Most patients begin their journey at Backs Etc receiving a combination of manual therapy and exercise protocols designed to retrain basic movement patterns. Some may wonder what is actually happening when a patient is being treated on the table, and why we emphasise exercise and movement retraining. Does the hands-on therapy physically lengthen muscles and connective tissue that have become contracted and fibrotic, thus changing their structure? Or is treatment more of an interaction with the nervous system, improving its ability to control the body, thus reducing pain? (If you’re interested in reading more about pain, see our posts here and here.) Does a muscle feel tight because it is physically shortened, or is it from changes in neurological control? We have always believed it to be the latter, which is why NeuroKinetic Therapy® (NKT) is one of the main tools used at Backs Etc. Sue’s adventures dissecting cadavers at St Andrews medical school have solidified our belief in this.
First off, working on dissections of various body types, it’s clear that there are deep layers of superficial fascia (AKA fat) covering the muscles in even the skinniest of us. What this means is that manual therapy is not directly affecting muscles and joints, especially those deeper inside the body. It is like the pea affecting the princess through the layers of mattresses, not impossible but hard to do. The only thing we can directly affect is the skin.
Furthermore, muscles, tendons, and other connective tissues are so strong that the force a manual therapist can exert is unlikely to change the nature of the tissue. In the four elderly cadavers that we worked with, the muscles looked completely healthy, with no evidence of fibrosis, trigger points or adhesions. In fact, the only adhesions found were caused by surgery or injury. From their case histories, it was apparent that they likely had aches and pains and restricted joints, but this would be coming from their nervous system and not the physical structures. The experience of pain is primarily due to the overall level of threat that the brain is experiencing, rather than an indication of tissue damage.
Therefore, when opting for manual therapy, understand that it will not necessarily be physically changing your body. What it can do is bring increased blood flow to an area which can improve the body’s ability to heal itself. It may also feel therapeutic and relaxing, which can be extremely important in these stressful times. The interaction with the nervous system using therapies such as NKT allows tight muscles and joints to relax as the brain receives more positive sensory input and so and reduces the threat level. This is why NKT has been so successful for us at Backs Etc. It is designed to correct the fundamental issues stemming from the way the brain and nervous system are interpreting sensations and inputs.
However, this is just the beginning, you need to consolidate these neurological changes by moving and breathing well on a daily basis. Exercise utilising quality controlled movement patterns and proper breathing technique will improve muscle function, mobilise your joints, and consolidate the changes initiated with the therapy and can positively affect the structure of your tissues much more than passive hands-on therapy.
We offer functional fitness sessions with Jack, our trainer at Backs Etc, as we believe that poorly executed exercise habits – excessive ‘balls to the wall’ pushing through pain, lack of quality movement, and poor breathing habits, are the root causes behind the majority of pain and injuries. Taking some time to learn good movement patterns, and then practising them regularly and incorporating all the elements of a balanced exercise program, is the key to avoiding the revolving door of repeated injuries or chronic pain. We strongly believe that your exercise program should enhance your longevity and fitness and not be the cause of pain and injury, and we’re here to help you achieve these goals.