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Post-op muscle pains may persist for years if the injured area doesn’t recover as it should. Photo: Shutterstock

How a holistic approach can improve post-op recovery

When chronic pain stubbornly lingers after surgery, sufferers may find that relief lies in neuromuscular treatments

When chronic pain stubbornly lingers after surgery, sufferers may find that relief lies in neuromuscular treatments

Many of us know someone who’s had an injury and never quite recovered, or we’ve experienced the struggle firsthand.

Perhaps it involved a torn muscle, or a broken bone that requires surgery. Perhaps there was nerve damage.

As far as the surgeon is concerned, after his part, the problem is fixed. And yet, something’s still not quite right. The person’s movements may never be as carefree, agility may be lost, and often the body simply becomes less flexible. They may also start to suffer seemingly unrelated injuries as the body tries to compensate for the weakened parts.

This is an indication that the body is out of balance.

The problem often lies within the nervous system, resulting in part from a lack of attention given to its role in recovering the body from injury and surgery.

When the body is damaged – say a muscle – the nervous system goes into overdrive to protect the area. For muscles to function properly, fibres need to be aligned in the same direction. But when a muscle has been injured, the body’s initial repair process creates an area of randomly aligned scar tissue. This becomes a weak link that is susceptible to re-injury.

But why? The nervous system reacts to even microscopic areas of scar tissue by keeping the muscle in a shortened, inflamed and usually painful state. Inflammation is the first stage of healing – by keeping the muscle short, the nervous system is trying to protect it from further harm.

Yet, the shorter and tighter the muscle, the less freely it moves. Over time, your nervous system may become so used to being in this heightened state of overprotection that it becomes stuck in that pattern, and this can result in chronic pain that persists for months or even years.

After surgery, the surrounding area often feels dead, or numb. Pinching the skin may not result in a correlative sensation, and this is indicative of a condition called “trauma reflex” – what happens when an injury alters muscle/movement memory.

Alone, strengthening and stretching are often inadequate to return muscular behaviour and movement to normal, because the nervous system isn’t being “exercised” as well.

Enter neuromuscular therapies – techniques that incorporate sensory re-education exercises (under supervised therapy) with correlated physical movement patterns to relearn correct movements. In other words, by tapping into the brain-body connection.

These types of holistic therapy fall under the category of somatics and include techniques such as the Feldenkrais method – designed to reorganise connections between the brain and body, and to improve movement and the psychological state – and Hanna Somatics, another form of mind-body re-education.
Moshe Feldenkrais, an Israeli engineer, founded the Feldenkrais method to improve the body’s functions by increasing self-awareness through movement.

In a Feldenkrais session, a practitioner focuses on habitual movement patterns that are weakened or compromised. Through gentle and slow repetition, the goal is to create new habitual movements that then become cemented in the brain, and therefore the body. The movements are either performed by the practitioner on the student, or by the student themselves.

The effectiveness of such holistic methods of treatment remain a contested topic, but there’s no shortage of proponents hailing the benefits of incorporating neural recovery methods in the healing process.

For some chronic sufferers struggling with limited movement or discomfort, particularly after surgery, a neuromuscular approach may help provide the relief they’re desperately seeking.

Six guidelines for performing somatic exercises, and two sample exercises

•Find a comfortable place, free of distractions

•Wear comfortable, loose-fitting clothes

•Perform each movement slowly, with minimal effort and no pain; never force it

•Mentally focus on the internal sensation of the movement

•Fully relax muscles before moving on to the next exercise

•Perform the exercises at least once a day, to maintain and strengthen the neurological pathways from the brain to the muscles

To release the lower back muscles:

Lie on your back with your knees bent. Concentrate on the sensation of deeply inhaling and exhaling, feeling your belly rise and fall with the breath. As you inhale, arch the lower back, and notice that the back is contracted, whereas the belly is lengthened and soft, and the neck is pulled long. And rather than force the back down, exhale while the body softly and gradually melts to the floor.

Notice how this lengthens the back muscles and slightly tightens the abdominals, returning the neck to its natural neutral curve. Now visualise the lower back as a rolling pin, and feel yourself rolling out dough as you arch and curl. Alternatively, you might try visualising your spine like a tide ebbing and flowing. Visualise in a way that works best for you, and repeat 12-15 times, concentrating fully on the movement.

Simple neck & shoulder release:

Lie on your back with your knees bent and feet on the floor. Reach both arms towards the ceiling, and imagine you are holding onto a large, heavy rope. Reach the right arm as if to pull yourself up the rope, and let the body respond to the movement fully. Notice that the left shoulder drops more heavily to the floor as the right arm reaches up. Mind the rotation of the neck. Release the right shoulder back to the floor, and repeat the reach with the left arm.

Continue to alternate arms while gazing up and visualising yourself climbing a rope. Stop after 10 sets and relax the arms, taking a moment to absorb the movement. Now, reach the right arm up the imaginary rope again, and this time slightly lift the right hip. Continue to alternate side to side, and visualise yourself being gently rocked, as if in a boat. Notice how your back opens up as you roll through this movement.


This article appeared in the South China Morning Post print edition as: Pangs for the memoriesSomatic exercise to relieve lower back injuriesSimple neck and shoulder release
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