Bowtech-Bowen Therapy

Knee Pain ⚡️

🔊 CALCIFIC TENDONITIS OF THE SHOULDER

🔔 INTRODUCTION

Calcific tendonitis of the shoulder happens when calcium deposits form on the tendons of your shoulder. The tissues around the deposit can become inflamed, causing a great deal of shoulder pain. This condition is fairly common. It most often affects people over the age of 40.

🔔 ANATOMY

Calcific tendonitis occurs in the tendons (tendons attach muscles to bones) of the rotator cuff. The rotator cuff is actually made up of several tendons that connect the muscles around your shoulder to the humerus (the larger bone of the upper arm).

Calcium deposits usually form on the tendon in the rotator cuff called the supraspinatus tendon.

There are two different types of calcific tendonitis of the shoulder: degenerative calcification and reactive calcification. The wear and tear of aging is the primary cause of degenerative calcification. As we age, blood flow to the tendons of the rotator cuff decreases. This makes the tendon weaker. Due to the wear and tear as we use our shoulder, the fibers of the tendons begin to fray and tear, just like a worn-out rope. Calcium deposits form in the damaged tendons as a part of the healing process.

Reactive calcification is different. Why it occurs is not clear. It doesn't seem to be related to degeneration, though it is more likely to cause shoulder pain than degenerative calcification.

No one knows what triggers the body to reabsorb the deposits. But once this occurs and the tissue begins to be remodeled, the pain usually decreases or goes away altogether.

🔔 SYMPTOMS

While the calcium is being deposited, you may feel only mild to moderate pain, or even no pain at all. For some unknown reason, calcific tendonitis becomes very painful when the deposits are being reabsorbed. The pain and stiffness of calcific tendonitis can cause you to lose motion in your shoulder. Lifting your arm may become painful. At its most severe, the pain may interfere with your sleep.

🔔 REHABILITATION

Even if you don't need surgery, you may need to follow a program of rehabilitation exercises. It is recommend that you work with a physical or occupational therapist for four to six weeks. Your therapist can create an individualized program of strengthening and stretching for your shoulder.

It is very important to strengthen the muscles of the rotator cuff, as these muscles help control the stability of the shoulder joint. Strengthening these muscles can actually decrease the pressure on the calcium deposits in the tendon. Your therapist can also evaluate your workstation or the way you use your body when you do your activities and suggest changes. Simple changes in the way you sit or stand can ease pain and help you avoid further problems.

SCIATIC NERVE (SN)

The SN is a major nerve of the lower limb. It is a thick flat band, approximately 2cm wide – the largest nerve in the body.
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ANATOMICAL COURSE
The SN is derived from the lumbosacral plexus (Nerve roots: L4-S3). After its formation, it leaves the pelvis and enters the gluteal region via greater sciatic foramen. It emerges inferiorly to the piriformis muscle and descends in an inferolateral direction. As the nerve moves through the gluteal region, it crosses the posterior surface of the superior gemellus, obturator internus, inferior gemellus and quadratus femoris muscles. It then enters the posterior thigh by passing deep to the long head of the biceps femoris. Within the posterior thigh, the nerve gives rise to branches to the hamstring muscles and adductor magnus. When the sciatic nerve reaches the apex of the popliteal fossa, it terminates by bifurcating into the tibial and common fibular nerves. In approximately 12% of people they separate as they leave the pelvis, that’s why the SN can be described as 2 individual nerves bundled in the same connective tissue sheath.
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MOTOR FUNCTION
Although the SN passes through the gluteal region, it does not innervate any muscles there. However, the SN does directly innervate the muscles in the post. compartment of the thigh (biceps femoris, semimembranosus and semitendinosus) and the hamstring portion of the adductor magnus.
The SN also indirectly innervates several other muscles, via its two terminal branches:
TIBIAL NERVE - the muscles of the posterior leg (calf muscles), and some of the intrinsic muscles of the foot.
COMMON FIBULAR NERVE - the muscles of the anterior leg, lateral leg, and the remaining intrinsic foot muscles.
In total, the SN innervates the muscles of the posterior thigh, entire leg and entire foot.
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SENSORY FUNCTION
The SN does not have any direct cutaneous functions. It does provide indirect sensory innervation via its terminal branches:
TIBIAL NERVE - innervates the posterolateral and anterolateral sides of the leg, and the plantar surface of the foot.
COMMON FIBULAR NERVE - innervates the lat. leg and the dorsal surface of the foot.

🔈 RELATIONSHIP OF SCIATIC NERVE TO PIRIFORMIS

(A) The sciatic nerve usually emerges from the greater sciatic foramen inferior to the piriformis.
(B) In 12.2% of 640 limbs studied by Dr. J. C. B. Grant, the sciatic nerve divided before exiting the greater sciatic foramen; the common fibular division (yellow) passed through the piriformis.
(C) In 0.5% of cases, the common fibular division passed superior to the muscles where it is especially vulnerable to injury during intragluteal injections.

The body is amazing isn't it!

🔈 THE FIVE JOINTS OF THE SHOULDER

Right shoulder, anterior view. A total of five joints contribute to the wide range of arm motions at the shoulder joint. There are three true shoulder joints and two functional articulations:

✅ True joints:
1. Sternoclavicular joint
2. Acromioclavicular joint
3. Glenohumeral joint

✅ Functional articulations:

4. Subacromial space: a space lined with bursae (subacromial and subdeltoid bursae) that allows gliding between the acromion and the rotator cuff (muscular cuff of the glenohumeral joint, consisting of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles, which press the head of the humerus into the glenoid cavity.
5. Scapulothoracic joint: loose connective tissue between the subscapularis and serratus anterior muscles that allows gliding of the scapula on the chest wall.

Besides the true joints and functional articulations, the two ligamentous attachments between the clavicle and first rib (costoclavicular ligament) and between the clavicle and coracoid process (coracoclavicular ligament) contribute to the mobility of the upper limb. All of these structures together comprise a functional unit, and free mobility in all the joints is necessary to achieve a full range of motion.

This expansive mobility is gained at the cost of stability, however. Since the shoulder has a loose capsule and weak reinforcing ligaments, it must rely on the stabilizing effect of the rotator cuff tendons. As the upper limb changed in mammalian evolution from an organ of support to one of manipulation, the soft tissues and their pathology assumed increasing importance. As a result, a large percentage of shoulder disorders involve the soft tissues.

Would you like to find out more about human anatomy, physiology and pathology? Stay tuned and make sure you turned on notification on Healthy Street and see all posts and updates.

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This makes it easier for you to make sense of your own xrays and also what the radiographer says in his report.

ABDOMINAL X-RAY ANATOMY ⁣
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👨🏽‍💻This is something I found challenging as a student but by using a structured system it became more straightforward. I highly recommend using a system, the system I use is the mnemonic AC POP:⁣
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AIR⁣
▫️Track every lucency you can see on the X-ray. Does every focus of gas look like it is in the bowel? If not there could be a perforation. Triangles of gas are bad news and commonly reflect extraluminal gas⁣
▫️Is there a Rigler sign? Ie can you see both the inner and outer bowel wall - this can be tricky in more subtle cases ⁣
▫️Is the bowel dilated? Small bowel can measure up to 3 cm, large bowel 5 cm and caecum up to 9 cm. If dilated we need to decide whether this represents a complete mechanical obstruction - a lack of gas within the re**um can help although the presence of re**al gas does not exclude a significant obstruction⁣
▫️Dilated small bowel tends to be central with valvulae conniventes traversing the whole bowel wall. Dilated large bowel peripheral with haustra that don’t traverse the whole wall⁣
▫️Is there pneumatosis? This is a mottled lucency which represents gas in the bowel wall and commonly a sign of ischaemia - if present check the liver for branching peripheral lucency representing portal venous gas ⁣
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CALCIFICATION⁣
Look for abnormal calcification in the following places:⁣
▫️Pancreas in chronic pancreatitis⁣
▫️Appendicolith in RIF⁣
▫️Gallstones/kidney stones⁣
▫️Outline of a calcified AAA⁣
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PSOAS⁣
▫️Outline the psoas muscles. These can be expanded in abscess or haematoma. Gas outlining the psoas can be a sign of a perforation affecting a retroperitoneal structure such as ascending or descending colon⁣
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ORGANOMEGALY AND SOFT TISSUE⁣
▫️Try and outline an enlarged liver/spleen or kidney (as in polycystic kidney disease)⁣
▫️Look for effaced bowel due to a soft tissue mass⁣
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PELVIS AND SPINE ⁣
▫️Don’t miss a fracture!⁣
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———-⁣
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👨🏽‍💻Try and look at as many AXRs as possible and use a system and I promise that you will become more confident once you know you have looked for all of the major pathology⁣
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These seem to help all types of back pain

Share these stretches with those suffering from back pain. Find more low back pain stretches here: https://bit.ly/35BtziP

🔈 TRIGEMINAL NERVE (CN V)

The trigeminal nerve (CN V) is the largest cranial nerve (if the atypical optic nerve is excluded). It emerges from the lateral aspect of the pons of the brainstem by a large sensory root and a small motor root.

The roots of CN V are comparable to the posterior and anterior roots of spinal nerves. CN V is the principal somatic (general) sensory nerve for the head (face, teeth, mouth, nasal cavity, and dura mater of the cranial cavity). The large sensory root of CN V is composed mainly of the central processes of the pseudounipolar neurons that make up the sensory trigeminal ganglion.

The ganglion is flattened and crescent shaped (hence its unofficial name, semilunar ganglion) and is housed within a dural recess (trigeminal cave) lateral to the cavernous sinus.

After one Bowen session, she walked out of the room with a smile from ear to ear and said “I'VE GOT NO PAIN!!!” 💖
Lorna Mair - Entrepreneur

https://www.youtube.com/watch?v=phERDe--iE4&t=102s

Bowtech-Bowen Therapy updated their info in the about section.

🔈 VAGUS NERVE DISTRIBUTION

The vagus nerve (CN X) has the longest course and most extensive distribution of all the cranial nerves, most of which is outside of (inferior to) the head.

The term vagus is derived from the Latin word vagary, meaning “wandering.” CN X was called that because of its wide distribution extending far from the head. It arises by a series of rootlets from the lateral aspect of the medulla that merge and leave the cranium through the jugular foramen positioned between CN IX and CN XI.

Distribution of vagus nerve (CN X).

A. After supplying the palatine, pharyngeal, and laryngeal branches, CN X descends into the thorax. The recurrent laryngeal nerves ascend to the larynx, the left from a more inferior (thoracic) level. In the abdomen, the anterior and posterior vagal trunks demonstrate further asymmetry as they supply the terminal esophagus, stomach, and intestinal tract as far distally as the left colic flexure.

B. Enlarged view of lower esophageal plexus transitioning to anterior and posterior vagal trunks.

🔈 VEINS, MUSCULOVENOUS PUMP & VARICOSE VEINS

Although most veins of the trunk occur as large single vessels, veins in the limbs occur as two or more smaller vessels that accompany an artery in a common vascular sheath.

Musculovenous pump. Muscular contractions in the limbs function with the venous valves to move blood toward the heart. The outward expansion of the bellies of contracting muscles is limited by deep fascia and becomes a compressive force, propelling the blood against gravity.

When the walls of veins lose their elasticity, they become weak. A weakened vein dilates under the pressure of supporting a column of blood against gravity. This results in varicose veins - abnormally swollen, twisted veins - most often seen in the legs. Varicose veins have a caliber greater than normal, and their valve cusps do not meet or have been destroyed by inflammation. Varicose veins have incompetent valves; thus, the column of blood ascending toward the heart is unbroken, placing increased pressure on the weakened walls, further exacerbating the varicosity problem. Varicose veins also occur in the presence of degenerated deep fascia. Incompetent fascia is incapable of containing the expansion of contracting muscles; thus, the (musculofascial) musculovenous pump is ineffective.

A pretty good explanation, been around for a while.

Bowen Therapy on the 6:00 news Amber Korobkina is interviewed by Maria Hayes of CHTV, explaining how Bowen Therapy can help you to reduce pain.

🔈 SHIN SPLINTS - MEDIAL TIBIAL STRESS SYNDROME

ℹ️ WHAT IS IT?
Clinically referred to as medial tibial stress syndrome, shin splints describe pain that develops at the front of the shin bone (tibia). It’s caused by excess stress and strain to the shins which may occur in multiple ways, including a bending stress on the tibia and excess strain on the musculature at the front of the legs.

ℹ️ CAUSES
While runners may be most familiar with this pain, other individuals may suffer from them as well. Repetitive activities, like running, are the most well known cause, but flat feet, tight calves, inappropriate training or poor shoes may also contribute to shin splints.

ℹ️ SYMPTOMS
Symptoms may include pain and swelling along the front and/or the inside aspect of the lower leg. Shin splints may go away for some runners after they become accustomed to the activity, but for others, the pain can persist. It is important to get treatment as the condition can progress to stress fractures of the tibia.

💡 SELF-CARE FOR SHIN SPLINTS
Self-care for shin splints begins with RICE: rest, ice, compression, and elevation. If the client/patient has anterior shin splints that is caused by running or some other physical activity that involves running, the client/patient should stop the activity until the condition is resolved. If the condition is not severe, then the client/patient might be able to continue participating in the sport if either the distance that is being run is decreased or the client switches to running on a softer surface. However, it is also likely that continuing to run will delay healing and prolong the condition. If the client has posterior shin splints that is caused by an activity that involves plantarflexion, the client should stop or lessen this activity.

Once the acute phase of shin splints is over, strengthening the involved musculature can be helpful. Individual muscle groups can be easily exercised at home with resistance tubing. Plantarflexion musculature (e.g., the soleus) can be easily exercised with heel raises. The client/patient simply stands and then rises up on their heels (engaging the muscles of plantarflexion concentrically) and then slowly lowers their body back down (engaging the muscles of plantarflexion eccentrically). The client/patient should do one set of heel raises until the musculature reaches exhaustion, working up to the goal of performing a set of 100. One to three sets should be done per day.

ℹ️ HOW MASSAGE CAN HELP IN SHIN SPLINTS?
Massage can improve shin splints as it relaxes the tension on the calf muscles and other nearby attachments. The massage should be done in both front and back portion of the leg for better results. It reduces pain and swelling.

🔈 TENNIS ELBOW VS. GOLFER'S ELBOW - WHAT'S THE DIFFERENCE?

While many people are familiar with the names of these conditions, there is less widespread understanding about how they differ. Both tennis elbow, or lateral epicondylitis, and golfer’s elbow, or medial epicondylitis, are injuries to the tendons attaching your forearm muscles to the bone at your elbow. The “epicondyle” part of epicondylitis refers to the bony bumps or protrusions at your elbow.

Lateral epicondylitis affects the tendons attached to the outer (lateral) side of your elbow, which are connected in turn to the muscles that extend your wrist backward and straighten your fingers. Medial epicondylitis affects tendons connected to the inner (medial) side of your elbow, which are attached to the muscles that flex your wrist and contract your fingers when you grip something.
Both injuries are usually the result of repetitive strain on the tendons, and although you don’t have to be a golfer or tennis player to experience them, the repeated forceful motions involved in both sports make them very common.
The anatomical structures involved in tennis elbow and golfer’s elbow are very similar and the symptoms are also similar, but they appear on opposite sides of the elbow and arm.

SYMPTOMS
Common symptoms of tennis elbow include:
• Pain that radiates from the outside of your elbow and down your forearm
• Tenderness on the outside of your elbow
• Weakness in your forearm or a weak grip
• Pain when you grip things, twist something or, if you play tennis, especially with backhand strokes
Golfer’s elbow symptoms are similar, but occur on the inside of your arm and include:
• Pain and tenderness on the inside of your elbow
• Pain that radiates down your arm from the inside of your elbow
• Weakness in your hand or wrist
• Numbness or tingling in your ring and little fingers
• Pain when you grip or twist things
• Pain when you flex your wrist

Bowen can help relieve most shoulder issues gently

🔈 SUBSCAPULARIS TENDINITIS: CAUSES, SYMPTOMS, TREATMENT

Subscapularis muscle is a large triangular-shaped muscle which fills the subscapular fossa. The term "subscapularis" means under (sub) the scapula (the wingbone). The subscapularis muscle originates beneath the scapula.

It is a part of the Rotator Cuff muscle group. It is the largest and the strongest muscle in this group. The subscapularis muscle is the most-used muscle in the shoulder.

🔒 CAUSES

Subscapularis Tendinitis usually occurs due to a direct trauma to the arm like that in a fall on the shoulders or arm or as a result of a sporting injury. A rupture of the tendon may also occur after a surgical procedure such as a shoulder replacement surgery in which the subscapularis tendon is removed and repaired.

🔒 SYMPTOMS

Some of the symptoms of Subscapularis Tendinitis are pain with any type of movement of the shoulder, especially overhead motions. Pain may also be induced with inward motion of the arms. In few cases pain is observed during sleep and early morning. Pain is often caused by hyperextension of shoulder joint during sleep resulting in hyperextension of rotator cuff and subscapularis tendon. The subscapular tendon inflammation is mild to moderate and responds to treatment.

🔒 TREATMENT

The treatment of subscapular tendinitis depends on severity of the inflammation. Mild to moderate inflammation of the subscapular tendon is treated by resting and initially with ice to reduce pain and inflammation. Massage and proper exercise will help the tendon and the muscle to recover.

🔒 EXERCISE

Performing isometric exercises that target the subscapularis involves contracting the muscle for five to 10 seconds at a time without moving your shoulder joint considerably.

Start on your back with your elbow about 6 inches away from your side and flexed to 90 degrees, so your forearm points upward. Place a large book by your hip on the same side. Inwardly rotate your shoulder, placing your hand on top of the book, and press downward for five to 10 seconds. Relax briefly, then move your elbow about 3 inches farther away from your side and repeat the same exercise. Perform the exercise twice more -- once with your upper arm pointed away from your shoulder and once with your elbow even with your ear. Repeat the series with your opposite arm.

🔈 NECK PAIN, HEADACHES OR TEMPOROMANDIBULAR JOINT (TMJ) SYNDROME?

[NEUROMUSCULAR INTERACTION BETWEEN SUBOCCIPITAL MUSCLES AND TMJ MUSCLES]

The TMJ is a complex joint that allows us to open/close our mouth. TMJ disorders do not only create pain and limitations with the jaw. Oftentimes, there are associated issues with the neck, face, and ears.

The body is classically divided into systems such as muscular, skeletal, nervous system etc.

However, this is a mirage as these systems are all a part of one super-system that works in unison to create function.

An excellent example of this is the links between the muscles of the suboccipital region, the jaw muscles and the central nervous system.

As you know the suboccipitals are short and have only minor contributions to gross movements of the spine. However, they are loaded with sensory muscle spindles which indicate these muscles have a strong link to the cerebellum and the CNS. Postural distortions that affect the position of the skull and upper cervical vertebrae are immediately relayed to the CNS via these spindle receptors and the ganglion of C2 which is the largest in the body with 49,000 neurons. For comparison, the T4 ganglion has 24 neurons. More neurons = higher speed delivery of information to the brain.

The muscles of the jaw include the masseter as well as the deeper pterygoid muscles. They obviously allow for chewing but also have an interesting link to the CNS. The masseter has been shown to spontaneously activate during periods of stress. The masseter will also activate in unison with the subocciptal muscles during sudden postural changes in order to keep the eyes stable on the horizon.

The suboccipital and TMJ muscles may not be physically linked but they are absolutely “connected” in the cerebellum and in most clinical cases. This relationship tells us these muscles have a large role in stress/sympathetic nervous system syndromes as well as global postural regulation. A patient may present with complaints of neck pain, but now we see how we must look globally at posture, TMJ function, vestibular function and stress management!

🔈 WHY ARE THE PSOAS MUSCLES CONSTANTLY CONTRACTED DURING PROLONGED PERIODS OF STRESS?

Whether you run, bike, dance, practice yoga, or just hang out on your couch, your psoas muscles are involved. That’s because your psoas muscles are the primary connectors between your torso and your legs. They affect your posture and help to stabilise your spine.

The psoas muscles are made of both slow and fast twitching muscles. Because they are major flexors, weak psoas muscles can cause many of the surrounding muscles to compensate and become overused. That is why a tight or overstretched psoas muscle could be the cause of many or your aches and pains, including low back and pelvic pain.

👩‍🔬 ANATOMY

Structurally, your psoas muscles are the deepest muscles in your core. They attach from your 12th thoracic vertebrae to your 5 lumbar vertebrae, through your pelvis and then finally attach to your femurs. In fact, they are the only muscles that connect your spine to your legs.

Your psoas muscles allow you to bend your hips and legs towards your chest, for example when you are going up stairs. They also help to move your leg forward when you walk or run.

Your psoas muscles are the muscles that flex your trunk forward when bend over to pick up something from the floor. They also stabilize your trunk and spine during movement and sitting.

👩‍🔬 THE PSOAS AND FIGHT OR FLIGHT RESPONSE

The psoas muscles support your internal organs and work like hydraulic pumps allowing blood and lymph to be pushed in and out of your cells.

Your psoas muscles are vital not only to your structural well-being, but also to your psychological well-being because of their connection to your breath.

Here’s why: there are two tendons for the diaphragm (called the crura) that extend down and connect to the spine alongside where the psoas muscles attach. One of the ligaments (the medial arcuate) wraps around the top of each psoas. Also, the diaphragm and the psoas muscles are connected through fascia that also connects the other hip muscles.

These connections between the psoas muscle and the diaphragm literally connect your ability to walk and breathe, and also how you respond to fear and excitement. That’s because, when you are startled or under stress, your psoas contracts.

In other words, your psoas has a direct influence on your fight or flight response!

During prolonged periods of stress, your psoas is constantly contracted. The same contraction occurs when you:

➡️ sit for long periods of time
➡️ engage in excessive running or walking
➡️ sleep in the fetal position
➡️ do a lot of sit-ups

💡 Here are some tips for getting your psoas back in balance:

✔️ Avoid sitting for extended periods
✔️ Add support to your car seat
✔️ Try Resistance Flexibility exercises
✔️ Get a professional massage
✔️ Release stress and past traumas
✔️ Stretch

💡 HOW TO STRETCH

Roller Psoas Stretch
Use a foam roller for this passive, relaxing stretch that lengthens your psoas, one of your deep hip flexors.

1. Place the roller perpendicular to your spine and lie with your sacrum (the back of your pelvis) — not your spine — on the roller.
2. Pull your left knee toward your chest, keeping your right heel on the ground. You should feel a stretch on the front of your right hip.
3. To increase the stretch, reach your right arm over your head and open your left knee slightly out to the left.
Hold for 30 seconds, then switch legs. Repeat as needed.

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How a Herniated Disc in Your Upper Back Causes Pain, Numbness, and Weakness A thoracic herniated disc can cause upper back pain, numbness, weakness, and radiating pain into the chest or abdomen.

KNEE JOINT
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The knee is arguably the most complex joint in the human body. With its daily exposure to high amounts of compressive and torsional forces, it requires an inborn shock-absorbing system.
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These photos display the complex interconnected network of synovial bursae. The bursae are synovial fluid filled sacs that exist at areas of high friction between tendons and bony prominences. Their function is that of a cushion. Due to the insertion of many large tendons on the tibia, fibula and femur, many bursae are found at the knee.
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The purple sacs represent the individual bursa, with special attention given to the posterior semimembranosus and medial gastrocnemius bursa and suprapatellar bursa. Both of these structures share direct connection to the joint capsule and internal synovial environment of the knee joint. They are a LINKed hydraulic system.
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Common disorders of the internal knee (meniscus tears, osteoarthritis) can lead to swelling of these bursae. The most common being the enlargement of the posterior semimembranosus and medial gastroc bursa, known as a Baker's Cyst.
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Minimizing friction on these tendons via normalizing fascial tensions is critical to bursa health, which minimizes compressive loads on the joints.
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Healthy fascia-health bursae-health joints-healthy movement!
Photo credit to K. Alyhaya.
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Credit:

All about the L4-L5 Spinal Segment The L4-L5 spinal motion segment provides a variety of functions, including supporting the upper body and allowing trunk motion in multiple directions. Due to its load-bearing function, this motion segment may be susceptible to injury and/or degenerative changes.

Degenerative Spondylolisthesis Degenerative spondylolisthesis symptoms include leg pain (sciatica) or a tired feeling down the legs when standing or walking for long periods of time.

Listening from your Fascia Ever wonder what intuition actually is? Well look no further than your fascial matrix which covers all your muscles, nerves, arteries and veins, organs, bones: in fact every structure in your body.…

How Bowen Therapy Can Help with Anxiety Anxiety surfaces when a person is stressed or worried. Being anxious is a normal reaction of our brain in response to a threat, be it a real or imagined one. In fact, a majority of the people suffer from anxiety when they’re feeling under pressure. While stress can be a helpful factor that