relief of aching legs using the World Run Recovery System

Hospital Staff-Patients-Visitors

Most people have hospital stays sometime in their lives for varying problems and periods of treatment-for the lucky ones, it is just an overnight stay and home again, for the unlucky the stay could be a lengthy one which can add to patient stress and extra time needed for recovery

This is because they are away from their familiar surroundings, friends, and life routine they may have developed, used and had control over a long period of time-suddenly they are placed in a totally alien sterile environment where most of the time they do not know what is going to happen, what tests they are going through, and how they are going to cope

No matter how friendly and efficient the staff are, the patient is not at home and can't go home while the doctors, nurses, cleaners, ward assistants can all leave at the end of the day

The main highlights of a patients day becomes mealtimes and visiting hours if they get someone who cares about them coming to see them

The patient long term stay has 3 main problems

• The isolation gap

• Lack of touch

• Lack of movement

During the lengthy stays that the patient becomes more isolated from friends and families; even if they visit often as allowed and stay for maximum time and they are emotionally attached to the patient, a physical gap can develop between them

Visiting time

Having worked for many years in and around hospitals as a ward assistant, I have observed the following on many occasions at visiting time which goes through a number of phases

Phase 1
Start of visit

Welcome-kissing-hugging-hand holding

Phase 2

Exchanging news both ways

Phase 3

All has been said that can be said-long silences while each party thinks of something to say

Phase 4

Start of wind down of visit

Phase 5

Wind down

Phase 6

Wind up and goodbye

Phase 7

Isolation of patient mixed with feelings of relief

Phase 8

Total isolation-the letdown

The letdown is when the patient feels that something has been missing from the visit, and much of the time can't understand what it is-they realize they are not part of the outside world anymore which their visitors have gone back to while they are left locked away

As the patient improves the emotional and physical gulf that has resulted between hospital patient and family needs bridging to bring them back to a normal life in readiness for discharge and ease their placement into life outside the ward again; this can be difficult as if the stay has been a lengthy one, they may have become institutionalised, and going home or any other changes may be stressful for them

Phase 3 to phase 5

The flat part of the visit and it is the most difficult to fill, so why not fill the void with activity?

Better still why not use touch and in particular constructive touch!

What is constructive touch?

Constructive touch is that given with a particular objective in mind

The longer someone is in hospital and under medical treatment, the more difficult it becomes to break down the barriers to give them touch-being in a hospital setting even for family and other visitors can be a daunting experience, so can place a strain on relationships and can make the patient feel even more isolated after the visit is over

Touch is one of the most basic needs, other than that of medical staff, patients are left to their own devices in their own locked in world-touch provides an option to bridge the gap

Appropriate Constructive Touch

In a hospital setting, touch other than the usual hugging and kissing at the start and end of the visit is not usually done-this can be because the patient is in isolation, or has bits and pieces of equipment attached, or some other reason; but there comes a time when touching is acceptable (with medical staff approval)

Any touch given to patients has to be given with their welfare in mind, operation wounds, pain, drug, equipment, and movement restriction all have to be taken into account by the medical team so the request may rejected with decision postponed until later when rehabilitation is started

Physio or physical therapists at this stage are usually brought in at the rehabilitation stage so you can ask if it is ok to get involved in giving appropriate constructive touch at this part of healing

Appropriate Constructive Touch deals with the 3 main problems of long term hospital stays at the same time; the isolation gap-lack of movement-lack of touch

Lack of movement

Long term hospital stays can have other problems connected with them-if the patient is confined to bed for any length of time, there is the problem of reduced lower leg circulation and loss of sensation of underfoot environment which can lead to loss of confidence when they stand and try to walk again

Sitting or lying down long term

Sitting or lying down for long periods also brings its hazards-by nature of their medical problems, many patients are forced to have extended bed rest, this can place them in the position of risk from developing an unwanted condition known as Deep Vein Thrombosis

Deep Vein Thrombosis-blood in the veins becomes static allowing the balance between clotting and anti clotting agents in the blood to be altered and clots to form in the veins which may break away and lodge higher up in the body

Most modern hospitals have access to up to date drugs, pressure stockings, calf pumping systems and modalities such as physio or physical therapists to deal with these problems, but in many countries there may be only the financial resources to cover treatment of the initial complaint and nothing left for the ancillary therapies needed for prevention of Deep Vein Thrombosis

Movement is needed to keep the lower leg circulation healthy

http://news.bbc.co.uk/2/hi/health/8480656.stm

http://hcd2.bupa.co.uk/fact_sheets/html/deep_vein_thrombosis.html

www.dailymail.co.uk/.../Socks-replace-drugs-lifeline-1m-hospital-patients.html

Lower Leg Circulation
Blood is sent to the lower legs under pressure through the arteries and vessels called arterioles and even smaller capillaries-as the vessel size reduces the pressure taking it there also decreases

By the time the blood reaches the feet, all the pressure has been used, and there is none left to return the used blood back up the legs to the body against gravity again

The Calf Muscle Pump

To keep the lower leg circulation working, the muscles rely on having a constant supply of fresh blood to the tissues to help prevent fatigue and to recover when they do

The calf muscle pump is responsible for circulation in the lower legs-another name for it is the peripheral heart because it is outside the body

Its main purpose is to move used blood from the lower legs back to the body for refreshment with oxygen and other elements that the muscles need to maintain an optimum environment for efficient working of the muscles

The calf muscle pump is made up of all the muscles in the legs, the motors that provide the power for the pump are the calf muscles-these are made up of 2 basic movers-Soleus which is used for standing upright, and Gastrocnemius used for running and jumping

As the muscles move, they increase and decrease pressure on the vessel walls (the veins) opening the one way valves to let the blood pass along them, and close to prevent the blood flowing back towards the feet

While the effects of the pump has a great effect on the physiological condition of the body, broken down into its various parts it is just a pump-not too sophisticated in the way it operates, except that it is made from living tissues rather than manufactured components

The calf muscles ability to keep working at applying and releasing pressure the tubes-once this stops, the fluid can't be moved up the legs-the used fluid is allowed to just become static

The Veins

Veins are flexible tubes that take fluid (used blood) from the lower legs back to the body against gravity-in the tubes are a series of one-way valves that open to let fluid pass through when the tube is squeezed by the pump motors (the calf muscles)

There are three types of veins

• Superficial veins act as a reservoir for blood, supplying it to the tissues as needed, they also carry blood from the muscle tissues to the perforating veins.

• Perforating veins that carry blood from the superficial veins through to the deep veins.

• Deep veins carry used blood and lymph fluid away from the legs towards the heart.

When the pressure on the tube is released, the valves close again to prevent the fluid going back down to the feet again

In this way, a balance is kept between the fresh blood going into the lower legs and the old blood leaving them on its way back to the body for refreshment and recycling again

Inactivity affects the circulation by reducing the ability of the pump to send used blood and by-products from the legs back to the body for recycling

When the muscles are not doing their job properly they become incompetent and the pump becomes inefficient

A result of calf muscle inefficiency

Problems caused by calf muscle pump inefficiency include

• Poor circulation

• Lymph system inactivity

• Venous return reduced

Swollen ankles from lymph fluid (or water) separating from the static blood and migrating through the vessel walls into the tissue spaces instead of being pumped away can be the result inefficient use of calf muscles

Poor circulation means less movement of fluids which may become trapped in the lower legs; water (or lymphatic fluid) may separate from the blood, migrate through the vessel walls and fill the tissue spaces-as it can't be pumped away quickly enough, the ankles swell (edema)

Used fluid build up restricts the supply of fresh oxygen filled blood to the muscle tissues without it, they quickly fatigue become inefficient and reduces the circulation

Being mechanically based, the system can be serviced or restarted using a manual system to remove some of the fluid and pressure that has built up-once started, fresh blood can more easily enter the muscle tissues and start the recovery process

The theory of starting the calf muscle pump

Light Manual Muscle Relaxation-A Tested Trusted Environmentally Friendly Alternative-for poor lower leg circulation and lack of touch

What is Light Manual Muscle Relaxation?

Light Manual Muscle Relaxation-the walk you have when you are not having a walk that anyone can do

It is a Self-Service leg circulation system

Developed for ultra marathon runners and walkers leg recovery Light Manual Muscle Relaxation has been tested on long distance events worldwide (ultra marathon is any distance over marathon-42.19 kilometers/26.385 miles)

Ultra marathon is very long distance competition where they have to run or walk as far as possible in a given time; it can be over 6 hours-24 hours-48 hours-6 days-16 days or even around the world www.worldrun.org

Using just these-and the knowledge of how to use them

Calf muscle fatigue, tight muscles, and poor lower leg circulation can chase each other around in a cycle that is difficult to break out from-each is a self destructive part that props up the other parts of the cycle and it will take a circuit breaker to disrupt the cycle of fatigue

Medically caused leg health should be referred to those best qualified to deal with it-the doctors, but there are non-medically related problems that can be dealt with by some simple activities

The advantages of using this system

• Do It Yourself recovery

• No disrobing

• Works with the muscles not on them

• No oil used

• Non invasive

• User friendly

Using a simple but effective lower legs strategy will help to keep them moving during those enforced long hospital stays

The hands are the tools to close the isolation gap and increase lower leg circulation

When the talk has dried up, and the silence is deafening, let the hands communicate for you; give some constructive touch to both cross the isolation divide and help to minimize the long term effects of restricted movement in walking

Use Light Manual Muscle Relaxation the walk you have when you are not having a walk to build bridges

Note-never doing anything with the patient without first discussing with the managing nurse/doctor and obtaining their permission or you may be interfering with any treatment for their health problems

Some References

Michael's methods of massage and blister care helped me to stay mobile throughout the race and to recover quickly afterwards. His techniques are safe and gentle.

Unlike some treatments, which put the runners and walkers at risk of muscle tears or infection, Michael's techniques are gentle, safe, reassuring, and highly effective. They enhance comfort and flexibility, build confidence, and promote success.

This booklet will help others to learn and practice Michael's methods. It is recommended reading for everyone who walks and runs and who wants to go further, go faster, or just to enjoy life more!!'

SANDRA BROWN 1996 Ladies 1000 Mile World Record Holder

1999 Ladies 100 mile Race walking World Record Holder
"I know that your massage kept a number of competitor<>s in the event. The cold weather of Saturday afternoon and night certainly got to many of the walkers and your prompt action had them back in the race after a short stop.

In years past, that would have ended up as a non-finish. A number of walkers were able to keep going for the full 24 hours on the basis of your expert help."

Tim Ericson Secretary Australian Centurions Club

'I have known Michael Gillan for many years and have always got quick relief for my aches and pains from the stretching he performs'.
CLIFF YOUNG-75-80 24 Hour World Record Holder (150.07 kilometers)

A word from Jesper Olsen World Runner about Light Manual Muscle Relaxation

"If I hadn't had the qualified help from the excellent masseur Michael Gillan, taking several thousands of km out of my legs, I could spare myself the effort!"

"My crew for the current stages, Michael Gillan, has proven to have other talents than the quite taxing job of taking care of all the requirements of a really tired ultra runner!
He has since years back been working on a new approach to stretching and muscle-rebuilding for ultra runners. I have the last two days tried his careful stretch and massage, and a bit to my surprise the muscles are beginning to feel like before the start back in Greenwich, London!!

Usually I doesn't take massage as the legs of an ultra runner will often be quite sore during the long time events (and especially in an multi-year event like this...), and getting a massage can at times cause more injury and cramping up than good. For example my last massage was some 12 000km ago when I ran the 12-hour competition in Finland. And so far that has been the only one.

But Gillan came with best recommendations from my main contact in Australia, Phil Essam, who besides being vice president in the Australian Ultra runners Association has heaps of good knowledge to share. And this new kind of mild massage for ultra runners is definitely one of the good tips! There should be a fair chance that I actually get fresh enough to do some decent running at the 6 Day Race that I have coming up in Colac from the 21.November. I quite look forward to that, even though I can't expect to make a top class result :-)"

He won! 756.2 kilometers (Jesper holds the record for the longest run in history over 26000 kilometers and the first person to run around the world Taken from www.worldrun.org


Some references for Light Manual Muscle Relaxation

To: mgillan@hotmail.com
Subject: RE: Emailing: m gillan reference.doc
Date: Mon, 4 May 2009 16:48:31 +1000

Hi Michael,

COBURG 24 HOUR CARNIVAL

May 3rd 2009
TO WHOM IT MAY CONCERN

For many years Coburg Harriers has conducted the Victorian 24 hour Track Championship and the Australian Centurion 24 Hour Race Walk, the overall event being the Coburg 24 Hour Carnival, which also includes a separate 6 Hour run/walk event.

This type of event is very demanding on Competitors, and each year, in addition to First Aid support, we seek to have the services of a masseur who can work on tired legs and also treat blisters in order to keep entrants on the track.

We have been privileged for many years to have had the voluntary services of Michael Gillan who with his techniques is able to coax renewed life from extremely tired muscles and legs to get athletes back on the track when they were thinking that they would have to retire.

Michael has a very well deserved reputation in the "Ultra" running and walking fraternity who look forward to his presence at our events as they know he gets results without causing further injury with his treatments.

It is rewarding to see exhausted competitors come from the track in the early hours of the morning, convinced that they are unable to continue, only to see them return to the event after being treated by Michael.

Our Organising Committee at Coburg is grateful to Michael for his dedication to the sport and can commend his techniques to Athletes.

Yours Sincerely, Bernie Goggin Raceday Director / Referee Coburg 24 Hour Carnival 2009

http://www.coburgharriers.org.au/joomla1/component/option,com_frontpage/Itemid,1/


Physiology References

The calf muscle pump
(p.209) Physiology: a regulatory systems approach. Fleur L. Strand. Macmillan Publishing Co. Inc.ISBN 0-020979860-4

(p.209)Physiology: a regulatory systems approach. Fleur L. Strand. Macmillan Publishing Co. Inc.ISBN 0-020979860-4

"Venous valve incompetence and varicose veins"
'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

Effect of "Hydrostatic" Pressure on Venous Pressure ( P.165)
'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

Effect of Hydrostatic Factors on Arterial and Other Pressures (P.167)
'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

Calf muscle pump inefficiency
'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0
' (P.177) 'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

The Blood Circulatory System
(P.150) 'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

"The Lymphatic System
(P.180) 'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

"Pumping caused by external Compression of the Lymphatics
Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0 (p. 182)

'Peripheral Nervous System'
'Textbook of medical Physiology" (Physiology- fourth edition-Robert M. Berne, Mathew N. Levy, Bruce M. Koeppen, Bruce A. Stanton-Mosby ISBN 0-8151-0952-0) (P.98)

You can buy an expensive book on medical physiology or you can check up for further information on Light Manual Muscle Relaxation at

When you refer to medical physiology and use it to work for you, it is possible to achieve things that were previously left to chance-a faster recovery is one of them

Some links

http://www.promote-health.org

http://www.feet-and-legs.com

Hospital Isolation Article


Hospital Stays

Contact mgillan@hotmail.com