Chronic pain and myofascial chains.

You’ll have to Google myofascial chains to understand them better. Adding a description of those will turn this blog post into a book. Here is a link with more information. It is pretty dense for a layman, but can be read through with some effort. You’ll pick up just enough if you skim through and look at the pictures

Or you could watch this two minute video from a real authority.

Myofascial chains can have a chronic overactivity or underactivity.
-chronic underactivity and overactivity of muscle chains leads to structural malalignments that are typical of the modern lifestyle
-for eg- the computer posture in the upper limbs and the torso
-for eg- the lumbar lordosis/anterior pelvic tilt, knock knees, flat feet, hallux vagus combination
-these malalignments are now epidemic, and can be diagnosed over the phone. Without even a video call.
-these malalignments are the reason for the epidemic of accelerated wear and tear, that lead to earlier and earlier joint replacements.
-the same malalignments cause chronic pain years before Santiago wear and tear becomes visible.
-most people will respond by limiting activity and range of motion. This is the worst thing to do.
-the way to fix it would be to restore pain free range of motion, through appropriate movement and strength training

-a chronically hypertonic muscle will slow down its own venous outflow.
-this will lead to stasis
-stasis leads to accumulation of metabolites
-accumulation above normal levels will trigger inflammation and pain
-leading to further spasm and pain
-vicious cycle is set up
-pain becomes chronic , spasm becomes chronic
-chronically spasming muscles can set up fibrous bands within them and in the fascial coverings
-the fibrous bands are an adaptation to try and become more energy efficient, instead of spending ATP on an active muscle tone to maintain a muscle length
-the adaptation helps reduce energy expenditure in the muscle cell which is already energy starved due to impaired blood flow.
-the negative effect is that the reduced muscle length becomes almost permanent, without some favorable tissue modelling.
-the aim would be to prevent the development of these fibrous bands/thickenings/permanently shortened areas in the muscle and myofascial system
-for this, you need constant full range movement that doesn’t threaten the stability of the joints or the structural integrity of the tendons and ligaments
-for this you need slow controlled movement under load.
-this is why passive stretching or dynamic stretching doesn’t work very well

Detailed below is an overview  of the methods that can be used to fix this.

1. Manipulation
-getting targeted therapy by someone who knows what they’re doing
-physiotherapy, deep tissue release, traditional massage(refer point above)
– chronically overactive muscles can produce pain when an attempt to move them to full range
– this can be overcome by manipulation by a therapist, if they know what they’re doing.
– a temporary relief can be obtained
– this relief can then be used to improve active range of motion by the patient themselves.

2.Self myofascial release
-same principle as above
-but done by patient themselves
-needs basic intelligence from the patient’s side
-needs commitment
-needs understanding of the principles of how myofascial release works
-needs understanding of the techniques used

-controlled stretching
-not bouncing violently into and out of extreme end range of motion, though, even that works sometimes.
-this is why yoga works
-this is also why mindless application of yoga poses to “increase flexibility” results in injuries
-there is a time and place for passive stretches and passive stretch holds. But it is usually not effective as a permanent solution in chronic pain

4.Breathing+ stretching
-muscle tone increases globally (all over the body) with inhalation. And decreases with exhalation.
-this is a function of the autonomic nervous system
-using breath to release overactive muscles can be learnt by someone who has sufficient awareness/mindfulness/interception

-physical heat, rise in temperature by means of hot fomentation and compresses can decrease muscle tone.
-this is why hot water baths help.
-heart also improves local blood flow
-this is also why cold weather aggravates chronic muscle pain
-this process is also mediated by the autonomic nervous system

-pain free, full range movement is key
-progressively increasing range of movement daily by exploring the limits set by pain is probably the only way to do it.
-the methods listed above will help in pain control
-sometimes you’ll need drugs, but personally, I would prefer if you didn’t use any.
-exercise that resets neurology is the key
-muscle tone is determined in the nervous system mainly
-the most effective way to change muscle tone is to change the neurological signal that comes to it
-strength training is key, because applied correctly, it fixes imbalances and instability that causes the nervous system to send maladaptive signals to the musculature
-posture correction is key for the same reason
-for posture correction, enviroment correction and lifestyle needs to be corrected
-the most important part of that puzzle is to interrupt sitting.
-movement snacking is how to solve that issue
-exercise selection for your movement snack is important. Selecting exercises that reinforce your computer posture will make things worse

You’ll have to go through other posts in this blog and ask your doubts. Not detailing them in this post

Same as for diet.

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