Physiotherapy Postural-pilates

Curriculum vitae

 

Eleonora Melloni

Physiotherapy doctor with honors at the alma mater studiorum in Bologna with an experimental thesis at the Rizzoli orthopedic institute on the role of the Fascia Corporis in the pain of the patient suffering from coxarthrosis. After completing the studies of Fascial Manipulation according to the Stecco method, he obtained the specialization in Global Postural Reeducation Sushard method, with particular emphasis on scoliosis, even in developmental age. He also holds a master's degree on lymphatic system disorders and on the treatment of these through the Vodder and Leduc method and functional bandaging.

University studies, continuous updating, a great passion for one's work and collaboration with other specialists are the key to helping solve the person's problems. Rehabilitation must be targeted for each individual patient, based on teamwork between all specialists and involve the person at 360 °.

Insights

Scoliosis treated with RPG in developmental age

Scoliosis is a complex deformity structural spine on three floors of space. Scoliosis can arise in several age, in particular: 

  • infant: 0-3 years (0.5%), 
  • youth: 4-11 years (10.55%), 
  • adolescent (10-18 years (89%), 
  • adult> 18 years (68% after 60
  • years) .

The scoliosis of the developmental age is defined idiopathic (unknown causes) and is classified by base the location on the column, age of onset and severity (degrees of torsion).
Normally it occurs at the moment of pubertal growth (10-13 years in females, 12-15 years in males) and evolves until the end of bone maturation (1-2 years after the end of the statistic growth). If left untreated, scoliosis has a high tendency to progress since the offensive muscle retractions, during growth, will continue their traction until they lead to structural deformations.

The exam clinical allows to distinguish scoliosis from an attitude scoliotic (posture defect caused by a difference in length of lower limbs or only incorrect posture). The clinical signs of scoliosis are postural level asymmetries
shoulders, shoulder girdles, hips (triangles of the size), the pelvis, up to the evidence of the hump and the protrusions on the back, a flexed torso, which show vertebral torsion.

The RX exam is useful for doing correct diagnosis, formulate a prognosis, indicate therapies best suited by measuring the corners of the curves scoliotic and vertebral rotation degrees.

The therapeutic procedure foresees, after the evaluation of the Orthopedist or Physiatrist with prescription of X-ray in orthostasis 2P panoramic of the spine, the functional evaluation by the Physiotherapist with subsequent cycles of weekly sessions of Global Postural Reeducation individualized followed by periodic reassessment by the Orthopedist / Physiatrist. Treatment in developmental age is long and continuous and to be continued as long as the evolutionary potential of the scoliotic curves does not will show that he has stopped. He will continue with maintenance sessions to avoid compensation and pain due to asymmetries.


Fascial manipulation in coxarthrosis pain

Coxarthrosis represents 25% of rheumatic diseases in Italy. In the management of this pathology there are two possible ways: the conservative and the surgical one. Pain is the main cause that pushes the subject to resort to surgery, but little is known about its etiology. One of the possible causes is the alteration of myofascial soft tissues.

This manipulative technique is not limited to treating the painful point or part, but through an accurate evaluation, based on deductive logical reasoning, it seeks and manipulates the body segment guilty of painful symptoms. All this is summed up in the motto that distinguishes the Manus sapiens, potens est method; the hand can be powerful and effective to the point of solving the problem when it is possible to recognize its origin.

A 2005 study by Schleip has, in fact, highlighted how a contracture of the connective tissue can generate passive rigidity to the movement of the affected body district. This contracture can be caused by movement dysinergism such as direct trauma, surgery or degenerative disease such as coxarthrosis. This is determined by microscopic modifications where a hyperstimulated or hypostimulated band tends to ignite causing a disruption of the arrangement of the collagen fibers, which will lead to fibrosis and, consequently, to an increase in soft tissue stiffness with adhesions and contractures. Alterations of the fascial structure, therefore, have a direct impact on motor performance and result in an increase in stiffness and pain. According to the Fascial Manipulation, through a targeted and direct action to the fluidization of the altered connective tissue, it is possible 

  • to restore and balance the tensions that allow the execution of the movement 
  • raise the pain threshold 
  • improve the functionality of the subject already in the pre-operative phase.

Pilates

Contrology is the complete coordination of body, mind and spirit. Through this method, first of all one expressly acquires complete control of one's body and then, through an appropriate repetition of the exercises, one can gradually and progressively acquire the rhythm and coordination necessary to perform all mental and unconscious functions.
J. H. Pilates 1945

The Pilates technique is an exercise system developed over 70 years ago by Joseph Hubertus Pilates. The benefits of this technique include, among others, an increase in the flexibility and strength of the muscles in the central area of ​​the body. Thanks to the practice of the Pilates technique, an individual can experience a general increase in physical strength and a significant decrease in stress.
This method combines deep breathing, coordinated with movement, stretching and strengthening of the muscles without placing unnecessary stress on the joints and ligaments. It also strengthens the deep muscles of the entire abdominal belt and back. This method is also adaptable to rehabilitation, both in the acute phase and in the management of chronic pathologies to focus on strength, flexibility and range of motion. I therefore believe it is very suitable for maintaining the work carried out during a global postural re-education session, for a gradual recovery of motor activity but above all it represents a working method that gives the patient the tools and means necessary to help himself, freeing him from dependence on therapist.

The benefits are manifold: greater energy, decreased pain due to muscle tension or stress, improved posture and biomechanical functions, increased sense of well-being.

Pilates is based on 8 principles:

  • 1. breathing: "first of all learn to breathe correctly and completely". Breathing is an integral part of all bodily functions capable of increasing the vital capacity of the lungs, oxygenation of tissues and other physiological exchanges. You will learn to use the thoracic and back muscles to allow the complete expansion of the chest and ribs, ensuring the contraction of the diaphragm and not of the accessory muscles. You breathe in to prepare for the movement and breathe out when you move. Inhalation facilitates spinal expansion while exhalation facilitates depression and scapular stabilization, abdominal contraction and spinal flexion. 
  • 2. Accuracy: one of the most important skills to learn while exercising is to work without unnecessary tension, relaxing the body before each exercise and focusing on the relevant area, learning to use the right amount of tension useful to achieve movement. 
  • 3. Concentration: being able to focus the mind on what every part of the body is doing is always a remarkable goal, considering that it is in the mind that all movements originate. 
  • 4. Axial alignment: our body has been designed to allow weight to be transferred through the center of each joint, from the skull along the entire column, to the center of the pelvis, to the lower limbs. If the body weight is badly positioned, then the result will be to increase the stress on the joints, bones, ligaments, muscle group. And so the pain will appear. 
  • 5. Fluidity of movements: many of the pilates' movements resemble yoga, but unlike the latter, the positions are not maintained, instead, the movements move harmoniously from one to the next. Performing the exercises in a fluid and continuous way gives flexibility to the joints and soft parts, integrates the nervous system and trains the body in a uniform and harmonious way. 
  • 6. Center: most exercises focus on developing the strength of the abdominal wall directly or indirectly, precisely because the great importance of the natural corset they generate is recognized.7. Endurance: postural muscles need endurance, and only regular daily practice can develop an improvement in both physical and mental endurance, even though most exercises are not aerobic.

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