Our bodies are incredibly adaptable. They will get better at the things we do with them regularly, and have incredible self-healing abilities. But sometimes things don’t work quite as they should.
In this article, I’ll talk briefly about the various clever mechanisms by which our bodies repair and adapt to how we use them, and how that can inform our prevention and treatment strategies.
Muscle strength & length
If we lift heavy things, our muscles grow stronger to be able to do this more easily. This is commonly known as the ‘Training Effect’. As we use our muscles near the limit of their capacity, this creates micro-tears in the muscle. When the body repairs this minor damage, it lays down more muscle tissue. This makes the muscle larger and stronger so it is less likely to be damaged again.
On the other hand, when we don’t use our muscles for a period of time, they start to atrophy, gradually getting weaker. When a broken leg comes out of a cast after 6 weeks or so, it will be visibly smaller than the other leg. Where the muscles aren’t being used, there’s no need for the body to expend the energy required to maintain all that muscle tissue, so it gets broken down again.
In a similar way, muscles can grow longer and shorter, not just by contracting and relaxing, but also by increasing and reducing the number of sarcomeres (individual muscle units).
These adaptations can be very useful, but can also lead to imbalances in muscle length or strength, pulling on other structures and causing problems with our alignment.
Fascia is the connective tissue that is distributed throughout the entire body. It encases organs, muscles, and even layers and fibres within each muscle.
It grows by laying down thin fibres in all directions, like candyfloss. These thin fibres can be easily broken by movement, but where there’s no movement, more and more fibres build up. This means that parts that are supposed to move can be flexible, while parts that aren’t supposed to have more rigidity.
Of course, this also means that if we don’t move parts of our body very much, the fascia in these areas will start binding it together. Soon it becomes too thick to break just by moving it, causing lasting stiffness and restricted movement.
Chronic muscle tightness can restrict the flow of blood and other fluids, reducing the ability of the body to repair damage and remove waste products. They can also press on nerves, causing pain.
Common examples are tightness in the shoulders and arms restricting flow into the hands and wrists. Problems in the hand and wrist like RSI or arthritis can benefit from releasing the tension further up in the shoulder.
The repair process
Following an injury, the body initiates a healing process. This can be broken down into three stages: Inflammation, Proliferation and Remodelling. There are lots of complicated things going on in each stage, but here is a simplified explanation.
Inflammation brings white blood cells to the area to repair damage and prevent infection. Damaged blood vessels leak ‘transudate’, causing swelling which helps immobilise the area, reducing the chance of further damage.
This is where the wound is rebuilt with new collagen fibres and a new network of blood vessels. At this point the collagen fibres are disorganised and the wound is thick.
Remodelling (or Maturation)
This involves transforming and aligning the collagen fibres, and removing the various cells involved in wound healing that are no longer needed.
Imagine a lorry smashes into a building.
At first, the emergency services arrive and barriers are erected to keep people away from the area (inflammation) – this causes some disruption but is worthwhile as it prevents further accidents happening.
Next, the lorry and damaged parts of the building are removed, scaffolding is put up and the shell of the new structure is built (proliferation).
Finally, the internal and external repairs are finished neatly and the scaffolding is removed (remodelling/maturation).
Sometimes the repair process is slowed or stopped by infection, re-injury or various other causes. I often see chronic injuries where the patient is stuck in the proliferation phase, or there’s repeated re-injury and return to inflammation.
Taking regular breaks is important, not just for your body but also for your brain, focus and motivation. Ideally, take short breaks every 25-30 minutes and longer breaks every 1-2 hours. At least once a day spend some time socialising with others and get some time in nature.
Some postures are better than others, but no posture is ideal if held for long periods of time without break or variation.
Changing your posture regularly from sitting to standing, floor sitting and squatting is better than looking for one good fixed posture. Stand/sit desks or even treadmill desks are available but you can improvise with coffee tables, standing at kitchen surfaces and so on.
When you take your regular breaks, try switching up your working position as well for more variation.
What should you do during your breaks? Ideally you want to move in a way that is different from how you’ve been working. It’s best if you can find out what your own particular pattern of tightness and weakness is and do exercises appropriate to you. But if you’re sitting a lot, hamstring and calf stretches are great. Also try to go through a wide range of motion with your body, especially reaching your arms overhead.
I think Qigong is a really efficient approach as it combines postural alignment, a wide range of movements, stretches (especially of the fascia), breath work and mindfulness into simple exercises that can be done anywhere with no equipment.
Yoga can offer many of the same benefits. It will probably require more space, a mat and a change of clothes, and anything more than basic postures may need guidance from an instructor to perform safely.
Massage is widely available, but it’s important to find a type that suits you. Personally, I think painfully strong techniques are unnecessary, especially if you can use some of the other techniques below. Massage can:
• Release tension
• Break up small adhesions
• Open joints
• Improve blood flow
Increasingly supported by research, acupuncture is becoming increasingly mainstream. For the widest range of techniques you should look for a traditional acupuncturist. There are various mechanisms by which acupuncture can help with postural and overuse injuries, for example:
• Release body’s endorphins to relieve pain
• Improve circulation
• Release tight muscles
• Electro acupuncture can stimulate inhibited muscles
• Pull through the whole length of fascia
Usually only performed by acupuncturists, this acts like a ‘reverse massage’ by creating a vacuum in a cup over the skin. This slightly pulls apart the layers of fascia to:
• Decompress tissues
• Break up more significant fascial adhesions
• Increase circulation
Some kind of tool is used to gently scrape the skin. As with massage, it’s important to go gently to avoid creating too much inflammation and sending the injury back to the inflammation stage. There are modern names and versions of this traditional Chinese medicine technique, but they all largely do the same thing:
• Increase local circulation
• Break up adhesions and scar tissue
• Can be used where cupping is difficult, especially joints and bony areas
The greatest hurdles to preventing workplace posture and overuse injuries are cultural expectations and our work habits. Making small changes to our work habits is the most sustainable way to make lasting changes of this kind.