To continue my discussion of Myomemory Advantage Transformation (M.A.T.) from the last article, it is an integrated, general systems, and functional approach to evaluating posture and movement developed by me from over forty years of a clinical physical therapy practice and over twenty-five years participating in the sport of the nordic ski jumping. Simply, it is the methodology I use at my clinic to treat musculoskeletal pain.
M.A.T.’s primary goal is to identify dysfunction of your nervous, skeletal, fascial, and muscular systems causing acute and chronic musculoskeletal pain. Persistent and chronic pain is the most common cause of disability in this country running at an annual cost of $650 billion dollars in healthcare and lost employment with musculoskeletal pain being a big slice of this cost.
Whenever discussing posture and movement, the journey has to begin with gravity and ground reaction force (GRF). These constant and vertical forces of the environment experienced day in and day out stimulate and trigger your central nervous system into action. They are recognized by your peripheral nervous system (PNS) becoming the circuit breaker in turning on your central nervous system (CNS) to create enough internal force by your muscles and fascia to offset or cancel out the effects of these external forces. In doing this, your nervous system (PNS and CNS) establishes skeletal balance and equilibrium creating your vertical balance, stability, mobility, posture, and movement allowing you to function in this environment. This internal force produced by your body is the product of your neuromuscular and fascial systems working together not in isolation, but in integration creating the holding patterns you learn to move within everyday while performing your activities of everyday life. It is an intimate relationship between the muscles and fascia of your body that create your posture and movement. These two systems are responsible for your skeletal structure being able to float and move against these outside, vertical forces by creating opposing tensile and compressive forces intertwined and interconnected down to the individual fibers of every skeletal muscle. It creates a constant, dynamic dance that is ongoing between the fascial and neuromuscular systems everyday of your life. The fascial and neuromuscular systems are constantly communicating with each other because when any skeletal muscle contracts producing tension or changes in length, it affects the tension and length of the global, integrated fascial web through what is called the “myofascia.” The fascia encapsulating the isolated, individual muscles fibers of any skeletal muscle also encapsulates your entire human structure. It is this dynamic relationship between the isolated muscles and the global fascia that gives us both views of seeing the body function in isolation and integration. In fact, the term “myofascia” itself implies that the nature of muscle tissue (myo) and the accompanying web of connective tissue (fascia) encapsulating it is inseparable. M.A.T.’s major focus and goal is on altering or transforming these internal, tensile and compressive forces produced by these two very important and often times forgotten systems of the body responsible for your vertical balance, stability, mobility, posture and movement.
First and foremost, it is important to recognize that the gravitational field of the earth is the most powerful physical influence you experience in life in regards to your vertical balance, stability, mobility, posture, and movement. Ida P. Rolf Ph.D., the founder of rolfing once stated,“Some individuals may perceive losing their fight with gravity as a sharp pain in their back, others as the unflattering contour of their body, others as their constant fatigue, yet others as their unrelentingly threatening environment. Those over forty may call it old age. And yet all these signals may be pointing to a single problem so prominent that it has been ignored: they are off balance, they are at war with gravity.”
It is easy to accept the presence of gravity on earth, but not recognize how essential it is to your functional posture and movement. Gravity drives everything towards the center of the earth, including you. When the acceleration of your center of the mass for your body interacts with the equal and opposite reaction force provided by the earth’s surface, a chain reaction occurs. Another quote from Ida Rolf describes gravity’s constant presence in your life, “Gravity is always there: You can never escape from it. From the day that single cell is fertilized and develops, gravity is with us. The fetus in the woman’s womb is under the effect of gravity; and until the undertaker gets the body and lays it away, it’s under the effect of gravity.”
Under the same breath, you have to recognize that the opposite and vertical force, GRF, is an essential component of your posture and movement. Your isolated joint motions in reaction to GRF especially of the lower extremity cause lengthening and loading of your muscles. Your body’s muscles react by adding active muscle force in response to complement these gratis, passive forces of GRF in order to effectively and efficiently accomplish any intended task. In addition to turning the muscles on during functional tasks, GRF also stimulates your muscles to become torque sensors. That is because in your body’s reaction to GRF, rotational forces or torques are created that need to be dampened and controlled. Otherwise, injury to the bones, joints, and soft tissues can occur. Your body’s muscles are able to sense the torque produced by GRF and use this information to orchestrate the proper combination of muscle contractions in order to successfully dampen and control the forces of torque while executing a desired movement. This is where your body’s power comes from in its reaction to GRF no matter the activity.
M.A.T. is foremost a brain driven system of analysis and treatment of chronic and acute musculoskeletal pain relying on the brain’s innate ability to recognize and predict neuronal patterns. In posture and movement, your brain is designed to recognize a pattern of neuronal activation and know the correct way to respond in reaction to gravity and GRF based upon the memory of your genetic and inherent neurodevelopmental sequences and your life experiences living in this environment. Researchers have found distinct firing patterns of individual neurons the brain uses when forming these memories and are replayed when remembering the experience. Each neuronal pattern developed in your nervous system was the underlying and foundation of all your future patterns. If there is inefficiency in one neuronal pattern, it will affect all others. As an example, foundational to all your posture and movement patterns your brain develops overtime is breathing. Dr. Karel Lewit, M.D. emphasized this in his statement, “Respiration is our primary and most important movement pattern…and is also the most dysfunctional.”
These patterns of neuronal activation within the brain regarding posture and movement are defined in M.A.T. as its four neuromyofascial patterns including the deep and superficial anterior/posterior linear, side linear, diagonal, and spiral patterns. M.A.T. recognizes that all posture and movement begins in your nervous system and more specifically in the brain and not the muscles. Your muscles receive stimulation from your CNS telling them what to do in response to the vertical forces of gravity and ground reaction force (GRF). The PNS and CNS along with the muscles, fascia, and bones create your posture and movement and also the dysfunction seen with musculoskeletal pain. However, muscle has the capability to change its tone and length in the response to these external forces with the help of the nervous system ultimately affecting the global fascia through the myofascia. That is the rationale behind M.A.T.’s exercises I give each patient.
Within this description, the isolated muscles are seen simply as pockets within the global fascia tied down at their insertions by their tendons. Muscles actually don’t attach to the bones as most of us have been taught, but in fact the muscle cells are intertwined with the fascial net through the myofascia. The fascia is what is attached to the periosteum and it is the periosteum that pulls on the bone. Therefore as Thomas Myer’s the author of Anatomy Trains states, “there really is one muscle; it just hangs around in 600 or more fascial pockets.” Unfortunately though, muscles are still perceived as isolated motor units. Understanding muscle force in this manner ignores its longitudinal and global effects and the latitudinal and isolated effects found in research. It is becoming more clear through this research that the fascia distributes laterally to the neighboring myofascial structures so that the pull on the tendon at one end is not necessarily taken by the insertion at the other end of the muscle demonstrating both the isolated and global effect of your muscles on your structure.
As mentioned in the previous newsletter, you enter this world of gravity and GRF as an infant with un-compromised stability and mobility, and your nervous system follows a natural, inherent and predictable progression of posture and movement patterns or neurodevelopmental milestones creating the foundation for your posture and movement. With this neurodevelopment, you along with every human being had to follow and experience a sequence in a hierarchy of posture and movement. From pre-natal positions and motions to cross-patterned walking everyone is genetically programmed to move through this ascending hierarchy. Each position and motion learned facilitated the next phase of your neurodevelopmental growth. Each layer of your neurodevelopment growth was built on the layer that occurred prior. Therefore, it is critical each stage be experienced and fulfilled. These primitive neuronal patterns of your neurodevelopment experienced as an infant are foundational to the neuronal patterns of your posture and movement developed as the CNS matures. The primitive and lower neurodevelopmental positions and motions provide the necessary strength, stability, mobility, and coordination required of more challenging physical activities as the CNS matures giving you the foundation needed to be successful at a higher skill level involving posture and movement.
The very first neurodevlopmental milestone, neuronal pattern integrated within the CNS involves head and neck flexion and extension control in the sagittal plane. This milestone was initiated and integrated in the CNS before an infant can progressively move onto other more challenging posture and movement skills. Each postural and movement developmental pattern learned served as a stepping stone for the next movement in this neurodevelopmental sequence. This becomes the foundation of your “myomemory” creating your posture, and movement. This neurodevelopmental sequence helped you build your vertical balance, posture, and movement from an infant with un-compromised stability and mobility to a mature adult living in this environment of gravity and GRF. For those of you who are fortunate enough to be around children, we identify with the terms such as head control, rolling, and crawling as being rooted in these early stages of childhood exploration and learning. Remember, before you learned to walk, you had to crawl. Keep this in mind as you continue learning about M.A.T. Through my clinical experience I find this as an explanation for the rationale you often hear when treating musculosekelatal dysfunction and pain, “you peel the away the layers of dysfunction and symptoms like an onion.” When I first start to work on someone’s musculoskeletal dysfunction and pain, it can be very complex and integrated. But as I continue to treat their dysfunction and pain and the layers of dysfunction peel away, I can arrive at an apparent, root cause of their dysfunction.
The simple narrative to describe how this brain driven system and neuronal patterning works in your everyday function is the brain listens to the eyes, middle ear, muscles, and fascia through the visual, vestibular, and proprioceptive sensory input regarding gravity and GRF. The sensory input from these vertical forces is fed to the spinal cord by the peripheral nervous system (PNS) which is relayed to the brain where it is integrated and processed causing a response. This response is communicated back to the muscles telling them what to do in creating your posture and movement in reaction to gravity and GRF. This direct communication between your brain and muscles of your musculoskeletal system is referred to as your “myomemory” or the “path of least resistance” within your nervous system. Simply, the habits and behaviors creating your posture and movement. Because humans are grown from a seed and not a machine, this process of your posture and movement needs to be viewed not as an isolated linear, cause and effect, but rather a more integrated “global and circular view.” A view of relationships between the various systems of your body working together in integration and synergy with its primary goal “to keep you alive, your survivability.”
The emphasis of M.A.T. is on the detection of inefficient and dysfunctional neuromyofascial patterns causing asymmetry of your posture and altering your joint kinematics during movement in the three planes of body position and motion. These inefficient and dysfunction neuromyofascial patterns eventually lead to inflammation and acute and chronic musculoskeletal pain where chronic pain is defined as pain lasting for at least 3 to 6 months. Overtime, it can lead to the degeneration of your skeletal joint surfaces. The repetition of isolated facilitated muscles within a neuromyofasical pattern creating your posture and movement will inhibit the other muscles of the same pattern as well as muscles within other neuromyofascial patterns. As already mentioned, this causes the asymmetry of your posture and alters your isolated joint’s functional biomechanics during movement.
Therefore, the focus of M.A.T. is not on the pathology of the isolated bones and joints as with our allopathic medical system, but rather on the functional muscle imbalances created over time by your habitual posture and movement altering your joint kinematics and causing arthritic joint changes and eventual joint pathology. Vladimir Janda, a clinician, researcher, and educator from Prague, who was a pioneer in assessing and treating musculoskeletal pain stated, “muscle imbalance is an impaired relationship between muscles prone to facilitation and muscles prone to inhibition.” The condition which seems to be a prerequisite for chronic musculoskeletal pain is this habitual imbalance of muscle usage around a particular isolated joint and/or a kinematic chain of joints. This creates a situation where some of the muscles crossing a joint become weaker while some become stronger causing relative weakness, but not absolute weakness. Your neuromuscular system now becomes a relationship of antagonists rather than one of synergists as its inherent design. Your own muscles counter act each other in order to create the stability and mobility of your structure without your weight habitually ever being transferred through the center of a joint and your body’s COG during activities of daily living. In short, it creates musculoskeletal dysfunction that if not treated can cause inflammation, pain, and eventual degeneration of your joints.
Understanding proprioceptive muscle spindle and golgi tendon organ actions of isolated muscles within a pattern and altering visual, vestibular, and proprioceptive sensory input are the keys to transforming a dysfunctional myomemory. M.A.T provides exercises altering visual, vestibular, and proprioceptive sensory input in order to alter the isolated tone and length of muscles and the myofascia within a dysfunctional neuromuscular pattern. By changing the dysfunctional myomemory and inhibiting the path of least resistance, it allows your CNS to achieve optimal “whole body” alignment and synergy once again which is its inherent design.
In order to successfully transform your “myomemory”, you must begin with your perception, your conscious awareness. You cannot begin to change and create a new neuronal pattern of posture and movement until you know there is something to change. Then you have to give your CNS a new pattern to access because without a new pattern, your CNS will only revert to what it knows, “the path of least resistance.”During your activities of daily living involving your brain driven posture and movement, it is composed with both the conscious and subconscious brain. Consciously, when you decide to do something it is cortically controlled by your brain limited to and including when you start and stop the activity, the direction and speed of the activity, and the quality and range of force to do the activity. However, things are also happening in your brain below your conscious awareness. This involves the neuromyofascial patterns of your posture and movement, the how of the activity you decided to do or the choice of neuromyfascial patterning made by your CNS. The choice of neuromyofascial patterning creating your posture and movement cannot be willed or directed by your conscious mind since it occurs without your recognition and awareness. You can consciously stop and redirect the resultant posture and movements if the goal of the activity is not being met, but you cannot consciously control the neuromyofascial patterning and coordination to perform the activity. This is the task of your involuntary nervous system, your subconscious mind. This implies again the decision to do an activity starts in your conscious mind, but the successful performance of the activity involving neuromyofascial patterning is the function of your subconscious mind. When I was teaching my kids any athletic skill, I would always stress to them to “take the conscious mind out of the skill.” Let the body do what it was trained to do. I heard that over and over again from my coaches when training and competing in the sport of nordic ski jumping for over twenty years.
With M.A.T., I have identified four intrinsic neuromyofascial patterns affecting your posture and movement at the subconscious level including the deep and superficial anterior/posterior linear, side linear, diagonal, and spiral patterns. Each of these patterns you developed over time starting with the neurodevelopmental sequence and as your nervous system matured, your life experiences surviving in the environment of gravity and GRF made its imprint on your nervous system. The neuromyofascial patterns of M.A.T. should work together in synergy to create your posture and movement by producing the internal force establishing balance and equilibrium of your skeletal structure against the vertical forces of gravity and GRF. By doing so, they generate a dynamic and constant interplay between stability and mobility of your skeletal structure. A dynamic process describing your body’s never-ending dance between these four neuromyofascial patterns of M.A.T. in managing your body’s vertical balance, stability, mobility, posture, and movement in three planes.
By identifying dysfunctional neuromyofascial patterns with M.A.T., it allows me to give your CNS access to new neuromyofascial patterns by altering your visual, vestibular, and proprioceptive sensory input through exercise. With each repetition you practice, it eventually creates a stronger impulse for the newer pattern at your subconscious level. It is my clinical experience over the last forty years that the only way to successfully treat and eliminate musculoskeletal pain is by active participation of your nervous system at the subconscious level to alter “myomemory.”
In my next article, I will go into more detail regarding M.A.T.’s neuromyofascial patterns beginning with the side linear pattern.