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The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

Hospital Staff-Patients-Visitors
The patient long term stay has 3 main problems
• The isolation gap

• Lack of touch

• Lack of movement

Most people have hospital stays sometime in their lives for varying problems and periods of
treatment-for the lucky ones, it is just an overnight stay and home again, for the not so lucky the
stay could be a lengthy one
It is during the lengthy stays that the patient becomes more isolated from friends and families; even
if they visit often as allowed and stay for maximum time and they are emotionally attached to the
patient, a physical gap can develop between them
The patient may miss the physical contact may not be allowed because the treatment being used or
isolation may prevent this-but there may be a time when touching can be recommenced
How to bridge the gap can be difficult because the gulf between patient and visitor may have
widened after initial welcome at the start of visiting time, the middle may become an area of
desolation with both parties trying to find common ground between the life they live and the sterile
life of social isolation the patient lives that others can’t relate to
Hospital staff; doctors, nurses, physical therapists, occupational therapists, cleaners, meal delivers,
are all a substitute family the patient depends on for all their needs; other patients may become their
confidante they tell all their fears and hopes to
As the patient improves the emotional and physical gulf that has resulted between hospital patient
and family needs bridging to bring them back to a normal life in readiness for discharge and ease
their placement into life outside the ward again; this can be difficult as if the stay has been a lengthy
one, they may have become institutionalised, and going home may be stressful for them
Patients are people who need touch other than that provided by hospital staff
The longer someone is in hospital and under medical treatment, the more difficult it becomes to
break down the barriers to give them touch-being in a hospital setting even for family and other
visitors can be a daunting experience, so can place a strain on relationships and can make the patient
feel even more isolated after the visit is over
Some patients may not be going home for some time
Some patients may not be going home as their age, domestic arrangements and medical status may
make it impossible for it to be considered-they are very long term stayers with little prospect of
leaving any time soon
These become even more isolated and institutionalised; they lack one of the most basic needs; that
of touch, other than that of medical staff, they are left to their own devices in their own locked in
world with the odd visitor now and again-they need another option to bridge the gap

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

Lack of movement
Long term hospital stays can have other problems connected with them-lack of movement and
restricted walking areas, and if the patient is confined to bed for any length of time, there is the
problem of reduced lower leg circulation and loss of sensation of underfoot environment which can
lead to loss of confidence when they stand and try to walk again
Sitting or lying down long term

Sitting or lying down for long periods also brings its hazards-by nature of their medical problems,
many patients are forced to have extended bed rest, this can place them in the position of risk from
developing an unwanted condition known as Deep Vein Thrombosis
Deep Vein Thrombosis-blood in the veins becomes static allowing the balance between clotting and
anti clotting agents in the blood to be altered and clots to form in the veins which may break away
and lodge higher up in the body
Most modern hospitals have access to up to date drugs, pressure stockings, calf pumping systems
and modalities such as physio or physical therapists to deal with these problems, but in many
countries there may be only the financial resources to cover treatment of the initial complaint and
nothing left for the ancillary therapies needed for prevention of Deep Vein Thrombosis
This leaves a gap that may be filled by Light Manual Muscle Relaxation-the walk you have
when you are not having a walk

Lower Leg Circulation


Blood is sent to the lower legs under pressure through the arteries and vessels called arterioles and
even smaller capillaries-as the vessel size reduces the pressure taking it there also decreases

On return to Blood pumped


body blood is from heart
renourished through
and recycled arteries under
pressure

Used blood is Reaches feet


moved up the Pressure runs
legs through out
the veins

Calf muscles
act as pump
motors

By the time the blood reaches the feet, all the pressure has been used, and there is none left to return
the used blood back up the legs to the body against gravity again

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

The Veins

Used blood is sent back to the body by a pumping system made up of the leg muscles and veins
which have one way valves in them which prevents it going back down to the feet

There are three types of veins

• Superficial veins act as a reservoir for blood, supplying it to the tissues as needed, they
also carry blood from the muscle tissues to the perforating veins.
• Perforating veins that carry blood from the superficial veins through to the deep veins.
• Deep veins carry used blood and lymph fluid away from the legs towards the heart.
Low-pressure High pressure

Blood is forced upwards Blood is resting on the valve

As muscles squeeze the vessels valves are open as they relax the valves close preventing leaks

In this way, a balance is kept between the fresh blood going into the lower legs and the old blood
leaving them on its way back to the body for refreshment and recycling again

The Calf Muscle Pump-its contribution to recovery from fatigue


To keep the lower leg circulation working, the muscles rely on having a constant supply of fresh
blood to the tissues to help prevent fatigue and to recover when they do
While the effects of the pump has a great effect on the physiological condition of the body, broken
down into its various parts it is just a pump-not too sophisticated in the way it operates, except that
it is made from living tissues rather than manufactured components
Basically the way it works is there are a series of flexible tubes (veins) to take fluid (used blood)
from the lower legs back to the body against gravity-in the tubes are a series of one-way valves that
open to let fluid pass through when the tube is squeezed by the motors (the calf muscles)
When the pressure on the tube is released, the valves close again to prevent the fluid going back
down to the feet again
The calf muscles ability to keep working at applying and releasing pressure the tubes-once this
stops, the fluid can’t be moved up the legs-the used fluid is allowed to just become static
Swollen ankles from lymph fluid (or water) separating from the static blood and migrating through
the vessel walls into the tissue spaces instead of being pumped away can be the result inefficient use
of calf muscles
Being a mechanically based pump, the system can be serviced or restarted using a manual system to
remove some of the fluid and pressure that has built up-once started, fresh blood can more easily
enter the muscle tissues and start the recovery process

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

The Calf Muscle Pump and the muscles that are its motors
The calf muscle pump is responsible for circulation in the lower legs-another name for it is the
peripheral heart because it is outside the body
Its main purpose is to move used blood from the lower legs back to the body for refreshment with
oxygen and other elements that the muscles need to maintain an optimum environment for efficient
working of the muscles

Old blood and fluid is taken out of the lower legs through the veins, fresh blood is supplied to the
muscles through the arteries

The calf muscle pump is made up of all the muscles in the legs, the motors that provide the power
for the pump are the calf muscles-these are made up of 2 basic movers-Soleus which is used for
standing upright, and Gastrocnemius used for running and jumping

Soleus Gastrocnemius

As the muscles move, they increase and decrease pressure on the vessel walls (the veins) opening
the one way valves to let the blood pass along them, and close to prevent the blood flowing back
towards the feet

To keep the circulation in the lower legs going, a similar volume should be
pumped out of the legs as flows into them

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

When the muscles are not doing their job properly they become incompetent
and the pump becomes inefficient
A result of calf muscle inefficiency

Inactivity affects the circulation by reducing the ability of the pump to send used blood and by-
products from the legs back to the body for recycling
Poor circulation means less movement of fluids which may become trapped in the lower legs; water
(or lymphatic fluid) may separate from the blood, migrate through the vessel walls and fill the tissue
spaces-as it can’t be pumped away quickly enough, the ankles swell (edema)
Used fluid build up restricts the supply of fresh oxygen filled blood to the muscle tissues without it,
they quickly fatigue become inefficient and reduces the circulation

Problems caused by calf muscle pump inefficiency include


• Poor circulation
• Lymph system inactivity
• Venous return reduced
Calf
Muscle
Fatigue

Fresh Tight
blood calf
reduced muscles

Poor
blood
return

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

Because of gravitational pull, fluid always finds its own level

It is generally accepted that reversing the effects of gravity by having the legs higher than the body
to change the direction of fluid can help the legs to drain of fluid

Feet-10 MM hg

Head +90 MM hg

Disadvantages of relying on chance to recover the legs


This is the most widely accepted form of leg recovery-it relies on a number of factors for its success
in helping to lower the fluid content in the lower legs-it is also the most passive

• Time-how much do you have to spare for elevating the legs for an unspecified
time?

• Schedule-what is your schedule for the next day

• Cold-do you get cold easily

• Place-are you somewhere you can lie down without being fallen over by others

• Convenience-it is difficult to do wherever and whenever you actually need it

• Health-depending on your age and health, it may be dangerous to be lying down


for long periods; some people suffer from vertigo when they stand up, and may go
light headed and dizzy-this can result in falls

Don’t rely on chance to recover your legs!


Chance is not going to assist you in working those extra years-you need a
simple tried and tested recovery system to keep the legs moving
try
Light Manual Muscle Relaxation-A Tested Trusted Environmentally
Friendly Alternative-for poor lower leg circulation and lack of touch,
anything else is a luxury or not necessary

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

What is Light Manual Muscle Relaxation?


The walk you have when you are not having a walk

It is a Self-Service leg circulation system


It is system developed for ultra marathon runners and walkers leg recovery and has been tested on long
distance events worldwide (ultra
marathon is any distance over marathon-
42.19 kilometers/26.385 miles)

Ultra marathon is very long distance competition where they have to run or walk as far as possible in a given
time; it can be over 6 hours-24 hours-48 hours-6 days-16 days or even around the world www.worldrun.org

It is making the calf muscle pump work again to take some of the pressure away from the lower legs and let
fresh blood into the muscle tissues to help the legs recover
They have to get up and get back on the track or road on a constant basis whether they want to or not to
achieve their objective-the person with aching legs also has to get up and move on a constant basis whether
their legs have recovered or not www.hazards.org/standing

Light Manual Muscle Relaxation-the leg servicing system

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

How Light Manual Muscle Relaxation leg servicing works

Fresh blood Light Manual


moves through Muscle
the arteries into Relaxation
the muscle applied
tissues

Used fluid Tense tight


moves through muscles are
the veins back to calmed relaxed
the body and moved
gently

Using just these-and the knowledge of how to use them

Calf muscle fatigue, tight muscles, and poor lower leg circulation can chase each other around in a cycle that
is difficult to break out from-each is a self destructive part that props up the other parts of the cycle and it
will take a circuit breaker to disrupt the cycle of fatigue
Medically caused leg health should be referred to those best qualified to deal with it-the doctors, but there are
non-medically related problems that can be dealt with by some simple activities

Such as knowledge about how the calf muscle pump works and using it to the best
advantage

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation
What effect can Light Manual Muscle Relaxation have on the legs?
Can chance give you recovery results like these?

FIGURES TAKEN FROM THE (1995 COLAC 6 DAY FOOTRACE)


NAME Day 1 Day 2 Day 3 Day 4 Day 5 Day 6
A Krouglikov 237.2 113.6 130 106 126 108Kilometers
539 284 325 265 315 270Laps
T Rusek 215.2 98.8 98 139.6 138.4 122.4Kilometers
538 247 245 349 346 306Laps
M Taylor 174.4 128.8 143.6 123.6 120.8 89.2Kilometers
436 322 359 309 302 223Laps
B Beauchamp 180.4 133.2 124 117.6 110 93.2Kilometers
451 333 310 294 275 233Laps
P Gray 150 134 105.2 94.8 111.6 106Kilometers
375 335 263 237 279 265Laps
D Parris 138.4 108.4 106.8 116.4 106 107.2Kilometers
346 271 267 274 265 268Laps
I Davis 168 119.2 90 116.4 72 98.8Kilometers
420 298 225 291 180 247Laps
G Watts 131.2 96.4 99.2 104.4 92.8 133.6Kilometers
328 241 248 261 232 334Laps
C Young 142 91.2 90 97.6 88 92Kilometers
355 228 225 244 220 230Laps
D Kettle 138.2 86.8 90.8 95.2 94.4 84.8Kilometers
332 217 227 238 236 212Laps
R Hill 128 80.8 99.2 70 95.6 96.4Kilometers
320 202 248 175 239 241Laps
K Fisher 164 91.6 50 115.2 49.6 81.2Kilometers
410 229 125 288 124 203Laps
G Pollard 120 74.8 73.6 68.4 69.6 61.2Kilometers
300 187 184 171 174 153Laps
The above group came in for massage and stretching
The group below did not or had their own massage people
T Rafferty 141.6 112.8 104.8 101.6 98 96.4Kilometers
354 282 262 254 254 245Laps
G McConnell 145.6 110.8 114.8 113.6 108.4 106Kilometers
364 277 287 284 271 265Laps
G Audley 152.8 110.8 126.4 113.6 114.8 95.2Kilometers
382 277 316 284 287 238Laps
S Scanlon 140.8 82 84 34 0 0Kilometers
352 205 210 85Pulled out (Blisters)
J Timms 127.2 98.4 74.8 0 0 0Kilometers
318 246 187Pulled out 0Laps
N Mercer 166 16.4 0 0 0 0Kilometers
415 16.4Pulled out 0 0Laps
Underlining in the top group shows where the results of Gentle Manual Muscle Relaxation
was starting to take effect. The inconsistencies in the results on a daily basis was
caused by reverting back to conventional massage to see what happened
Note the higher injury and drop out rate in the bottom group.

The above figures show what a leg service using the calf muscle pump can do for recovering the
legs-they are from the 1995 Colac (Australia) 6 day event-and show on a daily basis (Across the
page) the increase that was obtained using Light Manual Muscle Relaxation

More importantly it demonstrates the decrease in time needed for recovery when
increased fresh blood flow is obtained by working with the muscles not on them

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

The advantages of using this system


• Do It Yourself recovery

• No disrobing

• Works with the muscles not on them

• No oil used

• Non invasive

• User friendly
Using a simple but effective lower legs strategy will help to keep them moving during those enforced long
hospital stays

All that is needed are the hands


The hands are the tools to close the isolation gap and increase lower leg
circulation
When the talk has dried up, and the silence is deafening, let the hands communicate for you; give
some constructive touch to both cross the isolation divide and help to minimize the long term
effects of restricted movement in walking

Use Light Manual Muscle Relaxation the walk you have when you are not having a
walk to build bridges

Note-never doing anything with the patient without first discussing with the managing
nurse/doctor and obtaining their permission or you may be interfering with any
treatment for their health problems

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

Some References
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 competitor<>s 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)
A word from Jesper Olsen World Runner about Light Manual Muscle Relaxation
“If I hadn't had the qualified help from the excellent masseur Michael Gillan, taking several thousands of km
out of my legs, I could spare myself the effort!”
“My crew for the current stages, Michael Gillan, has proven to have other talents than the quite taxing job of
taking care of all the requirements of a really tired ultra runner!
He has since years back been working on a new approach to stretching and muscle-rebuilding for ultra
runners. I have the last two days tried his careful stretch and massage, and a bit to my surprise the muscles
are beginning to feel like before the start back in Greenwich, London!!
Usually I doesn’t take massage as the legs of an ultra runner will often be quite sore during the long time
events (and especially in an multi-year event like this...), and getting a massage can at times cause more
injury and cramping up than good. For example my last massage was some 12 000km ago when I ran the 12-
hour competition in Finland. And so far that has been the only one.
But Gillan came with best recommendations from my main contact in Australia, Phil Essam, who besides
being vice president in the Australian Ultra runners Association has heaps of good knowledge to share. And
this new kind of mild massage for ultra runners is definitely one of the good tips! There should be a fair
chance that I actually get fresh enough to do some decent running at the 6 Day Race that I have coming up in
Colac from the 21.November. I quite look forward to that, even though I can’t expect to make a top class
result :-)”
He won! 756.2 kilometers (Jesper holds the record for the longest run in history over 26000 kilometers and
the first person to run around the world Taken from www.worldrun.org

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

Some references for Light Manual Muscle Relaxation

To: mgillan@hotmail.com
Subject: RE: Emailing: m gillan reference.doc
Date: Mon, 4 May 2009 16:48:31 +1000

Hi Michael,

COBURG 24 HOUR CARNIVAL

May 3rd 2009


TO WHOM IT MAY CONCERN

For many years Coburg Harriers has conducted the Victorian 24 hour Track Championship and
the Australian Centurion 24 Hour Race Walk, the overall event being the Coburg 24 Hour Carnival,
which also includes a separate 6 Hour run/walk event.

This type of event is very demanding on Competitors, and each year, in addition to First Aid
support, we seek to have the services of a masseur who can work on tired legs and also treat
blisters in order to keep entrants on the track.

We have been privileged for many years to have had the voluntary services of Michael Gillan who
with his techniques is able to coax renewed life from extremely tired muscles and legs to get
athletes back on the track when they were thinking that they would have to retire.

Michael has a very well deserved reputation in the "Ultra" running and walking fraternity who look
forward to his presence at our events as they know he gets results without causing further injury
with his treatments.

It is rewarding to see exhausted competitors come from the track in the early hours of the
morning, convinced that they are unable to continue, only to see them return to the event after
being treated by Michael.

Our Organising Committee at Coburg is grateful to Michael for his dedication to the sport and can
commend his techniques to Athletes.

Yours Sincerely, Bernie Goggin Raceday Director / Referee Coburg 24 Hour Carnival 2009
http://www.coburgharriers.org.au/joomla1/component/option,com_frontpage/Itemid,1/

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html
The Calf Muscle Pump-Bridging the gap using Light Manual Muscle Relaxation

Physiology References

The calf muscle pump


(p.209) Physiology: a regulatory systems approach. Fleur L. Strand. Macmillan Publishing Co. Inc.ISBN 0-020979860-4

(p.209)Physiology: a regulatory systems approach. Fleur L. Strand. Macmillan Publishing Co. Inc.ISBN 0-020979860-4

"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

Calf muscle pump inefficiency


'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0
' (P.177) 'Guyton-Textbook of Medical Physiology eighth edition-1991 W.B. Saunders Company-ISBN 0-726-3994-0

The Blood Circulatory System


(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

"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)

‘Peripheral Nervous System’


‘Textbook of medical Physiology” (Physiology- fourth edition-Robert M. Berne, Mathew N. Levy, Bruce M. Koeppen, Bruce
A. Stanton-Mosby ISBN 0-8151-0952-0) (P.98)

You can buy an expensive book on medical physiology or you can check up for further information
on Light Manual Muscle Relaxation at

When you refer to medical physiology and use it to work for you, it is possible to
achieve things that were previously left to chance-a faster recovery is one of them

Contact mgillan@hotmail.com

Socks could replace drugs as lifeline for 1m hospital patients ...


25 Apr 2007 ... A substantial number of patients are struck by surgical DVT after they have been
discharged from hospital. A report from a working group set ...
www.dailymail.co.uk/.../Socks-replace-drugs-lifeline-1m-hospital-patients.html
http://aching-legs.org/closing_the_patient_isolation_gap.html
http://www.feet-and-legs.com/
http://www.seniors.aching-legs-relief.com/
http://www.aching-legs.org/increased_working_years_legs_maintenance.html
http://www.promote-health.org
http://www.seniors.aching-legs-relief.com/older_parents_pre-movement.html

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Copyright Michael Gillan Long Distance Recovery Specialist
http://aching-legs.org/closing_the_patient_isolation_gap.html

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