Soreness, discomfort, pain. Maybe it crept up on you and now you don’t even remember the last time you were pain free or maybe you remember the exact day because you were in a car accident. Maybe you self-treated with Ibuprofen and ice. Maybe a doctor prescribed muscles relaxers and ice. Maybe you’ve been massaging, stretching, strengthening, and moving, but you still have nagging pain in your back, neck, hip, shoulder—fill in the blank—and nothing seems to help.
In previous blog posts on pain and muscle tightness, I talked about the body protects a weakened or injured muscle by limiting range of motion and recruiting adjacent muscles to share the burden of work. Sometimes these protective mechanisms can cause a domino effect of weakened muscles.
Let’s say your shoulder aches all the time with sharp pain sometimes. Since, the shoulder consists of 15 or so muscles along with a myriad of nerves, tendons, ligaments and bones all working together to allow the arm to move in an astonishing number of positions, more information is needed. Does your shoulder pain occur when pulling on a pair of boots or reaching for something on an overhead shelf or pouring milk into your child’s cereal bowl?
However, the shoulder doesn’t perform these tasks in isolation. Muscles of the arm, neck, back, etc. are also called into action. It’s possible a compromised spinal erector putting undue strain across the musculature of the shoulder blade starts off a cascade (remember the brain recruits adjacent muscles in a domino-like manner to assist a weakened muscle) that causes your deltoid to feel pain. As you can see, when the shoulder hurts, the root cause might be elsewhere.
Is that discouraging? I hope not because this is where MAT excels. By understanding the compensatory mechanisms employed by the body to protect itself, we are free to search beyond the site of pain to look for the root cause of pain. Because we know the body often tightens one muscle to protect another muscle, we can use the resulting limited range of motion to guide us to weaknesses that need to be treated.
Why is range of motion such a great guide? Very basically, the mechanism is this: range of motion depends on a muscle’s ability to contract. A muscle’s ability to contract depends on its communication with the nervous system. We can test range of motion to identify which specific muscles are not communicating efficiently.
Let’s go back to shoulder pain. We test various ranges of motion and see that the shoulder blade is not retracting. We test the various muscles involved in contracting the shoulder blade and find they are contracting properly. We can then move on to another motion that affects the shoulder blade such as trunk rotation. Sure enough, we find that the transverse abdominis is not contracting efficiently. Now we can treat that specific muscle in order to reestablish communication with the nervous system. Reestablishing communication allows the brain to receive current, up-to-date information on that muscle. If the tissue is healed, the brain will call off the protection. Muscle tightness will go away and range of motion will be restored.
Of course, this is a simplified example. Often people don’t seek treatment for pain until other methods fail. By that time, usually multiple muscles have been compromised which complicates diagnosis and treatment. Fortunately, using range of motion to guide us, we can identify and treat a muscularly-based problem relatively quickly so you can get back to enjoying your life pain free.
-Yvonne Becker, for True Motion Fitness
The human body has an incredible ability to compensate for less than perfect functionality. For instance, when the body senses it’s not getting enough blood and oxygen, it increases blood pressure and heart rate while holding onto salt and water. For certain types of chronic respiratory conditions, the kidneys kick in to help compensate for too much carbon dioxide in the blood. From tweaking body chemistry to the limp you adopt after dropping a hammer on your toe, your body deploys an array of compensatory mechanisms in an effort to protect itself from potentially harmful weakness.
As an incredible self-healing machine, sometimes all we need is a little more blood volume or a bit less weight on a sore toe for a day or two. Sometimes though, we don’t heal as planned and the compensatory mechanism works too well. We don’t realize our heart is enlarging to push more oxygen and blood into the system. Or we don’t notice that limping around put stress on the ankle which made the hip work harder and six months later we have unexplained lower back pain.
Now you have back pain and if you’re like most Americans, you pop a few ibuprofen and get on with your day. In the next few months or years, the muscles in your back get tighter and tighter (despite your monthly massage) until you can’t sit at your desk for more than an hour before the pain drives you to stand or walk. At some point, you might start thinking about back surgery. This scenario might seem implausible until you think about how the body protects itself.
In my previous blog post on muscle tightness, I used an example of an overuse injury to the biceps which triggered the brain to tighten the triceps in order to protect the biceps by limiting its range of motion. In addition to limiting range of motion to protect the biceps, the brain recruits surrounding muscles to assist with the work the biceps normally does. (Imagine six people rowing a boat, if one goes down the other five have to work harder. And they can…for a while.) Hopefully, the biceps heal before another muscle wears out and forces the brain to compensate yet again by limiting that muscle’s range of motion and calling on additional muscles to share the burden.
Consciously, we probably won’t have any idea of what’s going on. We originally felt biceps pain, but when the brain put the biceps on R&R by shifting the work burden and flooding the area with pain-relieving hormones, we think we’re completely healed. We go back to our normal activities, maybe doing the same activities that caused the overuse in the first place.
However, the triceps are still on tighten mode, other muscles are still picking up biceps slack and soon we are sore everywhere but the biceps! We keep trying to work the tightness out of our triceps not understanding that the poor triceps are just trying to protect the still healing biceps.
Unfortunately, it’s possible that by the time the biceps heal, the triceps or some other muscle will now be traumatized from being overworked or being tight for too long or from our repeated attempts to mash or stretch the discomfort away. Unwittingly, we might have set off a cascade of compensatory mechanisms that could result in chronic pain in an area far from the biceps or triceps.
Understanding this mechanism is critical for successful treatment of muscular-based pain. By realizing that the cause of the pain could be far from the area where you are experiencing pain frees MAT practitioners from relentlessly pursuing non-effective treatment which can occur when the site of pain is the main focus.
-Yvonne Becker, for True Motion Fitness
Muscle “tightness” is a vague, non-medical term for something that everyone has felt and no one enjoys. We practice techniques—stretch, foam roll, massage, etc.—with great fervor, trying to eliminate muscle tightness as if it’s the Devil’s own work.
Is it possible muscle tightness serves an important purpose? Yep. It’s called reciprocal inhibition—a very important self-protective mechanism deployed by the nervous system when communication between the brain and any part of a muscle is lost.
Consider this scenario. In the bright afternoon sun, you stride confidently through your home without much thought. Since you can clearly see every obstacle, negotiating an injury free path from room to room is easy. Now suppose there is a power outage on a cloudy night and everything goes black—no street lights shining through the windows, no night lights, no glow from the digital clock on the cable box—utter darkness. Do you now stride confidently from room to room or do you take baby steps with your hands out in front of you trying to sense your position in the house? (Hopefully, before you kick something with your toe or fall down the stairs!)
Similarly, when muscle spindles (the sensory tissue embedded in muscle tissue that communicates with the nervous system) work efficiently to provide the nervous system with the equivalent of bright afternoon sunlight everything is great. Given the neurological equivalent of a dark house, however, the brain will not allow a muscle to stride confidently when baby steps are called for. If unable to “see” the muscle’s position, the brain assumes danger and initiates protection protocols by limiting range of motion.
Reciprocal inhibition works something like this: You incur some type of trauma to your biceps. Let’s say simple overuse that you barely notice. Just a twinge or two above the elbow, but enough to limit information coming from that area to the brain. If the brain can’t “see” the entire biceps, it doesn’t know if the muscle is slightly traumatized from too much gardening or if the biceps tendon is about to tear away from its attachment to the bone. To protect the biceps from a worst case scenario, the brain orders the triceps to tighten thus reducing the range of motion of the biceps. Protection initiated. Activities normally handled by the biceps are assigned to other muscles. Hopefully, this gives the biceps time to heal and reestablish communication.
The sensation of tightness we feel in our body is a signal that all is not right. It might be a little thing. It might be a big thing. The brain needs more information to assess the situation. It’s highly likely communication will be restored and the tightness will resolve on its own without any mashing or stretching on our part.
Of course, the problem comes when communication is not restored and the tightness lingers for months, even years. We become locked into patterns of limited or painful movement treating tightness as the enemy.
In MAT, we see muscle tightness as a useful tool. The tightness and subsequent limited ranges of motion are like blinking arrows pointing toward areas of poor communication which, if followed, can lead to the root cause of pain and if treated, to elimination of pain.
-Yvonne Becker, for True Motion Fitness
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