How is this summer finding you? I've had quite a few professional and personal things going on and so I haven't had the opportunity to sit down and write for a minute.
My mom recently sent me a BBC article (thanks Darlene!), which I will post at the bottom. The information got me to thinking and drove the content of this post.
The central theme of the BBC article surrounds evolution in human anatomy as a result of how we use our bodies. This happens on geologic terms over thousands of years and hundreds of generations as outlined by Darwin and his work on biologic specimens in the Galapagos Islands. But it also happens over the course of our own life times.
During my graduate studies we learned gross as well as neuroanatomy and did a very finite amount of histology.
Histology is the study of microscopic aspects of different tissues. Using a microscope we looked at spidery osteoclasts of bone tissue, the organized striations of skeletal muscle and the puffy marshmallow like adipocytes within fat tissue.
Each of these cells is perfectly adept at its function- whether that be to create movement, to provide cushioning and insulation or to conduct electrical impulses.
Much like the San Francisco symphony- the cells work elaborately together to provide near perfect function. And just like the symphony, the cells can become better (or worse) at their jobs depending on the time they spend in training specific to their performance.
Let’s consider each of the most commonly injured aspects of the musculoskeletal system and consider them as we would instrument groups in a symphony (woodwinds, brass, etc.)
Here is a short list of the specific ways in which we can nurture each specific cell type of some of the major players in our orthopedic system:
1) Bone: is anisotrophic meaning that is grows under compression. Adequate weight and weight bearing activities are the most important for bone health
2) Cartilage: is hydrophilic (meaning it draws water into it). It stays healthy when (like a sponge) it is compressed (for old fluid to move out) and then has a removal of compression. This can be achieved at joint segments by motion through a full range.
3) Muscle: Increases in size and blood flow to it is improved with use. Muscle does poorly when it is used in a lengthened state, required to generate more force than it is used to or when it is shortened (this can occur with joint or fascial tightness)
4) Ligament: tears or is injured with tension- is shortened (slackened) with compression. Requires balanced length and tension relationships.
5) Nerve: requires 3D space. Any time a nerve is compressed or stretched the blood supply to it is diminished.
6) Fascia: connective tissue like saran wrap flowing around all structures and thickest in our extremities. Fascia does best when it can slide easily between varied structures. When it has bound down in a place it can be quite painful and limit motion (including nerve mobility).
This is in no way a comprehensive list, but is important in demonstrating the nuances of the tissues within the musculoskeletal system and the necessity to engage and protect each of the tissues in varied ways. I think this also serves to speak to the incredible challenge to appropriately serve and protect each of the tissues at once. This is why rehabilitation requires all of those years of education.
I remember being in orthopedics (the study of pathology relating to the musculoskeletal system) class once and our teacher describing a patient presenting with posterior (on the back of the body) knee pain. He had us list all of the structures that could be causing pain based on the aggravating factors (which he intentionally made vague). I’ll never forget my class came up with 23 potential structures causing the problem.
Many of us treat our tissues (our bones, cartilage, brains) as though their function is fated. I cannot tell you how often I am met by someone in the clinic who reports "my mom always had bunions and so do I". This is largely because we are socialized to move like those around us while we are developing. If our parents assume gait patterns and postures that reinforce bunion creation, the chance are that we will too unless we cultivate a new movement pathway.
And so, another reason to maximize our performance and improve our cellular functions (in addition to becoming more efficient and avoiding undo pain) is to transform the physical outcome potential of our children. Just as language is influenced socially- so is posture and movement. By working to improve our biomechanics we allow for the emergence of new (and healthier) patterns in our loved ones.
We tend to remove ourselves from the equation of how we have good or poor health outcomes. Sure, we can inherit or be socialized into patterns. But, in general, we are in the driver’s seat (and we are indeed the only driver) in how our bodies and brains are used.
I hope this article serves to educate but also to motivate. When we can change the health and functionality of our tissues (based on our training and how we use them) the sky is the limit as far as our functional outcomes.
Here is a recent article from the BBC that got me going on this rant (though, I must admit, this is a common topic of rant for me)
Please share your comments or thoughts on this topic.