The Use of Integrative Manual Therapy to Normalize Muscle Rhythm
Author: Susan Digeser PT
Abstract: This article provides a thorough description of circadian rhythms in the body with a focus on the Muscle Rhythm. The article also illustrates the benefits of doing Integrative Manual Therapy on the Muscle Rhythm to improve strength and ambulation.
Key Words: Muscle, Muscle Rhythm, Strength
Discussion
Everything in life has a certain rhythm. Our days are governed by the rhythm of the sun and the moon. Plants and animals have a rhythm based on their innate biological clock as seen with hibernation and migration (1). Our own body temperatures and blood pressures are based upon a feedback loop governed by the hypothalamus (2). Physiologic functions are cyclical in nature. Cerebral spinal fluid as well as hormones have a certain rhythm that must be maintained in a precise and consistent way to stave off dysfunction. Upledger, D.O. found that the rhythmic flow of the cerebral spinal fluid is necessary for proper health and well being (3). Barrel, D.O. discovered that each organ has its own motility which is necessary for optimum function (4). W. Giammatteo, Ph.D., P.T. and Lowen M.T. have found that not only is there the innate motility of the organ but there is also a reciprocal motility that relates organs to each other. There is the motility of the organ’s fascial envelope as well as the motility of the organ on a cellular level (5). It is absolutely amazing to think that we can determine what a normal rhythm is, normalize it, attend to the reciprocal motion of a relating organ and have the body work in a better homeostatic environment. An Integrative Manual Therapist can affect the organ motility in a noninvasive way called Resistance Therapy. Using Resistance Therapy on a patient who was experiencing painful menstrual periods, I witnessed improved uterus motility, mobility and decreased pain.
Resistance Therapy can also be used to affect the function of a muscle whereby improving strength and function. This technique, developed by W. Giammatteo, Ph.D., P.T. uses Resistance Therapy to normalize a dysfunctional Muscle Rhythm. As already mentioned, everything has a rhythm and this includes each muscle. There is a consistent Muscle Rhythm that must be maintained for proper strength. W. Giammatteo, Ph.D.,P.T. found that muscle with innervation would have a certain rhythm; a muscle that is influenced by an upper motor neuron lesion may have a quicker or a slower cycle (6).
History
A dramatic example of the use of resistance therapy involves a man who sustained a closed head injury in a MVA on 2-26-00. MRI showed diffuse brain trauma secondary to anoxia and facial fractures.
Evaluation
Along with many other physical problems this client had left hemi paresis that made ambulating difficult. He was evaluated by another therapist on May 11th, 2000 who found the patient to have left lower extremity strength of 3-/5 throughout. He was able to move his left lower extremity throughout approximately 75% of his available range of motion. He was able to ambulate 250ft and could only negotiate 4 steps with a right handrail step to step. His impaired mobility appeared to be secondary to decreased strength rather than increased tone. His quadriceps muscle strength had increased to 3+/5 by the time this therapist evaluated him on October 8th, 2000. He was able to move his leg throughout his entire available range of motion (ROM) against gravity however without any resistance. His ability to climb stairs was still limited to step-to-step technique however he could do an entire flight using the handrail.
Treatment
The treatment included a very simple 5-minute Resistance Therapy technique that normalized the client’s left quadriceps Muscle Rhythm in all 4 quadricep muscles. Functional exercises such as PNF (Proprioceptive Neurofacilitation) and NDT (Neurodevelopmental Technique) were performed following the manual therapy.
Outcome
The strength of the quad increased to 4+/5 minutes after the technique was performed. The client was able to negotiate a full flight of stairs using the step over step method without the handrail and a much-improved gait in the same one-hour treatment session.
Discussion
The client’s quadriceps Muscle Rhythm was decreased following his motor vehicle accident. By normalizing this biological Muscle Rhythm, the patient was able to regain homeostatic balance and therefore, increased strength and improved function. When the inherent biological motilities are normalized function can improve.
References
1. http://www.orth.Isumc.edu/Faculty/Marino/EL/EL3/Biological.html
2. Martini, Ph.D. Fundamentals of Anatomy and Physiology. Prentice Hall, 1995.
3. Uplegder, J, Vredevoogd, J. CranioSacral Therapy. Seattle: Eastland Press, 1983.
4. Barrel, JP. Visceral Manipulation. Seattle: Eastland Press, 1987.
5. Weiselfish-Giammatteo, Ph.D., P.T . "VMET Gastrointestinal Tract." Vail, CO: 1998.
6. Weiselfish-Giammatteo, Ph.D., P.T., Thomas Giammatteo, D.C., P.T.. Integrative Manual Therapy for the Autonomic Nervous System and Related Disorders. California: North Atlantic Books, 1997.