When it comes to injury and chronic pain, a commonly overlooked aspect is motor control and tone. More importantly, inappropriate muscle tone and control.
It is important to remember that tightness is the body’s emergency brake that is reserved for when a fault or failure occurs. The constant tightness is a way to slow down our movement and keep us from injuring ourselves when normal muscle function is inhibited. This includes fatigue, injury or avoidance of pain. It also allows us to continue functioning even when there is a fault in the system.
For example, if you sprain your ankle, local tearing of the tissue and loss of function occurs followed by pain and a reflex for the body to remove all weight bearing from the affected structure. Following the initial shock of the injury, the body alters its movement patterns to prevent further pain and damage. This results in a limp. Every time we try to take a normal step, pain reinforces the injury, resulting in a learned movement pattern to avoid pain.
Over the next several weeks the body heals the torn tissue. The body continues to follow the movement pattern it learned as it continues to keep reduced stress on the new tissue. If we attempt a normal step or load the new tissue too quickly, we are quickly reminded by a burst of pain that the area is not ready to resume normal function.
Now fast forward several weeks: At this time a majority of the structures are healed and ready to resume normal function. It is possible to walk without being hindered by a limp. However, when increasing our pace or running, the limp returns. This is due not to issues with the new tissue, but the habit that was formed following the initial injury.
This occurrence is not limited to just acute injuries. In fact, the longer an injury or pain persists, the more dangerous the guarding mechanism becomes. For instance, take low back pain resulting from “throwing the back out.” The structures of the back, including muscle and possible disk and joint problems, would be involved. Basic movement such as lying in bed, getting out of bed or chairs, lifting objects or even finding a comfortable position can be difficult.
At this point, when every movement causes pain, we defer to the guarding mechanism to reduce pain to the injured structures. This can make it harder to recover. If every movement has the potential to result in pain, you won’t want to move. Without proper movement and rehabilitation, the muscles that are required to support the structures will further weaken. This leads to greater instability and pain, thus creating the proverbial snowball down a mountain.
In addition to injuries, improper posture can also play a role in improper motor control. Dr. Venturini covered Upper Crossed Syndrome in an earlier blog post. If you refer back to it, Upper Cross Syndrome occurs when the cervical flexors, rhomboids and lower trap are weak versus the suboccipital, upper trap, levator scapulae and pectoral muscles, which become tight and strong. This can occur from long periods of improper posture while sitting. The body tends to be lazy and will find the easiest and quickest way to complete a task with as little energy expenditure as possible.
When we sit at our desk, we tend to sit slightly flexed forward with our arms reaching in front of us (also known as a slouch). When we slouch, we rely on our tight muscles and ligaments to hold us up. The longer we sit in that position, the more prominent the muscle imbalance becomes. Since the weak muscles are no longer strong enough to support the neck, our stronger muscles have to pick up the slack and do 150 percent of the work.
Over time these muscles fatigue. As the fatigue sets in, the body will react by having the muscle spasm or tighten. The tightness in the muscles and ligaments is what allows us to remain in a functional position and complete our daily tasks. The stretches and exercises Dr. Venturini covered in his blog will help reduce some symptoms. Unless we change the way we move and sit, the likelihood of our symptoms returning the minute we stop those exercises becomes increasingly high.
It is crucial to remember that the guarding mechanism and neurological component of a musculoskeletal injury are just as, if not more, important as the healing of the injured tissue as this can persist well after the initial healing of the injured tissue.
If you have questions pertaining to your recovery, do not hesitate to ask at your next appointment, or feel free to give us a call and set up an appointment to address your concern.