February 2007 Integrative Medicine Interest Group Vol. II, Issue 6 LSUHSC School of Medicine—New Orleans Wellness Newsletter

Inside This Issue: February theme: Body Massage and Manipulation Rolfing: Focus on the 1 Fascia Rolfing: Focus on the Fascia Osteopathic Manipu- 2 Jeff Marino, L2 lative Medicine Most medical students have a The Benefits of SEX 3 limited relationship with fascia: it’s the stuff you dig through in anatomy lab in order to locate IMIG International 3 some nerve or artery that was Health and Cultural more important. Sometimes Awareness Week the fascia has fancy names: Camper’s, Colles, Scarpas. It Ask Dr. Roca—What is 4 can even determine the extent Fascia? of a nasty staph infection. Nevertheless, fascia often goes Well Tips of the Month 5 unnoticed in a medical stu- dent’s studies. Contributors 5 As much as fascia may be ig- nored in medical school, there freely. Additionally, Rolfing are some practices that actually contraction and relaxation and strives to integrate all regions focus on it. Rolfing is a holis- restricts the body’s easy move- of the body to maximize the tic system of body manipula- ment. The goal of rolfing is to efficiency of the body’s move- tion and movement education realign and balance one’s body ment within the earth’s gravita- that targets fascia—especially by helping it “unlearn” bad Upcoming meetings tional field. the deep, investing fascia patterns of muscle strain and misuse. and events: around muscles. One of the Rolfing can be used on just technique’s key principles is Through a specific sequence of about anyone—people with SPRING 07 meetings that injuries, poor movement deep tissue massage techniques injuries from auto accidents, (12 pm) patterns, or chronic muscle developed more than fifty neck or back pain, arthritis, or sports injuries, to name a few. • Thursday, March 1st tension from stress cause the years ago by its founder and fascia to tighten. Over time, namesake Ida Rolf, Rolfing Some people undergo a Rolf- • Thursday, March 15th this tightened fascia prevents seeks to loosen fascia and al- ing regimen simply to learn to • Thursday, March 29th the natural patterns of muscle low muscles to move more move better or to improve • Thursday, April 12th breathing, flexibility, or pos- ture. The only people for th • Thursday, April 26 whom Rolfing is not recom-

mended are those who have International Health and active cancer, broken bones, or Culture Week! a recent history of major sur- Feb. 28th —International Health gery. and Culture Fair March 1st —Diversity Panel: Cul- tural Competency in Health- Rolfers (as the practitioners are care called) evaluate a body’s sym- metry both at rest and in mo- Energy Medicine Workshop: tion to identify restricted movement or imbalance. March 4th Then, through a ten-session Egg Hunt for Health :

First week of April

IMIG Wellness Newsletter Vol. II, Issue 6 P A GE 2

Rolfing: Focus on the Fascia (cont’d)

protocol, the Rolfer systematically treats the to moderate cerebral palsy patient, focusing on a different anatomic region The degree of success of a Rolfing sequence is in each session—beginning at the feet and working large part determined by the patient, who gradually upward. Each session builds upon the last until learns about posture, alignment, and body position- the body is totally aligned; this is effectively ing so that he or she can achieve more efficient, demonstrated in the “before and after” photos more functional, and more balanced everyday move- of patients who have been “Rolfed.” ments. Additionally, Rolfing may offer other health Rolfing encourages the health care provider to rec- benefits. Although the amount of research spe- ognize fascia as a possible positive influence on the cifically devoted to Rolfing is limited, some stud- patient’s well-being, rather than an arbitrary sheath ies suggest that Rolfing increases the body’s surrounding tissues; by doing so, providers will have overall parasympathetic tone; others research the opportunity to offer their patients a course of has found that the myofascial changes it therapy that may have lasting beneficial effects. achieves are advantageous in patients with mild

References: Jones, TA. Phys Med Rehabil Clin N Am. 2004 Nov;15(4):799-809, vi. | The Rolf Institute of Structural Integration www.rolf.org | Rolf you pain away http://www.webmd.com/content/article/53/50479.htm | Photos: Boston Rolfer www.bostonrolfer.org

Osteopathic Manipulation Justin Meunier, L2 Osteopathic Medicine was meostasis, and emphasizing an founded in 1847 by Dr. An- increased awareness of physical drew Taylor Still, M.D. (1828 - imbalances within the muscu- 1917) as a reformation of what loskeletal system and tech- he perceived as the inadequate niques with which to treat medical treatments of his day. them. The principles upon which The practice of Osteopathic Osteopathic Medicine was Manipulative Medicine (OMM) founded brought into perspec- was derived to address these tive the importance of treating musculoskeletal imbalances, the whole patient--mind body which Dr. Still believed con- and spirit--taking advantage of tributed to the decline of the body’s natural tendency to health and the establishment of move toward health and ho- disease within the human body. Med student participants in the 2006 AMSA CAM Leadership Training Program Possible beneficial applications of in Rhinebeck, NY get a chance to practice OMM techniques on each other.

OMM include: OMM is a manual modality of pain relief experienced by re- treatment used to improve the • Maintenance of General Health cipients of OMM could be impaired or altered function of partially mediated by the induc- the musculoskeletal system. • Back and Neck Pain tion of the patient’s endoge- The act of manual manipula- nous opioid systems through • Arthritis tion, with roots in the ancient the patient’s belief or expecta- Greek "frictions," has long tion that the OMM would help • Chronic Pain Conditions been a part of health care, but alleviate his/her pain. modern OMM includes many • Enhancing recovery from surgery and/or refined techniques that can be OMM techniques can be ap- serious illness applied, such as myofascial re- plied to the joints, soft tissues, lease, cranial osteopathy, lymphatic muscles and fasciae to help • Fibromyalgia pump, high velocity low amplitude facilitate the body’s natural tendency towards health. • Musculoskeletal Pain thrust, muscle-energy technique, and counterstrain. It is also impor- • And others…. tant to note that some of the

References: Brigham and Women’s Healthcare: Alternative Therapies – Osteopathic Medicine http://www.faulknerhospital.org/ | American Association of Colleges of Osteopathic Medicine www.aacom.org

IMIG Wellness Newsletter Vol. II, Issue 6 P A GE 3

The Benefits of SEX Virginia Simon, L2

What holiday could be better than a holiday • Exercise. Intercourse burns about 200 calories on average, that promotes love? One that promotes men- which is about the equivalent of running on a treadmill for 15 tal, physical, and emotional health, of course! minutes. The heart rate rises from 70 to 150 bpm, and depending Valentine’s Day provides the opportunity to on your workout preferences you can workout a whole assort- incorporate all of these benefits. One could ment of different muscle groups. even say that Valentine’s Day is a public health • Reduced Depression initiative. On this one special day, scores of • Less frequent colds and flu. A study at Wilkes University in couples rush home from work to meet their Pennsylvania shows that people who have sex a few times a mates, indulge in a nice romantic dinner, maybe week have higher levels of IgA antibody. a movie, then head back home to celebrate • Reduced risk of heart disease. A 2001 Queens University both love and health by indulging in something study showed that men reduced their risk of stroke or heart at- even more pleasurable—sex. This single word tack by 50 percent by having sex three or more times a week. probably elicits different emotions in everyone, • Pain relief. Immediately before orgasm, levels of the hormone but for now, let go of those and consider the oxytocin rise to five times the normal level; this releases endor- health benefits. For instance, sex is a form of phins, which can alleviate pains like headache and arthritis. In exercise, stress relief, and pain relief—and it women, sex also releases estrogen, which relieves pain associ- doesn’t need to be saved for Valentine’s Day! ated with PMS. So, make some time for you and your special • Better sense of smell. Sex makes levels of prolactin surge caus- someone: close your laptop, pause the iPod, ing stem cells in the brain to develop new neurons in the olfac- turn off the television, light an aromatherapy tory bulbs. candle and engage in the one pastime that con- • Better bladder control. Sex strengthens the same muscles that tinues to stand the test of time. kegel exercises strengthen--the pubococcygeus muscles.

IMIG Wellness Newsletter Vol. II, Issue 6 P a ge 4

Question of the Month to Dr. Roca—What is Fascia ?

What is fascia? cle and can therefore directly Surgical repairs depend upon influence myofascial tone and fascial strength and healing. Fascia is a specialized dense pain. This ability to contract Infections track along fascial connective tissue layer which appears to be due to the pres- planes. surrounds muscles, bones, and ence of an integrated matrix of joints, providing support, pro- contiguous fibroblasts within How is fascia tection and giving structure to the fascial extracellular matrix. manipulated? the body. Fascia is a mechani- cally continuous extracellular Myofascial release can be either matrix throughout the body Tensegrity is a field of study direct or indirect. Direct re- and is the only tissue when originating in architecture that lease is the process of using present by itself that reflects describes how a system con- slow focused pressure to en- the individuality of a person’s structed with elements in a courage adhered areas of fascia internal and external appear- tensional matrix retains its to release. Rolfing and ance. It is a series of proteins shape in response to compres- ischemic compression are and glycoproteins secreted by sional forces. Within the hu- forms of direct myofascial re- fibroblasts which are embed- Fascia forms a vast network through- man body this same principle lease. Indirect release encour- ded within the matrix. It con- out the body and is continuous from appears to hold. Within sists of three layers: the superfi- head to toe. The white tissues in the the cytosol, key enzyme cial fascia (beneath the skin), the picture above are thicker forms of systems appear to be deep fascia (below the superficial fascia. scaffolded upon key fascia) and the subserous fascia elements of the cy- (between organs and structures functioning. The field of ten- toskeleton. These cy- of the body and the deep fas- segrity describes the changes in toskeletal elements in cia). Another type of dense cell function as a result of dif- turn are connected to connective tissue is the ferences in stress and strain the extracellular matrix aponeuroses, which invests induced in the cell though in- via membrane bound muscles. tegrins and adhesions that con- adhesion molecules. nect the cell to the extracellular When the extracellular Why is fascia matrix. These changes in stress matrix changes shape important? and strain have been implied in due to fascial changes, spread of cancer, differentia- these adhesion mole- Fascia appears to be a compo- tion of organ systems during cules are strained dif- nent of our evolutionary re- embryologic development, and ferently causing sponse to gravity and a key changes in hormone secretion. changes in cellular component through which In addition fascia appears to shape and therefore mechanical forces are trans- have the ability to contract in a cellular functioning. Nerves and blood vessels run through fascia. lated into changes in cellular manner similar to smooth mus- Chief among the dis- eases that cause signifi- If the connective tissue is tight and stiff, the associated tissues can have poor nutrient cant changes in strain exchange and other problems. is obesity . According to animal studies, ages fascia to relax by applying fascia is a piezoelectric tissue either slow gentle cross fiber which can transmit electrical stimulation to the area or by signals induced by movement applying counter strain stretch- of the tissue itself. These mod- ing techniques. In addition to els imply that acupuncture dry needling, injection of sterile meridians are located within saline and/or lidocaine, or fascial planes of the body. Cur- acupuncture can be used to rent theories propose that the release myofascial structures. efficacy of acupuncture is de- These techniques allow the pendent upon the creation of fascia to become more fluid needle-extracellular matrix and reorganize itself to allow Fascia can extend between muscle fibers, which have been greater flexibility and reduce teased out from the muscle above. complex that can transmit me- chanical and electrical stimuli. pain.

References. Acta Physiologica 186 Suppl 1, 247 (2006) | The Anatomical Record 269:257–265, 2002 | Journal of Cell Science 116, 1397-1408 (2003) | Journal of Cell Science 116, 1157-1173 (2003) | Obesity Reviews (2006) 7 239–250 | Photos: About Fascia, Rolfing Seattle. www..rolfingseattle.com

IMIG Wellness Newsletter Vol. II, Issue 6 P a ge 5

Wellness Tips of the Month Nijel Baron, LSUHSC Wellness Fitness Center Manager Thank you… We would like to offer thanks to the Okay, so you’ve stuck to your New metabolic disease workout at 65% - Year’s Resolution faithfully. You have 80% of their maximum heart rate for American Medical Student Association made it to the Wellness Center at at least 30 minutes; no less than three Foundation’s EDCAM program, Whole least three to four days a week. days per week. You ask yourself what Foods Company, the Wholistic Well- Grilled and broiled foods are now part is 65% - 80% of my maximum heart of your new nutritional library. To your rate mean? Your heart rate max is the ness Network, LSUHSC Family Medi- dismay, the scale has not changed! maximal heart rate a person should cine Department, and our faculty advi- Slowly and surely, you are losing your achieve during maximal physical exer- sor, Dr. Henri Roca who is Chief of will to keep going. Do not fret. Help is tion. This number can be determined LSU’s Section of Integrative Medicine here! by a simple formula: 220 – age and multiplying that number by .65 or .80. and a Holistic Area Resource Person of That gives an estimation of your heart the American Holistic Medical Associa- There are so many different reasons rate range. why the scale is not budging one bit... tion. I know you have heard the phrase “ Muscle weighs more than fat.” This is For example, if you are 25 years old, very true and it has been proven in 220 – 25 = 195. Multiply 195 by .60 numerous studies, but maybe there is = 117. Now, multiply 195 by .80 = something else to blame. Genetics? 156. Your estimated range would be Our bodies want to look like our par- 117 – 156 ( 60% - 80% of your heart ents’ bodies…gulp! True, but you can rate max). To ensure you are exercis- change that by increasing your physi- ing within the proper range during a cal activity and eating a healthy diet. cardiovascular workout take your Has this thought ever occurred to pulse for 10 seconds; multiply that you, “Am I working hard enough?” number by 6. That number is your heart rate and it should fall within 117- 156. Too much math!!! Heart In the late 90’s the American Heart rate monitors automatically read your Association reported that most Ameri- pulse and let you know your intensity cans do not workout at an appropri- level without all the math. Some heart ate intensity or duration for achieving rate monitors even alarm when you effective weight loss. This simply are exercising above or below your means, if you are on the treadmill estimated heart rate range. and holding an “easy” conversation with your neighbor, chances are you’re not working hard enough. Hopefully, this will get you on the right path to your goal. Please feel free to contact the Wellness Center if you The American College of Sports Medi- have any questions. We would love to cine recommends that healthy adults help you! Our number is 504-568- without cardiac complications or 3700 or email [email protected] .

Editor: Mamina Turegano , L2 Medicine Assistant Editor: Lauren Hebert , L1 Medicine Contributors/Helpers: Nijel Baron , LSUHSC Wellness Fitness Center Manager Jeff Marino , L2 Medicine Justin Meunier , L2 Medicine Virginia Simon , L2 Medicine Donations can be made out to the LSU Founda- Faculty Advisor: tion. Please specify LSU Section of Integrative Henri Roca, MD , Medicine on the comment line. Send donations to 2364 Constance Street, New Orleans, LA 70130. Chief of Section of Integrative Medicine, Department of Family Medicine