Body Unity

When we consider a human body we commonly see the skeletal (i.e. bones) as the structural core with all the other tissue surrounding it. But is this really the scaffolding which knits everything together?
If the bone were the scaffolding then should we not be able to recognise a person from their skeleton alone? The common person would find it difficult to differentiate a female from a male skeleton whilst an expert would be able to identify an approximate age and gender but little more. However if we were to remove every piece of tissue with the exception of our blood vessels, you would have enough detail to recognise your family member or friend. The same is true of our nerves.

When we consider our development within the womb, the nervous systems is the first to arrive on the scene in week 2. The blood system (i.e. blood vessels and heart) and the embryonic tissue that will form our muscles / bones (termed mesoderm) arrives together in week 4. The nervous system will dominate the growth of the embryo for the first 6 week thereafter the other tissues grow outwards together influencing each other as they progress.

In general we can describe this interaction as the mesodermal cells multiplying outwards and suck / drag the blood vessels and nerves with them. In this way they [blood vessels and nerves] become embedded in the developing tissue to such an extent that no cell is a cell width away from a blood vessel or nerve! In addition, due to the tensile strength of the blood vessels and nerves they provide resistance to the growth thus influence the overall shape of the muscle or bone.

In this way the blood vessels and nerves form a scaffold throughout the body which give our muscles / bones a unified strength. When we consider the reach of our blood vessels and nerves it begs the question ‘what are the consequences of dysfunction in these systems?’. In a world where stress and anxiety are high can we be certain that these abnormalities are confined to the nervous system alone. In a world where blood pressure is commonly high, can we be certain that this is just a problem for the cardiovascular system alone?

Fetal Development

The formation of a human is extraordinary as it requires such a high level of organisation and accuracy to coordinate trillions of cells to create the same form time and time again. So how do we do it? In this article we look to provide you with a simplified overview of our current understanding of this extraordinary process.

There are 3 basic components to organised growth:

  1. Genes – these provide the basic plan for our development and drive cellular division.
  2. Cellular movement – this is a consequence of cellular division and thereby creates forces which mould the shape of our overall structure as well as stimulating surrounding cells.
  3. Chemical signals – these are released during stimulation and alter the function of the affected cell as well as the cells around them.

Let us delve in the detail of this process starting with the genes. These provide the basic information of what we are. They are the building plans of our form. And like all building plans they are modified as the project progresses. There is a greater degree of modification in the creation of a living being, as opposed to a house (for example) because in a living being everything is in a constant state of change. The cells (new or old) are moving, the surrounding fluid (amniotic fluid) is moving, the uterus is moving, etc. When building a house everything is still yet even then the completed article looks different to the initial plan. A further complexity is that cells that are being added are created from the existing cells. In the case of a brick wall the last placed brick does not generate the next brick.

It is this replication which generates the bulk of the movement and in so doing creates pulling, pushing, stretching and suction forces. It is this cellular movement which shapes the structure. For example, if the bone cells of an arm are replicating faster than the cartilage cells immediately in front of it, what will happen? The cartilage cells will get flattened and be forced to grow sideways. Hence why the bones have a flattened cartilage lining at the end of them.
The forces placed on the cells will not only influence their direction of movement but also what is chemically happening inside of it. Inside a cell we have many thousands of chemical reactions occurring. When the outer wall is deformed by a pushing force for example, it will change these reactions. The change may cause:

  1. The cell to change its function, i.e. turning from a bone making cell to a tendon making cell or
  2. The cell will release chemicals into the surrounding space.

These chemicals are called signalling molecules and they are absorbed by the surrounding cells. Which you guess it, affect their internal reactions. In this way, the cellular motion alters the direction of construction in the area. In a similar way to how a brick layer will signal to the plasterer that he is to take over. In our our bone-cartilage example as the bone cells push into the cartilage cells it causes them to flatten. The flattening force alters the internal reaction. Some of the signalling molecules would then activate a different part of the gene turning the cell into a synovial fluid producing cell. In addition some signalling molecules would be released into the outside and be absorbed by the surrounding bone making cells. This would affect their internal reactions in such a way that they stop replicating. Hence the bone stop growing, has a thin cartilage layer on its end and at the periphery are synovial producing fluid cells which lubricate the joint.

Through this complex interaction of gene expression, cellular motion and chemical signalling we replicate a human form time and time again.

Neuroplascity

Neuroplasticity is the secret to our success on this earth. Other animals are stronger, faster, more dangerous, can see/smell and hear better, etc yet we humans have dominated the earth.

What does neuroplasticity mean? Simply the ability of our nervous system to adapt. This extraordinary ability has enabled us to live in all corners of the earth. What other complex creature do you know which can claim the same feat?

From an evolutionary perspective it gives us the edge, because our wiring [of our nervous system] modifies with each year and varies greatly with each generation. Thus we are evolving weekly without having to wait for the rare occurrence of gene mutations. Other species like insects work on the basis of numbers. Their life spans are short and their families large. Therefore they will go through a thousand or more generations for every one of ours. However they are relying on a gene mutation to occur somewhere along the linage which gives them an edge. But if that mutation does not occur then they change very little. Hence why the common flies behaviour has changed very little since humans have evolved from cooking on an open fire to landing on a moving comet!

So how does neuroplasticity work? Well it essentially means that there is no stringent plan for the wiring of our brain and body. The complexity and number of nerve cells {i.e. Billions – trillions} means that there are hundreds of ways to perform a given task. This is why we see stroke patients recover their ability to walk or use their left arm to open a door. The original path has been permanently damaged however with time, practice and the right rehabilitation they are able to rewire a new pathway which performs exactly the same outcome.

This process of rewiring applies to all aspects of our lives. If you more from a hot climate to a cold, after a few months the rewiring of your temperature control will change, the metabolism rate and absorption rate of your food will alter, etc. Thus giving you the greatest chance of survival in that altered climate. In a negative sense this also applies. It our emotions (e.g. fear, depression, anxiousness) forces us to limit our exposure, our bodies will start to break down those learn pathways because they are not being used and thus a waste of valuable energy to keep them functional. This then makes it harder to do those activities (whatever they are) because our wiring has changed. However, these activities can be wired again but that takes the courage to return to those ceased activities. .

The conclusion to this article is a positive one, we have the greatest gift in the world; our ability to adapt and learn. The more we use it, the greater we and our next generations become.

Blood Cleanliness

Our blood gets dirty like all things and therefore requires cleaning. The dirt can consist of foreign invaders (bacteria, virus, fungi, etc), toxins (drugs, alcohol), our own mutated or defective cells, used hormones and waste products from cellular metabolism. If this dirt is not removed our blood becomes poisonous leading to disease. Fortunately our bodies have developed a conceptually simple but thorough 4 stage cleaning process. This month our aim is to help you understand this system.

The lungs, liver, spleen and kidneys are our main cleaning organs and their role is to remove specific components of dirt. The diagram below outlines the basic process and what components are removed by which organs.

Diagram describing the process of how blood is cleaned

LungsThe lungs main role is the removal of carbon dioxide from the blood. Carbon dioxide is a waste gas released into the blood stream by all our cells. We wish to avoid carbon dioxide accumulating in the blood because it forms carbonic acid. The lung’s second role is the defence against foreign invaders. Immune cells live in the lung tissue and like a venus fly trap capture any invader passing close to them in the inhaled breath. Any foreign invaders that make it past these cells enter the blood stream. Fortunately our second and third lines of defence are not too far away.

SpleenThe spleen and the liver have immune cells (similar to the lungs) embedded in them. They attack those invaders that have made it into the blood stream. The spleen designates half of its function to fighting these invaders. The other half involves recycling damaged red blood cells. Red blood cells spend their lives travelling through turbulence blood vessels and squeezing through narrow capillaries / holes and so are prone to damage. There average life span is only 120 days before the spleen breaks them down. Fortunately our bone marrow reproduces them so we maintain a constant functional number.

LiverThe liver has the largest role in the cleansing process. It is our biggest asset against fighting cancer as it destroys mutant cells. Our cells are dividing all the time with millions of division occurring per day. With these numbers there is a high probability that one of these divisions will go wrong producing a mutant cell. Fortunately a functioning liver is quick to destroy these cells before they have a chance to divide sufficiently to produce a colony. Another important and arduous task is the break down of toxins. A toxin is any foreign chemical that is hazardous to the body and includes recreational drugs, prescribed medication, alcohol and pollutants (e.g. smog, cleaning chemicals, etc). The liver has to absorb these toxins first and then break them down into something harmless. Once broken down, it injects the harmless products back into the blood where it leaves through the kidneys.

KidneysThe role of the kidney’s is well documented acting as an exit route for any water soluble waste as well as any excess water, salts and sugars the body has produced. Waste products are by-products of the chemical reactions occurring in the body. They are harmless in small quantities however are dangerous if allowed to accumulate e.g. urea. What is left is clean blood that travels back to the heart to be pumped around the body. Like drinking water our blood needs to be clean. We shall explore a few simple ways to maintain their health next month.

 

The Digestive System

The digestive system is simple in design and concept. It starts off as a single tube from mouth to anus in the foetus. As the system matures [in the foetus] our digestive organs (stomach, liver, spleen and pancreas) sprout from the tube with the remaining tube forming the small and large intestines. When we eat, our chewed food passes through the tube and different components are absorbed through the walls into the waiting blood vessels. Our digestive organs produce specialist chemicals that empty into the intestines at key points and facilitate the breakdown of the chewed food. Whatever remains at the end of the process is expelled and the whole process takes between 8-24hrs.

Movement
The digestive system is tightly packed into the abdominal cavity however the individual organs (in particular the small & large intestines) are still able to slide over one another. Think of spaghetti with a generous coating of olive oil compared to non-oiled spaghetti. When this sliding motion is impaired the movement through the intestines is also impaired leading to abdominal cramps, collick pain and problems passing stools. This is very evident in those who have inflammatory bowel disease such as ulcerative colitis or Crohn’s disease. Our general movement (I.e. bending ,twisting, rotating), breathing and regular intake of food ensures these sliding characteristics are maintained. Sitting however is not conducive as the volume within the abdominal cavity is decreased.

Absorption
As we touched on earlier, the chewed food is absorbed by cells that are situated on the intestinal walls. These walls need to be clean for the cells to absorb effectively. Unfortunately, some food types can stick to the sides creating scum in a similar manner that limescale sticks to the side of our water pipes. This means that although we are eating correctly we will not get the maximum benefit, i.e. we are absorbing less nutrients per kg of food. Fear not, as nature has created its own tube cleaners for us in the name of roughage. Many food groups can be considered roughage but are broadly found in a wide range of vegetables, fruits, grains and pulses. These have compounds which passes through the tube with no intention of being absorbed. Rather they bang against the walls on their way down eroding the scum. This is one of the reasons why the recommended vegetables per day has increased from 5 to 7.

Communication
Our digestive system has its own communication system. This means that when food enters the mouth, the organs further down the line are already preparing for the arrival of the chewed food. This is logical because the food flows through the intestines quickly. Therefore if the organs start producing the chemicals when the food arrives by the time the chemicals are released the food would have already gone. We can sometimes trick this system into coming alive when there is no need. The most common example is chewing gum or sweets. These give the impression food is arriving when in reality nothing is. The organs have wasted energy producing these chemicals and these chemicals then sit in your intestines with potentially negative consequences. The same is true (but to a less degree) for snack-like foods such as crisps, nuts, crackers, etc. Interestingly, eaten after a meal they may prolong the release of chemicals thus improving digestion.

We hope this article has helped you understand your digestive system better and given you insights into how to care for it. Have a lovely month.

Digestive Health

This month we start a series of articles looking at our organs. Being hidden inside our bodies, they tend to be ‘out of sight, out of mind’. Subsequently we seem to them and focus on the what we can see, i.e. our hair, skin, nails, muscles, etc. It is our mission over the next few months to bring the organs into sight and help you understand how to care for them. Today we start by considering the general principles that govern organ health.

These principles are similar to various principles we live our daily lives by. As individuals need:
1) the freedom to move around,
2) good quality air to breath,
3) a reliable water source into and out of our homes,
4) good communication with our surroundings (be them neighbours, family, friends or work colleges),
5) a ranges of tasks to keep us occupied.

Our organs are no different.

The freedom to move
Movement is a life force that all living things require. Imagine if we were locked in a room for longer than a few hours. We would get grumpy, tired, irritable and a poor productivity. The same is true for our organs, they like to move and their productivity depends on it.

The air we breathe
We breathe air, our cells (i.e. what makes up our organs) breathe fluid. The air we breathe is dissolved into our bodily fluids and it is this fluid our cells breathe. It may sound strange but remember as a foetus we breathed in amniotic fluid for 9 months. The quality of our bodily fluids will thus determine the health of our cells. Think of a runner running in a polluted traffic filled city road or the open countryside. Which environment will produce the best time?

Reliable water flow
The flow of water to our homes is important. If the water flow is slow or obstructed we start to accumulate water. Accumulated water can becomes stagnant, smelly and toxic (think of the quality of water in a still pond compared to a flowing river). In the same way, our cardiovascular & lymphatic system replenish the fluid surrounding our cells. If these systems are hindered then our bodily fluid becomes stagnate which can lead to the accumulation of mild toxins. You can appreciate that a cell breathing in mild toxins is not likely to yield positive outcomes.

Good communication
Each part of our body is but a cog in a wheel. If one cog starts to do its own thing, then the whole system will be affected. For this reason our organs communicate with each other via hormones and chemicals released into the blood stream. These communicating chemicals are produced in various organs / tissues throughout the body. Thus an ill functioning organ will have an effect on the rest of the body systems. The question is how strong is that effect and how long do we allow it to carry on?

Diversity
This point, is best emphasised with an extreme example. Say we eat pizza and chips every day all our lives. Our digestive system becomes very good at digesting the components of pizza and chips. Great. But then we decide to move to China, there is no pizza and chips there. How will our system cope with dumplings, stir-fry or duck pancakes? The answer unfortunately is poorly as we have trained it to be a specialist rather than a generalised.

As humans we are generalist, therefore our systems need variety to give them the tools to cope with an ever changing environment. Unfortunately, in the modern world we seem to encourage a specialist approach to most of our tasks. This is certainly easier & more convenient. The bigger question is, is it better?

Muscle Spasms

Nervous systemIt is a painful experience that always occurs when you least expect it! But why do they occur? Lets start by understanding the basics, how do muscles contract?

Muscles contract only because they are told to by the nervous system. The brain creates the signal and passes it down through the spinal cord into the carrier nerves (the large nerves which exit the spinal cord). These then divide and divide again as they travel towards their destination. They terminate as local nerves which make direct contact with the muscle.

When the signal arrives, it triggers the muscle to release some positively charged ions (e.g. calcium being the main one) which in turn starts the process of muscle contraction.

A muscle contraction is simply a muscle shortening and thus pulling on the bones it is attached to. The process involves thousands of fibres aligned in parallel sliding past one another towards a central point thus decreasing the overall length of the muscle. Throughout the process, like all cells, the muscle will use up energy which is made from oxygen and sugars. It will also create waste products that are removed via the blood.

A muscle spasm differs from a regular contraction because it very strong, prolonged and unplanned. The nervous system is ultimately responsible because it controls the muscle. The fault can occur anywhere in the nervous system as the following paragraphs explain.

1) Brain and spinal cord
The brain / spinal cord lose effective control of a portion of the muscular system leading to ill timed, uncoordinated and strong contractions. This occurs following spinal cord or brain injuries as well as disease processes such as dystonia.

2) Carrier nerve
Commonly referred to as a trapped nerve. The mechanical compression associated with the entrapment irritates the nerve making it hyper-sensitive and hyper excitable. Thus any signal travelling down this route is likely to be distorted and amplified. An amplified signal will create a large response in the muscle, hence a muscle spasm.

3) Local nerve
The local nerves make direct contact with the muscle and thereby share the same environment. We know from above that nerves are sensitive to changes in their local surrounding. Therefore, excessive waste products from the muscles will irritate the local nerves.

FlowchartMuscles generally produce little waste however if they are over-used or do not have enough oxygen or energy they will produce more waste. If this situation continues for a long time the waste products build up and start irritating the local nerve making it hyper-excitable. The consequence of excitability is more signals asking the very same muscle that is producing excess waste to contract more. More contraction equals more waste which equals greater excitability. This cycle will culminate in a muscle spasm.

4) Ions / water concentration changes in the body
In these cases the muscle spasms tend to be body wide (i.e. not localised to a single muscle group). They again occur because the nervous system as a whole becomes hyper-excitable. Remember, our body work within a set range of tolerances with respect to a number of variables such as temperature, water/ion concentrations, pH, etc. Deviations outside these tolerances creates side effects, one of those being a hyper-excitable nervous system.

The most common reasons for muscle cramps are related to changes in ion/water concentrations as well as irritations to the local nerves (i.e. points 3 and 4).

Fascia

‘What is it?’ we hear you ask. The best visual reference [apologies to all our vegetarian readers] is the shiny stringy film like substance that is visible when preparing meat. All mammals have it but why does it exist?

Fascia is an exciting new area in medicine and in particularly in manual therapy. Osteopaths have been working with it for many decades however research is only now appreciating its importance. Before surgeons used to simply ignore it and cut through it with little regard for its relevance. However, this tissue plays an important role in the long term (termed chronic) aches and pains we feel. As the majority of our patients are long term suffers of pain, it is something we have become accustom to working with.

Think of fascia as a continuous sheet of cling film that wraps around all our structures (i.e. our bones, muscles, nerves, blood vessels and organs) starting at the head and working its way down to our feet.

What does it do? Well it provides a loose binding between all the structures keeping them together and in the same place. I.e. it keeps the blood vessels close to the muscles, the nerves close to the blood vessels, the muscles close to the bones, etc. It works in a similar way to how we use cling film. Because the fascia is the connection between different structures it also transmits forces between them thus allowing the body to work as a unit rather than as individual parts.

Each individual, dependent on their lifestyle, will have a different baseline fascial tension. In the event of injury the fascia is guaranteed to be damaged because it is everywhere. Thus the fascial tension will increase. This will transmit tension throughout the body and is usually the culprit for distant [from the site of injury] pulling or stretching pains.

The complex path of the fascia also means that it is difficult for the excess fascial tension to be resolved. In many cases, the fascial tension remains long after the structure (e.g. the muscle or nerve) has healed. In these patients we commonly see repeated episodes of symptoms or very prolonged recoveries.

As osteopaths our treatment approach always looks to address the tension in the fascia as well as helping the damaged structure, i.e. the muscle, tendon, joint or spine. By working on both factors we usually see faster and longer lasting recoveries.

 

Muscle control

On many occasions in the clinic room we hear variations of the phrase “my muscles have seized up”. The question is how do muscles seize up? Well, read on to find out more.

Muscles are like soldiers, they do what they are told without question. This is important because a slight hesitation could mean the differences between catching a swing door or having a big bruise on your face! Within the body, there is a chain of command and unfortunately for the muscles they sit at the bottom of this chain. The command chain is:

Brain > Spinal cord > Nerve > Muscles and Joints

If the brain wants something done, it transmits a signal down the spinal cord which in turn relays the message to the nerves. They take that message to the muscles and tell them to contract. The muscle contraction moves the joint and completes the action. The joints and muscles work together thus alternating who commands the other. i.e. in the example above the muscles are telling the joint to move however if the joint feels it is being pulled to hard or fast it will command the muscles to relax..

Essentially muscle seize when there is a prolonged muscular contraction. This causes pain because:

1 – The muscles get tired (no muscle is designed to stay contracted for greater than a few minutes),

2 – The muscle contractions squeezes the veins and arteries that run through them. This reduces the local blood flow causing pain producing nerves to get irritated (as their nutrient supply is being affect).

So we know that muscles respond to commands. Therefore a seized muscle is the fault of one of the command levels and not the muscle itself. Examples of how different command levels can cause muscles to seize is shown below:

Command level = Brain; Example = Mental Stress.
The brain responds to stress by preparing the body for action. The muscles are put on high alert (meaning held slightly contracted), the blood sugar levels are raised to increase energy supplies, the sleep centre suppressed, etc… If stress is prolonged and continues for a few days, weeks or even months the muscles get tired because they are not designed to hold that prolonged contraction.

Command Level = Spinal cord; Example = Slipped disc.
A slipped disc can push against the spinal cord. The increased pressure causes the nerves in that area to fire erroneously. If the affected area is where the nerves to certain muscles come from, they will receive erroneous signals and contract. The brain cannot override this signal, as it cannot remove the pressure on the cord.

Command level = Nerves; Example = Inflammation or nerve trauma (e.g. a fall).
An impact can mildly damage a nerve. The nerve like any other tissue will swell. This swelling irritates the nerve and causes it to continuously fire. The muscles it supplies therefore remain contracted. The brain and spinal cord cannot modify the signal as they communicate with the muscles via the irriated nerve!

Command level = Joints; Example = Osteoarthritis or rheumatoid arthritis.
If the joints themselves are irritated, they can tell the local muscles to contract thus reducing their movement and allowing them to heal. The joints are clever because they too send a message to the brain explaining what they are doing. As a result the brain tends to help out, reinforcing the contraction.

It is for this reason that osteopaths rarely work on just the irritated muscle. i.e. the muscle is not the problem, it is usually the victim! We hope this article has been of interest and we wish you all a good health.