Let's get straight to the point: muscles have no memory that controls their activity. Muscle memory (more properly, movement memory) resides in the brain, a product of brain-conditioning, i.e., learning.
Patterns of muscular tension result from that conditioning, acquired by learning and by incidents of injury and/or stress.
Think about it: muscles act in patterns of coordination. How can any one muscle control the activity of other muscles? What would be the mechanism? Willpower? Telepathy? And without the ability of a muscle to control other muscles, how could their activity by synchronized in coordinated movement?
No. Something must centrally control and regulate all muscles to enable coordination, and that something is our nervous systems, the seat of movement memory.
Whether learning to walk or to dance, if you want to change muscle memory, or movement memory, you have to do it by training your nervous system -- and if you're stuck in a tension pattern from an injury, you have to do it by training your nervous system -- by un-learning the dysfunctional pattern and learning a healthy pattern of function, i.e., healthy movement.
MORE:
Completing Your Recovery from an Injury
learning coordination with somatic exercises
Showing posts with label clinical somatic clinical somatic education. Show all posts
Showing posts with label clinical somatic clinical somatic education. Show all posts
Somatic Ethics
There is a way about somatic education that can be seen as a kind of ethic or approach to life. By that same token, there is a way of seeing how the way someone participates in somatic education is the way they participate in life.
For one thing, we're dealing with matters of relationship, where relationship isn't a static thing like an abstract concept, but a dynamic of play -- how we do things.
For our first example, let's take the case of how a somatic educator may conduct a session of somatic education with someone. In general, our way is to observe and understand, from within, the predicament of our client. We may look at him or her standing full length, and by observing the stance of that person, replicate its feeling in ourselves. There's a feel to what we see. We kind of get inside you like a hand in a glove and, aided by our theoretical understanding of the behavior of the three major reflexes of stress and our recognition of interconnected movement patterns, we discern what's going on in you. Of course, we cross-verify those findings with your history of injuries, palpation (manual assessment) and your current sensations.
So, here's the first ethic: We get information from both inside and outside, in feeling and in understanding.
Having done that, we choose and guide you into the easiest, most accessible, and generally, most direct route into what you're already doing habitually. We have you make it more. To do so, you must first recognize it as something you can do -- and then do it. So, we guide you, we direct you, into replicating elements of the action you are habitually doing (differentiation) then guide you into assembling all those elements into an integrated pattern -- the more integrated and complete, the better. You go in; you come out. You learn the path into and the path out-of. We help you find it.
You see what I mean about relationship, yet? There's are patterns in us formed by the physical, emotional, mental and intuitive stresses of experience, patterns of remembered tension in our musculature and arrested-but-held impulses to action. We guide you to awaken to what each one is -- and generally, no sooner has that awakening occurred then you are already at least partially, if not largely, out of that pattern. It happens before you know it, actually (although we feel it). Then we have you move about so that you can feel what's changed. Then we do some more.
Into . . . . . out of
The Rule of Thumb, here, is "Whatever they are doing 'wrong', have them do it MORE, and then less -- alternately. Imagine the liberation. "Destination -- Jello" -- but Jello with an attitude!
Now, I suppose there are various ways of going into and out of -- some of which look like going around the problem. So there are degrees of relationship -- degrees of directness -- degrees of relevance -- degrees of comprehensiveness. See?
Now, consider that language: relationship, directness, relevance, comprehensiveness. Those four terms are sufficient to define an ethic.
Relationship | Directness | Relevance | Comprehensiveness
Here's where some variation can creep in. An additional "point on a continuum" is "more and less", "consistent and inconsistent".
"More or less" may be more or less force, more or less speed, more or less intensity, more or less subtlety.
"Consistent and inconsistent" are terms having to do with times and occurrences and also with changes of rules.
Do we change the rules in the middle of the game or do we change the rules between games?
In the case of somatic education, since we are showing a person how to go into and come out-of, some consistency is "desirable". We want to make enough of an imprint in a person's memory that they can find it at will, and then they have also found the way out. In general, "The way it goes in is the way it comes out - and "The way it comes out is the way it goes in."
That's a high-speed strategy because it makes the greatest imprint with the least effort. Another ethic: A case of "get more result with even less effort". Targeted, rhythmic repetition helps a bit.
That kind of high-speed strategy makes even lesser efforts cumulatively effective.
But of course, the point is to get the result -- not to reduce effort.
Another ethic: The way to conserve effort is to get the result very efficiently -- at least as efficiently, and perhaps even more subtly than by less focussed, less specific, less intent, less attentive efforts.
Those are just of few of the ethics we may see in the process of somatic education.
I have observed other variations on ethics among clients.
COMMON ETHICS
There are some interesting ones. I gave them names.
The Wooden Man appears, to others, to change slowly, if at all, but he reports how much change he is feeling. This is a really sensitive individual because (s)he feels so much change when so little is happening.
Half-Hearted Participants don't really put much into it. They don't "ramp up" enough really to engage. You've got to ask them. Repeatedly. They may say one thing and do another -- or promise something and not do what they say.
The Really Hard Worker on the other hand, never quits! (S)he springs into action, sometimes ahead of you so it's a little like reigning in a horse. Thoroughbred. Jumpy. A bit high strung. Tends to hurt him or herself by excessive effort or by never taking rest. We repeatedly have to remind him or her to use less effort and to go more slowly. Be more leisurely.
It's Over Before It's Really Over is the person who, somewhere near the middle or three quarters through a movement, suddenly gives way and quits. Understand, this is a movement for which the person set the effort-force level to begin with -- and (s)he gives way, feeling overpowered by someone who matched her example at the beginning! Misconstruing that she is resisting being overpowered by them, rather than they that are respectfully resisting her, she feels overpowered. Pacing, follow-through -- and recognition of responsibility -- are the teaching, here.
Doesn't Know When to Quit never takes a vacation. This is a person who is a bit slow to enter the relaxation from a "movement into tension" and a bit slow to relax faster. Even after a move to complete relaxation, this person also springs into action at a moment's notice -- even when you want him to relax and have said so. It's a learning thing. We take such a person down in stages, having him/her use progressively less effort with each repetition. We sneak up on the relaxation state. (Shhhhhhhhh.)
All or Nothing -- such a person in a high-powered sports car would be dangerous. (S)he knows only "all on" and "all off". It's "pedal to the metal" or "hit the brakes!" Fitful. Sudden. Not much gradation of control. Can you imagine? Workaholics. Such people may look forceful, but tend to cave in a bit more suddenly than you might expect. They just need practice floating in the mid-range of things -- the so-called "Middle Way" -- which is not mediocrity or "centered balance", but variable, floating self-regulation with capacity for the extremes.
and Chris Cross -- this is a very interesting person. Confuses right and left. Ask him to lift his left arm and he lifts his right, for a moment. Sometimes a long moment. You ask him to look right, he looks left, for a moment, then looks right. Catches himself. Feels dumb. This typically happens with new, non-habitual movements. Here's the news: four (4) out of five (5) people do this a few times during a session. It's very confusing for the person when I bring it to his attention -- and it is for that eventuality that the sayings, "the other right" and "the other left" were framed. This is a person who means to do one thing and does the opposite. Which can be handy -- if we're engaged in learning the way in and the way out. But also amusing.
Anyhow, you can see that these types together define a kind of ethic and more types could be added to make a more complex ethic.
But let's look again at what we have, here.
Here's the last somersault: We contrast/relate the sets of ethics:
http://somatics.com/somusic/Angels_in_Winter.MP3
For one thing, we're dealing with matters of relationship, where relationship isn't a static thing like an abstract concept, but a dynamic of play -- how we do things.
For our first example, let's take the case of how a somatic educator may conduct a session of somatic education with someone. In general, our way is to observe and understand, from within, the predicament of our client. We may look at him or her standing full length, and by observing the stance of that person, replicate its feeling in ourselves. There's a feel to what we see. We kind of get inside you like a hand in a glove and, aided by our theoretical understanding of the behavior of the three major reflexes of stress and our recognition of interconnected movement patterns, we discern what's going on in you. Of course, we cross-verify those findings with your history of injuries, palpation (manual assessment) and your current sensations.
So, here's the first ethic: We get information from both inside and outside, in feeling and in understanding.
Having done that, we choose and guide you into the easiest, most accessible, and generally, most direct route into what you're already doing habitually. We have you make it more. To do so, you must first recognize it as something you can do -- and then do it. So, we guide you, we direct you, into replicating elements of the action you are habitually doing (differentiation) then guide you into assembling all those elements into an integrated pattern -- the more integrated and complete, the better. You go in; you come out. You learn the path into and the path out-of. We help you find it.
You see what I mean about relationship, yet? There's are patterns in us formed by the physical, emotional, mental and intuitive stresses of experience, patterns of remembered tension in our musculature and arrested-but-held impulses to action. We guide you to awaken to what each one is -- and generally, no sooner has that awakening occurred then you are already at least partially, if not largely, out of that pattern. It happens before you know it, actually (although we feel it). Then we have you move about so that you can feel what's changed. Then we do some more.
Into . . . . . out of
The Rule of Thumb, here, is "Whatever they are doing 'wrong', have them do it MORE, and then less -- alternately. Imagine the liberation. "Destination -- Jello" -- but Jello with an attitude!
Now, I suppose there are various ways of going into and out of -- some of which look like going around the problem. So there are degrees of relationship -- degrees of directness -- degrees of relevance -- degrees of comprehensiveness. See?
Now, consider that language: relationship, directness, relevance, comprehensiveness. Those four terms are sufficient to define an ethic.
Relationship | Directness | Relevance | Comprehensiveness
Here's where some variation can creep in. An additional "point on a continuum" is "more and less", "consistent and inconsistent".
"More or less" may be more or less force, more or less speed, more or less intensity, more or less subtlety.
"Consistent and inconsistent" are terms having to do with times and occurrences and also with changes of rules.
Do we change the rules in the middle of the game or do we change the rules between games?
In the case of somatic education, since we are showing a person how to go into and come out-of, some consistency is "desirable". We want to make enough of an imprint in a person's memory that they can find it at will, and then they have also found the way out. In general, "The way it goes in is the way it comes out - and "The way it comes out is the way it goes in."
That's a high-speed strategy because it makes the greatest imprint with the least effort. Another ethic: A case of "get more result with even less effort". Targeted, rhythmic repetition helps a bit.
That kind of high-speed strategy makes even lesser efforts cumulatively effective.
But of course, the point is to get the result -- not to reduce effort.
Another ethic: The way to conserve effort is to get the result very efficiently -- at least as efficiently, and perhaps even more subtly than by less focussed, less specific, less intent, less attentive efforts.
Those are just of few of the ethics we may see in the process of somatic education.
I have observed other variations on ethics among clients.
COMMON ETHICS
There are some interesting ones. I gave them names.
- The Cooperative Helper
- The Wooden Man
- Half-Hearted Participation
- The Really Hard Worker
- It's Over Before It's Really Over
- "Doesn't Know When to Quit"
- All-or-Nothing
- Criss Cross
The Wooden Man appears, to others, to change slowly, if at all, but he reports how much change he is feeling. This is a really sensitive individual because (s)he feels so much change when so little is happening.
Half-Hearted Participants don't really put much into it. They don't "ramp up" enough really to engage. You've got to ask them. Repeatedly. They may say one thing and do another -- or promise something and not do what they say.
The Really Hard Worker on the other hand, never quits! (S)he springs into action, sometimes ahead of you so it's a little like reigning in a horse. Thoroughbred. Jumpy. A bit high strung. Tends to hurt him or herself by excessive effort or by never taking rest. We repeatedly have to remind him or her to use less effort and to go more slowly. Be more leisurely.
It's Over Before It's Really Over is the person who, somewhere near the middle or three quarters through a movement, suddenly gives way and quits. Understand, this is a movement for which the person set the effort-force level to begin with -- and (s)he gives way, feeling overpowered by someone who matched her example at the beginning! Misconstruing that she is resisting being overpowered by them, rather than they that are respectfully resisting her, she feels overpowered. Pacing, follow-through -- and recognition of responsibility -- are the teaching, here.
Doesn't Know When to Quit never takes a vacation. This is a person who is a bit slow to enter the relaxation from a "movement into tension" and a bit slow to relax faster. Even after a move to complete relaxation, this person also springs into action at a moment's notice -- even when you want him to relax and have said so. It's a learning thing. We take such a person down in stages, having him/her use progressively less effort with each repetition. We sneak up on the relaxation state. (Shhhhhhhhh.)
All or Nothing -- such a person in a high-powered sports car would be dangerous. (S)he knows only "all on" and "all off". It's "pedal to the metal" or "hit the brakes!" Fitful. Sudden. Not much gradation of control. Can you imagine? Workaholics. Such people may look forceful, but tend to cave in a bit more suddenly than you might expect. They just need practice floating in the mid-range of things -- the so-called "Middle Way" -- which is not mediocrity or "centered balance", but variable, floating self-regulation with capacity for the extremes.
and Chris Cross -- this is a very interesting person. Confuses right and left. Ask him to lift his left arm and he lifts his right, for a moment. Sometimes a long moment. You ask him to look right, he looks left, for a moment, then looks right. Catches himself. Feels dumb. This typically happens with new, non-habitual movements. Here's the news: four (4) out of five (5) people do this a few times during a session. It's very confusing for the person when I bring it to his attention -- and it is for that eventuality that the sayings, "the other right" and "the other left" were framed. This is a person who means to do one thing and does the opposite. Which can be handy -- if we're engaged in learning the way in and the way out. But also amusing.
Anyhow, you can see that these types together define a kind of ethic and more types could be added to make a more complex ethic.
But let's look again at what we have, here.
- The Cooperative Helper MEETS Chris Cross
- The Half-Hearted Participant MEETS Wooden Man
- All-or-Nothing : It's Over Before It's Really Over
- The Really Hard Worker : "Doesn't Know When to Quit"
Here's the last somersault: We contrast/relate the sets of ethics:
- The Cooperative Helper MEETS Chris Cross | Directness OF Relationship
- All-or-Nothing : It's Over Before It's Really Over | Staying Related
- The Really Hard Worker : "Doesn't Know When to Quit" | Getting More with Less
- Half-Hearted Participants MEET Wooden Men | Focus with Consistency
We get information from both inside and outside,
in feeling and in understanding.
It goes "Inside-out" and comes "Outside-In".
Somatics has an inside.
Fun, huh?
Therapeutics and Somatics
This entry contrasts standard therapeutics for pain with clinical somatic education, for relief of pain. It explains the origins of pain and how therapeutic approaches work (or don't work).
When pain from injuries lingers beyond the expected few weeks of tissue healing, it generally comes from residual muscular tension triggered by the injury. Tight muscles cause muscle pain, joint compression (leading to osteoarthritis) and nerve impingement (e.g., sciatica, Thoracic Outlet Syndrome).
Conventional therapeutics and alternative therapies (e.g., bodywork of all kinds) generally produce temporary and partial relief from moderate-to-severe injuries and may be slow to produce durable improvements.
Clinical somatic education, in the tradition of Thomas Hanna, generally produces rapid, durable, and complete relief from moderate-to-severe injuries. That distinction makes it a better choice, in general, than both conventional and other manipulative therapies.
This article contrasts those methods to an approach that deals with many musculo-skeletal problems, including back pain, more effectively.
It seems obvious that stress and trauma leave impressions in memory and that those impressions might be associated with tension of one sort or another. The piece I'm adding, here, is that the memory of injury, if intense enough, can displace the familiar, healthy awareness of movement, position and self-control. That displacement creates a kind of amnesia of the body; we forget how we were before injury and get trapped in tension.
It's this kind of tension that conventional medicine tries to "cure" by means of manipulative therapeutics (including chiropractic, bodywork and acupuncture), drugs, and surgery.
That this approach works better than the methods this article critiques remains for you, the reader, to see for yourself. I can't convince you, here (any more than I could be convinced before seeing for myself), but can only offer you a line of reasoning and ... at the bottom of this page, a bit of evidence -- a link to a candid, two-minute video clip that shows the first moments of a client after a one-hour session of clinical somatic education.
So, I must appeal to your capacity to reason and to your intelligence and you must seek out the experience, for yourself.
We begin.
Two of these three approaches, drugs and manipulation, are best for temporary relief or for relief of new or momentary muscle spasms (cramp), not for long-term or severe problems.
The third, surgery, is a last resort and is appropriate for only the most severe of degenerative conditions beyond the reach of therapy.
You can get a comparison chart of common modalities here.
Muscle relaxants have the side-effect of inducing stupor, as you have found if you've used them; they're a temporary measure because as soon as one discontinues use, muscular contractions return.
Anti-inflammatories (such as cortisone or "NSAIDS" - non-steroidal anti-inflammatory drugs) reduce pain, swelling and redness, and they have their proper applications (tissue damage).
Cortisone, in particular, has a side effect of breaking down collagen (of which all tissues of the body are made). When pain results from muscular contractions (muscle fatigue/soreness) or nerve impingement (generally caused by muscular contractions), anti-inflammatories are the wrong approach because these conditions are not cases of tissue damage.
Nonetheless, people confuse pain with inflammation, or assume that if there's pain, there's inflammation or tissue damage, and use anti-inflammatories to combat the wrong problem.
Analgesics (pain meds) tend to be inadequate to relieve back pain or the pain of trapped nerves and, in any case, only hide that something is going on, something that needs correction to avoid more serious spine damage.
Most back pain consists of muscular contractions maintained reflexively by the brain, the master control center for muscular activity and movement (except for momentary reflexes like the stretch reflex or Golgi Tendon Organ inhibitory response, which are spinal reflexes). I put the last comment in for people who are more technically versed in these matters; if these terms are unfamiliar to you, don't worry. My point is that manipulative techniques can be only temporarily effective (as you have probably already found) because they don't change muscular function at the level of brain conditioning, which controls tension and movement, and which causes the back muscle spasms.
Nonetheless, people commonly resort to manipulative techniques because it's what they know -- and manipulation is the most common approach, other than muscle relaxant drugs or analgesics, to pain of muscular origin.
Surgery is the resort of the desperate, although surgery has a poor track record for back pain.
There are situations where surgery is necessary and appropriate -- torn or ruptured discs, fractures, spinal stenosis, rare cases of congenital scoliosis. There are situations where surgery is inappropriate -- bulging discs, undiagnosable pain, muscular nerve impingement.
Severity of pain is not the proper criterion for determining which approach to take. The proper criterion is recognition of the underlying cause of the problem and dealing with that.
Clinical somatic education is not about convincing people that 'things are not so bad, and live with it' or 'understanding their condition better' or instructions for maintaining good posture. It's a procedure to eliminate the underlying cause of pain symptoms and to improve function by retraining an aspect of brain function that can readily be retrained (with the correct approach): movement memory (a.k.a., "muscle memory").
In the case of back pain, the underlying cause -- chronic back tension -- causes muscular pain (muscle fatigue and spasm), disc compression, nerve root compression, facet joint irritation, and the catch-all term, arthritis.
Degenerative Disc Disease, for example, though called a disease, is no more a disease of the discs than is excessive wear of tires on an overloaded vehicle with wheels out of alignment. Over a long period of time, accelerated wear accumulates. With discs, they call that a disease. There is no such thing as Degenerative Disc "Disease"; it's breakdown caused by bad movement-memory conditioning.
It isn't a "brand" of therapy or treatment, but a category or discipline within which various somatic "brands" or approaches exist. Examples of "brands" include Trager Psychophysical Integration®, Aston Patterning®, Rolfing Movement®, Orthobionomy®, Somatic Experiencing®, The Alexander Technique®, Feldenkrais Functional Integration®, Hanna Somatic Education® and others.
The prime approach of somatic education, through whatever method or "school", is to retrain the nervous system to free muscles from an excessively contracted state and to enhance control of movement, function, and physical comfort.
One key difference of clinical somatic education from manipulative practices is the active participation in learning by the client. It's not just strengthening or stretching, but gaining the ability to relax completely, to exercise full strength, and control of every strength level in between. The added freedom and control that a client learns during sessions, and not what a practitioner does to the client, per se, causes the improvements. In clinical somatic education, the instruction comes from outside; the improvement comes from within.
As education, clinical somatic education deals with memory patterns -- the memories of incidents of injury, of stressful situations and of how to move and how to relax. Memory patterns show up as habitual muscular tension and changes of movement (e.g., limping) and posture (e.g., uneven hips or shoulders).
Deeper-acting somatic disciplines, such as Feldenkrais Functional Integration and Hanna somatic education, deal with more deeply ingrained and unconscious habit patterns formed by injuries and stress.
The "how" of it is that the brain learns control of muscular tension and movement -- both in the formation of pain patterns and in the formation of healthy functioning -- through the feelings of movement -- slowly or quickly, depending on the kind of technique used.
The distinction of a clinical approach to somatic education is the speed with which improvements occur and the ability of its practitioners to predict with a high degree of reliability how many sessions will be required to resolve a specific malady, without further need for medication or treatment by a health professional -- "how long before I can have my lifestyle back".
Even "enriching" somatic education (such as Feldenkrais Somatic Integration or Aston Patterning) alleviates pain, given enough time -- even where more conventional therapeutic methods -- manipulation, adjustments, stretching, strengthening, drugs, acupuncture, surgery -- are less successful or fail altogether.
The specific advantage seen in clinical somatic education by referring physicians is that clinical somatic education, while being effective in the relief of muscular pain and spasticity, has the specific virtue of teaching the client an ability to improve control the muscular complaint (i.e., pain) to the point that there is little chance of a future return of the problem.
For a technical comparison between somatic education and chiropractic (as an example of a manipulative approach), you may click here
For a discussion of back pain and clinical somatic education, you may click here.
For a discussion of clinical somatic education and recovery from injury, in general, you may click here.
THERAPY, BODYWORK, and SOMATIC EDUCATION
To begin, I'll state my bias: I am a clinical somatic educator trained in methods of mind-brain-body training that addresses chronic, non-malignant, musculo-skeletal pain (e.g., back pain) and stress-related disorders (breathing difficulty, headaches).When pain from injuries lingers beyond the expected few weeks of tissue healing, it generally comes from residual muscular tension triggered by the injury. Tight muscles cause muscle pain, joint compression (leading to osteoarthritis) and nerve impingement (e.g., sciatica, Thoracic Outlet Syndrome).
Conventional therapeutics and alternative therapies (e.g., bodywork of all kinds) generally produce temporary and partial relief from moderate-to-severe injuries and may be slow to produce durable improvements.
Clinical somatic education, in the tradition of Thomas Hanna, generally produces rapid, durable, and complete relief from moderate-to-severe injuries. That distinction makes it a better choice, in general, than both conventional and other manipulative therapies.
This article contrasts those methods to an approach that deals with many musculo-skeletal problems, including back pain, more effectively.
How Chronic Muscular Tension Forms
In the viewpoint of somatic education, muscular activity comes either from voluntary behavior, from habitual (involuntary) learned behavior, or from involuntary reflexes. That means that movement, posture, and muscular tension come conditioning of our nervous system.It seems obvious that stress and trauma leave impressions in memory and that those impressions might be associated with tension of one sort or another. The piece I'm adding, here, is that the memory of injury, if intense enough, can displace the familiar, healthy awareness of movement, position and self-control. That displacement creates a kind of amnesia of the body; we forget how we were before injury and get trapped in tension.
It's this kind of tension that conventional medicine tries to "cure" by means of manipulative therapeutics (including chiropractic, bodywork and acupuncture), drugs, and surgery.
That this approach works better than the methods this article critiques remains for you, the reader, to see for yourself. I can't convince you, here (any more than I could be convinced before seeing for myself), but can only offer you a line of reasoning and ... at the bottom of this page, a bit of evidence -- a link to a candid, two-minute video clip that shows the first moments of a client after a one-hour session of clinical somatic education.
So, I must appeal to your capacity to reason and to your intelligence and you must seek out the experience, for yourself.
We begin.
OVERVIEW OF THERAPEUTIC MODALITIES FOR BACK PAIN
First, I'll comment on drugs, then manipulative techniques in general, then surgery, then clinical somatic education.Two of these three approaches, drugs and manipulation, are best for temporary relief or for relief of new or momentary muscle spasms (cramp), not for long-term or severe problems.
The third, surgery, is a last resort and is appropriate for only the most severe of degenerative conditions beyond the reach of therapy.
You can get a comparison chart of common modalities here.
DRUGS
Drugs can provide temporary relief or for relief of new or momentary muscle spasms (cramp), but can't provide a satisfactory solution for long-term or severe problems. They generally consist of muscle relaxants, anti-inflammatories, and analgesics (pain meds).Muscle relaxants have the side-effect of inducing stupor, as you have found if you've used them; they're a temporary measure because as soon as one discontinues use, muscular contractions return.
Anti-inflammatories (such as cortisone or "NSAIDS" - non-steroidal anti-inflammatory drugs) reduce pain, swelling and redness, and they have their proper applications (tissue damage).
Cortisone, in particular, has a side effect of breaking down collagen (of which all tissues of the body are made). When pain results from muscular contractions (muscle fatigue/soreness) or nerve impingement (generally caused by muscular contractions), anti-inflammatories are the wrong approach because these conditions are not cases of tissue damage.
Nonetheless, people confuse pain with inflammation, or assume that if there's pain, there's inflammation or tissue damage, and use anti-inflammatories to combat the wrong problem.
Analgesics (pain meds) tend to be inadequate to relieve back pain or the pain of trapped nerves and, in any case, only hide that something is going on, something that needs correction to avoid more serious spine damage.
MANIPULATIVE TECHNIQUES
Manipulative techniques consist of chiropractic, massage, stretching and strengthening (which includes most yoga and Pilates), most physical therapy, inversion, and other forms of traction such as DRS Spine Decompression.Most back pain consists of muscular contractions maintained reflexively by the brain, the master control center for muscular activity and movement (except for momentary reflexes like the stretch reflex or Golgi Tendon Organ inhibitory response, which are spinal reflexes). I put the last comment in for people who are more technically versed in these matters; if these terms are unfamiliar to you, don't worry. My point is that manipulative techniques can be only temporarily effective (as you have probably already found) because they don't change muscular function at the level of brain conditioning, which controls tension and movement, and which causes the back muscle spasms.
Nonetheless, people commonly resort to manipulative techniques because it's what they know -- and manipulation is the most common approach, other than muscle relaxant drugs or analgesics, to pain of muscular origin.
SURGERY
Surgery includes laminectomy, discectomy, implantation of Harrington Rods, and surgical spine stabilization (spinal fusion).Surgery is the resort of the desperate, although surgery has a poor track record for back pain.
There are situations where surgery is necessary and appropriate -- torn or ruptured discs, fractures, spinal stenosis, rare cases of congenital scoliosis. There are situations where surgery is inappropriate -- bulging discs, undiagnosable pain, muscular nerve impingement.
Severity of pain is not the proper criterion for determining which approach to take. The proper criterion is recognition of the underlying cause of the problem and dealing with that.
A NON-MANIPULATIVE APPROACH that RELIABLY GETS RESULTS when THERAPY LEAVES SYMPTOMS IN PLACE: CLINICAL SOMATIC EDUCATION
Working with Brain-Level Control
Most back disorders are conditioning problems - correctable by clinical somatic education.Clinical somatic education is not about convincing people that 'things are not so bad, and live with it' or 'understanding their condition better' or instructions for maintaining good posture. It's a procedure to eliminate the underlying cause of pain symptoms and to improve function by retraining an aspect of brain function that can readily be retrained (with the correct approach): movement memory (a.k.a., "muscle memory").
In the case of back pain, the underlying cause -- chronic back tension -- causes muscular pain (muscle fatigue and spasm), disc compression, nerve root compression, facet joint irritation, and the catch-all term, arthritis.
Degenerative Disc Disease, for example, though called a disease, is no more a disease of the discs than is excessive wear of tires on an overloaded vehicle with wheels out of alignment. Over a long period of time, accelerated wear accumulates. With discs, they call that a disease. There is no such thing as Degenerative Disc "Disease"; it's breakdown caused by bad movement-memory conditioning.
Clinical Somatic Education
Clinical somatic education is a discipline distinct from osteopathy, physical therapy, chiropractic, massage therapy, and other similar modalities.It isn't a "brand" of therapy or treatment, but a category or discipline within which various somatic "brands" or approaches exist. Examples of "brands" include Trager Psychophysical Integration®, Aston Patterning®, Rolfing Movement®, Orthobionomy®, Somatic Experiencing®, The Alexander Technique®, Feldenkrais Functional Integration®, Hanna Somatic Education® and others.
The prime approach of somatic education, through whatever method or "school", is to retrain the nervous system to free muscles from an excessively contracted state and to enhance control of movement, function, and physical comfort.
One key difference of clinical somatic education from manipulative practices is the active participation in learning by the client. It's not just strengthening or stretching, but gaining the ability to relax completely, to exercise full strength, and control of every strength level in between. The added freedom and control that a client learns during sessions, and not what a practitioner does to the client, per se, causes the improvements. In clinical somatic education, the instruction comes from outside; the improvement comes from within.
As education, clinical somatic education deals with memory patterns -- the memories of incidents of injury, of stressful situations and of how to move and how to relax. Memory patterns show up as habitual muscular tension and changes of movement (e.g., limping) and posture (e.g., uneven hips or shoulders).
Deeper-acting somatic disciplines, such as Feldenkrais Functional Integration and Hanna somatic education, deal with more deeply ingrained and unconscious habit patterns formed by injuries and stress.
How it Works
Clinical somatic education uses movement and positioning to enable the client, by combining sensation and improving control of movement, to recapture control of out-of-control muscles. As muscles come under voluntary control, they relax and become responsive, again.The "how" of it is that the brain learns control of muscular tension and movement -- both in the formation of pain patterns and in the formation of healthy functioning -- through the feelings of movement -- slowly or quickly, depending on the kind of technique used.
The Distinction: "Clinical" vs. "Enriching" Somatic Education
Most forms of somatic education are not "clinical" somatic education; they are "enriching" somatic education that gradually improves movement and sensory awareness. They have limited predictability about when a specific outcome, such as pain-free movement, will occur.The distinction of a clinical approach to somatic education is the speed with which improvements occur and the ability of its practitioners to predict with a high degree of reliability how many sessions will be required to resolve a specific malady, without further need for medication or treatment by a health professional -- "how long before I can have my lifestyle back".
Even "enriching" somatic education (such as Feldenkrais Somatic Integration or Aston Patterning) alleviates pain, given enough time -- even where more conventional therapeutic methods -- manipulation, adjustments, stretching, strengthening, drugs, acupuncture, surgery -- are less successful or fail altogether.
The specific advantage seen in clinical somatic education by referring physicians is that clinical somatic education, while being effective in the relief of muscular pain and spasticity, has the specific virtue of teaching the client an ability to improve control the muscular complaint (i.e., pain) to the point that there is little chance of a future return of the problem.
For a technical comparison between somatic education and chiropractic (as an example of a manipulative approach), you may click here
For a discussion of back pain and clinical somatic education, you may click here.
For a discussion of clinical somatic education and recovery from injury, in general, you may click here.
a back pain client's first moments
after completing a one-hour session
of clinical somatic education
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Lawrence Gold is a certified clinical (Hanna) somatic educator who has served a world-wide clientele of people with chronic (long-term), non-malignant pain (i.e., caused by injury) -- in practice since 1990. Contact him at https://somatics.com/wordpress/contact.
Lawrence Gold is a certified clinical (Hanna) somatic educator who has served a world-wide clientele of people with chronic (long-term), non-malignant pain (i.e., caused by injury) -- in practice since 1990. Contact him at https://somatics.com/wordpress/contact.
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