The most frequent question I get asked today is, “What kind of therapy do I do at my clinic?” The answer I give now is that I specialize in musculoskeletal pain and inflammation by treating the body’s fascial and neuromuscular systems. The system I use is simply called, M.A.T., an acronym for “Myomemory Advantage Transformation.”
M.A.T. is a general systems approach to postural analysis and movement based upon my experiences as a physical therapist and an athlete in the sport of nordic ski jumping I use in the treatment of musculoskeletal pain.
From my experiences I have learned that relationships as found by Einstein and Bohr in physics and science is the foundation of human posture and movement. That is why over the years, my mantra has become, “Everything is connected!”
However, most people even today continue to view human posture and movement from a mechanistic and “isolated muscle” point of view. Posture and movement is seen as a linear cause and effect like the views of Aristotle and Newton centuries ago.
Almost every book you read still presents muscle function by isolating an individual muscle without integrating it with all its connections above and below. Nor does it connect it to the rest of the body’s systems involving the body’s neurological, vascular, fascial, and lymphatic systems to name a few. Muscle identification and function is still from an isolated point of view.
That is I believe because in our learning of the muscular system, the isolated muscle is still usually dissected and severed from its regionally adjacent structures with a scalpel on cadavers. An environment where there is no nervous system and movement involved, there is no life. The student, therefore, cannot see how the body thinks or is biologically assembled by just studying cadavers. Because, “Motion is life!”
No one can deny that working on cadavers has helped our understanding of the body. But, it doesn’t allow us to see how everything is integrated and connected within the living and moving body. Therefore, we have been taught to look at human posture and movement in a very mechanistic manner as if the body is made up of parts like a car.
Repeatedly you hear the metaphor “the body is a like a machine” in helping us understand how the body works, but that does not tell the whole story. Something is missing and a paradigm shift of how we view the living body is needed.
Over the years of study, we have finally to come to a realization that a machine has limited capacities and can’t fully explain what is going on especially with human posture and movement. After all, we are not machines, but rather grown from a seed. That is the reality, that is life as we know it.
Also, no one can deny that the isolated, cause and effect views, the scientific ideas of Aristotle and Newton were valid during their time. But, their concepts have become too restrictive for what we know today in the world of physics. There time is over!
Therefore, we need a paradigm shift in how we view and study the body from being broken down into its isolated parts to a more “global and integrated view.” Then and only then, can we truly understand how we are able to hold ourselves and move against these vertical forces of gravity and ground reaction force (GRF).
M.A.T. can connect the dots of posture and movement for you and identify the relationships of the body’s skeletal structure with its neuromuscular and fascial systems.
But in order to understand these relationships, we have to start with gravity and GRF, the two vertical forces of our environment experienced day in and day out by everyone stimulating the human nervous system into action.
Gravity and GRF is the circuit breaker that turns on the human nervous system to create enough internal force that will offset or cancel out the effects of these external forces. By cancelling out these constant forces of our environment, the human nervous system is able to establish and maintain skeletal balance and equilibrium keeping us upright, vertical, and moving.
The internal force produced by the body is the product of your body’s neuromuscular and fascial systems working together not in isolation, but in integration creating the, posture, the holding patterns you learn to move within everyday while performing activities of everyday life.
These two misunderstood and often forgotten bodily systems actually are responsible for the skeletal structure being able to float and move against these outside, vertical forces by creating the opposing tensile and compressive forces which are intertwined and interconnected down to the individual fibers of every skeletal muscle.
That is because when any skeletal muscle contracts increasing its tension that ultimately affects its length, it also affects the tension and length of the global, integrated fascial web through what is called the “myofascia.” It is impossible for a muscle to contract or lengthen without affecting the tension and length of the connective tissue or fascia that encapsulates the individual muscles fibers and the entire human structure.
The term itself “myofascia” implies that the nature of muscle tissue (myo) and the accompanying web of connective tissue (fascia) encapsulating it is inseparable. The fascia can only be separated from muscle tissue by the scalpel as in the dissections of a cadaver.
M.A.T.’s major focus and goal is on altering or transforming these internal tensile and compressive forces produced by these two bodily systems responsible for your posture and movement. There is no doubt the human fascial and neuromuscular systems create the tensile and compressive forces effecting the bony structure in creating our posture and movement, but how it is achieved by each system is very different.
Muscles of the neuromuscular system for example are designed to contract, lengthen, and relax quickly in succession. Also when stretched over time, a muscle will attempt to recoil back to its resting length before giving up and will add more cells and sarcomeres to bridge that gap. However stretch the fascia quickly, it will tear which actually is the most common form of connective tissue injury. But if the stretch is applied slow enough, fascia will deform “plastically” by changing its length and retain that change.
Try it! Take a plastic bag from the grocery store and stretch it slowly. The bag will stretch and when you let go, the stretched area will remain and not recoil. When comparing the stretching characteristic of muscle to fascia, muscle can be described as being elastic while fascia as being plastic. In fact, the plasticity of the fascia is its essential nature and is responsible for the long term holding patterns we see with human posture and movement.
When analyzing anyone’s posture and movement, one must first look globally as is fascia’s inherent nature. However, also recognizing the effects of body’s neuromuscular system and the myofascia on the isolated joints of the structure is a requirement in understanding posture and movement. The position, motion, interconnection, and responsiveness in this world of gravity and GRF can only occur by these two forces of tension and compression or some combination that is provided by the body’s fascial web and neuromuscular system.
The tension of the fascia and compression provided by the neuromuscular system is mixed and matched in what we see and experience while living under the influence of these two vertical forces. Our skeleton is anything but stable without the body’s fascial and neuromuscular systems. Take all of its soft tissues away and the bones would just clatter to floor. Therefore, the best way to describe the human musculoskeletal system is “islands of compression in a sea of tension.”
Whereas the fascia, “the organ of form” is more global in its affect, it is the myofascia that provides a continuous network of isolated, restricting, and adjustable compressive forces. It affects the mobility and stability around the bones and cartilage of the isolated joints while pushing out against the body’s global, fascial metamembrane. You can be sure then that the soft tissue balance between the body’s fascial web and the neuromuscular system’s myofascia is an essential element in keeping our structure upright and vertical while moving against gravity and GRF.
It is the “tensegrity” a phrased coined from tension integrity by the designer R. Buckminister Fuller, an American architect and systems analyst, which describes the structural relationship principle regarding human posture and movement. Our structural shape is guaranteed by the finitely, closed, comprehensively continuous, tensional behaviors and tensegrity of the fascial system. In fact, every moving animal of creation and their structure, must be finitely closed and independent in order to survive. Within the human species, we must be able to hang together whether standing on our feet, standing on our head, or flying through the air as I did for so many years in the sport of nordic ski jumping.
The human body is thereby ultimately held together against the forces of gravity and GRF by a necessary balance of tension and compression provided the body’s “metamembrane,” the fascial web and the neuromuscular system. The fascia’s foundational characteristic of tensegrity best describes the body’s continuous global tension with the neuromuscular system providing isolated and localized forces of compression that creates the “islands of compression in this sea of tension.” It is our muscles, bones, and cartilage that are the compression resisting struts providing the framework of human posture and movement.
For you to be upright and vertical and move in this environment of gravity and GRF, you need both these elements, tensile and compressive forces, to provide the stability and mobility of the human structure. Viewing the body’s structure in this manner where the bony struts of the skeleton seem to float within this sea of tension, the position of these boney struts, the alignment will be dependent upon the tensional and compressional forces provided by the body’s soft tissue.
Therefore, all human posture and movement can be best described as a constant, continuing, rhythmical dance between stability and mobility within a world of gravity and GRF provided by these tensile and compressive forces. The tension of the fascia and compression provided by the neuromuscular system is mixed and matched in what we see and experience while living under the influence of these two vertical forces.
Whereas the fascia is more global in its affect, it is the myofascia that provides a continuous network of isolated, restricting, and adjustable compressive forces. It affects the mobility and stability around the bones and cartilage of the isolated joints while pushing out against the body’s global, fascial metamembrane, the fascial web. You can be sure then that the soft tissue balance between the body’s fascial web and the neuromuscular system’s myofascia is an essential element in holding our structure upright and vertical while moving against gravity and GRF.
Within this concept, visualize the bones as the spacers pushing out into the global, fascial metamembrane while the tone of the myofascia creating the localized compressive forces that is an important criteria for a balanced structure. It is the bones of our skeletal structure, the compression members, that keep the structure from collapsing in on itself while the tensional and compression members keep the compression struts relating to each other in both a local and global fashion.
Therefore if you wish to change the relationships among the bones of the skeleton, the alignment, you must change the tensional and compressive force balance through the soft tissues causing the bones to rearrange themselves. That is where M.A.T. comes into play in the the treatment of musculoskeletal pain and inflammation with its focus being on the neuromuscular system that affects the tension of the fascia.
However unlike the fascial web, the neuromuscular system is under the constant command of our nervous system. “All muscle use and development, all human body posture and movement is directed and coordinated by the activity of our nervous system.” Therefore, in order to change the active postural and movement patterns, you must change the neuromuscular activity. Most of this neurological activity within the body’s neuromuscular system happens to be habitual or occurring at the subconscious level creating this constant compromise between this continuum of skeletal stability and mobility.
In real life, the human body can best be described as an unstable structure constantly in motion, constantly vibrating like a tuning fork between this compromise of stability and mobility around its point of mechanical balance, its center of gravity (COG). It is the tensile forces of the fascia and compressive forces of the neuromuscular system that is constantly trying to keep us at and around the body’s balance point located at sacral segment (S2) within the pelvic girdle. The closer the body can approach this integrated, mechanical balance point, the greater the balance of muscle action around its isolated joints.
This minimizes the mechanical and physical stresses of gravity and GRF on the joints and ligaments and lessens the possibility of chronic pain or injury. If the muscles around a joint are all working together in a balanced, synergistic, coordinated way, none of them is neither constantly contracted nor are any of them constantly at rest. They work synergistically as a team. By doing this, the neuromuscular system achieves an alternating and rhythmical activity of the muscles that serves as an important function in pumping blood through the body against gravity while maintaining flexibility and strength of posture and movement.
In a situation of poor balance where the skeletal structure is not aligned through the body’s integrated, optimal or ideal COG, the alignment of the isolated joints are also affected and are out of alignment. They are no longer positioned to move through their optimal or ideal axis of rotation in reaction to gravity and GRF. As a result, a neuromuscular imbalance will occur where some of the muscles must now contract continuously to counteract the effects of its antagonists. This results in limited motion because of an imbalance of muscle tension where some muscles are constantly contracted while others will have to lengthen.
All this neuromuscular system activity we are talking about is initiated in the brain, the CNS. Therefore, you could say human posture and movement is “brain driven.” Yes, there are things that happen locally at the spinal cord level with the nervous system, but it is human brain that initiates, regulates, and monitors all human posture and movement. This organization takes place predominately at the subconscious level and over time this brain driven response to gravity and GRF becomes your own habits and behaviors of posture and movement. You own it.
You can be sure there is no posture and movement without muscular activity and there can be no muscular activity without neuronal stimulation involving the PNS and CNS. Nor can there be any muscular activity without impacting the tension of the fascial web. Once again, demonstrating the wondrous integration of the body’s systems.
With posture and movement, the specific quality of every muscular action performed in your daily function, its timing, duration, style, effectiveness, is a summation of all the activities of both the central and peripheral nervous systems at that moment responding to the external forces of gravity and GRF.
The neuromuscular system includes all the skeletal muscles of which there are about 320 on each side of the body and includes the peripheral nervous system that sends information back to the spinal cord and brain, the CNS. This information from the muscles can trigger a response at the spinal cord level, but is ultimately integrated and processed in the brain before sending back a response. An output in the form of a neuronal response to the muscle telling it what to do. Everything you do in life regarding posture and movement requires this communication between the PNS and CNS and the muscles and their tendons.
The PNS and CNS function to provide the links between our thoughts and actions in order to create the mobility and stability of our skeletal structure allowing us to function against gravity and GRF. This does not occur through the conscious mind, but rather the neuromuscular patterning that keeps you upright and vertical with posture and movement existing in the subcortical area of the brain.
When it comes to posture and movement, the brain is especially reliant upon neuronal pattern recognition and prediction. Therefore, the brain is designed to recognize a pattern of neuronal activation and knows the correct way to respond to the sensory input based upon a memory. A memory that creates your own posture and movement. Your template that becomes your “path of least resistance.”
Yes indeed, you can consciously control the goal of movement, the time, space, and dynamics of the movement, but not the “how” of movement. That occurs in the subconscious mind as your habits and behaviors of posture and movement. Your memory of neuromuscular patterning that is recognized and predicted by your CNS. You cannot consciously control what muscles actually do what movement. This is patterned in and below your normal conscious functioning. Simply speaking, these neuronal patterns are “brain memory.” With M.A.T. the ultimate goal is the transformation of “brain memory” which I have paraphrased as “myomemory,” which is the neuromuscular patterning your brain recognizes and predicts with the sensory information fed into the CNS.
As already mentioned, the sensory input that facilitates the neuromuscular system comes into the CNS via peripheral nerves that can either cause an immediate, local reflex arc or motor output at the spinal cord level or it can be sent up to the “higher centers” of the brain for processing and integration. The sensory input is integrated and processed within the different parts and specific localities of the brain to create the motor output. In short, a motor memory, “myomemory.’ With M.A.T., the primary focus is on the “myomemory.”
Motor output of the neuromuscular system involving the higher centers of the brain can be either controlled by reflexes that are initiated on the opposite side of brain as seen with the lower and upper extremity chain of joints in reaction to gravity and GRF or it can be controlled by reflexes of stability initiated on the same side of the brain. Regardless, the motor output that becomes your own posture and movement is the total sum output of the neuromuscular system and the sensory input fed into the CNS by PNS.
In M.A.T., it is recognized and stressed that there are three primary systems of sensory input involving the PNS and CNS which include visual, vestibular, and proprioceptive. But when talking about the body’s postural control system, it includes all the sensorimotor and musculoskeletal components involved in the control of your postural orientation and postural equilibrium that involves these three systems of sensory input. Postural orientation refers to the relative positioning of the isolated, body segments with respect to each other and to gravity and GRF.
Postural equilibrium, on the other hand is the state in which all the external forces including gravity and GRF acting on the body are offset or canceled out by the body’s internal forces coming from your fascial and neuromuscular systems in order to keep the body in a desired position and orientation referred to as static equilibrium. Static equilibrium then allows you to move in a controlled way which is referred to as dynamic equilibrium. It is posture control involving the body’s PNS and CNS and the response by the neuromuscular and fascial systems that provides a stable body platform for the efficient execution of your focal or goal-directed movements during daily activities. In a sense, you cannot have dynamic equilibrium without static equilibrium. Therefore, you cannot have movement without posture. I guess you could say they go together like peanut butter and jelly.
With any discussion of posture and movement, most will think of balance as a static process and movement as dynamic. But posture too is actually a highly integrated dynamic process involving multiple neuronal pathways and sensory input again coming from the body’s visual, vestibular, and proprioceptive systems. Because of our perception of balance, no pun intended, we tend to think of it as a static process like when a person stands rigid and stationary on one leg for a period of time. That couldn’t be further from the reality.
Maintenance of postural balance and equilibrium, postural stabilization involves sensory detection of motion, sensorimotor integration, and the execution of the appropriate musculoskeletal responses in order to keep you upright and vertical against gravity and GRF. It requires optimal postural alignment, muscle balance, dynamic flexibility, core stabilization strength, multiplanar functional strength, and neuromuscular stabilization. This can only occur when the static body in standing, its postural alignment is positioned over its ideal or optimal center of gravity (COG) located at the second sacral segment (S2) equal distance between the right and left sides and front and back of the pelvic girdle. In M.A.T., I refer to this as “neutral alignment” of the body.
When the body achieves neutral alignment in standing over S2 as described above, there will be an equality of neuromuscular tension and length or stiffness provided by the neuromuscular and fascial systems. Then and only then, the body’s cartilage, joints, ligaments, muscles, and tendons are arranged in the best and most efficient way to react to gravity and GRF during movement. The skeletal structure aligned in neutral alignment, allows the relationships between the tension and length of muscles and connective tissue to be optimal. This ensures the highest overall efficiency for the skeletal system moving against gravity and GRF both in isolation and integration causing the least amount of wear and tear on the body’s musculoskeletal system. However If the body is not positioned in its neutral alignment, it can create an inequality of neuromuscular tension and length causing a muscle imbalance that ultimately affects one’s movement.
Over time, these neuromuscular imbalances can lead to abnormal physical and mechanical stress in the lower extremity kinetic chain that not only affect isolated joints, but eventually the entire structure. If the neuromuscular system is not working optimally at rest, it surely will be unable to respond to the imposed demands of the environment during functional activities of movement causing functional pathology. A neuromuscular imbalance is an example of a functional pathology.
Since the body is continuously in motion it simply means we change positions and the body’s COG changes. Therefore, the body’s COG is constantly changing. With each new position, comes a new location for the COG away from the ideal, static standing position located at S2. However when coming back to rest in static standing, the fascial and neuromuscular systems should allow the COG to return to its ideal, optimal position. The body’s COG is indeed a continually changing point in or outside the body that represents where the weight or mass of the rest of your body is equally balanced in every direction. This point can and does change based on what you are carrying and how you’re carry it, as well as with the position you take and the movements you make.
Unfortunately in our western culture most of us have been taught to hold and carry our COG in standing with the chest out and belly in which deviates from the natural structure, the natural curves of the human body. Holding the body in this manner only shifts the COG upward to the chest and the middle of the body forcing one to swing between a state of hypertension and slouching. Instead, your body’s COG in standing should not be drawn upward but held firmly in the middle, in the region of the navel. Your belly should not be pulled in, but free and slightly tensed.
Again, neutral alignment refers to the correct alignment of the body at rest so that when you are moving to perform any physical task, you are moving from the body’s true, ideal center. In doing so, the least amount of muscle tension is required to perform any physical, movement task. By achieving neutral alignment, you are able to maintain a good posture, optimal skeletal alignment, walk, stand, lie, or run with the least amount of strain placed on supporting muscles and ligaments which limit the degenerative changes of the skeletal system that can and will occur at the isolated joints.
For this reason, starting from the optimal, neutral posture, neutral alignment is essential to all activities, to all movements. In trying to center the human structure achieving neutral posture and alignment, attention has to be drawn to the funnel shaped pelvic girdle which physically holds our center of movement at S2. The pelvic girdle provides a stable base of support for the powerful and wide-ranging movement of extremities when it is aligned in a neutral alignment in relation to the rest of the structure. Mechanically and functionally speaking, the human pelvic girdle is like the hub of a wheel. Within this circle of bone your body’s COG is located, the point around which your entire body weight is balanced equally above and below and to all sides.
It is from this still point, equilibrium point at the center of the wheel that radiates the spokes of your movements, your extremities causing the body’s COG to move. But when coming to rest, it must be able to return to a neutral posture, neutral alignment. In the human body, it is the fascial and neuromuscular systems that connect the other skeletal parts including the legs, spine, rib cage, arms, and head to the pelvis so that movement can and should be initiated from your COG. That is why it helps to visualize the human pelvis moving through space just like the hub of a wheel carrying the rest of the body along.
With the human structure, the arms have been freed for self-expressive and functional movement by standing the spine upright and perpendicular to the ground. But that comes at a price by having a somewhat less stable pelvis than seen with the rest of creation. Even though that maybe the case, the pelvis can still be centered over the legs and provide a foundational base for a vertical spine with neutral alignment.
The human structure’s COG again located at and around the second sacral segment actually is the function of the sacrum in its role as a keystone of an arch providing support for the spine. Just as man in history has used the arch structure to build its gothic cathedrals, so too the arch appears in nature to provide strong weight support with a minimum of building material. Remember from an engineering perspective, an arch is composed of two columns that fall toward each other. The space between the columns is filled by a wedge called a keystone that is fulfilled by the sacrum in human structure. With the human pelvic girdle, the pillars of the arch are formed by the two innominate bones that make up the pelvic girdle with their base being at the femoral, hip joints. The heads of the femurs or thigh bones fit into sockets in the pelvis when standing or when sitting at the rocker-shaped parts located at the lower end of the pelvis referred to as the tuberosities of the ischia. In sitting, we physically sit on these tuberosities. Each side of the pelvic girdle has a tuberosity which are often referred to as the SITS bones. The tuberosities are also attachment points for sacral ligaments and the hamstring muscles.
This arch referred to as the posterior arch of the pelvis, supports and transfers the body’s weight downward from the spine and sacrum to the SITS bones while sitting and to the legs and finally to the ground in standing. Conversely, the anterior arch of the pelvis counterbalances the weight forward from the spine to the femoral, hip joints. The keystone for this arch is the cartilage at the mid-front of the pelvic girdle called the pubic symphysis.
The pillars, the femurs on either side of the pelvic girdle brace against the dual bases of the posterior and anterior arch of the pelvis while standing. When someone is unable to achieve “neutral alignment in all three planes of posture and movement whether standing or sitting, they will be out of balance which simply means that their COG is no longer above the base of support in an optimal manner where everything looks and appears to be symmetrical. The consequence of someone unable to achieve “neutral alignment” is a functional pathology of the neuromuscular system.
Functional pathology again describes impaired function of its body’s structures rather than the pathological damage to structures as is searched for with the x-rays and MRI’s of our medical system. In our allopathic medical system, traditionally clinicians have taken a more structural approach, relying on their knowledge of anatomy and biomechanics in a purely orthopedic approach to chronic musculoskeletal pain. In contrast, a functional approach recognizes unseen mechanisms related to the overall function of the neuromuscular system in posture and movement such as the location of the structure’s COG as seen with M.A.T.
The focus in treatment then becomes how the body’s COG has changed from the ideal, optimal position thus creating muscle imbalances of the neuromuscular system that ultimately affects the position and motion of the isolated joints. A muscle imbalance is an example of a functional pathology created when opposing muscle groups become imbalanced in tension and length, creating abnormal, isolated joint function ultimately causing the alteration of the body’s COG from the ideal. Isn’t the integration of the body wondrous?
This alters length-tension relationships, force-couple relationships, and joint kinematics which decreases overall human performance against the vertical forces of gravity and GRF during movement that over time can lead to tissue overload and inflammation. As the efficiency of the neuromuscular system decreases from the optimum with poor postural stabilization and alignment, the ability to maintain the appropriate internal forces in reaction to the external forces of gravity and GRF in movement gets less and less. The resultant compensation, substitution, and dysfunctional posture and movement patterns leads to excessive mechanical loading in both the muscle-tendon and fascial tissues. With the body’s musculoskeletal system, compensation by the body’s neuromuscular and fascial systems is the way the body adapts to a misaligned skeletal structure.
The compensation is part of an effort by the nervous system to help the misaligned posture and movement become less of a short-term risk to the body. Remember, the primary goal of the human nervous system is your survivability. Do not think of compensation as a skill, but as rather a symptom of an ongoing issue within the body. It this compensation that helps the body get by until the fundamental, posture and movement issue, the reason for the misalignment is addressed. Compensation simply is the “path of least resistance” the nervous system will take to allow you to continue to function against the forces of gravity and GRF.
I know I have emphasized that the body is not a machine, but using the analogy that involves your car’s wheel alignment is warranted for your understanding of compensation. If the tires are out of alignment, the more you drive eventually the misalignment will begin to wear down the tires that causes other mechanical problems until the entire car breaks down. The same thing happens to your body. Think of musculoskeletal pain as the sensor lights in your car telling you that something is wrong. With most of us, we will ignore the pain, the warning sign and try to push through it. We keep saying, “Oh, it will go away!” or better yet, “No pain, No gain!” However, the pain and dysfunction usually continues until your body can no longer can compensate for the misalignment and it breaks down. I experienced this especially with my left knee injury and surgery that became my motivation behind the development of M.A.T.
The focus of M.A.T. is not on a structural lesion, even though it cannot be ignored, but more on the functional pathology involving the neuromuscular and fascial systems. However with most treatments for musculoskeletal pain today, clinicians still usually focus on the structural lesion relying on their knowledge of anatomy and biomechanics. They also rely on information from images of the skeletal system provided by the x-ray and MRI taking more of an orthopedic approach to musculoskeletal pain. Clinicians search for a pathology of your skeletal system to explain your warning sign of pain. In our allopathic medical system, treatment of pain and inflammation and surgical intervention of the structural lesion becomes the focus. The utilization of anti-inflammatory and pain medications is the foundation of the treatment offered for musculoskeletal pain. When that does manage your pain and dysfunction, surgery becomes your only alternative. With M.A.T., however, the functional cause that is revealed and treated becomes the focus.
While in the discovery and treatment of the functional cause, inflammation is most likely the cause of your musculoskeletal pain which cannot be ignored. Inflammation is complicated, but definitely plays a role in achieving musculoskeletal health. Inflammation is natural and part of the body’s immune system, a defense mechanism that plays a role in your healing process. When the body detects an intruder, it launches its biological response to try to remove it. It could be a foreign body, such as a rose thorn, an irritant, or pathogen. Pathogens can include bacteria, viruses, and other organisms which cause infection. However with the musculoskeletal system, inflammation is an essential tissue response to either extrinsic or intrinsic damage to its bones, joints, muscles, and fascia. In short, damage to the soft tissues of the body. Extrinsic damage to these tissues may be when you sprain an ankle or fall on a shoulder whereas intrinsic damage can be caused by a systemic disease like rheumatoid arthritis.
No matter the cause, the primary purpose of inflammation is maintaining tissue integrity and homeostasis. In the case of trauma caused by extrinsic factors, the process of healing and recovery are driven by these inflammatory pathways and mediators within the body’s immune system. Inflammation that is acute can cause noticeable symptoms like pain, redness, increased skin temperature, or swelling. In acute situations, you want to limit the amount of swelling during the first 24-48 hours after the injury so the treatment of “R.I.C.E” is usually the course of action. R.I.C.E. is the acronym for rest, ice, compression, and elevation.
However most of the client’s I see at my clinic are not experiencing acute inflammation, but rather chronic inflammation which is a horse of a different color. It happens when the inflammatory phase lingers on overtime with episodic flare ups. The common symptoms of chronic inflammation include fatigue, body pain, depression, anxiety, gastrointestinal complications, weight gain, and persistent infections with these symptoms ranging from mild to severe lasting for several months and even years. In addition, they will experience flare ups and symptoms similar to the acute phase.
Causes of chronic inflammation include untreated causes of acute inflammation as with an infection or injury, an autoimmune disorder such as RA and lupus involving your immune system mistakenly attacking healthy tissue, and long term exposure to irritants from chemicals found in our environment.
That is to say, however, these issues don’t cause chronic inflammation in everyone. In fact, most cases of chronic inflammation don’t have a clear cut underlying cause. It is also believed that a range of factors may also contribute to chronic inflammation like smoking, obesity, alcohol, and chronic stress.
I am not against taking over the counter medications like N-SAIDS for the relief of pain and inflammation. Ibuprofen in Advil and Motrin in most cases is very effective in reducing inflammation in the short term. The same is true with naproxen or Aleve. It is in the long term where there are complications to their use. That also can be said of acetaminophen and Tylenol for pain relief. In addition, aspirin can be used to manage pain and inflammation. No matter what you decide to use, communicate with your primary care physician and/or pharmacist.
There are many topical ointments on the market today that help manage pain and inflammation. The key word here is manage and not cure. Products like Topricin, Arnicare, and Aspercreme to name a few. In addition, Hemp CBD creams, salves, and roll on treatments seem to be very effective in managing pain and inflammation of the musculoskeletal system. I have these available to purchase at the clinic.
I emphasize these treatments to help manage your pain and inflammation while trying to discover and treat the break down of your musculoskeletal system. However, it has been my own experience that the only way to eliminate musculoskeletal pain caused by a functional pathology is by altering or transforming your muscle memory, myomemory.
As I mentioned earlier, M.A.T. is my creation based upon my experiences as an athlete and my forty years of practicing physical therapy. I love that play on words. Anyway, the foundation of M.A.T. was clearly established after reading and studying Thomas W. Myers “Anatomy Trains” that transformed what I knew about the fascial system and integrated his findings with my knowledge of the neuromuscular system. By doing this, it gave me a better understanding of what was happening with my own posture and movement.
Just as with the concepts of Anatomy Trains put forth by Thomas W. Myers, my ideas, my point of view, my experiences regarding the neuromuscular system is still being worked out and refined. That is because M.A.T. is based upon both my knowledge and experience. Knowledge that is the distributed information and data we have in our heads based on theory and experience is the systematic information and data linked to each other based on both theory and practice.
It was my experiences in both the world of nordic ski jumping and physical therapy that have given me what I feel is a unique perspective on human posture and movement. From my reading and studying the most recent information out there about posture and movement as well as my experiences in sport, I knew a paradigm shift in how we presently view the body is still required.
I firmly believe Thomas Myers and “Anatomy Trains” started that momentum for this paradigm shift, but the involvement of the neuromuscular system with the fascial system was still unclear to me. That became a major motivation for me to develop my system of M.A.T. when looking at posture and movement. It is my sincere hope that M.A.T. can become just as much of a game changer in the understanding of human posture and movement as did Thomas Myers and “Anatomy Trains.”
His work accurately defines the importance of understanding the tensile forces of the global fascia and the role it plays in human posture and movement. But just as important, is understanding how the neuromuscular system with its muscle-tendon complex and myofascia creating the compressive forces at and around the isolated joints. Because as with most things involving the human body, you affect one of its system, it will affect all the others. That is referred to as “integration.” Something we have forgotten in our study of the human body in a reductionist manner.
With the integrative nature of our bodies, if the tension provided by the fascia in keeping us upright and vertical is altered, so will the compressive forces provided by the muscles, tendons, and myofascia and vice versa. You just can’t get away from it. Everything is integrated, connected together.
In my forty years of practicing physical therapy, I have observed and studied many client’s posture and movement. From this process, I found many consistencies and inconsistencies helping me discover the neuromyofascial patterns of M.A.T. Patterns the CNS recognizes and predicts in the creation of posture and movement. I have named these neuromyofascial patterns as the Anterior and Posterior Linear Vestibular-Ocular (VOR) Pattern, Superficial Anterior and Posterior Linear VOR Pattern, R/L Side Linear Cervical-Ocular (COR) Pattern, R/L Oblique COR Pattern, and R/L Spiral COR Pattern. The VOR and COR refer to the vestibular and cervical reflexes involving the sensory input from vision. Something I will talk about further in another article.
As already mentioned, most of the clients I see at my facility have as their cause of musculoskeletal pain, a functional pathology involving a muscle imbalance. Over time, the muscle imbalance and dysfunction causes inflammation and pain that can lead to a structural lesion. Sometimes, the structural lesion has progressed so that surgery is the only option. However, the surgery doesn’t treat the functional pathology, only the structural pathology. Therefore after surgery, M.A.T. can be of use in treating the still existent functional pathology.
In using M.A.T., the functional pathology, the muscle imbalance affecting one’s posture and movement is seen as the primary cause of the structural dysfunction and pain rather than actual damage, pathology to the joint structures. With other systems of musculoskeletal treatment, clinicians usually take a more structural approach, relying more on their knowledge of anatomy and biomechanics in a purely orthopedic approach to chronic musculolokeleal pain.
In contrast, M.A.T. takes a more functional approach recognizing underlying mechanisms related to the function of the neuromuscular system and its affects on the skeletal structure. M.A.T. instead looks at the muscle imbalance as the primary cause to the functional pathology in which opposing muscle groups and muscle patterns demonstrate an inequality of tension and length, creating trigger points and abnormal joint function that can cause the inflammation and pain.
The muscle imbalance occurs not only at the isolated joints, but also within the five neuromyofascial patterns I mentioned earlier. Therefore, the exercises of M.A.T. I have designed are specifically used to address the muscle imbalance from both an isolated and integrated viewpoint and not for improving one’s fitness level as seen with most physical therapy programs.
These exercises are very specific and involve movements to alter the visual, vestibular, and proprioceptive input in order to transform the “myomemory,” the primary goal of M.A.T. The only way I know to make lasting changes of a client’s posture and movement is through myomemory. That is why no one leaves my clinic without exercises to do at home. However, the key to transforming myomemory is practice and repetition of these movements.
In my next article, I will talk in more detail about each of these neuromuscular patterns. Until then, please be smart and be well.