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Sunday September 8, 2013 MYT 12:00:00 AM
Sunday September 8, 2013 MYT 8:42:48 AM
by revathi murugappan
In chronic joint pain, the body should be assessed as a whole and not be compartmentalised.
There are many underlying causes of chronic joint pain, and some factors include emotions and lifestyle habits.
DO you have a nagging joint pain that refuses to go away despite the many doctors you’ve consulted?
If it is not a result of an accident or trauma, chronic joint pain can be caused by many underlying factors.
“Pain can also come from improper posture, stress, emotion, nutrition and poor sleep patterns. It can be debilitating, but all is not lost as pain can be addressed,” says sports therapist Liam Harkness.
Basically, there are two kinds of pain – acute and chronic. According to the Cleveland Clinic in the US, acute pain can begin suddenly, and it is usually sharp in nature. It can be caused by many circumstances, including accidents, surgery, broken bones, childbirth and cuts or burns.
In most cases, acute pain does not last longer than six months, and it disappears when the underlying cause of the pain has been treated or has healed.
Chronic pain persists even after the injury has healed. Pain signals remain active in the nervous system for weeks, months or years. Physical effects include tense muscles, limited mobility, lack of energy and changes in appetite.
Unrelieved acute pain might also lead to chronic pain. Some people suffer chronic pain in the absence of any past injury or evidence of body damage. Common chronic pain complaints include headache, lower back pain, arthritic pain, neurogenic pain (pain resulting from damage to nerves) or psychogenic pain (pain not due to past disease or injury, or any visible sign of damage inside).
“Many people think that nothing can be done for their pain, and that they just have to live with it. You do not need to live with these problems. Advances in technology can now eliminate these problems, as what has been done for the world’s top athletes and celebrities,” says Harkness.
Originally from United Kingdom, Harkness has spent 15 years in Hong Kong, teaching and training some of Asia’s top athletes. Now based in Kuala Lumpur, Harkness combines Active Isolated Stretching (AIS), visceral manipulation and holistic lifestyle coaching to treat clients.
Discovered by Aaron Mattes, the AIS method of muscle lengthening and fascial release is a type of athletic stretching technique that provides effective, dynamic, facilitated stretching of major muscle groups. It provides functional and physiological restoration of superficial and deep fascial planes.
Over the past few decades, many experts have advocated that stretching should last up to 60 seconds. However, research has shown that this can potentially lead to irritation or injury of local muscular, tendinous, lymphatic, as well as neural tissues, similar to the effects and consequences of trauma and overuse syndromes.
Performing an AIS of no longer than two seconds allows the target muscles to optimally lengthen without triggering the protective stretch reflex and subsequent reciprocal antagonistic muscle contraction as the isolated muscle achieves a state of relaxation.
Mattes concludes that these stretches provide maximum benefit and can be accomplished without opposing tension or resulting trauma.
“Now AIS is being used to improve postural-related conditions and slow down the physical ageing process. The combination of stretching and strengthening exercises has been very successful in treating all forms of physical dysfunction. You can see the difference in one session,” adds Harkness, who studied with Mattes.
Harkness asserts that to eliminate chronic joint pain, one needs to understand and pinpoint the root cause of the dysfunction, and not just treat the symptoms of mechanical pain.
“While physicians deal with acute pain, osteopaths deal with the chronic. Most of my skills are osteopath-based, so my job is to rebalance the body, as opposed to just treating one joint.”
However, Harkness points out that there is no form of passive healing, and you have to take steps to heal yourself.
He says, “We can narrow it down, but it’s eventually the proactiveness of the individual. I can tell by touching the client whether they’ve done the exercises. Malaysians tend to think that massage can do wonders. It’s very passive and really doesn’t heal pain.”
For chronic joint problems that persist despite regular treatments, it is said that “it is the victim that cries out, not the criminal”.
“This analogy is very apparent with pain in the upper back and shoulders caused by tight chest muscles pulling the shoulders forward and weakening the upper back area.
“Often, patients have no idea of the tension in the chest but continually go for relaxing shoulder massages. The origin of the problem is the chest muscles, and the victim who cries out in pain from being overstretched are the upper back muscles,” explains Harkness.
Also, there could be multiple causes for one joint problem. For example, he says the knees can hurt every time one climbs the stairs because of dysfunction of the ankles, calves, adductors, Iliotibial band or hip imbalance.
This could be complicated by a nutritional intolerance (eg gluten or nightshade vegetables) creating inflammation, or even insufficient water intake, causing dehydration of the lubricating synovial fluid in the joint.
“Hence, we should address the body as a whole, and not compartmentalise chronic joint pain. If not, the pain will eventually come back to the joint from the area/location that is untreated. If you only assess the knee, then in time, the problem will reappear because the hips keep putting inappropriate pressure on the knee.”
He cites stress as another example. While it is not mechanical in nature, after a while it affects posture, and this affects the lower back, or may cause the knee to go out of alignment.
Likewise, Harkness claims digestive problems can also cause back pain, while sleeping problems can lead to constipation and back pain.
“Many issues are intertwined. When I follow the line of dysfunction and find the origin of tension, some people cry. It’s an emotional release. Perhaps the mind does not have time to deal with issues such as coping with the death of a family member while having a hectic job.
“So the issue is stored in the body to be handled later. This emotion manifests in the tissues as tension, and causes problems elsewhere in the body,” he says.
Harkness also supports the use of oxygen therapy for better health.
“We’ve got clients who managed to get better just by going into the oxygen chamber.”
Oxygen therapy involves breathing in pure oxygen in a pressurised setting. While it is a common treatment for decompression sickness as a result of scuba diving, the therapy is being used for many other ailments as well.
The Mayo Clinic explains that in an oxygen therapy room, the air pressure is raised up to three times higher than normal air pressure. Under these conditions, your lungs can gather up to three times more oxygen than would be possible breathing pure oxygen at normal air pressure.
Malaysians generally suffer from neck and knee pain, observes Harkness, who has been here for six months.
“People here seem to be generally far behind in their knowledge of health. They seem to be more accepting,” he opines.
“For example, in Hong Kong, when you tell someone he has borderline diabetes, he will immediately take measures to address it. But here, people are like, ‘Oh, ok. It’s borderline, so there really is nothing to worry about’, and they continue their lifestyle!
“And I cannot get anyone to sleep by 11pm! You have to work on shifting the mindset and creating a sustainable habit for overall wellness.”
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Health, chronic pain, joint pain, sports therapist
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