Re: 's back spasm - -Jill

[Guest guest]

Jill:

I am glad to hear that responded to the PT for relief of the

spasm what you ahve to remember is that your typical doctor might

not know the mechanics of spasm and wouldn't therefore respond the

same way in treatment

:

She got a bad muscle spasm during the massage when she lifted her

head to scratch. She was crying and in so much pain.My PT went in to

her, and after trying a few things (ice - changing position) he told

her to try to get on her hands and knees. She could do this. Then he

told her to sit back on her feet, and put her head down - sort of

like curled up.It worked! The spasms started to go away.

Mike:

I didn't pick up on something when I read your original post above.

Jill's comment triggered something in the back of my mind. But

before I get into that, I would like to add that Jill is " smack on "

with her comment about typical doctors not knowing the mechanics of

spasm. Relatively few have any meaningful training in soft tissue

issues. Their training, and mind-set, is to treat spams or cramps

with rest, ice and muscle relaxing pills.

I can't say precisely which muscle was involved without knowing

exactly where the spasm was in 's back, but it sounds like it

was in one of the three ESG (erector spinae group) muscles. These

are the longisimus, spinalis and iliocostalis. Per my " Trail Guide

to the Body " book, all three of them originate at the " common tendon

(thoracolumbar aponeurosis) that attaches to the posterior surface

of the sacrum, liliac crest, spinous processes of the lumbar and the

last two thoracic vertebrae. " In other words, most of the bony

attachment points across the low back.

All three of these muscles are bilateral in that there are left and

right longisimus, spinalis and iliocostalis muscles. When they act

bilaterally, they extend the vertebral column - they arch the back

posteriorly. When only one side is acting, they flex the spine to

that same side. They have different insertion points, or where they

attach to the upper body. The spinalis attaches to the spinous

processes of the upper thoracic and lower six cervical vertebrae.

The longisimus attaches to the lower nine ribs, the transverse

processes of all of the thoracic and cervical vertebrae and to the

mastoid process at the base of the skull. The iliocostalis attaches

to transverse processes of the 1st to 3rd lumbar vertebrae, the

posterior surfaces of the ribs and the transverse processes of the

lower cervical vertebrae.

Because of the above description, I would guess that if the spasm

was centered along the spine that the longisimus was the prime

culprit. If the spasm was more outward from the spine, then the

guess would be for the iliocostalis. The likelihood is that both or

all three were involved. There are other back muscles as well, but

they are not the prime movers for back extension. They assist, but

they are not primary.

Remember the night the three of you came out to the house and we

were talking about cramps in general and how to stop them? There are

both passive and active ways to stop a spasm or relieve a cramp or

contracture. The standard passive technique is RICE (Rest, Ice,

Compression, Elevation). There are three active, mechanical ways to

do it. The first is a form of compression - deep, direct pressure

right on the cramp/spasm - but it is much more aggressive than just

straight compression. Using the calf as an example, you would take

your fist and bascially put your full weight into it, pushing the

muscle right into the bone.

The second is called origin-insertion approximation. This is not

something that you can generally do on yourself because it takes two

hands to perform and it requires a fair working knowledge of both

anatomy and kineseology. You have to know which muscle is involved,

what action(s) it does, and where its origin and insertion

attachment points are. Other than that, you put one hand on the

origin and the other on the insertion and then actively push the

muscle ends toward each other.

The technical name for the third is Reciprocal Inhibition. This is

just fancy language for making the muscle perform the opposite

action to the cramp - getting it to straighten out and relax. When

went into spasm on the table, the fastest way to stop the

cramp would have been the deep, direct pressure on the cramp. And in

fact, as long as she stayed prone on the table, that was about the

only one that would have worked. She couldn't do Reciprocal

Inhibition because she was already in the farthest forward position

she could get - the table would have prevented her from getting into

any position other than neutral. That would not have been enough.

She had to put her back into a flexed position to counter the

cramping from the back extensors.

And that is exactly what your PT did. He had her get into a postion

(back on her heels) where she could then roll her head and back

forward into a flexed position. As soon as she was in the " opposite

action " position, the back muscles had to relax and release.

[Guest guest]

Yea, Mike. You are right on.

The spasms always go from her neck down to her bum. Always on the left side.

[Guest guest]

Massage has been the most helpful treatment for me as well.

And I know first hand how the energy work is amazing.

Mike worked on for 3 hours, after she had been on crutches for 2 weeks,

sprained her back 4 times in 2 weeks, and had a migraine for 3 days. She got up

from his table and had no pain at all. Her knee hasn't bothered her since.

He worked on me for 3 hours, and I didn't notice a difference until the next

day. I felt better than I have in 11 years. I felt pretty good for about 4

days, spiraling down each day. The 2nd time he worked on me, I felt like I had

the flu the next day. I know he can help me and , but it the same thing -

the cost. Mike isn't set up for insurance. So, even though I want to call him

every week, I have to be careful, because of the money issue.

I don't know if you saw the post about Mike working on 's shoulder. She

had surgery and the dr couldn't aligned it perfectly. So she was left without

full range of motion. After 10 minutes with Mike, she could move it better. It

seems she has something going on in her elbow. I need to have Mike work on

that.

I think I need to start a budget, so I can get him over here more!!!!!