Energy Medicine Part 2: Joints, Proprioception and Pain

By Dr. Michael Cerami

Last month we introduced the term Energy Medicine and gave a few examples of what functions your internal “hardware and software” perform. This month, we’ll take it a little deeper and talk about proprioception, nerve impulses, joint alignment and your brain’s perception of pain. Warning: This topic is pretty cool but a little technical. Try and wade your way through the first section and I think you’ll be rewarded for the effort.

Proprioception is defined in Wikipedia as the sense of relative position of neighboring parts of the body. It is the awareness in our brain that indicates whether the body is moving with required effort, as well as where the various parts of the body are located in relation to each other (UHP determines whether a driver is DUI by testing their proprioception) .  The initiators of proprioception that we are concerned about in this article are located in the joints of the body. All joints in the body provide continuous feedback to the brain about where that part is located in space. These joint sensors are called Mechanoreceptors (4 types) and register not only position but motion, vibration, pressure, temperature and chemistry. The curious #4 type of Mechanoreceptor is called a Nociceptor and is like a chicken wire matrix and located throughout the body. Nociceptorsare very important because they are initiators of pain and reflexively activate the sympathetic nervous system. All Mechanoreceptors (and Nociceptors) send impulses to the final interpretation area- the sensory cortex of the brain.

OK, let’s review:

• Proprioception:  The sense of where your body parts are in space.
• Mechanoreceptors:  In our example, 4 types of sensors located in all of the joints of the body that send messages to the brain.
• Nociceptors: A special kind of mechanoreceptor that initiates pain and activates the fight or flight part of the nervous system.
• Sensory cortex of brain: Where all of the above messages are assembled.

Now that we’re done with the anatomy, let’s get to the good stuff. Nociceptors begin excessively firing when a joint has restricted motion or is out of position. Mechanoreceptors fire when joints are in neutral position or have normal motion and SUPRESS Nociceptor firing. So, the more of your joints that are in good alignment, the less pain your body actually feels! On top of that, proper alignment in the spine, knees, hips, ankles, and other joints desensitize your body’s flight or flight reaction to stress.  How cool is that?! 

Since the sensory cortex of your brain receives 3 trillion impulses every second and only 50 (yes 50) of those are conscious impulses, it’s clear that many of the Nociceptor messages that are getting through are registering “sub threshold” and not being felt. (I.e. you can have misalignments throughout the body without knowing it). Studies have shown that the accumulation of this noxious input can cause symptoms related to a “hyper excitable central state” and put you on edge and contribute to feeling “stressed out”.

What does this mean for you? Keeping yours joints aligned actually acts as a natural pain suppressant and can reap huge, unexpected benefits. As science finds out more about how the central nervous system regulates and controls our internal and external “reality”, we’ll know where to put our efforts and energy in order to stay health and active well into our senior years.  As a physician, using information from the new energy medicine paradigm not only allows me to find the source of the problem faster but fix it immediately. This means the athlete is back in action much faster than ever.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a consultation one Saturday per month at Salt Lake Running Company (700 East store) by appointment. His next visit to the store will be January 22 from 10 a.m.-2 p.m.  To schedule a free consultation, please call the Salt Lake Running Co. at 801-484-9144. Dr. Cerami can also be reached at 801-486-1818 or online at www.utahsportsandwellness.com.

Posted in General | Tagged ankle pain, consultation, Dr. Carmam

Energy Medicine Part 1: Hardware and Software

 by Dr. Michael Cerami

Over the years we become accustomed to the way we look in the mirror every morning. Most of us takefor granted what’s staring back at us, until that “thing” in the mirror doesn’t behave the way we want itto. Then it gets our attention; especially if we are an athlete.

Because I’m a visual person, I’d like to introduce the basics of Energy Medicine by looking under the surface, inside your body as a new way to look at health and wellness. If you can get an idea of how the body is working, it will help you solve your own problems and give you a better “language” when dealingwith health professionals.

The first concept is what I call Hardware and Software. Hardware items in the body include the physicalparts: bones, muscles, nerves, tendons, ligaments, etc. Everything that has a physical component ishardware, including even the small stuff: cells, organs, glands, etc. Software items, on the other hand,don’t have a physical space. They are processes that coordinate and communicate with the hardwareand tell it what to do. Software is the biological information traveling throughout the body by way of thenervous system, blood vessels and even connective tissue.

Basically, the hardware does what the software tells it to do. Want to speed up your run and finish with a PR? Software impulses (brain thought) are sent to hardware (muscles, glands, organs, etc) viathe nervous system and blood vessels. This software action is initiated and constantly coordinatedwith tissues, for example increase heart rate and respiration, cooling your body through perspirationand more. The hardware also sends software messages back to the brain and other tissues about itsenvironment.

The interesting thing is that the entire body acts as a conduit for the software. There is information traveling all over your body constantly. The old paradigm was a linear system with messages going frompoint A to point B. Energy medicine research shows that all cells act to transfer information over entiresystems that were previously thought to be irrelevant. In our office we do a procedure, with the Cold Laser which I learned from Dr. Jeff Spencer, Lance Armstrong’s chiropractor. In brief, we identify a weakmuscle through a series of tests and then use the Cold Laser to “up- regulate”, or turn on, the muscle from another location in the body. The change in the muscle strength is dramatic and occurs because the light energy of the laser works through the connective matrix to affect the nerve that was involvedwith the weak muscle. Most people are stuck in the old science model because they learned at a very young age that the problem is where you hurt or are weak.

While wisdom is timeless, old models of thinking don’t always work in a rapidly changing world.  Ultimately, your body doesn’t care what model you believe in. It will heal faster and perform better withwhichever model is more effective.

Getting better results in anything, including running, may require new thinking. Begin with gettinga grasp of what your hardware and software do. Well build on the Energy Medicine concept in nextmonth’s article: Joint alignment and its effect on pain threshold.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a consultation one Saturdayper month at Salt Lake Running Company (Salt Lake store) by appointment. He can be reached at 801-486-1818 or online atwww.utahsportsandwellness.com

More on injury self care, taping, proteolytic enzymes and using The Stick.

Participation in sports usually means that at some point or another you’ll be faced with an injury. Even if you take good care of yourself, there are so many variables that can take us out that a little information ahead of time can go a long way to speed things up if you go down. That doesn’t mean you need to be a nervous Nellie, but if you can manage that injury quickly, you’ll be better off in getting back to what you like much sooner.

Deb talked about joint care and reducing inflammation with supplementation in theAugust 12^th blog so today I’ll go over the soft tissue strategies you can use to help recovery.

When an injury occurs the patient should always use the R.I.C.E. (rest, ice, compression and elevation) plan first. This approach will limit the inflammatory response of the body and keep swelling down. Ice can usually be used for 20 minutes on and then 40 minutes off. The next step during the inflammatory phase is to employ compression with an ACE bandage.

Once the body has recovered from the initial trauma, Kinesiotape can help stabilize an injured part to allow the tissue to heal or Rocktape can be applied improve proprioception (positional awareness) which will change the way you use the muscles in the injured area. Both tapes are designed to pull the skin away from the muscle which promotes blood flow and debris removal.  Faster blood flow means more oxygen and more lymph drainage, which helps remove Lactic Acid.

Taping is great because it can be self applied by the athlete and will stay on for 2-4 days. Taping will not fix mechanical distortions or correct structural imbalances but it can get you through a race and many times allow you to use muscles without causing further injury. Many basic taping methods can be taught to the athlete by a professional and then self applied. Rocktape also has great video library of self taping on their website that I encourage runners to check out (Rocktape.com). Certain complex injuries and cases require experimentation between the athlete and professional until the correct application is found.

Another method to help reduce congestion and inflammation in the connective tissue are the use of proteolytic enzymes which help break up stuck cellular debris. These can also help in pain reduction but should not be taken if you are on blood thinners (always consult your primary care physician before combining supplements to any medications you may be taking).

I also recommend The Stick to all of my patients. It’s a great tool to help move fluid more easily throughout the tissue and improve pliability within individual muscles and adjacent muscles groups. Use the Stick each night before you go to bed to help flush tissue congestion from the arms, legs, butt, IT Band, shoulders and thighs. I suggest each person trade a 3 minute session with their Significant Other; just tell them to “Hit me with the Stick!” J

It’s amazing how much shorter the recovery time will be when the athlete takes immediate care of themselves. If you get a few basic items for your home and look over some of the references I’ve provided you’ll save yourself time and money (and pain) if and when that injury occurs.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available fora consultation one Saturday per month at Salt Lake Running Company (Salt Lake store) by appointment. He can be reached at 801-486-1818 or online at www.utahsportsandwellness.com

Symmetry, muscle imbalance and hip rotation

Runners and athletes at any level usually want to go faster or go longer. It’s just human nature to want to do better.

The limiting factors to achieve these goals usually fall into 3 categories: Emotional (psychological, motivation), Chemical (bio chemistry, fueling, nutrition, and supplementation), or Physical (biomechanics, symmetry, distortion).

From the weekend warrior and casual runner to the ultra marathoner or Ironman triathlete, we all have limitations. Some are easier to resolve than others. It may only take a sunny day in September to provide the motivation to get us out on the road again. But pain and injuries are a different story.  Our initial impression when pain strikes might be to push through the problem, interpreting the body’s messages as a natural resistance to better performance. This may be true occasionally but more often than not, pain and injuries in the same area have a root cause from improper alignment which causes poor body mechanics. Interestingly these “cause” areas may or may not be in the same region as the pain.

One of the most common problems causing injuries to runners is muscle imbalance caused by hip rotation. Because the pelvis is attached above to the spine and below to the legs, rotation or distortion of one hip as compared to the opposite hip can affect everything above and below the pelvis; from IT band pain, psoas muscles tightness, knee and ankle tracking, lower back pain and of course the hip or SI pain.

Long term bio mechanical distortion causes structural adaptation over time which leads to anything from asymptomatic subpar performance to increased injuries and frustration. Proper structural alignment saves valuable body energy, reduces inflammation, and improves efficiency which means you’ll be able to push harder with fewer injuries, recover quicker and extend your running career.

How do know if you have muscle imbalance and hip rotation. One easy test is to look at your leg length while lying on your back. Lay on a flat surface with your shoes off and have a friend lift both of your feet off the floor (holding the soft area behind your ankles) about 18”.  Keeping the inner ankles together and the legs parallel and in alignment with the spine, see if the ankles touch each other or become misaligned. Although very basic, misalignment at the ankles will usually indicate hip rotation. Under a ¼” difference is probably OK but anything more is significant and indicates imbalance. Pain is not a good gauge for this test as I’ve seen many patients whose ankles more than a 2” difference and were not experiencing any symptoms.

Correction of structural alignment is not usually complicated or time consuming. A complete evaluation and history to determine the cause, direction and degree of the hip rotation and associated muscle imbalance tells us where and how to adjust the pelvis and which muscles need activation. Once the distortion is removed at home exercises will stabilize the alignment and keep the body working the way it should.

The lasting result of these steps is a happier runner that will probably need less pain killers, and is not on “skating on thin ice” with a body that is only one step away from its next injury. So if you have injuries that don’t heal, or feel like you are doing everything right but not getting the results you want, check for one of the signs of muscle imbalance; it could be the answer you’re looking for.

Dr. Michael Cerami is an avid runner, cyclist and triathlete. He is available for a consultation one Saturday per month at Salt Lake Running Company (Salt Lake store) by appointment. He can be reached at 801-486-1818 or online at www.utahsports andwellness.com