Chronic Tension and Pain - A new explanation and longer relief

It is not unusual for new clients to blame themselves or their muscles for feeling tight and hurting.

​With a little show-and-tell, I am able to convince them that it isn’t their fault. In fact, it's not even the fault of their oft blamed muscles. Better yet, there are better solutions than ordinary massage.

It begins with “I hold my stress here” or “I have poor posture.” 
Their tension is real, but it isn’t where they hold their stress nor is it because of their working posture nor is it even the fault of their muscles. It goes deeper than that: It goes to the bones.

The bones are the deepest connective tissue in the body and we, The People, tend to fear going deep. I've never encountered more fear from people until I started talking about bones. So, let's see what we can do about facing this fear for the sake of feeling and living better in our bodies.

I’ve been observing a rising tension trend in my clients, who tend to represent a broad spectrum of society, and as is my wont, instead of offering temporary relief by massaging muscles, I seek to find permanent relief by getting at the root of the problem, and muscles just aren't it.

Blame Not The Muscles
Muscles are reactionary and protective workhorses, but are rarely the source of any problem. In fact, to the extent with which they perform their duties, even to the point of rupturing, muscles should get a purple heart, not the blame!

For example, when a joint is tired or struggling, for any reason, muscles step in by grabbing on to protect the joint. And why shouldn't they? Muscles are the only tissue in the body that are purposely designed to connect from joint to joint!

The Circular Path of Pain

1. Muscles are already contracting for joint (or injury) protection, then
2. muscles are asked to do added work on top of that, whether repetitive motions or in dealing with added emotional stress, or both; and
3. chronic muscle tension from being already overworked begets some of the posture problems that add to the chronic tension.

Muscles Tense When Poked
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. 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!

So, what kinds of “sharp objects” might we find inside the body to cause muscles to contract in a protective manner?

Gout
A buildup of uric acid “crystals” is one type of “sharp object” that, in high enough concentrations, gets labeled as gout and gouty arthritis, both of which involve tense muscles in addition to the inflammation. Long before gout is painful enough to be identified as a diagnosis, it's beginnings are often the reason for underlying pain and tension 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?

Osteophytes
Bone spurs (osteophytes) are another type of “sharp object” that causes muscle tension. Bone spurs are usually the body’s protective response to joint-related problems most commonly referred to (and often a misnomer) as arthritis (“arth” meaning joint and “itis” meaning inflammation) or degenerative disc disease (also known as "normal aging.)

A huge hindrance to learning about bony issues is too many names for the same thing. For example, osteophytes tend to be named based on their location or who studied them: Heberden's nodes are found in the last finger joints; Bouchard's nodes are located in the knuckle joints; rheumatoid nodes are found throughout in those with rheumatoid arthritis; and Cam and Pincer lesions (nodes) are common to hip joints. Different names - same issue - and that's the easy to understand example!

Calcific Tendonitis
Most commonly, I find crystallizations where tendons attach at the bone. A common medical example is calcific tendonitis, which is most often found in the shoulder, but only because it's difficult-to-impossible for diagnostic imaging machines to document calcific tendonitis elsewhere. While most tendons attach at the joints, many also attach on the ribs, the surface of the flat bones, and in the long crevices of the long bones, etc. While small, sharp calcifications can create havoc with neighboring tissues, including your muscles, they are usually far too small to be identified even by today's best imaging machines - and this is vitally important to accept, if you want to feel better without waiting for it to get bad enough to become a diagnosis down the line.

The assumption I am making, for the time being, is that most of what I am finding on my clients is calcific tendonitis. The difference being that I can diagnose it easier and earlier than most diagnostic equipment being used today, because much to the chagrin of doctors who have been educated otherwise, sometimes nothing beats great palpation skills: To touch with the intention to accurately identify tissue differences and changes. Compare this to veterinarians who understand all too well how vital palpation skills are to their ability to accurately diagnose.

But more importantly, calcific tendonitis is best treated with manual therapies, not exercise regimens or pain medications. Reason: these calcifications seem to appear primarily due to both over-use syndrome and to stress.

Palpation Vital For Early Onset
Uric acid crystals and bone spurs are commonly known, but I suspect there are other irritating sharpies under the surface. More importantly, sharpies may exist for a long time before they become big enough to show up in a diagnostic test, but not before they’ve been bothering you. Sometimes, they exist without causing any pain or trouble, and this usually happens when they are not sharp or inflamed. Again, only palpation can identify them, early on, and identify which nodes are normal and which are not.

Palpation isn't a skill one is born with, it is a learned skill over many years - and anyone can learn it. Not everyone can accurately define what they are palpating, however. This therapist works hard at being accurate, not just skilled.

Finding The Sharpies
In my practice, because my special skill is palpation, I find sharp crystals in the soft tissues and, more often, sharp edges and points on the bones to be the leading, underlying cause of most muscle tension. By breaking down the crystals and smoothing down the sharpies, the muscles relax, the inflammation and "cloudy" congestion that’s usually there is disbursed, and relief is felt as healing begins. Both scenarios require a series of treatments, differing by individual case.

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. Fortunately, I like a challenge. 

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 follow him on Facebook and feel like a proud mama as he does extraordinary things like ice climb and post-hurricane cleanup.

Scraping Off The Sharpies
It was about this time that I discovered gua sha. It’s a scraping technique from ancient China that is unbelievably effective in “scraping” off the sharp edges. But, because gua sha can leave marks behind, people get the wrong idea, so it often gets shunned.

Looks are deceiving and it looks like the gua sha patient has been abused, so unless one experiences the scraping for themselves, they will refuse to believe you did not cause harm.

Fortunately, I’m the type who is open enough to try before stating my opinion, and the rewards have been heaped upon my clients. Also open were the inventors of the Graston technique, which was taken from ancient gua sha and is used in modern medicine to tame scar tissue after joint surgery.

Before gua sha, I ground out the sharp edges with my knuckles. Suffice to say that any gua sha instrument is easier to use than my knuckles. Although intense for the client during treatment, gua sha is faster, easier, more effective, and longer lasting. At least it was, until a client forced me to discover Tok Sen.

Hammering Down The Sharpies
Peculiarly, hammering is less painful, more relaxing, causes little to no redness, and lasts even longer than gua sha. Hammer massage, however, is relatively rare. It's a part of Thai Massage called, Tok Sen, and is now being investigated by this author and therapist as a more satisfying and complete solution to the problems whose solutions are rooted in the deepest connective tissue of the body: The bones. Tok Sen only works to the benefit of the bones, however, if one has exceptional palpation skills. Clinical research has only just begun at Paula's Body Shop, so stay tuned for more news in the future on this amazing modality. Or sign up now to be one of the early beneficiaries of Tok Sen for the bones.

Find Out Where Your Tension Comes From
If you have tension that won’t let go or cannot be diagnosed, come on by. I’ll let you know what I find.

Your next best option is to show this article to a Rolfer and let them do their thing; their work involves releasing tension at the joints, so it inadvertently helps these conditions, although it will likely take longer.

Most massage education is still muscle focused, but if you find a connective tissue wizened or trained massage therapist, they might be open to investigating for your benefit, so show them this article.

Medications and an anti-inflammatory diet might help reduce the inflammation, but I don’t (yet) know of anything that can eliminate irritating calcifications or break down crystallizations, aside from manual therapy or a skilled surgeon's scalpel should those sharpies be inside the joint where we manual therapists can’t reach.

More Research Needed
As for why our bones are talking to us in such large numbers in younger and younger adults, I don’t know. I have a few ideas, and I am doing my own brand of research. I welcome respectful collaboration. There is no doubt (and plenty of proof) that much of it comes from our diets, whether it be from eating foods that are wrong for us or eating foods loaded with pesticides or allergic substances, such as nickel. The question is whether these things are causative or just aggravators.

For now, I suggest that we all listen a little more closely to our bodies: rest and drink water when we are tired; eat healthy and clean foods when we are hungry and only when we are hungry; and take a break and play when we are stressed.

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Originally posted 5/20/2015. As information changes, the date up-top will change.