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The Price of Adaptation: Mid-Back Tension

New Help for Whiplash Injuries

 

 

The Price of Adaptation:
Mid-Back Tension

by Taum Sayers
 
Imagine the body as a tightrope walker, with its many muscles
making small adjustments right and left, backwards and forwards,
in order to maintain an upright balance…

The human body performs many automatic tasks including self-repair, maintenance, and an incredible ability to adapt. We fall, get up, pay too little respect to the pain (we have more important things to do), adapt to the pain and get on with our busy lives. We usually take our ability to recover for granted -- until that ability falters. We often adapt many times throughout our day to the little and big insults to our body, but at what price? How many adaptations can we make and still function without interfering with our self-repair and maintenance abilities?

One indication of an excessive level of adaptation often includes tension and pain in the mid-back region. It is a rare and lucky individual who does not have some degree of tension or discomfort in their mid-back. In my 20-plus years of practice, I have probably come across no more than 10 clients who did not share this common regional tension. Mid-back tension can be a result of several things, one of which is an unbalanced posture wherein the body has to adapt to that unstable situation.

What is a balanced posture?

A balanced posture finds the muscular/skeletal system organized so that your skeletal bones are 'stacked and balanced,' thereby keeping you upright with ease (as opposed to dis-ease). Gravity is a never ending and constant force. When you are off balance, your brain automatically responds by sending a message to your muscles, making them continually work overtime to hold you up and to prevent you from tilting too far in any one direction. As long as you are off balance, this neuromuscular adaptive reaction contributes an ongoing and constant stress that over time can wear on you in many ways.

Frequently, it really is that simple. We have an amazing physical body with abilities we all too often take for granted (rumor has it that we humans use less than 10% of our abilities). Often times by simply learning a bit about our physical structure, respecting its basic principles and reducing those obstacles that interfere with our natural abilities, we can often help ourselves to de-stress, repair and maintain our body rather easily.

Jacques Descotes, former President of the French Osteopathic Association, uses the following analogy: "Imagine the body as a tightrope walker, with its many muscles making small adjustments right and left, backwards and forwards, in order to maintain an upright balance. Any small deviation from this sometimes fragile equilibrium can accumulate and contribute over time to a functional difficulty."

How do I find balance?

Quite often, one of the means to reducing mid-back tension can be found by simply balancing your sitting posture!

Do you know what your "sit bones" are? If you are leaning too far forward in your sitting position, you might feel pressure in your hamstrings. If you are slouching too far backward, you might feel pressure on your gluteal muscles. When you are balanced, take time to practice feeling the pressure on your "sit bones". In that position, the weight of your upper body is more likely to be balanced on your skeletal structure. This enables the surrounding muscles to relax. When your upper body weight is resting on your hamstrings or gluteals, the muscles in your upper back often respond to this imbalanced state by tensing up. You might consider tension in your mid-back as a signal from your "internal monitoring system" that your posture is off balance.

How do I balance my standing posture?

Imagine standing at your sink or counter, doing any number of things (washing dishes, cooking, brushing your teeth, etc.). Try to avoid leaning forward into the "Hunch Back of Notre Dame" position. Pay attention to your body and respect your posture. You might lower your torso by spreading your legs and feet. This would enable you to accomplish your task in a posture more ergonomically balanced instead of hunching over (remember the leaning tower of bones).

A "Therapeutic Shopping List" for Mid-Back Tension

The next time your bodywork therapist works on your mid-back, you might request specific work on the following muscles in addition to the regular routine:

Chances are that any or all of these muscles are in a state of distortion, tension, and adaptive compensation (holding you upright when they have better things to do). By correcting the issue in the tissue and returning your body to a healthier state of balance, you stand a far better chance of relaxing, letting go, and releasing the tension in your back.

Clearly, good health is not a static state so much as it is an ongoing quest -- for equilibrium, balance, and ease. Maybe our parents were onto something when they told us to "sit up straight."

Taum Sayers is a CMT and practitioner of The Berry Method® of corrective massage.

 

New Help for Whiplash Injuries
by Barry Matthisen
 
For years, whiplash injury results show up as negative
or normal, but the patient who is still suffering insists
the symptoms are real…

Stopped at a red light, Mary leaned forward, just a bit to the right, to get her cell phone when she heard a thundering noise. Her head slammed against the head rest. The air gushed out of her lungs as her chest was compressed by the shoulder harness and her chin was slung down toward her chest. Mary sat there dazed. It took a few moments before she realized she was rear-ended.

There was minimal damage to Mary’s car, and the other car suffered a dented hood. But what happened to Mary’s body was much worse. Her medical doctor’s initial x-rays noted a slight reversal of the normal curve of the spine. Mary was diagnosed with whiplash and given medications and a soft collar to wear. When, after a few weeks, Mary still experienced neck pain radiating down into her shoulder blades, an MRI was ordered. This was found to be a normal study, and Mary was prescribed physical therapy. This aggravated her condition, however, and so was terminated. Nerve blocks were done, which helped but only temporarily. With nine months of constant pain and no answers, Mary grew increasingly frustrated. Finally, Mary’s insurance company ordered an independent medical examination. The examination labeled her to have malingering pain and no impairments. Now, her insurance benefits were in jeopardy and there was no objective evidence to substantiate her symptoms. Mary had difficulty performing the repetitive arm tasks required at work and had to quit.

Mary’s situation is not uncommon. Whiplash injuries are now considered an epidemic in the United States. The recent outbreak of whiplash claims over the last few decades has lead to the emergence of research institutions to analyze this problem. The many avenues of investigation range from studying the biomechanics of rear-end impact collisions to how insurance companies adjust their claims. More and more people who have suffered whiplash injuries have been coming forward to reveal they are suffering persistent symptoms, but have no medical answers as to why.

For years, whiplash injuries were believed to be disc and nerve root type injuries. Thus, diagnostic studies, such as MRI and CT, have been ordered to evaluate these conditions. Many times, the results show up as negative or normal, but the patient who is still suffering neck pain, headaches, or radiating arm and upper back pain insists the symptoms are real. Many of these people are labeled “malingerers” by insurance companies. Such was the case for Mary. This is why I decided to become a research participant at the Spine Research Institute of San Diego and the Center for Research of Automotive Safety and Health.

At these research facilities, we examine the bio-kinematics (how the auto collisions affect the human occupant) of rear-impact collisions using live human test volunteers and test dummies. The research shows conclusively that rear-impact collisions which result in a change of velocity as little as 5 miles per hour can and do cause injury.

The most common type of whiplash injury is not disc and nerve root compression, as we have been lead to believe, but rather ligament damage resulting in permanent joint instability of the neck. This ligament damage and resultant instability produces neck pain and spasms, radiating upper back pain and spasm, referred arm pain, and headaches. While these injuries are not found with conventional plain film x-ray, MRI, or CT scan, they are found with digital motion x-ray (DMX). I have ordered many DMX studies for my whiplash patients who suffer these symptoms and found the resultant ligament damage when MRI studies of these patients were normal.

When I performed a DMX for Mary, we found ligament damage and resultant painful instability. These findings directed the specialized, appropriate treatment for her and she is doing much better. Without a DMX, people who suffer from whiplash symptoms may not have the correct diagnosis. Unfortunately, this can lead to improper treatment and prolonged suffering.

The combination of research findings and new diagnostic technology with DMX has unraveled the truths and myths of whiplash injuries. They have allowed for accurate diagnoses and directed a new path of appropriate treatment. The research findings have been published, and the DMX protocol is now included in the American Academy of Pain Management’s medical textbook Pain Management: A Practical Guide For Clinicians, sixth edition.

If you or someone you know has suffered neck or back pain from an auto collision, it is crucial to obtain the research information and ask your doctor about ordering a DMX to evaluate for ligament damage and instability as soon as possible prior to implementing a rehabilitation program.

Barry Matthisen, D.C., LOSRIC Auto Crash Reconstructionist, is the director of Alaska Back Care Center (349-4212) and Director of Motion Imaging (349-4244), and specializes in the research, diagnosis, and treatment of auto crash injuries.