Linda Gillespie wrote:
>
>
> Dear Henry,
> I've just read most of a week's worth of mail, so please excuse me if
> I'm asking question already answered.
>
> Firstly, regarding disc healing: I always assumed that diffusion of
> nutrients from the vertebral end plate allowed healing to occur, as
> long as the disc material was maintained in its normal position. I
> have no evidence to back this up, I just assumed this was the case.
>
> Secondly, regarding the patient you mentioned: you say 'From his
> presentation, I knew that he had psoas problems.' Do you mean that he
> had an overactive psoas, and if so, do you think that other structures
> than his psoas were implicated in his symptoms? By what mechanism is
> psoas likely to cause irritable bowel sydrome? And by what mechanism
> does the iliacus muscle 'give severe migraines through a chain of
> muscles up the back ending up in the sternocleidomastoid.' I was under
> the impression that migraines (as opposed to other forms of headache)
> were not due to mechanical factors (such as the upper cervical spine,
> and its associated muscles, ligaments and fascia) and therefore not
> amenable to physiotherapeutic intervention.
>
> My final question relates to psoas, the topic of much debate lately.
> I had been of the impression that psoas was more likely to be a
> stabiliser of the lumbar spine which becomes long and inhibited in
> cases of LBP. Is there any research to suggest that it may in fact
> become short and/or overactive? And finally, how do you perform a
> 'spray and stretch' technique on such a deep muscle? I personally
> don't do spray and stretch as I've only heard of it but not seen it
> demonstrated.
>
> I am glad that the patient's posture improved following treatment, but
> am still unsure of the precise reasoning behind your treatment. Do
> you expect the migraines and IBS to improve or change, and if so, by
> what mechanisms?
>
> Yours,
> Linda Gillespie
> Physiotherapist, London
> >
The psoas fascia is in continuity with the fascias of the posterior
abdominal wall as well as the supporting fascias of the
ascending/descending colons (of Toldt) which are continuous with the
supporting structures of the cecum or sigmoid (R/L respectively) and the
pelvic fascia which finally terminates at the perineal raphe. The
continuity cranially centrally follows via the hepato-renal fascia to
the ligamentous apparatus of the liver, to the pericardium and the
mid-cervical aponeurosis-which in its laminations envelopes the
sternocleido-mastoid- and the pharygo-basilar fascia where the fascias
interface with the cranium passing through the spheno-basilar symphisis
and the thence to the 3rd ventricle and ending at the vertex. It is also
possible to trace a contiunity of fascial tensions laterally - but you
get the idea. Headaches can easily derive from strain anywhere along
this continuity.
Mike
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