MTC
Abstract: The purpose of this case report is to describe the clinical management of a patient with sacroiliac joint dysfunction (SIJD) and a concomitant asymmetrical hip-joint rotation range of motion. The patient was a 53-year-old male whose chief complaint was right low back pain (LBP) that interfered with work and leisure activities. Physical therapy consisted of manual therapy, stretching, and postural education to address SIJ and hip motion abnormalities. At the conclusion of 6 visits, the hip-joint rotation range of motion was more symmetrical. The patient reported self-correction of unilateral standing and sitting postures. He returned to full-time work and to playing golf, and he rated pain at 0-1/10. This patient's asymmetrical hip-joint rotation range of motion may have been associated with SIJD, either as a result of trauma or subsequent habitual postural adjustments. Clinician awareness of the possible relationship between SIJD and asymmetrical hip joint rotation range of motion is recommended.
The Journal of Manual & Manipulative Therapy Vol. 11 No. 3 (2003), 153 - 159
Effects of a manual therapy technique in experimental lateral epicondylalgia
Slater, Helen and Arendt-Nielsen, Lars and Wright, Antony and Graven-Nielsen, Thomas (2005) Effects of a manual therapy technique in experimental lateral epicondylalgia , Manual Therapy.
Abstract
In patients with lateral epicondylalgia, mobilization-with-movement (MWM) is used as an intervention aimed at achieving analgesia and enhancing grip force, although the mechanisms underlying these effects are unclear. The present study investigated the acute sensory and motor effects of an MWM intervention in healthy controls with experimentally induced lateral epicondylalgia. Twenty-four subjects were randomly allocated to either a MWM or a placebo group (n 1⁄4 12). In both groups, to generate the model of lateral epicondylalgia, delayed onset muscle soreness (DOMS) was provoked in one arm 24 h prior (Day 0) to hypertonic salineinduced pain in the extensor carpi radialis brevis muscle (Day 1). Either a MWM or placebo intervention was applied during the saline-induced pain period. Saline-induced pain intensity (visual analogue scale: VAS), pain distribution and pain quality were assessed quantitatively. Pressure pain thresholds (PPTs) were recorded at the common extensor origin and the extensor carpi radialis brevis muscle. Maximal measures of grip and wrist extension force were recorded. In both groups (pooled data), DOMS was efficiently induced as demonstrated by a significant decrease in pre-exercise to pre-injection PPT at the common extensor origin (45719%) and at the extensor carpi radialis brevis (61723%; Po0:05), and a significant decrease in maximal grip force (2576%) and maximal wrist extension force (40712%; Po0:001). Moreover, both groups experienced a significant increase in muscle soreness (3.970.2; Po0:0001) at Day 1 compared to pre-exercise. During saline-induced pain and in response to intervention, there were no significant between-group differences in VAS profiles, pain distributions, induced deep tissue hyperalgesia or force attenuation. These data suggest that the lateral glide-MWM does not activate mechanisms associated with analgesia or force augmentation in subjects with experimentally induced features simulating lateral epicondylalgia.
Coupling Behavior of the Lumbar Spine: A Literature Review
Chad Cook, PhD, PT, MBA, OCS, COMT
Abstract: Coupling behavior has been described as fundamental to the theory of lumbar biomechanics. Different manual therapy approaches use discrepant coupling biomechanical models. Despite these inconsistencies, coupling models have been frequently used in the management of low back pain. The purpose of this paper is to investigate evidence for the use of coupling biomechanical modeling in manual therapy assessment and treatment. The findings of this paper suggest that use of a single dogmatic lumbar spinal coupling approach utilizing a side-bend initiation may not be appropriate and could lead to unreliable findings. The use of rotation initiation needs further consideration. Coupling behavior may be more consistent if rotation is initiated first, however there is insufficient evidence to substantiate this view.
The Journal of Manual & Manipulative Therapy Vol. 11 No. 3 (2003), 137 - 145
Four Cardinal Principles of Joint Mobilization and Joint Play Assessment
John R. Stevenson, PhD, PT, CEA, Dan W. Vaughn, PT, MOMT
Abstract: The teaching and learning of fundamental principles that guide valid and effective assessment and intervention techniques in joint mobilization is a basic foundation to those health professions that make use of manual therapy. Such principles help establish the specificity of manual therapy techniques, the foremost quality of 'best practice.' However, authors of few textbooks or reference books devote space to establishing such fundamental principles for learners and practitioners of manual therapy techniques. The purpose of this paper is to present four cardinal principles that have impressed us, over our years as educators and clinicians, as the foundation for the teaching and practice of sound manual therapy techniques for either joint play assessment or joint mobilization. These principles are utilized in practice from entry-level to master clinicians, they can guide educators as to how to introduce and monitor effective manual therapy skills among students and colleagues, and they can also serve as a source of refreshment for experienced clinicians who desire continuing education for maintenance of their hands-on skills in manual therapy interventions and assessment.
The Journal of Manual & Manipulative Therapy Vol. 11 No. 3 (2003), 146 - 152
Management of a Patient with Sacroiliac Joint Dysfunction: A Correlation of Hip Range of Motion Asymmetry with Sitting and Standing Postural Habits
Phillip H. Warren, PT, DPT, OCS, MTC
Abstract: The purpose of this case report is to describe the clinical management of a patient with sacroiliac joint dysfunction (SIJD) and a concomitant asymmetrical hip-joint rotation range of motion. The patient was a 53-year-old male whose chief complaint was right low back pain (LBP) that interfered with work and leisure activities. Physical therapy consisted of manual therapy, stretching, and postural education to address SIJ and hip motion abnormalities. At the conclusion of 6 visits, the hip-joint rotation range of motion was more symmetrical. The patient reported self-correction of unilateral standing and sitting postures. He returned to full-time work and to playing golf, and he rated pain at 0-1/10. This patient's asymmetrical hip-joint rotation range of motion may have been associated with SIJD, either as a result of trauma or subsequent habitual postural adjustments. Clinician awareness of the possible relationship between SIJD and asymmetrical hip joint rotation range of motion is recommended.
The Journal of Manual & Manipulative Therapy Vol. 11 No. 3 (2003), 153 - 159
Effects of a manual therapy technique in experimental lateral epicondylalgia
Slater, Helen and Arendt-Nielsen, Lars and Wright, Antony and Graven-Nielsen, Thomas (2005) Effects of a manual therapy technique in experimental lateral epicondylalgia , Manual Therapy.
Abstract
In patients with lateral epicondylalgia, mobilization-with-movement (MWM) is used as an intervention aimed at achieving analgesia and enhancing grip force, although the mechanisms underlying these effects are unclear. The present study investigated the acute sensory and motor effects of an MWM intervention in healthy controls with experimentally induced lateral epicondylalgia. Twenty-four subjects were randomly allocated to either a MWM or a placebo group (n 1⁄4 12). In both groups, to generate the model of lateral epicondylalgia, delayed onset muscle soreness (DOMS) was provoked in one arm 24 h prior (Day 0) to hypertonic salineinduced pain in the extensor carpi radialis brevis muscle (Day 1). Either a MWM or placebo intervention was applied during the saline-induced pain period. Saline-induced pain intensity (visual analogue scale: VAS), pain distribution and pain quality were assessed quantitatively. Pressure pain thresholds (PPTs) were recorded at the common extensor origin and the extensor carpi radialis brevis muscle. Maximal measures of grip and wrist extension force were recorded. In both groups (pooled data), DOMS was efficiently induced as demonstrated by a significant decrease in pre-exercise to pre-injection PPT at the common extensor origin (45719%) and at the extensor carpi radialis brevis (61723%; Po0:05), and a significant decrease in maximal grip force (2576%) and maximal wrist extension force (40712%; Po0:001). Moreover, both groups experienced a significant increase in muscle soreness (3.970.2; Po0:0001) at Day 1 compared to pre-exercise. During saline-induced pain and in response to intervention, there were no significant between-group differences in VAS profiles, pain distributions, induced deep tissue hyperalgesia or force attenuation. These data suggest that the lateral glide-MWM does not activate mechanisms associated with analgesia or force augmentation in subjects with experimentally induced features simulating lateral epicondylalgia.
re when we treat leg length discrepancies
axcerpted from the Review
Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry
by Gary A Knutson *
Conclusion
Anatomic leg-length inequality under 20 mm and leg¬length alignment asymmetry caused by supra-pelvic mus¬cle hypertonicity may interact in a loaded (standing) pos¬ture, but not in an unloaded (prone/supine) posture. Any leg-length alignment asymmetry due to suprapelvic mus-cular hypertonicity should be eliminated before any nec-essary treatment of anatomic leg-length inequality. By using this information, which is open to change based on new studies, the clinician may better understand the diverse and sometimes confusing findings relative to ana¬tomic leg-length inequality and functional or unloaded leg-length alignment asymmetry, and be better able to make treatment recommendations.
Anatomic and functional leg-length inequality: A review and recommendation for clinical decision-making. Part II, the functional or unloaded leg-length asymmetry
by Gary A Knutson *
Conclusion
Anatomic leg-length inequality under 20 mm and leg¬length alignment asymmetry caused by supra-pelvic mus¬cle hypertonicity may interact in a loaded (standing) pos¬ture, but not in an unloaded (prone/supine) posture. Any leg-length alignment asymmetry due to suprapelvic mus-cular hypertonicity should be eliminated before any nec-essary treatment of anatomic leg-length inequality. By using this information, which is open to change based on new studies, the clinician may better understand the diverse and sometimes confusing findings relative to ana¬tomic leg-length inequality and functional or unloaded leg-length alignment asymmetry, and be better able to make treatment recommendations.
Passive prone technique notes
These notes are not meant for manual med specialists with weak hearts. If that fits your constitutional makeup, please, kindly back off NOW.
Anyone who’s learned PPTs with us, this is for you and anyone else brave enough to breathe with their eyes open.
Since some of us so very much love a good debate, let’s play!
Point of argument:
A working model for pelvic articulation must satisfy these working criteria:
1. It has to account for the walking action of the legs
2. It has to account for how the vertebral spine moves to complement the biomechanics of walking.
3. It has to act as a precursor for the lumbar spine to side-bend and rotate in non-neutral (both forward and backward bending)
4. It has to act as precursor for thoracic spine rotation with lumbar neutral and forward bending.
5. It has to block thoracic backward bending.
6. The pelvis should not dislocate when completing the first four items.
Since, as one of my buds says, “talk is cheap, and nothing slides like bullshit,”
Let's try an experiment. Proof, man, show us some cold friggin proof!
Test “A” for rotation.
1. Ask a colleague to sit sideways on the plinth, with buttocks even, and feet planted firmly flat on the floor.
2. Weight should be equally balanced at both buttocks.
3. Stay behind your colleague and place your hands around the pelvis, to block or completely immobilize it.
4. This isolates lumbar rotation as a motion without contribution from the pelvis.
5. Now, if muscles are the singular cause of lumbar rotation. The L3 joint can still rotate.
a. Ask your colleague to rotate their lumbar region slowly in either direction.
b. Be very careful not to force the rotation to the point of engaging the pelvis and leverage.
c. keep the pelvis immobile.
d. The result of this test is that the lumbar spine blocks after a mere few degrees of rotation.
e. Now we know that the L3 joint can’t rotate far with the pelvis immobilized
Test “B” for side-bending.
1. As with previous experiment, we block the pelvis.
2. This time, we engage the lumbar spine in side bending to either side.
3. We likewise find that side bending is restricted to mere few degrees.
Test “C” for combined side bending and rotation
1. blocking the pelvis, ask your colleague side-bend their lumbar spine as best they can toward one side and then attempt to rotate to the opposite side
2. Now, if Freyette’s laws are correct, This combination movement should account for real-world lumbar rotation in neutral / forward bending (these are Bayliss-adapted conventions; In other words, side-bending to one side with rotation to the other side should occur nicely with the spine in AP neutral).
3. We however find that the amount of rotation possible remains minimal at the lumbar vertebrae.
Test “D” for combined rotation and side-bending
1) The same experiments as previous can be repeated, blocking the pelvis and this time starting with
a) lumbar rotation
b) followed by side bending to the same side.
2) This, according to Fryette’s laws of traditonal spinal mechanics, Is how the lumbar vertebrae in work in non-neutral / extension. (Translation: with the spine engaged extended, rotation and side-bending should occur nicely to the same side)
Conventions used here:
1) By extension, we mean that the lumbar spine is in either neutral or forward bending.
2) Again, lumbar extension is here meant to signify lumbar spine being either neutral or forward bent.
Reason for conventions:
When a bone is brought towards bone by contraction of the muscle between those bones, that’s “flexion,” isn’t it? Now, where are the muscles that contract when the lumbar spine bends backward? So isn’t that “flexion?”
For simplicity, then, let’s stick to “forward-bending” and “backward-bending.” It’s just so much clearer.
Discussion:
1) trying out the same experiment in neutral or forward-bending for combined rotation and Side-bending to the same side, we find that rotation is not improved.
2) These simple tests shows that isolated combinations of
a) Local side-bending and rotation and of
b) Local rotation and side bending for the lumbar spine do not and can’t account for the observed real-world amount of lumbar rotation.
I have included the convention of “local” to signify isolation of biomechanics to the segments tested, with no contribution from the SIJ. This is in keeping with the premise of Fryette’s mechanics in the pure form they are presented in textbooks.
Test E.
Adding pelvic side bending:
1) With your colleague in the same position as previous, prop a one-inch thick block or book under the right ischial tuberosity.
i) This side-bends the sacrum to the left. Have a look.
ii) The lumbar spine becomes side-bent to the left as well. Note that the sacrolumbar spine acts biomechanically as one unit here.
2) Now, ask your colleague to rotate to the right, making sure to block all pelvic side-shift to the left. (Side-bent left, rotated right).
3) Note that, in comparison to the previous experiments, Your colleague will be able to rotate further to the right for the lumbar area tested.
4) With the pelvis merely held in horizontal, We observe that the circumferential range of rotation does not equal what we notice in the real world , Insofar as lumbar rotation goes
Pelvic criteria:
Test “F.”
Add a side shift left, still in lumbar flexion, with the patient is same position as in previous, with a block under the right buttocks. (Side-bent left, rotated right, ischial tuberosity elevation Right, pelvic translation left)
Observe that the lumbar spine automatically rotates to the right without any muscular leverage within the sufficient range reflective of what we notice usually happens. This is a range of motion traditionally ascribed as a local lumbar capability phenomenon. We have taken for granted that Fryette mechanics are a local vertebral phenomenon.
Observe the thoracic spine.
Thoracic Experiment one:
1) Repeat the above test. With your colleague sitting up straight, notice that the thoracic spine refuses to rotate right.
2) It is important not to force it to rotate.
a) The thoracic spine is designed to restrict rotation in thoracic (extension) backward bending.
b) This automatic blocking mechanism does occur for forward bending and neutral.
Thoracic Experiment two:
1) In same position as above, side shift the pelvis to the right (rather than the left, as done previously.)
2) This causes the pelvis automatically rotate right, and almost automatically level out on the horizontal plane.
a) Observe how the thoracic spine automatically rotates to the right, together with the pelvis and lumbar spine.
b) On top of this collective rotation of the thoracic vertebrae, there is also an independent movement of the thoracic vertebra into rotation right and side-bending left.
c) Notice how this collection of movements in combination sufficiently mimics the ranges of segmental motion we regularly observe.
These tests basically tell us that the pelvis provides the angle plus side-shift that enables lumbar and thoracic vertebrae movements we take for granted.
We may extend our studies to walking thus:
Setting aside the role of muscles, isolating for bony articulation, we note that walking involves several forces. The main forces involved are:
1. Weight-bearing and leaning.
2. Leg lifting and direction.
3. The changing angles of the Ilia and hip joint.
4. The reciprocal action of the sacroiliac joints.
5. Lumbar vertebral accomodation for this action.
6. the action or contribution of side shift
These notes were based on the highly esteemed and much recommended work of JR Bayliss, D.O.
This intro appears in abbreviated form in the Mini Manual for Manual Medicine by
S. Strix Toledo www.manualmedsolutions.org www.manualmed.blogspot.com
Anyone who’s learned PPTs with us, this is for you and anyone else brave enough to breathe with their eyes open.
Since some of us so very much love a good debate, let’s play!
Point of argument:
A working model for pelvic articulation must satisfy these working criteria:
1. It has to account for the walking action of the legs
2. It has to account for how the vertebral spine moves to complement the biomechanics of walking.
3. It has to act as a precursor for the lumbar spine to side-bend and rotate in non-neutral (both forward and backward bending)
4. It has to act as precursor for thoracic spine rotation with lumbar neutral and forward bending.
5. It has to block thoracic backward bending.
6. The pelvis should not dislocate when completing the first four items.
Since, as one of my buds says, “talk is cheap, and nothing slides like bullshit,”
Let's try an experiment. Proof, man, show us some cold friggin proof!
Test “A” for rotation.
1. Ask a colleague to sit sideways on the plinth, with buttocks even, and feet planted firmly flat on the floor.
2. Weight should be equally balanced at both buttocks.
3. Stay behind your colleague and place your hands around the pelvis, to block or completely immobilize it.
4. This isolates lumbar rotation as a motion without contribution from the pelvis.
5. Now, if muscles are the singular cause of lumbar rotation. The L3 joint can still rotate.
a. Ask your colleague to rotate their lumbar region slowly in either direction.
b. Be very careful not to force the rotation to the point of engaging the pelvis and leverage.
c. keep the pelvis immobile.
d. The result of this test is that the lumbar spine blocks after a mere few degrees of rotation.
e. Now we know that the L3 joint can’t rotate far with the pelvis immobilized
Test “B” for side-bending.
1. As with previous experiment, we block the pelvis.
2. This time, we engage the lumbar spine in side bending to either side.
3. We likewise find that side bending is restricted to mere few degrees.
Test “C” for combined side bending and rotation
1. blocking the pelvis, ask your colleague side-bend their lumbar spine as best they can toward one side and then attempt to rotate to the opposite side
2. Now, if Freyette’s laws are correct, This combination movement should account for real-world lumbar rotation in neutral / forward bending (these are Bayliss-adapted conventions; In other words, side-bending to one side with rotation to the other side should occur nicely with the spine in AP neutral).
3. We however find that the amount of rotation possible remains minimal at the lumbar vertebrae.
Test “D” for combined rotation and side-bending
1) The same experiments as previous can be repeated, blocking the pelvis and this time starting with
a) lumbar rotation
b) followed by side bending to the same side.
2) This, according to Fryette’s laws of traditonal spinal mechanics, Is how the lumbar vertebrae in work in non-neutral / extension. (Translation: with the spine engaged extended, rotation and side-bending should occur nicely to the same side)
Conventions used here:
1) By extension, we mean that the lumbar spine is in either neutral or forward bending.
2) Again, lumbar extension is here meant to signify lumbar spine being either neutral or forward bent.
Reason for conventions:
When a bone is brought towards bone by contraction of the muscle between those bones, that’s “flexion,” isn’t it? Now, where are the muscles that contract when the lumbar spine bends backward? So isn’t that “flexion?”
For simplicity, then, let’s stick to “forward-bending” and “backward-bending.” It’s just so much clearer.
Discussion:
1) trying out the same experiment in neutral or forward-bending for combined rotation and Side-bending to the same side, we find that rotation is not improved.
2) These simple tests shows that isolated combinations of
a) Local side-bending and rotation and of
b) Local rotation and side bending for the lumbar spine do not and can’t account for the observed real-world amount of lumbar rotation.
I have included the convention of “local” to signify isolation of biomechanics to the segments tested, with no contribution from the SIJ. This is in keeping with the premise of Fryette’s mechanics in the pure form they are presented in textbooks.
Test E.
Adding pelvic side bending:
1) With your colleague in the same position as previous, prop a one-inch thick block or book under the right ischial tuberosity.
i) This side-bends the sacrum to the left. Have a look.
ii) The lumbar spine becomes side-bent to the left as well. Note that the sacrolumbar spine acts biomechanically as one unit here.
2) Now, ask your colleague to rotate to the right, making sure to block all pelvic side-shift to the left. (Side-bent left, rotated right).
3) Note that, in comparison to the previous experiments, Your colleague will be able to rotate further to the right for the lumbar area tested.
4) With the pelvis merely held in horizontal, We observe that the circumferential range of rotation does not equal what we notice in the real world , Insofar as lumbar rotation goes
Pelvic criteria:
Test “F.”
Add a side shift left, still in lumbar flexion, with the patient is same position as in previous, with a block under the right buttocks. (Side-bent left, rotated right, ischial tuberosity elevation Right, pelvic translation left)
Observe that the lumbar spine automatically rotates to the right without any muscular leverage within the sufficient range reflective of what we notice usually happens. This is a range of motion traditionally ascribed as a local lumbar capability phenomenon. We have taken for granted that Fryette mechanics are a local vertebral phenomenon.
Observe the thoracic spine.
Thoracic Experiment one:
1) Repeat the above test. With your colleague sitting up straight, notice that the thoracic spine refuses to rotate right.
2) It is important not to force it to rotate.
a) The thoracic spine is designed to restrict rotation in thoracic (extension) backward bending.
b) This automatic blocking mechanism does occur for forward bending and neutral.
Thoracic Experiment two:
1) In same position as above, side shift the pelvis to the right (rather than the left, as done previously.)
2) This causes the pelvis automatically rotate right, and almost automatically level out on the horizontal plane.
a) Observe how the thoracic spine automatically rotates to the right, together with the pelvis and lumbar spine.
b) On top of this collective rotation of the thoracic vertebrae, there is also an independent movement of the thoracic vertebra into rotation right and side-bending left.
c) Notice how this collection of movements in combination sufficiently mimics the ranges of segmental motion we regularly observe.
These tests basically tell us that the pelvis provides the angle plus side-shift that enables lumbar and thoracic vertebrae movements we take for granted.
We may extend our studies to walking thus:
Setting aside the role of muscles, isolating for bony articulation, we note that walking involves several forces. The main forces involved are:
1. Weight-bearing and leaning.
2. Leg lifting and direction.
3. The changing angles of the Ilia and hip joint.
4. The reciprocal action of the sacroiliac joints.
5. Lumbar vertebral accomodation for this action.
6. the action or contribution of side shift
These notes were based on the highly esteemed and much recommended work of JR Bayliss, D.O.
This intro appears in abbreviated form in the Mini Manual for Manual Medicine by
S. Strix Toledo www.manualmedsolutions.org www.manualmed.blogspot.com
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