Muscle News Vol I.14:  Restless Legs Syndrome  
Suffering from Restless Legs, Pain or Insomnia?  Try this "Restful Legs Recipe"
Through our Muscle News publications, every 2 weeks you've been learning great techniques for relieving pain and improving your muscular and skeletal health.  Typically, each issue is focused on a single muscle, teaching you the symptoms it causes, how to assess its myofascial health and how to treat it so it functions better for the rest of your life.  

In this issue, we're going to put together the knowledge you've acquired to practice a self-care routine called the "Restful Legs Recipe"!

The Restful Legs Recipe is something we all can benefit from due to our modern sedentary lifestyle.  As one trigger point therapist pointed out at an event this week, "Sitting has become an Olympic event."  She explained that we "practice" sitting hunched over a desk, a computer or a steering wheel more hours per day than many Olympic athletes might practice their sport. 

All this sitting leads to shortening of our hip, thigh and leg muscles, causing trigger points and all manner of muscular and joint problems.  The Restful Legs Recipe is a great solution to balance out all this sitting.

However, no one might benefit more from this recipe than those who suffer from Restless Leg Syndrome or Insomnia.  A case study published in the Journal of Bodywork and Movement Therapies, November 2007, showed that trigger point therapy and massage applied to a group of muscles in the buttocks and legs were able to relieve the symptoms of a woman with Restless Leg Syndrome to almost no symptoms in 3 weeks of treatment. The treatments managed the symptoms, rather than cured the condition, as doctors still aren't sure of the exact cause of Restless Leg Syndrome.  However, the relief experienced through trigger point and myofascial treatment was exciting.

You have already learned to evaluate and treat the same muscles in this case study in previous issues of 
Muscle News.

 The three primary muscles/groups in the 
Restful Legs Recipe are the:
1.)    Gluteus Maximus (& Piriformis)
2.)    Hamstrings
3.)    Soleus (& Gastrocnemius)

Let's review these muscles and look at how to put them together into
one effective self-care routine for Restful Legs.

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.
The "Restful Legs Recipe" (3 Muscles):

For each of the the 3 Muscles (groups), we will assess their Range of Motion, Palpate, and Treat them as follows below.  A great time to perform these self-care procedures is during an episode of discomfort or restless legs.  All the techniques are gentle enough to perform in the middle of the night during a bout of insomnia and should help significantly.

SELF ASSESSMENT 1:  Range of Motion Tests


You can bring your knee quite close to your chest
NOT PASS:  Your knee will not reach your chest


PASS: You can touch your toes with knees straight and no pain        
NOT PASS:  Your cannot reach your toes  
PASS: You can squat all the way down without raising your heels
NOT PASS:  Your heels lift up or you can't attain a full squat


As always, with palpation (the medical term for pressing, feeling and squeezing to evaluate body tissue) we are looking for taut bands of muscle or tender spots, indicating trigger points and myofascial dysfunction.



Press with your finger tips into the muscles in your buttocks in the areas shown.  Press deeper to reach the Piriformis muscle which is a big contributor to restless leg symptoms          



Press with your finger tips into the bands of muscle behind your thigh in the areas shown        


Press into the muscles in the back of the calf starting right behind the shin bone

3 STEP TREATMENT:  Heat, Compression, Stretching

It is very important to follow these procedures thoroughly and gently.  This is the heart of the "Restful Legs Recipe":

1 Moist Heat.  

To relax and warm up the fibers of the 3 muscles in our Restful Legs Recipe, soak in a warm bath or place moist heat such as a Fomentek bag under your buttocks, the back of your thighs and your calves.  You will need more than one Fomentek bag.  





2 Calm Firm Compression.  Compression softens bands of muscle tissue, relaxes nerves, and increases circulation.  Compression involves pressing your hands or self-care tools into the tender spots and taut bands we found during palpation and holding for 10 seconds or 2 full breaths.  Then move on to cover the entire muscle.  Only compress enough to feel tolerable discomfort ("feel-good" pain), not sharp pain or pain that causes withdraw.  Perform compression for each of the 3 muscles 2-3 times per day (especially at night during insomnia), as follows:


Click here to view larger imageSelf-care tools offer a precise compression used lying on the floor.  Different size balls and firmness are used leaning against a wall or sitting on top of the ball on the floor.  


 Leaning either up against a couch/chair or against a wall, place your self-care tool underneath the hamstrings, starting at the sit bones right beneath the buttocks.  




Finger tips or self-care tools work very well to press into the back of the calves. 





 3 Slow Stretching and Movement.  Perform the following stretches 2-3 times per day in order.  If you are having a bout of insomnia, these stretches can be very relaxing to perform and help you get back to sleep.


Perform these positions as slowly as possible with gentle breathing.  Slowly transition from position A to B to C to D.  Hold each position for 5 -10 seconds.  Then breathe in and use the entire exhalation to transition to the next position.  If your heart rate or breathing increases, you are moving too quickly or holding too long - shorten the holds and take rests in between the positions.


Next is a gentle passive stretch to help relax after the last exercise.  Lie on your back in a doorway with one leg up against the wall and the other leg flat (or slightly bent) on the floor through the doorway (as shown).  You can use a strap or jump rope to keep the leg steady.  Move gently toward the doorway as close as possible without straining your hamstring.  Rest and breathe for 30 seconds up to a minute or more.  Switch legs.  If any numbness occurs, switch more often.  Repeat 3 times per leg.


Gently take your Soleus through its full range of motion.  Alternate rolling the foot back and forth, flexing the toes back as far as you can and then pressing the toes back down and lifting the heel off the floor as far as possible.  Perform 20 repetitions on each leg.

Naturally, there are many factors that may play into Restless Leg Syndrome.  This Restful Legs Recipe is meant to address some of the aggravating symptoms and muscular components.  If performed daily, patients have experienced dramatic relief, just as in the case study mentioned earlier.  
We wish you the best of success with this protocol!
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