It’s over 5 years now since my life changing experience. An epiphany if you will. For some people this may might be finding religion. For some it may be the birth of a child. For me it was a weekend course with South African Physiotherapist Douglas Heel! Granted I should get out more. 5 years on here’s my story of how Doug’s Muscle Activation techniques have transformed my practice and a critique of the effectiveness of the techniques from a therapists and clients perspective.
A little bit of history to give the story some context. I qualified as a Sports Therapist back in 2004. I’d spent 7 years working hard to become as proficient as possible. I was using an array of Sports Massage techniques combined with a variety of physiotherapy techniques primarily involving Maitland and Mulligan joint mobilisation. With some exercise based advice – for those rare clients with motivation to do any exercises! See previous post Does Exercise Based Physiotherapy Actually Work?
I had recently added a neurological slant to my work having greatly enjoyed the NOI Groups courses. Enabling me to join nerves and muscles together from top to toe and investigate there interaction for the benefit of the clients.
I had developed a methodology. One I believed was pretty good. Even if I do say so myself! To grossly simplify I was mobilising the nerve root of the muscles I was looking to affect before treating the muscles – including synergists and antagonists (that’s muscles that work with and oppose muscles for the non-technical readers).
This seemed to be reasonably effective. But there was something missing. Sometimes it worked perfectly. Well as much as things can be perfect when dealing with the human body. Other times it worked a little bit. But sometimes it just didn’t work at all. What was I missing?
What Happened In April 2011?
Not that I’m a sucker for marketing, but I found myself watching one of Doug’s promotional video via the Physio UK website. It showed him testing psoas (your main hip flexor) before and after his ‘magical’ intervention. It really did seem too good to be true. Curiosity got the better of me. I put my hand up (no that’s not me!) and I signed up to the course immediately. Leaving my my bank balance somewhere bereft!
I went along to the Be Activated course in April 2011 looking to get a magical new trick to get the exceptionally important psoas firing as I would like. This would fit very nicely into my tool kit and current model and allow me to push my treatments onto the next level.
What I hadn’t bargained for was having to rip up everything I had been doing for the past 7 years and start from scratch on Monday morning. With a clearly more effective, totally different approach to the bio-mechanics.
So How Effective Is Muscle Activation?
Very! I actually didn’t want it to work. Surely it meant all the previous learning was wasted? I still remember hating that first week back at work grudgingly fixing clients that I’d been struggling to get a long term solution. Having to admit this new approach was clearly the way forwards.
Of course I’ve since been reminded that nothing is wasted and all of the old skills and knowledge have merely been built upon. I even throw in a mobilisation every now and then! But it was a very scary process.
The real proof is in the pudding of course. In April 2011 I was a one man band working out a room in my house in Swindon. Fast-forward 5 years and I now have 2 clinics and a total of 4 therapists working for me. I’m not about to give Doug all the credit for this. There’s been a lot of hard work going on behind the scenes. But would I have been able to it without the Activation revolution? Probably not.
This is just the headline to illustrate the point. The more important fact is that clients were getting better faster. I was beginning to get a reputation! The clients attracted to the clinic were getting more and more challenging as reputation built. Why wait 6 weeks to see if some exercises that clients probably can’t be bothered to do will make a difference when you change a bodies movement pattern in a matter of minutes?
What Is It Great At?
Muscles. Lots of them. All of them! And by implication joints too. Here’s some thoughts from the last 5 years as to where it works particularly well:
- Calming The Nervous System – Calming people down. When people are more stressed out, tired, emotional they feel more pain. The combination of breathing work and being able to interrupt that with the techniques is invaluable. Releasing the diaphragm and psoas just seems to turn the volume down on even the most painful of conditions. The adrenal points, front and back further add to this calming effect.
- Sorting The Wood From The Trees – You’ve just sat down with a client. They’ve told you their life history and they’ve explain in great detail 4 conditions in one. Using the activation frame work it’s quite possible to get a shift in all 4 conditions at the same time. It enables you to see if there is a genuine issue locally with the tissues that feel pain or they were merely a scapegoat for bio-mechanical imbalance.
- Low Back Pain – Everyone wants the magical panacea for low back pain. It may well just be the posterior adrenal activation point. Never mind affecting calf length. Get involved to sort back pain! For the non-technical this a little magic button stolen from Chinese Meridians. It’s buried within the muscles either side of your low back and seems to be responsible for a whole lot of back pain.
- Developing Clinical Intuition – You start thinking in different ways very quickly. Previously if I’d have seen a client clenching their jaw I wouldn’t have thought twice about it. Now it leads me down a whole other path of clinical reasoning. And it’s fun. It gives you a platform from which you can grow and further expand your clinical knowledge. I think my favourite one still to date is fixing someone’s right knee by rubbing their left temple! It took me a while to justify it, but I got there.
When Is It Not So Great?
Of course no system is fool proof and Doug himself talks about using the approach with any other techniques you see fit that will compliment the techniques. Now this sounds a bit fluffy but the one to be wary of is when people just aren’t ready to go there. I feel I need to elaborate on such a non-descript sentence.
One of Doug’s many catch phrases is of course: “Whatever is in the mind is in the body.” I couldn’t agree more with this statement and the latest in pain science is agreeing with this. If you have a client in front of you who, for example, is going through a lot then you need to ask the question is this person ready to let go of these problems. In some cases they are not. It takes a great deal of clinical experience and confidence to realise when the best thing to do is not to actually treat the client but talk to them. Once you have a addressed the psychological side of the problem you will of course get better results.
Genuine muscular issues. I have no doubt that the Activation’s work as desired. I have tested and tested the theories. I’m the kinda guy that needs evidence! Sometimes even if there is no pain on the activation site it will still have the desired effect on the muscle you are trying to improve. On occasion however the lengthening in the muscle does not last. It’s at this point that my old Sports Massage skills come in handy to release the offending trigger points. If the activation hasn’t been ‘sticking’ these are usually quite knarly!
Even in this case I find that the muscle will respond better after the muscle has been activated. A great example of this is an ACL reconstruction case – I’ve seen plenty. The Activations are fantastic at desensitising the area around the knee which then allows you to release the muscles around the creaky knee without aggravating the previously sensitive area.
This approach can be applied all over the body. Desensitise the area using the muscle activation approach to bio-mechanics and then any localised work you do simply works better. Of course in many cases by the time you’ve been through your Activations you don’t need to touch ‘the bit that hurt’ at all.
What Can It Do For Me?
For any potential clients who’ve got this far through the blog well done! What it can do for you is give you a far more effective treatment option than traditional physiotherapy methods can give you. For a lot of people we’ve treated it’s given them hope and ended in a huge change in the quality of life. If you’re based in Swindon or Brighton great. Give us a shout. But if you’re not still get in touch as we’ll hopefully be able to find an activator near you using our wider activating network!
For any therapists who’ve got this for down the blog, well done. Thanks for taking time out of your busy schedules to read these words. My advice to you. Stick with it. It can be daunting changing your approach and the temptation is to always stick to what you know. But maybe what you knew isn’t now what you know?!
I would further condone Doug’s philosophy of adding anything that compliments the activation work. We use the activations as the basis of our daily practice. But, every now and then, we throw in a joint mobilisation. Maybe a bit of massage and in certain circumstances that just seems to get the client that little bit further. Respect and learn from the past but don’t be afraid to walk boldly to the future.
I would say that Muscle Activation will help in the region of 80% of clients. If this was a randomised controlled trial this would unprecedented! But it’s not and there are still those 20% of people. What I’m currently working on is an approach that will help the remaining 20%, get that 80% even higher. Am I ever going to get to 100%. No. Am I going to still chase the impossible. Yes! I suggest you do to. It’s more fun that way 🙂