Is getting massaged, mobilised, injected the answer? Are we relying too much on modern medicine to cure our aches and pains? how much do we know about our bodies and how are we educated? This is just a blurb from myself on my opinions and thoughts. Read on to find out more……

The majority of my patients present to me because they are suffering with pain and they want to know how to get rid of it. There are variety of options that I can offer, which to say the least have minimal evidence to support their efficacy. These passive approach therapies have a short term affect and are claimed to address the structure of the tissue but they tend to have more of an effect on neural input/output at the dorsal horn in the spinal cord and create lots of nice descending inhibitory effects, good stuff from the brain!

Other treatments available are to have injections or surgery, which also have a multitude of controversial evidence. Pain does in a lot of cases resolve (which is great) only for it to come back again when we continue with our daily lifestyle.

So what is it that we are doing wrong?

Well function, pain science and psycho-social factors are frequently overlooked and in some cases can be the reason for the underlying cause of the structural failure. I’m not going to delve into pain science and psycho-social factors in this post as I will discuss that in a later post. I refer to a wonderful article written by Professor Karim Khan (reference) demonstrating the mechanical physiology of cells in the musculoskeletal system and how they have been affected in the wrong way. Rather than inhibiting them with medication we should be stimulating them through exercise and load thus promoting tissue repair. Our cells are desinged to communicate with each other, they are load bearing structures. Bone is a perfect example if you take load off a bone then your body will reabsorb the molecules that make up bone and use it elsewhere causing your bone strength to weaken. So the musculoskeletal system is about tolerating load. Therefore it is important to gradually load our tissues in the correct way in order to preserve tissue make up. maintain the neural connections and optimize body function. Check out my post on optimal loading here

Our Musculoskeletal system is an amazing piece of machinery. Scientists around the world have been working on ways to create muscle, exoskeletons, robots that mimic human movement and can manipulate objects, identifying the complexities of human structure and function (reference, reference, reference). We underestimate the sheer ability of what our bodies can do at a cellular level in order for us to function optimally. These amazing studies into human structure and function do have the hallmarks of a certain James Cameron movie.

To me this highlights how complex but how amazing the human body is and how important it is to keep it functioning correctly. As we age biologically our body takes longer to recover and somewhere along the way we may have become ignorant of this. Yes we function in a world that runs at 100 miles an hour and we expose ourselves to stress and strains everyday but this shows how adaptive and unique we are. So when something goes wrong as in the case of an injury looking for the quick fix in order to maintain the 100 miles an hour pace is not a viable option for our bodies biology. We might see a health professional that can push, pull, rub, prick and stretch us, which alleviates the pain resulting in us feeling great afterwards. Yet this tends to be a short term relief and symptoms often return.

Why do problems persist?

All our body systems are adaptive to change in a positive or negative way. When it comes to pain a lot of mechanisms contribute to a pain experience, having a better understanding of what happens and why creates a novel approach to understanding our bodies. A classic example is returning to a sport or activity that we haven’t done for a while, we get such a rush (lots of happy hormone and neurotransmitter release - serotonin, dopamine) and play for a couple of hours resulting in us feeling sore. We rest up and then play again in a couple of days only for our tissues to object because they are not used to this unrecognized stress. In terms of an injury rest is never the solution, yes it will help to heal the tissues but wont improve their strength and preserve function in fact it will weaken them!

If we don’t look after ourselves or in most cases don’t recognize how our body moves and works, understanding what happens at a cellular level we continue to move in a habitual way that disturbs our tissue structure and function. Shocking our tissues creates a disturbance in the biology often resulting in injury or muscle soreness. Understanding that it takes time for tissues to heal and gradual stimulation in the right way helps to promote healing biologically.

Explaining to the public the reciprocal relationship structure and function have at the cellular level together in unison with the Neurological system, provides a sound educational framework towards injury recovery. These components are fundamental to our ability to survive, to perform everyday tasks, eat, sleep, walk, run, jump and perform the impossible.

Is it down to expectations?

Potentially yes and modern medicine can sometimes overlook this……perhaps our expectations of modern medicine overlook this is a better way to put it. For example having a surgical procedure is crucial in a lot of respects it aims to preserve life, to improve quality of life (?), improve structural integrity (?), benefit function (?), or reduce pain (??), if it meets our expectations. However there are many instances where modern medicine does not meet our expectations and with respect to the musculoskeletal system a change in structure will not necessarily change function.

Tapping into the neurological system, understanding the functions of the body at a biological level and how you can affect neurological input/output is imperative to our quality of life. Take a look at eating your way to a better recovery here. It goes deeper still, understanding how cognition, behavior and beliefs affect the way we function is imperative to our health and well being. This is not mumbo jumbo it is proven science. I realize that I may piss a few people off by saying this but it is still an overlooked and neglected component of injury management and rehabilitation. I hold my hand up and admit that I/we don’t have all the answers but I am extremely grateful to those researchers out there that keep me up to date (and allow me to sleep at night) that I can see my clients everyday delivering good honest and effective evidence based medicine.

So there you have it my take on how structure and function (and the neurological system) form a reciprocal relationship and how one can influence the other. When it comes to injury management addressing these components is key to recovery.

Have an opinion, thought or comment?

Thanks again for having a read.

TNP