Dr Siff,
That is very interesting that you noted the fact that strengthening vs
stretching techniques... it would be a great topic for research. The
exercises I give my patients with back pain are a regime of stretches... the
strengthening of tight and weak muscles are only done during treatment. The
muscles that I target in back pain sufferers and allow patients to
strengthen are the transversus and multifidus... but it has been shown by Dr
Richardson and Dr Hodges that when the psoas muscle is dysfunctional, the
transversus and multifidus muscles do not work, and hence becomes weak.
Therefore, I only teach these strength exercises after a few session of
releasing the muscles at fault.
Henry***
>From: [log in to unmask]
>Reply-To: [log in to unmask]
>To: [log in to unmask]
>Subject: Psoas & Back pain
>Date: Tue, 3 Oct 2000 00:37:46 EDT
>
>On 10/2/00, Henry Tsao<[log in to unmask]> wrote:
>
><< Re: your comments about hypertrophied psoas muscles on MRI, this is
>where
>basic theory is important. A hypertrophied muscle does not neccessarily
>mean
>that it is tight... a tight muscle can also be weak, which is what a
>dysfunctional psoas muscle is. Therefore, we not only stretch the psoas
>muscle, but strengthen the muscle to increase its muscle bulk. I hope this
>clears up my previous statement. >>
>
>***I did not refer to 'tightness' at all in my letter, especially since
>that
>term alone can be rather colloquial and vague. Had I done so, I would have
>questioned the nature of the alleged 'tightness' on the basis of mechanical
>vs neural grounds. I was curious to know why the muscle diameter
>increased after stretch and spray alone. As you stated:
>
><<These patients went through a regime of psoas stretch and spray over the
>next 3 weeks only, and had psoas stretches and psoas ice exercises to do at
>home. Over the 3 weeks, they re-MRI'ed these people and measured the
>diameters again. What they found is that there was a significant increase
>in
>the psoas and multifidus muscles diameter, and the patients subjectively
>stated that they were ~80-90% better. >>
>
>***As far as I know, the only case of muscle mass and diameter increasing
>in
>response to stretching has been in laboratory situations in which birds
>have
>had weights hanging from their wings for several weeks at a time. I was
>intrigued to know how humans can increase muscle bulk with brief episodes
>of
>stretching and spraying.
>
>Now you have added that you also had your patients do regular strengthening
>exercises. How can you now be so certain now that it was the stretching
>and
>spraying alone which resolved the back pain? In terms of research
>standards, you cannot deduce that the success which you claimed with
>"stretch
>and spray" was thanks to the method which you singled out for praise. Back
>pain is well known to resolve itself spontaneously or in response to
>regular
>strengthening exercises. As I commented in another letter, if one combines
>a
>series of different modalities, then the likelihood of success will often
>improve, irrespective of the theories suggested. Have you compared the
>relative recovery patterns of "stretch and spray" vs strength training
>subjects?
>
>Dr Mel C Siff
>Denver, USA
>http://www.egroups.com/group/supertraining
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