Often, pain patterns are the result of protective mechanisms. On a practical level, the more primary a systems is, the more it will influence other systems. A tension in the spine limits movement in the periphery. What’s causing a tension in the spine? Treat this and there will be less systemic tension. For example, potential signs of spinal tension may include tight hamstrings, neck tension, headaches, etc.
There is no stasis, everything is either evolving or devolving.
So the idea of maintenance is off the mark.
As we age, our capacity may change. But, function itself may be improved upon.
Good Manual therapy alleviates physical restrictions that impair function and accelerate degeneration.
Yes, when the anterior abdomen is punctured, inflated and probed, the muscles, connective tissues and nervous system will react. The Connective tissue of the anterior abdomen directly connects with the pelvis. So along with low back pain, hip and knee pain may be traced back to poor mechanics in the abdomen and pelvis.
Manual therapy works with two aspects of the healed laparoscopy. Scar tissue and tissue reactivity. Tissue reactivity results from the inflation process and probing. Tensions that are part of a reactive process rather than scarring itself, tend to resolve quickly with correct treatment.
There will be scarring at the site requiring surgery, i.e. appendix, fallopian tubes, gall bladder, hernia, etc. What is less obvious are the adaptations the body will go through in response to the scarring. Scar tissue is contractile in nature, this contraction impedes blood flow and nerve conduction. It will also effect static posture and functional movement.
Modalities like Unified Manual Therapy change the tension in the scar itself and addresses secondary effects, restoring blood flow, improving nerve conduction, and balancing adjacent tensions.
Because the binding characteristic of scar tissue remains, periodic treatment may be necessary for optimal function.
In hands on therapies it is well known that trauma may be stored in the body. Sometimes when considering the long term effects of trauma, the idea of cellular memory comes up. 
Because memory is considered a cognitive process, the idea of cellular memory occurring in a area that isn’t the brain may be met with some resistance. From a Unified Manual Therapy perspective it is simpler to think of these things as a reaction to the initial trauma. The body is stuck in the pattern that was generated as a response to the trauma. It is the elements of these patterns that we work with.
Regarding memories that surface in response to treatment. Of course aspects of the mind are tracking what’s occurring in the body all the time. In treatment when an area that contains unprocessed information is interacted with, aspects of the mind pick up on it. Much like a laser accessing particular data on a DVD. A thought, image, emotion, etc. are pulled up on the screen of ones attention. How does one know if the information is processed or unprocessed? Unprocessed information contains some resistance or contraction, there is a lack of smooth flow or transition of forces through the body. Determining the of the origin of the restriction, trauma, over use, long term emotional posturing, unprocessed emotional responses to trauma, etc. is critical to solid therapeutic outcomes.
If I had six hours to chop down a tree, I’d spend the first four hours sharpening the axe.
Abraham Lincoln
Exercise is an important part of the rehabilitation and so called maintenance program.
As a practice, it’s analogous to practicing a musical instrument.
A broken E string on a violin will effect ones ability to play their music.
Good manual therapy is akin to tuning the instrument.
The stretch and strengthen approach is limited in that one can only condition the existing movement capacity, i.e. one may play all the notes except E. This is where stretching is applied.
However if a protective mechanism is causing of the lack of flexibility or decreased range of motion, then any gains will be nominal and hard won (effortful). Additionally it is likely that one becomes accustomed to a fairly low plateau, and or the benefits will be transient.
Protective mechanisms are at the root of many pain and limited movement patterns.
Some properties of protective mechanisms are
Manual therapy seeks the origin of these postures or those things that the person is posturing around.
Treatment of these dysfunctional patterns usually alleviates pain and restores mobility that is readily maintained.
In the case of low back pain it is often found that sacral movement is compromised.
This may be from abdominal surgery, faulty ankle or knee mechanics; or stored trauma from a fall, whiplash, or old concussion, etc.
The quality of interaction during treatment is important, with good interface, the therapist is granted deeper access to the body, this improves the depth and scope of the treatment exponentially.
Our Doctor just diagnosed our 12 year old daughter with scoliosis. Is manual therapy helpful in these situations?
As the twig is bent so grows the tree
I think the key application of manual therapy in adolescent scoliosis is balancing tensions surrounding the spine. By keeping the forces being exerted on the spine in check, the degree of curvature may be decreased or maintained rather than increasing during their growth period.
By working with these elements we decrease the forces being exerted on the spine.
This changes a persons posture, as well as improving movement patterns, both of which will effect the body’s environment within which growth occurs.
An analogy would be having a destination at due north, but one is heading 15-20 degrees northeast, will one get to their destination?
By consistently checking ones compass, (modifying the tensions around the spine)
the goal of decreased or maintained spinal curve is very attainable.
Rest and avoiding re-injury or re-aggravation are often the sum of what is offered for treatment of concussions. This is a great beginning, but incomplete as a stand alone treatment process.
There are some key areas that should be assessed and treated if necessary.
-Fluid drainage from head, including venous and cerebral spinal fluid.
-Asymmetric neural tension
-Asymmetric bone tension
-Asymmetric membrane tension (meninges).
- Cervical alignment, though high velocity manipulation often re-aggravates.
Each of these contribute to pressures inside the skull, these very pressures inhibit optimal healing.
For a simple analogy, consider someone that has lost 50% of arm flexion. They can do biceps curls as much as they like, but they’ll only get stronger within the range of their existing movement. By increasing arm flexion (through manual therapy) a greater portion of the muscle will be conditioned through exercise.
The brain has similar limitations, if there is a physical barrier. For instance, diminished blood flow, swelling or inflammation, scarring, minor displacement of tissues, etc.
Then exercising and retraining the brain is literally going to be met with resistance.
Restoring good blood flow and balancing pressures inside the head are often primary objectives. All tissues need oxygen and nutrients to heal, but this is heightened in the brain. For instance the brain constitutes roughly 2% of the body by weight, but receives 20% of the blood flow and 20% of the oxygen. If vascular flow is affected, its restoration is imperative. To intentionally challenge this system is like having a clogged sink and attempting to unclog it by turning the hot and cold water on at the same time.
The heads internal pressures are also effected by, the cerebral spinal fluids ability to drain and circulate. An example of how vascular pressures are effected by cerebral spinal fluid flow and how cerebral spinal fluid pressures are effected by the vascular pressures would be; to place two non-inflated balloons in a jar, begin inflating one, we can see that the more we inflate the first balloon, the greater the effect it has on the remaining space for inflation of the second balloon. The point here is, there is a relationship between these two systems, and each has a direct influence on the function of the brain.
Manual therapy is very effective in treating of concussions and minor traumatic brain injuries. Because there are specific techniques to improve the function of the nervous system, vascular system, biomechanics, etc.
Manual therapy works by:
Understanding anatomy and working with the various relationships that arise as a result of trauma.
Respecting the body where it is and working with it, rather than imposing treatment with a willful and non-receptive attitude.
This is critical to gaining deeper access to the body, many styles of treatment elicit defensive posturing. Defensive posturing and access to the body’s deeper structures run counter to one another.
