Author: Sue

I am looking forward to teaching the Hendrickson Method Study Days, exploring how we can help those patients that are really struggling with chronic pain, this could be due to trauma, or impact injuries that occurred many years ago. Then there are the pain syndromes, chronic fatigue, fibro myalgia, ME. The thing they all have in common is that they leave the body with:

Central sensitization

—  Hyperalgesia, allodynia (pain produced normally innocuous)

—  Inconsistent response to stimuli and tests

—  Widespread, non-anatomical distribution

—  Pain seems to have ‘a mind of its own’

—  Drug treatment ineffective

—  Unpredictable or no response to passive treatment

With all of these kinds of patients we need to find ways of calming down the sensitization, for me the Hendrickson Method give me the tools to be able to offer this, with Tom’s wave mobilisation® I can create gentle rhythmic movement to the spine bringing a steady calming state to the body. We have to have communication skills to help them re-frame their vision of their pain. WE have to show empathy, and understanding with this support we have found they are better placed to make choices on how best to take cares of themselves, getting to grip with the need for ‘pacing’ or a ‘re-group’ and a little rest through theirs days. Most importantly explaining their pain, David Butler from the Noi group, his material has been so successful in our practice.

If you would like to join us there are just a few places left, you can find all the info on the link below or at the events page

Hendrickson Method Study Days: Chronic Pain – 2 Days

Back in October I presented a four days Level One Hendrickson Method Upper Extremities workshop with a wonderful group of therapists. I had the good fortune to be accompanied by a photographer, John Kirkbride, who documented the class. I think he has done a fabulous job of capturing the experience of being part of these workshops. It demonstrates a little example of what I want therapists to get from these workshops.

I endeavour in every one to create a warm atmosphere, where people feel relaxed and thereby in an environment where they feel comfortable to learn. Equally so, I really love it when I challenge therapists to explore new ways of thinking, and see them grow and flourish as therapists in their own right, incorporating what they learn into their practice. I also think it is essential to ensure we meet individual learning needs and requirements, and I am enjoying hearing how students that have been recording my classes with tablets or microphones for personal use are finding this a really helpful supporting tool to look back on with their clinics.

I hope you enjoy this little snapshot. If you think that this could be the right kind of environment for you, take a look at the workshops I have on offer for 2016 on my website.

Big hugs Sue

I have a number of patients that come to me for TMJ, referred to me from several dental practices in my area. I find it interesting work, and have found that the people referred fall into three groups:
1.)    THE PROBLEM:
People suffering from osteoarthritis or dislocation of the temporomandibular joint. This group is relatively small in my experience.

THE FIX:
These people often need to be helped by the dental surgeon. We are able to help with the soft tissue, to keep the joint relaxed and as form of pain relief. However ultimately, once diagnosed, it is best to refer back the dentist.

2.)    THE PROBLEM:

Patients who have received dental treatment, and have as a result been sat in a dentist’s chair from anywhere between 1 to 3 hours, where they have been tense, fearful and holding tight the entire time. Staying so tense for such a period of time results in the body struggling to let go of the tension afterwards.

THE FIX:

In this case, lots of reassurance and explanation of what has happened is key. The muscular response is linked intrinsically to the emotional and neurological reaction of the event, and therefore we have to remind the muscles that they can relax. If we create soft tissue mobilisation that is pain free, the brain will establish that there is no longer a threat and cause the muscles to reset in a new relaxed state.

THE METHOD:
The best method I have found to achieve this is through Hendrickson Method soft tissue mobilisation. With the patient supine, I explain exactly what I am going to do, and then begin the treatment with anterior neck, paying special attention to scalenes, sternocleidomastoid and the hyoid group. I would then move on to the masseter, temporalis and digastric. I find once I have brought relaxation to the anterior, the posterior neck is ready to release.

3.)    THE PROBLEM:

People with busy or stressful lives, who often present with a forward head position or rounded shoulders, creating compression through C1 and C2. These people are often found with clenching jaw, but with no awareness that is occurring. With these people, it is as much about communication as it is the hands on approach.

THE FIX:
With these people a subjective and thorough initial assessment is crucial, where we can establish the root of the cause through examining lifestyle.

THE METHOD:
It is vital to first assess posture, exploring tight versus weak muscles to determine the muscular pattern they have adapted to manage the stress of their lives. I find commencing the treatment with a side lying wave mobilisation® works best, which helps to relax the patient. Address tight muscles first with soft tissue mobilisation and METs, explaining clearly each step. I then give the patient ‘homework’ which consists of a breathing routine using the abdomen, side and back ribs and sternum, which helps relaxation and acts as an exercise in body awareness.

I encounter these three problems, and variations on them, frequently, and the methods I have outlined above are consistently successful in helping the patient. The real key to treating TMJ however is seeing each patient as completely individual, and establishing a clear line of communication to understand their pain.

To find out more:

Treatment of TMJ Dysfunction & Pain – 1 Day

 

 

I find this technique really useful for lots of reasons, the major one for me, as Tom Hendrickson explains in.

‘Massage and Manual Therapy for Orthopedic Conditions’ ‘because MET uses voluntary effort, we are using the highest part of the central nervous system to re-program involuntary patterns in the muscles.’ I believe that when we can get our patients to engage at a conscious awareness that change can take place from pain free perspective, their confidence grows in their ability to recover.

It is super important that we enable/coach the patient create the ‘right ‘ or voluntary movement /contraction.

In some publications the movements to create the ‘resistance’ or contraction are quite big, creating either a pain, or a struggle, both ending up leaving the patient doubting the process, or causing the patient to guard against the action be that consciously or sub-consciously.

In training, seminars and publications we were told to hold the contraction for 5-10 seconds with 10 – 20% effort. Which I my experience works to a degree. Tom Hendrickson uses the cue ‘don’t let me move you’ which is extremely useful because you can decide/create the amount of resistance. This inspired me to use ‘just meet my hand’. What I have discovered with those patients in chronic pain, is to use ‘feather like’ resistance which creates the neurological (the sensory-motor process) process we are wanting that will bring about change with the soft tissue within the patients understanding of comfort.

In our practice, those patients who are finding it a bit of a challenge to create the movement that is being asked of them. We describe the movement, ask them to create that picture in their mind, remembering when it was pain free and easy. We find this coaching very successful along with gentle palpation to create a sensory cue

Also in my experience is that often the patients recruit a number of muscles to create a minor contraction i.e. piriformis. They will often bring in glut med, TFL, & IT band. Piriformis solo action is to create external rotation. I often coach my patients into making just a minor solo action with gentle fingers on piriformis acting as a gentle cue or encourage them to imagine the movement before they actually make the movement. I seem to be creating a more useful neurological connection which lengthens the fibres, warms the muscle up ready to move into Hendrickson Method® soft tissue mobilisation which eases the torsion through the fibres. I am finding patients returning to injury free movement much more swiftly with a deepening awareness of their own body and increasing confidence in their bodies can heal, leading to a more active lifestyle.

Would love to hear other practitioners experiences, as these are mine.

 

Flexible Healing describes the way we work in our practice, each person that comes through our treatment room is seen as a unique person. Each treatment is created just for them and often can and does change with their needs. It takes a great belief in yourself as a therapist to be flexible and also have a broad and deep understanding of your anatomy and physiology including sensitive communication skills that are clear, creative and empathic.

At the workshop, all of the above are reflective.

Communication is an ongoing development for myself also.

Our practice is made up of a number of people in long term chronic pain; the workshops thus reflect that knowledge gained.

When treating long term chronic pain sufferers, as David Butler and Lorimer Moseley suggest that pacing through the day and resting at times is really great to minimize pain that can be tiring.

What I have noticed is that often patients find it hard to accept ‘rest’ or even ‘taking it easy’. They may see it as ‘giving in’, ‘being weak’ or because ‘you don’t understand how busy my life is’ – All of this is correct because it is ‘their’ experience of ‘their’ world and life.

It is up to us to find a language that becomes meaningful for them. For example, if the word ‘rest’ or ‘resting’ doesn’t work for them then I try ‘how about pushing the pause button?’, you are not saying ‘no’ or ‘yes’ to anything, simply ‘I just need to take a moment’ throughout the day or even on a day out. It has been a surprise just how many people, women and men alike, can place some meaning and attachment to ‘taking a pause’!

We often rehearse when to take a moments ‘rest’ pause; when would this feel easy; doing it before they become too tired or it becomes too painful; investigating what would stop them? All really useful in encouraging these people to take charge of their condition and themselves.

Sometimes when patients can’t do this, I ask them if ‘Rest’ had a colour, what it would be. In my experience a colour is often attached to a moment when they felt at peace. Help them to build on that memory, encourage them to recall that moment when they need to ‘pause’ or ‘rest’ but also having some fun with it.

Smiles and laughter to a long way in enabling people to overcome something they find tough.

Just my thoughts, I hope you find them helpful.