Low Back: The big picture

Treatment at Synergy


Low back pain is a common, almost universal complaint. At some point in life, almost everyone has experienced this problem. Some unfortunate people are plagued with a chronic condition that continues despite medication, treatment, and expensive mattresses. Americans spend at least $50 BILLION each year on low back pain. It is the most common cause of job-related disability and a leading contributor to missed work. Low back pain follows headache as the second neurological ailment reported in the United States. Here at Synergy Healthcare, we have effective treatments for this universal ailment.

Most acute low back pain is mechanical in nature, owing to trauma, overuse, or incorrect use of the musculoskeletal system. Symptoms can range from restricted range-of-motion, muscle ache, or stabbing pain to the inability to come to upright standing. If not remedied, this can lead to chronic pain that is more difficult to deal with. Synergy Healthcare has multiple therapies geared toward addressing low back pain, including: Strain Counterstrain, Myofascial Release, Feldenkrais, Total Motion Release, Craniosacral Therapy, Muscle Energy and specific movement.

The low back area is similar to a complex freeway interchange in a major city. It houses and protects the internal communication and electrical systems of the body, transfers gravitational, load bearing, and shear forces. It mechanically articulates with other structural components of the skeleton for movement and support, allows transport of fluids (blood, lymph and wastes), and protects internal organs. All this activity takes place in one of the most structurally vulnerable places in the human body. When the low back is dysfunctional, it can affect many of the body’s functions.

Skeletally, the low back is made up of the lumbar vertebral bodies attached superior to the sacrum and pelvis and inferior to the thoracic spine & ribs. These 5 bones not only stack on one another to support the weight of the upper body but also house the spinal cord that innervates the lower body. Between each of these bones are gelatinous intervertebral disks that act as shock absorbers and allow movement.

A unique therapy offered at Synergy is the Feldenkrais Method, based on the work of Moshe Feldenkrais, D.Sc. A form of somatic education, it focuses on the skeletal system and uses gentle movement and directed attention to improve movement. It is based on the principles of physics, biomechanics, and human development. We offer group lessons called “Awareness Through Movement” as well as individual sessions called “Functional Integration”. These address functional movement, posture, and unnecessary habitual patterns that relate to the whole body.

Many muscles are involved in the low back region including: latissimus dorsi, external obliques, serratus posterior inferior, longissimus thoracis, multifidus, spinalis thoracis, transversus abdominis, internal obliques, quadratus lumborum and psoas major. And these are just the tip of the iceberg, so-to-speak. Each of these muscles attach to other structures via ligaments that can all have their own mis-alignments and dysfunctions.

One of the manual therapies utilized at Synergy Healthcare is Myofascial Release, MFR. Fascia is a thin, tough, elastic connective tissue that wraps around all the organs, muscles, and structures of the body. It can become restricted due to trauma, overuse, injury, scar tissue, muscle tension, diminished blood flow, or inactivity. Often the result is pain. The therapist locates restricted areas of movement and then directly or indirectly manipulates the fascia to regain mobility.

We all know that low back pain does not exist in a vacuum. The human body is a whole entity, where each part affects all the other parts. The place where pain or symptoms present themselves is not always where the dysfunction or primary problem exists. Treating just the symptom “low back pain” will not necessarily cure the root problem. We make an effort to observe and treat the “whole” person. It might be a leg length problem, a knee or ankle problem or even a digestive issues contributing to the issues at hand.

Some of the therapists at Synergy have been trained in Total Body Balancing, TBB. This technique is based on the work of John Wenham D. O. It assesses and treats the whole body with the use of long levers and rhythmic mobilization to release tension in the muscles, fascia, joint capsules, and ligaments to improve circulation, and arterial, venous, and lymphatic flow. It helps to normalize sympathetic and parasympathetic neurological activity, and improves global systemic vitality. TBB influences all systems of the body including lymphatic, visceral, myofascial, and musculoskeletal systems.

Total Motion Release, TMR, is an effective therapy used in treating low back pain. It allows the therapist to evaluate and then treat the patient by identifying movement imbalances. The therapist first evaluates the patient in the office and then gives them a simple, easy-to-follow home exercise program designed to address imbalance throughout the whole body. It is unique because it focuses on utilizing the strong side to remedy imbalances on the weak side. This leads to a more symmetrical presentation, which ultimately leads to less pain.

Chronic pain, pain lasting more than 6 months, can originate with an initial trauma or injury but persists long after the injury heals. Prolonged pain leads to anxiety, stress, depression, and fatigue that may interact with the body’s production of natural painkillers. These negative feelings may increase the level of substances that amplify sensations of pain, causing a vicious cycle of pain. There is evidence that unrelenting pain can suppress the immune system.

One of the most widely used treatments for chronic pain at Synergy is Strain Counterstrain, SCS. This technique is a type of “passive positional release” created by Lawrence Jones D.O. It is a manual therapy that alleviates muscle and connective tissue tightness in a gentle and non-traumatic way. During a treatment, the involved tissue is put “on slack” enabling aberrant reflexes that produce muscle spasms to relax. In most cases, it has almost immediate effects on reducing pain and swelling while improving mobility.

Lastly, specific visceral restriction can be the cause of low back pain including chronic constipation and diarrhea, reflux and surgical scar adhesions from laparoscopic or other major surgeries.

Overall, Synergy Healthcare has many treatment options for people that suffer from low back pain. If you have a patient that has not gotten results from traditional physical therapy for their pain, please consider referring them to Synergy Healthcare, where we treat our patients as a whole, well-balanced person, not just a symptom or disease.


Give us a call at 509. 413. 1630 or leave your contact information  and we will get back to you!

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Feldenkrais- The Key to Unlocking a Better Yoga Experience


Balance and Ease


While yoga poses create awareness, they can become habitual in the way they are practiced. Without realizing it, many are using more effort than is needed  which can lead to neck pain, back pain, during their yoga practice, making it a much more difficult and potentially painful experience. The gentle, simple, inquisitive process of an Awareness Through Movement (ATM) lesson opens and deepens your kinesthetic knowledge paving the way for a better yoga experience.

Feldenkrais emphasizes small, enjoyable and subtle movements to give more insight into the way that you habitually move. Once a bad habit is discovered it can be retrained into a more efficient pattern. This can improve yoga poses and deepen the practice, guiding to you to move more smoothly and easily. By slowing down, so that we can sense and feel more clearly how we are moving, we begin to experience the yoga postures as dynamic, rejuvenating and endlessly interesting.  Flow, fluidity, and flexibility—supple strength and repose-in-action—welcome to your new yoga experience!

What Feldenkrais – “Awareness Through Movement” lessons can do to help improve your yoga practice:

  • increased awareness of self
  • increased range and ease of motion
  • help identify habitual misuse and/or overuse of self
  • unify the body as a “whole” in yoga asanas
  • further enhance breath work
  • break down asanas into smaller, slower, easier segments

The essence of yoga has always been about transformation, invention, and adapting to the times. In that spirit, Feldenkrais is an exquisite way to enter into the practice of yoga that is relevant, safe, and empowering for you, as an individual. First and foremost, the Feldenkrais Method is concerned with learning—our endless human potential to reorganize and adapt, to reinvent ourselves and evolve—much like the essence of yoga.

Synergy Healthcare offers Feldenkrais along with physical therapy and occupational therapy  in Spokane Valley, WA. Our highly trained therapists are ready to get you back on track fast! We try to prepare helpful articles that can help enrich your life. Have a question you want answered? Email us at info@synergyspokane.com or call at 509-413-1630 for more information. Comment below or give us a shout-out on Facebook– we love to hear whats on your mind!


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Move From Muscle Pain to Flexibility with ATM lessons


What can you expect if you come to an Awareness Through Movement® Class?

ATM ® is a  group lesson in a casual, relaxed setting. They can be done lying or sitting on the floor, sitting on a chair or in standing. The overall goal is to make sure the student is as comfortable and relaxed as possible. Plan to wear comfortable, loose fitting clothing that will not restrict your movement. Learning and awareness are optimal when a person is not stressed, uncomfortable or in pain.

Verbal instructions are given directing movement sequences and focusing awareness on particular areas of the body or how to improve posture.  Lessons are not demonstrated but rather described, allowing the student’s brain and body a chance to “learn” the movement from conception. The lessons start out with simple movements based on infant development, such as: lifting the head, reaching with the hand, rolling over, or crawling. Then, as the student progresses the lessons become more involved, exploring optional movements to use with daily functions or more complex combinations. There are no right or wrong ways to do a movement, only your way. During a lesson you “explore” the different options and combination of movements your brain and body come up with, improving your flexibility and range of motion.

ATMs have two basic rules: first, move only in your comfort zone. Not what you think the instructor wants you to do, not what the person next to you is doing.  Your body interprets the instructions as your brain figures them out. The idea is work smarter not harder. The lessons take you beyond your normal limits by finding new combinations of ways to move. Second, carry out the instructions only as long as you are aware of what you are doing. If the mind begins to wander, if the movement becomes mechanical, stop, rest and then resume.

Awareness is key to learning, “if you know what you are doing, you can do what you want”, a favorite saying of Moshe Feldenkrais, the founder of The Method. There are hundreds ofATMs that each address unique functional movements demonstrating how the whole body needs to participate as a unit. Each lesson is structured to include thinking, sensing, awareness, movement and imagination.

ATM lessons can often produce surprising and pleasing results. Making a seemingly impossible action easy, Feldenkrais lessons allow us to question our assumed limitations. Though our range of motion may be mechanically limited, there are no limits to the quality of movement. These lessons re-ignite early childhood impulses to move, explore, learn and can be actually fun!

The Feldenkrais Method works with each person from pediatrics to geriatrics and everyone in between.  This process is for people any ability or level of mobility, helping them explore how they move, increasing flexibility, promoting relaxation, decreasing tension, improving dynamic posture with overall positive effects on well-being and increased vitality. If you are experiencing pain and stiffness with movement or you would just walk more efficiently ATMs may be for you.

Watch ATM in action!

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Think you might like to try one? Call Synergy Healthcare in Spokane Valley at 509-413-1630 to find out our current schedule of ATM lessons. Or email Nora Graebner, GCFP at norag@synergyspokane.com with questions or comments.

Synergy Healthcare offers physical therapy and occupational therapy in Spokane Valley, WA. Our highly trained therapists are ready to get you back on track fast! We try to prepare helpful articles that can help enrich your life. Have a question you want answered? Email us at info@synergyspokane.com or call at 509-413-1630 for more information. Comment below or give us a shout-out on Facebook– we love to hear whats on your mind!

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Nora’s Story of Feldenkrais

Awareness of use of skeleton in functional activityFeldenkrais. I admit, I had never even heard the word, nor did I have any idea, WHO or WHAT it was prior to my sister, Nancy’s experience.

Nancy was involved in a serious motorcycle accident, that resulted in a “below- the-knee” amputation several years ago. In the course of her rehab she needed to learn to walk with a prosthetic leg. This task proved very difficult and discouraging until she worked with a Physical Therapist who also happened to be a Certified Feldenkrais Practitioner CFP. At the time, I was attending school in Memphis to get licensed as a Physical Therapist Assistant. Nancy shared in me, what a remarkable difference using the Feldenkrais Method® made in her progress with integrating the use of an artificial leg in re-learning to walk. She felt strongly that I should look into this method to enhance my physical therapy education. Thus began my four year journey into exploring how my own body moves while studying to become a Feldenkrais Practitioner.

Very few of us are aware of “how” we walk, which muscles the brain fires to contract and release, the relationship of our skeletal frame as it stacks upon itself to support the weight of our body and the complex integrated whole of ourselves that are involved in average daily movements. Likewise few of us are “aware” of which leg we bear more weight on in standing, which shoulder blade contacts the floor more fully in lying down or which ear is closer to our shoulder. Why should we even care, isn’t life busy and complicated enough without having to focus on such things?

Moshe Feldenkrais, often said, “if you know what you are doing you can do what you want.” Instruction in the FELDENKRAIS METHOD allows a person to shift their attention to different parts of their bodies enabling them to become more fully aware of how they move. Being aware of what you are actually doing opens the door for choice when moving. Do you want to move in an automatic way, a way that may be causing pain or that involves more effort, or would you choose to move in an easier, lighter, more enjoyable way?

Come to a series of FELDENKRAIS – Awareness Through Movement® classes, centered around HOW YOUR BACK MOVES offered at Synergy, the Spokane Valley location (12012 E Mission Ave).  The cost will be $12 per session or $40 for 4 lessons. Space is limited so please call 509-413-1630 to reserve a place. Wear comfortable, loose fitting clothing. If you have questions please email me at norag@synergyspokane.com. I look forward to meeting you and being a part of your journey in exploring how you move.

Synergy Healthcare offers physical therapy and occupational therapy in Spokane Valley, WA. Our highly trained therapists are ready to get you back on track fast! We try to prepare helpful articles that can help enrich your life. Have a question you want answered? Email us at info@synergyspokane.com or call at 509-413-1630 for more information. Comment below or give us a shout-out on Facebook– we love to hear whats on your mind!

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