Chronic Tension and Pain - A new explanation and longer relief

It is not unusual for clients to blame their pain on muscles, posture, or where they store their stress. Please don't blame. Blame never solves problems. Instead, let's address the common source of this pain through compassionate, logical understanding of our bodies. Then, let me share with you a new therapy that helps alleviate this pain, so that one day we can learn to prevent it. ​

Cultural Conditioning
Unfortunately, we have been culturally conditioned to focus on muscles. Whenever we let cultural conditioning stand in for truth, we do harm to ourselves. So, do yourself a favor:  For the duration of this article, let go of what you think you know about the body. Let me share with you what I learned that led me to question my cultural conditioning in every area of life. This discovery I made changed the way I think and live and work, for the better. And, had I not been willing to look past culturally approved blame, the discovery would never have been made. Blame, itself, guarantees we will miss out on the important truths in life. The moment I am tempted to blame is the moment I know I need to step back and take a closer, more balanced, look.

Don't Blame Muscles
What I have learned has convinced me that muscles are not lazy or out to get us, they work for us. Muscles are responsive, protective workhorses driven by us and our perceived circumstances. If our muscles are in pain, they don't deserve to be blamed and they don't need to be driven harder. They deserve some R&R and a purple heart for all that we put them through!

Don't Blame Posture or Stress
One of the most common comments I have heard from clients over two decades of this work, is when they say to me, often with a (false) sense of shame, “I hold my stress here” or “I have poor posture.” It's just another form of blame, and it is just as false. Their tension is real, but it isn’t where stress is held. What they are feeling is usually the result of some kind of joint instability, and it does not have to be, and rarely is, major.
When a joint is unstable, for any reason, our muscles quietly hold on to give support to the joint. It is not only a logical statement, but truthful. If the instability is low level (minor) yet chronic, those muscles are kept working whenever we are in motion or have to hold a position. That can lead to the muscle stiffness that leads to postural distortion. Over time, the muscles get tired and overworked, dehydration sets in and inflammation begins. Where there is inflammation there is pain. Suddenly, you have trouble maintaining a good posture or think you must be holding stress there. Stress and your posture may be a cause of pain, but just as often if not more so, they are victims of chronic tension and pain, not the cause, as you will soon understand, because you are keeping your mind open for the duration of this article, right?
Before I share the source of this pain, it is important to get clear on a couple of anatomical truths, simplified:

Muscle Clarity

• Muscles are inseparable muscle-tendon units that connect from joint to joint.
• Tendons are connective tissue. 
• At the muscle belly in the center, there's much more muscle than connective tissue. 
• At the tendon where the muscle attaches to the bone, there's much more connective tissue than muscle.
• Even at the muscle fiber level, there is no disconnect between a muscle and its connective tissue. Even at the cellular level this is true.

Pain Clarity

• Without nerves and their associated glial cells, you can't feel physical pain.
• With nerves, you cannot feel pain without some kind of inflammation.
• According to early fascia science research, nerves end in the connective tissue. That has huge implications, but a simple one is this: Muscle tissue cannot be the source of pain if nerves end in connective tissue. Time will tell if this research is correct. I think it is going to prove correct. And the concept is helpful to offloading muscle blame, so keep that mind open.
• To make this point through an example of absurdity: If you removed all the connective tissue of a muscle, then cut that muscle even with a dull, jagged knife, you'd feel nothing. Connective tissue and the nervous system - there is no disconnect. Not like the disconnect between this sentence and the next.

Joint Instability
Our joints are a major hub of activity. Lots of things can affect our joints causing instability. Just being tired can reduce joint stability! How many of us have the common complaint of tired? Maybe there is an overlooked reason to our collective tiredness.
I get countless clients who have been conditioned to believe that they are not exercising enough and that they just need to "strengthen this muscle." Yet when I palpate their tissues, I find overworked, overtight, bound up, adhesion-loaded muscle bellies, including entire muscles that are so overused as to feel like piano chords. That's not how healthy muscles are suppose to feel. Healthy muscles have a softness to their firm and a firmness to their soft. If they feel like ropes or rocks, that's not a sign of health.
More to the point, when I release that which is causing those muscles to be in constant contraction, the first thing the client says is "Wow. My arm (or leg or whatever) feels so tired all of a sudden!" What goes on with our muscles is not much different than what goes on with us when we've been working way too hard and finally get to stop: We suddenly feel how tired we really are. We can ignore it to some degree while we're fully engaged in our "work", but once we don't have to work anymore, we feel the tired. Same thing happens with muscles, when I remove their reason for working. 
Before I explain that reason, to add insult to injury, we blame our already overworked muscles and demand they work more by putting more exercise on the menu, leading to overuse syndrome. My clinical observations and before-after results have proven to me, thus far, that muscle overuse over time is a leading cause of joint instability. Not the underlying cause, but the leading common cause. Overuse syndrome causes joint dehydration, inflammation, and destabilization of tendon attachments. Then, the bones step in to help.

Down To The Bone
Bones are connective tissue. Aside from their marrow, bones are the deepest connective tissue in the body. Bones are hard fascia as compared to most fascia which is soft. Our bones may also be the least understood anatomical structure. If muscles are accused of being wicked masterminds, bones aren't considered at all aside from being taken for granted as inert scaffolding. I surmise that our fear of pain causes us to cling to cultural conditioning for comfort, but if we can escape that conditioning and see that we need to hear what our muscle servants have to say, then maybe we can also see that our bones are incredibly sensitive and intelligent regulatory engines. Which means we need to wise up and hear what our bones are saying, too.

Fear and Pain
We tend to fear what we do not understand. I've never encountered more fear from people until I started talking about their issues coming up from the bones using the dreaded, misunderstood umbrella term "arthritis." By using that word, I inadvertently contribute to their pain because fear exacerbates pain, and people fear the word arthritis. Health professionals call it catastrophizing. Fear faced is a fear evaporated, so let's get to it, starting with the distilled definition of Arthritis: inflammation at or near a joint. That's it. Are there forms of arthritis that are a lot more than that? Sure. But basic arthritis, as annoying and painful as it can be, is not life threatening. It's quality of life threatening, though, and we are here to improve quality of life by understanding the truth of much of our so-called muscle pain and tension.
By the way, science will likely, eventually, show that the kind of pain I help people with is just a subclinical version of calcific tendonitis. And calcific tendonitis is the underlying diagnosis of acute overuse syndrome. Full circle.

The Circular Path of Musculoskeletal Pain
Without your awareness of any symptoms, muscles are already in chronic contraction in any situation where the bones - or joints - are saying, "Hey, I need help here!" When the bones need help, the muscles obey, without you even being aware. If muscles are overworked over a long enough time, they become tight which can pull joints out of alignment. If back or neck muscles are the overworked ones, it's the spine that gets affected - leading to poor posture. If muscle tightness is too severe or goes on for too long, it can destabilize their tendon attachments on the bone. The smart, caring bones step in and lay down "scar tissue" to help secure that tendon's connection.
Ever wondered what a muscle knot really is? When muscles have been too tight for too long, the infamous "knot" forms at the center of the muscle belly, practically strangling the nerves of the connection tissue, and voila! We have muscle pain. That knot results in more pull on the tendons causing more joint destabilization. See the vicious cycle? Interestingly, ironing out the knots - which is what traditional massage still prefers to do - is not the solution to muscle pain, it gives only temporary relief, like a 15-minute break after 16-hours of working. Solving the problem at the joint, though, allows the muscle to relax, and that knot disappears for good all by itself.

When Bones Lay Down Supportive Tissue
I don't have to convince you that the skin (also connective tissue) will lay down scar tissue to help heal a cut in the skin. Well, the bones do the same thing. But because bones are more dense and also mineralized, that scar tissue takes the form of what is called in laymen's terms, a bone spur. Science labels those spurs differently and by too many names depending on their location, but it's all the same thing: calcifications as a result of the wound healing process that results in scar tissue.
It may be helpful to know two main medical terms for when bones lay down scar tissue: Osteophytes are bone spurs located inside the joint between the ends of bones (although in some joints they are called lesions or pincers!); enthesophytes are bone spurs located where tendons attach to the bone, most often at or near a joint. Both are the result of the intelligent and sensitive bones of the body trying to handle overuse, stress, or trauma of some kind. And because bones are hard and mineralized, the scar tissue they lay down often has teeny, tiny sharp jagged edges. <-- This is key and this is why we are here. Let's take a look at why a sharpie, as I call them, would be a problem for muscles.

Don't Poke A Sleeping Muscle
Decades ago, science wanted to learn what would make a muscle relax. To do that, they had to first figure out what would make a muscle contract or tighten. To do that, they pinned a muscle fiber on each end and tried various chemicals and methods to get it to spasm. Nothing worked consistently. The day they took the sharp end of a pin and started poking the thing, they learned that after a number of pokes, the fiber would contract. Well, duh. If I kept poking you, repeatedly, you would likely contract on me, too, with a well-aimed fist!

It's All About The Sharpies
If you have something super sharp inside your body, even if it's really tiny, it's going to stab or cut whatever gets in its way. In fact, the tinier it is, the more painful it tends to be. Ever been cut by a baby's fingernail? So tiny and yet so painful! The thorns on regular roses are more plentiful and more painful than the larger thorns of the long stemmed rose. Doctors and surgeons deal with the bone thorns of the long stemmed rose variety. I deal with the tiny bone thorns of the less-loved rose varieties. 
Whatever the size of the calcification or thorn or sharpie, the type of tissue getting slashed or stabbed by the thorn determines the kind of pain and symptoms. Either way, it's creating an  internal injury that the body's immune system will attempt to heal through its primary healing process: Inflammation. And inflammation usually means pain. Whatever the countless causes of emerging calcifications on the bone, the inevitable sharp edges that result sets up a cycle of harm-and-healing. How that cycle plays out is completely dependent upon the choices we make to deal with it, for better or worse.

Sharpie Therapy
Until we learn to prevent this chronic pain cycle, the therapy to arrest the pain involves finding then dulling, melting, or otherwise subduing the sharpies. By so doing, the muscles relax, the inflammation and "cloudy" congestion that’s usually also there is disbursed, and relief is felt as healing begins and the cycle finally ends. In clients with thin muscles or connective tissue, it is easier to palpate for these “sharp” conditions and also easier to change them. Clients with dense or healthy and strong connective tissue are more of a challenge as it is like trying to feel detail through a rubber wall, but the therapy still works even if it takes a little longer.

Case Study
One such “rubbery” challenge was an athletic fella who was coming in fairly regularly, and overall improvements in his body were reflected in his competition scores and post-event recoveries. However, there were areas of pain and restriction that just wouldn’t go away. One day, he entered the office looking thinner. He had changed his diet and was taking a little break from intense athletic activities. And for the first time, because his tissues were less dense, my fingers started finding things on his bones. He didn’t just have inflamed sharp edges on the bone in the usual locations, he had them everywhere and in difficult to access locations, like the ribs under the collarbone. However, he also had grit and determination. Between the two of us, we ground down every one of those “sharpies” and he’s doing great today. I feel like a proud mama as he does extraordinary things like ice climb, post-hurricane cleanup, and raising a family.

Prevention
I hope to one day have definitive insights for prevention of this sharpie phenom that underlies most of our tension and pain. Awareness of the problem and awareness of the problem that is blame, are important first steps to helping people get out of pain.
There are countless aggravators of the condition, like stress, diet, and lifestyle, but I'm looking for the instigating causes.
What I know is that sometimes our sharpies form on the bones as some kind of allergic reaction to chemicals or foods. I lightheartedly refer to such people as having "porcupine bones," despite needing a much better natural comparison. Even in myself, taming the sharpies on my sinus bones tamed my allergic rhinitis that flared up as a result of an episode of excess sugar in my diet at a time when stress led me to the bad decision to choose sugar as soothing agent. Whew, what a thing to say! But this is the kind of honest thinking that is needed if we are to solve this sharpie problem.
Our bones are talking. Our bones are talking louder and to more people than ever before, and to more younger people than ever before. The problem goes as deep as our bones. It's a societal problem, I'm certain of it. It's a problem born of unhelpful attitudes, thinking, behaviors, and systems, all of which lead to internal stress that goes to the bone. How we choose to deal with that stress, determines our outcomes.
Healing requires a two-prong approach: Identifying and eliminating the unhelpful aspects of ourselves and the systems we put into play, and being smarter about identifying and dealing with those aspects when they do come into play.

For now, I suggest that we all listen a little more closely to our bodies:

• Rest and drink plain water when we are tired;
• Eat healthy and clean foods when we are hungry, and only when we are hungry;
• Keep our distance from people who create toxic mental or emotional environments; and
• Take a break and play or do something very different when we are stressed.

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A Word About Gout
Sometimes, there are tiny sharp objects in the soft tissues just outside the bones. They can cause their own fair share of pain troubles, so it's important to include them here, but these are usually caused by diet combined with cellular dehydration. (Please drink just enough plain water, daily.) A buildup of uric acid “crystals” is one type of sharp object that, in high enough concentrations, may get labeled as gout or gouty arthritis. Long before gout is painful enough to be identified as a diagnosis, its beginnings are often the reason for underlying pain and tension (stiffness) in many people. Wouldn't it be nice to get those crystals out of the tissues before they accumulate to the point of being diagnosed as an illness? Well, crystals in the soft tissues and fascial fluids can be "melted" with the right "touch."

X-Rays and Other Fancy Tests
While small, sharp calcifications can create havoc with neighboring tissues, including nerves, lymph, fascia, and our muscles, for a very long time they are usually too small to be identified even by today's best imaging machines. If you don't think something that small, that deep, could possibly hurt, may I remind you of the most painful of all small cuts - the paper cut and the baby fingernail cut? Small and difficult to image our sharpies may be, but they can be found with skilled palpation.

The Exercise Dilemma
Dulling down the sharpies is the best solution, for now, and best done with manual therapies. More exercise is not the answer for it adds to the overuse syndrome that often starts the cycle, causing a buildup of scar tissue - which can then form a callus that only insulates the sharpie. Pain medications are not the answer, either, for they mask the problem allowing it to grow worse. Better to get rid of the sharp edges and then seek to alter any lifestyle issue that caused them to begin with. I've had a few stress- and trauma-caused sharpie flare-ups, myself, and I've palpated and treated them as well as altered my lifestyle in order to prevent or reduce the number and size of flare-ups. In fact, it was through helping my clients that I discovered my own sharpie problem - and the first solution I employed that helped was to reduce exercise.

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Originally posted 5/20/2015.
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