Dr Siff,
I am more or less just telling you what I know so far about what I do,
because I am still learning. But I agree, there needs to be more research,
especially in the area of the psoas muscles.
The first research that I came across (and when I remember the title I will
tell you) did a correlation between psoas wasting using U/S scan and back
pain. What the authors found was that in 80% of people with back pain for
more than 6 months, the psoas was tight and had atrophied.
I have seen in Brisbane a doctor who has developed the standing MRI, and
what they have done is taken 5 patients with back pain, and measured from
the MRI the diameter of the psoas and multifidus muscles at L2-3 region
(where the psoas and multifidus is suppose to be the most bulky in fibres).
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.
A standing MRI costs $2-3000 per person, hence you can understand why there
isn't as much research... as far as I know, the doctor who did this wanted
to find out for himself and to help the physiotherapists who were using the
psoas techniques. I know this is not a very standardized research, but is
the only few that I can find regarding the psoas muscles. I am not a
researcher, but I am not going to give up what I do that works much better
than conventional physiotherapy techniques simply because there is little
research behind it.
Henry***
>From: [log in to unmask]
>Reply-To: [log in to unmask]
>To: [log in to unmask]
>Subject: BACK PROBLEMS
>Date: Fri, 29 Sep 2000 14:21:39 EDT
>
>On9/29/00, Henry Tsao<[log in to unmask]> writes:
>
><< As with anything, it really depends on the presentation of the patient.
>Sometimes you only need to treat the psoas muscles, where as other times
>you
>need to treat muscles of the lumbar spine, and sometimes even down to the
>buttocks and to the lower limbs. The worst case that I have seen involved
>almost all the muscles around the lumbar spine, but it did not mean that we
>had to treat all of these, because some muscles will refer satellite
>trigger
>points to other muscles (eg, psoas can refers trigger points to quadratus
>lumborum - so if you deactiave psoas, then you release quad lumb. also).>>
>
>***This still suggests that we may as well treat everything that may relate
>to the back pain and, after ruling out any serious pathology, fractures
>etc,
>ignore any further testing and have the patient execute a rather
>generalised
>trunk conditioning programme to 'balance" or "release" anything and
>everything. Is there any evidence that the use of extensive manual,
>non-radiographic testing to produce an 'isolationist' type of
>rehabilitation
>regime is significantly more successful that this generalised sort of
>conditioning approach?
>
>Note that I am not stating this as a fact, but simply asking if there are
>any
>references to support an approach which is very popularly used in therapy.
>Maybe a great deal of testing is unproductive and unnecessary.
>
><<However, I have read texts which say that in back pain, you "always" get
>weak abs (particularly the transversus abs) and gluts, and tight iliopsoas
>and extensor muscles. This is a big generalization, but true for most
>patients. >>
>
>***This sounds like a very safe bet. Mention MOST of the major muscles
>that
>are associated with trunk stabilisation and you are sure to correlate back
>problems with "dysfunction" or "imbalance" in at least one of the muscles
>listed. It is tantamount to saying, if the engine of a car is not running
>well, then it must be due to the fuel system, the electrical system or the
>fuel. We have to face the facts that back pain relates to such a plethora
>of
>possible structural, functional and psychological causes, that no
>researcher
>has yet been able to pinpoint any single or multiple cause of back pain.
>
>Dr Mel C Siff
>Denver, USA
>http://www.egroups.com/group/supertraining
>
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