Medical Student Aching Legs Article

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation Medical Students Aching Legs To support my research into muscle recovery, I work as a hospital porter (or orderly)-at the hospital where I work, we have medical students from all countries coming for training-many of them are from third world countries and they are basically just living on a daily basis They are also spending many hours on their feet both around the wards and in the operating theatre Towards the end of a shift they can barely put one foot in front of another, and yet in their few hours off they some how have to recover in time for the next shift to go out and do it all again, and of course, not only our med students have to do this, but all other students around the world do too Luckily I am a massage therapist who has practical experience in recovery of ultra marathon athletes (anyone who runs or walks over marathon distance), of hospital caused aching legs, and fixing them, and medical students, and a recovery system the med student can use during their breaks? ? ? ? ? during a long shift at the hospital

These runners who have just spent 3 days on the running track represent how the med student feels after a heavy roster at the hospital Other than having aching legs why do they need to be relieved?

Other than simple tiredness and fatigue brought on by being on duty for too many hours and not enough sleep, fatigue can be brought on by being on the legs for too long-for short periods of time, the legs will recover quite quickly with rest Over the longer term, there is simply not enough time to recover because the med student has to get up and get back out onto the hospital floors again-the long term effect on the lower legs and circulation may lead to health problems (For more on this see www.hazards.org/standing) If the poor circulation is medically related there is not much to be done except get them dealt with by the medical profession-but if the lack of circulation it is related to not moving enough then it may be helped by restarting the calf muscle pump using Light Manual Muscle Relaxation-a self help massage-lite recovery system Copyright 2009 Michael Gillan 1 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation The Calf Muscle Pump The calf muscle pump is a very important part of the circulatory system-the purpose of the calf muscle pump is to force used blood against gravity up the legs back to the body for recycling (p.209) Physiology: a regulatory systems approach. Fleur L. Strand. Macmillan Publishing Co. Inc.ISBN 0-020979860-4

The muscle pump is made up of all the leg muscles-the main motors for the pumping system are the calf muscles, the soleus which is used for standing and walking and the gastrocnemius used for running and jumping, and together they work to move blood up the legs by alternately putting pressure on the veins and releasing it (p.209)Physiology: a regulatory systems approach. Fleur L. Strand. Macmillan Publishing Co. Inc.ISBN 0-020979860-4

soleus

gastrocnemius

The veins have one-way valves in them-as the muscles squeeze, they open the valves, letting blood pass through them; when the tension is released they close, stopping it flowing back down towards the feet, but if someone has a job that involves standing for long periods and the calf muscle pump is not working, the weight of fluid in the body can put pressure on the veins The veins which take blood back to the body have one-way valves in them-as the muscles squeeze, they open the valves, letting blood pass through them; when the tension is released, they close stopping the blood flowing back down towards the feet If the pump is not working properly, the weight of the used blood can remain on the valves causing the veins to widen and gaps in the valves to allow leakage of fluid back into the lower legs “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

Lack of movement reduces the veins ability to open and close by keeping constant tension on them, this is called calf muscle pump inefficiency ‘Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

Copyright 2009 Michael Gillan 2 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation Calf muscle pump inefficiency also affects the Lymphatic System through a reduction of lymph fluid flow ’ (P.177) ‘Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

Problems caused by calf muscle pump inefficiency include

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Poor circulation

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Lymph system inactivity

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Venous return reduced

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

This can lead to long term leg health problems (See www.hazards.org/standing)

Muscle health is based on having a constant supply of oxygen and nutrients to them (P.150) ‘Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

To maintain the supply of fresh blood to the lower legs a balance between what goes into the muscles and what comes out of them is important-fresh blood can't enter the muscle tissues if nothing is coming out of them

Here is an image of a leg of a swollen lower leg and ankle-it shows how lack of movement and exercise can affect lower leg circulation and make it more difficult for the exchange of warm blood for cold (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

I work with ultra marathon runners and walkers (people who walk or run any distance over marathon) on recovery during and after their event-I work at events that range from 6 hours to around the world (www.worldrun.org)

My knowledge offers a simple self help-system developed on and for ultra marathon runners and walkers that works with the muscles-this makes it easy to do and it does not need equipment or any complicated hands on training to do Unless you know what you are doing most modern massage techniques are not only too technical-they can be too rough on tissues, arteries, and veins in the legs from uncontrolled finger force and untrained hands working on and into the muscles causing damage

Copyright 2009 Michael Gillan 3 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation Why is working with the muscles more important than working on them? “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)

The circulation is already challenged and the muscle tissues already struggling for fresh blood-working on the muscles entails using the hands and fingers to encourage circulation and this means using uncontrolled finger force into the tissues Dealing with the muscles in an appropriate way is important if using manual therapies-to help increase lower leg circulation it is important to make a choice that is not going to make things worse This the integrity of the venous and arterial systems is compromised by breaking the fine capillaries and venules that run throughout the circulatory network of blood carrying vessels There are many other problems caused by venous inefficiency and it may be worthwhile looking at http://care.diabetesjournals.org/cgi/content/full/26/12/3333 Peripheral Arterial Disease in People With Diabetes http://www.o-wm.com/article/8057 Controversies Regarding Vascular Disease in the Patient with Diabetes: A Review of the Literature VOLUME: 53 Issue Number: 11 author: Robert J. Snyder, DPM, CWS http://www.videomd.com/PeripheralArterialDisease-fv-465.aspx

Copyright 2009 Michael Gillan 4 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation Fatigued legs need something simple that is easy to do without putting the system at risk of damage Light Manual Muscle Relaxation the Massage-Lite leg assistance What makes Light Manual Muscle Relaxation so different from other recovery systems? The theory of Light Manual Muscle Relaxation is based on

“Pumping caused by external Compression of the Lymphatics Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-7263994-0 (p. 182) While the practical part of it is fully hands on work at many ultra marathon events both in Australia and internationally (see www.aching-legs.org for events and research undertaken) It is an alternative stripped down basic tool which uses the muscles to work with themselves rather than relying on the skills of someone who works on them This model has many benefits for someone who has to take the place of a skilled therapist in a remote area where there is a shortage of them or there is not the financial ability to afford the real thing (Like medical students) You can use aimless guesswork and prod and poke and just move the legs in an aimless fashion and hope what you are doing is working and to some extent any movement is better than none Or you can use planned and structured movement that is based on medical physiology and been tested on many ultra marathon runs and walks around the world that takes into account the problems of the client and makes the most of any movement restrictions placed on them The advantages of having a massage-lite system •

No equipment needed

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No disrobing

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No oil

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No washing up

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No long training

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No clean area needed

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Can be done by anyone

Works with the muscles not on them

Copyright 2009 Michael Gillan 5 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation Light Manual Muscle Relaxation-(Massage-Lite) works through •

Simplicity

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Predictability

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Consistency

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Non invasive

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User friendly

How user friendly?

I worked for 24 hours off this chair (next to the bottles) without any equipment in unhygienic conditions

There are other ways to help the circulation in the lower legs

This is the last thing someone at home needs because they already have a problem with movement-and it is needed to make the calf muscles work to pump the used blood from the legs This is very passive and for not much use because they are not implementing those needed lifestyle changes and getting that exercise part of treatment working- they need a pro-active role in helping the calf muscles to work the pump at moving the fluid up the legs How to do this just needs the knowledge of how to work with the muscles not on them!

Copyright 2009 Michael Gillan 6 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation Light Manual Muscle Relaxation is a Do-It-Yourself method based on encouraging the muscles and tissues to assist with their own circulation •

It is not a massage system

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It is not invasive

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It is not aggressive

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It is not time consuming

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It does not need disrobing

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It does not need oil applied to the skin

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It does not need strong hands and fingers

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It does not need hand/brain coordination

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It does not need equipment

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It does not work on the muscles

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It does not work on any specific injuries

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It does not threaten the integrity of the muscles

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It does not use force on the muscles

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It does not need more than a few minutes to do

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It does not require a long course or workshop

It makes it easier for someone who has to become their own physical and muscle therapist-and they have to learn how to do this with a minimum of education and training

Giving a massage-lite leg workshop Working with the muscles Copyright 2009 Michael Gillan 7 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation You are at this website because you obviously have an interest in warm feet so if you want more information on Light Manual Muscle Relaxation and you can afford it-please buy a manual The money raised from this goes towards supporting my project on establishing classes around the world in countries that do not have access to many health services

Michael Gillan Long distance recovery specialist I should point out I am not a doctor so I am not treating anything and what I say should not be taken as a medical treatment or implied that it is-medical treatment should be sought and advice taken about whether it is suitable for your complaint For more information on Light Manual Muscle Relaxation go to http://aching-legs.org/medical_students_fatigued_legs.html

Helping aching legs caused by the calf muscle pump not working properly is simple-All you have to do is to read up on medical physiology and try it out-or you can go to the end and check my websites and buy my manual (doing this you will save on doing a massage course you may not need while at the same time helping me to get onto the world run, and contribute to my aim of setting up workshops on Light Manual Muscle Relaxation in third world countries-and supporting some medical students through scholarships-see website)

This runner (waving) was like the ones at the start of the article twenty minutes before this image was taken-if the medical student could recover so quickly half way through their time on the hospital floor or after they would be able to concentrate on learning Copyright 2009 Michael Gillan 8 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html

The Calf Muscle Pump-Light Manual Muscle Relaxation as an aid to lower leg circulation And they can using “Pumping caused by external Compression of the Lymphatics Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-7263994-0 (p. 182) 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 competitors 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)

[email protected]

Copyright 2009 Michael Gillan 9 ultra marathon recovery specialist http://aching-legs.org/medical_students_fatigued_legs.html