Manual Therapy

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The manual therapy practices used by the MSK Specialist are based on traditional osteopathic principles (focusing on muscles, joints, and bones), Eastern European physiotherapist principals, modern myofascial principals, and an applied understanding of the fluid dynamics of the muscular and fascial system. The goal of manual therapy is to center every joint in the body, including the spine and pelvis. This results in smoother movement for the joints and help free impinged nerves, which translates to improved performance and pain relief. 

Manual therapy is used in conjunction with therapeutic exercise. When the body is not able to move in an unimpeded way, manual therapies are used to open the body, allowing more functional movement. Once passive movement becomes possible for the joint, muscle activation will be performed around the joint to teach the muscles to maintain the new, healthy position. Passive manual therapy alone will not teach the body to hold its new position; thus, the corrective exercise potion of MSK treatment focuses on this aspect as it activates muscles around the centered joint. In this way the body "learns" how to hold the joint in a centered position.

Muscle knots and trigger points are a function of the brain (or nervous system) telling specific muscles to contract. Simply massaging these knots offers only temporary relief, as many of us have experienced, because they will return without neuromuscular reeducation. The nervous system must be taught correct muscle balance to eliminate these chronic, painful knots. MSK Specialist manual therapies and exercise communicate to the nervous system to release contracted muscles. For example, neck and chest muscles are chronically contracted due to the incorrect upper chest breathing patterns seen in many desk workers. This can lead to neck pain, headaches and numbness into the hands.  By reeducating the breathing pattern to proper abdominal breathing, these muscles release as they are no longer required to pull the chest up and open 20,000 times a day during the breath cycle.  Proper breathing techniques are a key point of any MSK treatment. 

The MSK treatment is designed to minimize the discomfort experienced during body work. When pain is introduced in the body, the body will naturally enter a fight-or-flight stress response, regardless of what the brain is actually capable of handling. The tension caused by this response is counter-productive to true healing. Therefore, the MSK treatment is designed to remove pain from the body with as little discomfort as possible. High velocity chiropractic techniques are not used in our clinic; rather, we use alternate techniques to produce favorable results.

Functional Exercise

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The MSK Specialists’ functional exercise is rooted in the proper stabilization of the core through diaphragmatic control and intra-abdominal pressure. This is maintained through the contraction of the transverse abdominis (the innermost of the flat muscles of the abdomen; this muscle wraps around the torso like a natural weight belt or corset).  The expansion of the diaphragm lowering into the the abdomen creates the pressure that the transverse abdominis contracts against.  This outward motion creates a slight outward barrel, not an inward hour glass shape.  This activity also expands the pelvic floor and properly exercises this area.  The anatomically correct way to support the core is not through muscle strength; rather, it is by hydrostatic pressure, which is much more powerful.   This method locks the rib cage and the pelvis in a single, solid unit to offer the extremities and the back a solitary source of support. This practice is based upon normal baby development, the stabilization used by indigenous people, and human development prior to the modern age.

 

When children sit for long periods of time and bend forward during their school years, proper diaphragmatic descension into the abdominal cavity is prevented. This fails to create the adequate abdominal pressure necessary to stabilize the back, arms, and legs. As children grow older, their core is not stable; however, they often develop arms and legs stronger than their point of stability. This causes the body’s joints to become destabilized, misaligned, and injured.

 

The functional exercises that we provide seek to reestablish proper intra-abdominal pressure and neurologically reconnect the core to the movement of the extremities. A properly balanced and stabilized extremity is more exact in its motions, produces more power, and is less likely to be injured. These exercises will reawaken natural neuromuscular memories from early childhood when proper stabilization was natural as we learned to turn, crawl, and walk. When implemented correctly, it will feel natural and remain stabilized with little effort.  Our exercises are based upon the teachings of Kolář, Václav Vojta, Janda, Karel Lewit, and others.

Postural Analysis

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MSK Specialists are trained to perform a complete postural and gait analysis, orthopedic tests on all joints (including the spine), and range of motion analysis for every joint in the body. We also have an arsenal of specific tests to identify incorrect stabilization patterns which denote weaknesses and over-use in the body. Once these tests are complete, manual therapy and corrective exercise will be implemented to correct misaligned joints so that proper posture and stabilization can be maintained. 

Functional Taping

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Proper taping applications can stabilize an injured joint and improve muscle function. The MSK Specialists are trained to perform an evaluation of a patient and properly apply the tape if indicated. Although there is a large amount of information on sport taping on the internet, this information is often very general and can be inaccurate. Incorrect sport taping can cause improper pulling on the fascia (the connective tissue beneath the skin that attaches and stabilizes muscles) and unbalance the joints, actually causing an injury. In order to prevent the improper taping applications often seen on young athletes, we are happy to teach a parent, spouse, or friend how to properly tape your specific need so you are able to utilize the tape in a beneficial way whenever the need arises.

Body Education

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No body comes with a user’s manual, and every person is different. We seek to educate our patients throughout treatment by discussing the anatomical connections of the body and how a patient’s body is holding him or her. By taking the time to teach you about your specific musculoskeletal system, stabilization patterns, and source of pain in your body, your treatment will become more effective in the long-term. When a practitioner is vague in describing his or her findings, patients lose valuable information that could aid in their recovery. We discuss everything we find in your body, explain our beliefs regarding the cause, and give you tools and education to prevent the reoccurrence of your problem. Additionally, we will discuss the specifications and effectiveness of the techniques we are using so that you may apply they at home in order to relieve pain.