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Towards a unified theory of injury treatment

Discussion in 'Optimal Fitness' started by René Borg, Aug 7, 2015.

  1. René Borg

    René Borg New Member

    Starting this thread in the hope of harnessing the brain power on these forums to connect the dots between current best practices (and expose not-so-good practices) in the area of injury prevention and treatment with particular emphasis on so-called 'sports injury'.

    It's obvious that Jack's overall theory sets the scene for how likely we are to pick up an injury and provides much of the information we need to map the full etiology of various injuries.

    I am a movement and athletics coach so hope to get more underlying theory to provide the mechanism between what we 'observe works' and what we 'know doesn't work'. I have painful experience from my own long-distance running career having suffered 17 major injuries in a 4 year period including Achilles tendinitis, retrocalcaneal bursitis, plantar fasciitis, metatarsal stress fractures, torn meniscus, head trauma, osteitis pubis, heel spurs/pumps, sprained ankles, big toe calcification, shinsplints, midfoot sprains and subtalar joint sprain. I suppose you can call this 'first hand experience'.

    I treat runners through firstly restoring natural movement patterns and optimal biomechanics after analysis (optimal meaning = 'maximal potential to create force' + 'avoidance of excessive joint torque' + 'avoidance of unnecessary and inappropriate muscle tone') and work with Barry Murray (known on these forums) to put the more important 'wrapping' environment, lifestyle and nutrition around this 'optimal movement'.

    Most of my own injuries now largely healed, or in remission, through a system of natural movement rehabilitation (restoring motor skill stones) I consider the practical leaders in this field to be Lee Saxby (Born to Run system), Erwan Le Corre (MovNat), Ido Portal (Movement Culture) and dr Nicholas Romanov (Pose Method) and Gray Cook (Functional Movement Systems). But all of this sits within the shell of creating an 'optimal environment' and seasonal diet (as described on this page)

    I'd like to have discussions here that links the best practices they have created and are creating to the underlying theory to get closer to the dream of a 'unified theory of injury'. Pain and injury are not synonymous, of course, and some athletes are in pain and not injured and viceversa (partly explained by the Pain neuromatrix hypothesis) and this would be an interesting topic to branch off into as well here.
     
  2. René Borg

    René Borg New Member

    TOPIC #1 - Local energy crisis in muscles, trigger points and injury

    SUMMARY: Local energy crisis in muscle cells, along with other factors, cause trigger points which causes the pain associated with many common sports injuries. How does Jack's theories help us understand the underlying mechanisms better and how should we modify our approach to 'symptom treatment' (the trigger point) and prevention (not getting trigger points) in light of this new understanding.

    We can create great relief for most sporting injuries, albeit temporary, by using several types of conventional treatments for trigger points (self-massage, cold treatment, dry needling, laser, etc.) but a complete theory of the why trigger points occur is not yet set in stone. Symptomatic causes seem to be:

    - Motor end plate dysfunction
    - Upregulation of genes that cause muscle hyperexcitability
    - Spontaneous electric activity in trigger point site while adjacent muscle tissue is electrically silent
    - ATP energy crisis causing sensitisation of nociceptive nerves in the vicinity (including bradykinins, cytokines, serotonin, histamine, potassium, prostaglandins, leukotrienes, somatostatin, and substance P)
    - Demyelination of sensory nerves
    - Central sensitisation of the CNS from constant nociceptive signals caused by biomechanical and chemical stress

    Central to biomechanical stress is Gary Ward's 'Flow Motion Model of Movement' or rule that 'joints act, muscles react' or more fully expressed: GRAVITY acts on JOINTS/SKELETON to which the BRAIN/CNS react by asking MUSCLES to act. So when a joint moves towards a position away from what the brain perceives as the 'stable safe centre', muscles are recruited to bring the 'joint back to safety'. So 'static' postural misalignment will cause biomechanical stress and trigger points because certain muscles will be constantly activated to 'pull' the joint back in 'safe position'.

    The poorer the tensegrity of the body the more susceptible a person would be to biomechanical stress I would think. Apart from that I am interested in people's views on the linkage between what is known about the 'symptom' of trigger points and Jack's theories and how we might use this fuller understanding of the mechanism to modify the current approaches to treating these points.
     

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