A day in the human dissection lab

Last week I spent a day in a human dissection lab.  It’s not the normal place to spend a windy Wednesday, but nonetheless I’d been looking forward to it in the same kind of way as people look forward to going to Alton Towers for about 8 months.  In fact it was visiting Gunther von Hagen’s Bodyworlds Exhibition three years ago that made me decide I wanted to change careers.  The presentation of plastinated bodies in their sporting poses got me hooked on functional anatomy – what an incredible assembly of pullies and levers, electrical circuits, pumps and mechanics we are!

Bodyworlds Exhibit "Running Man"

But despite my enthusiasm as we climbed the stairs to the dissection lab at King’s College London my nerves began to kick in – what if I were to have an involuntary reaction that people speak about, and pass out on the floor?  What would the smell be like, and would I actually be able to bring myself to palpate the specimens?  We reached the double doors at the top of the stairs and I was ready to walk through and pick up my white coat and gloves and receive our briefing but BANG we were straight in – oh my goodness.  Within a few seconds I realised that this was the best way to do it though, there was no putrefaction smell and I breathed a sigh of relief.  We skirted around thirty gurneys - some closed and some open revealing various specimens, to our briefing area which was surrounded by pots full of further dissected specimens.  Wow!

We were given the format for the day, a little workbook, a white coat and gloves and invited to wander around and acclimatise ourselves to the environment.  And so it began…  I approached the first table really nervously and was presented with two legs dissected at the hip, with skin and fat removed to reveal the impressive musculature of the quads, hamstrings, gastrocs and soleus.  And now I can immediately understand how knee problems are created by muscle imbalances in the leg, and how a tight ITB can alter gait and hinder progression.  It’s one thing looking at 2d images and computer simulations but to see the muscles spiralling around a leg and inserting into the knee really helps you to understand how we move, and how injuries arise.

Bodyworlds Exhibit "Basketball Player"

We spent an hour or so picking up and palpating the specimens, seeing how muscles contract and lengthen in movement, checking out real origins and insertions, comparing the differences between specimens and pretty soon most of us were completely absorbed in what we were doing and all our nerves had disappeared.  I was blown away by the thickness of the sciatic nerve, and how it passes through/around piriformis in the buttocks which in itself was so surprisingly small.  Such a little muscle can cause so many problems!  And further amazed by the depth and thickness of psoas – no wonder it’s a nightmare to stretch and contributes to back pain and disfunction.

After a little while we were invited to open the closed gurneys which contained entire donors.  Their faces were covered and all we knew about them was their age, sex and cause of death.  It wasn’t the first time that I’d seen a corpse but for some people it was and we were mindful of our colleagues’ reaction as some chose to stand back or sit down.  Everyone was composed, dignified and completely respectful - carefully removing the plastic and choosing to keep the donor’s face covered.  Gently palpating and exploring the bodies I was struck by (and I know this sounds ridiculous), quite how lifeless and inanimate they were.  It didn’t upset me – their life had left, and what remained was a vehicle that served them all brilliantly until an excellent age of 80 plus.  This body, this complex assembly of sciences had escorted them through amazing lives and now these very generous people and their families were allowing students to learn from its successes and ultimate failure.  What very kind people these were, and how privileged were we.

Phewee…  What an amazing experience, and as somebody who struggles with books I learned more functional anatomy in that day than in two years of referring to my anatomy books.  A big thank you to the staff at King’s College London, the London Massage Company and of course to everybody who carries a donor card.  If you have any questions please email me at georgie@gbsportstherapy.co.uk.

New technique offers huge benefits for clients... Targeted, effective scar-tissue removal for improved function and performance.

Neuromuscular Re-education (NMR) is a “stand-alone” hands-on technique for the evaluation and functional treatment of 90+% of soft tissue injuries, and it’s now available via GB Sports Therapy.  I’ve chosen to incorporate this powerful technique because of its huge success in treating common injuries presented by athletes and more amateur trainers alike.  It’s quick, successful, targeted and actively involves the athlete in their treatment - encouraging participative investment in their own healing.

Dr Peter Levy, NMR Founder says; “When an area is injured, whether it's muscle, connective tissue, fascia, tendon or some combination of these elements (as most injuries are), the body handles this inflammatory response the only way it knows how - through a hyperplasia of the affected tissue followed by a fibrous healing, the laying down of a less elastic, second grade, poorly vascularized scar tissue to protect the involved areas. Adhesions occur wherever damage and inflammation have occurred and they limit both strength and range of motion". 

Once there is fibrous healing these adhesions pull us out of a three dimensional orientation with gravity. As a muscle tendon begins to stretch and encounters an adhesion, the muscle contracts to prevent any further stretching and to protect the area involved.

The result is that the muscles involved are not as strong and the range of motion is limited in the involved joint. Adhesions can affect areas that are quite small, sometimes just a few muscle fibers, and other times there can be a number of areas like that scattered throughout a muscle group.”

The NMR technique is now being incorporated into sessions where appropriate, and is also available as a 30 minute appointment where appropriate.  Please contact GB Sports Therapy for further info; 07588 605276.

Some time with Saracens Rugby Club

I’ve been very fortunate this week to spend some time with current England champions Saracens, at their home at old Albanians, St Albans.

I wanted to get hands-on with some seriously developed physique and see how the techniques that I use in everyday clinic need to be adapted to deal with the extreme forces that their bodies are put through, and get some top-notch rehab experience.  And of course, to be pitch-side at a game would be the icing on the cake! 

A friend of mine told me to expect injuries akin to being in a car accident – shoulder dislocations, whiplash and head trauma.  Blimey, she wasn’t wrong but I didn’t see any acute injuries of this degree as the season’s just opening, but I had great contact with all of the players that had surgery at the end of last season, and I was able to shadow their rehab and talk to them about their progress and hopes for the premiership.

The excellent experience was topped off with pitch support at a victorious game against Esher, where the Sarries won 30:10.

Below are a few select pics from my time with the Sarries, you can also view Training and Physio pics, and Sarries vs. Esher pics.  
I would like to thank the Vickers family, the Sarries medical team and of course the players for letting me sit in on their treatment.  

Physio Room

Richard Wigglesworth receives treatment
after sustaining a head injury
playing for England

Former England Captain Steve Borthwick
undergoes enough taping to constrain a small
mammoth.  Steve had AC shoulder
surgery at the end of last season

Hip-flexor stretch to Steve Borthwick.
Pelvis is stabilised by the physios weight

No 8 Ernst Joubert in proprioceptive
rehab for an  inversion sprain.

Assessing Ernst's flexibility and strength in anticipation
of return to the squad.

Dry needling to tibialis anterior and peroneals

Dry needing to tibialis anterior and peroneals

Prop Carlos Nieto has pressure and ice applied
to a grumbling hamstring

Increasing hip ROM with a belted technique

Saracens vs. Esher

Pitch support

With hooker Schalk Brits

Scrummage!

Kameli Ratuvou leads the dressing room celebrations

Photography for the GB Sports Therapy Website

A very good friend who is fortunately blessed with magnificent photographic skills, has buddied up with me over the last week or so; photographing treatments and various bits and bobs for the forthcoming GB Sports Therapy website. 

Thank you, Jayne Odell, Jim Rees, Tracey Davidson and Danielle Smith.

 Here’s a select few…

and finally...

Supporting the RAF Pathfinder March

You just can’t beat the atmosphere of a charitable event whether it’s a 5k run, marathon, or Race for Life.  Thankfully I don’t personally have to put myself through any of this pain, but I do like to do my bit for charity and provide massage support on these occasions.  Recently I did something a little different – a gruelling overnight event called the RAF Pathfinder March.

The Pathfinder March was inaugurated in 1997 to commemorate the Pathfinder Force which operated out of RAF Wyton, Gravely, Oakington, Warboys from 1942-1945.  Flying Halifaxes, Lancasters, Mosquitos, Stirlings and Wellingtons, the Force was instrumental in the outcome of the second world war.

The historic event is an annual 46-mile walk/run with a route taking in the four main RAF bases in the south east.  Walkers set off at 4am, and the masochistic runners get going a couple of hours afterwards.  It’s a gruelling test of strength, stamina, mud-wading and map-reading skills!

The swiftest runners chasing their personal bests started to come through to us at their second rest-base at about 10.45 am, where the majority of them took advantage of some relief to their aching leg muscles and backs.  Some of these guys were carrying full combat backpacks and were grateful to disregard them for a short while.  Also on hand were the RAF medics, thankfully relieving us of blister duty!

A fantastic 250 out of 300 of the walkers and runners made it through to the finish-line after lunch and into the evening.  What a brilliant outcome!

If you know of an event that would benefit from free post-race massage then you can make a nomination by contacting me with a brief outline.

Sunday - a day of rest?

I got thinking about the importance of rest and rehabilitation after speaking with a friend of mine this Sunday morning as he buzzed around the house hoovering…  I jokingly made the comment “but today should be a day of rest – quit the housework!”

Any personal trainer or coach will tell you how important it is to actually build rest into your workout/training regime - primarily to allow your body to recover from what you put it through, whether you’re an elite athlete or a devoted gym-goer.   But I guess that’s not really an excuse for the housework not to get done ;-)

What about rest after injury? 

Rest after injury promotes full rehabilitation and the safe return to sport, but it’s so difficult to alter the mindset and to actually take time out or train differently.  When all our friends are training together and there is the fear of gaining weight or halting development, the fear of “missing out” will often push people into continued training and further towards re-injury. 

So often an old injury will reoccur with more severity than before because rest and rehabilitation has not run its full course.  If you sprain your ankle for example, the ligaments that surround this joint will lengthen and loosen (and in some cases rupture).  Just resting and doing a few ankle rotations until it feels a bit better will only return its function and strength to a small percentage of what it was before, and six months later it’s highly likely to resprain or break.  A thorough rehab programme will go a long way to ensuring this doesn’t happen. 

Think of it like this – if you don’t complete a course of antibiotics, how often does the condition reoccur within a couple of weeks?

Better than 100% performance

Through rest and the adoption of a good rehabilitation programme it is normally possible to achieve an outcome of greater than 100% original performance.  This sounds a bit silly – but if you can make that ankle stronger than it ever was you can ensure that the risk of re-injury is minimal, and achieve the confidence to excel and push towards that new personal best without fear of reoccurrence.

Rest – it’s not just about stopping doing something

The reason that most of us enjoy sport is because of the sense of wellbeing, being part of a team etc that it makes us feel.  If you take that away from anyone that needs it in their life, they’re likely to experience a major downer.  Bearing that in mind, except in cases of a major injury or illness it’s nearly always possible to mix up your training by substituting what you ordinarily do, whilst still incorporating a rehab programme to improve the injury.  This type of rest keeps you involved, helps you see progression, and ensures that you’re doing your very best to return to your full potential as quickly as possible.

Remember the antibiotics analogy?  Rest up and finish the course so that you’re back to your full capacity for whatever sport/housework is your preference!