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Κυριακή, 5 Απριλίου 2015

Reflexology and Sports Related Injuries

Article written for the ICR International Council of Reflexologists Newsletter March 2015 here.

It has been a long time now since Eunice Ingham first started visiting clinics and hospitals trying out Reflexology in order to formulate her chart, but also to inform patients and physicians about our beneficial method. So nowadays it comes as no surprise when we hear that Reflexology has been integrated into that clinic or that hospice or other medical settings for that matter.

There is another area though that Reflexology has proven worthy of integration but unfortunately this is not well known, neither researched nor documented thoroughly. This area would the area of sports. Athletes either your average weekend warrior or the high performance athlete all want to live up to the Olympic motto “Citius, Altius, Fortius”, latin for "Faster, Higher, Stronger” In order to do this they too require wellbeing, stamina, health and a injury free status.

Reflexology most of the time will not be their first choice in order to acquire these elements. 

But as is with most of our “ordinary” clients seeking to resolve health issues, athletes will come to us when they have tried everything else. This means that by the time they visit us, a possible muscle strain for example, will be chronic and unresolved.

Hopefully one day when a Reflexologist has built his reputation, athletes will be requesting his/her services much sooner, possibly even sports clubs will integrate us in their standard medical team.

What are we good at?

There are definitely quite a few areas that are modality will prove of benefit to all athletes.
One of my favorites has to do exactly with our immediate influence on the feet. Of course we work through a concept of an exact reflection of the human body on the feet, thus affecting it indirectly, but is there anyone who will deny the direct relief to the feet themselves offered by the experienced and loving hands of a reflexologist? 
So yes, we still remember and live by Eunice Ingham’s dictum 

"If you're feeling out of kilter. Don't know why or what about. Let your feet reveal the answer. Find the sore spot, work it out".

But, besides what that sore spot refers too, will our hands not loosen up all the joints in the feet, thus loosening up all the bodies’ joints? Let’s take as an example the most common stiff big toe (Hallux Rigidus). In sports (and in life!) this joint is very important because it has to bend every time you take a step, jump, and run or propel yourself.  If the joint starts to stiffen, even walking can become painful and difficult.
So, among numerous sports, imagine if a swimmer or a diver has a stiff big toe, will he/she propel themselves from the diving board or every time they flip turn inside the pool the best they can? The answer is no! 

Obviously besides thumb walking, I like to work on this joint sitting on the side of the foot and holding it between the base of the palms of my hands pumping it and gently rubbing it with circular movement. After a while the joint softens and loosens up. To finish off I like to practice a wave like traction movement on the two joints of the big toe. Many times I hear the popping release sound the joint makes, but I never struggle to make this happen, if it does good, if not no problem. Anything else I consider invasive. Of course when I approach such an issue I will obviously ask the athlete about any complaints/issues in the head/neck area (organs and myoskeletal), and have a look out for signs along the spleen and liver meridians since they too are associated with the big toe.

Let me finish off on this part by saying that I pay extra attention in loosening all toes and opening up the metatarsals. Besides a stronger push off phase, this spreading offers more stability and flexibility that will be utilized by the athlete. It will also improve proprioception and in cases of pain conditions associated with the sclerotomes of the feet, for example low back pain, you will be stimulating the normal somatosensory input that closes the pain gate thus hopefully reducing the perception of pain.

Another area that definitely stands out is that of issues regarding the digestive track. We all know that reflexology is beneficial and has an immediate effect on the autonomous nervous system thus on the organs because the two major nerves involved in Reflexology, the tibial nerve and the median nerve have a high neurovisceral portion (Barral-Croibier)

In sports, athletes especially high performance ones, are trained to not complain about pains and aches this is part of their life so they build tolerance, and this has to do mostly with their myoskeletal system. But they are still human and under stress, so it is very common to encounter a hiatal hernia or acid reflux or constipation. Now something strange that cannot be easily explained happens often here.  I will ask them while working on their feet and feeling something at a given reflex “is there anything wrong or are you concerned with your ….stomach, for example?” And the answer will be “yes”, but not in a concerned way, rather in a “…do not concern yourself with that, make sure my shoulder is alright.” Be on the lookout for these issues and treat them accordingly. It is imperative that a form of “training“ take place here on the importance of the digestive system for example and a more wholistic approach to health, or that shoulder will possibly not be alright.

In order to treat these issues the area we are interested in is definitely the solar plexus. Inghams solar plexus on the diaphragm line has proven worthy many many times. 

Let me just add the solar plexus reflex according to nerve reflexology (Nico Pauly). This would be placed on the plantar aspect of the base of the first metatarsal bone and the plantar surface of the medial cuneiform bone, all in zone 1. I love this reflex because besides the solar plexus reflex, close to it is the adrenal reflex and the attachment of peroneus longus.
Peroneus longus is important because of its connection in myofascial terms with the lateral line which coincides with the gallbladder meridian.
According to Tom Myers: Postural function of this Lateral line is to balance the front - back and the left - right sides of the body; it also mediates forces among other lines. This line can bend the body, flex the trunk, and function as a brake for any lateral and rotational movements. It participates in frontward or backward movement by "containing it". When we use this line in movement we go or turn sideways = think of obstacles in life, avoiding them or looking the other way.
I like using a circular movement with my thumb on this area, move in both directions clockwise-anticlockwise and use the one that feels more relieving to your client. A related article of mine on this topic here.

It is so interesting that though neurologists, physiotherapists and gymnasts have been taught this knowledge, have documented it and researched into this field they do not use it. Reflexologists are the ones who broadly use this therapeutic concept as it was handed down to us by Eunice Ingham in her books. I have to admit though that I have noticed unfortunately the last few years there is a tendency to leave this knowledge out of our basic training. None the less it is a very efficient method for treating pain and assisting various myoskeletal issues.

For example, for a sprained right ankle on the medial side – hallux zone, one could look for the most painful area on the medial side of the left ankle (cross reflex), or the lateral side of the right wrist – thumb zone, (referral area). Upon locating the painful area apply forcible rubbing and in between sedative technique. I advise you to teach the athlete also to do it himself 4-5 times a day, they are more than willing to learn and apply, plus it has remarkable
Other examples are:
biceps brachii – biceps femoris
triceps brachii – quadriceps femoris
first metatarsal – first metacarpal
tibia bone – radial bone

The ear, the face.
The ear chart is a great tool to know of because it might "unblock" something that otherwise would have not. I remember last year towards the end of the championship our team captain had sustained severe muscle strain in his hip after direct contact with the knee of an opponent. Although the medical team was treating it with standard care the player did not feel as the pain was being addressed nor was he gaining mobility. What happened was that I started working on his hip reflex on his ear the morning of game day.

When we met up at court, he anxiously came up to me and showed me his ear; some skin had peeled off from the spot I had been working on. But what was really interesting was that he also showed me his hip, it seems that the internal bruise had surfaced in a couple of hours relieving him of pain but also adding mobility.
The ear is a great tool also to teach athletes to use at home or on their own.

The face is very interesting because I will use it under specific circumstances. Extreme stress is such a circumstance. During competition an athlete might need stimulation, but it is not always easy to offer treatment especially if they are dressed and wearing their shoes ready for competition. When I am with my handball team at the court on game day I touch everyone’s hand, try to see if they are sweating or not, stressed or not. 
So when I find them sweaty/stressed I try to bring balance utilizing the ear and the face. Once during a title game, our star player was not himself in the court. At half time I let the coach speak to all of them and just as they were ready to go out for the second half I asked him how he was. He answered that he did not feel well, something was wrong. I offered to treat him on the face, he gracefully accepted. This was a two minute maximum stimulation, the player had the best game of his career and was announced MVP. I am sure you would like to know what I focused on…,  I followed Ingham’s dictum, “find the sore spot, work it out.”

Like I stated in the beginning ordinary people and athletes come to us when they have first tried everything else. So what is left to try? Chinese medicine is one concept we could and should bring into our reflexology work.
So for general tissues and muscles we should initially palpate and then treat accordingly the earth element reflexes on the feet which would be stomach and spleen/pancreas but also follow the meridian up to just below the knee or elbow respectively. For issues regarding muscles, tendons and ligaments we will do the same but for the wood element meaning the liver and gallbladder reflexes. In my experience the gallbladder reflex is very effective for any muscle issue.

In the early 1960’s George Goodheart came up with the new idea for working with muscles. Goodheart’s research showed that most muscles have an association with internal organs through the meridian system. Through this concept he devised a system of therapy called applied kinesiology. The association of each organ/meridian and muscle follows.

Small intenstine - Abdominals, Quadriceps
Triple Heater- Sartorius, Gastrocnemius, Soleus & Gracilis (Adrenals), Teres Minor (Thyroid)
Heart - Subscapularis
Pericard - Adductors, Piriformis, Gluteus
Stomach - Neck Flexors and Extensors, Levator Scapula, Pectoralis Major Clavicular, Brachioradialis
Spleen/Pancreas - Trapezius (M & L), Triceps, Latissimus Dorsi, Palms, Opponens Pollicis Longus
Large intenstine - Hamstrings, Fascia Lata, Quadratus Lumborum
Lungs - Deltoid, Diaphragm, Coracobrachialis, Serratus Anterior
Urinary Bladder - Sacrospinalis, Anterior & Posterior Tibialis, Peroneus
Governor vessel - Teres Major
Kidney - Psoas, Iliacus, Upper Trapezius
Conception Vessel
Gallbladder - Popliteus, Anterior Deltoid
Liver - Rhomboids, Pectoralis Major Sternal

So, when do we use this knowledge? 
Many conditions that seem to be of a mechanical nature may not have mechanical etiology. It might be caused by organic, Chi, lymphatic or emotional conditions and the mechanical condition is where the athlete is housing the symptoms. One good way to find out is to ask how the condition appeared. If it was a direct injury or sprain then standard procedures may be used. If the answer is “it happened suddenly or built up slowly” then we are not dealing with mechanical etiology and the therapist has to find out what the real cause is or else the symptoms will return.

LynneBooth is well known in sports reflexology; from her I have been influenced and utilize concepts from her vertical reflex method. The needed weight bearing position of the recipient in this approach offers something that having the client lie down does not. The clients muscle chains are activated and will show tender spots then contrary to having them lie down where their muscle chains will be deactivated possibly showing no tender spots. Give it a try, have them stand for a while and work on the feet, pay attention to the reflex area we recognize as “fallopian tube or seminal vesicle” respectively. Something beautiful happens there but I will let Lynne tell us herself this September in Sheffield.

Lastly I would like to add some knowledge from our colleague Arve Fahvlik (Norway). For any chronic issue, meaning anything over four months, it is safe to assume that the homunculus also has been affected. For example, if an athlete has had a tight left biceps femoris for several months something additionally we could try is to work out the representation of that muscle on the homunculus reflex on the right foot! The homunculus being in the cortex would be around the edge of the thumb. Article source: Introduction to full-body-reflexology - part 4 - by Arve Fahlvik 

As a final piece of advice, if you choose to work closely to athletes, try the best you can to be fit, to be optimistic, psychology is very important, and try not to be affected if they are victorious or when they are not, somebody has to keep the balance. You can cheer silently at home alone later, you can also be sad alone later. 

You will be the one that will feel their anxiety, their pain, their tiredness, you will also be the one that will feel their positive prospective and their joy.  If we are blessed, we might be the person that touches last these super people, before they accomplish the unaccomplishable

Have you ever seen in formula1 racing when it rains that there is someone holding the umbrella over the pilot? This is his therapist!
In conclusion, I know as a certainty that we have a lot to offer in this part of life also. When in high performance sports winning first place or second place comes down to details, reflexology is one such detail.