Early in my training I realised that we name conditions for their symptoms but, so that the herd shall not realise this, we do it in a dead language, mostly Latin with the odd bit of classical Greek. If we went to a mechanic and said we had a knocking noise coming from down there and he replied it’s a ‘Geräusch aus da unten klopfen‘ or it’ a ‘klepání hluk z tam dole‘ We’d be duly impressed with his linguistic skill but probably go to the mechanic who grunted ‘yer big end’s gone’
We have a plethora of names for the same condition at different sites. So Tennis Elbow, Golfer’s Elbow, Carpel Tunnel syndrome, Repetitive Strain Injury, Student’s elbow, all involve the muscles of the forearm and are regarded as completely different problems, whereas they should be regarded as the same problem in different muscles and joints. Equally Runner’s knee, Low Back Pain and most other named musculo/skeletal pains. It’s nearly all the same pretending to be different.
The joints have no nerves, I’ll bet you already learnt that in your training, but it’s a fact we all ignore because we think we work on joint pain. So how is it that joints hurt when there are no nerves in them.
Here is a joint with its capsule round it, no nerve or blood vessel penetrates that capsule so there can be no pain inside it unless the ends of the bone are damaged, there are loads of nerves in the bone. So does ‘joint pain’ mean damaged bone? Less than 20% of the time and that is Arthritis Q.V.
What is it that hurts then? The muscles, nerves and bursae around the joint, which is explained under Arthritis so reading that may help to understand what comes next.
The capsule of a joint gets caught into the joint and subluxates [moves the bones out of their correct alignment within their socket] the joint. Generally this happens when the muscle has not prepared for the movement that it makes, so usually when we are hit or when we slip or trip, when something unexpected happens. If we sneeze there are two options the sneeze we feel coming and we prepare for, that is unlikely to cause a problem and the one that sneaks up on us and we sneeze without warning this is the one that does the damage. The trip or slip on a damp surface, we slide or stumble and recover but any consideration of having damaged ourselves is dismissed as there is no resultant pain either immediately or over the next few days. By the time it does hurt we have entirely forgotten the incident that caused it.
So here’s a capsule caught into the joint, which as you can see is setting up inflammation inside, but remember this can not be felt.
The next picture shows how on every capsule the passing muscles all have fibres that attach to the exterior of the capsule which will, simply because they are shorter, pull on the capsule before their partners can pull on the bone beyond to move the joint.
This means that the capsule is tight when the joint moves and does not get caught into the joint but should the joint be moved as in a slip or trip or a blow the only thing holding it clear of the joint is the internal pressure of the synovial fluid. Should this prove insufficient the capsule gets caught and the joint is probably subluxed.
Once the capsule is caught these fibres too are caught and their reaction to being pinched is to spasm in an attempt to pull themselves and the capsule free and we have no idea how often they succeed but probably more often than not. However when they fail the increasing spasm spreads to more and more of the muscle’s fibres eventually including the spindles.
The spindles, in some cases, being part of the muscle trains that transfer loads to the core then pass the spasms on to the next muscles In that line. Probably toward the core, but sometimes away from it and sometimes in both directions.
This could quite conceivably cause pain at the next joint rather than the one where the cause is located. Remember the next joint is probably the next toward the core but could be away from the core or even in both directions.
Frozen Shoulder is sometimes started by a subluxed elbow but more often it originates at the shoulder joint but both will always need treatment because by the time the Patient is aware of it, it will have spread to both joints and probably to the wrist and into the vertebrae of the upper back and neck nearly always, so causing stiff necks and even headaches and migraines sometimes.
Through the Latissimus Dorsi it may even involve the Low Back vertebrae and thus become linked to a tipped pelvis and sciatica by predisposing both to happening by restricting movement and recovery options in the area. A bend and lift that the body could normally cope with, but only just, proves too much with this pull into the area.
Correcting one or two of the problems could be good for business as the Patient goes away happy that their pain has been resolved but within a couple of months there is pain again either at the original site or at the secondary problem so lots more treatment and more success but there is never a complete recovery.
This shows how it is that all those names are really just naming the symptom without understanding the cause, and understanding the cause means that the treatment for each condition is much the same.
It involves relieving the pressure on the joint [Gapping the joint] and helping the patient to use the muscle that is trapped to pull itself and its capsule free and realign the joint. This takes the spasm out of the muscle train so long as no other joint has subluxated along that train and reduces the subluxation of the joint.
To treat any of the conditions mentioned in the forearm the treatment is the same, Mobilisation.
Find the spasm in the muscle track it to the joint/s that it is trapped in; release the spasm by gapping the joint/s and have the patient tighten that part of the muscle. This pulls the spasming muscle fibres free and reduces the subluxed joint at the same time. The only thing left to do is treat the damaged fibres for inflammation.
So again being thorough and aware of the likely train/s that may be involved is more likely to bring success.
More coming when I have time
We are also members of the Complementary Therapists Association