For the Prevention and Care of Joint Pain
Jean-Pierre Barral DO, MRO(F)
ALSO BY JEAN-PIERRE BARRAL
Understanding the Messages of Your Body (Albin Michel, 2005)
Visceral Manipulation (with Pierre Mercier)
Visceral Manipulation II
Trauma: An Osteopathic Approach (with Alain Croibier)
Urogentital Manipulation
The Thorax
Manual Thermal Evaluation
Manual Therapy for the Peripheral Nerves (with Aain Croibier)
Manual Therapy for the Cranial Nerves (with Alain Croibier)
Manual Therapy for the Prostate
Visceral Vascular Manipulation (with Alain Croibier)
New Manual Articular Approach; Upper Extremity (with Alain Croibier)
New Manual Articular Approach; Lower Extremity (with Alain Croibier)
ACKNOWLEDGEMENTS
This book is dedicated to all the patients who have advanced my understanding of human beings and their health problems.
Although I may have covered only a small bit of ground here, I will endeavor to continue the journey along this infinite road.
CONTENTS
Introduction
PART ONE: An Articulated Body and Its Emotions
1 An Articulated Body
The Innate and the Acquired
By Accidents?
2 Emotions for Life
Emotion: Between Reason and Instinct
The Body Has a Gift for Memory
Some Wounds Are Visible, Some Less So
PART TWO: Why Do Joints Hurt?
3 Causes of Pain
Traumatism
Rheumatism
Poor Diet
Hormonal Imbalances
In Relationship to Our Organs
The Emotions
An Energetic Problem
4 Trauma
At the Origin of Trauma: the Accident
Reactions t Trauma
Post-traumatic "Scarring"
Can Pain Be Revived?
Can a Trauma Be Healed?
Is Immediate Treatment Necessary After an Accidents?
Accepting Pain
5 Rheumatisms
Arthrosis
Arthritis
Osteoporosis
Medical Progress
6 Connections Between Joints and Organs
Referred Pain
Our Organs Also Articulate One with the Other
PART THREE: Messaes from Our Joints
7 The Ankle and Foot
Function
In Relationship to Our Organs
What the Feet Represent
Attitudes
Foot and Ankle Problems
Advice
8 The Knees
Functions
The Knees in Relationship to Organs
What Knees Represent
Knee Problems
Advice
9 The Pelvis and Hips
The Pelvis
The Hips
Hip and Pelvis Problems
Advice
10 The Vertebral Column
What It Represents
Relationship with Our Organs
Back Complaints
Advice
11 Lumbar Column: Sacrum and Coccyx
What the Lumbar Column Represents
What the Sacrum Represents
What the Coccyx Represents
Coccyx Problems
Advice for Backache
Exercise
12 The Thoracic Column and the Thorax
The Thoracic Column
The Thorax
What the Thoracic Spine Represents
What the Thorax Represent
Relationship Between the Thorax and Our organs
Thoracic and Upper Back Problems
Advice
13 The Cervical Column
What It Represents
Neck Problem
Relationship with Our Organs
Advice
14 The Shoulder
What It Represents
Relationship with Our Organs
Shoulder Complaints
Advice
Exercise
15 The Elbow
What It Represents
Relationship with Our Organs
Elbow Problems
Advice
16 The Hand and Wrist
What It Represents
Relationship with Our Organs
Wrist Problems
Hand Problems
17 The Cranium and Jaw
The Cranium
What It Represents
Cranial Problems
Relationship with Our Organs
Cranial Osteopathy
The Jaw
What It Represents
Relationship with Our Organs
Jaw problems
Advice
PART FOUR: Taking Care of Yourself
18 When Pain Arises
The Onset of Pain
Listen to Pain
Interpreting Symptoms
Manual Therapies
Basic Advice in Choosing a Therapist
19 To Be Lucid and to Remain So
Be Aware of Limitations
Be Aware of Your Fears
Be Aware of Weaknesses
20 Eating Well
Drink Water!
Eat with Pleasure
Is There an Eating Regimen Ideally Suited to joint Problems?
A Healthful Diet
Illnesses Have Their Foods
Medicinal Foods
Watch Your Weight
Is There a Solution?
21 A Healthful Way of life
Move and Practice a Physical Activity
Pay Attention to Potbelly
Sleep Well
Have Your Vision Checked
Breathe Well
To Be Avoided
22 Stand Up Straight
Good Posture
Positions to Avoid
Allow your Head and Body to live Together
Service your Body
23 Natural Care
Home Remedies
Conclusion
Glossary
Introduction~
In Understanding the Messages of Your Body. I explored the relationship between our organs and our emotions. In this new book I share more of what I have learned in the course of more than forty years of osteopathic practice. Observations about human nature are interwoven with a theoretical and practical understanding of structure and physiology.
The workings of the body and spirit are closely and permanently linked. Emontions, organs, and joints are interconnected. They communicate with each other, and their messages can carry rich meaning.
It is important to give some thought to the significance of pain and to understand that our weak points merit attention. In these pages I will help you to interpret the messages of your joints.
- What are the possible meanings of joint pain?
- Are they entirely random?
- What do they express about our attitudes, postures, and general way of going about life?
- What can we do to prevent joint pain, and how can we treat it if it comes along?
People do not become therapists by chance. Within every one of them is an urge to discover the mysteries of the human being. Along with that is perhaps an inclination toward self-discovery. Integrating psychological and philosophical aspects into physical care in order to decipher the profound causes of pan takes a lifetime. It is a legitimate approach worth undertaking. The road is long, and step-by-step perseverance is required.
In reading this book, do not be surprised to encounter hypothetical formulas such as "a trauma can produce..." or "a treatment can result in......" While these are meant to be helpful, they are sometimes contestable, as nothing is sure in medicine. A treatment that might prove highly effective for one person may have no discernible effect on another. Medicine is more of an art than a science, and this is particularly true of manual medicine. That is why it is important to remain humble in the presence of a patient in pain and to ask questions. This in itself is a sign that we are listening to the individual and taking in his situation.
All of the examples I use are real cases. Only the names have been changed to respect patient confidentiality.
PART ONE~
An Articulated Body and Its Emotions
1~ An Articulated Body
The human body is a complex construction: a subtle, overlapping arrangement of systems in immediate and constant relationship. Communication is interconnected thanks to the brain, which receives, processes, and transmits information between various elements. The body is organized around a bony framework set on permanent alert. Joints are a key part of this structure; without them we would not be able to move and live normally. Movement involves joints functioning in an automatic sequence managed by the cerebellum, the part of the brain involved in coordination, posture, and balance. Continual mechanical work of the skeleton can cause restriction of joint motion, aches and pains due to trauma and the passage of time, or to other factors that I will touch upon.
Anatomical study reveals the numerous postural and positional changes that humans have undergone in the course of evolution. Our skeleton, muscles, and ligaments have slowly transformed. Man began as a cell. Over a span of several million years that cell became a fish, then a reptile, then a bird, then a monkey, and so on. While many questions remain and will persist about the process, anatomical variations testify to evolutionary change over time. Since becoming a biped, man has found himself in a constant search for balance.
Just imagine the process of Homo erectus becoming "vertical!""The species must have lacked any confidence. Like an infant of today, walking had to be learned.
For smooth movement and to maintain equilibrium, the human being relies on his sense of proprioception. Proprioception is the inner awareness of movement and spatial information arising from muscles and joints.
Sensory receptors allow position and location of information to be relayed between the muscles, joints, and the brain. Nerve receptors located in the tissues inform the cerebellum, which analyzes the incoming data and sends our commands without delay: This provides for the coordination of gestures and movements.
As I described in Understanding the Messages of Your Body, our frame (the skeleton and its joints) also has its weak points. These areas tend to bear the brunt of trauma, natural wear and tear, and poor posture.
It is not uncommon to hear complaints about one particular joint or another. People say things likes, "I have weak ankles," or "I have delicate intestines," or even "I always have pain on the same side."
These expressions convey the burden that these weak points can put on our day-to-day existence. They also emphasize the importance of our joints in daily activity.
The Innate and the Acquired
Our individual constitution and joints are partly innate and partly acquired.
Like begins well before birth. The fetus is a living being, and the line between the innate and the acquired is far from clear. For example, in the case of a mother who experience psychological complications during pregnancy, these events inevitably reverberate to the fetus.
How then do we differentiate between the innate and the acquired in an infant who was troubled in utero?
The importance of the innate is easily seen in families by observing siblings. Children who have theoretically received the same education and nourishment are nevertheless quite different.
Innate Factors
Innate qualities are the strengths and weaknesses that we receive at birth:
- genetics: that which comes from our ancestors. Each of us is endowed with a relatively robust or weak constitution together with an individual form and structure that are dependent on our gencetic inheritance.
- congenital factors: repercussions of life in utero, in birth, and in delivery.
Acquired Factors
Acquired factors are everything that comes along and marks us in the course of life.
- the family and social environment that guides our behavior through the active and passive messages of upbringing and education.
- the cultural and geographical milieu in which we live. (A mountain dweller, for example, acquires a different constitution than someone raised in a city.)
- dietary habits that affect the physiological balance of bones, ligaments, and tendons.
- sports, particularly intensive sports, which place greater demand on some joints over others and involve certain activities that carry accident risk.
- daily habits and working posture.
- lifestyle the body may be subject to.
- visceral problems that can influence joint balance and stability.
- emotional shocks and psychological difficulties that tend to land on the body's weak points. One such vulnerable place certainly can be a joint.
Physiological age retraces the life experience of each individual and reflects what he has made of his body. This physiological age can be very different from a person's chronological age. One can be surprised by the physical differences between two people of the same age. The innate and the acquired influence our behavior and attitudes.
There can be times when life throws us so off-kilter that we might collapse, rise up, or even go into survival mode. Somehow our behavior is automatically altered, and our normal bearing is either exacerbated or diminished. The resulting conflicts n our body schema (the collection of processes that registers the posture of one's body parts in space) very often weakens the joints.
Joints are dependent on the general functioning of the body: its mechanical workings, any functional disturbances, and its ability to compensate and adapt. It is easy to understand that a young Alpine dweller growing up as a skier in a family of mountaineers is at greater risk of spraining his knee than is an urban student who spends most of his time at the computer. It also is conceivable that the computer science student can suffer neck pain from learning into the computer screen for hours on end. If the student adds stress and poor diet to the mix, his problems surely will be amplified.
By Accident?
Our acquired experience is not purely a game of chance (from the Arabic a-zahr, game of dice). Rather, the acquired can be seen as a succession of events that do not play out like a roll of the dice but are somewhat orchestrated. This being said, it is best to avoid trying to find an explanation for everything. After all, there is best to avoid that outright escapes us or is unrecognized.
While every trauma might be attributed to had luck, why not endeavor instead to find a glimmer of a deeper explanation? This might help you to better understand your body and to take better care of its equilibrium, Consider, for example:
- Why did I have a third bike accident?
- Why do I have this recurrent neck muscle spasm?
- Why do I have this tendency to fall on my hands?
- Why am I developing tendonitis?
- Why do I have severe, deforming polyarthritis?
- warning signs of other functional disturbances?
- alerting us to pay better attention?
- an unconscious revelation of ancestral or familial fears?
- the conflicting desire to refuse or to let go of something or someone?
- the response to a challenge to show your know-how or to prove your existence?
- a sign that you are not on the right path?
- a signal from your body to take better care of yourself or get more rest?
- an SOS, a final warning, urging you to change your diet, limit alcohol consumption, or alter your way of life?
Weigh your words carefully and send small subliminal message. Be so diplomatic that they might have the impression that they came to a new conclusion themselves.
2~ Emotions for Life
Emotion expresses itself. It is written on a face as eyes light up for joy or a mouth gapes in astonishment. It appears on the skin when we blush, go pale, or get goose bumps. It is played out in gestures as we raise our hands to our face in dread.
Depending on our education and the social setting in which we were raised, our emotions become suppressed and internalized to a greater or lesser degree. While the person who manages to hide his entire emotional register is very strong indeed, he will find such a feat to be a grave error for his psychic equilibrium. Still, we are not all the same when it comes to emotion. We have not all been formed in the same school to react to events in a particular way.
Emotion: Between Reason and Instinct
To some degree the physical mechanisms linked to emotions are under our control. For example, by breathing deeply we can relax our muscles and cardiac rhythm.
It s only through observing and attempting to understand the expression of our emotion that we can better mange----or at least aspire to have some thoughtful control over----our instinctual drives. This attitude does not come naturally; it requires considerable practice! We cannot do away wit emotion entirely; however, it is best to avoid emotional excess. The solution rests within. Methods to help us maintain physical and mental well-being are numerous (see P.151). Each of us arrives at our own nuanced results, as we all deal with emotion so differently.
Emotional Quotient
IQ (intelligence quotient) was considered for a long time to be the only standard measure of intelligence. EQ (emotional quotient) has been added to our current understanding of a new intelligence.
Two people of equal IQ, and capable in theory of understanding and solving the identical problem, do not make the same decisions because their emotional reactions are different. Why? Very simply, we are not robots. Each of us is endowed with his own complex emotionalism----the way he identifies, assesses, and harnesses emotions, even negative in making decisions.
At the extreme, emotionalism can be either too impulsive or overly restrained by education. Depending on the degree of awakening, emotion helps a person to advance, remain at a standstill, or, worse, to regress.
Emotional Quotient
IQ (intelligence quotient) was considered for a long time to be the only standard measure of intelligence. EQ (emotional quotient) has been added to our current understanding of a new intelligence.
Two people of equal IQ, and capable in theory of understanding and solving the identical problem, do not make the same decisions because their emotional reactions are different. Why? Very simply, we are not robots. Each of us is endowed with his own complex emotionalism----the way he identifies, assesses, and harnesses emotions, even negative in making decisions.
At the extreme, emotionalism can be either too impulsive or overly restrained by education. Depending on the degree of awakening, emotion helps a person to advance, remain at a standstill, or, worse, to regress.
Antonio Damasio, an American neurologist, researcher, and internationally, recognized specialist in emotions, maintains that our intellectual and moral judgments are determined by our emotions and that sentiment arises from the awareness of certain emotions. This implies that emotions precede and are independent from reason. When circumstances provoke an intense emotional reaction, rare is he who manages to keep control. Whenever our deep emotional nature manifests, it is the innate that is revealed.
Emotion: the Cement of Our Makeup
It is said that experience molds character. More accurately, it is the emotions accumulated over the course of a lifetime that make up the personality. Painful experiences are sometimes described as trials or tests. Confronted with the same challenge, two individuals often react and evolve differently. Unconsciously, deep emotions direct the game and its outcome, as the following example illustrates.
two brother lose their mother at the ages of twelve and fourteen. They are brought up by their father who remarries. Twenty years later, the eldest is married and father to a young child. He thinks positively of the infant's future. The second son is celibate and sickly. he complains of various aches and pains, maintains a strong sense of injustice, and holds a severe grudge against life. At birth, the two boys possessed different psychic aptitudes. "My little ones did no have the same character," their father said. "Astonishingly, when their mother died, the more indolent boy reacted combatively, and the one who had appeared so willful collapsed."
How is it that behaviors alter so much, even in children so young? It is said that by age seven the personality is largely determined, and parental education ends. The preadolescent adds to his genetic inheritance the educational and moral values necessary to refine his already very personal emotional nature.
A Four-Level Pyramid
An individual can be seen as constructed in four levels:
- the deep self,, which is the innate being and the future promise.
- the family, which develops feelings and disposition, shapes character, and instills precepts and values.
- the society into which the person must become integrated through his complement of initiations and difficulties to be faced.
- the individual himself who is formed by the symbiosis of the innate and the acquired.
The sum total our life experiences--the combination of the inborn and the collected--is inscribed in the body as if on a recording device, complete with images and sound. For example, at the moment of an accident, the shock of the event is preserved with all of its pain and emotion. Time passes and the event seems to have been forgotten. However, as soon as a similar stress occurs, the past and present become reconnected, reviving old fears that were in the repositories of memory.
One of my patients had a bicycle accident when a dog jumped out in front of her. She jammed on her brakes, which locked her wheel, throwing her forward onto the road. At the same moment she heard the loud noise of a truck coming up just behind her. Having no idea exactly where she had landed, her great fear was to be run over. As it happened, the truck passed her by. She suffered a jaw fracture and neck sprain. Sometime later I treated her for persistent headache. She could not imagine that her headaches could be linked not just to the mechanical problems but also to the memory of cervical vertebrae. On the other hand, she confided that whenever she was on her bike and heard a truck coming, she became paralyzed to the point of falling in the ditch.
Fear had left a more lasting impression than pain did.
The Body Has a Gift for Memory
We know that the body keeps the memory of shocks, be they physical or emotional. Physical shocks are direct. They cause harm, and the body reacts to the immediate pain they bring on. The brain registers all physical and emotional suffering together and at the very same time. Everything is written in our physical and psychic unconscious:
- genetics: diabetes, allergies, psoriasis, asthma, autoimmune disorder
- fetal life: deficiencies, infection, malformation, mechanical constraint in utero
- vaccinations: some can trigger allergic reactional in sensitive people
- infections: contracted during life
- physical trauma: falls, fractures, sprains, surgical intervention, accidents
- psychoemotional trauma: linked to family, education, friends, partners (divorce, separation, aggression, etc.)
- social trauma: unemployment, insecurity, socio-professional problems
Some Wounds Are Visible, Some Less So
The unconscious is capable of recording an accident in as little as one two thousandths of a second. Immediately after an impact, physical wounds can be seen, felt, and cared for. However, accompanying fear is dispatched from the brain to the joints along a route that is beyond our control.
Following its own itinerary, fear permeates the unconscious with the slightest of ambient recollections for an event: every smell, sound, movement, agitation, or immobility; sometimes it is a heavy, cottony silence. After an accident, the organism can develop a recurrent urinary or pulmonay infection. Over time such infections can weaken an associated joint, making it susceptible to additional stress. A joint has memory. Emotion stored away can materialize as a new shock.
Tension Is Palpable
The hand can feel physical and emotional tension. A trained person--whether or not an osteopath--can easily find the physical weakness of strain or disease. Placing no more than the weight of the hand on the body, the therapist will invariably be attracted in the direction of the problem area. The mechanical attraction of the tissues pulls the hand toward it. Tension loves the hand. To feel emotional stress, manual touch must be extremely light, just at the limit of losing contact. Placed on the cranium, the hand is quite able to discern where the brain has stored the biggest emotional tensions. The osteopathic metier is empirical. For this reason, objective scientific experiments are best repeated in order not to go down the wrong road.
PART TWO~
Why Do Joints Hurt?
3~ Causes of Pain
A joint is endowed with an elaborate and finely tuned nervous system. Movement mechanisms are very subtle. Walking, for example, requires that the joints of the lower and upper extremities, the vertebral column, the pelvis, and even the organs move at the same time. In order for walking to be neither halting nor expending of excessive energy, these parts of the body must continuously and concomitantly exchange information with the brain. When a joint suffers, its tremendous sensitivity automatically sends millions of negative impulses to the pain centers of the brain.
Joint pain has numerous origins. I will present each one briefly before offering a more in-depth study in the chapters that follow.
Traumatism
It is easy to understand how a fall, an accident, and acts of physical aggression in general can create joint problems. Lesions can be cartilaginous, osseous, ligamentous, or muscular. They can involve tears, brusies, edema, swelling, joint locking, bleeding, etc. Keep in mind that a joint problem can arise far from the site of traumatic impact due to the "collision" force enerated by the shock when it hits the body. This collision energy travels through and across the body before stopping at a location where it produces a sprain, fracture, or lesion that affects a bone or an organ.
Rheumatism
Rheumatism is a term used for the pain associated with inflammatory or degenerative processes seen in the joints, muscles, and connective tissues. Rheumatism is a favored topic in the over-sixty age group. "My rheumatism is acting up" is a common social expression that reinforces the notion that rheumatism is just a fact of life the must be endured. However, the rheumatoid variety of arthrosis can exist before any symptoms manifest, and it sometime comes on prematurely in the young.
Poor Diet
Dietary habits affect joints indirectly. Everything that the body has trouble eliminating gradually changes acidity levels. Waste products created and accumulated by the organism have a tendency to land in the soft tissue surrounding joints. Specifically:
- the joint capsule. This protective envelope normally maintains a negative pressure, creating a sort of void that facilitates cartilage sliding.
- the synovial pouch. The internal part of the capsule produces synovial fluid. Synovial effusion causes swelling around the knee. Synovial fluid is like oil to our joints. In a car, low oil levels cause the motor to overheat. Metal parts can twist and buckle to the point of breaking. Similarly, if there is insufficient synovial lubricant in our joints, they overheart, swell, and stiffen up.
Hormonal Imbalances
Joints are made up of bone and cartilage surrounded by a capsule, synovial fluid, ligaments, and muscles. Thus constructed, they react to all that affects their environment. The soft tissue surrouding joints is hormonesensitive. Hormonal imbalances, which mainly affect women, can cause muscle and tendon problems as well as joint dysfunctions such as carpal tunnel syndrome, rhizarthrosis, and arthrosis of the hip. An imbalance of estrogen and progesterone is usually implicated, as fluctuations surges during puberty can cause knee pain in young adolescent women.
Menopausal estrogen/progesterone imbalances (usually the effect of deficient progesterone) cause the soft tissue surrounding the joints to become stiffer and "fibrosed," and thus painful. Additionally, certain menopausal medications congest the venous and lymphatic systems, provoking cyclical pelvic pain accompanied by lumbago.
"What I have is not complicated," Jeanne, 53, declared. "All my joint hurt." Palpating and mobilizing her shoulders, wrists, elbows, knees, and spine all triggered pain. On the other hand, while movements were painful, they were still possible.
Radiographs shwed nothing more than slight innocuous arthrosis. Jeanne had not had a menstrual cycle in two years. It is important to keep in mind that menopause is a process not limited to the last menstrual period. Familiar effects can last from two to three years, sometimes longer. These may include hot flashes, sweats, emotional ups and downs, as well as digestive, skin, and joint problems. In Jeanne's case, it is useless to hope for results by manipulating the vertebral column and other joints. It is necessary to work with the organs of the liver, intestines, kidneys, and uterus. It also is important to give general recommendations such as taking up swimming and stretching, and consuming soy and citrus fruit.
In Relationship to our Organs
It generally can be said that any organs might be involved in joint pain should they have trouble carrying out their role of providing for the major functions of the body. Nevertheless, in forty years of practice, I have observed that some organs have more influence than others (see page 56).
The Emotions
Everything is related. The human body is a complex mechanism of interconnections and exchanges between systems: articular, nervous, endocrine, respiratory, vascular, digestive, genital, and more. The brain is capable of receiving ten billion bits of information a second. Cells depend on each as they harmoniously organize to ensure the homeostasis that is vital to all major functions.
Cells also communicate with our emotional system. The limbic system is that group of brain structures involved in memory and emotion. It unites the olfactory pathways (small is very important in emotion), the amygdala, hippocampus, septum (partition), and the corpus callosum. Note that the cerebellum is also a player in analyzing our emotions and the reactions they cause. This part of the brain is involved in memory too.
Short-term memory loss is common after trauma, especially what is known as "rabbit punch" impact (see p.122). Suppose yo suffer from recurrent joint pain. Such pain will send negative messages to your brain, which in turn will wake up other messages previously recorded and stored. The brain has a propensity to store the negative. People who suffer from insomnia are quite aware of this. When we cannot sleep during the night, our thoughts are rarely positive. We ruminate over intangible problems and conflicts that seem difficult, if not impossible, to resolve.
Philippe found himself the victim of a seemingly mild car accident that triggered cervical pain. Several days later he developed a stomachache. Philippe saw no connection between the two. Nevertheless, osteopathic questioning revealed a link. The cervical pain reverberated to the area of the brain where the emotional shock of his parents' divorce lay dormant. They family breakup had caused a stomach ulcer. This point on the stomach became his "weak point."
In its desire to rid itself of accumulated negative messages, the brain discharges the stress. It does this by using in reverse the same nerve pathways by which the trauma reached the brain, even if this amplifies the neck pain. The old stomachache wakes up, and a depressive emotional phase is initiated. The fact that emotions generate physical pain is no longer in doubt. We have all experienced it.
The body cannot be dissociated from spirit and emotion. They are totally interdependent Modern man has invented nothing new as to emotion. The closest we have come is to develop scanners able to detect areas of the brain that are stimulated and activated by emotion and information receptor sites.
Emotions cause the body to react in a way that has important repercussions for health. We know how much stress, anger, anxiety, and depression can harm our organisms. Before symptoms worsen and cause physical deterioration or a weakened immune system, it is preferable to find antidotes other than medications. Emotional support will someday be established within the scope of practice of therapists who deal with physical pain. Doctors increasingly find themselves integrating emotional factors in the practice of medicine at the behest of their patients.
As described above, our entire emotional experience is stored in the limbic system of our brain. In my earlier book, Understanding the Messages of Your Body, I explained the brain as being like any other organ in its effort to rid itself of emotional tension.
When we live through painful, dangerous, or conflicting situations, every brain cell reacts to the emotional upheaval. These very real experiences enter the realm of the unconscious, where they lie dormant unless and until the slightest emotional stimulation might awaken them.
At the age of seven Sophie was violently awakened by a thunderstorm. Alone in her room, she was terribly afraid. Her parents were not near; they were playing cards at the neighbors. Her terror of thunderstorms continued in the from of nightmares up to age eighteen. Around age forty she found herself riding home on a bike when a thunderstorm struck. Heavy rain caused her bike to skid on the wet road. She fell and hurt her knees and hands. Once she picked herself up, she was seized with panic. The memory of the stormy childhood night came rushing back. From then on a double connection was established: Whenever her knees hurt, even with mild swelling, she experienced fear. Knee pain became forever linked to her cerebral fear centers.
Having her knee treated was enough to eliminate part of the viscous knee-pain cycle. She had no wish to consult a psychologist since her condition had become more or less tolerable.
We often interpret messages from our bodies as a funcion of our knowledge, which is inevitable limited and culturally adapted. The brain is an extremely mysterious organ. Nobody can explain how this physical mass is able to think, or where and how it forms thoughts. The brain trades in billions of pieces of information in a manner still far from our comprehension. Weh the brain receives a stress, it stores it away in a small corner. The brain is in continuous communication with the body, receiving and emitting information. Messages are sent out to all parts of the body, including the organs and joints.
Our joint system reacts to physical aggression as well as the discharge of nerve impulses coming from the brain. Feeling emotionally ill at ease can trigger digestive problems such as stomach trouble, or it can set off joint pain. The pain can be in a joint that suffered in the past, or t can be a new problem arising from emotional behavior or posture, like slouching. In manual therapy it is important that we avoid thinking of joint pain as being invariably mechanical.
An Energetic Problem
To carry out its function, the organism uses energy from food we eat, air we breathe, our genetic inheritance, the electromagnetic field, energy from the brain, and doubtless innumerable unknown factors. Our muscles and joints require energy to work. In times of illness, significant fatigue, organ dysfunction, worry, or exposure to an area of electromagnetic disturbance, we can feel the effects and repercussions in our joint system. A sprain, inflammation, or locked joint can show up as a consequence of a drop in energy.
To regain lost energy it is advisable that we sleep more, avoid overeating in the evening, take suitable homeopathic remedies, and drink chamomile tea. We easily can become mentally fatigued and not tired enough physically. To counter this, you may consider walking home briskly from work and taking some time to yourself to listen to music rather than the continuous and frequently negative news cycle.
4~ Trauma 創傷
At the Origin of Trauma: the Accident
創傷的起源：意外事故
An accident results from a conjunction of events, some of them beyond our control, others more foreseeable. It is difficult to rationalize the role of destiny--that supposed supernatural force that predetermines the course of events. How do we explain the coincidences that produce an accident at any given moment?
A Series of Factors
Two cars set off on the same route at the same time--one from Dijon to Valence and the other from Valence to Dijon. Before the journeys begin, we can predict that the drivers will pass each other at some unknown point. Millions of cars driving from Dijon, fell asleep at the wheel. At this hour there was no traffic on the road other than Pierre's car coming from the opposite direction. A terrible fatality occurred as Gerard's car crashed into Pierre's car. Pierre had no chance either to swerve out of the way or to accelerate. He was killed instantly.
Had the cars been two meters or a few seconds closer, the accident would not have happened. Pierre would have escaped death. However, from birth to the moment of tragedy, these two lives were unconsciously arranged to meet. When fate is less cruel, we tend to call it luck or good fortune. The encounter is imagined as the result of random circumstances--an event that might nt have happened if a few meters or seconds had intervened.
It is possible to scroll down a parade of events leading to a meeting. For example, the birth of two people is programmed by the birth of their parents and their grandparents, and so on.
Preoccupation, Carelessness, or Joint Weakness?
In daily life we are confronted with all manner of risks and twists of fate. How we react depends on our strengths and weaknesses.
Alain dislocated his shoulder by falling into an empty swimming pool that he had been spring. "He was lucky. It could have been a lot worse," those around him said. Alain explained how he slipped on the ledge of the pool rim. Wet leaves caused him to lose his footing. But why, you might ask, did he not see them and avoid this hazard? The fact was he found this chore to be a burden. When his friends remarked, "This was bound to happen. You are careless," or "You should pay better attention. You know you often lose your balance," he invariably replied, "In fact, I find cleaning the pool tedious. Personally, I loathe swimming. I do it for the family."
When we do something reluctantly, we unconsciously put ourselves in danger.
Preoccupation
Jean tore his cruciate ligaments when he sprained his knee by missing a step. He had been running late and was by a dossier he had a hard time completing. He finished the file just twenty minutes before leaving the house, not long after the concierge had washed the stairs. The concierge had taken time to place a small notice to be careful on the landing. But Jean had failed to see the sign. "It happened stupidly, and I fell on the same knee that had been bothering me for several months," he said. However, his wife chimed in with, "You had no business going down the stairs while reading that document you were so absorbed in."
From the therapist's point of view, it is no by chance that the torn ligament was on the right knee. Jean is right-handed, meaning he automatically leads with his right leg and naturally places more demand on it. This is the leg he relies on to keep his balance. However, this is only part of the explanation. His brain and cerebellum, which should have been vigilant, were instead focused on the dossier and unable to correctly analyze the data coming to them from his feet.
A Rupture of Perimeter Protection
Around our bodies there is an invisible perimeter of security that protects s and prevents intrusions. Physiologically our joints are defended by ligaments, cartilage, fat, muscles, fascia (muscle envelopes), and skin. We instinctively define a personal space between ourselves and others. In doing so we establish an enclosure of protection against malevolence, be it physical, material, psychic, or emotional. Our mental state is conditioned by this protection. Normally we allow nothing past this perimeter, whether a being, an object, a thought, or feeling. Should this occur against our will, this unacceptable violation of our "body" territory is experienced as aggression, provoking fear and suffering. We become alarmed.
Traumas are attacks our perimeter protection. The body is unable to defend itself against transgression. The shield is broken. Our defenses are blunted.
A Disturbed Electromagnetic Field
Research conducted with engineering equipment demonstrates that this safety enclosure, or circle of vigilance, largely corresponds to the electromagnetic field that surrounds us. This physical field is a combination of wavelengths--infrared, ultrasound, high frequency, radio waves, etc.----that is conducted especially from our brain and skin. Globally the electric and magnetic fields extend from the earth's core and are what move the needle of the compass, for example. Man is sensitive to these subtle, tiny waves produced at the center of the earth.
Humans are sensitive as well to sources in the everyday environment----electric appliances, radio and television antennas, computers, cell phones, microwaves, etc.----that interfere with and influence our organisms. These effects probably are not beneficial, as they disturb both our own and the earth's electromagnetic fields. While the electromagnetic charge carried over electrical power lines is clearly marked and well defined, others flow in every direction, penetrating our bodies without our knowledge.
As demonstrated by Michael Faraday in 1831, an electromagnetic field produces electric current. The human body is a conductive material that exists in the midst of this electric current. The nerve impulses that run through the brain and nerves are electric currents. These impulses are propagated at such tremendous speed that the brain s instantaneously informed about what is happening in the body. This is how we are able to make corrections in our movements or to the organism as a whole. It is the electromagnetic field that alerts us to the presence of another entity, even before seeing it. It allows us to detect positive or negative zones where we feel good or relatively less so, either in a given geographical location or in the company of a particular person. It is through this awareness that we find ourselves spontaneously on the defensive or welcoming of an individual.
We all have had the experience of feeling particularly well in certain rooms of a house--even more precisely, in particular areas of a room. Take family members for example. Each person generally will sit at the same place at the dinner table every night. None are pleased if somebody else takes their chair! Perhaps this unconscious arrangement depends on individual electromagnetic fields that organize and arrange us. Perhaps we are allocated positions according to the spacing ascribed by those around us.
If a stranger touches you, your first reaction is to think of danger. Imagine a projectile, even something miniscule, suddenly thrown in someone's direction. Just being aimed at, let alone hit, is interpreted as an act of aggression and a violation of one's protective ring.
Did you know that when a bone fractures there is an immediate break in the continuity of the brain's electromagnetic field? This interruption enables the brain to know exactly where the fracture is located, thus initiating the scarring and consolidating processes. Granted, it is not possible to formally prove that electromagnetic waves have a direct effect on our joints. Yet we could say the same of the effects of food! Still, we know that poor health is the result of various factors: mechanical, digestive, hormonal, immune, psychological, emotional, and electromagnetic. I will demonstrate later in the book that, when it comes to the vertebral column, the electromagnetic field has an indirect influence on our lumbar discs.
Reactions to Trauma
Immediate Reactions
With a fall or major blow there is pain, but are we really conscious of it? Very curiously or organisms perceive small injuries more forcefully and immediately than they do serious injuries. Think of the immediate pain caused by a burned or pinched finger. Serious trauma, on the other hand, leaves us "in shock." For a few moments we are dazed, in a trance. When we come to our senses and pick ourselves up, we realize what just happened. Often we forget the pain caused by the trauma. It is as if the body is anesthetized and the brain disconnected.Delayed Reactions
Sometime after the trauma, consciousness awakens little by little and pain arrives n proportion to the trauma (bruise, hematoma, sprain, fracture, or ligament tear). This delayed reaction can occur several hours or even days later. Sometimes it can take months to accept the reality of an accident because the unconscious refuses to do so. This refusal creates significant psychological tension that reverberates over the whole body----sometimes at the joints particularly.
Anne and her granddaughter Lucie were in a car accident. The car rolled over several times. Lucie sustained cranial trauma with loss of consciousness. Anne had a lot of bruising and a broken leg. As long as her granddaughter remained in a coma, Anne experienced no pain and complained of nothing. As soon as Lucie regained consciousness, her grandmother started to feel her own injuries. Curiously, she began by experiencing shoulder pain, even though other parts of her body were more injured.
Amazing, you may say. Not really if you consider that Anne's brain was so powerfully focused on Lucie's well-being that it obscured the information coming from her own body. Of course she felt guilty. Lucie's condition put everything else in the shade, as it were. Once awakened, Anne's pain was referred to her left shoulder, which it turned out had been injured some years previously but without much aftereffect. It seems that with the car accident the rain chose the weak point of the shoulder as an outlet for stress.
Here is another example:
Marie was a victim in a serious car accident. It entailed several rib fractures, a broken arm, and a concussion. Immediately after the accident, when any of her friends asked, "How do you feel?" she invariably replied that everything was fine and that it was no big deal. Her positive way of seeing the situation quite amazed her friends who had thought of her as fragile. They marveled at her strength. Several months later, however, Marie became sad, depressed, and lost al motivation. She began tirelessly repeating to whoever would listen that she nearly died in the accident. The fear, too long repressed, suddenly broke through and engulfed her. Since that cascading moment, her joint pain, which had become bearable, had become intolerable.
Pain is an individual experience that can appear quite out of proportion to the trauma sustained. Neither is it always commensurate to the seriousness of the injury. A sprain can hurt more than a fracture. Whatever degree of pain we feel, it is inscribed physically and psychically in our bodies and our brains. Pain is both a signal calling for urgent care and a demand for protection.
Amazing, you may say. Not really if you consider that Anne's brain was so powerfully focused on Lucie's well-being that it obscured the information coming from her own body. Of course she felt guilty. Lucie's condition put everything else in the shade, as it were. Once awakened, Anne's pain was referred to her left shoulder, which it turned out had been injured some years previously but without much aftereffect. It seems that with the car accident the rain chose the weak point of the shoulder as an outlet for stress.
Here is another example:
Marie was a victim in a serious car accident. It entailed several rib fractures, a broken arm, and a concussion. Immediately after the accident, when any of her friends asked, "How do you feel?" she invariably replied that everything was fine and that it was no big deal. Her positive way of seeing the situation quite amazed her friends who had thought of her as fragile. They marveled at her strength. Several months later, however, Marie became sad, depressed, and lost al motivation. She began tirelessly repeating to whoever would listen that she nearly died in the accident. The fear, too long repressed, suddenly broke through and engulfed her. Since that cascading moment, her joint pain, which had become bearable, had become intolerable.
Pain is an individual experience that can appear quite out of proportion to the trauma sustained. Neither is it always commensurate to the seriousness of the injury. A sprain can hurt more than a fracture. Whatever degree of pain we feel, it is inscribed physically and psychically in our bodies and our brains. Pain is both a signal calling for urgent care and a demand for protection.
The Cumulative Effects of Trauma
Our bodily hard drive has a prodigious memory. Nothing is forgotten. A lifetime of traumas accumulates and can reappear at random with incredible force. With this in mind, you should never neglect any shock or trauma. Do not hesitate to consult an osteopath, physiotherapist, or other practitioner of manual medicine. Just because an X-ray reveals nothing doesn't mean all is well.Emotional Resonances of Trauma
A trauma can arouse old psychological issues. By the same token, a troubling psychological event can have repercussions for a joint. We never know which part of the body the brain will discharge its message onto.
At age twelve, Florence landed in a curious state of depression following a knee injury. Everyone reassured her, saying, "Don't worry. It is nothing serious. You will be back together in no time." Physical evaluation revealed nothing serious. She was referred to a psychotherapist who discovered in Florence a dread of familial instability. Her parents argued continuously and often threatened to leave each other. Florence was going through puberty with all its normal physiological changes. The emotional disturbances crystallized on her weakened knee.
Why the knee? Two reasons: The knee shares some nerves with the genital system, and the knee is the key joint of instability. Psychological tension, together with hormonal imbalance, was reason enough for Florence's knee flare-up. Psychological treatment and the end of puberty permitted Florence to resolve her problem.
The inescapable end of puberty makes me think of a phrase attributed to Jean Cocteau: "Youth is an illness easily cured." He is not alluding to the psychological factors that accompany youth, but only to the time that passes so quickly!
Around the age of fifty, Catherine live through an extremely difficult moment in her married life. Separation seemed inevitable. Once separated, she developed incapacitating lumbago that sometimes obliged her to lie down for several hours a day.
While the words "lying down is not standing" states the obvious, the message couldn't be more clear. Catherine's backache conveyed the fact that she was not able to cope with the separation and accompanying insecurity that she inevitably would have to face. The lumbar vertebrae represented her state of balance and rootedness. Staying in bed showed a refusal to accept reality The separation had created a psychic state of deep insecurity which, in turn, caused spasm of the lumbar muscles.
Pains have their echo.
Post-traumatic "Scarring"
Even if an accident is not caused by others, and no cuts or bleeding are involved, the event automatically ruptures an individual's physical and psychic perimeter protection. This break is due to fear and aggression. Trauma generates negative energy. Shockwaves travel through the body until they reach the weak link in the organism, the place where they have the best chance of provoking a lesion. If the injury is well treated, we feel no lasting, obvious effect. On the other hand, we must be alert if a second trauma comes along. There is always a risk that the preceding injury might resurface in an unexpected physical or psychological form.
A good therapist can reduce pain and restore a measure of equilibrium to the weak point in the body, but he cannot guarantee the length of time healing will take. One never entirely recovers from an attack, accident, or trauma. One adapts and compensates. The consequences of an accident are never necessarily fully discharged. The underlying pain can always be revived. The feeling of insecurity induced by the accident remains latent to some degree or another. Even if we have no apparent aftereffects, the incident forever marks our spirit and neurons.
Scarring is every bit as emotional as it is physical. It is difficult to accept a fate such as an accident, not to mention come to terms with all the conditions leading up to it. Every effort must be made toward psychic as well as physical restructuring. Physiologically a sprain, a torn ligament, or any other joint lesion alters the surrounding tissues. Repeated trauma to the same joint leads to degenerative arthrotic changes. The fear and stress generated by the accident are added to the emotional stresses we have lived through previously. Sometimes there is no clear relationship between events, but most of us know the phrase "the straw that broke the camel's back." Accidental repercussions can be very damaging and create real depression in some people.
Odile had three car accidents in a row, all involving whiplash. She suffered from cervicobrachial neuralgia, known colloquially as sciatica of the arm. As time went by, bone spurs (also referred to as parrot beak or osteophytes) developed on the margins of her cervical vertebra. She complained of frequent headache, unfamiliar stomach problems, and back pain. The lesional patterns followed by the successive traumas may have projected onto any number of joints and organs.
Odile was not at fault in any of the accidents. All of the impacts had come from behind. As such, the insurance company had sided with her. But three accidents s a lot! She never ceased repeating, "What is it about me that I had these accidents? It was not on purpose."
Eventually, after finding no objective explanation for these "inopportune collisions," she decided to travel by train. Even then she would say, "I hope I will not derail the train!" She had adopted an avoidance attitude and kept a certain superstition in her heart. "I feel more vulnerable, and I have a hard time coping with this feeling of insecurity," she admitted. Odile was not able to put the idea of a curse out of her mind, on top of which she had marital problems.
Can Pain Be Revived?
Try to remember a physical pain and it is nearly impossible. You might say, "It was excruciatingly, horribly painful." You can attempt to re-experience the time it happened, but you never quite manage to mentally reconstruct the pain.
The brain memorizes physical pain but cannot revive it. You would more easily reproduce a color, flavor, or depressed mood, as the brain retains an infinite number of things at the moment of trauma.
When the passage of time, events come back and are progressively organized. We are able to recompose the event with astonishing precision: the place, weather, noises, smells, movements around us, the people who were there, help that arrived, and what was going through our minds at the time.
Once the pain subsides and joint is repaired, the "inscribed memory" of the trauma can sometimes alter our comportment. Our body tends to adopt a defensive or withdrawn bearing. This compensatory posture is harmful to joint equilibrium. It is important to monitor these attitude changes that occur following trauma, as they often can cause pain to arise in other nerve centers in the joint system. In the long run, poor posture wears out the joint system and weakens it.
Can a Trauma Be Healed?
We never fully heal from trauma. Injury is forever inscribed as an inescapable element of our physical and emotional existence. It becomes part of our "curriculum vitae." We can, however, avoid letting trauma endure in the form of major symptoms.
Beyond obvious initial healing, restoration, and physical rehabilitation, trauma of any nature requires convalescence and psychological work. We must try to understand why it happened and what it has changed in us, both the negative and the positive.
Our perimeter protection was breached and trampled by the aggression sustained. This is something we must accept as having happened as we rebalance our morale in addition to our physical selves.
During the physical and psychological reconciliation phase, individual reactions can surprise us. Those we though of as sturdy and strong can collapse in pain and become paralyzed with fear. Others, whom we believed to be more fragile, outdo themselves at overcoming their handicap, oging beyond medical and self-imposed restrictions to show what they are capable of.
Jean was the boss of construction company. A born leader, he was always on the job and slept no more than four or five hours a night. His workers considered him a "superman." The body always has its limits, however.
One day, Jean fell asleep at the wheel of his car and hit a tree. Fortunately the airbags deplayed, cushioning the blow and its physical consequences. Unfortunately, he event was a psyhological blow to Jean.
Before the accident, things always seemed to go along just as they should without questions. But now Jean began having doubts. Making decisions became difficult. He lost the indisputable confidence of a leader who had previously controlled next to everything. His business continued to do well, but little by little competition began to gain market share.
Jean consulted me for diffuse pains, but his main problem was that he become slightly unraveled. He could not find his own self-image. He had lost the former picture of a successful entrepreneur who understood risk and reward. The accident had caused him to lose his social appearance of certitude. He was not ready to confront any other more fragile and, to his mind, less acceptable aspect of his personality. He did not wish to go to a psychotherapist. "I am not crazy," he said, like so many proud and unyielding men. He preferred to take any reflection alone, and in this he succeeded. He worked less, tried to sleep better and longer, and tried to eat a balanced diet. Even though he continued to have some shoulder pain, his life was better. Above all, he was no longer a slave to his own self-image.
Paradoxically, an accident can be construed as a positive "encounter." Following a knee sprain, with complications requiring long rehabilitation, a young athlete became interested in anatomy and biomechanics through contact with the physiotherapists who treated him. Eventually he became a physiotherapist and specialized in sports injury, a field in which he excelled. "I am passionate about my job,:" he liked to say. "Without such a serious sprain, I certainly would never have been directed along this path, and I would have become somebody else entirely!"
Some have a tendency to say that nothing is by chance. This may be true, but the meeting of beings and events is surrounded in mystery. We search for answers to try to make some sense of our lives. Finding meaning in trauma should be part of any rehabilitation. We should look for the root of the problem to understand the messages and emotional components involved in such abrupt meetings with our fragility and our mortality. So many questions arise that are worth exploring after a trauma. The idea is to work at the behavioral and psychological levels, with a goal to find the best individual therapeutic direction.
Beyond obvious initial healing, restoration, and physical rehabilitation, trauma of any nature requires convalescence and psychological work. We must try to understand why it happened and what it has changed in us, both the negative and the positive.
Our perimeter protection was breached and trampled by the aggression sustained. This is something we must accept as having happened as we rebalance our morale in addition to our physical selves.
During the physical and psychological reconciliation phase, individual reactions can surprise us. Those we though of as sturdy and strong can collapse in pain and become paralyzed with fear. Others, whom we believed to be more fragile, outdo themselves at overcoming their handicap, oging beyond medical and self-imposed restrictions to show what they are capable of.
Jean was the boss of construction company. A born leader, he was always on the job and slept no more than four or five hours a night. His workers considered him a "superman." The body always has its limits, however.
One day, Jean fell asleep at the wheel of his car and hit a tree. Fortunately the airbags deplayed, cushioning the blow and its physical consequences. Unfortunately, he event was a psyhological blow to Jean.
Before the accident, things always seemed to go along just as they should without questions. But now Jean began having doubts. Making decisions became difficult. He lost the indisputable confidence of a leader who had previously controlled next to everything. His business continued to do well, but little by little competition began to gain market share.
Jean consulted me for diffuse pains, but his main problem was that he become slightly unraveled. He could not find his own self-image. He had lost the former picture of a successful entrepreneur who understood risk and reward. The accident had caused him to lose his social appearance of certitude. He was not ready to confront any other more fragile and, to his mind, less acceptable aspect of his personality. He did not wish to go to a psychotherapist. "I am not crazy," he said, like so many proud and unyielding men. He preferred to take any reflection alone, and in this he succeeded. He worked less, tried to sleep better and longer, and tried to eat a balanced diet. Even though he continued to have some shoulder pain, his life was better. Above all, he was no longer a slave to his own self-image.
Paradoxically, an accident can be construed as a positive "encounter." Following a knee sprain, with complications requiring long rehabilitation, a young athlete became interested in anatomy and biomechanics through contact with the physiotherapists who treated him. Eventually he became a physiotherapist and specialized in sports injury, a field in which he excelled. "I am passionate about my job,:" he liked to say. "Without such a serious sprain, I certainly would never have been directed along this path, and I would have become somebody else entirely!"
Some have a tendency to say that nothing is by chance. This may be true, but the meeting of beings and events is surrounded in mystery. We search for answers to try to make some sense of our lives. Finding meaning in trauma should be part of any rehabilitation. We should look for the root of the problem to understand the messages and emotional components involved in such abrupt meetings with our fragility and our mortality. So many questions arise that are worth exploring after a trauma. The idea is to work at the behavioral and psychological levels, with a goal to find the best individual therapeutic direction.
Is Immediate Treatment Necessary After an Accident?
I am not referring here to violent accidents that create significant bodily injury for which hospitalization is vital for emergency care and a complete physical assessment. In the case of less serious trauma, excepting fractures, hemorrhage, or visceral lesions, it is far from certain that immediate treatment is necessary. The person is still dazed from the shock. The "collisional" forces have not yet finished their deleterious work. Pain and other symptoms generally intensify several days after an impact.
Elodie fell from a wall, injuring her shoulder and neck. Her friend advised her to see a practitioner immediately who "worked miracles," according to him. The consultation happened on the same day. After the treatent, Elodie did not feel too badly.
During the night and following day, however, Elodie experienced sever pain. Alarmed and worried, her friend called the practitioner who explained that such pains were a normal reaction and would disappear quickly. Alas, this did not happen. It took three weeks for Elodie to feel better. She thought that the practitioner had not treated her correctly. In fact, the therapist had simply treated the trauma too soon. The pain had not yet completed its course. It would have been better to let Elodie rest, with sedatives and pain medication.
Accepting Pain
After an accident, the body tries first to integrate the traumatic forces and their emotional components. It then allows the collision forces to make their way as far as the weak point, where they want to settle. The patient must take the time to analyze the route that the trauma took through his body. He must reflect on the effects and accept the waiting period of an appropriate recovery timetable, without frustration. The stronger the trauma, the longer the acceptance time that must be allowed.
Following trauma, athletes, for example, commonly pass through four phases:
- anger and frustration;
- reflection on the circumstances and reasons for the accident;
- acceptance of the waiting period for scarring to heal or rehabilitation to run is course;
- reflection on new ways to approach his discipline and his conduct in the sport (if still possible).
5~ Rheumatisms 風濕病
"I have arthrosis." How often I have heard this phrase in my office. Arthrosis is not to be
關節病
confused with arthrits.
關節炎
Arthrosis 關節炎
Arthrosis refers to any degenerative condition that causes local wear and tear at joint cartilages. With time the disease can affect bone. The affliction is brought on by age, repetitive strains, menopause, family tendencies, fractures, recurrent sprains, etc. It is not inflammatory but rather mechanical in origin.
Cartilage
When a joint is moving, cartilage friction is so negligible that it may be compared to a bar of soap gliding on wet marble. With age, however, cartilage loses it smoothness. Roughened cartilage provokes inflammation, particularly inflammation of the synovial sac, which responds to the irritation by secreting excess fluid. Pain accompanies this inflammatory state. With overuse, cartilage degrades and bone-on-bone joint play occurs. These surfaces are neither made nor suited for gliding. If this happens at the knee or hip, surgical intervention is inevitable sooner or later.
Parrot Beak or Osteophytes 鸚鵡喙或骨贅
Parrot beak or bone spurs are bony projections that form along vertebral joint margins. Calcified projections can form at the attachment of ligaments or small muscles.
Osteophytes are not the cause but rather the consequence of joint damage. These spurs are not necessarily painful, and they form naturally as a person ages.
A sign of Longevity
Pain of mechanical origin is experienced during activity and can persist after physical strain. It is relieved by rest and does not occur at night. This type of joint stiffness is apparent upon waking, and it lessens during the course of the day. People can have unbeknownst arthrosis that causes no pain. This type of jint damage is three times more common in women than in men. After age fifty it is natural that we all have some arthrosis. Like any device, the "human machine" wears down. Arthrosis is in itself indicative of a long life.
What to Do
Keep in mind that arthrosis stiffens our joints. To conserve good range of motion we must move, stretch, keep flexible, go to the gym, bike, swim (avoiding cold water), and reduce the consumption of dairy products to avoid waking up with a feeling of heavy joints.
A Beneficial Exercise
If it is possible to install a bar in the house, suspension is an ideal excrcise. Begin very slowly by first resting you feel on a stool or chair to lighten the weight of the body. Progressively relax your shoulders, then push the stool away and maintain the stretching position for several seconds. Suspending yourself too suddenly can damage the shoulder muscles and ligaments.
It is equally important to pay attention to diet (refer to chapter 20). Cervical arthrosis is specifically described in chapter 13.
Arthritis
Arthritis refers to cartilage inflammation of infectious, immunological, or metabolic origin. Unlike arthrosis, which results from mechanical wear, arthritis can affect even young people (juvenile arthritis). It is characterized by spontaneous and theoretically random inflammatory episodes that are not attributable to any precise mechanical cause. Arthritis can bring on acute or chronic joint pain that persists both at night and at rest. During acute flare-ups the joint often swells and becomes rosy red and hot.
Arthritis affects more women than men. It is more common in Anglo-Sax-on and Scandinavian countries. Cold and damp weather exacerbates it. Over time, joints can become deformed. While the reason for arthritis is not precisely known, it may be caused by many factors acting together. It is thought to be partly genetic, environmental, stress-related, and the result of under activity, infection, or immune deficiency. Diet certainly play a big role.
Deforming Rheumatoid Arthritis or Juvenile Chronic Polyarthritis
Martine, a young, cheerful, motivated, and ambitious esthetician had just opened her own esthetics center. She had long dreamed of creating her own business. Having made it happen, she had every confidence in herself and her professional ability. Since the day she opened her door, the appointment book was filled for days ahead. Her clients said that she had "magic finger." The only shadow on the horizon was that her financial obligations worried her. She had never mastered accounting. She wondered how she would ever manage to repay her bank loans.
One morning Martne work up with numb fingers. Each day she felt her fingers retract and deform a bit more. The rheumatologist she consulted diagnosed acute deforming rheumatoid arthritis. "I have sorcerer's fingers," she said. "This will not do in my practice." She became dejected.
Being courageous, however, Martine decided to take charge of her problem without resorting to medication. Inflammation gradually spread from her hands and feet to encompass all the joints, including her jaw. She was able to move only with great difficulty. Her attitude was to make a mockery of her physical deformities, sometimes thinking of them as her friends, other times as enemies. She was determined to thwart rather than become caught up in the spiral of fear she found in her body along the path of its weak points.
Martine consulted many and various alternative health practitioners to help her with treatment and advice. It would take six months for her to feel better, but better she did feel, apart from a few short flare-u[s. It was six months of effort working her fingers and all her joints; six months of exercising her will and her mind so as not to allow the disease state to take hold; and six months to adopt better eating habits.
Ankylosing Spondylitis 僵直性脊椎炎
Ankyosing spondylitis is a type of chronic inflammatory rheumatism found mainly in young men. The hallmark of this condition nocturnal pain n the joints at the base of the spine. Rest has no calming effect; however, physical exercise brings some relief. It is vital to pay attention to nocturnal pain as it can be a sign of a visceral problem or inflammatory rheumatism. By contrast, pain of mechanical origin is classically accentuated by activity and very much relieved by rest.
Jeremy consulted me for increasngly annoying back pain. "I have the feeling of being in a vice with my ribs squeezing me," he said. Manual examination failed to identify any precise areas of pain, but I did find a group of stiff and sensitive vertebrae. He joint pain had not arisen in connection with any strain or trauma, but rather had developed insidiously over time. Imaging showed the involvement of the sacroiliac joint. The test for HLA B27 was positive. HLA B27 is the protein marker that is active in this type of disease and underscores its hereditary nature.
Ankylosing spondylitis requires that the patient take imitative by studying the effect of medications and working with the physician to determine the correct dosage. I advised Jeremy to consult a homeopath, to be vigilant about his food intake (carefully avoiding all animal protein), to drink small amounts of water at frequent intervals, and to have a weekly sauna to help eliminate toxins. The sweat of persons with ankylosing spondylitis has a characteristic sour odor as the skin tries to get rid of what the organs are not capable of eliminating. I asked him to do regular movement therapy and to absolutely avoid any forceful rehabilitation. Flexibility must be restored slowly and gently.
This affliction can be a long struggle, but some patients are very sucessful at coexisting with their condition.
What to Do
- Consult a rheumatologist for a general assessment. Ask questions about the risks and drawbacks of any proposed medical treatment.
- Without advocating self-medication, I would advise you to be a little bit your own doctor. That is, listen to your own pain and symptoms and try to participate in understanding your condition.
- You might consult a homeopath who would prescribe treatment suited to your biological terrain.
- Embark on very gradual rehabilitation in water.
- Avoid red meat.
- Judiciously avoid all dairy.
- It is worth your while to analyze the whys and wherefores of the awakening of such a disease. It had been lying dormant until a convergence of circumstances revived it. Sometimes a small, seemingly insignificant event is enough to have brought it on.
- Search for the trigger factor: personal conflict, work trouble, accident, surgery, excess drinking or eating.
- Work by yourself or with the help of a therapist on both psychological and nutritional levels.
- Consult a manual therapist who can gently make the afflicted joints more supple.
- You might seek the help of an acupuncturist, phytotherapist (botanical medicine), or relaxation therapy practitioner. There are many ways to take care of yourself. The key is that you feel confident in, but never dependent upon, the therapist you choose.
Osteoporosis 骨質疏鬆
Osteoporosis is a reduction in the protein matrix of bone. It is detectable by X-ray as excessive transparency of bone and trabeculae. Bone becomes spongy. Instufficient calcium intake or deficient calcium absorption, which can be a digestive problem, are implicated.
Densitometer devices reveal the presence of osteoporosis to varying degrees in many women. Do not be alarmed if the test calculates an elevated fracture risk. Be aware that osteoporosis is common in women and, with the exception of certain diseases, is largely attributable to menopause. Due easily remedied. It is quite normal that we lose of calcium that is not easily remedied. It is quite normal that we lose height with age. We have twenty-four discs. A loss of just one millimeter per disc ca shorten us by two to three centimeters. It is important to distinguish between ordinary and severe osteoporosis.
Densitometer devices reveal the presence of osteoporosis to varying degrees in many women. Do not be alarmed if the test calculates an elevated fracture risk. Be aware that osteoporosis is common in women and, with the exception of certain diseases, is largely attributable to menopause. Due easily remedied. It is quite normal that we lose of calcium that is not easily remedied. It is quite normal that we lose height with age. We have twenty-four discs. A loss of just one millimeter per disc ca shorten us by two to three centimeters. It is important to distinguish between ordinary and severe osteoporosis.
Advice
- To combat osteoporosis, drink calcium-rich mineral water. Mineral levels vary from region to region. Of the most common bottled brands in France, I would recommend Hepar or Contrex.
- The best assimilable cheese sources are Gruyere, Comte and Beaufort. Consume a small slice before lunch.
- Movement is an excellent remedy, as it activates the circulation of blood that transports the cells used to make bone.
- Take some "good sun" before 11 a.m. and after 5 p.m., when there are fewer infrared and more ultraviolet rays. Optimal bone health associates with vitamin D derived from the sun.
- It is important to take vitamin D in winter in the dosage recommended by your doctor or pharmacist.
Osteoporosis Is Not the Same as Osteopenia!
Osteopenia is a sign of bone mineral density loss. Sixty percent of vertebral fractures are linked to this deficiency. In this case refrain from manipulation. Half of the population over age eighty present with vertebral fracture due to osteopenia.Medical Progress
Tremendous advances have been made in pain management. Morphine and its derivatives have changed the course of severe pain. However, in the case of chronic rheumatic conditions, in the aftermath of accidents, and in all types of recurrent pain in general, advances are more measured. Of course there has been some progress, but I notice that treatments remain symptomatic. Anti-inflammatories are very quickly toxic. A renowned rheumatologist has even affirmed that "their positive effects have never been proven."
In the treatment of knee arthrosis, the injection of viscous products can bring durable relief lasting up to a year. Surgical hip replacement achieves very convincing results, as does knee replacement, although knee surgery is a little more delicate.
One can only marvel at advances in medical engineering. Arthroscanners, MRIs, and ultrasounds are becoming more and more perfected. They are allowing us to establish extremely in-depth diagnostics, even if the same cannor yet be said of the treatments that ensue. The precision of these images is remarkable. A lumbar arthosis or a herniated disc has little chance of going undetected. But what about treatment when surgery is not indicated?
It is common among the patients who bring an MRI to the consultation that many of them have exactly the same diagnosis: compressed disc between the fourth and fifth lumbar vertebrae. What to do? Generally I advise them to come in to see me during the acute phase, which allows me to better understand the source of their pain. For example, lumbago is not the cause of a problem. It is the consequence of several factors such as prolonged strain, poor nutrition, psychological tension, intestinal problems, prostate or gynecological conditions, and bad foot support, to name a few.
Manual therapy offers gentle and effective treatment for the above problems. Osteopaths employ specific techniques for the disc based on manipulations that address intradiscal pressure as well as the lumbar venous system. Ask your practitioner if he is familiar with them.
Dragging One's Feet
By this attitude a person unwittingly shows that he is neither for nor against something. as he is unwilling to confront or take action.
Crossing the Feet
Crossed feet are a sign of protection or even closing. Observe a person stretched out. If he crosses his feet it is a sign that he is not entirely at ease and has closed his territory. It also can indicate modesty.
As if Springing Along
The person who appears to be walking on springs is unconsciously expressing a desire to escape from someone or from some problematic situation. He dodges along not wanting to leave himself trapped in a "small territory." He looks for a way to escape while knowing he cannot. Such a person is at greater risk for uscle problems as opposed to joint problems.
Going Too Fast
The person who trots along or walks very quickly does not wish to be approached or adominated. He flees others and his own existence as well.
Piggeon-toed
A person who presents with feet turned in and knees flexed shows a tendency for withdrawal and passivity, a certain timidity in facing up to events, and a lack of defense. So revealed, this weakness leaves him vulnerable to the will of others. Internal messages tend to run in a loop, and he finds emotional expression difficult.
Active Feet
By contrast to the pigeon-toed, and energetic individual has active feet that are well positioned on the ground and ready to leap into action.
The "Plus" of a Firm Stance
When standing, the best posture is to place the feet firmly on the ground in slight external rotation (eleven o'clock and one o'clock) with the chest forward. This position exhibits natural confidence. Faced with a panel of examiners or an important meeting, you have a better chance of managing the situation in this posture. When the body is clearly present, securely occupying its space, and "well planted on two feet," behavior naturally follows with and openness of spirit and dialogue. Such an attitude helps us to better understand others and to find our words more easily. Healthy self-esteem and physical health generate good body position, which induces a reciprocal positive social attitude.
Trauma
Any significant trauma to the lower extremity, such as severe knee or ankle sprain, hip arthrosis, or bone fracture, gradually alters the way the foot meets the ground. The brain stops receiving precise and proper information from the foot. Physical instability of this sort can intensify psychic imbalance if the person happen to have vulnerability in this direction. Effects are cumulative. The accident destabilizes the physical, which naturally has behavioral outcomes.
France, who was by nature generous and joyous, suffered a severe car accident with injury to her foot. "I was betrayed by my foot," she said. "It was not very pretty to look at and prevented me from sustained physical activity. Not having good contact with the floor disturbed me. I became less sure of myself and then my behavior began to change. I grew mistrustful and less nice." Hapily she ventured to an osteopath and a podiatrist for rehabilitation. After a few sessions she confided, "It seems that I am more likeable after all."
Manual therapy offers gentle and effective treatment for the above problems. Osteopaths employ specific techniques for the disc based on manipulations that address intradiscal pressure as well as the lumbar venous system. Ask your practitioner if he is familiar with them.
6 ~ Connections Between Joints and Organs
If our organs function well, our joints feel better. If our joints function well, our organs feel better.
Our bodies operate with a foolproof logic of reciprocity, a relationship of mutual dependence. This is why it is our duty to watch over every element of our being.
Referred Pain
Pay attention to sudden, intense joint pain that comes on mainly during the night. This can indicate referred visceral pain. It is a sign that an organ is expressing dysfunction and merits immediate attention. Acute referred visceral pain also can arise after an ordinary fall, a particular effort, or a position of constraint.
Anne-Marie is very purposeful. She enjoys bustling around the house and in her garden. One day she bent down on one knee to clean under an armoire. She extended her other leg so that she would be able to crouch low to reach the dust against the wall.
In standing back up she felt intense pain in her left groin. "Oh dear," she said to herself. "I have torn a muscle or put out a vertebra!" This had happened once before. This time the pain persisted, and she came to consult me.
The lumbar spine and pelvis were a little sensitive, but they had kept their mobility. However, palpation of her sigmoid colon (the lower part of the colon just above the rectum) provoked very sharp pain. It turned out that she suffered from inflammation of the sigmoid due to diverticulitis. Moving her leg into extension had either triggered or amplified the symptoms. She admitted to having intermittent pain but concluded: "You can't always be listening to yourself!"
When a patient arrives with a precise idea of what is wrong and pretty much comes up with a diagnosis before the therapist does, the therapist must be vigilant. Generally this type of patient will insist that the therapist concentrate on the painful area and nowhere else. He believes he knows what he is suffering from and is not very good at accepting a more global investigation. Such was Anne-Marie's case. It turned out that manipulation of the sigmoid was what released the groin pain, without touching the lumbar spine, pelvis, or hips.
Below is a concise list of the main visceral pain projections related to our joints in the absence of previous trauma. Of course there are variations and exceptions.
Articulation Related Organ
Jaw and upper thoracic spine Heart
Neck Throat, nose, ears, thyroid
Upper thoracic spine Lungs, breasts, heart
Middle thoracic spine Liver, stomach, pancreas, duodenum (junction
between stomach and small intestine)
Lower vertebral column Kidneys, small intestine (seven meters long)
Upper lumbar spine Kidneys, colon, ureters (the run from kidneys to
bladder)
Lower lumbar spine, pelvis, knees Urogenital organs: ovaries, uterine tubes, uterus,
prostate, bladder
Right shoulder Liver
Left shoulder, upper back Stomach, pancreas
Inferior limbs Genital organs, intestine
Knees, hips Kidneys
Feet(3) Kidneys and genital organs are the organs that most
frequently trigger foot pain
(3) There is a map of visceral projections on the feet. It is at once complex and approximate. Such a diagram does not mean that everything is in the feet, but neither is everything represented in other parts of the body.
Let us take the kidneys as an example. Pain provoked by a renal stone or kidney infection (nephritis, polynephritis) often spreads toward the lumbar spine, hips, and knee. It is transmitted by nerve fibers of the kidney itself and some that pass around it.
Maxime consulted me for slight diffuse lumbar pain and a more precise pain in his left knee. My line of questioning revealed no recent or old trauma connected with the knee. Nevertheless, he insisted that "in the middle of the night, even without moving, I feel my knee ache."
Continuing the interview he disclosed that his father and grandfather had both suffered from kidney stones. At once I understood the probable source of Maxime's pain and explained it to him. Several days later he came to me and said, "I peed out the stone." With that his backache disappeared.
Anatomical interconnections make it possible to feel pain in a knee without kidney symptoms. This is why the clinician must be circumspect and alert in cases of joint pain. Our back muscles share nerve fibers with organs to the extent that a pain in the back is often far from being entirely mechanical. It can signify an organ problem.
Our Organs Also Articulate One with the Other
Our organs have articulations! When we walk, our organs move with each step. They are kept in place by ligaments and the pressure exerted by muscles. Any loss of mobility or reduced slide and glide between organs has an irritating effect.
We breathe about 20,000 times a day. With each respiration, our organs follow the movements of the diaphragm, which is the muscle that makes us breathe. Add to this the motion we impose on our organs in the course of our daily and recreational activities. The millions of continuous visceral interactions required must be repeated harmoniously if they are not to cause irritations.
An appendix scar can reverberate to nearby organs, such as the kidney, intestine, or ovary, and interfere with their normal articulations. Compromised coordination between these organs can generate back or hip pain because the organs have special links with the lumbar spine and the lower extremities.
PART THREE
Messages from Our Joints
In the following chapters, I will attempt to explain messages from our body in terms of each joint. I will explore the physical and physiological connections of joint trauma as well as the psychoemotional repercussions. A better understanding will enable you to pay more attention to your body----its attitudes, discomforts, and injuries--in order to participate in your own well-being. To achieve the best possible oint health, you should approach life in general in the same way that you would practice sports. That is, with physical, psychological, mental, dietary, and lifestyle preparedness.
7 ~ The Ankle and Food
The foot is composed of 26 bones, 114 ligaments, and about 40 articulations. Multiply these figures by two and you have an idea of the complexity of our footing. Walking unrolls rather like organ music. The cerebellum plays a whole set of pipes that must be played in total harmony to ensure good balance. One false note and the whole instrument finds itself discordant.
The ankle is make up of the inferior ends of the tibia and fibula (peroneus), which articulate on the talus (ankle) bone. The feet and ankles form one system. In the interest of readability, I will use the word "foot" to designate this system.
Function
Man is one of the few mammals who now moves about on only two feet, The adaptation to the vertical balance left him somewhat weakened. As bipeds, our feet must support the entire weight of our bodies. Animals of similar build still walk on four legs. Our feet are in direct contact with the ground. They immediately inform the cerebellum about the smoothness, roughness, hazards, or unevenness of the terrain. This data is vital to maintaining and preserving our stability. Feet are meant to "keep our feet on the ground" so that we stay in contact with reality. They are so exceptionally sensitive that even the smallest grain of sand in a shoe can make walking insufferable.
In Relationship to Our Organs
As alluded to earlier, the plantar surface has been mapped out to precise degrees. These charts can appear overly elaborate. It would seem difficult, for example, to recognize a dysfunction of the pituitary in the foot, let alone to treat it there. On the other hand, the vast numbers of patients who have consulted me through the years have enable me to establish a relationship between the feet, the kidneys, and the intestines. In simple terms, I find that the inside part of the plantar arch relates to the urogenital system, while the outside portion corresponds to the intestines. This means that pain in the arch can indicate a problem in these areas.
What the Feet Represent
Our Roots
Even if they are moving, our feet root us. The expression "keep two feet on the ground" describes how they anchor, calm, and keep us stable physically and psychologicaly. Any distortion of the ankle and foot disturbs this equilibrium and can cause psychological instability in the form of anxiety, timidity, and the inability to act.
Contact with Reality
The feet represent our connection with concrete reality. Firm footing requires certain vigilance on the part of the brain. Someone who is scatterbrained or preoccupied is not paying full attention. If just one foot-brain connection is missed at an inopportune moment, the foot can lose contact with what is underfoot and and in a twist. When a person is subject to frequent ankle sprains, the message is clear: Either he is too much in his head and not enough in his body, or his body is in need of attention. Apart from detecting and treating ligamentous weakness due to the sprain itself, the person might do well to examine his relationship to the concrete and search for better balance between dream and reality.
Instability
Foot instability reflects physical, emotional, or relational instability.
Frederic was preoccupied by an interview for a job he did not particularly want. He was going to apply anyway because he needed the work. Walking to the interview with his head in the clouds, he twisted his foot and suffered a sprain. He arrived at the meeting limping. His foot hurt, and he botched the interview. His application was not accepted and he found himself almost relieved by the result. His sprain represented his of interest in the potential position.
Attitudes
It is possible to cheat with words but not as easily with the body. What might be hidden behind screens of self-confidence is soon given away by the position of our feet or hands. Observe people when they dance. At the beginning they can be very attentive to the position and control of their gestures. Little by little they let themselves go and are revealed.
Command and Counter-Command
Feet that do not follow the brain's command are hesitant. On the other hand, feet that seem to hesitate can be a mark a decision on how to proceed with a certain project or on what path to take in a particular situation.
Growing Up
An adolescent who grows up too quickly can lose his physical bearings. He can have a poor sense of where he is in space. His gestures become awkward and clumsy. He bangs into things and easily twists his feet. He is no longer "small" but not yet "big."
Twisting the Foot
To have "feet in the sand" with no stability denotes a lack of psychic strength, fear of confrontation, and fear f the future.
Dragging One's Feet
By this attitude a person unwittingly shows that he is neither for nor against something. as he is unwilling to confront or take action.
Crossing the Feet
Crossed feet are a sign of protection or even closing. Observe a person stretched out. If he crosses his feet it is a sign that he is not entirely at ease and has closed his territory. It also can indicate modesty.
As if Springing Along
The person who appears to be walking on springs is unconsciously expressing a desire to escape from someone or from some problematic situation. He dodges along not wanting to leave himself trapped in a "small territory." He looks for a way to escape while knowing he cannot. Such a person is at greater risk for uscle problems as opposed to joint problems.
Going Too Fast
The person who trots along or walks very quickly does not wish to be approached or adominated. He flees others and his own existence as well.
Piggeon-toed
A person who presents with feet turned in and knees flexed shows a tendency for withdrawal and passivity, a certain timidity in facing up to events, and a lack of defense. So revealed, this weakness leaves him vulnerable to the will of others. Internal messages tend to run in a loop, and he finds emotional expression difficult.
Active Feet
By contrast to the pigeon-toed, and energetic individual has active feet that are well positioned on the ground and ready to leap into action.
The "Plus" of a Firm Stance
When standing, the best posture is to place the feet firmly on the ground in slight external rotation (eleven o'clock and one o'clock) with the chest forward. This position exhibits natural confidence. Faced with a panel of examiners or an important meeting, you have a better chance of managing the situation in this posture. When the body is clearly present, securely occupying its space, and "well planted on two feet," behavior naturally follows with and openness of spirit and dialogue. Such an attitude helps us to better understand others and to find our words more easily. Healthy self-esteem and physical health generate good body position, which induces a reciprocal positive social attitude.
Foot and Ankle Problem
Sprain
Sprain is the most common foot trauma. It involves torsion of either the tibiofibular or the lateral collateral ligaments. It is rare to get through life without an ankle sprain or simply a bad turn of the ankle.
Hallux Valgus (Bunion)
A hallux valgus is a lateral deviation of the great toe. It is much more frequent in females and even more common in women with intestinal problems. The reason for this is not entirely known. Statistically, however, hallux valgus runs in families. A grandmother, mother, and daughter can all share the affliction. Apparently genetics sometimes concentrates even in the foot.
Monique, who had a mild tendency toward foot deformity, developed a large hallux valgus soon after menopause. She complained of pain while walking. This trouble embarrassed her. "I have the impression that people are only looking at my feet, and this makes me uncomfortable in public," she said. "I feel more and more awkward, even though a toe should be no big deal!"
Pins and Needles First Thing in the Morning
Experiencing tingling sensations when you first step out of bed is linked to renal dysfunction in relationship to excess protein or dehydration. What can be done? Drink more water and reduce protein intake. Very often there is a family history of kidney stones. If the condition persists, consult your doctor about having your kidneys checked.
Morton's Neuroma
Morton's neuroma is characterized by a thickening of tissue that compresses and squeezes the nerves leading to your toes. It very often shows up after years of poor foot support or as a compensation for pelvic or general body imbalance. It can come on quickly after wearing tight new shoes unsuitable to your foot or following an excessively long walk. To release the compressed nerve you can perform the exercise on page 68, or condult an osteopath or a kinesiotherapist.
Collapsed Plantar Arch
Fallen arches are linked to age, menopause, and fatigue, as well as to mineral and trace element deficiencies (see P.176). Several physiological factors can be associated: general fatigue affecting muscle tone, iron deficiency sometimes due to overabundant menstruation, intestinal polyps, or even a bout of depression. A stretching regimen combined with a podiatrist's prescription for orthopedic insoles is the solution.
Sciatica
Sciatica is compression of the sciatic nerve by a herniated lumbar disc. It disturbs foot sensitivity and increases the risk of sprain. It is worth knowing that as much as 90 percent of the foot's nerve supply comes from the sciatic nerve. Consult your referring physician or a manual therapist (acupuncturist, osteopath, chiropractor). Sciatica can be months or even years in the making. It is no use looking for an immediate cause.
Cramping in Both Feet
Bilateral cramping can be of venous origin. Cramping in both feet is frequently accompanied by a sensation of heavy legs. Cramping in just one leg is more connected to the articular or nervous system. One also can experience pain in both feet from metabolic causes such as poor uric acid elimination on the part of the liver or kidneys.
Simone was awakened suddenly by a sharp pain in the calf together with a severe foot cramp. She insisted that this occurred "even though I never moved in my sleep!" Simone was not aware that the muscles of her legs and feet are very sensitive to uric and lactic acid. She may have simply overindulged in cheese or animal protein or had not drunk enough water the previous evening.
A simple involuntary muscle contraction during a dream can induce a cramp. This sort of cramp is not necessarily a mechanical event. It is more likely to be of metabolic or chemical origin signifying that the muscle is not clearing wastes. It also might point to a vascular problem that, if it occurs frequently, requires medical attention.
Trauma
Any significant trauma to the lower extremity, such as severe knee or ankle sprain, hip arthrosis, or bone fracture, gradually alters the way the foot meets the ground. The brain stops receiving precise and proper information from the foot. Physical instability of this sort can intensify psychic imbalance if the person happen to have vulnerability in this direction. Effects are cumulative. The accident destabilizes the physical, which naturally has behavioral outcomes.
France, who was by nature generous and joyous, suffered a severe car accident with injury to her foot. "I was betrayed by my foot," she said. "It was not very pretty to look at and prevented me from sustained physical activity. Not having good contact with the floor disturbed me. I became less sure of myself and then my behavior began to change. I grew mistrustful and less nice." Hapily she ventured to an osteopath and a podiatrist for rehabilitation. After a few sessions she confided, "It seems that I am more likeable after all."
Advice
- Maximize your efforts to have a supple foot that is in good contact with the ground. "Well on your feet, well on the road of life," you might say. When your brain receives positive information coming from the body, the message is reinforced on a psychoemotional level. Similarly, when we are happy, the whole body feels it. Good ground contact, good shoes, and good joints are the ideal.
- Look to make the link between your foot pain and your attitude in life. While the connection is certainly physical, it also can have to do with your feelings, psyche, and way of relating. This endeavor will help you to find the attitude that will restore equanimity and self-confidence. For example, a hallux valgus can oblige a person to deviate her foot, giving the impression that her body is betraying her. Treating her bunion wil allow her to regain both her physical stability and her psychic equilibrium.
- Begin at the base of the body, which is easy to observe in detail. Teach yourself to walk with stable foot alignment, toes oriented toward eleven o'clock and one o'clock. Walk with a soft object, something easily kept in place, held on top of your head. Keep in mind that foot position involves the rest of the body. From a good base posture everything strings together in a logical sequence and fashion. Walk a little first thing in the morning and in the evening before going to bed. This brings awareness that enables you to feel your body.
- By changing your attitude you will influence the way you face life. Pascal wrote: "If you want to believe in God, fall on your knees." By this he meant that right body attitude generates right spiritual attitude.
- Show naturally that you exist. Assert yourself by your physical presence. Feeling your feet in all their breadth will impart a sense of confidence.
- Observe people who appear self-confident and remember their attitude. Have a good look at how they hold themselves and the way they walk.
- For recurrent injury linked to deformations such as fallen arches, poor foot contact, or Morton's neuroma, adopt the use of proprioceptive insoles made only by podiatrists. These insoles stimulate the various nerves on the bottom of the foot that inform the cerebellum (the balance center) as to where the feet are in space. It is essential that correct or inappropriate commands. Podiatry has envolved enormously; it now holds a central and active role in proprioceptive re-education as it works to rebalance foot support.
Lie on your back and place both feet against the wall. Position two tennis balls under the plantar arches and roll your feet on the balls. Repeat several times. This exercise is very beneficial for veins, lymphatic vessels, and joints.
- Women, be advised: Pay attention to your choice of shoes. Do not sacrifice your feet for the fashion of the day. Your shoes must not be too pointed or too high so that you avoid cramping the toes and arching the lumbar spine. They also must not be too tight or too open-toed so that you avoid the foot curling into hammer-toed positions. Look for comfort. Given all the models of footwear made today, you should have no trouble combining function with esthetics----although perhaps not the high fashion that comes at the expense of health.
- Regularly massage your own foot arches or have your partner massage them. The foot is the most compressed part of the body. Oil softens the foot and keeps the skin healthy and problem free.
- If you feel unsteady on your feet, begin a walk looking at your feet so that the brain can clearly register data about your relationship with the ground. Afterward you will see that you can proceed more easily while looking up and about.
- For athletes, one suggestion is to war up by making small movements. Focus your awareness on each part of your body from head to toe and then from your toes to your head. Once all parts of your body feel well connected, gradually begin your sporting activity. Skilled action and performance are within reach when we feel perfectly fluid in space.
- Practice running with good shoes that absorb and cushion shocks. Try a few before choosing the right one. The correct shoe gives you the impression of being lifted. Run on soft terrain, not pavement, in order to reduce microtrauma.
- Be alert both to small pain and fatigue. It is not normal to have chronic foot pain. Fatigue fractures are very difficult to diagnose on X-ray. Very often they are not seen until two or three months later during the consolidation phase. Some fractures take years to mend.
In the case of fatigue fracture, it is necessary to stop activities that put pressure on the foot. This includes jumping or standing on hard surfaces. Biking and swimming are recommended, where the weight of the body is not resting on the feet. Fatigue fracture can be thought of as a tiny fissure in the bone. It is a common sports injury particular to athletes in excellent physical condition. These fracture always occur on bones that support the weight of the body, such as the tibia, fibula (peroneus), and metatarsal bones of the lower extremity.
8 ~ The Knees
The knee is the largest joint in the body. It is formed by three bones: the femur, the tibia, and the peroneus (now internationally called fibula). While the knee bones are strong, the joint is fragile due to our bipedal stance.
The stability of the knee comes from ligaments, tendons, and muscles. The bones articulate on their menisci, which act as shock absorbers in the knee joint, dispersing the weight of the body and cushioning the forces of jumping.
The knee is a common site of pain and injury in athletes, particularly because of cruciate-ligament and meniscus damage. The knee can be compared to the elbow (see p. 133) in that they are both intermediate hinge joints. The knees, however, bear the weight of the body, making them more fragile.
The stability of the knee comes from ligaments, tendons, and muscles. The bones articulate on their menisci, which act as shock absorbers in the knee joint, dispersing the weight of the body and cushioning the forces of jumping.
The knee is a common site of pain and injury in athletes, particularly because of cruciate-ligament and meniscus damage. The knee can be compared to the elbow (see p. 133) in that they are both intermediate hinge joints. The knees, however, bear the weight of the body, making them more fragile.
Function
The knee governs flexion and extension of the lower extremity. Blocked beyond straightening at the front, the joint is designed to hinge backward. The knee enables genuflection, submissiveness, and meditation, as well as jumping, dynamic momentum, and forward projection.
The Knees in Relationship to Organs
In women the knees relate to the genital system, specifically the ovaries. Knee problems are common in adolescent girls whose joints can all of a sudden swell and become painful for no apparent reason. More thorough investigation often reveals the involvement of a nerve to the knee that becomes irritated as it passes behind the developing ovary. In this scenario the only thing to do is to wait for puberty to end, plus avoid squatting, crouching, or being on the knees too long. Consulting a homeopath for a constitutional remedy is an option.
Fig. 05: The Knee
The knee also relate to the kidneys. In this instance, the symptoms generally appear in only one knee. It is generally advisable to modify your diet and consult your physician as a precaution.
What Knees Represent
A person's natural knee position tells us something about his state of well-being and level of self-confidence. How the knees are held is an expression of our stance and behavior people standing, we generally see the knees as either somewhat flexed or tensed.
Knees Slightly Flexed
Slightly flexed knees show a lack of self-assurance, incertitude, fear of confrontation, fraily of being, or state of withdrawal. The more bent the knees are, the greater the likelihood that the person is passive, submissive, resigned, or timid. Whenever you feel like a victim or are fatigued or demoralized, your knees bend as if by reflex. In these moments you reveal the burden of your life as well as your lack of energy and responsiveness. You lose your bearings in time and space to the point of losing self-confidence and allowing yourself to be influenced by the opinion and judgement of others.
If this occurs in passing, it has no significant consequences for your body. It is simply a reflection of a mood. If this attitude remains constant, however, the problem must be taken more seriously. This posture can lead to ligamentous or cartilaginous knee strains and sometimes even osseous problems. This is to say nothing of the psychological influences (timidity, retreating into oneself, meekness) on your general state of being. Unrelenting compression on any one part of the body literally wears out the cartilages and weakens the joint involved.
Dorothy, who worked in sales, was called in by her manager and reproached for having missed on important deal for the company. She consulted me for generalized lumbar pan. She imagined the cause to be the weight of the briefcase she perpetually carried on the same side.
In the course of conversation I noticed her knees flex slightly. She noticed it as well. "Ah, yes," she said, "It is as if the weight of my words were too heavy for my knees. What's worse I have had this sensation all day. In fact, it happens a lot."
The weight was not exactly where she wanted it to be. Her all-too-frequent knee flexion had altered the alignment of her lumbar spine. The awareness of the problem helped her. I also recommended that she take time to look in a mirror and imagine herself in front of some dominant, impressive, perhaps even aggressive person, and to adjust her body position accordingly: shoulders down, sternum forward, directly facing the person with open plams facing forward.
If this occurs in passing, it has no significant consequences for your body. It is simply a reflection of a mood. If this attitude remains constant, however, the problem must be taken more seriously. This posture can lead to ligamentous or cartilaginous knee strains and sometimes even osseous problems. This is to say nothing of the psychological influences (timidity, retreating into oneself, meekness) on your general state of being. Unrelenting compression on any one part of the body literally wears out the cartilages and weakens the joint involved.
Dorothy, who worked in sales, was called in by her manager and reproached for having missed on important deal for the company. She consulted me for generalized lumbar pan. She imagined the cause to be the weight of the briefcase she perpetually carried on the same side.
In the course of conversation I noticed her knees flex slightly. She noticed it as well. "Ah, yes," she said, "It is as if the weight of my words were too heavy for my knees. What's worse I have had this sensation all day. In fact, it happens a lot."
The weight was not exactly where she wanted it to be. Her all-too-frequent knee flexion had altered the alignment of her lumbar spine. The awareness of the problem helped her. I also recommended that she take time to look in a mirror and imagine herself in front of some dominant, impressive, perhaps even aggressive person, and to adjust her body position accordingly: shoulders down, sternum forward, directly facing the person with open plams facing forward.
Looked Knees
Tensed knees are mainly a sign of confidence, combativeness, dynamism, and the desire to conquer. In combination with other general body postures and the neck in extension (that is, very straight), the knees can reveal significant traits.
- ambition. In addition to standing with his knees in extension, the ambitious person holds his head high. The dominator bulges his torso forward.
- leadership. The instigator intends to bring others around to his point of view. He wishes to impose his views and has no tolerance for being challenged,
- seduction. The seducer adds the forward projection of his pelvis.
- action. The optimist, having and active temperament, keeps his knees in extension in contrast to the flexed knee of the pessimist.
- appearances. Extension of the knees is clearly noticeable in the person who lives in the world of appearances. He wants to occupy his space and often the space of others. As a result, his sheer determination to appear confident eventually affects his joints.
Since Fabien's natural position was to keep his knee flexed, such a change in posture had irritated his cartilages and menisci. This artificially forced position revealed that he did not want to let go of control. This is nevertheless what he had to do to be free of pain. He needed to understand that it was not always necessary to be in seduction mode.
Wheat is perferable: a passive attitude and good knees or an active attitude with meniscal pain? It is better for Fabien to allow his fundamental nature to express itself without changing it? The ideal is to experience your body as flexible and without tension. It doesn't much matter whether you like your knees straight or flexed. As long as it causes you no trouble or pain, there is no problem. If your position becomes problematic, however, you need to learn to change it with the help of a manual therapist. A few degrees difference is enough to put you at ease.
Knee Problems
The knee is dependent on a great finesse of neurological connections. Nerves, muscles, cruciate, and lateral ligaments must be perfectly in tune. If the mechanoreceptor neurons are not able to transmit correct information to the cerebellum, the inferior limbs can no longer be guaranteed their function. By nature the knee joint is not fit together well; in fact, it is altogether rather "poorly kept." It is imperative, therefore, that its nerve connections be in perfect working order.
Knee pain can originate as a dyfunction of the knee itself or in the aftermath of a fall or a sprain where the menisci or ligaments have been damaged. Pain also can be the consequence of a lesion coming up from the foot or of a problem descending from the vertebral column or the hips.
Julie grumbled about her knee. No objective exam revealed even the smallest lesion. On palpation her left leg was stiff and the ankle was considerably lacking in range of motion. Needless to say, I asked her if she had incurred an ankle sprain. "Yes, but it was a long time ago." she said. "Come to think of it, however, after the injury my foot remained swollen for more than a year."
A poorly functioning ankle causes an ascending compensation from bottom to top. First the knee is affected, then the hip, and finally the vertebral column. Imagine the damage that can be done to the knee cartilage and meniscus from a deviated foot position. In Julie's case, osteopathic treatment was simple enough. One manipulation of the junction between the ankle and the cuboid bone (one of twenty-six bones of the foot) restored her ankle range of motion almost immediately. As a result, the intra-articular pressures of her knee were harmonized.
A Diet High in Sugar and Lactic Acid
An overly sweet diet combined with an excess of lactic acid, which causes muscle contracuture, can underlie knee pain.
Intensive Sporting Activity
Who is the sportsman who has not sprained a knee? The phenomenon is so common as to prove the innate and acquired constitutional fragility of the joint. Whether due to excessive fatigue, a period of stress, a lack of confidence, overtraining, or perhaps muscle weakness, knees are inherently vulnerable and injury cannot always be avoided.
One seemingly harmless movement and the knee can snap. The solution is to methodically strengthen the muscles of the lower extremity in conjunction with relaxation techniques. In preparation for the winter season, champion skiers regularly and intensively cycle all summer. Do not hesitate to bring out your bike.
Synovial Effusion
When a knee is hurt, synovial fluix production increases. This creates synovial effusion. The immediate indication is to stop all activity and place ice on the joint. Next, the ideal treatment is to apply a poultice of green clay to the posterior and anterior surfaces of the knee, keeping it on all night and repeating for eight days.
Popliteal Synovial Cysts
Popliteal synovial cysts show up mostly in females during menopause. They are located behind the knee. Since they coincide with menopause, it is fair to say that there is probably a hormonal influence. A decline in progesterone levels may be the underlying reason for cyst formation. Surgery is rarely the solution since cysts have tendency to return because nature abhors a vacuum. They can become problematic, however, if they provoke compression of the vascular or venous system.
Ruptured Ligaments
Rupture of the cruciate ligaments is a characteristic accident of skiers. Be wary on any ski trip of the third hour of the third afternoon. Three risk factors converge at this critical moment: a rise in skier confidence, insufficient training, and afternoon digestion. All of these are added to the fatigue of the first two days. Note that almost all competitive sports carry risk for the knees. In general, treatment consists of surgery in the young. For those over forty, the bicycle is recommended as a way to build up knee muscles.
The Cabbage Leaf
Amazingly, the leaf of a green cabbage is an excellent remedy for the injured knee. (Read the history of the soccer player on P.192) Its anti-inflammatory power is incontestable. Place two cabbage leaves in the oven for thirty seconds to soften. Next, wrap them on the anterior and posterior surfaces of the knee, and maintain them in place with a bandage. Keep the cabbage on through the night and repeat nightly for eight days.
Who is the sportsman who has not sprained a knee? The phenomenon is so common as to prove the innate and acquired constitutional fragility of the joint. Whether due to excessive fatigue, a period of stress, a lack of confidence, overtraining, or perhaps muscle weakness, knees are inherently vulnerable and injury cannot always be avoided.
One seemingly harmless movement and the knee can snap. The solution is to methodically strengthen the muscles of the lower extremity in conjunction with relaxation techniques. In preparation for the winter season, champion skiers regularly and intensively cycle all summer. Do not hesitate to bring out your bike.
Synovial Effusion
When a knee is hurt, synovial fluix production increases. This creates synovial effusion. The immediate indication is to stop all activity and place ice on the joint. Next, the ideal treatment is to apply a poultice of green clay to the posterior and anterior surfaces of the knee, keeping it on all night and repeating for eight days.
Popliteal Synovial Cysts
Popliteal synovial cysts show up mostly in females during menopause. They are located behind the knee. Since they coincide with menopause, it is fair to say that there is probably a hormonal influence. A decline in progesterone levels may be the underlying reason for cyst formation. Surgery is rarely the solution since cysts have tendency to return because nature abhors a vacuum. They can become problematic, however, if they provoke compression of the vascular or venous system.
Ruptured Ligaments
Rupture of the cruciate ligaments is a characteristic accident of skiers. Be wary on any ski trip of the third hour of the third afternoon. Three risk factors converge at this critical moment: a rise in skier confidence, insufficient training, and afternoon digestion. All of these are added to the fatigue of the first two days. Note that almost all competitive sports carry risk for the knees. In general, treatment consists of surgery in the young. For those over forty, the bicycle is recommended as a way to build up knee muscles.
Advice
General recommendations:
- Be careful when crouching or going down on your knees. Avoid doing it abruptly or too rapidly. Do not hold the position for too long. The knee requires delicacy and attention.
- In flexion, certain knee attachments can become overly stretched. If this happens for too long or too frequently, the attachments weaken, thin, and fray to the point that they tear one day for no reason.
- Bending the knees too much or spending long hours on bended knees cause the joint to suffer and develop arthrosis or synovidal effusion. These disorders are common in tillers, floor layers, and those in monastic life.
- Long after meniscus surgery (meniscectomy), the body sometimes naturally constructs a kind of new meniscus to make the knee more functional. Over time, the knee occasionally regains a measure of stability and solidity, but it is always less than it had originally,
- When the knee has been traumatized, as n a sprain, it has a tendency to lose extension. This is termed a flexum. The knee can no longer straighten fully and remains a little flexed. This flexion posture wears out the cartilage prematurely, fatigues the muscles, and causes the knee to swell. Such flexion contractures occur almost automatically post surgery. They are one of the main causes of knee arthrosis. To avoid this happening after surgery, when you are sitting at rest, place the foot of the operated leg on a low table or stool, making sure that the knee is in extension. If possible, place the other leg on top of the operated leg to put pressure on the extension.
- Be careful and pay attention not to cross your legs for too long. It is not good for venous and lymphatic circulation. Kept up for a long period, this position eventually tightens the whole body.
- Avoid certain foods such as charcuterie, fat, seafood, and chocolate; all of these can raise uric acid levels (see p.170). I observe patients who experience a swollen knee in the fifteen minutes after eating seafood. On one hand this can be due to metabolic problems involving the liver or kidneys. On the other hand, a knee that has become particularly sensitive following a sprain or other trauma will be indirectly targeted as one of the organism's weak links.
Amazingly, the leaf of a green cabbage is an excellent remedy for the injured knee. (Read the history of the soccer player on P.192) Its anti-inflammatory power is incontestable. Place two cabbage leaves in the oven for thirty seconds to soften. Next, wrap them on the anterior and posterior surfaces of the knee, and maintain them in place with a bandage. Keep the cabbage on through the night and repeat nightly for eight days.
- Bicycle riding is strongly recommended to support the flexibility and strength of the knee. Since the body is not bearing down on the inferior limbs, the knees are unburdened by any weight.
- After a knee operation it is very difficult to recover muscular strength around the joint. Rehabilitation is indispensable but not in itself sufficient. Here too cycling assists muscle reinforcement. I would urge you to adopt and develop cycling.
9 ~ The Pelvis and Hips 骨盆和臀部
The Pelvis 骨盆
The pelvis is composed of two symmetrical bones: a right and a left. These bones are fastened to the sacrum and coccyx in the back and to the pubis in front. It is a central anchor for:
- both femurs at the coxofemoral junctions, which are the hip joints themselves;
- the vertebral column at the sacroiliac joints.
Function
The pelvis is the crossroad of mechanical forces. The pelvis redistributes these incoming movements between the lower limbs and the upper body. Eighty percent of the mechanical forces received are directed onto the lower limbs. Only 20 percent land in the sacrum. The bony pelvis is a strong structure that is closed at the back, leaving the abdominal muscles to protect the organs in front.
A woman's pelvis is naturally broader than a man's. The pelvis must be sturdy enough to support the infant for nine months in utero. At the same time, it must be flexible enough to relax for birth and delivery. Nature, in its wisdom, provides hormonal fluctuations that facilitate the opening and relaxation of the pelvis. These hormones influence muscle tone and ligamentous elasticity.
What It Represents
- the strong element. Just like n the old architectural dictum "The church and the town hall must be at the center of the village," the pelvis is the central structure of the body. The much more mobile legs and vertebral column are fastened to it.
- our foundation. In humans, the pelvis represents the house and its foundation. As the sturdy, protective nest for the reproductive organs, the pelvis is the expression of our roots, our territoriality, and our family lineage, as well as our capacity to anchor ourselves.
- the sure element. The pelvis develops into the bony symbol that maturity has been reached.
The Hips
The hips are a pair of solid, compact joints situated between the pelvis and the femurs. Considerable forces are exerted at the hips as they support the great amount of body weight passing through them in a vertical stance. While largely determined by genetics, the shape of the hips can be altered due to fetal position in the womb. Hip problems are routinely detected in newborns. Rare congenital luxation aside, these commonplace problems are due to awkward fetal positioning of the lower extremities. Mothers need not worry, as these hips recover easily.
New data is coming to light telling us that the growth curve of the human species has evolved in recent decades. Although this phenomenon seems to have slowed down, babies are bigger and thus more casily squeezed within their mothers' bellies. The head, hips, and feet bear the consequences. It is very useful for the mother to visit an osteopath following the birth of her baby.
Function
Current language glosses over any distinction between hips hips and pelvis. In true anatomical terms, the hip articulates with the pelvis. More precisely, the hip is the junction between the head of the femur and the liac bone that makes up the pelvis (together with the sacrum and coccyx).
The hips distribute most of our body weight onto the lower extremities. The weight descends through the knees to reach the feet. In turn, the feet automatically return upward forces that ascend to the knees and through the hips, pelvis, and vertebral column.
A subtle play of lines of force runs continuously through our bodies. When all goes well we move naturally and with ease. This is not the case, however, if any one element fails to perform correctly. Very often we only realize we are in good health when we suddenly feel unwell or become sick. Reflecting on this curious paradox might encourage us to be a bit more conscious of our physical fitness. When you are feeling well, take time during the day to be fully aware of what good shape you are in. Tell yourself I feel well. Repeat this while walking and at work in order to discover and enjoy a relaxing moment.
Compared to the relatively static pelvis, the hips is very mobile. It is not accurate to describe a person as being "flexible in the pelvis." This suppleness derives from the joints linked to the pelvis: the femur and vertebral column. The hip is a very strong joint rarely subject to sprain or luxation, except in cases of severe trauma or congenital disorders. There are entire "hip" families where arthrosis is perpetuated through generations.
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