This series was first published in 2014 for Arizona Dance e-Star, a publication of the Arizona Dance Coalition. In this series of articles you’ll learn how to treat low back pain… hip and groin pain… knee and leg pain… and ankle and foot pain. In Part 5 I’ll discuss the history of the Kraus-Weber Test, what happens when you rely on “RICE,” and the value ot using myotherapy and corrective exercises on a sprain within that Golden Hour.
In the early 1930s, a young Austrian doctor whose specialty was repairing fractures was preparing a medical paper using several 100 patients. All the patients had wrist fractures and casts. As part of his study he gave half the group simple exercises to do such as shrugging the shoulders. What he noticed was that the ones who did the exercises healed better and faster — even when the injuries were worse.
As a teenager this young doctor’s hands had been badly cut up during mountain climbing. He had tried to hold the rope as his friend fell to his death and in the process the rope had cut his hands to the bone. The local doctor bandaged him up with the instructions to leave the bandages on for several weeks and use the hands as little as possible. And he added:
“Your hands will never heal completely and you will never regain full use of your hands.”*
This was quite a sentence for a 16 year old who loved to climb. One voice told him to follow the doctor’s orders. But the other inner intuitive voice told him that the body needs movement for health and healing.
He prescribed his own treatment based on movement: warm water and gentle stretching. In a few weeks his hands were completely healed. This young man was Hans Kraus. He went on to become one of the foremost sports doctors in the world and one of top rock climbers in the world — both of which require strong, steady and flexible hands.
While in Austria young Dr. Kraus, who graduated from medical school in 1930, worked out at the local gym with his friend Heinz Kowalski. KO (as Dr. Kraus called him) was a circus performer, boxer and president of the Austrian Sports Teachers Federation. While talking sprains and fractures one day, KO relayed how injured circus performers treated themselves so that they could perform the next evening: steam followed by gentle movements.
The following week two injured teen skiers showed up in the young doctor’s office with badly sprained ankles. This was not uncommon in 1930 when boots were soft and offered no support. Dr. Kraus explained the treatment of the day: a cast for two months and no skiing. After lamenting two months in casts and off the slopes, Dr. Kraus told them what he had just learned. The boys were game and after showing them the treatment (heat and exercise), they went off to carry out instructions. The next day they were back, greatly improved. They followed the treatment on their own and in a week were back to their joy of skiing.
When Dr. Kraus immigrated to American in 1938 he brought IMMEDIATE MOBILIZATION with him.
The Golden Hour
The best time to treat a sprain or strain is in the first hour following the mishap. It is called ‘the golden hour.” The quicker the treatment the less time the body has to get organized against itself. Have you ever noticed that if you were out for a hike and a sprained ankle occurred, if you kept going you could get back home? Then you were so happy to have made it home you sat down and put your foot up. Almost immediately your ankle started to swell, the pain increased, there was limited range of movement and your ankle began to turn black and blue.
When a sprain occurs, the body’s programmed reaction is to send help in the form of muscle spasm as a protective measure. Muscle spasm means that the trigger points light up, everything tightens up and the “doors close,” preventing the newly formed injury debris from leaving the site. The swelling begins and then pain accompanies it. The compression doesn’t allow the debris to go anywhere. Elevating gives you the opportunity to stay put and icing keeps you busy.
Bonnie Prudden, Myotherapy, Trigger Points and M.I.C.E
Bonnie Prudden knew Dr. Kraus from 1938 when they met in the “Gunk’s” — a climbing area in NY. He mentored Bonnie’s climbing career. She also worked in his N.Y. medical office overseeing exercises for bad backs and other muscle problems. In 1976 when she developed Bonnie Prudden Myotherapy®, she added Myotherapy and Corrective Exercise (MICE) to Immediate Mobilization, enabling the process to become even more effective.
One of our Bonnie Prudden Myotherapists, Angela, lives in the Philippines. She was privileged to work with the National Philippine Ballet Company. During that time she treated every ballet injury you can think of and recorded her results. Her success rate was remarkable.
Here is what she did:
M Myotherapy — First she addressed all the trigger points. This relaxed the muscles and opened up the pathways.
I Ice — Not necessary, but if it feels good then it can be used.
Bonnie Prudden Myotherapy® Treatment
Suppose you sprain your ankle. In Part II of this series, you were shown how to erase low back pain by finding and treating trigger points in the seat muscles. That is where you start: your feet begin in your seat!
Begin by locating and treating the trigger points in the seat, and then move on to the groin and upper legs as shown in Part III of this series. This begins the process of relaxing the muscles and opening the pathways.
After Quick Fixing the seat, groin and upper leg, move to the lower leg and feet for a more thorough treatment of the trigger points as shown in the June issue (Part IV).
When you get to the ankle you may only be able to use fingertip pressure. That is Ok. The treatment will still be effective.
Slowly point the toe downward, upward, inward and outward. Repeat 4 times. Do this often throughout the day. You are encouraging the muscles to pump out the debris from the injured area. That means less swelling, less pain, more mobility and faster healing.
Resistance Exercises For The Ankle
To speed the recovery even more, add resistance exercises using the same pronation, supination, inward rotation and outward rotation. If you thought to measure your ankle prior to treatment you could note the difference with the tape measure.
1. Have your friend support the ankle at the heel and place her fist against the ball of your foot.
2. You press the foot down against resistance: #1, 2, 3, 4.
Note: Resistance must not be so hard that you can’t push, nor so light as to prevent a real squeeze of the muscles. You need to be able to go through a full range of motion with a steady rhythm.
But What If?
What if my ankle is really broken? If you have any doubts, head for the emergency room. But on the way, start looking for and treating your trigger points. You don’t want to waste any time. Remember the “Golden Hour.” If you really do have a broken ankle, clearing the trigger points from the seat, hip, groin and leg will not fix the problem but it will help start the healing process. It will help restore circulation, get the debris out and bring healing nutrition to the area.
If your ankle really is broken and over time you heal but develop a limp, continue with your trigger point work, your exercises — including the resistance — and one more thing: walk backward to music. Limping backward is not a part of your brain program. We have found over and over that lasting limps reprogram OUT when walking backward to rhythm.
An Extreme Example
A friend was putting in fence posts using a rotating tool to make the holes. The tool caught on the barb wire which started wrapping around her lower leg. While getting herself untangled she yelled for help and immediately started her trigger point search. Although her injuries were very ragged and very deep, her recovery was swift and without any limitation. The depth of the wrapped-around barb wire scars was lasting evidence of the severity of the accident — and also the efficacy of Bonnie Prudden Myotherapy® and trigger point treatment.
NEVER underestimate your own ability to take charge once you have the information needed for whatever situation you are in.
Next month I’ll tell you how to test the children in your classes so that you know their muscle strengths and weakness.
For more information about Bonnie Prudden®, Bonnie Prudden Myotherapy®, workshops, books, self-help tools, DVDs, educational videos, and blogs, visit www.bonnieprudden.com. Or call 520-529-3979 if you have questions or need help. Enid Whittaker, Managing Director, Bonnie Prudden Myotherapy®.
Drawings by Bonnie Prudden.
* Into the Unknown: The Remarkable Life of Hans Kraus, by Susan E. B. Schwartz