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Carol came to my office
on the advice of her friend who had
asked me during her own treatment for
low back pain if there was anything that
could possibly be done. I told her that
I have had a number of clients who have
had restless leg syndrome who
experienced a significant reduction in
symptoms and often were able to go off
their medication for restless leg
syndrome. Carol, a 65-year-old
retired school teacher, was having
trouble sleeping due to sensations and
movements in her leg at night. She had
gone the medical route and was taking
strong medication for what was diagnosed
as restless leg syndrome. However, her
symptoms were getting worse requiring
more medication, and she was beginning
to believe that it would be a life long
condition. Carol came to my office on
the advice of her friend who had asked
me during her own treatment for low back
pain if there was anything that could
possibly be done. I told her that I have
had a number of clients who have had
restless leg syndrome who experienced a
significant reduction in symptoms and
often were able to go off their
medication for restless leg syndrome.
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Restless legs, according
to Tabers’ Cyclopedic Medical
Dictionary, is a "…condition of unknown
etiology characterized by an intolerable
creeping and internal itching sensation
occurring in the lower extremities.
Symptoms are worse at the end of the day
when the client is either seated or in
bed. With the onset of symptoms the
client is compelled to move legs to
bring relief. …It can sometimes be
associated with kidney stones,
neuralgia, psychotropic medication,
trauma and excessive stress." |
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Massage therapists are
seeing an increase in clients with
restless leg syndrome since a greater
percentage of the population is aging.
It is unclear whether there is a higher
frequency of restless leg syndrome in
the elderly age group than before, or if
there are just more elderly clients.
Restless leg syndrome often becomes
apparent after the age of 40. Usually
clients who present with restless leg
syndrome have had long periods of high
stress in their lives.
When restless leg
syndrome is associated with traumas like
falls and auto accidents, I have found
that structural evaluation reveals a
significant structural collapse of the
client’s core distortion pattern which
involves an anterior/posterior rotation
of the iliums, a long/short leg, and a
tipped sacrum. This structural collapse
usually results in the client’s having
significant discomfort not only in the
legs but also low back and head, neck
and shoulders often including nerve
entrapments of the upper extremities.
Inflammation from nerve entrapments in
other parts of the body usually
increases the discomfort that the client
experiences from restless leg syndrome.
When the traumas such as a fall are so
severe that there are damaged the nerves
resulting in neuralgia, this is an
additional factor causing the client’s
discomfort and complicating the
recovery. Sometimes the traumas are
caused by surgeries that leave nerves
damaged or entrapped by surgical scar
adhesions. This again further
complicates the client’s symptoms and
recovery. When excessive stress is
involved with its negative effects on
the nervous system, client symptoms and
challenges again increase. In a worst
case scenario psychotropic drugs could
further complicate the client’s
problems. People do not take
psychotropic drugs without experiencing
stress in coping with their daily lives.
Sometimes the emotional stress that
leads to psychotropic drugs along with
the drug itself is all that is necessary
to produce the onset of restless leg
syndrome.
From the above discussion
it is apparent that there are many
conditions associated with restless leg
syndrome that can be effectively treated
with therapeutic massage.
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Stress is one of the
major causes and contributors to
restless leg syndrome, so it is obvious
that massage therapy is most beneficial
in reducing this stress and tension in
the soft tissue of the body. In
addition, massage also helps reduce
ischemia, inflammation, and swelling,
all of which affect the nerves of the
legs. Advanced therapeutic massage
techniques that use directed myofascial
unwinding strokes facilitate the release
of the tension from the holding pattern
found in the fascia that is often
chronic and makes it almost impossible
for the clients to relax on their own. |
The structural collapse
of the core distortion that was
mentioned earlier in association with
accidents and falls is present with
every restless leg case that I have
treated, even when accidents and falls
were not part of the client history.
When clients are in the structural
collapse of the core distortion the soft
tissue of the legs is in strain patterns
that greatly reduce the strength and
function of the muscles. In addition,
the muscles work harder, produce more
waste, become chronically tightened to
make up for the weakness, and develop
adhesions and scar tissue that tend to
entrap and impinge on the nerves. If the
focus is on rehabilitating the
structural collapse in the client’s
pelvis and legs as part of the treatment
for restless leg syndrome then you will
be addressing the source of the
inflammation, irritation, ischemia,
chronic tension and nerve entrapment. As
the structure improves the muscles of
the legs won’t have to work as hard and
won’t become so fatigued.
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When the structural
collapse of the core distortion is a
result of trauma or surgery, often the
scar tissue that builds up at the site
of injury (or surgical wound) is a major
contributor to the nerve entrapment or
neuralgia associated with restless leg
syndrome. Again advanced therapeutic
massage that softens and normalizes the
adhesions and scar tissue that entrap
the nerves has a significant positive
effect in reducing restless leg
syndrome. |
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The 3-step approach is
extremely effective when applied to
structurally balance the collapse of the
core distortion. The milking strokes
reduce fluid ischemia and inflammation.
The directed myofascial unwinding
strokes reduce the myofascial holding
patterns and unwind structural
distortion. Then the individual fiber
strokes lengthen tightened fibers and
soften and normalize scar tissue and
adhesion.
When Carol, the retired
school teacher, started therapy she was
in a structural collapse of the core
distortion and had a history of an auto
accident 10 years prior. At the time of
the auto accident she had been treated
by a chiropractor for a whiplash injury
with the focus solely on her neck area.
Unfortunately, the imbalance of her
pelvis that had become worse due to the
accident had not been addressed. In
Carol’s last eight years of teaching she
had developed low back pain from
standing on her feet while in this
structural collapse which only made her
symptoms increase. The structural
collapse of the core distortion left her
with only 30-50% of muscle strength in
about half the muscles in her legs due
to the strain patterns in the structural
collapse. This resulted in further
tightening of the myofascial holding
pattern to compensate for the weakness,
and the development of adhesions and
scar tissue where there was tissue
damage due to long hours on her feet
without a balanced structural support.
Shortly before she retired at 63 she
noticed her first symptoms of restless
leg syndrome. At this point she was in a
significant structural collapse with
back pain, strain patterns going down
both legs, a myofascial holding pattern
compensate for the weakness, and the
formation of adhesions and scar tissue
were starting to entrap nerves. The
physicians who had examined Carol were
only interested in the nerve sensations,
and had not paid any attention to her
structure or the soft tissue
involvement. Consequently the only
therapy or solution they could offer was
medication which had its usual negative
side effects.
When Carol came for her
first session I applied a low back
structural balancing protocol which
included the 3-step approach that
allowed me to work deeply to effectively
address the soft tissue restrictions
while staying within her pain threshold.
Carol had a left anteriorly rotated
ilium and a right posteriorly ilium
which produced a long left leg and short
right leg. The sequence of this protocol
first addressed the specific muscles and
soft tissue on the anterior hip and leg
to allow the ilium to rotate into
balance posteriorly and to release the
distortion that had developed in longer
leg. Then the specific muscles and soft
tissue were addressed on the posterior
hip and leg to allow the ilium to rotate
into balance anteriorly and to release
the distortion that had developed in the
shorter leg. This initiated the
structural rehabilitation, and the
adhesions and scar tissues that were
entrapping the nerves were addressed
from the very first session. After
several sessions using this same
protocol Carol reported that she was
having less severe and less frequent low
back pain and a decrease in the
frequency of her restless legs symptoms.
We continued on a weekly basis with the
same protocol for three more treatments.
When she came for her next session she
reported only one instance of low back
pain for the entire week which occurred
after a long shopping trip to the mall.
She also had only one instance of
"creepy leg" which was during the night
after her shopping trip. After two more
sessions using the same protocol, she
reported no low back pain or restless
leg symptoms for the entire week. She
was scheduled for two more sessions 10
days apart, and again reported no low
back or restless leg symptoms during the
10 days. As she continued to improve she
was able to schedule at two week and
then three week intervals.
Treatment that focused on
rehabilitation of the structural
collapse of the core distortion not only
effectively addressed her low back pain,
but also the symptoms of her restless
leg syndrome. As the sessions progressed
deeper strokes were able to be applied
to the tissues using the 3-step approach
to release the deeper adhesions and scar
tissue. As her body softened, the
inflammation, swelling and ischemia were
reduced, the myofascial holding pattern
was released, and these deeper tissues
became more readily accessible. I have
found that working in this manner on
clients with conditions like restless
leg syndrome is the most effective way
to have long lasting positive
therapeutic results.
Don
McCann, founder Structural Energetic
Therapy |
