Muscle Splinting Psychology & Foot Keystones

An Impetus to Psychological Splinting:
Muscle splinting is a phenomenon where the body will try and protect itself by causing certain muscles to become hypertonic or stiff in order to help protect underlying visceral or somatic tissue.  A couple examples that come to mind would be in the case of appendicitis or whiplash.

Considering appendicitis, when a doctor performs an abdominal exam they will palpate and percuss four quadrants of the abdominal region, in the lower right quadrant is an area known as McBurney’s point which is about 1/2 way between the umbilicus and anterior superior iliac spine (ASIS) or about 2/3rds of the way down for doctors practicing in Europe.  The muscles superficial to the appendix will tighten up to help protect an inflamed appendix and this point will cause pain when palpated in a pt with appendicitis.

McBurney's Point

McBurney’s Point

A similar mechanism takes place in a whiplash patient regarding the muscles around the neck.  Again, the body is trying to protect itself.

As I wake this morning there is a bit more stress and anxiety inherent with another trip and another round of reviews for my impending Part III boards testing.  In the medical community the Part III analog is called Step 3.

Steps 1 and 2 for MDs or Parts I and II for DCs are essentially test which cover basic sciences like chemistry, physiology, anatomy, biochemistry, pathology and the like.  For chiropractors I know Part 1 consist of 9 hours of testing spread out over a two day period of time and part II is a bit longer and also spread out over two days.  Part III is only a 4 hour exam with half given in the first two hours, then a 20 minute break then another 2 hours of testing to finish up.  Part III is more clinical in nature and among other things covers all the basic exams, such as the aforementioned abdominal exam.

I’m not exactly sure why but some things stick very well the first time I hear them while other things take considerable focus and effort to get in my brain.  One thing that stuck when first learning the abdominal exam is a condition known as Caput Medusa.  I guess it has a catchy name that’s hard to forget.  Caput Medusa (CM) is a distention of veins around the umbilicus and although it can be caused by increased pressure in the inferior vena cava the liver is usually what I think of first regarding CM and portal hypertension.

Patient with Caput Madusa

Patient with Caput Madusa

My writing has gone a little tangential but my original thinking was engaged in finding insight into a possible phenomenon I’ll refer to as psychological splinting.  The brain is a visceral organ but instead of thinking in terms of a physical insult or any type of trauma we may also consider psychological insult or trauma and ways we, as humans may and up splinting ourselves psychologically in order to help protect ourselves.

As mentioned earlier, I am currently in a position which allows me an opportunity to use myself as a kind of living laboratory in order to examine my own responses to increases in stress and anxiety.  In order for my brain to help figure out a scientific type allegory I was lead to the concept of muscle splinting and have just started to ponder and consider implications associated with such thinking.

However, I am pressed for time so I’ll have to allocate portions of my four and a half hour trip to Kansas for further evaluation and pondering of psychological splinting.

 

Foot Keystones
There are three arches in the foot; a lateral and medial arch as well as a transverse arch.

Three Arches of the Foot

Three Arches of the Foot

In each of these arches, one bone in each arch acts as a keystone to each arch, the place where maximal stress and load takes place.

In the medial arch the navicular bone is the keystone.  In the lateral arch it’s the cuboid and the transverse arch most commonly has the 2nd metatarsal as the keystone.  An interesting part about this is that those bones, particularly the navicular and cuboid bones are bones that we, as chiropractors, have specifically learned to adjust.

The second metatarsal bone is most common in people with normal biomechanics however that load might also be found on the third or sometimes even as far over as the 4th metatarsal depending on the particular individual.

Morton Neuroma is found along the transverse arch, usually between the 2nd and 4th metatarsal and most commonly between the third and fourth metatarsal.  It is a perineural fibrosis (a thickening of tissue around one of your nerves) and causes nerve degeneration of the common digital nerve.  This usually results in a burning pain (which is common for nerve injuries) and often refers to the dorsal or top surface of the foot.

High heeled shoes have been linked to the development of Morton’s neuroma.  However, it should be noted that when referring to something like high-heeled shoes we come back to a basic situation of altered biomechanics.

One type of psychological splinting discovered for myself. 
Today, it looks like I’ve managed to put off final packing for my trip by writing in this blog so, avoidance may be considered one type of psychological splinting (PS) that I employ in my own life.  Beyond that, however, I’ve taken note of the method employed for my own method of PS which would have to do with reaching out to others and communications.  I would consider avoidance to be a general manifestation of PS while the mode employed i.e., communicating, to be a subset of that general mode.

That insight comes about as a result of recalling that, in the past, when I would be driving to school and have a particularly imposing and intimidating test looming that I would often text my girlfriend at the time and that communication frequency was much higher than normal communications under less stressful circumstances.

As a further offshot and tangent, I know have to wonder if the artificial manufacturing of stressful situations in a coupled relationship is done so that increased communications does take place and as such may be somehow perceived as a benefit to the one who might instigate say, an argument when no perceivably real genesis for an argument or altercation exist to begin with.

 

Reference: for those interested in some of the neuromusculoskeletal (NMS) aspects of Muscle Splinting:  The role of autogenic inhibition in the reduction of muscle splinting by Herbert Miller, PhD

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A Musical Distraction from Self Condemnation

adam phillips

Insights and self knowledge can come at peculiar times.

When I first started listening to music during my runs I told myself I was distracting myself from my running.  This makes perfect sense and is believable to most people.  This was not the fundamental truth.

The jogging and running is what I was doing.  I was the instrument from which the running occurred.

I was distracting myself from myself.  I was distracting myself from that inner part of me that was scared and afraid.  I was distracting myself from the parts of me that doubted my ability to succeed.  I was distracting myself from the parts of me that would appear less than noble, less than confident, less than praiseworthy.  I was distracting myself from parts of me that I would publically want no one to ever see.

With human nature, it’s usually easier to see fault and folly in others than it is in ourselves and, as such, I was easily able to parlay my initial thinking regarding myself to mankind in general and even more specifically to myself.

Essentially, I was distracting myself from my ability to handle a certain aspect of life for which I was ill equipped.  

Isn’t this a basis for a myriad of distractions we may imbue ourselves with?  Sex, smoking, shopping, eating, drinking, drugs, music as well as many other clever distractions and the items listed may or may not be inherently bad in and of themselves until we can honestly answer the question of why and to what extent we saturate ourselves with the distraction.

I think the clever part is when we can pass off destructive behavior under the guise of something normal and well accepted.  We could simply say we “like to party” then surround ourselves with people of similar ilk to further fortify and maintain our behavior.

There are a lot of subtle nuances here and many variables especially with regards to the types of distractions as well as the various aspects of life for which we may be ill equipped to effectively handle.

I also think, just as it may be easier to see faults in others rather than ourselves it may also be the case that this self reflection into myself may have been most easily realized due to the fact that it was seen in a rather benign and self imposed activity such as running.  It may have been harder to see more fundamental and base aspects of life for which I was ill equipped to effectively deal with.

Life, jobs, relationships, marriage, kids, parents, our health, maintaining a household and finances could be among the things for which we are ill equipped to handle

but …what if the distraction and the aspect of life for which we are ill equipped to handle are the same thing?

We may drink to distract ourselves but then the drinking may be a thing for which we are ill equipped to handle.  We may smoke to distract and put things off but the smoking itself may be itself an aspect we are ill equipped to handle.

I may write a blog, such as this, to put off getting to the park and getting my run in which… is exactly what’s going on right now – tbt.

When thinking through all this stuff a quote my Marianne Williamson came to mind

“The only way to end the torture of self condemnation is to live a life that earns your self respect.”

Upon first thinking, I wasn’t exactly sure how that phrase by Marianne fit into the previous thinking but, now it seems a bit clearer.

The distractions and aspects of life we struggle to deal with can be those things which detract from earning self respect.

I think I will make a meme with Marianne’s quote, then get my ass to the park and knock out my 3 mile run (that should have been done yesterday).

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Doubt, Faith, Trust & Fear

My running partners tend to be those I have never actually met.  There is a guy on Instagram called Mathew Bolet (?sp) who is a great mentor and inspiration and another guy who shares his own running blog on wordpress named, Ryan, I believe who lives in Memphis, TN.  I relate to those I see at the park.  The constant walkers who show me where I’ve been and those who run like the wind and show me where I want to be someday soon.

I tag my runs via Instagram use that app to check into the park where I run.  I add hastags on my running post to help connect with other runners.  #nikeplus is a good tag and #marathon or #marathontraining helps to connect with a specific audience but, lately I’ve been adding tags I feel are of greater significance.  #faith, #hope, #love and even #life

The path is my classroom and the effort necessary for running is my teacher.  Some routes may be the same but, the lessons are always evolving.  Failure has been one of my current ponderings but, lately my pensive ponderings have brought me back around to doubt.  Little by little thoughts form like bricks waiting to be constructed into something useful and maybe someday something even glorious and grand.  The aesthetic architecture sometimes takes me a while to achieve.

With doubt – it may be well known that doubt may give pause to trust and doubt may also give fear a basis for growth but, is it necessary to abolish doubt?  I don’t think so.
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The one picture above may give the impression that doubt and fear are along different paths than faith, hope & love but, i’m thinking maybe they are just different sides of the same road.
Doubt can give greater meaning and life to faith.  Doubt may give texture to hope.  I seem to sense a muddled truth in all this although my expression may be lacking.  But, I do think the two are more interconnected and doubt & fear are not necessarily bad things per se.

I like the following quote by MLK
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This may be something I ponder with today’s scheduled 30 minute run.  I’m not at the level yet where I can know the entire outcome of my runs.  I had a 76 minute non-stop run last week but a sub 12 minute run this past Monday.  I have hope and faith I’ll eventually get to where I want to be but ….I suppose doubt is the friend that’s helping to keep things exciting and palatable.

MLK’s quote reminds me of something I saw Jack Canfield say in a movie called The Secret.  He mentioned that we can drive, in the dark from New York to Los Angeles with headlights that can only light up a couple hundred feet in front of us.  Again, we don’t need see the whole road ahead, just enough for us to take us that next precious step.

In a way, I think being able to reel in our visions and sometimes only focusing on those next few steps can help us gain control over the fear we might feel by trying to look at a big picture which, we really don’t know anything about.  I don’t know much for certain but, I want to believe things will work out.

I want more life and more energy and running seems to be a very good conduit for interfacing with that energy.

Well, anybody reading this  – wish me luck 🙂  I’ve got 30 minutes running scheduled for today, another 25 minutes tomorrow and then 40 minutes this coming Saturday.  I will try to keep in mind LSD – Long, Slow, Distance.  This is what my running coach kept saying when I took a running class at SIUE.  anytime i had to stop he would simply say I’m going too fast and tell me to slow down.  That was how i started 20 years ago and how i started my training for my very first marathon.  And, I know I was cranking out tenths of a mile in under 60 seconds and was able to keep that up for several miles.

I want that again.  I have hopes & beliefs and time will ultimately grade these efforts.  Improvements have been made over the past three months and I must allow myself the opportunity to see if June is capable of another set of improvements.  No guarantee and the specter of failure is one with a very sharp and unforgiving edge to it.  Perhaps this is when bravery and courage enter into the picture.

We are brave when we do what we must in spite of our fear.

We believe when we trust in spite of our doubts.