Leigh Blyth BVM&S. Here to share my Base-Line Theory of Health and Movement - the key to better health. Grounded in some basic anatomy, the the 5 main muscles for a full range of natural movement, body alignment and balance. Hoping for some thoughts and feedback.
I watched a few videos and contact improv looks great. (Full disclosure I watched the videos x2 speed I've little patience watching most stuff). For people in a good enough physical condition, and relaxed enough to go with it, I can see it being beneficial and a lot of fun. (5 years ago I would have hated the idea because back then movement = pain, pain, pain and I couldn't have let go to move) It looks like free-flowing movement, guided instinctively by the body rather than the brain trying to control and direct. Support is being provided which allows increased movement (I achieve similar things by legs hanging off the bed, leaning over arm of chair, using the kitchen worktop as a bar, swinging from posts...) Working towards a full range of natural movement means moving through all the positions possible, the "more awkward" is easier when support is available and the 'support' is also moving which adds more randomness and further increase range of movement. I find a similar, gentle, effect moving around in water and letting my limbs float around but if I get the opportunity I will try contact improv.
Now seems a good time to have a minor rant about our modern flat earth..... Walking (especially barefoot) over uneven terrain flexes and stretches the whole of the body in a way that shoes and flat ground just don't allow.
I will take some time to have a good read of bewelltuned. Are there particular bits that resonate with you? For now, pulling this quotation:
By repeating certain movements and positions over and over again (e.g. during sitting work), we involuntarily strengthen connections between movements and muscles that don't make much sense lumped together.
This fits with my distorted 'body map in the mind' that sends motor commands to the 'wrong muscles', adding to imbalance and misalignment.
(body scanning? I don't know much about the methods involved)
My 'conscious proprioception' skills were pretty much at zero when I started and it's been a revelation actively experiencing the sensory feedback from by body. Starting with focus on my pelvic floor and rectus abdominis 'Base-Line' muscles from where movement originates and using my midline anatomy as the reference for positioning of the rest of my body.
Active engagement of the Base-Line muscles creates a positive feedback loop, increasing awareness of :
Now I'm aware of my body in a way I never was before. I was always very clumsy...
Some comments on Dr Scott Dye's failure-of-homeostatis model:
I read the abstract "Patellofemoral Pain: An Enigma Explained by Homeostasis and Common Sense" and found myself nodding along...
overload and/or injury produces pain. Bone overload and synovial inflammation are common sources of such pain.
Patience and persistence in nonoperative care results in consistent success. Surgery should be rare"
I agree with all that. I'd classify it as common sense as they say in the title.
But after reading the article a couple of times I don't feel the authors were saying anything new.
Our Hypothesis: Loss of Homeostasis Causes Pain
We hypothesize that pain is the result when load applied to musculoskeletal tissues exceeds the ability to maintain homeostasis. Loss of tissue homeostasis from overload and/or injury produces pain.
Overload/injury = stresses beyond tolerable levels --> damaged tissues & inflammatory processes,
which the authors are describing as "loss of homeostasis". The use of "homeostasis" feels unnecessary.
Injury/overload = damage. simples.
However, the inflammatory processes are anything but simple. Inflammation is a rabbit hole I avoid looking to deeply into, I'd be lost for a very long time!
Pain anterior knee. —a consistent set of symptoms, signs, and test results—that does not exist.
I agree with this, and it happens to fit with my 'individual trauma imprint' explanation for pain-related symptoms. What our bodies have been subjected to, the damage sustained. With innumerable positions the body has a massive capacity for adaptation. As damage builds up, patterns of symptoms will emerge throughout the body but we're all a bit different.
Emotions play a role in pain as well, and somatization resulting in knee pain is a well-known phenomenon, particularly in adolescent women related to stress or even abuse.
I checked the article's references for more details about somatization but found nothing listed. (I also noted the references are mostly to other articles by the authors.) Whilst I do believe emotions and the physical body are intertwined, this statement feels more like a dismissal of knee pain when reported by the young and female. Adolescent women being told "it's all in your mind" when nothing shows on exam or standard imaging. I wonder how often adolescent men with knee pain are told it's due to their emotions too, or do they get a "diagnosis" of patellofemoral something or other? I didn't find anything to back up this as a "well-known phenomenon".
I say: The knees are joints that are under a lot of stress with little slack so problems appear here first when the body is not aligned and fully balanced. Stress/abuse affects positioning of the body.
Poor positioning can be subtle but it takes its toll. Knee pain - slight adjustments in the joints above and below i.e. hip and ankle to avoid the pain. It affects the whole leg, which then affects the body-whole over time. The body is very adaptable, able to cope with a lot of misusage and abuse but the imbalance and misalignments are cumulative.
The treatments listed: activity modification, cold therapy, anti-inflammatories, physical therapy. are (or at least should be) standard protocols. I'm cringing at the thought that surgery might be pushed in some parts of the world (without good reason), and thankful I wasn't prescribed opiates as a teenager.
I was going to comment more on cold therapy but I thought I'd check some things I'd always been told, turns out it's an another rabbit-hole to go down.
https://www.physio-pedia.com/Cryotherapy
https://thesportjournal.org/article/the-r-i-c-e-protocol-is-a-myth-a-review-and-recommendations/
Cold - good or bad? It does numb the area for a while but what's the deeper effects on the tissues...
I hope your Dad is doing OK. No worries with timeframes - less than immediate responses are one of LW's strengths IMO.
Abs, butt, quads, traps. I'll try being more mindful of those,
Fricking awesome! Feel for positioning, freedom to move, and balance in left and right. Just to expand a little ...
abs. All good. Imaging extending the linea alba between the rectus abdominis every in-breath. Pubic symphysis to sternum.
butt. fair enough. Big ass muscles - gluteus maximus.
quads. What makes you say "quads" here? It would be very useful for the insight. Focus on the rectus femoris, shin to hip bone. The quadriceps share a distal insertion (common ligament of quads.-patella-patellar ligament-tibial tuberosity) but the rectus femoris is only one of the quads to cross both hip and knee joints. image here. or in the post main muscles made easy. I think of the rectus femoris as the guide muscle of the quadriceps, positioning the leg so the 3 vasti muscles 'fall into line' (I don't like that phrase - but have nothing better).
traps. Excellent. The trapezius muscles should free to support the head and arms through a full range of movement. Movement starting from lower trapezius.
(coughs) Pelvic floor. The base foundation of the body.
It would be useful to me to know how much is "the pelvic floor muscles being important" common knowledge here?
This honestly sounds amazing. Is there a way for a civilian to get access to large mammal [human?] dissections?
Commenting here got me thinking about who has the opportunity to handle really really fresh tissues like I've had. It's not a long list: Anyone who turns animals into meat. Anyone performing autopsies on the freshly dead. Euthanasia and immediate post-mortem is possible in the veterinary world but human corpses are likely to be older when examined and it doesn't take long (1-2 hours) for connective and adipose tissues to change consistency - temperature and humidity dependant. A certain class of serial killer (skip over that one). Anyone who turns animals into meat. Surgeons, especially those dealing with mass trauma injuries. Removing dirt out of fuzzy connective tissues is a bitch...
I imagine most human dissections aren't fresh enough to really appreciate "live" tissues. So, how to get in on the action? If you can find a farmer/small-holder type willing to let you watch a butchering, a hunter that processes the carcass, a fresh meat butcher. Or a friendly large animal/equine vet that's willing to call you when the chance to do a fresh post mortem arises.
I've been fortunate with the opportunities I've had to increase knowledge and understanding of mammals 'in the flesh', something I appreciate a lot more now that I've stopped to think about it.
I have quite a lot to say about the link you provided, so will be back with a separate comment. Have you worked through "DAMN-IT" (from one of my previous comments) and seen where that gets you?
Yes, there are a lot of ways to get sensory feedback. I listed some to increase awareness of the relative positioning of the midline anatomy here.
imagine a string attached to the top of your head, towards the back. "
The "imagine a string" example is great - if it works for an individual and they engage the 'right' muscles to improve posture. It didn't for me, my body was too restricted and misaligned, my 'myalgia of imbalance' too advanced for imagining a string to be of any help.
To take the string idea further, think of the linea alba and nuchal & supraspinous ligaments as part of this string. To straighten the string the main muscles are the rectus abdominis and trapezius muscles. The "attached to the top of your head, towards the back" I'd replace with the external occipital protuberance.
From the link you provided:
"A very recently reported third discovery demonstrated a previously unknown tissue component-'interstitium'-a networked collagen bound fluid-filled space existent in a number of human organs."
I read that and thought:
"What? The interstitium? I learned about that 30 odd years ago. Wasn't that one of the things I had to label when sketching from a histology slide, wow that was so long ago .... "
What has been recently noted and publicised is the interstitium in its form in living tissues. From this article:
The researchers said these fluid-filled spaces had been missed for decades because they don't show up on the standard microscopic slides that researchers use to peer into the cellular world. When scientists prepare tissue samples for these slides, they treat the samples with chemicals, cut them into thin slices and dye them to highlight key features. But this fixing process drains away fluid and causes the newfound fluid-filled spaces to collapse.
Histology 101. Tissues are distorted when prepped for slides. I was taught that at vet school (if not before). I'd assumed / never thought about it, that it was common knowledge amongst medical folks.
I've handled a lot of 'fresh' mammalian tissues (canine, feline, bovine, equine, ovine, caprine and various others). I'll go out on a limb and say it's all the same stuff - bone and muscle fibres all wrapped and blended in a web of connective tissues ... in humans too. (This could be a major error. I've not handled enough human flesh to really know....)
Seeing live/freshly dead tissues, feeling them in your hands, is a very different experience from learning from a textbook, histology slides or studying bodies prepared for dissection. They can't compare in giving understanding of how a body is put together, of what it really consists of. These experiences give me lot of confidence in what I say about the role of connective tissues, also the knowledge that defining and delineating is very difficult so I'm sticking to the covering term of 'connective tissue' which I wrote a bit about here. I don't know the precise pathology of 'physical restrictions in connective tissues'. (Is it collagen fibres cross-linking? Is it interstitial components hardening from fluid to gel to the palpable lumps I can feel subcutaneously? Is it a combination of many factors?!) A good question is how to sample and examine these tissues without distortion.
Putting aside the issue of levels of certainty here,
Phew, much appreciated. : )
I'd agree with ChristianKl that I'm a bit unclear what the implications of your model are, except perhaps, "pay attention to your posture and movement" which I already do a fair amount.
I've been side-tracked by "posture".
My model is about learning to use your body better. I believe the 5 main muscles of movement are key to this, leading to:
The level of knowledge about the structure and location of the anatomy I share is at a sufficient level for me to use the word "fact" ( grinding my teeth as I type this, I don't like to use "fact" for anything).
Muscle tissue blending with connective tissues is very hard to describe in full detail but, ignoring the pelvic floor for a minute, the other 4 main muscles are big and easy to palpate. We know their attachment points to bone and connective tissue structures (minor variations in individuals have been noted and no doubt there are more that have not).
The is enough information for someone to find the muscles on their own body, to touch them and increase conscious awareness of them.
There is much still to learn, to put together, to figure out. I believe Base-Line Theory increases understanding of how we could better use our bodies, of why there is so much unexplained pain -and how to fix it.
As a simple experiment if you are willing, find the 5 midline markers and feel for their relative positioning. As you move through your day, pause to take a few deep breaths and try to be more aware of your midline anatomy. Use it as a reference for the positioning of the rest of your body. See how it feels, what you experience.
Thank you for the interaction! It's very useful.
Posture it's where the body naturaly without effort. For a muscle to hold something in a specific position it has to fire constantly which costs energy. It makes sense for the body to save that energy by using fascia to hold the posture.
This is an issue of definitions then. I agree that it is the connective tissue system that provides passive support for the body, minimising muscular effort. I also believe it is the location of 'physical restrictions' that cause tension, alter positioning and restrict range of movement.
My definition of posture: The position of the body - all of it, at any time.
(I checked a few sources for a definition of posture. Lots of options out there, pretty much saying what I am calling posture and several mentioning the role of muscles.)
I'm not advocating attempts to get muscles to hold a specific position - in any shape or form. Think gentle movement and relaxation ...
Working with the '5 main muscles of movement' and consciously connecting with them provides a lot of sensory feedback about the relative positioning of the torso, head and limbs. Whether it be using 5 midline markers, the linea alba or Base-Line muscles (pelvic floor + rectus abdominis) as the starting reference for positioning (whatever works for an individual). This sensory feedback provides the information needed to work towards a full range of natural movement and a body that is balanced and aligned - where all the parts of the body in the correct relative positioning and free to move, including the myofascial meridians.
I agree, biology is a realm of uncertainties. The wonder of how living organisms function blows my mind. The level of complexity phenomenal.
However, anatomy is much more fixed. Grossly examinable and recordable. Studied in detail for hundreds of years. We have accurate atlases of how the body is put together, what attaches where....
Anatomy can be complicated (I've very much skipped over a lot of details about the pelvic floor muscles and connective tissue structures) and individual variations are seen, but there is much more certainty about how we are put together than biology as a whole.
I know I am right. It has taken a lot for me to get to the point of saying that out loud. Question everything has been a motto of mine for a very long time - and it will always be with me. But I feel how I feel, and accepting that feels right - especially having facts and logic on my side (IMO at least - please someone look at the anatomy!).
Thank you for providing some background. I found it very insightful into your methods of thought and what you consider evidence. (I had to google pedagogy, I don't know what to make of "perceptive pedagogy".)
You've studied anatomy, I think great! Most people (in my experience) find anatomy intimidating but I would hope someone who has studied it would feel more comfortable giving some consideration some, fairly basic, anatomical facts.
I said something about posture being a mix of fascia and muscle and she said: “No, it’s just fascia”
And you are happy to accept that statement? That muscles, the bodily tissues that change the relative positioning of different parts of the body, don't affect the position of the body (i.e. posture)?
The state of the connective tissue system (including the ill-defined fascia) is important. The way muscles are functioning, moving the parts and repositioning, is also important. Humans have the capacity to send motor commands to "voluntary muscles". Muscles can be used to consciously alter positioning, to change posture. Anyone who says body position is just about fascia loses a lot of credibility in one swoop IMO.
Those are the kind of people I ask when I want to know something about how human anatomy works.
Have you done any independent research? Fact checking? Thought about it for yourself? Or are you relying on the opinions of others (however great you feel their experience/knowledge/credentials are)?
I don't want anyone to just believe me, I want the anatomy to be given some thought. I am constantly open to updating my model, but without feedback I can only work with my experiences. And the facts.
You didn't answer the question I asked:
A simple yes or no will do at this point.
I've read Painscience over the years. It's one of the few places that attempts to cut through the BS of "pain medicine" and I agree with Paul on many things.
However, I am looking at "posture" from a new perspective. (Kind of wish I had another word for body-position - pose? A lot of bad thinking is currently applied to "posture".)
Posture = the pose you are in = the positioning of all the bits of your body, at any time.
The body is an incredible machine with a massive capacity to tolerate misusage, adapting its positioning to avoid pain and spread the burden of misplaced forces. Every adaption however, reduces alignment and increases imbalance, a progression of worsening positioning overtime. The more strain/exertion/trauma the body is expose to the more misalignment develops. For the body to function at/near optimal, it much have all potential position possibilities open to it - a full range of movement - allowing whatever posture/position that is most appropriate to be used for the task at hand.
Paul Ingraham says in the article you linked to:
Poor posture is any habitual, self-imposed positioning that causes physical stress, especially coping poorly with postural challenges.
There is a big difference between “poor posture” and “postural stress,” but the distinction seems to be absent from most discussions of posture and ergonomics.
I say poor posture is when there is postural stress. Also posture can be active or passive (conscious engagement of muscles or subconscious brain to body commands to muscles - habits).
If there isn't stress, it's not a bad position to be in so it's not a poor posture. Examples Paul uses:
The most stereotypical poor posture of them all — a hunched upper back, with the shoulders rolled forward
Is this really an example of "poor posture"? If the shoulders can be "unhunched", if the subject has a full range of movement, hunched is just another pose. Being in a position that is classically labelled "poor posture" isn't an issue if stress is minimal, and no pain is generated (RSI in wrists much more likely with "texting hunches"). However if movement of the neck and shoulders are restricted, if "hunched" is a fixed feature, the body is less able to adjust when it needs to, so it becomes a bad posture, generating postural stresses.
“Squatting like a baby” ...... hopelessly unrealistic for most people.
I understand Paul's view on this, a few years ago I would have laughed at the thought of getting into a squatting pose and cried out loud twisting and rotating to get into an approximation of the position. I would have battled a lot of pain to stay there, fidgeting and adjusting looking for the least painful option. But I can squat comfortably now. It wasn't an aim, or something I intentionally did. It's just another position to move into and out of as I work with the whole of my body, using my Base-Line as starting reference for relative positioning of the rest of my body - to sense my posture for myself and feel how to move to improve my range of motion.
Read though my take on posture. Question the validity of each statement.
Read though Paul's take on posture. Question the validity of each statement. (I still agree with a fair bit in the article.) Check the references and consider what, who, how was studied. I'm not impressed with the quality of any studies listed. It'd be more efficient if you link to any ones you find that have some validity rather than me trying to comment on them all.
On a personal note, my patellofemoral pain started (bilaterally) when I was about 7 yrs old. I got a diagnosis of chondromalacia patellae, a label that sounded special but did nothing to reduce the pain in my knees. Walking was always painful, occasionally to the point of almost non-weightbearing. The pains shifted around and around in my knee (and the rest of my body) as my posture altered to avoid pain and keep on going. Now that use the right muscles to position my legs to torso (rectus femoris to align hip and knee joints, gluteus maximus to stabilise the posterior pelvis) my knee pains have finally gone.
A new paper that might be of interest:
Recalibrating SARS-CoV-2 Antigen Rapid Lateral Flow Test Relative Sensitivity from Validation Studies to Absolute Sensitivity for Indicating Individuals Shedding Transmissible Virus