Connective Tissue Reflex Manipulation, (Formerly known as; Connective Tissue Manipulation or CTM.)

Connective Tissue Reflex Manipulation is performed by the Physiotherapist using the soft pads of the fingers to move one layer of skin on the layer below. This movement creates a short, sharp, stretch reflex, creating an impulse, which spreads out through the connective tissue. The patient's brain translates this impulse as if it were a 'cut' or a 'scratch'. The tighter the connective tissue the bigger the stretch reflex and therefore the sharper the 'cut' feels to the patient. The reflex is a small impulse which passes through the fluid in the connective tissue and releases tension. The reduction in tension around the blood vessel walls allows more blood to flow into the damaged area and so reduces the inflammation. Softening the connective tissue also allows more movement to occur without causing irritation and therefore pain. Treatment often starts at a distance from the injured part gradually working closer to the source of injury. The benefits of Connective Tissue Manipulation are cumulative. Once the tension has been lowered by treatment the reduction is maintained. Further reduction in connective tissue tension occurs with each additional treatment. The degree to which the reduction in connective tissue tension is maintained is conditional upon the level of stress added to the system by the patient's lifestyle. Connective Tissue Manipulation is a technique learnt at postgraduate level in the UK and because of this it hasn't spread very rapidly around the country. At the last count, there were something like two dozen Physiotherapists in the UK actively practising Connective Tissue Manipulation. See History of CTM.

MANUAL LYMPH DRAINAGE (MLD)

Manual Lymph Drainage (MLD) is an Austrian technique, created by Dr Vodder in the 1930's, to manually 'unblock' the lymph system.
The effect of MLD is made longer lasting when used with the Connective Tissue Manipulation technique described elsewhere. Lymph is a clear almost colourless fluid which transports various substances from the fluid around the cells back to the blood vessels. It is important in the removal of bacteria, vitamins, hormones and waste products and also carries out vital functions in defence and protection from illness. The lymph system is part of the auto-immune system. Manual Lymph Drainage is a very gentle massage that uses stationary circles over the lymph nodes and superficial lymph vessels to improve the flow of lymph. If the massage is too firm the tiny lymph vessels in the skin are squashed and lymph is unable to flow. Stimulation of the lymph system enables more fluid to drain from the tissues back into the blood vessels in the base of the neck. Tension often builds up in the neck and shoulders due to stress or neck and upper limb injury. This causes the connective tissue to tighten and restrict the return of lymph into the blood vessels. There is a build up of fluid and pressure within the tissues, which causes pain and other symptoms. By stimulating the lymph flow with MLD and reducing the connective tissue tension with Connective Tissue Manipulation the backlog of fluid in the tissues is lessened. This reduces the pressure and therefore eases the pain. MLD is always used prior to Connective Tissue Manipulation for the treatment of upper limb and neck conditions. This improves the drainage before Connective Tissue Manipulation increases the blood flow. A patient with frequent headaches would be treated with Manual Lymph Drainage to ease the pain and Connective Tissue Manipulation to reduce the frequency of recurrence. See Lymph system.

THE MACKENZIE EXERCISE REGIME

Statistics show that 80% of us will experience back pain during our lifetime. With understanding of the working of the spine comes the ability to treat it with care and consideration. Back problems occur when a disc bulges backwards pressing on a nerve as it emerges from the spinal cord. This pressure causes inflammation and swelling around the nerve and therefore pain. Once the disc has started to move, the position of the spine affects the pressure exerted by the disc. By understanding how we can affect and change the mechanics of the spine, back and neck pain can be alleviated with THE MACKENZIE EXERCISE REGIME. The Regime helps to educate patients on ways to react when they first become aware that their back is in difficulties. Simple stretching exercises and special ways of using 'push ups' help adjust the mechanics of the back and help shepherd the discs on the move back into their rightful position. See Back Pain

The History of CONNECTIVE TISSUE MANIPULATION

In the late 1920's a Physiotherapist in Germany, called Elizabeth Dicke, suffered from a widespread infection of the blood vessels which affected the circulation to her right leg. She developed gangrene and her doctors wanted to amputate. As she had also developed angina, gastric, kidney and liver problems she was too ill for surgery and was effectively left in a side ward to die. She had agonising backache and being a Physiotherapist started to massage her back. She noticed an unusual, sharp sensation with the massage and an occasional warm sensation down her leg when there was a sharp feeling. She was so weak that she asked a colleague to continue to produce these strange sensations. Within four months her colleague had Elizabeth out of Hospital and started back at work within a year. She had normal circulation in her leg and her back pain, angina, kidney and liver problems had all resolved. Elizabeth and her colleagues then spent the next 10 years doing research into the new technique that she had discovered, finding out how it worked and what it was effective in treating. They set up a teaching protocol for all physiotherapy students in Germany. The English name for the technique is Connective Tissue Manipulation In the mid 1980's Jacqueline Flexney-Briscoe studied with a German Physiotherapist who was teaching Connective Tissue Manipulation in England. Jacqueline has since been developing the clinical use of the technique and combining it with Manual Lymph Drainage so that it can be used to treat any condition where the circulation is below par. Connective Tissue Manipulation is a post-graduate Physiotherapy technique in the UK and is not as widely used here as on the continent where it is part of the undergraduate study course. Because of its effect on the circulation and the reduction of tension within the tissues it is effective in treating not only muscle or joint problems area of swelling, pain or stiffness but also in the treatment of organ related problems like indigestion and constipation.