I don’t want to cast aspersions on any childhood songs in particular, but we have a tendency to imagine the body as a rigid frame, and its movement via distinct muscles pulling on levers to produce specific joint actions. eg: the hamstrings pull on the shin bones to produce knee flexion. While this is not technically incorrect, is it the most authentic way to view functional (and therefore dysfunctional) structure and movement in vivo?
If we were treating robots not people, then I think it would be fine. In that case, addressing any pain or dysfunction would be more a case of finding the part that wasn’t working and fixing the hydraulics at that particular joint.*
When we are injured or in pain, for example lower back pain, many of us – and naturally so – will think: “My back is sore, I must have hurt my back, I need someone to treat my back.”
But unfortunately it’s not that simple – and this is why you might come in with pain at the back of your neck and we start pummeling the front of your chest, or with one gammy shoulder and we ask questions about ankle injuries and prod around your hips and spine.
In our line of work the site of pain and the cause of the pain cannot be assumed to be the same, or even close.
But, why not?
Well … one could make a thesis out of that question, but I’m a biter-offer of more than I can chew so here goes 500 words. Bear with me, friends.
First off, the musculoskeletal system is a lot more than muscles attached to a skeleton.
‘Fascia is a band or sheet of connective tissue, primarily collagen, that attaches, stabilizes, encloses and separates muscles and other internal organs.’ (Wikipedia)
Healthy fascia is a thin, extremely tough but supple layer or sheath that surrounds muscle fibres, fibre bundles, whole muscles and muscle groups, and forms an unbroken network throughout the entire body. The. Entire. Body. The fascia of your Achilles tendon can be traced up over your head to your eyebrows, or from one hip to the other shoulder, or from your toes through your diaphragm to your chewing muscles, etc. etc. etc. This is HOW the toe bone can be connected to the foot bone, all the way up to the head bone connected to the neck bone.
Tensegrity (ie: tension + integrity, or my third favourite word mashup after snacktivity and banoffee) is an architectural concept “based on the use of isolated components in compression inside a net of continuous tension, in such a way that the compressed members (struts) do not touch each other and the prestressed tensioned members (cables) delineate the system spatially.” (Wikipedia)
Try imagining a part of the body like this sort of cable bridge type thing, where the struts are bones and the cables are muscles, tendons and their fascia:
Biomechanically speaking this is a way of viewing the body where the skeleton is held up or ‘floating’ in that “net of continuous tension” provided by the softer tissues. From this perspective the bones provide ultimate rigidity and support, as well as act as levers for movement, but it is the connective tissues that give the body its form and function.
Your fascia is that continuous net of tension – pretty much every part is connected to everything else. Some suggest viewing it like a knitted jumper or a stocking. If you get a snag it may create a small hole in one area, but with time and movement that hole will eventually knot up or unravel to affect parts of the garment that are pretty far away.
And as you can imagine, if something goes wrong in this model – for instance one of the bands starting to fray – you can’t simply fix that single band. It’s too interdependent on all the other structures. It may be fraying because a band on the other side is pulling it too taut, or because one above or below it is too slack.
The symptoms clearly appear in a specific spot, but the problem originates somewhere else. If you try to fix the frayed area before you bring the net of tension back to normal around it, you will find yourself constantly repairing and re-repairing that one fault.
Which is exactly the case with our work – a client may come in with a stiff, sore neck, for example. Local massage may restore range of motion and help with the pain acutely, so that will almost definitely be a feature of their treatment. But it’s only one part of the plan, and may even be a relatively small part. Lasting outcomes are more likely to occur if we seek the root cause of the problem, not by just slapping a bandaid over the frayed cables.
So this is why treatment, rehab and accessory training need consistent effort and take some time – not only do we have to work to loosen off the tight spots and strengthen up the weaknesses, we have to keep at it until the effect has made its way across the whole net.
*(any robot mechanics reading this please contact email@example.com for necessary revisions).
Peta is the head Remedial massage therapist at Evolutio. She's been coaching CrossFit for several years and is a qualified S&C coach. Peta works Mondays, Thursday and Friday afternoons at our new clinic in Richmond and will soon be working Fridays. You can book in with her here or follow her sweet instagram @peta_glastier