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Aging Does Not Cause Aches And Pains! But What Does?

Perhaps one of my tallest soap boxes (which I have a ladder to get on top of) that bugs me the most is how we use the concept of age in this society in relation to health. As I’ve said to many of you, hearing the phrase “Well, I’m getting older” as a way to explain an ache or pain makes me want to slap people with a fish (preferably a rather large one). Aging does have some effect on our physiology (mostly in hormone production and balance, especially things like DHEA), but I would posit that when it comes to aches and pains, posture, and movement…your age itself has very little to do with it.

I know that your first thought at this notion may raise an eyebrow at the least, but stick with me. What causes all these aches and pains we feel as we get older if not the age itself? When it comes to your aches and pains the time accumulated is what is making aches and pains worse but it is NOT your age or aging processes specifically. It’s that you’ve had more time for postural deviations or the impacts of old injuries to snowball into tissue damage and cascading dysfunctions that do cause damage. I know some of you also now may be saying this seems like a rather hairs width matter of semantics, but that is only true if these issues aren’t preventable, then it’s a very legitimate inseparable correlation between aging and these kinds of pain and complaints. But the thing is, you can reach a ripe old age without ever understanding what all the fuss is about with aches and pains.

Most of you are familiar with NKT already, and if you’re reading this article then you may have a decent idea of how the body works with compensations. In short if you get injured your brain will not let a muscle that is injured contract as this will obviously stop the healing, or if a tissue/bone is damaged that a muscle would pull on, the muscle will similarly be inhibited. If posture has altered so that the ‘ideal muscle’ is now no longer mechanically advantageous, it may also be passed over in favor of something else. There are other reasons as well, but basically if the body feels unsafe or unstable (most especially around joints or injuries) it will change which muscles and tissues to use in a given situation or role.

For each muscle function in our body we almost always have at least 2-3 muscles that can get the job done, with decreasing degrees of efficiency and capability. Because we spent 2 million years as animal humans (or something very close to what we today call humans) hunting, foraging and running from predators on a daily basis for survival, an injury did not change the fact that the next day we would have to hunt, forage, and run from danger. This meant that we were, and are, fantastic at compensating by picking that next most ideal tool to keep functioning and thereby staying alive and procreating. This also meant that without the time to rest, no real medical intervention of any kind until very recently in our history, and very limited chance to heal well…it was expected these compensations would be permanent.

So we get to keep functioning, what’s the big deal? Less ideal muscles are less ideal for a reason. The joints they are attached to become less stable, kind of like a 4 leg stool now only having 3 legs. Also the angle of tension is different on the movements, forcing us to change posture, and thereby the angles of pressure on the joints, bones, and soft tissues. Also, with less ‘cables’ working, those that are still working need to be that much tighter. And one of the biggest elements that I will soon explain the implications of, is that when a joint feels very unstable, or if the body as a whole feels very unstable, the joints will start compressing and limiting range of motion.

Illu_synovial_joint A fully functional and healthy joint has some space between the actual bones, and the space is filled with lubricating fluids and pads to keep the joint from wearing itself down. When it has to compress to feel stable the bones will actually jam into each other, the result unsurprisingly being that the padding gets ground down over time. When there’s normal amount of wear the body can keep up with joint damage and heal it to keep it fairly pristine, acute injuries aside. With joint compression lasting months…years…decades? This is more than half of what causes arthritis , and what eventually leads to a need for joint replacements. The increased tension on the few muscles that are being allowed to work also changes the shape of the bones and causes bone spurs, which can be pretty damn painful and debilitating itself. If the bones start causing actual damage to each other because the pads are too far gone, the pain is obviously prohibitively immense to allow movement, adequate tissue repair, and means surgery is now the only viable option.

The thing is, if we catch these before the joint and tissue damage has gone too far we can use Neurokinetic Therapy® to reset the brains muscle and tissue priorities, getting those ideal muscles back on and working when they should. This makes for stable functional joints that do not need to compress, and keeps pressure from being shunted through more limited vertices (like the spine, causing great back pain instead of through the whole torso!) and resulting in pain, mobility limitations, and even more painful posture (like hunching that you can see take some people nearly to parallel).

Feeling the aches and pains of age? Get NKT assessed and get things back in order. Stop accepting pain as a normal part of aging. Pain is a signal telling you something is going wrong and asking you to fix it! Your age did not cause this, the time your body has spent using its various tools of motion and posture incorrectly has, but a lot of it can be fixed permanently!

How Long Is It Going To Take?

One of the most common questions I get from my patients is “how long is it going to take to fix this?” in regards to how long it’s going to take for the ‘homework’ to do its magic. This is at the same time a simple and complicated question. It’s not really a matter (at least not entirely) of how strong or weak a muscle is in that it needs to be re-strengthened to make the pain and any dysfunctions go away. Instead we are teaching your brain to change its strategy for a certain ‘function,’ which means we are changing one of its’ established ‘movement habits’ to a new habit. Returning strength and endurance to a muscle may be an important part of its return to proper function, but the bigger part is effectively changing a habit and to do this we must show the brain that this new habit is one that is here to stay and convince it to have confidence in the specific muscles and tissues we have told it to use for this habit.

We’re all quite aware I’m sure that changing a habit can be really hard and consistency is the biggest aspect to making it stick. Your body is the same way. If a couple days a year it frosts over where you live and you have to very consciously think about how you walk to not slip, these ice walking skills aren’t really sticking around from year to year. If it was icy for a couple of months every year, do you think those ice walking skills would become better, more natural, and stick around from year to year? If we show the brain a new challenge but don’t show it that learning how to deal with this new challenge is important to accomplish and we will keep facing it, it won’t bother keeping the skills in its movement version of long term memory. This is why consistency is so important to a ‘speedy’ change in our movement habits and stopping the symptoms from dysfunctional movements. If homework is done sporadically without consistency, the brain doesn’t deem it something that it needs to hold onto.

On top of consistency/frequency, the number of times the body/brain is faced with a new or different challenge that requires it to behave different is also a crucial element to changing a behavior. The number that is oft quoted in the rehab world is that a movement needs to be done 3000 times to actually change a pattern/habit. I don’t know how exactly accurate this specific number is, but the idea it represents is big. If the habit (aka compensation strategy your body has chosen instead of the way of moving it was meant to use) is new, like right after an injury, it won’t take that long because it’s a habit that is still forming. If it’s been 20 years then chances are it will take a while! Consistency and frequency are going to be a big deal here to make the transition as complete and as quick as possible.

So the last part of this trifecta to talk about is that the biggest thing we’re really doing is trying to convince the motor control center (the part of the brain that decides how we actually carry out movement and posture) that it should have full confidence and trust in the methods we are telling it that it should use. This is why our homework is a carried out in such a specific way (and yes you can think goldilocks here with not too hot, not too cold) with exercises starting light but being done frequently and consistently. If we overdo the intensity, duration, or resistance, or use the wrong exercises, etc. then we will only reinforce the compensation. Let’s take a look at a metaphor to describe what I’m talking about (we all knew a metaphor was coming at some point in this article!).

If a patient is doing, say, release of the illiacus followed by corrective exercise for the same side psoas, but instead of going to their first fatigue and only executing a set or two, they go until the muscle is burning and they do 5 sets three times a day, then they are definitely over doing it! With our metaphor you’ll see why this is definitely not a productive approach: Let’s say you’ve been on maternity leave for some time, and come back to your job and are getting settled back in. If you’re still getting poor sleep (as happens often with new children!) or just aren’t caught up to speed with the changes that have happened in your job, your boss may not be confident in your ability to fully take over your old responsibilities. If the job is important and fast paced, it is all the more likely. If you mess up or get pushed beyond your ability to do the job when you return, especially if it’s over and over, your boss is just going to keep your temporary replacement doing the work because there really isn’t another choice.

So what is our body/rehab equivalent? We’ve taken your inhibited muscle and shown the MCC (your manager) that you are ready to come back to work, but if every time you go to use it, you over use it and with its lowered endurance/strength/neural connectivity, the MCC has no choice but to put a facilitated compensator back to work. If you take a previously inhibited muscle past its ‘confidence point’ it will be compensated for. This is why we start slow and don’t overdo things: we want to regain the MCC’s confidence to use that muscle in those patterns. By starting with lower intensity and duration we are able to get the muscle ‘back up to speed’ without blowing the confidence of its neurological manage and in the process get the strength and endurance back, and get rid of the related symptoms.

So back to the original question, how long is it going to take? As you probably guessed from the above, it really depends. It depends on how severe the original incident was, how long it’s been (the longer it’s been means the longer it’s going to take), how severe the compensations are, etc. The best thing we can do is be as consistent and exact with the homework as possible and keep progressing things as appropriate. I’ve seen some patients ditch their symptoms after our first session, some after a week of homework, and some after several weeks to find complete relief. This doesn’t mean their homework is done; changing such deeply entrenched habits can take some time, but the long term outcome can be profound and permanent change and improvement.

To Ice Or Not To Ice?

Roll an ankle, break a bone, get a bad jolt to your shoulder; one of the first responses is ice and anti-inflammatories right? While I’ll be one of the first to tell you that we are a culture bathing in inflammation and we need to make this stop, just as with all other bodily processes there is a time and a place, and a reason it exists in the first place. The problem is that we have endless things throughout the day that are causing enormous amounts of inflammation and this is what leads to the vast majority of our diseases. But what about when you sprain your ankle? Why do we want to get rid of the inflammation there? Let’s take a brief moment to look at what inflammation is.

When you get an injury, an infection, some kind of allergic reaction, the body needs to react to protect itself and fight the infection or repair the damage. Inflammation acts as both alarm bells and emergency services at the same time. The area becomes more bloated or swollen with interstitial fluids, it gets hotter, and loads of immune cells and rebuilder cells show up on the scene as appropriate. Supplies and these ‘workers’ come in, and then waste (like damaged cells being removed and destroyed) or toxins get pulled out of the area. Thus, the healing begins. If, however we sit down and stop moving, and start icing the area the healing stops in its tracks. “Inflammation can happen without healing, but healing cannot happen without inflammation.”

Straight off this seems like a pretty obviously bad idea! We delay the healing substantially and the only thing we get in return is a bit of temporary pain relief. This doesn’t sound like the best trade to me. Just like rolling the IT band or plantar fascia, you just address the symptom and not the problem at hand.

lymphatic system

The issue goes past just the repair of injuries as well. The mechanism behind our local inflammation is the lymphatic system. This is a circulatory system just like what our blood goes through, but this moves a lot of nutrients and liquid in, toxins and waste out, while also being a major part of our immune system. Some of our immune system is in the blood circulatory system, but much of it is in the lymphatic system. Cold slows down its ability to move, but the real crux of the issue is that the lymphatic system doesn’t have something to pump the fluid around like the heart. Instead it depends on the movements of our body and muscles to move fluids into, out of, and along its pathways. This is why it is so important to get moving here and there when you’re sick in order to help the immune system, just nothing strenuous. Instead a very light topical massage can help simulate this movement without having to use a joint or muscle you just injured. Some massage therapists are trained in lymphatic massages to help you do just this, with added benefits of detoxifying the body.

Icing and immobilization are definitely not the way to go. Use mild heat and light massage (just make sure not to rub open cuts or broken bones!) or you are simply putting a roadblock to healing.

For a lot more full information, take a look at one of the best rehab guys in the industry and his guest speaking on the issues behind why to ice, or not to ice:

The Truth On Flexibility

Flexibility is one of the big goals people pursue in health, performance and mobility, and the holy grail for achieving this has always been stretching the muscle or tissues in various degrees of complexity and intensity. Stretching does have its place in the therapeutic and health realm, but the notion that you can tug and tug on a part of you and have it change is entirely flawed. The nervous system is what controls our soft tissues and what they’re doing at any given time, including how tight muscles are. If a 20 year old ballet dancer, and a 60 year old lifelong desk worker both get in a car accident and do not survive, their bodies are suddenly just as flexible. If the mechanical tension model of a muscle literally being too short would not allow this to be the case if it were true. Even in the most severe living tissue cases, such as frozen shoulder where someone gets severe mobility limitations for their arm in the shoulder, once they are fully anesthetized, full mobility is again possible.

I don’t feel like it’s necessary to try to fight the issue further, so let’s take the discussion in the more appropriate direction. So if the nervous system has decided to make some tissue tighter, or even looser, the obvious question that no one seems to ask is why? There are a few possible reasons, but what it all comes down to is the body protecting itself either directly or through a more complicated strategy.

The simplest reason is that the muscle, tissue, or a connected tissue (like the tendons attached to that muscle) are damaged and if we allow too much stretch it will tear more or rupture completely, let alone heal. The nervous system simply will not allow you to stretch to that point, and so trying to push past that acute hard stop in your range of motion will only cause damage and prevent healing. It may also be weak and be tightening because it does not have confidence that it can stretch fully and hold itself in that mechanically disadvantageous position safely.

A similar mechanism is that a bone, joint, or other part of the body that the tissue you are stretching is attached to, is similarly going to need to minimize its ability to negatively impact this joint. Usually instead of being tighter, muscles that would pull on this spot would actually become inhibited and possibly more flexible, while muscles that will minimize the range of motion in that joint or injured bone will often get tighter. When there is an injury to a joint or something as crucial as the spine, this is very common and can lead to some severe tightness and dysfunction to keep the spine or other joints compressed as a way to manage a sense of instability or injury.

Taking to a bit of a more complicated situation, tightness is a way the body adapts to feeling some more global (whole body) instability. Hamstring flexibility seems to be the ultimate holy grail of mobility, but no one ever asks why. With so many other muscles often not working that keep the hips in their proper place such as the glutes not working to keep the back of the hips down, the QL’s (muscles above the hips acting like suspenders for them) pulling them up, and then similar on the front of the hips. The hamstrings end up being one of the few things still working that can keep the hips in place and extend the leg backwards at the hip. To stretch the hamstrings is to add even more instability to the situation.

NKT lower cross Sometimes stretching is beneficial and useful, but to use it to become more flexible will make the muscles react by becoming even tighter to protect themselves or whatever structure they’re attached to. Show the body that past injuries are healed, and get muscles turned on so that joints will be stable and don’t need the brain to protect it with a tightening compression strategy and flexibility can return. Stretching in this situation is just like trying to make someone feel safer by locking them up or attacking them.

Another thing to keep in mind is that the body does mechanically and, more importantly, neurologically adapt to the actual life your body leads. If you spend the whole time at your desk with shortened hamstrings, slack abs, tight hamstrings, and other such situations, that is where your body feels comfortable and the range that it believes it should be fit to ‘perform’ in. Living more active and in a more standing and dynamic lifestyle is going to be one of the most important things to keep these problems from happening in the first place and then reemerging. NKT can fix you, but you have to live so that it won’t just be put right back! Our species spent two million years walking around all day, crouching, climbing, carrying and throwing. Sitting is a relatively new ‘invention’ or behavior as far as humanity is concerned, for more than a few minutes to an hour a day to now we do it all but a few minutes a day. Standing desks, walking, and moving dynamically is more key to creating and maintaining flexibility than having a few moments of high stretch could ever be. With Neurokinetic Therapy™ we can find out what protective strategies the body is using to find a sense of stability, why, and how it is carrying them out. We can then fix these dysfunctions and faulty tissue relationships, thereby allowing flexibility to return without damaging tissues or making the body less stable.

Inhibited Doesn’t Mean Weak. Tight Doesn’t Mean Strong

As I go through my explanation of Neurokinetic Therapy™ and how the motor control center in the brain orchestrates movement and the protective strategies it uses that result in the injuries and pain I work on, inevitably I see a question pop up on their face. If it’s so common for people’s core muscles to not work, how can I have a six pack? The thing is, just because a muscle is inhibited doesn’t mean it’s weak; the brain just isn’t allowing it to work because in some kind of functional relationship with the rest of your anatomy, it believes it would create instability around a joint or organ, so shuts it off. The problem is even 50 years after an injury your body may still be using the same protective mechanism as if the injury were still present, so in that particular role, if not every role, it turns that muscle off.

Let’s go with an example and a metaphor. Two previous people I’ve worked on come to mind. One is a slender ~80-90 pound woman, and the other is a 240 pound athletic male. Both of them had glutes that weren’t firing. The glute is one of the mechanically strongest muscles we have. I turned the glutes on for both of them and naturally I couldn’t shift the guy’s leg during the test, it was just too strong, but with his size it isn’t surprising. But the thing is, I couldn’t shift hers either. Despite the fact that they couldn’t use their glutes, they were still really strong, I just had to ‘plug them back in.’ For our metaphor, imagine you’re a lawyer making embarrassingly large amounts of money, so that each month a mountain of money is being put in your account. You think one day, I need a Porsche and go to purchase one, but you forgot your debit card and checkbook at home. You have all the money in the world but you can’t access it. Strength can be the same thing; the brain is our access point to that strength and it determines if we can use it or not.

glute max

Sometimes a muscle is so inhibited for long enough that it does atrophy to a degree and has to get its strength and endurance back in order to regain the confidence of the brain to complete tasks, but this is definitely not always the case. In the gym you may be able to work out your abs, but be unable to use them in the functional roles for which it was intended. The abs themselves were meant to be used to stabilize the core more than actually move us, so it makes sense that it may work in the gym and become strong and chiseled, but be useless in its stabilizing role. The same is the case for so many other muscles, which contribute to instability and pain, and we just have to find the right light switch to flip to get them back on.

On the other side of things, we have a sports and fitness culture that loves to stretch. Lengthening tight muscles and working on general flexibility is a big goal for many people, but we rarely broach the question ‘why is it tight?’ The vast majority of the time the brain is telling a muscle to become tight as a way to limit the range of motion around a joint it feels is not stable enough to allow unrestricted movement, or because the muscle does not actually feel strong enough to have confidence that it will be safe stretching all the way in dynamic motion and having the ability to keep itself from stretching too far and ripping itself or other tissues. There are other mechanisms, but tight muscles are tight as a protective mechanism for themselves, or for something else. Stretching a tight muscle often leads to it tightening further to try to protect itself from what it sees as an obvious threat, or it may actually cause damage to what it was protecting if the issue is still present. Hamstrings in particular should rarely be stretched as they are tight for a reason, and when you stretch it is generally non-specific, so you stretch parts of the hamstring that really shouldn’t be stretched at all, even if some of the hamstring could use it.

Muscles and tissue can be tight, inflexible, painful, and even somewhat rigid, but we always have to ask; ‘why is it this way?’ The answer is almost invariably “to protect itself or something else.” The same question goes for why something won’t work, or why it seems ‘weak’ even when you exercise it. It’s time to ask why, and then search out the cause. Neurokinetic Therapy can figure out what and why, and set it right.

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