Jean Pierre Barral DO
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New Manual Articular Approach - The Elbow, Wrist and Hand
New Manual Articular Approach (MAA) is a manual therapy
modality that applies a comprehensive approach to the treatment of joints. It
integrates all aspects of the joint including the nerve, artery, bone, capsule,
and ligaments, as well as visceral and emotional connections. MAA delves into
the joints like never before. It examines the nerves of each joint, along with
the arteries, meniscus, ligaments, capsule attachments and folds. It
incorporates soft tissue mobilization of the associated bones, while looking at
direct and indirect relationships between the bones of the body. The
relationship between the viscera and the joints is not widely understood. MAA
shows how interconnected they are and that without addressing this visceral
connection many joint issues may not fully resolve. The application of the
gentle MAA techniques improves the body’s ability to heal and restore itself to
This DVD about the dysfunctional tension around the joints
is also about the pressure inside the joint capsule. Barral is aiming for a process of restoring
the negative pressure inside the capsule, to distribute the synovial fluid
evenly and thereby “save” the cartilage. This is based on the observation that
the pressure difference between the inside of the joint capsule and its
surrounding tissues is maintained or –
in case of dysfunction – disturbed by strain, present in all sorts of tissues.
Strain can be found not only within muscles and their fascia, but strain is also
present in membranes, ligaments, the capsule itself, and even in certain layers
of fat tissues. In this DVD Barral shows, how to make the choice for efficient
treatment for elbow and wrist problems, by distinguishing between the large
variety of anatomical units and tissues involved. (60 minutes)For treating epicondylitis at the elbow, the DVD shows a clear
distinction between the "tennis elbow“ and the "golf elbow." Both
dysfunctions require a distinct treatment strategy, because both can be
related to different nerves, involved in the irritation of the elbow.
For carpal tunnel syndrome, the DVD gives clear instruction, how
to choose and execute the most efficient manual interventions. Barral
demonstrates an almost microscopic evaluation of the way that the
median nerve moves between the shoulder area and the wrist. All the
possible "narrows,“ all the places where the nerve may loose its freedom
to slide, are included in the evaluation. With this knowledge, he discusses a
clearly defined program, showing how to treat these components to carpal tunnel
syndrome, including, the carpal ligaments, joint capsules, and the
impingements of peripheral nerves.
In addition, Barral discusses the influence of hormonal changes, like
in pregnancy or menopause, which may be part of the cause for problems
around carpal tunnel syndrome by causing change in the elasticity
of the connective tissues. With this in mind, he arrives at a complete
spectrum of New Manual Articular Techniques that add to traditional
biomechanical manual intervention.
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