Pain Free for Women: The Revolutionary Program for Ending Chronic Pain
By Pete Egoscue
The French philosopher Rene Descartes said, "I think, therefore I am." My take on the nature of being is slightly different: I move, therefore I am. Without movement, the I, in the sense of a living human presence and an accompanying conscious thought process, would not exist.
Where Descartes was plumbing the metaphysical depths, I am paddling in the shallow end of the gene pool, where basic functions like breathing, blood circulation, and metabolism take place. These functions are muscle-driven, as directly and decisively so as heavy lifting, trudging up a steep flight of stairs, and heaving a bulky carry-on bag into an airplane overhead bin. Muscle power is as elemental to every function of the human body as electrical power is to a refrigerator. If the wattage going to the fridge is insufficient, the ice melts and the vegetables spoil. Likewise, if muscle power is inadequate, the consequences from head to foot, inside and out, are drastic.
By the end of this chapter, I hope you'll have a new appreciation of exactly what your muscles do for you and what you do for your muscles. My purpose is to remove the "dumb and dumber" label that somehow got slapped onto muscles and persuaded many people to regard them as being of trivial importance except for athletes and stevedores. Three pounds of brain tissue are going nowhere without the musculoskeletal system.
By standing Cartesian logic on its feet-not its head-we can guarantee the mastery of the mind through the ministry of the muscles. We move, therefore we are.
Cut to the Bone
Our bones are sturdy. If I said that your femur (thighbone) is as solid as a rock, I'd be demeaning its true quality. A femur makes a rock look like-well, a rock: clumsy, brittle, and lifeless. Human bones are incredibly tough, flexible, and alive. Not only do they provide support for the body, they are a source of red blood cells and a reservoir of vital minerals that are central to our fundamental biochemical processes.
Even so, bones taken alone, or even bones strapped together with ligaments, don't amount to anything more than a formless heap of collagen and calcium. One reason that those skeletal models in classrooms and clinics-whether made of bone or plastic-hang from a stand and are loosely wired at the joints is that they would be too fragile and tipsy if glued together and propped up on two feet. What's missing is musculature.
Whether it is working individually or collectively, a skeletal muscle's first test of strength is its ability to give the skeleton the strength it needs to maintain structural integrity while bearing its own weight in an upright posture. Skeletal misalignment-the situation in which the horizontal and vertical lines of the grid are not parallel-is conclusive evidence of muscular dysfunction. The muscles are simply not doing their job.
But why not? Is it age? Disease? Accident? Individual variation? The answer is-none of the above.
The signature postures of musculoskeletal system dysfunction that we see all around us-and inside the frame of your own mirror-are primarily caused by lack of motion I said that already in Chapter 1, and I'll be saying it many more times, so brace yourself. I'm out to motionalize your life.
Muscles operate on a use-it-or-lose-it principle. Anyone who has been bedridden with an illness for more than a few days knows this, as do those who drop out of an exercise class and rejoin a few weeks later. In both instances, there is a noticeable decline in muscular strength.
For a quick practical demonstration, sit on the front edge of a chair with your back straight and your arms at your sides Bring your shoulders straight back, as if you were trying to squeeze your shoulder blades together. Hold this position for about ten seconds. Now relax. You probably haven't used those muscles for several days or even longer. Thus, the muscles that helped you draw your shoulders back are probably relatively weak. To verify that, notice that your shoulders have already returned to a slumped forward position. They are not strong enough to keep your shoulders square without an overt, conscious effort.
If you have time, do that same exercise again, holding your shoulders back for ten seconds, relaxing for ten, and then holding for another ten. Do a total of six sets. Notice that after each set, as your shoulders relax, their forward slump diminishes At the end your shoulders will be straighter and closer to vertical alignment with your head, hips, knees, and ankles. What's happening is that relatively dormant muscles are being engaged, put to work, and strengthened. As they strengthen, the muscles automatically resume their task of supporting the musculoskeletal system grid.
It didn't take long, did it? The fact is that muscles are motion sponges. They soak up motion and expand accordingly. (But in a motion drought, they dry up.) They are gorging on the energy distilled by extra helpings of oxygen-laden red blood cells that are being pumped to them to support their increased activity levels. The body is fairly ruthless. It treats muscles like ancient galley slaves: no work, no food The system is based on rewards and punishments. Fortunately, the rewards are readily available. As you just demonstrated, the simple act of repeatedly flexing and relaxing the shoulder muscles provides enough motion to activate this feeding and strengthening process. The payoff is immediate.
Later in this chapter, you'll see that some muscles work and eat more than other muscles, and that this inequity leads to trouble. First, though, I want to spend a bit more time on muscle mechanics, since I'm a firm believer in the old mangled maxim "What you don't know will hurt you."
Muscles seem so deceptively simple. They only have one card trick in their magic act-they contract. Or, even more banal, they twitch. When zapped by a neural pulse of bioelectrical energy, a bundle of muscle fibers shortens in length. This bundle is pail of a larger muscle structure that is anchored at one end to a relatively stationary bone and at the other end to a bone that is more mobile, so the shortening of the fibers pulls the bones closer together. Other bundles get zapped-twitch!- and the bones are pulled back. Whether it's a laborer digging a hole with a shovel or Julia Child whipping up a souffle, what's happening is basically the same: zap, twitch, zap, twitch.
To make use of the energy generated by the alternating zapping and twitching, the skeletal muscles tend to be paired off. One muscle flexes (pulls the bones toward one another), while the other extends (pulls the bones apart). Remember this concept, because fluxion and extension are important terms in this book.
Flex and extend, flex and extend: it's a tug-of-war between muscles designed to be equals in terms of strength and function. Some muscles (including several that also flex or extend, depending on the joint) perform a third role: they stabilize joints or other components of the musculoskeletal system to allow them to smoothly open and close.
Moving the human body-I'm talking basics, like going from point A to point B, not anything fancy like ballet-requires coordination and teamwork on the part of the muscles. The team is made up of every skeletal muscle, not just the ones closest to the action. To walk a few steps, you shift your weight to one side-let's say the left-by stabilizing your left hip and knee, as you flex the muscles of the right thigh and knee. To lift the foot, you extend the muscles of the right hip. To swing it forward, the right side's knee and thigh muscles extend (move bones away from each other) As weight shifts back to the right side, the right hip muscles flex, the foot lands, and the hip and knee are stabilized for the impact. Meanwhile, the back and shoulder muscles are engaged in a similar process of flexion, extension, and stabilization. All the load-bearing joints-shoulders, hips, knees, and ankles-and their attendant muscles are involved.
This kind of teamwork is predicated on each team member having the strength and functional capability to carry out the assigned role. But as your mirror has shown us, even before the first step is taken, the musculoskeletal grid is misaligned. It's sagging under the weight of gravity. Key muscles lack the strength and functional capability to hold the vertical and horizontal lines parallel, let alone execute flexion, extension, and dynamic stabilization of the joints as they move.
A Disease Known as Progress
In sports or business it's relatively easy to improve a team's performance: you get rid of the duds. With the body, it can be done even more readily: you make every member a star by serving them the real "breakfast of champions"-motion.
Dysfunctional muscles are generally not diseased, aging, or broken. They are starved of motion. When I asked you to try the exercise with your shoulders, I said that some of those muscles probably hadn't moved for days or weeks. I wasn't kidding. We assume that because we lead busy and active lives, our musculoskeletal system is also busy and active. It is, but only in a piecemeal fashion. The conveniences of modern life-tools, furniture, appliances, cars-as well as architectural design and the routine tasks that we perform have bypassed parts of the body that people once relied on to meet their basic needs.
It's called progress. If your grandmother loved to garden or if she lived on a farm, she was probably pretty handy with a hoe to keep weeds under control. Just imagine, for a moment, using a hoe. This movement is pretty basic, but it engages all the load-bearing joints, plus the back, the arms (including wrists and hands), and the shoulders. Flexion, extension, and stabilization are under way throughout. Now here comes progress. A modern woman combats weeds by squirting herbicide out of a spray bottle. Most of her effort involves pointing the bottle, squeezing the trigger, and walking back and forth.
Yes, this is a lot easier than hoeing, but there's also a lot less muscular engagement and stimulation going on. I'm not saying that backbreaking physical labor is the only way to achieve a fully functional musculoskeletal system. But I want to show how our motion-even with weeding-is conscribed. Our muscles respond, but we have to ask them to. We have to find effective ways and means to stimulate our muscles to keep them functional-otherwise more and more muscles will opt out. And as that happens, misalignment increases along with stiffness, chronic pain, and disability. That's really not progress at all-it's pain and poor health.