Chronic Tension and Pain - A new explanation and longer relief

It is not unusual for clients in pain to tell me that they blame their #$@&%*! muscles, posture, or even some magical ability to store stress in specific locations in their body. Allow me to ease your mind by ending the blame game and getting to the likely root of the issues in your tissues. Better yet, there's a new solution, too.

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, our strongest muscles, usually the largest due to how we exercise, step in by gripping the joint to protect and stabilize it. And why shouldn't muscles do this? Comparatively speaking, muscles are the only tissue in the body that are purposely designed to connect from joint to joint across long distances while doing all the heavy lifting!

Blame Not Your Posture - Yet
I hear a lot of, “I hold my stress here” or “I have poor posture.” 
Your tension is real, but it isn’t where you hold your stress. What you are feeling is joint instability causing the beginning of postural distortion. Your posture may become, or be a problem but poor posture is usually a symptom of chronic tension and pain, not the cause.

Down To The Bone
Aside from their marrow, our bones are the deepest connective tissue in the body. (Think hard fascia.) 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. When it comes down to it, we don't understand our bones, at all.

We tend to fear what we do not understand. And, we tend to fear the deep.
I've never encountered more fear from people until I started talking about their issues coming up from the bones. And, fear begets pain. Health professionals call it catastrophizing. Let's begin our pain reduction by facing these fears by shining a proverbial light on the subject.

The Circular Path of Musculoskeletal Pain

1. Without your awareness of any symptoms, muscles are already in chronic contraction for any situation that causes the bones - or joints - to say, "Hey, I need help here!"
2. These quiet, already taut muscles are then asked to do the additional work of running upstairs or carrying heavy boxes or pushing through any physical or stressful activity despite feeling tired, to begin with.
3. This chronic muscle tension from at least a double shift of work ends up pulling the joints out of alignment and now you may also have posture problems added to the mix. While poor posture isn't an initial cause, once poor posture is in play it becomes a contributing factor.

Overuse, Stress, and Traumas
Today, exercise gurus make you feel guilty if you aren't working out all the time, so oddly enough, much of today's overuse syndromes come from repetitive events like exercising too much. But to be fair, it's also from working too much and texting too much, too. Doing any of the above and not liking it is like doubling down and losing. The events that cause us stress tend to be unique to the individual, but the kind of stressors that causes the most health problems are of the mental and emotional varieties, like bullying or gaslighting in the home, school, or office, or doing work you hate and feeling trapped. Traumas to the body can be obvious and blunt like getting into a car accident, or they can be the trauma to your internal body from an acute illness and a trip to the emergency room or surgery.

Overuse, stress, and traumas are the circumstances that bring about dehydration and inflammation in the body, both of which over time may lead to destabilization of any structures that attach to the bones: primarily ligaments and tendons.

A destabilized body is one that requires a bit of patching up, not unlike a wobbly bookcase needs a stabilizing crossbar or two. So, let's learn a thing or two about patching up. I'm only going to use two technical terms and then we're back to simple language.

Bone Conditions Caused By Overuse, Stress, or Trauma
Osteophytes and enthesophytes are two terms that mean the same thing but are named differently because osteophytes form at/within the joint ends of bones and enthesophytes form elsewhere on the bone, primarily directly under where tendons and ligaments attach to the bone. Both are the result of the (intelligent and sensitive) bones of the body trying to handle overuse, stress, or trauma of some kind.

I don't have to convince you that the skin will lay down scar tissue to help heal a cut in the skin. Well, the bones do the same thing. But, because bones are denser and more mineralized, sometimes the hard scar tissue that results has jagged edges. Let's take a look at why a jagged edge might be a problem for the muscles that you know attach to bones through the muscle's inseparable tendons.

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!

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 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?

A Word About Inflammation
Quite frankly, when you have tiny, sharp swords slicing and dicing your soft tissue, it's gonna bring on scar tissue and fiery inflammation. Where you find inflammation, you usually experience pain. You can take an anti-inflammatory to cool things down, but until you remove the swords ... need I say it?

A Rose By Any Other Name
Another name for osteophyte is a bone spur and ... Heberden's nodes and Bouchard's nodes and rheumatoid nodes and Cam lesions and Pincer lesions and calcifications, etc. Different names - same issue. There are a shocking number of different names for the same thing in the science field, with too many narcissistically-named, not by location, but by whoever noticed the pattern in a given location across a specified population. There is a good reason I choose to communicate using simple language: My goal is to help people understand the vital basics in a useful way. Speaking of which ...

Arthritis is an umbrella term where (“arth” means joint and “itis” means inflammation.) If I said you had calcific tendonitis you probably wouldn't react much, but if I said you had arthritis, you'd likely have a very unhappy (fear-based) reaction. They're the same thing, just different locations and likely studied by different disciplines hence the differing views.

Then there's degenerative disc disease (scary!), also known as "normal aging." 

My point is that we need to get the fear out of our knowledge about our own bodies and how they work. We eat and sleep and go to the bathroom and work and fix things up, well so do the cells, fibers, and fluids of our body. The difference? They don't lie or play games. They can be stubborn, but usually for good reasons. 

X-Rays and Other Fancy Tests
While small, sharp calcifications can create havoc with neighboring tissues, including nerves, lymph, fascia, and our muscles, by the time you start hurting 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 cuts - the paper cut?

Slow, deep, joint-focused manual therapy is called for if you want to feel better without waiting for it to get bad enough to become a permanent-seeming diagnosis down the line. That's not fear-mongering, that's pretty much a fact.

Unless I have reason to suspect something else is going on, for the time being, the assumption I am making when I find sharpies on the bone is that most of what I am finding on my clients is calcific tendonitis. (When the sharpies form a line, they resemble tartar ridges along the gum line.) I can diagnose subclinical sharpies easier and earlier than most diagnostic equipment being used today, because much to the chagrin of doctors who have been educated otherwise, sometimes (often, actually) 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, regardless of what you call it, dulling down the sharp edges is best treated with manual therapies, not exercise regimens that only add to the overuse issue causing a buildup of scar tissue, or pain medications that 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 flareups, myself, and I've palpated and treated them as well as altered my lifestyle in order to prevent future flareups. In fact, it was through helping my clients that I discovered my own sharpie problem, not the other way 'round.
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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 by palpation can they be identified, early on, and identify which nodes are normal and which are not, usually by the pain or inflammation that tends to co-exist at that location.

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 usually 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.

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. Much longer, but you will likely get relief.

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 (other than surgical debriding) that can eliminate irritating calcifications or break down crystallizations aside from manual therapy.

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, but emotional and mental stress is high on my list of suspects. 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 dietary triggers are causative or just aggravators.

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, and
• Take a break and play when we are stressed.

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