I have been reading a few articles on muscle fibrosis as I try to figure out how to fix muscle
problems quicker. After all, it’s clear that standard rehabilitation techniques of exercise and
stretch are just a reiteration of what Chiropractic was back in the 80’s. That was when
Chiropractors were paid very well to work on people but they began creating long, mundane
treatment plans that were stuck in the “standard of care” model of the time. That was fabulous
for a decade or so. Then people began to complain that they were paying a lot of copays and
spending too many hours in the chiropractor’s office. Before long the tide changed and
Chiropractors found themselves in the hot seat trying to justify their treatments.
That is exactly what we’re seeing in physical therapy now. These highly trained therapists are
hitting the same walls that Chiropractors hit 30 years ago. Lots of money and lots of easy
referrals but, from what I see, many people asking why they are going to PT appointments 3
times per week month after month for exercises and stretching with some electrical modalities
applied and, often, with little to show for it.
So what is going on?
I’ve come to the conclusion that it is the lack of cooperation that is holding physical medicine
back. First we need to meld the two disciplines together so that exercises are combined with
highly refined manual soft tissue techniques, and then we need to incorporate the advances in
regenerative medicine like PRP, A2M, Amniotic fluid, regenerative medicine, etc. With such a combo the
therapeutic efficiency will dramatically increase and the patient will spend far less time in a
therapists office and spend far less of their money. But, from a professional standpoint I think
we need to look at the nature of soft tissue injury and build our treatment plans around the
different types of pathology that we find. I’m in the process of defining, researching, and writing
about that these days.
This is my basic summary of the catagories of muscle disorders:
1. Genetic disorders of muscle (Muscular Dystrophy)……….can’t fix that.
2. Auto-immune disorders of muscle (Lupus)………tough to fix that.
3. Traumatic disorders of muscle (car crashes, pulled hamstrings, etc.)
4. Micro-traumatic disorders of muscle (martial arts training, running, etc.)
5. Pro-inflammatory disorders of muscle (unhealthful dietary choices)
The three physiologic responses that we can really do something about are
1. Traumatic
2. Micro-traumatic
3. Pro-inflammatory
More serious trauma predisposes muscle to the formation of scar tissue that can be extremely
difficult to remove principally because the collagen forms irreversible cross linking bonds
between the proteins that can be virtually impossible to remove. This scar tissue almost
permanently alters mechanical force transmission as the scar tissue fibers interfere with the
directional fibers of the collagen matrix (much more on this later).
Micro trauma results typically from repetitive stress which places excess strain along lines of
force transmission as described by Luigi Stecco in his masterpiece text on Fascial Manipulation.
This excess stress causes overproduction of Hyaluronic Acid (HA), the principal lubricant of
muscle, which becomes dense and obstructive to normal mechanical force transmission and
neurologic communication between muscle groups. This dense HA will not resolve itself with
exercise or stretch alone. I’ve said this repeatedly and it needs to be said again and again.
However, with correctly applied manual technique, we can induce the body to resolve this HA
densification on it’s own. Then the correct exercise will firm up the muscles that hold us and
move us. The trick is determining the correct placement of the technique to clear the
obstructions and balance tensions without springing the whole web (much more on this later,
too).
Without correction to inappropriate force vectors, joints will become inflamed and that will eat
the cartilage. Once that happens we need to step things up therapeutically to use IRRITATIVE
therapies like PRP, PRFM, A2M, Amniotic growth factors, and regenerative medicines to first stop the
degeneration of joint cartilage and then begin the process of REGENERATION.
Finally, the pro-inflammatory diet is absolutely one of the leading causes of illness in America.
In fact, I took a class once in which it was clearly stated that it is the acidosis in blood that kills
cells. Acidosis comes from build up of carbon dioxide if we stop breathing……….and, if we eat a
bunch of refined carbohydrate and corn feed beef. True poison if there ever was one. A body
already in an inflammatory state is predisposed to injury because the tissues are already frail and
hypersensitive. Furthermore, once injured, the healing process is less controlled and results in
far more scar tissue production and HA deposition at the site of injury.
So, here’s the cut to the chase. Stop eating refined carbs and beef (unless its pure grass-fed beef
or buffalo), Ask Dr. Pam what kind of supplements will reduce the inflammatory state, and ask
Dr. Ed (your author here) what needs to be done to balance fascial function from a muscle AND
visceral point of view and what might need to be done with regenerative medicine for the
purpose of actually stopping joint degeneration and growing new tissue. It all matters to your
WELL BEING. Or, as they say in Latin, Salus!
Something to think about.