I’ve always been troubled by the Dem Bones lyrics. It’s just not anatomically accurate. I mean is the toe bone really connected to the foot bone. It’s just not right.
But why should you care about why and how things are connected? Simply because it very much affects how we look, feel and importantly function. If something is not performing it’s function somewhere then this puts increased load on another area.
When it comes to injury and dysfunction it is unusual that it’s the bit that hurts that is the true culprit and that’s why our job as Sports Therapists and Physiotherapists is to play detective and understand what went wrong first.
We simply then need to put it right. In this article we’ll start to talk about what you can do about it to make sure you don’t make errors which will causes extra load and pain on the wrong bits.
Dem Bones Dem Bones!
So I’ve got an itch I’ve been wanting to scratch for a little while now. Indulge me if you will. I’ve always wanted to re-write the lyrics in a more anatomically correct manner. Call me a geek if you like. You won’t be the first. Here goes:
Toe phalanges bone connected to the foot metatarsals bone
Foot bone Metatarsals are connected to the heel calcaneus
Heel bone calcaneus is connected to the foot distal tibia and fibula bone
Distal tibia and fibula connected to the shin tibia bone
Shin Tibia connected to the knee patella bone
Knee Patella connected to the thigh femur
Thigh Femur connected to the hip accetabulum
Hip bone connected to the back coccyx / lumar spine
Back lumbar spine / coccyx connected to the shoulder
Shoulder scapula connected to the neck cervical vertebrae
Neck cervical spine connected to the head cranium
I feel better now! You might be a bit latin’d out after my geek fest there but there is a reason to my madness. The point I wanted to make, albeit in a very geeky way, is that everything is connected to everything else. Hence one of my catch phrases: “It’s all connected otherwise bits would start falling off.” I’ve got more catch phrases then Bruce Forsyth and thankfully more hair too.
This is something that is hugely overlooked by conventional medicine. Regularly we will fix someone’s knee for example by treating a muscles in their stomach. Equally it may work the other way around. We may fix someone’s knee by treating their ankle. I think one of my favourite treatments was fixing someone’s right knee by releasing a muscle on the left side of their temple.
For those that haven’t seen this in action I can understand how you would be sceptical. Many years ago I was too. But having seen this in action many times over for me there is no questioning the interconnectedness of the body and how important it is to use this in your treatment to find the underlying reason there is a problem.
How It Really Is Connected – Modern Anatomy
So the idea of easing knee pain by releasing off a muscle in someone’s head seems crazy right. But it does happen. And we can explain it scientifically using the work of American doctor Thomas Myers.
Not to put too fine a point on it he spent many years cutting up dead people. It’s not the kind of work for me, but you know, everyone has their vocation.
This of course has been done before. He just did it differently. As with all great insight this is so simple it’s frightening few people had done this before. Rather than slice through the muscle and connective tissue he kind of peeled it out.
For those who aren’t too squeamish I highly recommend his book Anatomy Trains. From his cadaver studies he has produced a series of easier to digest cartoon like pictures of anatomy and how the muscles are connected.
His idea has revolutionised how we consider the human body. The theorists have been talking along these lines for many years and Eastern Medicine approaches for thousands of years but now we have a framework which helps explain how one area of the body affects another.
For copyright reasons I can’t show these diagrams here on the website but if you click through to this page on the Anatomy Trains website there are a few examples. Try to view it with your own body in mind. It may explain how different pains you have been getting in your body are very much connected and affected by each other.
Often when people look at these pictures the pain they have been feeling for years suddenly all makes sense. Although not always. It wouldn’t be fun if it was easy right?
Just What Is Connective Tissue?
Traditionally doing dissections they threw away any connective tissue or sinew to get down to the muscle. They would then play with the muscle to see what action it performed and that formed the basis of anatomy until very recently.
This new approach pays much attention to the connective tissue. It does after all surround our whole body. To give you an example if you’re cutting chicken then it’s the sinewy stuff between the skin and the meat.
New thinking suggests that muscles and fascia communicate with each other separately from nerves. Which is quite clever. There also seems to be a very good correlation between Eastern Medicine with their acupressure lines or meridians.
Maybe all that Eastern stuff isn’t as “fluffy” as Western medicine has lead us to believe. My view is that if something evolved through thousands of years of insight and experience chances are it’s good stuff.
How Does This Affect Me?
If you take a look at the Deep Front Line here: http://thrivebodybalance.com/treating-the-deep-front-line/ we can look at an example. We can see here in the stomach region the muscle which lifts your leg up in the air – called psoas – often referred to as hip flexor. Notice how it attaches to all of the lumbar vertebrae and discs and in so doing can be a large component in low back pain.
Notice how it’s continuous down into the legs up into the diaphragm continuing via the lungs into the muscles of the neck and muscles that open and close the mouth. So theoretically we could find that these muscles are affecting anything along these lines. It could be that the muscles in the neck or jaw for example are overworking to compensate for a lack of strength in the hip flexor.
This is a movement pattern we see frequently at the clinic. Consider a runner or weight lifter grimacing to get that extra bit out of their body. This is a very visible compensatory movement pattern. When the body is unable to perform the task in the most efficient way it looks for help from other muscles to ‘chip in’ and help out.
How Can I Feel This?
It’s all be a bit theoretical so far so time for something practical that you can actually feel. Find yourself a nice chair and sit in it. If you’re feeling crazy have you cup of tea at hand too. You won’t need it but tea is always good!
When seated place you arms across your chest as shown in the first picture and the rotate as far as you can as shown in the second picture. Try this with you normal posture. Be honest! Now try with a really big slouch on. Finally try in what you think is good posture. You should feel that the better your posture the more movement you have.
Now try a standing up equivalent. We’re going to do gleno-humeral abduction. In English that means moving your arms out the side until your upper arms end up by your ears. Picture making yourself streamlined like and arrow. Some people find this harder than others.
Now try this again with a slumped belly poking outwards. Again you should find this movement now much more difficult if it wasn’t already. For those that found it tricky to start with you may even get some pain.
This simulates what happens if the muscles affecting these movements get’s short and tight. This is a concept we in the trade call adaptive shortening. Simply put if you put muscles in a short tight position for a length of time they think they should stay they and so do.
For example if you sit for most of the day slumped over to one side then when you stand up your body will stay in this position. Applying this back to our new found knowledge of myofascial lines we know this can of course not only affect the muscles that have become short but potentially muscles elsewhere.
What You Can Do About It?
So this being first in a series I’m going to leave you with a cliff hanger. A bit like The Empire Strikes Back. Don’t worry you won’t have to wait three years to find out what happened though. I’m going to be writing the advice about all of this in the coming weeks.
But I wouldn’t want to over promise and under deliver so here’s a link to one of our most linked to posts from around the world. If it doesn’t sound to patronising we teach you How To Sit To Avoid Injury!
This article first appeared on our Brighton site.