<This morning I was testing on the 13″ box squat. As I came off the box
about an inch or so? I felt what I believe to be my adductor tear, very
painfull. I dropped the bar on the pins and hit the floor. I thought I might
have to cut the suit off but got it off without ruining it. I had not yet
reached my top set and it did not feel too heavy. I noticed no lapse in
form. It just went. I got a prescription for a muscle relaxer and am taking
Ibupropfen until I can get to the doctor. Also using Ice packs 20 minutes on
and 20 minutes off. So far I do not see any bleeding, bulges or gaps, very
tender to the touch. Have any of you experienced this injury and what might
be ahead. I have not had this particular injury before.>

*** Many years ago, while I was jerking 325lb overhead, my front foot
slipped on baby powder left by a preceding 90kg division lifter on the
platform and I landed in a full ballet splits position. This was one of the
most painful experiences of my life and my adductor magnus was severely
ruptured, as indicated by massive bleeding and bruising that became visible
soon afterwards in all of the area from my groin down the inside of my left
leg and into the hamstring area. I could not adduct my left leg and I
couldn’t do any exercises which involved movement of my left leg for months
afterwards.

Nevertheless, several months later, without surgery, I managed to compete by
using power cleans and push presses (130kg) and power snatches (100kg)
without any sideways movement of my legs – I still don’t know how that was
possible, but you know what one becomes like when the urge to lift overcomes
one’s intelligence! I eventually returned to normal functioning within about
10 months. Since you can still voluntarily move your leg inwards and have no
extensive bleeding into the tissues, it is unlikely that you have
experienced a serious rupture, so you will probably be able to return to
action quite easily.

You may even have experienced a severe spasm, which would be even better news
for you – your medical specialist will have to determine if that is your
problem. Just avoid any loaded or rapid movement for a while, but move
gently over as full a pain-free range as is possible. Continue using ice,
but beware of rubbing DMSO on the inside of your leg, because that area is
easily irritated. Don’t massage the area and don’t use any “hot”
embrocations. You could try large doses of MSM. Vitamin C also plays a role
in connective tissue repair. Remember the old adage: “More haste, less
speed” – don’t try to train with heavier weights too soon, because this
muscle can be very easily reinjured. If you display some intelligent
patience, you will probably return quite happily to where you were before.

Remember, too, that wider powerlifting or sumo squats place great demands on
the leg adductors, so that it would be advisable to use much narrower squats
when you return to leg training. Since adductor magnus also serves as a sort
of adjunct hamstring, be cautious of executing movements which flex the knee
or extend the hip. Whatever you do, simply explore every type of leg
movement in all directions with no added loading and at slow speed before you
even consider adding any weights.

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

In response to Dr Mel Siff’s Subluxation Paradox http://www.melsiff.com/12359/subluxation-puzzle-and-paradoxes-by-mel-siff/

Here is some further discussion from another list on my subluxation paradox:

Mel Siff:

< Can you cite any scientific references which definitely relate these small
“disturbances” to any significant pathology? What you are iimplying is that
the spine is critically tuned, displays a very sharply defined range of
efficient functioning and has a negligible “safety factor”, so that even
minor perturbations will cause genuine pathology or pain. This is not a very
efficient way for the body to have developed and evolved, so I have to wonder
about the validity of such an hypothesis.>

Comment:

Your point about the evolution of the system is well taken. As you point out
there must be some safety factor. I am not trying to suggest that it is
negligible, merely susceptible to problems. For example when trunk
stabilization via muscles is especially important in neutral spine postures
due to the inherent low levels of stiffness in the “neutral zone” (a small
range about the mid-position of the joint where little resistance is offered
by passive constraints).

The multifidus has been implicated in providing much of the control in the
neutral zone. Several other mechanisms contribute to trunk stability
including muscle stiffness, co-contraction, and pre-programmed (i.e.
anticipatory contractions) contractions.

Perturbal first maintain posture (primary task) and second, perform voluntary
tasks (secondary task) when the two are presented concurrently. This makes
sense in that without adequate posture, voluntary movements do not happen.

However, the co-demand of voluntary movement and postural control can lead to
a sudden loss of balance, particularly when performing rapidly or under high
loads. Such events have been called “motor errors”. These “errors” can lead
to injury through inappropriate coordination dynamics that require different
functions out of the same muscle(s). An acute injury (eg whiplash) can
instantly impair stabilization due to tissue damage which leads to
subluxation. However, more frequently, authors view repeated motor errors
over the long term as the primary in subluxation. This last statement has
yet to be verified.

Here are a few references:

1. Burns LA. Viscero-somatic and somato-visceral spinal reflexes. J Am
Osteopath Assoc 1907; 7:51.

2. Triano J, Luttges M. Subtle intermittent mechanical irritation of the
sciatic nerves of mice. JMPT 1980; 3(2): 75-80.

3. Winsor, H., Sympathetic Segmental Disturbances- 11. The Evidence of the
Association in Dissected Cadaver of Visceral Disease with Vertebral
Deformities of the Same Sympathetic Segments, Medical Times,49 1-7 Nov. 1921.

4. Gore DR. Roentgenographic findings in the cervical spine in asymptomatic
persons – A ten-year follow-up. Spine 2001; 26: (22) 2463-2466.

5. Dishman RW. Review of the literature supporting a scientific basis for
the chiropractic subluxation complex. J Manipulative Physiol Ther 1985; 8:
163-174.

6. Lantz CA. The vertebral subluxation complex part 1: an introduction to
the model and the kinesiological component. Chiropractic Research Journal
1989; 1(3):23.

7. Rydevik BL. The effects of compression on the physiology of nerve roots.
J Manipulative Physiol Ther 1992; 15(1):62.

8. Kirkaldy-Willis WH. The relationship of structural pathology to the
nerve root. Spine; 9(1): 49-52.

Mel Siff:

< After all, many competitive weightlifters subject the spine to very heavy
loads which surely cause many such small (and even some large) disturbances
in every training exercise and every competition, year after year, yet the
incidence of back pain and dysfunction in this cohort is considerable less
than in the general population which never imposes that magnitude and rate of
loading.>

Comment:

True, but there are studies (eg. Videman T, Battie MC, Gibbons LE, et
al.Lifetime exercise and disk degeneration: an MRI study of monozygotic twins
MED SCI SPORT EXER 29: (10) 1350-1356 OCT 1997) that show higher rates of
disc degeneration which according to ref #4 above will lead to subsequent
symptoms and dysfunction in the future. Besides, the absence of symptoms by
itself is not a good indicator of performance or physiologic function. Also,
are there studies done with weightlifters and controls on coordination
dynamics?

Mel Siff:

<The existence of these well-known structures and processes does not
necessarily suggest that they make pathology more likely. All this means is
that the spinal complex has a very extensive and efficient cybernetic system
which ensures that the spine is well controlled over a wide range of
different conditions in space and time.>

Comment:

AMEN! But when there are problems, it makes it difficult to find the source
of the problems and to find efficient solutions. Overt pathology in many
cases takes a relatively long time to develop (eg heart disease). Sure our
systems are efficient but the trick is finding the inefficiencies (subtle)
and correcting these to prevent future problems.

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

When Serge Reding and I discussed the possible mechanisms for strengthening
by means of electrostimulation training about 30 years ago, we both felt that
the process may have to do with enhancing the ability of the athlete to
tolerate high levels of muscle tension if the ES is applied with progressions
to very high levels of activation. The following paper offers some
corroborating evidence in this regard.

——–

Improvement in isometric strength of the quadriceps femoris muscle after
training with electrical stimulation.

Selkowitz DM

Phys Ther 1985 Feb; 65(2): 186-96

The purpose of this investigation was to determine if training isometrically
with electrical stimulation (ES) alone would significantly increase isometric
strength of the quadriceps femoris muscle.

The relationships between the strength changes and the relative force and
duration of training contractions were also studied. An experimental group
(Group 1) and a control group (Group 2), 12 subjects in each, underwent
pretesting and posttesting to obtain their maximum voluntary isometric
contractions (MVICs). Group 1 trained with maximally tolerable isometric
contractions induced by ES, three days a week for four weeks.

Results showed that although both groups demonstrated increases in isometric
strength of their quadriceps femoris muscles, training isometrically with ES
produced a significantly greater increase than not training with ES. The
relative strength improvement in Group 1 was positively and significantly
correlated with training-contraction intensity and duration.

The relative increase in isometric strength, using only ES, may be determined
by the ability of the subjects to tolerate longer and more forceful
contractions. Suggestions for further research and implications for the
clinical use of ES for strength-training are discussed.

Dr Mel Siff
Denver, USA
http://groups.yahoo.com/group/Supertraining/

The next article in this series will be a Bulgarian critique of Dr
Verkhoshansky’s article. Note that all of Dr Verkhoshansky’s criticism was
directed at the work of Matveev. There are many models of periodisation, a
large variety of which are discussed elsewhere (Siff & Verkhoshansky
“Supertraining” 1999 Ch 6).

—————————————————————————

THE PATH TO A SCIENTIFIC THEORY AND METHODOLOGY
OF SPORTS TRAINING

PART 4 (Final)

J.V.Verkhoshansky

6. The rudimentary part of periodisation lies in its manner of constructing
the training process.

The idea of periodisation consists of joining separate parts of the training
process in a linear sequence. The main structural unit in training is the
microcycle. The training process is represented as the sum of microcyles
aligned in a chain, the logic of linearity being defined only speculatively,
mainly on a principle of “it is possible, so it is valid to use standard
separate ‘typical’ microcycles with various names” thus ‘lining up’like
children’s building blocks under various names appointed by Matveev for the
longer parts of training process such as “mesocycles” which, in turn, are
united in “macrocycles”. Such a linear principle of constructing the
training process, according to Matveev, allows one to overcome the familiar
vagueness of the structure of training and to more accurately reflect its
actual variability.

However, subsequent research has not confirmed this conclusion. It tends to
reveal a na€  ïve primitiveness of similar technology and has shown, firstly, in
practice, that other methods produce results indistinguishable from those of
periodisation; secondly, they have shown the superficiality of models of the
training process as a linear combination of certain standard parts and,
finally, they have again confirmed the opinion of experts that the progress
of a sport is unpredictable if one uses periodisation.

——————————————

7. One of most essential deficiencies in periodisation highlighted today by
progress in the biological sciences, is that it consists only two factors in
regulating the training of the athlete, namely the volume and intensity of
the training load. This concept does not consider different ways for
constructing training, except, perhaps, for the primitive undulation of the
total amount of the load. Thus, since this involved a total increase of
volume of loads over all years of sports programming , periodisation remained
the primary factor for increasing the efficiency of the training process.
This explains why periodisation became not only a procedure of training, but
also the entire system for preparing athletes.

Thus, outside the field of vision of periodisation, there was the vast field
of adaptable processes, associated with the transformation of the qualitative
characteristics of external influences on the body into internal physical
changes. Misunderstanding problems of specificity of adaptation of the body
has involved Matveev in verbose reasoning on the so-called ‘carry-over’ of
skills and potential talents – a genuine phenomenon, inherent mainly to
physical training, but not to the specifics of the major sports. Now, for
example, if a physical education student in physiology today wrote in an
examination, that “many cyclic locomotor exercises, obviously varying
according to their specific form (running, swimming, skiing and a bicycle
etc.), are close in nature to the actual competitive exercises on the basis
of their character of displaying endurance and other motor qualities”, a low
mark would be awarded.

Questioning periodisation appeared powerless before the person of its
creator, though it was only necessary to open books to easily discern that
the phenomenon of selective, specific adaptive reactions of the body to a
given mode of training has been known for a long time. There it would also
have been noted that this is one of the major criteria for choosing the
content and organising training loads, the primary orientation of their
training influence and their general composition.

Today, when possibilities of the finding new methods of periodisation have
strongly decreased, and volumes of loads have reached a reasonable limit,
management of specific training strongly influences the training load,
which offers a unique way of increasing the effectiveness of training of
highly qualified athletes. Reasoning based on ‘carry-over’,especially in
emphasizing the role of periodisation in sporting preparation, return one to
the level of the 1950s.

The literature concerning the physiological mechanisms of the specificity of
training is extensive. Ignoring these insights – one more most serious
aspects of periodisation -involved huge expenditure of money and time, as
well as great energy devoted by athletes to training with very little effect.
Finally, it ruined the plans of preparation of many athletes who aimed to
achieve top sporting performance.

So, four fundamental defects have deprived periodisation of any theoretical
and practical importance:

1. Weak representations of actual sports activities, of technology in the
preparation of very qualified athletes, and of specificity in the
professional skill of the trainer.

2. The primitiveness of the methodological concept, a model not supported by
an objective foundation; mental methodological principles; absence of proven
practical recommendations.

3. The disregard for biological research.

4. The neglect of progress in adjacent sciences and experimental work in the
field of sports training.

——————————————

CONCLUSION

Very often critical remarks end with conciliatory conclusions such as
“nevertheless the merit (of the author, the theory, a literary work and so
forth) consists of…..”. I cannot follow this principle. I want to
emphasize that, if theory and practice had not followed the path of
periodisation theory, as planned by our trainers and scientists over the past
50 years, by today we would have achieved a far superior scientific, more
consistent, advanced theory and methodology of sports training.

But for the carelessness of the former federal, political and educational
authorities in the USSR, a main specialist subject of the curriculum for
physical culture would not have been be submitted by the scholastic demagogy
cultivating obscurantism of scientific knowledge; and whole generations of
students and post-graduate students would not have been subjected to the
deformed representations about the sports profession. Many capable experts
would have been freed to publish and exchange ideas and experience, as well
as successfully presenting substantial dissertations and endowing the theory
of sports training with a solid scientific basis.

—————————————————————————

Dr Mel Siff

***Interestingly, Kendall’s methods recently have come in for a great deal of
criticism in many physical therapy and biomechanics circles, especially since
they have been based upon some rather thin research involving testing of
isolated joints under static conditions. I am sure that Barrett Dorko could
supply some references on this.

‘ACTIVE RELEASE’ TECHNIQUES

For those who may not know, ‘Active Release Treatment’ (ART) is a collection
of techniques simply given a new name by chiropractor Michael Leahy from
physical therapy (especially Janet Travell’s work on trigger point and
myofascial release), classical massage, Shiatsu, osteopathy and other
well-known tissue therapies.

I wrote an Internet review of its origins and requested any so-called ART
practitioners to furnish any research or peer-reviewed clinical studies which
showed categorically that ART is equal or superior to other therapies being
used to treat the same type of musculoskeletal problem. All that I received
was a series of the usual indignant letters quoting more anecdotal evidence,
none of which even vaguely controlled for the possibility of a placebo
effect.

Most significantly, I even received an offended letter from Michael Leahy
himself, who admitted that there was nothing original about ART, but that he
had just formalised it into an organised system with his own certification
scheme. In essence, he felt that I had not adequately recognised ART as
highly effective therapeutic system and that I should give it a fairer
hearing.

He also iterated anecdotally the great success enjoyed by ART, so I wrote
back stating that it would be a pleasure for me to write (for all the
Internet groups to which I belong) another article on ART if he could kindly
send me a list of references proving all claims that have been made for its
efficacy with respect to other standard methods of physical therapy, medicine
and chiropractic. Most significantly, he failed to reply and I have not
heard from him since.

Anyway, I was referred to websites such as the following by other ART
practitioners:

http://www.chiropractic-sports.com/reference/ART.HTML

Here is an interesting extract from this site:

<The skill of application of ART is highly dependent upon the practitioner’s
knowledge of anatomy, biomechanics and most importantly touch. One must not
confuse terminology related to performing ART. Often when a practitioner is
asked if they do ART, they respond by saying “yeah I do that, it’s like
myofascial release right?” You can tell immediately that they are not
properly trained and you can be assured you will not be getting ART. To be
certified in ART, the Doctor or therapist MUST have completed a course in ART
and passed a national certification exam.>

*** The implication immediately is that ART is somehow superior to Janet
Travell’s myofascial release and trigger point work, as well as its
simplified borrowings in the form of Bonnie Prudden’s ‘Myotherapy’, a claim
which is totally unsubstantiated by research or clinical studies. There are
just as many therapists who claim equally impressive success to ART.

The reference to a “national certification exam” has nothing to do with any
medically recognised national qualification. ART certification is a private
commercial scheme administered by Leahy. You do not have to be certificated
in ART to practise its techniques because all of those techniques existed in
other therapeutic systems way before ART was conceived as a separate
therapeutic modality. The name may be protected, but all of the techniques
may be used by any other therapist who is familiar with them.

The above extract also mentioned that the success of ART depends “most
importantly on….touch”, in other words on certain individual skills of the
therapist. This is true of all therapies. I have little doubt that Leahy
probably enjoys numerous successes with ART, not simply because of the
system, but because of his special personal touch and subjective qualities.
I have personally witnessed healing success with Therapeutic Touch,
shamanism, magnets and several other ‘complementary’ therapies, BUT this does
not constitute valid scientific proof of their effectiveness. Such
observations do not rule out the possibility of a strong placebo effect.

This does not mean that I would ever state that someone should not use any
therapy because of lack of scientific validity. As one of my physics
professors one said to me about a tedious and lengthy mathematical method
that I had unhappily used to solve one of the problems that he set for us:
“If it works, use it!”. I always felt awed when I saw how craftily and
succinctly many of the world’s truly great physicists solved problems, and I
felt that I should at least be a bit more elegant with my own solutions. My
physics prof put everything into a more realistic light with that remark
which I have remembered some 35 years later.

By all means, let anyone use ART, Therapeutic Touch or what they will, but
please don’t let them make unsubstantiated claims about clinical efficacy or
underlying mechanisms if they do not exist. Rather say what the TV detective
hero, Hunter, said about his method of solving criminal problems: “Works for
me!”

STRENGTH TRAINING & POSTURE

<<The same goes with strength training exercises. I realize that there are
many studies which say that strength training does nothing to improve
posture, but again and again I’ve seen athletes demonstrate dramatically
improved static posture after participating in a strength training program.>>

*** I agree with you on this score, but it may be that the improvement does
not necessarily have to do with increases in strength, but with other
processes that resistive training may mediate, such as disinhibition of
certain muscle actions, facilitation of other muscle actions, post-exercise
relaxation, overflow, enhanced proprioceptive sensitivity, conditioning of
certain reflexes or other neurally based facilitatory processes. So, while
strength increase may not always be the direct cause of postural improvement,
other processes involved with strength training may be responsible for
causing definite change. There is some interesting scope for research here.

Dr Mel C Siff

Another great article by Mel Siff, from his Supertraining List at YahooGroups.

Now that the Pilates system of training has undergone a huge rebirth in the
USA and started to attain the status of culthood, its latter day
practitioners are now reviving some of the myths of strength training. Here
are a few that are now doing the rounds, taken directly from the advertising
copy that is promoting Pilates in the media:

MYTH 1.

Weight training tends to shorten the muscles, but Pilates lengthens them. All
that lifting bunches up the muscles and makes one tight and stiff.

FACT:

All muscles contract and shorten when they are activated. All muscle lengthen
when they relax. If muscles appear to lengthen and flatten with training,
then this would imply that one is losing muscle bulk, which is not a highly
desirable state for anyone. This Pilates belief is total nonsense and betrays
a sorry knowledge of muscle physiology. It would also seem to suggest that
the more Pilates work you do, the longer your muscles become. That, of
course, would mean that your muscles would develop slack and you even tually
would not be able to move your joints!

MYTH 2.

Pilates offers much more variety than weight training. It now has over 2000
exercises.

FACT:

The field of weight training, which includes free barbell and dumbbell
weights and machines, offers at least ten times that number of exercises and
exercise variations. Pilates does not even come close.

Pilates practitioners, of course, should note that the well-known Pilates
machine, the Reformer (a type of lying sled device), the Cadillac, the Spine
Corrector and various other machines were developed by Joseph Pilates from a
host of earlier weird and wonderful machines that were on the fitness and
gymnastics market of Europe and Russia during the late 19th and early 20th
century. If one examines some early patents from Germany, for example, even
some weight training devices like some made by Nautilus were derived from
these earlier innovations.

One might even state that “Pilates training” constitutes just another man’s
own range of strength training routines and machines, someone like Arthur
Jones, Bob Hoffman, Eugene Sandow, Professor Attila or Joe Weider. Those who
are “doing Pilates” thus are simply doing another type of strength training
program and they don’t even recognise that fact. If any of their instructors
think that old Joe Pilates had a totally unique approach or philosophy, then
they would do well to learn that several of the strengthening trend setters
of the past 100 years all had some fascinating philosophies and methodologies
that are not dramatically different from that of Pilates. Reading through a
book such as Webster’s “The Iron Game” or talking to Dr Terry Todd and his
wife will fill in some of the gaps in their education if anyone is unaware of
that fact.

MYTH 3.

Pilates realigns the body, corrects muscle imbalances and helps to heal
injured backs. Weight training usually causes imbalances and overstresses the
back.

FACT:

Suitably individualised Pilates and progressive weight training programs both
can be used to “correct imbalances” and improve postural alignment, which
actually have a lot more to do with motor education than what means is used
to achieve those ends. Conversely, poorly taught Pilates and weight training
both can be injurious. There are very few other methods that can develop such
great spinal strength, power and stability under loading as a well-designed
heavy weight training program.

The bottom line? Why don’t modern Pilates teachers and enthusiasts simply
state that they really prefer Pilates training to any other methods at the
moment and that other forms of training may well be more enjoyable and
productive for others? There is no scientific or clinical evidence that
Pilates is any better or worse than any other form of training for the
average population, so let it be marketed as such.

Of course, anyone who is a student of international sport knows that Pilates
training done as the sole form of conditioning has produced very few or none
of the world champions in sport, nor has it been shown to offer superior
musculoskeletal healing to any other form of therapy. That does not make it
any the less enjoyable or effective for those who feel justified in spending
thousands of dollars a year to learn it. Those people simply enjoy it because
they have found that it suits them, nothing more, nothing less.

Fortunately, when I was being taught Pilates methods more than 15 years ago
by some Pilates teachers in return for my teaching them modified forms of PNF
training which Pilates did not specifically address, we discovered that we
all had something to teach and learn from one another’s training — though we
agreed that Pilates methods of pelvic stabilisation were not intended for
lifting heavy loads in weightlifting and powerlifting. Once again, a case of
live and let live! Pilates teachers and weight trainers were getting along
just fine until the commercial marketeers came along to distort the facts
with their comparative advertising.

Dr Mel Siff

Most physical therapists are also able to apply trigger point therapy and
myofascial release methods as well, since these methods are taught to them at
medical or physiotherapy school. In fact, these methods were pioneered by a
remarkable medical practitioner, Dr Janet Travell, who died at the age of 95
only a few years ago. Much of her innovative work appear in her own books or
in others written in collaboration with Dr David Simons, another MD. Here is
a web tribute to Dr Travell:

http://www.aapainmanage.org/aapm/travell.html

BOOKS ON TRIGGER POINT & MYOFASCIAL THERAPY

Here are the books that have established trigger point and myofascial therapy
as effective and valuable approaches to pain management and certain other
problems:

David G Simons, Janet G Travell & Lois S Simons. Myofascial Pain and
Dysfunction: The Trigger Point Manual Vol 1, 2nd Edition

JG Travell MD & DG Simons MD Myofascial Pain and Dysfunction: The Trigger
Point Manual Volume II – The Lower Body, Williams & Wilkins, 1983, Vol. II,
1998.

Janet Travell & Seymour Rinzler “The Myofascial Genesis of Pain”
DG Simons “Myofascial Trigger Points: A Need for Understanding”
J Travell “Myofascial Trigger Points: Clinical View”
J Travell “Temporomandibular Joint Dysfunction”
D Simons “Myofascial Pain Syndrome Due to Trigger Points”

There is a huge amount of information on the use of myofascial therapy
methods in the treatment of fibromyalgia, for which I can post further
information, if anyone is interested.

SELF TREATMENT

In fact, with a little practice at palpating and pressing very firmly in a
progressively fashion with small increments along the length of the relevant
muscle, you will soon become able to identify “trigger points” (which have
been known in the East for millenia, by the way) and treat them quite
competently. Like any form of deep massage, one never exerts intense
pressure over any areas that are inflamed, swollen, bleeding, bruised or have
recently been fractured or exposed to surgery, or may exhibit tumours,
varicosities or other significant medical conditions.

In a short time, you or your partner should be able to develop the necessary
skills to be able to deal with most of your normal training aches and pains -
and you will save a fortune in the process. Of course, like any other
physical problems, there are times when medical or other therapeutic
attention may be necessary, but this is one case where you can do a great
deal on your own. When in doubt, of course, obtain a genuine medical opinion
from some professional such as an orthopaedist.

In fact, this is exactly what Bonnie Prudden did when she slightly modified
Dr Travell’s work and created what she called “Myotherapy”.

Others might like to share their information on and experience with these
forms of soft tissue therapy.

Dr Mel C Siff
Denver, USA