Eliminate Back Pain with ELDOA

At MHP, we believe self care is the best care. We utilIze a unique and extremely effective exercise system that teaches clients to fix their own neck and back pain- ELDOA.  The ELDOA was developed by French Osteopath/MD Dr. Guy Voyer to allow patients to have an exercise to treat and resolve their spine pain by themselves.  Dr. Markel teaches this system to his patients in order to empower them to be “their own best therapist”File_000 (4)

Goals of the ELDOA:


•To create more space between the vertebrae

•To create awareness for the intervertebral disc. This space allows it the freedom to move and adapt to the forces and movements of the spine

•To depress the nerve between the vertebrae, or “create space” for the never

•To improve proprioception of the vertebrae joint segment. Supporting good fascia stability and stimulating the brain

•To improve proprioception of the Functional Spine Unite (FSU)

•To move all parts of the annulus fibrosis to stimulate water (intake/imbibition) and hydrate the intervertebral disc

•To strengthen the Postural System. The ELDOA mobilize the intrinsic muscles, improving kinesthetic stimulation (micro-stimulation) of the muscles.

Why Am I Always Tight?

Working with people in both the athletic and clinical setting, there is a common question raised: “My low back/knee/ankle/neck are killing me…oh, and I’m always super tight, my flexibility is terrible. Why am I always tight??” This question is especially prevalent among athletes and active people.

The reality is that most of these people are chronically tight in their hamstrings, calves, low back and neck because of the loads they are putting on their bodies. As a reaction to these loads, their nervous systems’ strong protective/defensive mode comes to action. What often creates these loads is poor or incorrect body function/movement. In other words, if you run 6-8 miles per day every day, you practice yoga 6 days a week or you lift every day, but don’t really know how to move efficiently, your central nervous system will trigger mechanisms to rescue you from eventual breakdown. Protective tension is one of those mechanisms.

Just go for it, no pain no gain! This mentality is very common and although that mantra may help you finish a long race or lift a heavier weight at that moment, the reality is that this approach can breed longstanding overload in the body taking away stability where it matters. This in turn will create an overload effect on a muscle/joint. When the brain perceives that a muscle or joint has been overloaded and is in danger of failing/tearing/becoming injured, the body creates an inhibition or a “shut down” of that muscle/joint. The nervous system reaction is one of protection to prevent injury, usually resulting in local tension. While a typical reaction to a very tight hamstring is to stretch it more and more, the brain puts a premium on protecting from injury first, especially when the demand of intense daily exercise remains. But, usually the cycle continues despite the discomfort/tightness felt in the hamstring or hip, you continue to run or push harder in the yoga studio, etc., etc.

What in fact is this tightness that you feel in any particular tissue? The actual mechanism of tightness in this scenario is often misunderstood. The perception that a particular muscle has gone rogue and just tightened is inaccurate. The body provides slack for movement through the complex network of fascia and nerves; muscles only stretch or move because of the fascia and nervous system allow it. Fascia can be thought of as a web of tissue that acts like an inner skin, encasing muscles and spanning the entire body head to toe. Fascia was once thought to be just dead connective tissue, but we now know it is the interconnected web of tissue that supports us against gravity and actually creates movement with signals from the nervous system. There are even some experts that suggest fascia can independently contract and send signals through the body without conscious control. Fascia does not change with classic stretching methods, which only serve to create a temporary change in muscle-tendon structures. An overload to any tissue triggers the system’s defense mechanisms causing the fascia and nervous system to inhibit movement to avoid potential injury. In addition to fascia, nerves under tension react poorly to stretching and will elicit a strong protective reaction. We feel this inhibition in movement as muscle tightness. While stretching the “tight” muscle may make a temporary reduction in the tight feeling, at best, it will not solve the “overload” issue.

The true way to reduce tightness or tension is to prevent the nervous system from locking down the tissues via appropriate loading and conditioning in training. Training the nervous system to accept controlled, safe movement is critical. In this quest, it is helpful to gain a better understanding of your fascial system and identify restrictions in that network that are worth reducing so long as they serve to improve function. Just because you can stretch further doesn’t mean that you can move better or with less risk of injury. The key to all increased ranges of motion is stability and efficient/correct movement from that point of stability. Without these two things, any seeming “improvement” will not be sustained.

So the next time you spend an hour stretching your hamstrings or your neck only to have it “tighten right back up”, consider your daily routine and the demands you’re putting on your muscles and associated joints. Perhaps your chronic tightness is just your nervous system and fascia pulling the emergency brake in your body. Give it an override code for a day, back off the long run or the aggressive stretching and see what happens. Maybe go for a walk instead of a long run or take the gentle stretch yoga class instead of power yoga that day. The body functions optimally when given a variety of physical tasks with varying intensities. To help more directly, perhaps get an evaluation from a qualified instructor, trainer or doctor so you can identify potential weaknesses or instabilities in the body or fascial restrictions that may be working against you in your activities. This way you can address these “hidden” areas through stabilization or mobility work and go back to the gym or the yoga studio with improved function and be able to have a new conversation about how tight you used to be.

For more information or to set up an evaluation at Markel Health Performance call        704-499-9128.

Diversity of the Diaphragm

Diaphragm Power

When asked to describe the diaphragm, most would identify it as the breathing muscle.  That is certainly true, but the diaphragm’s true importance goes even beyond the vital function of breathing.  The average person should do their best to develop their diaphragm, but the athlete or the yogi should make it absolutely essential.  It is not an overstatement to say the diaphragm, along with the heart, is the most important muscle in the body, but not using it properly can lead to a wide variety of dysfunctions in the body. 

The diaphragm is a flat muscle that attaches to the base of the ribcage like a parachute-like dome.  It also anchors to the front of the lumbar spine and has some connection the abdominals on the front of the body.  The primary role of the diaphragm is breathing, which we all are programmed to do perfectly from birth.  That does not mean we have all maintained perfect breathing mechanics throughout our lives.  In a healthy, normal system the diaphragm initiates breathing by contracting and expanding the lower rib cage which enlarges the lung space to draw outside air in (inspiration).  The diaphragm will then relax, which pulls the ribcage in and squeezes the lungs, expelling the air (expiration).  If a person has been chronically under stress from emotional or physical sources, a typical over-activity of the chest and neck muscle results.  This over-activity leads to chronic muscle tightness and leads to chronic “chest breathing” where the upper chest and neck muscles start to take on the role of the diaphragm.  This disturbs natural function and leads to a common presentation of a raised chest and arched low back called “Open Scissors Syndrome” (below) 

C -Open Scissors Positon

This is an unstable body position where the ribcage and pelvis are “disconnected” and point in opposite directions like a pair of open scissors blades.  The hard curve in the low back stresses the spine and will limit mobility and stability in the core of the body.  The over-activity of the chest and neck muscles will often result in chronic neck pain, headaches and shoulder tightness.  The trickle-down impact of the scissors position and a downward titled pelvis is stiff hips joints.  One can imagine that tight hips and shoulders is not conducive to efficient movement in yoga as nearly all human movement is predicated on stable spine-pelvis and mobile shoulders and hips.

The lesser known importance of the diaphragm lies in its relationship with the spine.  During a proper breath, the diaphragm stabilizes it’s attachment to the lumbar spine, which allows it to initiate a natural chain reaction of the abdominals, pelvic floor and lower back muscles that all work to stabilize the ribs, spine and pelvis all at the same time!  This is an automatic reflex that is the key to true core stability which is vital for protection of the spine during movement.

In our clinic, breathing is evaluated in all patients as it can lend insights into the cause of chronic pain or dysfunctions.  Without professional evaluation, the best advice is to truly spend time practicing diaphragmatic breathing each day as this alone will help activate the reflex.  Sometimes people with layers of dysfunction need additional treatment and rehabilitation of the diaphragm in order to normalize breathing.  Normal breathing is a skill that should be practiced and mastered as it will allow the body to reach new levels of performance. 

Injury-Proofing Yoga


One of the most widely practiced forms of exercise in the world today has actually been around for 5000 years. Yoga, both exercise and spiritual practice for some, can be extremely effective at improving flexibility and body control.

A surprisingly large and diverse sequence of moves or poses can be used in a typical yoga practice. These movements can be as “simple” as bending forward to touch the toes or to pull one of the legs behind the head.

Experienced yogis typically work for years to develop the flexibility and control to perform incredible movements. However, despite the stereotype that yoga only demands extreme flexibility, it is in fact a delicate balance of joint mobility AND stability. The human body is a complex machine that is designed to move through specific patterns of joint actions.  Some joints are designed for mobility, like the hips and shoulders, while others are designed primarily for stability, such as the knee, the spinal joints of the low back and neck.  These joint systems are always working together to produce safe and efficient movements. If some joints  are too mobile and unstable, or others are too stiff, the chain of movement will be disrupted and movement will be limited. This can happen if one’s hips are stiff and their low back and core muscles are weak from years of disuse.

All of the sudden, the “simple” action of bending forward to touch the toes is not so simple.  This can explain why the new yoga practitioner is always tight in this movement and the disturbed mechanics can lead to joint, ligament or muscle overstrain and pain.

This scenario can happen all over the body during challenging movements in yoga. This is why Markel Health Performance works closely with our yoga patients and yoga instructors to fully understand a individual’s movement patterns and abilities. The pirmary tool used to assess movement skills at MHP is the Functional Movement Screening (FMS).  The FMS is the gold standard mobility/stability test used in the NFL, NBA, and MLB to identify a person’s movement abilities while performing a series of tests that challenge body control and coordination.  The FMS findings allow the clinician, patient and instructor to see where the patient needs to use caution and where they need to focus on improvement in their yoga practice. This awareness is critical in preventing repetitive movement faults and potential injury during yoga practice.  This knowledge, combined with a personalized corrective exercise and treatment program designed to improve movement limitations can help our patients to continue their practice of yoga safely for many years to come.

Self-Maintenance For Your Machine

Everyone can classify themselves as an athlete, even if you haven’t picked up a ball or run/walked further than the car to the office in years.  In fact, one could think of an athlete as nothing more than someone who has to perform a skilled movement with efficiency.  This can be throwing a ball, sprinting or just simply walking up stairs or gardening.  Most people may not play sports, but they almost certainly perform certain “movement skills” each day such as walking, bending, lifting, cleaning, getting out of a chair, picking up kids, etc.  While we take these for granted as easy tasks, they all require a constant coordination of controlled movements from many muscles, joints and the brain.  And more accurately, the body needs to have a certain level of mobility and stability in the joints to move efficiently.  These activities should require no effort, but over time and years of inactivity and deconditioning, many people lose their ability to move without inducing stress and strain on their system.  This is just in reference to the average person, the mobility and stability demands rise tremendously when the average person goes from “desk athlete” to “weekend warrior athlete”.  Every person should be able to perform daily activities and their chosen sport without pain or breakdown, but this usually requires some self-maintenance or correction of movement skills.

The usual mechanism for injury in sports is a failure of some joint or muscle in the system.  This may seem obvious, but the real reason this structure fails is likely due to the person’s inability to get into a range of motion or control that motion.  If a runner sits at a desk or a car daily for 8+ hours, the probability of developing stiff hips or hamstrings from being in the seated position is very high.  Many of these people aren’t able to bend down and touch below their knees, but that certainly doesn’t stop them from running.  Taking tight hips/ hamstrings out on the road and then trying to run 10 miles greatly increases the range of motion demands from these structures and once those tight hamstrings are forced into a full stride, a strain or pull is just waiting to happen.  You could use this analogy with the golfer’s lower back which has tightened up from years of poor posture and sitting and then violently turned for hours on the course.  Just like pro athletes who train their bodies for their sport, the average person should do some training to adequately prepare for their activities.  This can be done in as little as 20 minutes a day once they realize what their body needs.

The concept of corrective exercise is becoming increasingly popular in the sports medicine world. An athlete can figure out what their biggest movement limitations or weaknesses are and then correct them before injury occurs.  Truly understanding what your movement limitations are typically requires evaluation from a doctor, therapist or sports performance coach.  A clinician can take a person through a series of tests called the Functional Movement Screen which measures that person’s ability to perform fundamental movements.  This information can then be used by the clinician to prescribe a series of home stretches, core exercises, joint stability exercises or postural drills that the person can perform to correct and remove their limitations to movement.  This will help the athlete function more efficiently and more importantly, reduce their injury risk.  The concept we use at Markel Health Performance is the same that is used at the highest levels of sports medicine, being proactive is always a better than being reactive when it comes to injury treatment.  Don’t wait for the injury that keeps you from running or exercising for weeks, when you can prevent it from ever happening.  If interested in a Functional Movement Screening and corrective exercise program, please visit contact us at (704)499-9128 or NmarDC@gmail.com