Fibroblasts and fascia are my favorites

Few things make me as excited as fibroblasts and fascia do.  Okay, okay.  That is a bit of a stretch, but it doesn't change the fact that I think that these cells and tissues are insanely interesting.  Bare with me as I share my nerdy side.

A fibroblast is a cell that is found all over the body within connective tissue.  It helps to create and maintain the matrix of our tissues.  By definition, it makes and secretes collagen.  This is very important for the upkeep of our muscles, ligaments, and tendons and is crucial for wound healing.  Graston Technique, and possibly even some forms of massage, stimulate fibroblasts and accelerates the healing process of damaged tissues.  It is also likely that as the fibroblast is stimulated, it changes shape and thus secretes different amounts of, or even just different, hormones.

Fascia is my second favorite child.  It is a tissue that is also found all over the body and surrounds organs, muscles, nerves... you name it.  Most people know that this is important for the structure of our body and for the function of joints and muscles.  It can be too tight or too lax and cause dysfunction.  And while fascia has the ability to relax, it can also contract.  When it has been contracted too long, it begins to get thicker.  It is this change or increase in thickness and tensile strength that can cause dysfunction.  Imagine that the muscles of your shoulders and neck become tight when you get stressed.  This process contracts the fascia.  Now imagine that you have stress and  a stiff neck and shoulders all the time.  Can you imagine that this would eventually cause pain?  

Sometimes the details of how our body works can be information overload.  While it is likely that you won't be adding fibroblasts and fascia to the top ten list of your favorite things, I hope that it gives you some insight into how our body functions. 

P.S. Did you know that fascia is the tissue that is being manipulated in acupuncture?  It actually binds, clings or wraps around the needle being inserted.

Morning spine: A spine not equipped for flexion

If spinal flexion were a person, it wouldn't be a morning person.  Instinctively, many of us rise and have the urge to stretch.  While I encourage this animal instinct at most times (including in airplanes, supermarkets, and bookstores), spinal flexion upon rising is very risky, even in the absence of pain.

Spinal flexion is the movement of forward bending or rounding your spine similar to Halloween cat.  If you think that you are in the clear because you avoid all feline movements in the AM, note that bending over to pick up the morning paper, put on your pants or put on your shoes all qualify as spinal flexion.  This movement at any time of day puts a great amount of load on the low back.  During sleep, the tissues in our body become stiff and our intervertebral discs become more hydrated.  This is a state that is not ready for a lot of bending because there is too much tension in the supporting ligaments, tendons and muscles.  This, coupled with the stress that flexion puts on our back increases our risk for injury, instability and pain.

If you exercise or do specific flexion movements in the morning, do some light walking and allow your body about an hour to prepare for those movements.  You might even consider changing your workout regimen so that those movements are done late in the day.  If forward bending is a must, such as putting on shoes, bend at your knees and minimally in your low back so that your back is in the safest position possible.

Plantar Fasciitis: Don't drink the water!

Plantar fasciitis is not contagious.  This is something for which I am quite certain.  Still, by the amount of people I have seen recently with this problem, I might be able to be convinced otherwise.

Plantar fasciitis is an inflammation of the fascia on the bottom of the foot which is typically caused by overuse or poor biomechanics.  Normally this thick tissue is used to absorb shock, but as it becomes inflammed, it also becomes more rigid and doesn't provide the spring that we need.  The fascia also begins to tug on our bony heel and create a heel spur on the bottom of the foot.  

As it is a package deal, you don't just get inflammation, you get pain.  The hallmark pain (which is on the bottom of the foot and often near the heel) is on the first step you take out of bed or after you take off your shoes for the day.  Of course you can have pain elsewhere, too.  In some cases, I have seen the problem be so severe that it was creating a numbing sensation near the ball of the foot.  

It is rare to find someone who has plantar fasciitis and does not have tight calf muscles.  The calf muscles, in conjunction with the fascia on the bottom of the foot, act as a sling.  When the calf muscles are tight, the fascia also gets pulled taut and thus contributes to the tightness and the decrease in shock absorption.  It is also common to see plantar fasciitis in people who have weak arches or tend to pronate.  

While lots of factors come into play, the treatment is actually quite simple: soft tissue therapy of the calf and plantar fascia (Graston has profound effects), stretching the calf muscles and feet, and strengthening the arches and/or addressing issues with pronation.  Of course, as with all things, a little yoga helps, too.  Two really great yoga postures for treating this condition are downward facing dog (with straight legs and with slightly bent knees) and toe sits.

By the way, it probably is okay to drink the water.  In summer, we are not only more active and demanding more use from our legs and feet, but many of us wear flip-flops.  Because most styles are not supportive at all, the jump from wearing shoes with good arches to nothing is a giant leap.  Our feet have gotten used to relying on the support of the shoe.  Without it, our feet become unhappy.  Rest assured that these are more probable reasons for the frequency of seeing this condition in my practice, not the water.  

I could go on and on... but it is summer.  I'm going outside to play! 

Did you remember to take your exercise pill?

At some point, I am sure that I have revealed my love of the NPR program Science Friday to everyone I know.  I rarely get to listen to it, but podcast and occasionally catch up on the segments I have missed.  Last week's program had a researcher who has created a pill to trick our muscles into thinking that they have exercised.  Thus, the researcher has created the long awaited 'exercise in a bottle'!  As I played devil's advocate in my car, as if I were on peer review for the article/journal, I was listing all of the reasons this wouldn't work.  There are so many things that exercise provides for us that this pill could not.  On the other hand, what a breakthrough for people who have disease processes that create atrophy of muscles.  A review of the article was in Scientific American.  It is worth a read... 

Could a pill replace exercise?

Ex-Olympian, 80, banned from running up escalator? Now we're talkin...

The other day. a 72 year old mother of a patient of mine asked if I worked with older people like her who may be too old to do yoga.  I chuckled, threw her a gigantic grin, and told her that the 'too old' excuse doesn't fly around me.  Yes, I am less than half of her age, but I just don't see how getting old can be an excuse for not dropping into your body or even a reason to accept having pain.

Today, on my way to work, I heard the most charming story about an 80 year old man running up an escalator backwards in a department store.  As the story goes, he wanted to prove that he could still do what was once a part of his training regimen for the Olympics.  Apparently he even frightened some women in the lingerie department.  The post is below.  You must read.

http://www.telegraph.co.uk/news/newstopics/howaboutthat/2465330/Ex-Olympian,-80,-banned-from-running-up-escalator.html