Articles by Kit Laughlin

Kit Laughlin is an authority on the subject of stretching and strengthening, and many areas in between. Kit developed Stretch Therapy over the last 30 years.

He has written two best-selling books about Stretch Therapy, Overcome Neck & Back Pain (for injury rehabilitation, now in its 4th Edition) and Stretching & Flexibility (for performance enhancement, well being, and injury prevention, now in its 2nd edition) and numerous DVDs, videos and many articles.

Kit teaches Stretch Therapy to practitioners of Chiropractic and Osteopathy, Physiotherapy, medicine, Yoga, Pilates and Massage Therapy and to people everywhere who want to rehabilitate or avoid injury, enhance performance or maximise wellbeing, in Australia and around the world.

He was awarded a Master of Letters degree by the Science Faculty of the Australian National University in Canberra (1992) and was granted an Australian Postgraduate Research Award (1993–96) for Ph.D. research, where back pain was the main case study. This research led directly to his first book, Overcome Neck & Back Pain.

Articles for a general audience

Piriformis and its role in sciatica

The effectiveness of treating trigger points in the buttock area is well known. In this short article, I wish to remind you of a biomechanical and muscular problem associated with the hip, and in the process prescribe an effective exercise treatment for the common problem of the piriformis syndrome as identified by Travell and Simons in their excellent Myofascial pain and dysfunction: the trigger point manual (here, volume 2, p. 186 ff.,1992).

Piriformis spasm and sciatica

Piriformis is an external hip rotator, acting with the adductors to facilitate walking and running, stabilising the femur in the sagittal plane so that the prime movers (gluteus maximus, quadriceps and the hamstring group) can propel the body over the legs. Less known about piriformis is that in about a fifth of the general population, one or both branches of the sciatic nerve pass directly through this muscle instead of passing between it and the one inferior to it, gemellus. Accordingly, this muscle can place sufficient pressure on the sciatic nerve to cause the familiar sciatica if it is in spasm. The unfortunate aspect of this for patients with sciatica is that if they demonstrate disc pathology the sciatica they suffer will normally be attributed to it­ and the possibility of misdiagnosis and ineffective treatment is high. This argument is developed in detail in my book Overcome Neck & Back Pain, 4th edition, Simon & Schuster, 2006, in the Causes of neck and back pain chapter, p. 225 ff.).

Full article

The role of iliopsoas in neck and back pain & its treatment

Pointers, Journal of the Shiatsu Association of Australia, 1998.

An exploration of the global significance of this muscle group, both posturally and in terms of its role in neck and back pain, dynamically and statically.

Anyone who knows anatomy will be able to tell you that iliopsoas spans the anterior surfaces of the transverse processes and the femur, attaching just below the greater trochanter – but, really, what does this tell us in a functional sense? In respect of neck or back pain, why should iliopsoas be given any more attention that, say, gamellus or any of the other 600-odd muscles around the body?

Full article

Integrating diagnosis and treatment for massage

How does the practitioner integrate diagnostic processes (such as leg-length testing and assessment of patterns of functional flexibility) into a treatment?

The question of how the practitioner can incorporate diagnostic techniques (assessment of structural and functional considerations deemed relevant to the patient’s problem) into a standard massage treatment is not an easy one to answer. This question give rise to two additional questions: what are the expectations of the patient, and how may they be changed for the patient’s ultimate benefit?

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Neck and back pain: are conventional treatments effective?

Briefing prepared for A Current Affair, 1997

The background information that led to three appearances on ACA, and which started all our workshops!

We have been presenting workshops around the country since the exposure of the Overcome Neck & Back Pain approach in January. In this short note, I wish to present a precis of the main points of the book Overcome Neck & Back Pain, and the confirming evidence of approximately 1,500 workshop attendees since the approach was aired on A Current Affair.

Full article

Getting back to work

Many studies have shown that the prognosis for a full return to work after time off for a broad range of back problems is poor, if the patient has not returned to work within twelve weeks of the onset of the problem. What I wish to address in this brief note are some of the possible reasons for this statistic, and make some suggestions for strategies we have found effective in the pursuit of the goal of full return to work.

Leaving aside for a moment certain aspects of the relation between injury and compensation, it should come as little surprise that return to work is less likely after a protracted period of absence: the simplest analysis suggests that the patient will have adjusted his or her lifestyle to use the time that is usually spent at work to pursue a variety of endeavours, if enough time passes. Researchers have identified a cluster of entailments that follow the identification or diagnosis of a condition by a health care professional that are called the Rumpelstiltskin effect.

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Articles for a technical audience

Supervenience, massage and stretching

Prepared for the Australian Association of Massage Therapists, April 2004

Massage is often the first recourse for people with sore and aching muscles, and massage has been practised with these problems in mind for thousands of years. Few working practitioners confine themselves to these problems today, however. The range of problems considered tractable to the various forms of massage is vast; examples include general and specific tension associated with stress, neck and back problems, postural problems, sporting injuries, digestive problems, headaches, and the pursuit of enhanced well being.

All forms of massage use manual techniques applied to the surface of the body. The general goal is reduction of tension held in the muscles and fascia (or a redistribution of tension, according to principles that vary between different forms of massage), and that, among other effects, blood flow will be enhanced and the state of mind improved.

The deep belief of any bodywork technique is that improvement in health will follow this kind of physical intervention. In this note, I wish to argue for an addition to your present techniques – specific stretching exercises – and will support this with reference to a branch of philosophy, called supervenience theory.

Full article

Low back pain: Review and Prescription

Part 1

Introduction

Writers, philosophers and surgeons share a common dilemma: in order to be able to begin, they must decide where to put the knife in. The foci of interest must be decided, and the ontology and epistemology that will be brought to bear on the subject defined. In this essay, the reader will be informed of the derivation of the reference sources, and what has been left out of the study and why will be described. The essay will briefly review current medical anthropology, and briefly review the philosophical and epistemological inheritance of the particular ethno-medicine under study.

The focus of this paper is a common illness, low back pain, which will be referred to from now on simply as “back pain”. Back pain has been described as, “A wilderness across whose inhospitable terrain orthopaedic surgeons, neurosurgeons, physiotherapists and, above all, general practitioners are doomed to travel [50].” The medicine under study is biomedicine, called “allopathic,” “cosmopolitan,” “Western” and “modern,” among others; in any case the dominant form of the many forms of medicine available in Australia today.

This paper will attempt an anthropological analysis of the area of study. That is, anthropological as defined by Young, “A viewpoint in which one’s own concepts and ideas are simultaneously privileged and part of a cultural system, and thus also subject to analysis [90:260].” Young also identifies a group of anthropologists whom he identifies with the explanatory model of illness approach, and whose work we will draw upon. Most important among these anthropologists are Good and Good [26], and Kleinman [30, 30a, 42, 43]. Their areas of interest are primarily the clinical encounter and medical efficacy, and their focus is the individual. Other anthropologists important to this paper are Taussig [78] and Moerman [52, 53], the former because of his emphasis on the effects of social structure on medicine and the latter because of his emphasis on the mind’s effect on bodily processes; or as Young so neatly puts it, “The effectiveness of healing on curing [90:266].

Before reviewing the literature on back pain, I will outline a brief history of biomedicine, in an attempt to trace the antecedents that have led to its current development and attitudes. A following section will look at the reference articles and relate them to the work of the anthropologists mentioned above. Hahn and Kleinman have noted that medical anthropology has assisted biomedicine in its search for efficacy in some ways by shedding light on the whys and wherefores of practice [30a], and in similar fashion, the final section includes some suggestions for how general practitioners might improve the clinical efficacy in the treatment of back pain. The essay will conclude with a few suggestions for a preventative medical position.

Reference sources – see the appendix for important notes in regard to selection criteria and methodology for the articles, books and anthropology sources.

Full article

Pro-Active Occupational Health and Safety

Prepared for the inaugural COMCARE National Rehabilitation Conference; Canberra, November 2003.

In this paper, I argue that the standard definition of “rehabilitation” is fundamentally flawed, and in need of a major overhaul.

Introduction

In this brief note, I wish to raise a few points for discussion at the inaugural Comcare National Rehabilitation Conference. Specifically, I wish to discuss whether there might be new opportunities to revisit what ‘Occupational Health’ can look like in the 21st century and what the implications for prevention and rehabilitation of common workplace problems might be if these suggestions are facilitated.

This paper will concentrate on broadening the definition of occupational health by considering aspects that are given low, or no, priority presently. The paper will argue that a widening of the traditional OHS focus – moving from focussing on treatment or rehabilitation to an explicit preventative perspective (which includes treatment and prevention) will better serve employers and employees alike, with benefits to both. I note here that the Australian Government operating environment continues to change and that risk management strategies are being built into its activities explicitly. This trend may provide the motivation to update the OHS legislation, or, perhaps, simply the focus of its implementation. In addition, I will consider a few examples of what appear to be contradictions between ‘duty of care’ and the rights of individuals. Finally, the paper will identify a number of potential ‘pressure points’ in the present system, via which change, if desired, might be effected

I speak for a small organisation which has been active in pursuing ‘organisational health’ in a few different ways: by working with individuals in group situations, by providing lunchtime seminars on a wide variety of health-related topics, and by working one-on-one with individuals with identified problems in a clinic environment. From many conversations with the participants of these classes, and with patients in the clinic, I wish to discuss how both ‘rehabilitation’, the OHS (CE) and SRC Acts are implemented presently from our perspective. This note is not intended to be a rigorous examination of either the legislation or its implementation – it is more of an ‘impression piece’, to facilitate ideas generation and exchange at a forum that is likely to provide ideas and, possibly, visions of how the future might unfold.

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Hidden causes of back problems

Hidden causes of back problems

Journal of the Royal Australian College of General Practitioners.

This is a technical article on the ‘hidden’ causes of back pain, written for doctors. Referenced.

Introduction

In this note, I wish to share the results of workshops I have been running around Australia since February this year, 2000. These workshops offer the approach to treating neck and back pain outlined in the book [Overcome Neck & Back Pain (Simon & Schuster, revised 4th edition). The book advocates a structural analysis followed by a functional analysis, and treatment using an exercise-based approach. Approximately 1,350 people have attended the various workshops to date. All were long-term neck or back pain sufferers, all of whom had sought treatment previously from physiotherapists (around 30%), doctors (35%), chiropractors and osteopaths (over 60%), and a variety of other treatments. Most had sought treatment from more than one kind of practitioner. In the vast majority, any relief had been temporary (a day to a few days the most common response) and most participants expressed the desire to learn how to look after themselves, preferably freeing themselves from the necessity of seeking regular treatment.

Full article

Hidden muscular causes of neck and back pain

Abstract prepared for Chiropractic & Osteopathic College of Australasia Conference, November 1999

The three ‘big ones’ are considered here: piriformis, quadratus lumborum, and levator scapulae.

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