Sunday, February 18, 2018

Back Pain? Check The Psoas

See the how the Psoas attaches to the spine
Here's a patient who came to our clinic this past week complaining of perpetual low back pain. He seemed more frustrated because he had not been able to do his "normal" exercise for over two weeks. The patient is young medical doctor in his mid thirties and among other things does a thousand sit ups a day (2 sets of 500 each).

At Physio and Sports Solutions, our challenge is always to find out the cause of the patient's problem. (and not just treat the pain). It's quite similar to detective work. We look for clues from the moment they walk into the clinic/ treatment room, how they sit/ stand when we are talking to them.

Next is asking the patient many questions about their condition, their exercise routine (if they have one) and their daily routine followed by a physical assessment.

When he told me about his 1000 sit ups a day routine (in addition to his 12-14 hours of desk bound job), I knew that this was a key component to his pain.

Physical assessment revealed exquisite discomfort to his Psoas and Illiacus muscles among other things. Now the Psoas muscle has been described as "the most important and vital skeletal muscle" in the human body for it connects the spine to the legs.

It is structurally the deepest muscle we have in the core/ tummy. They start at the thigh bone (see picture above) and finish at the 12th thoracic vertebrae and all five lumbar vertebrae. That's how it can cause your back pain!

Any force on the Psoas muscle (muscular contractions) is also thought to support our internal organs and work like hydraulic pumps allowing blood and lymph to pushed in and out of the area. Organs stimulated include the intestines, kidneys, liver, spleen, pancreas, bladder, stomach and the reproductive organs. This is why after my accident, every time my stomach hurts (usually from eating something that my stomach doesn't like), my back hurts too.

These deep organs are often referred to as viscera, and communication from theses organs to the brain is called visceral messaging. (My colleagues Sham, Ting Jun and Aized can do visceral manipulation if you need).
Connection between the diaphragm and psoas
Here's another remarkable fact. Your diaphragm (main breathing muscle) is connected to the spine where the Psoas muscle attaches. The diaphragm's medial arcuate ligament also wraps around the top of the Psoas along with fascia that connects to the other hip muscles.

These connections connect your ability to walk, run and breathe and also how you respond to fear and excitement - a direct influence on your fight or flight response.

So I addressed my patient's Psoas problem and got rid of his back pain without even touching his back.  As a medical doctor he and his previous physio had been attempting to treat his back for over a month with no real improvement. He was totally amazed as everyone else had told him it was his back that gave him problem.

Having back pain and not better after your back is treated? Make sure you get your physiotherapist/ healthcare practitioner to check your psoas and your internal organs/ viscera (although your healthcare practitioner may think you're nuts if they're not trained in that area).

Sunday, February 4, 2018

Kaboom! Went The Bulb

You wouldn't have guessed it from the group picture above. Just before we ended yesterday's lesson, the bulb on the projector exploded with a loud pop! Gave all of us a shock. I kid you not.

I was afraid I had to buy a new projector for today's Day 2 of the Kinesio Taping Assessments, Fundamental Concepts and Techniques (previously know as Kinesio Taping Level 2 or KT 2).

Thank goodness for Amy from Sanctband who kindly agreed to loan me their projector. She went back to the office yesterday and Audrey (who lived nearby their office) picked it up for me. Thanks to Amy and Audrey again!
Diyanah and Audrey my saviour
Other than that the course went smoothly. I had to go through the last bit of yesterday's content to catch up, but it worked out well in the end.

Here are some more pictures from the course.

Working hard
The RI teachers and Sham
Thank you all for coming to the course. Next course is on 16-17th June. Call or email us for details or you can sign up here.

Saturday, February 3, 2018

Incredulous At The Kinesio Taping Course

Agog ...
Yes, that's Mona listening, mouth agape with incredulity at how wonderful our epidermis, dermis (skin) functions when I was explaining about how Kinesio Taping works.

Well, after my re-certification as a Certified Kinesio Taping Instructor earlier in January this year, I felt ready to teach again. I wrote earlier  last year that I wouldn't teach again until I've clarified my doubts (after Kinesio Taping International tweaked the course) so as not to shortchange the participants attending the course.

After going through the basic concepts, it was time for the practical.

Discussing which direction

MDT 12 'o clock with Ryan and Tricia
We will do Day 2 of the Kinesio Taping Assessments, Fundamental Concepts and Techniques (what the course is now called, previously Level 2) tomorrow. Stay tuned.

Wednesday, January 24, 2018

Patient Has Neck Pain, But I Treated Her Leg

Last year I wrote about how your hips are connected to your shoulder, which turned out to be a really popular post.

Well, today I had a patient who told me she had neck pain as well. This was after I treated her for her plantar fasciitis problem and knee pain. I had only 2 mins left before my next patient. Here's a screen shot of the video I took before I treated her neck pain.
Before -12:58 pm
Here's the before video.

After treatment at 1:05 pm. Here's the screen shot of the video after at 1:05 pm.

After - 1:05 pm
Believe it or not I treated her leg, yes you read correctly. Watch the video how her neck range changed, without me going near her neck at all.

Many thanks to my patient for allowing me to post the images and videos.

Want to know what I treated? Here's a clue, look at the picture below.


Monday, January 22, 2018

Oops, Just Pooped During My Run

*Wouldn't wish this on anyone
Do you often need to go to the toilet just before your race? For lots of runners, the urge to go to the toilet happens during the race as well. I've occasionally needed to when I was racing, especially before a big race. But thankfully, never during an important race.

Well, you'll be surprised to know that the cause of you going to the toilet may be coming from your head.

A recently published study done only on 150 runners suggest that runners' gastrointestinal (stomach) problems during training runs and races were significantly related to their stress and anxiety levels. The runners were followed up for 30 days in this particular study.

This is after accounting for other known causes of stomach issues such as caffeine, medication, carbohydrates consumed during the run and workout intensity.

There is previous ample evidence that running intensity is closely linked to gastrointestinal issues. The faster (or eventually further) you run, the more blood is diverted temporarily from elsewhere (such as from digestion areas) to running muscles.

In this study, the runners who reported more anxiety and stress in their daily life were more likely to have flatulence, stomach distress and mid-run pit stops while running.

Other than running intensity and other contributing factors tracked, the major reason from this study showed that the runners' reported level of stress and anxiety was the other major factor linked to "on the run" gastrointestinal problems.

Bear in mind that the runners' in the study were not stressed about their running. From the questionnaires, the reported stress were based on people recalling their daily lives, not a specific activity such as work, or in this case, exercise.

So if you're having stomach issues before, during or after a stressful or anxiety provoking event, it makes it more likely that your stomach symptoms (and the need to use the toilet) are stress and anxiety related. Make sure you try to use the toilet before you run.


Wilson PB (2017). Perceived Life Stress And Anxiety Correlate With Chronic Gastrointestinal Symptoms In Runners. J Sports Sci. Dec 1:1-7. DOI: 10.1080/02640414.2017.1411175.

*Took the picture off the computer from

Friday, January 12, 2018

Drill Bit Left In Ankle After Operation

11:42 am -before treatment
Have a look at the picture above. My patient came to our clinic with "problems" in his right ankle. He fractured the ankle in 2010, had pins and plates inserted (but the surgeon did not suggest physiotherapy after that).

He resumed running and football after that and subsequently needed an ankle reconstruction last year as another surgeon told him all his ligaments were now torn and the ankle unstable. Again there was no referral for physiotherapy after this second operation.

One year later, he still had lots of pain in his ankle and lack of range of motion. He saw another surgeon for a second opinion and the MRI was inconclusive. He underwent another operation and in the operating theater, the surgeon found a bone spur in front and a broken-off drill bit left behind! Yes, you read correctly, a broken-off drill bit from the earlier operation ??!!!

Finally, this third surgeon he saw referred him for physiotherapy.

11:55 am 
Well, it took me about 13 mins to change his right ankle if you look at the time difference between both pictures. Actually it was less because I treated his left leg too, before re-assessing him.

Now if we put both pictures together, you can definitely see the difference.

See the difference?
Having a difficult time before or after your operation? Come and see us in our clinics. We'll definitely be able to help you get better.

Sunday, January 7, 2018

Job Done

It was raining cats and dogs this morning when we returned for Day 2 of the re-certification of the Kinesio Taping Instructors course. This was the last re-certification course available for this period for Instructors as there had already been courses in Albuquerque, Prague and in Brazil in the past 2 months.

Being the model for Graceann
The other Instructors present had become familiar faces and we discussed different teaching strategies. It was good for me to meet the other Instructors in Asia as previously I'd only done the re-certification courses in Albuquerque and Venice. We watched some videos and had the practical sessions to clear our doubts.
Getting my cert from Graceann
My 2 students before and now fellow Instructors
Well, my certification will qualify me to teach for the next 3 years til end 2020. And the next course I'll be teaching will be at Sports Solutions on 3rd-4th February 2018. You can sign up for the February course here.

Next course will be on June 16th-17th 2018.

Here's my cert