Part II – Proprioception in FM and MPS: Are you a bull in the china cabinet? What can we do? by Celeste Cooper

In “Part I, Proprioception: Are you a bull in the chinacabinet? Is it fibro or myofascial pain syndrome?”  we talked about proprioception, what it is and how it relates to fibromyalgia (FM) and myofascial pain syndrome (MPS). 

PART II

It’s morning and if you are like me, you can see that your feet are attached to your body as you place them on the floor. Unfortunately, for some of us, as we start to walk, our appendages seem completely unaware of where they are. Our feet should go in the direction we believe we are headed, and our arms should not hit door jams that we have lived with for 10+ years. Slam, bang, crunch, there’s that darn wall again.

What can we do to improve balance and minimize 

the bull in the china cabinet effect?

Treating the myofascia

For the myofascial pain syndrome group (considered by many as the most apparent comorbid disorder to FM, usually a pain specialist, physical therapist, or body-worker) treating trigger points  in sternocleidomastoid and its branches is imperative.

The first treatment suggestion is to identify and correct perpetuating factors and adapt trigger point therapies that calm the hypersensitive areas in the myofascia.

Perpetuating factors include poor spinal alignment, repetitive motion, static positioning, carrying a purse or backpack that is too heavy, head forward posture, extended computer time, ill fitted chair, out of control comorbid conditions, etc.

Releasing trigger points by manual techniques can reduce or alleviate pain. However, it is important to remember that if you also have FM or CFID, the release of cellular byproduct from muscle manipulation can instigate a flare of FM or CFID symptoms. Stay hydrated, even after self-treatment. 

“Trigger points do not respond to positive thinking, biofeedback, meditation, or progressive relaxation. They respond only to physical intervention. However, positive thinking, biofeedback, meditation, and progressive relaxation can help prevent the stress that is thought to aggravate chronic myofascial pain.” (Cooper and Miller, 2010)

Therapies to improve balance

Therapies that are thought to improve balance and proprioception are T’ai Chi, gentle chair Yoga, gentle stretches, whole body vibration, and myofascial release. Also helpful is to balance on a therapeutic ball to improve your kinesthetic awareness (in this case, knowing where your legs and feet, and arms and hands are located). Neuroscience validates that we can train our brain. People with traumatic brain injury are learning to live life again. 

“The only way we could remember would be by constant re-reading, 

for knowledge unused tends to drop out of mind. 

Knowledge used does not need to be remembered; 

practice forms habits and habits make memory unnecessary. 

The rule is nothing; the application is everything.” 

― Henry Hazlitt, Thinking as a Science

Also see:

Five Safety Tips for the Holidays for Persons Living with Fibromyalgia and Myofascial Pain Syndrome by Celeste Cooper

http://fmcfstriggerpoints.blogspot.com/2014/11/five-safety-tips-for-holidays-for.html#.VHjBzjHF86w

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Update 2015

"Adversity is only an obstacle if we fail to see opportunity."  

Celeste Cooper, RN

Author—Patient—Health Central Chronic Pain Pro —Advocate

New Website

Celeste’s Website: http://CelesteCooper.com

Learn more about what you can do to help your body function to its potential in the books you can find here on Celeste's  blog. Subscribe to posts by using the information in the upper right hand corner or use the share buttons to share with others.

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Resources:

Carson JW1, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD. A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia.

Pain. 2010 Nov;151(2):530-9. doi: 10.1016/j.pain.2010.08.020.

Castro-Sánchez AM1, Matarán-Peñarrocha GA, Arroyo-Morales M, Saavedra-Hernández M, Fernández-Sola C, Moreno-Lorenzo C. Effects of myofascial release techniques on pain, physical function, and postural stability in patients with fibromyalgia: a randomized controlled trial. Clin Rehabil. 2011 Sep;25(9):800-13. doi: 10.1177/0269215511399476. Epub 2011 Jun 14.

Cooper, C and Miller, J. Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-body Connection. Healing Arts Press: Vermont. 2010.

Prado ET1, Raso V2, Scharlach RC1, Kasse CA1.Hatha yoga on body balance.Int J Yoga. 2014 Jul;7(2):133-7. doi: 10.4103/0973-6131.133893.

Sañudo B1, Carrasco L, de Hoyo M, Oliva-Pascual-Vaca Á, Rodríguez-Blanco C. Changes in body balance and functional performance following whole-body vibration training in patients withfibromyalgia syndrome: a randomized controlled trial. J Rehabil Med. 2013 Jul;45(7):678-84. doi: 10.2340/16501977-1174.

Jones KD1, Sherman CA, Mist SD, Carson JW, Bennett RM, Li F. A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients.Clin Rheumatol. 2012 Aug;31(8):1205-14. doi: 10.1007/s10067-012-1996-2. Epub 2012 May 13.

Part I – Proprioception: Are you a bull in the china cabinet? Is it fibro or myofascial pain syndrome? By Celeste Cooper

Are you a bull in the china cabinet? I know I sure feel like one. We run into things at an extraordinary pace, and we have the bruises to prove it. We feel like our legs are tied together or we are walking a 90 degree angle plank. A disturbance in proprioception is thought to occur in both fibromyalgia (FM) and myofascial pain syndrome (MPS), but for different reasons. Myofascial pain syndrome  can co-exist or be confused with FM.

Proprioception = a sense of where our body and its appendages are located in relationship to the space around us.

Proprioception in Myofascial Pain Syndrome

Myofascialtrigger points (MTrPs) are knotted up pieces of muscle fiber that shorten the muscle, cause pain locally and in a pain referral pattern. They also cause muscle weakness, and joint dysfunction. A temporary problem experienced by those with an athletic or other muscle injury becomes myofascial pain syndrome in others. (Learn more here.) Most people have experienced the pain and stiffness of “sleeping on their neck wrong,” as an example, and they respond well to usual treatments, i.e. massage or in more severe injury, trigger point injections. But in those of us with chronic myofascial pain a simple injury, or a slight breeze can activate trigger points and trigger points develop in other compensating and opposing muscle fibers. 

So How is Proprioception Affected by Myofascial Pain Syndrome? 

A very important muscle in the neck, the sternocleidomastoid (SCM), functions to keep our head where it belongs and provide range of motion. Among other things, it also keeps an eye on where our head is located in space (proprioception) and provides feedback to the brain to help us maintain balance and interpret visual information. When trigger points develop in the sternocleidomastoid, they shorten the muscle placing its job in jeopardy. When this happens we walk into things, drop things without warning, become dizzy, have visual disturbances, experience headaches, and more.

Trigger points in the legs can also affect gait and cause imbalance—another blog for another day.

Proprioception in Fibromyalgia

Proprioception and balance problems have been studied in relationship to fibromyalgia and sleep, posture problems, and neuro regulation. This suggests that fibromyalgia does affects our brain’s ability to orchestrate important information correctly. A Great deal of research suggests this “neuro dysregulation,” is at play, but it is still unclear as to which came first, the cart or the horse. Does the dysregulation that affects proprioception also affect the brains ability to lead the band for immune regulation? Some think yes it does, but that is another story for another day. You can read more about this and the role of myofascial trigger points in Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome,and Myofascial Pain: The Mind-body Connection. 

What is the Difference between FM and MPS, What Sets Them Apart and Links Them Together?

Fibromyalgia is accompanied by certain specific symptoms and particular conditions, such as:  gastrointestinal disorders, TMJ, Raynaud’s, migraine, restless leg syndrome, hypothyroidism, SICCA, bladder and pelvic difficulties  and sexual dysfunction (male and female), chronic fatigue syndrome, hypothyroidism, ankylosing spondylitis, Sjögren’s,  systemic lupus erythematosus, rheumatoid arthritis, multiple chemical sensitivities,  and autonomic dysfunction. Many of these conditions also share a myofascial component and is why some believe myofascial pain syndrome is a common comorbid disorder to fibromyalgia that explains many symptoms we experience. There are however, some who believe the symptoms we experience are nothing more than random complaints. The later is unfortunate because it impedes important research that might lend better information for why we have such difficulty with our proprioception.

Watch for Part II – Proprioception in FM and MPS: Are you a bull in the china cabinet? What can we do?

Five Safety Tips for the Holidays for Persons Living with Fibromyalgia and Myofascial Pain Syndrome by Celeste Cooper

http://fmcfstriggerpoints.blogspot.com/2014/11/five-safety-tips-for-holidays-for.html#.VHjBzjHF86w

Resources:

Alonso-Blanco C1, Fernández-de-las-Peñas C, Morales-Cabezas M, Zarco-Moreno P, Ge HY, Florez-García M. Multiple active myofascial trigger points reproduce the overall spontaneous pain pattern in women with fibromyalgia and are related to widespread mechanical hypersensitivity. Clin J Pain. 2011 Jun;27(5):405-13. doi: 10.1097/AJP.0b013e318210110a.

Cooper, C and Miller, J. Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-body Connection. Healing Arts Press: Vermont. 2010.

Cooper, C. Questioning the Preliminary Proposed Diagnostic Criteria for Fibromyalgia. The Pain Practitioner. 21(2):24-25.

Starlanyl, DJ and Sharkey, J Healing through Trigger Point Therapy: A Guide to Fibromyalgia, Myofascial Pain and Dysfunction. North Atlantic Books (September 11, 2013).

Wolfe F, Brähler E, Hinz A, Häuser W.Arthritis Care Res (Hoboken).Fibromyalgia prevalence, somatic symptom reporting, and the dimensionality of polysymptomatic distress: Results from a survey of the general population. 2013 Feb 19. doi: 10.1002/acr.21931. [Epub ahead of print]

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"Adversity is only an obstacle if we fail to see opportunity."  

Celeste Cooper, RN

Author, patient/ advocate

http://CelesteCooper.com

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.  

Five Safety Tips for the Holidays for Persons Living with Fibromyalgia and Myofascial Pain Syndrome by Celeste Cooper

Patients with fibromyalgia and/or chronic myofascial pain from myofascial trigger points (MPS) are subject to a loss of ability to know where our limbs are in space in relationship to our body, proprioception. (There will be more on proprioception later.) This puts us at risk for soft tissue injury, falls, and even fractures. Prevention is worth a pound of cure. Following are five tips to minimize risk of injury over the holidays.

1. Don’t create clutter. Our home décor is familiar to us, yet we still find ourselves walking into things. Imagine what can happen when we add more to the mix. Instead of adding Christmas trees, Menorahs, Kwanzaa candles, decorative statues, gifts, etc., exchange them for something occupying that space. Place items on surfaces well away from the edge, because if it falls, we can too. (We all know what it’s like to do a juggling act trying to prevent an egg or favorite souvenir from breaking.) Accidents do happen despite the best plans. Let the items break instead of your hip. 
2. Don’t overtax yourself. When preparing food, bring your work area to you. Work at a table and prepare as much as you can in small increments ahead of time. Sit in a stable chair with arms. Use large grip utensils to help avoid the "droppsies." When we are off balance, we can fall out of a chair. 
3. Do a quick assessment of the environment when visiting others. Be aware of the number of people in your space. Gatherings of celebration often include crowded rooms and little ones under feet. Lighting may be insufficient because of a subtle ambiance, decorative throw rugs may be present, and footpaths may be cluttered with decorations that wouldn't normally be there. Find your place and stay put as much as possible.
4. Ask for help. Celebrations usually include food. Carrying a plate or drink can divert our attention. We need to act defensively, because we cannot predicts others' behaviors, especially when alcohol is involved. 
5. Beware of what you wear. Holiday clothing may be something you wear once a year. What we wear can be restrictive to our normal movement and gait. Ill fitting clothing, fancy shoes, not wearing glasses, etc. are all things that can put us at risk. 

Practicality is especially important when dealing with the proprioception and balance problems associated with fibromyalgia and myofascial pain syndrome. Make a plan so you can enjoy a safe holiday season.

Blogs to watch for:

Part I – Proprioception: Are you a bull in the china cabinet? Is it fibro or myofascial pain syndrome? By Celeste Cooper

Part II – Proprioception in FM and MPS: What can we do? By Celeste Cooper

~ • ~ • ~ • ~ • ~ • ~

"Adversity is only an obstacle if we fail to see opportunity."  

Celeste Cooper, RN

Author, patient/ advocate, fibromyalgia health expert

Website: http://www.TheseThree.com

All answers and blogs are based on the author's opinions and writing and are not meant to replace medical advice.