But, before you are too quick to blame the seemingly obvious culprit, consider another possibility, the fascial tissue. This connective tissue, which covers the muscles, has a high sensory feedback (lets you know that you just messed up!). The thoracodorsal fascia (TLF) that covers the posterior aspect of the torso is a major player in virtually every trunk motion; an injury to this tissue can cause unlimited potential movement disorders. In fact, pain found in other areas can be resultant from problems in the TLF. Fibers from this tissue attach to the lats (broad climbing muscle that connects the back to the shoulder), the internal obliques (along the flanks above the hips)and even the diaphragm, which can make for better reasoning why a shoulder can hurt with a problem originating in the lower back, or why it is difficult to breathe well with back pain.
So, what are the signs of TLF dysfunction?
1. Tightness or spasticity in the back between the bottom of the shoulder blades and the lower back even after localized therapy.
2. Chronic lower back pain (not diagnostically confirmed in itself)
3. Repetitive or chronic sacroiliac locking.
4. Nagging shoulder and hip pain that does not improve with localized treatments to painful area.
5. Inability to expand the ribcage with diaphragm breathing.
6. Decreased thoracic (mid spine) motion.
7. Altered gait pattern with poor arm and leg swing.
8. Base of the skull type headaches or plantar fascial pain due to the fascial attachments referenced in Thomas Meyers’ Anatomy Trains.
9. Spasms or weakness of the quadratus lumborum muscle(below the obliques, attaching the pelvis to the last rib).
Now, what can be done?
In previous articles, I have addressed the successful protocols that we utilize to treat adhesions and fascial dysfunction, but, I will briefly address them here for clarity purposes.
1. Evaluate for muscle motor inhibition (locate what is not working).
2. Find any restrictions due to adhesion build-up.
3. Break down adhesions via therapies such as cold laser,Active Release or Graston protocols.
4. Activate (wake up) muscles that are inhibited via electrotherapy techniques.
5. Adjust the spine (or other involved joints) that are dysfunctional.
It has been a pleasure and an honor to be able to care for you and your family and friends over the past year that have entrusted me with the challenges of pain management, as well as functional improvement. Daily, I seek the wisdom and insight to meet those challenges in order to be the best in my field. May you each be able to enjoy a healthy, warm and enriched Christmas season that is blessed beyond your dreams! Also, be careful shoving that Christmas tree back up in the attic!
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