Paraplegia and manual therapies as an aid to lower leg circulation

Paraplegia and lower leg circulation making life more comfortable

I work with ultra marathon runners and walkers (people who walk or run any distance over marathon)
on recovery during and after their event-I work at events that range from 6 hours to around the world
(www.worldrun.org)

There are many sites on the internet about massage and paraplegia-simply type in ‘paraplegia and
massage’ into any search engine-you may have been there and been just as confused as me about what
to do and where it actually may relate to you-you may also be wondering where I come into the scheme
of things and why my knowledge is different to everyone else’s information
My knowledge offers a simple self help-system developed on and for ultra marathon runners and
walkers that works with the muscles-this makes it easy to do and it does not need equipment or too
much complicated hands on training to do
Unless you know what you are doing most modern massage techniques are not only too technical-they
can be too rough on tissues, arteries, and veins in the legs from uncontrolled finger force and untrained
hands working on and into the muscles causing damage
Why is working with the muscles more important than working on them?

The circulation is already challenged and the muscle tissues already struggling for fresh blood-working
on the muscles entails using the hands and fingers to encourage circulation and this means using
uncontrolled finger force into the tissues
This the integrity of the venous and arterial systems is compromised by breaking the fine capillaries
and venules that run throughout the circulatory network of blood carrying vessels
Dealing with the muscles in an appropriate way is important if using manual therapies-to help increase
lower leg circulation it is important to make a choice that is not going to make things worse
For the para problems exercising and moving the legs becomes more difficult-as lower leg circulation
decreases the lack of blood supply to the muscle tissues can make the feet go cold-this increases their
discomfort-many people then have to wear lambs wool boots to keep the feet warm

Here is an image of a leg of a swollen lower leg and ankle-it shows how lack of movement and exercise
can affect lower leg circulation and make it more difficult to even wear a pair of shoes without rubbing
and causing feet problems

Copyright 2009 Michael Gillan 1 ultra marathon recovery specialist

http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html
 Paraplegia and manual therapies as an aid to lower leg circulation

Muscle health is based on having a constant supply of oxygen and nutrients to them
To keep this supply going a balance between what goes into the muscles and what comes out of them
must be maintained-if for some reason fresh oxygen rich blood can't enter the muscle tissues levels the
muscles fatigue
To keep it reaching them the body has a circulatory system; part of it takes fresh blood to the muscles
pumped there by the heart through the arteries-another part of the system takes the used blood away
back to the body where it is re-nourished with oxygen and nutrients and recirculated again.

The Calf Muscle Pump

The muscle pump is made up of all the leg muscles and together they form a pump which forces used
blood against gravity up the legs back to the body for recycling by alternately putting pressure on the
venous system and releasing it
The veins which take blood back to the body have one-way valves in them-as the muscles squeeze,
they open the valves, letting blood pass through them; when the tension is released, they close stopping
the blood flowing back down towards the feet
Lack of movement reduces the veins ability to open and close by keeping constant tension on them, this
is called calf muscle pump inefficiency
Problems caused by calf muscle pump inefficiency (even without the problems of diabetes) include

• Poor circulation

• Lymph system inactivity

• Venous return reduced

There are many other problems caused by venous inefficiency and it may be worthwhile looking at
http://care.diabetesjournals.org/cgi/content/full/26/12/3333
Peripheral Arterial Disease in People With Diabetes
http://www.o-wm.com/article/8057
Controversies Regarding Vascular Disease in the Patient with Diabetes: A Review of the Literature
VOLUME: 53 Issue Number: 11 author: Robert J. Snyder, DPM, CWS
http://www.videomd.com/PeripheralArterialDisease-fv-465.aspx

Copyright 2009 Michael Gillan 2 ultra marathon recovery specialist

http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html
 Paraplegia and manual therapies as an aid to lower leg circulation

The wheelchair person needs something simple that is easy to do without putting
the circulatory system at risk of further damage

Light Manual Muscle Relaxation the Massage-Lite leg assistance

What makes Light Manual Muscle Relaxation so different from other recovery
systems?
It is an alternative stripped down basic tool which uses the muscles to work with themselves rather than
relying on the skills of someone who works on them
This model has many benefits for someone who has to take the place of a skilled therapist in a remote
area and who cannot afford the real thing
To try and help with paralysed legs you can use aimless guesswork and prod and poke and just move
the legs in an aimless fashion and hope what you are doing is working
Or you can use planned and structured movement that is based on medical physiology and been tested
on many ultra marathon runs and walks around the world

The advantages of having a massage-lite system

• No equipment needed
• No disrobing
• No oil
• No washing up
• No long training
• No clean area needed
• Can be done by anyone

Works with the muscles not on them

Light Manual Muscle Relaxation-(Massage-Lite) works through
• Simplicity
• Predictability
• Consistency
• Non invasive
• User friendly

Copyright 2009 Michael Gillan 3 ultra marathon recovery specialist

http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html
 Paraplegia and manual therapies as an aid to lower leg circulation

How user friendly?

I worked for 24 hours off this chair (next to the bottles) without any equipment in unhygienic conditions

There are other ways to help the circulation in the lower legs

This is the last thing the legs need because they already have a problem with movement-and it is
needed to make the calf muscles work to pump the used blood from the legs
This is very passive and for not much use because they are not moving- they need a pro-active role in
helping the calf muscles to work the pump at moving the fluid up the legs
How to do this just needs the knowledge of how to work with the muscles not on them!

In countries such as my own (Australia) with a good health system, improvement using drugs, exercise,
or surgery with inputs from physiotherapists, dieticians, chiropodists for foot care is available as are
gymnasiums to help with weight and exercise
In many countries-there is no help for those who do not have the financial ability to pay for treatment
and only basic care may be given-self treatment for these people is a necessity rather than a choice
issue
In countries that have more poverty, having massage schools for training, and paying clients to pay for
massage is not an option they can barely afford the clothes on their back without having to pay tuition
fees, massage table, oil, towels etc
There is also the hygiene aspect-washing facilities, soap powder, the absence of clean running water,
dust sticking to oil which has to be washed off

They have to become their own physical and muscle therapist-and they have to
learn how to do this with a minimum of education and training
Copyright 2009 Michael Gillan 4 ultra marathon recovery specialist
http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html
 Paraplegia and manual therapies as an aid to lower leg circulation

Giving a massage-lite leg workshop

Working with the muscles

You are at this article because you obviously have an interest in warm feet so if you want more
information on Light Manual Muscle Relaxation and you can afford it-please buy a manual
The money raised from this goes towards supporting my project on establishing classes around the
world in countries that do not have access to many health services

Michael Gillan
Long distance recovery specialist

I should point out I am not a doctor so I am not treating anything and what I say should not
be taken as a medical treatment or implied that it is-medical treatment should be sought and
advice taken about whether it is suitable for your complaint
For more information on Light Manual Muscle Relaxation go to

http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html
Copyright 2009 Michael Gillan 5 ultra marathon recovery specialist
http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html
 Paraplegia and manual therapies as an aid to lower leg circulation

mgillan@hotmail.com

Copyright 2009 Michael Gillan 6 ultra marathon recovery specialist

http://aching-legs.org/charity/paraplegia_cold_feet_strategy.html