Where’s the Manual – Part 4

L0014606 Hand from “Anatomia Humani Corporis”, Bidloo, 1685 Credit: Wellcome Library, London. Wellcome Images http://wellcomeimages.org Hand Engraving 1685 (?) By: Gerard de LairesseAnatomia Humani Corporis Bidloo, Govard Published: 1685 Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

L0014606 Hand from “Anatomia Humani Corporis”, Bidloo, 1685
Credit: Wellcome Library, London. Wellcome Images http://wellcomeimages.org
Hand Engraving 1685 (?) By: Gerard de LairesseAnatomia Humani Corporis Bidloo, Govard
Published: 1685
Creative Commons Attribution only licence CC BY 4.0 http://creativecommons.org/licenses/by/4.0/

Next on the list of parts to consider are the soft parts and how to help them. These include the ligaments, tendons, muscles, and fascia. To help you remember:

  • Ligaments hold one bone onto another
  • Tendons hold muscles onto bones
  • Fascia surrounds all the pieces of the body and provides a web for them all to interconnect with.
  • Muscles provide the actual force to do anything – they are the only tissue that can change length in a controlled way and also generate force.

Many of the most common injuries are of the ligaments and muscles. When you injure a ligament it is called a sprain, if you injure a muscle it is called a strain. The difference is important because ligaments (and tendons) are tough strong cables but they have very poor blood supply. This means when you get a sprain the area has a lousy system of draining out waste or getting new materials in to rebuild. Consequently sprains swell as the injured tissue leaks fluids that can’t be carried away and they are slow to heal. On the order of 16 weeks to get back to full strength, if you are nice to them.  Muscles, on the other hand, have a lot of blood supply so they swell a lot at first but settle down in the first 4-7 days and they heal fully in 6 -8 weeks or so.

Injuries to muscles and ligaments are so common that there have been hundreds of techniques developed to help these injuries. The most common is massage of many sorts. What the various techniques generally have in common is to stroke, compress and stretch the injured fibers in ways that push blood and nutrients into the area, push waste materials out, and align the fibers so they can heal in a manner that puts them in the best position for their task. There are literally dozens if not hundreds of specific massage systems in use. No one technique is better than another but no one is the best for all injuries so you just have to try and see if it helps you. If not then try a different technique. Most therapists are practiced in several methods and techniques so they can handle a variety of injury needs. These techniques have long been recognized to help speed return of function and diminish the pain of strains and sprains.

Some techniques focus on altering the tensional pattern generated by the ligaments and fascia. The idea is that having the proper length and flexibility in the tissues allows the body to have the best mechanical advantage in movement tasks at any time. Rolfing, myofascial release, and Craniosacral therapy fall in this category. Which specific tissues and how you can assess them varies among the techniques but they all involve a practitioner positioning and holding a client in a manner that applies a force on the tissue in question, usually a light force, for a sustained period so the tissue can change its length.  They all can assist a client in regaining better overall functioning and movement.

Another category works with changing the body’s perception of how much tension to maintain in the muscles and ligaments.  Strain Counterstrain is one of several techniques based on the concept that receptors in the body are set to keep some fibers in muscles and ligaments too short and so the body is keeping discreet areas tighter than they should be relative to the tissue around them. Think of it like having an patch on your jeans that is sewn in a little too short, the entire leg hangs a bit funny even though the patch is just on the knee. In these techniques the problematic tissue is positioned so it can no longer exert any force for 90 seconds or so while the nervous system resets the fibers’ resting length.

The consistent thing with all these techniques is that they require a competent practitioner to help you. While they can in some cases be done by a person on their own body, generally the client needs to relax and have the tissue manipulated by someone else to get the best results. Techniques that help people do things for themselves is the topic for next time.