Massage Science, and Australia

Many of the readers of this journal are from the northern hemisphere, and understanably, are fascinated by our kangaroo; we, on the other hand, or, the other paw, often see these creatures as a cute, cuddly nuisance.

However, I was quite surprised, and somewhat gratified, to come face-to-face with a host of these weird animals, no more than 20 minutes away from my own home, just a few weeks ago. Local readers will, perhaps, have heard of the location of an asylum for the insane, in the early days of the settlement of our island colony, at Morrisett.

A few friends dropped in to see this wonderful site, after many years absence, and as we stepped off the tourist coach, the herd slowly descended upon us, seeking easy food, no doubt.

Nuisance they might be, to many, but mesmerising to others - consider these amateur shots, possums.

Knee surgery

I met an old friend today at the usual haunt, the coffee shop. He is my age, mid seventies, and has had left knee joint replacement, (tibio-femoral) three years ago. He was subdued about the success of the procedure - for those of us who have never had surgery of any kind, I believe we can never imagine the impact on our day-to activities that follows surgical intervention.

Many people feel a great relief from the cessation of pain - others, well, they often report a reduction in mobility, and a sense of frailty.

Let's discuss this latter group, including my friend at the coffee shop.

His concern was a reduction in mobility in the left knee joint - flexion was, immediately after the operation, limited to about 40 degrees; remember, this man and I were very active in our early years in mechanical and structural engineering, so our grasp of this aspect of his situation was quite clear. Medical scientists, who have a clear understanding of the methods, and the intricacies, of joint replacement, seem to have a poor view of the structural side-effects of their wonderful efforts.

Having adhered to the advice of the orthopaedic surgeon, which included the almost compulsory recommendation of physiotherapy, my friend returned to his daily walking and golf programme, and today, almost three years post-surgery, flexion is still limited to about 90 degrees, and when he walks, his paces are no more than one third of a metre.

After consulting the original surgeon three times, and another specialist in the next capital city for a second opinion - he was left with the forecast that: such poor results are not uncommon, you have an abnormally high degree of fibrosis. Either you learn to live with the situation, or, come back in year or so and we will slice through the tendon of the offending extensor muscle, to give some relief to your problem.

I propose to you possums reading this diary entry that some people just don't understand that fibrosis - excess scarring - is common; it is a natural adjunct to many forms of bodily invasion, such as surgery, radiology, and muscle tears. Such scarring limits movement of the joint(s) in the vicinity of the invasion, so that recovery can occur.

To propose surgery as a means of improving mobility is a contradictory thesis - surgery will only promote more scarring - this man needs a programme of stretch, either alone, or assisted, and much of the fibrotic tissue can be modified, and mobility enhanced.

I'm only an out-of-work engineer/lawyer kiddo's, but I know how this stuff works at a basic level - and that's manual therapy, massage science, my massage science, working at a basic,yet vital level.

Lymphoedema

In our business as manual therapists, we are aware that there are, - broadly speaking, - two body systems that we can have a significant influence over; these are the circulatory and the nervous systems. Your influence in these areas can be positive, or damaging, depending on your intention, your training, or your current attitude.

I'm prompted to speak to you today about circulation - there are many people with sedentary jobs - maybe computer-stuck - others are elderly, or not energetic for whatever reason; their lower limbs will suffer from poor circulation, maybe leading to varicose veins.

Unfortunately, walking, as an exercise, has its upside and its downside, for all of us.

Walking, whether slow or brisk, means the leg muscles, (and many others) will call for additional fluid, to provide the fuel for the task. A lower limb that is already struggling to cope with normal, day-to-day functions, may not be able to deal with a surge in the fluid that walking invites.

A solution , you ask ?

You can answer this yourself - this is a column for thinkers, for massage scientists.

Ban walking ? Unless you have severe skeletal difficulties and ailments, this would be poor advice.

Apply a garment to the lower limb? If it is to be effective, any garment, whether surgical or bandage, must be firm-firm enough to influence the peripheral circulation -that's the whole point - so there will be negative outcomes.

There is oedema, that is our starting point. If you have read my other publications, you know that oedema is, in a way, self propagating; oedema is one of the side-effects of poor circulation, and oedema has a seriously negative effect on the circulatory system - the very system that was originally designed to deal with oedema.

I propose, that unless dealt with promptly, varicose veins, like other forms of oedema, will self propagate.

One of the solutions is inversion therapy - think about this, possums, and we will speak again.

Massage Science.

Yesterday, I met an old friend, limping towards me at the local shopping village.

I am a manual therapist with an avid interest in anatomy, and anatomical irregularities; this girl, 45 years old, had an obvious injury to her left ankle, which she said was due to" a fracture of the ankle."

We moved away from the bustle into a coffee-shop, so she could rest her foot a little, and she revealed a few things to me:

1. While delivering product for her employer, she stepped out of her car, tripped on a loose piece of paving, and falling, fractured her fibula. This is a slender bone in the lower leg, that really, is an ankle bone, rather than a leg bone - but I digress...

2. She had the necessary examinations, and fibreglass cladding, and here we are, four weeks after. Her foot is swollen, and quite uncomfortable in the shoe; her calf is also enlarged, and she is beginning to experience hip pain.

3.She has been receiving physiotherapy treatment, for ankle rehabilitation, as well as the post-injury oedema - this involves the use of a surgical garment for the lower limb. I would point out here that outside the coffee shop it was approaching 35 degrees, so, any kind of bandage, any kind of excess clothing, was not a good option.

4. The employer is trying to avoid liability - and is making noises about stopping,or limiting, the insurance cover.

Another life, in another city; oedema can not always be helped with bandages, or garments - adding heat to an already stressed zone will only invite more fluid into the area.

Consider the extra effect of the emotional stess of a lone parent, desperately needing the job, on her feet much of the day, with the insurance company breathing down her neck.

A lot of the therapy we are asked to provide goes beyond structure, possums,

Massage Science-shoulder pain.

I am interested in science, and the methods of science; I understand that advancements in general knowledge, very often , need to rely heavily on data, tests, accumulation of results, and interpretation of these results, so that old assumptions can be supported, or that new assumptions can be made. This is OK, and it is fairly normal for today's scientists to suspect, or even reject, any thesis that lacks a scientific framework; but, I have this strong suspicion that (a) either some of the data is interpreted badly, and/or (b) all un-scientific offerings to the data pool are rejected out of hand. Let me give an example.

I am a massage therapist, with an engineering and legal studies background; anatomy has fascinated me since I had my first lesson in 1985. Because of its complexity, and because of the large number of complaints, the shoulder assembly captured the bulk of my attention, mentally and in the clinic.

I have developed a system of examination of shoulder malfunction that is brief, non-invasive, and quite simple; having applied this system over a 25 year period, I have no hesitation in carrying out this examination, and, applying the appropriate soft-tissue corrections, in order to prove my thesis. Clinical results stand at about 85% success.

Firstly, I am not a recognised scientist, so most professionals would ignore any of my publications; and, secondly, journals such as those issued by physical therapy associations would never be found guilty of allowing feral documents, regardless of the level of veracity within, to be considered for examination, or publication.

What are we left with ? A search of the internet by those who are affected by shoulder malfunction generally suggests radiological or ultrasound examinations, followed by the offer of three alternatives:

1. Adapt to the discomfort, or
2. Adopt a series of exercises to correct the so-called rotator-cuff injury, or,
3.Consider surgery to the damaged rotator cuff component.

I put this to you, possums; speaking broadly, there are only two main causes of shoulder malfunction - one of them might require surgery, and the other does not.

I, and those who I have trained, can easily carry out the examination, and subsequent treatment, to demonstrate the appropriateness of the thesis. If we fail to help ? You have spent a few dollars, and you can continue down the path to surgery.