Untie

Coincidental Diagnosis

A student asked me the other day if she could help reduce the discomfort in her 83 year old father’s leg. He had gone to the doctor and was diagnosed as having “shrunken veins”. A variety of medications had been prescribed and taken, but none were helping. She had already worked briefly at the site of the pain and the pain diminished significantly for two days after the session. He had even been able to walk more easily. She wanted to know if UNTIE could really help this condition.

This was a particularly intriguing question, especially since I always make it quite clear whenever I teach, that UNTIE is a method for normalizing soft tissue (muscle, tendon, ligament and fascia) and certainly, the veins are not on this list. Yet the father had shown definite improvement from what she had done. How can this ambiguity be explained? Obviously, of primary importance is the fact that he was helped. Even though the first attempt gave only temporary relief, it was considerably more relief than had been achieved by other methods of intervention. The question remains then, did it actually help to improve the vascular condition? 

Frequently, there are multiple problems which occur in the body simultaneously. These problems may, or may not be related. In the case of our 83 year old father, at least two possibilities exist:

 a) The pain is caused by the vascular condition and since UNTIE helped to reduce the pain, improvement in the condition would be expected, specifically, improvement in the pathology noted by the physician at the time of diagnosis. Since UNTIE works with the soft tissues, we will assume that this is not what happened and that possibility b) is the more appropriate explanation.

 b) The diagnosed vascular condition may not be the cause of the pain at all. It may merely occur coincidentally, while the pain is actually soft tissue related. When the soft tissues are normalized and pain is reduced, the vascular condition may or may not improve. This would depend on whether the soft tissue imbalances were actually involved in exacerbating the condition. Should only the pain go away, certainly, this is still of great service, although, the vascular condition should continue to be monitored by the physician. 

This is a very common type of story, not just regarding 83 year old fathers, but for people of all ages and physical conditions. We commonly suffer from recurrent pain and physical and emotional deterioration  due to the subtle but insistent pressures exerted by imbalances in the soft tissues. It is of great concern that the significance of these soft tissue imbalances frequently go unnoticed, are dismissed as being unimportant or, they are just simply ignored. The pain is inadvertently diagnosed as being caused by some sort of readily observable pathology, in this case the vascular condition. The fact that the pain was the original complaint and not the pathology is then, often overlooked. All too frequently, attempts to reduce the pain by correcting the diagnosed pathology fail and the patients are faced with learning to live with pain that they consequently believe, cannot be alleviated. 

The fact that a comprehensive soft tissue evaluation is not part of the standard assessment procedure contributes significantly to this dilemma. Practically speaking, the soft tissues could be considered as the most overlooked and perhaps least understood system in the body. They account for 50% of the body weight and are involved in everything that we do. We can’t eat, sleep or even breathe without activating them. The muscles in the jaw are so powerful, that they can actually crush bone. Changes in the soft tissues due to overuse, misuse or just plain old lack of use, affect the position of the vertebrae and exert pressure on the joints, nerves and vascular system. The soft tissues are also involved in postural misalignments, functional limitation of movement and are now know to refer pain to distant areas of the body. What we experience along with the pain and limitation of movement is tension, tightness, a feeling of getting older and finding it more difficult to do what we used to do easily. Simple things like turning on a light switch, putting on our clothes or driving the car begin to require more and more effort. We may find it difficult to walk, exercise or sit, or perhaps we wake up in the middle of the night from the pain. It becomes increasingly difficult to do what we need to do. 

Most of the time, when soft tissue imbalances are properly addressed, pain can be substantially reduced while related pathology improves. In general, a comprehensive soft tissue evaluation, which takes from 15 - 60 minutes, is recommended whenever a problem becomes chronic.  A soft tissue evaluation would be specifically indicated in persistent and reoccurring cases of discus, sciatica, scoliosis, bursitis, tendonitis, back pain, headaches, TMJ, frozen shoulder, non-inflammatory arthritis, sprains, strains or sensitivity which remains after broken bones have healed. The purpose of the evaluation should be to determine whether or not there is soft tissue involvement and if so, how it should be corrected.

A thorough evaluation should include three stages. The first stage is the interview or auditory portion. The history of the problem and the patient's subjective evaluation of the pain along with all pertinent medical reports are reviewed. The information collected should indicate areas requiring further investigation and provide an important reference for determining progress on a subjective basis.

The second stage is the analytical exam, which is the visual portion of the evaluation. Objective measurements in limitation of movement and postural imbalances are taken. The purpose is not to categorize, but instead to provide insights. The practitioner must question why these changes have occurred in the patient and what part they play in the problem, since long term change is not possible without thoroughness and attention to detail. This stage will be helpful later for objectively measuring improvement but more importantly, it should contribute to the overall plan for intervention. For example: When a patient complains of cervical pain and the evaluation shows an imbalance in the pelvis which is causing a functional leg length difference, if the pelvic imbalance is not addressed, relief no matter how profound, will in most cases, only be temporary.

The third step in the evaluation is the palpatory or kinesthetic portion. During this stage an overall soft tissue examination is undertaken with special attention paid to areas revealed by the first two stages. Tissue quality is systematically checked and noted. If the area of complaint is not sore and tender to the touch, then where is the pain referred from? If there is a difference in shoulder height, what are the tissues involved? At this point, it is important to interject that usually, everything that is happening in the body from a soft tissue standpoint, is interrelated in some manner. So it is imperative that all soft tissue imbalances be located, if subsequent intervention is to be effective.

Since 80% of the population currently suffers from back pain, soft tissue related conditions might be considered the plague of the twentieth century. The negative effect that they can have on the overall health and well being of the individual is awesome, while the relief that one can experience with proper attention, can make a significant difference in our ability to function effectively. Incidentaly, the 83 year old father came to his daughter for several additional sessions and is no longer experiencing any leg pain at all.

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