“You translate everything, whether physical or mental or spiritual, into muscular tension.” — F. M. Alexander (1869-1955)
“Suppose you’re interacting with an abusive boss. Without realizing it, you hold some part of your body still in order to manage your behavior during the confrontation. Tension in your jaw, throat, or shoulders keeps you from lashing out and losing your job. Tension in your hips or feet keeps you from storming out of the room. Similar tensions may arise when you deal with a relative’s expectations of you or during a disagreement with a friend.” — Mary Bond (b. 1942)
This chapter discusses a form of trauma that transforms muscles on a cellular scale: repetitive strain. The first half of the chapter introduces the concepts of bracing and persistent muscular tension and explains how to recognize them in your own body. The second half dives into the social and emotional aspects of muscle tension, laying out the relationships between long-term strain, pain, breathing, and submissiveness. Exercises are offered throughout to aid you in recovering from your bodily tension.
Recognizing Excessive Muscular Tone
It can be difficult to recognize the physical sensations of muscular strain. We become so accustomed to the pain and discomfort that they become effectively imperceptible, the same way we stop noticing unpleasant smells. It often takes a significant shift for us to notice how our bodies really feel. This happened to me after I strained my shoulder skateboarding. After the accident, a doctor prescribed me a dozen pills of meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with analgesic effects. After my first dose, I spent a few hours trying to analyze the effects of the drug. My muscles felt looser, and this quickly put me to sleep.
I woke up in the middle of the night to feel my hamstrings burning intensely, but they had not been stretched or exercised recently in any unusual way. It took me a few minutes to realize that this pain was their normal baseline condition. The strain had simply been unmasked by the NSAID drug. I had become utterly accustomed to the fact that this tension went to bed with me every night. I quickly realized that the problem was widespread. My hamstrings were chronically strained from overzealous exercise, but so were my hips, lower back, shoulders, and neck. That night, as I focused on gradually relaxing these body parts, I began to realize just how much I had been clenching them in a bizarre, contorted way.
This experience made me think of a lesson that my mother taught me. In my twenties, I developed a condition called plantar fasciitis that causes pain in the soles of the feet. She shared the method that she used to cure her plantar fasciitis, saying something along these lines: “Jared, it’s a medical disorder, but it comes from tension. You must be curling your feet into ‘fists’ at night. Right now, you are unconscious of this tendency, but it is possible to create awareness. Each evening before you go to bed, focus on the sensations in your feet and tell yourself that you plan to let the tension release and remain released as you sleep. Don’t allow your feet to remain clenched all night.” I had painful plantar fasciitis for a full year, yet after two nights of following her instructions, meditating closely on the sensations of tension, the pain in my feet was gone. Right there, lying in bed, I saw the connection and realized that this same lesson applied not only to my heels, but to my hamstrings, my heartache, my headache, and my whole body.
Tone, Hypertonia, and Hypotonia
Muscle tone, also referred to as residual muscle tension or tonus, is a continuous and passive partial contraction found in all skeletal muscles. It is often conceptualized as the muscles’ resistance to passive stretching during a resting state. Muscles receive continuous innervation from the nervous system ensuring that, even in rest, they remain in a semi-active default state. Thus, there is no complete rest in living muscle tissue.
Both extensor and flexor muscles are constantly kept activated, which helps us maintain muscle readiness. For instance, your bicep (a flexor) and triceps (an extensor) are both always in a state of partial contraction. They complement and support each other, no matter how much you try to relax them. Muscles on opposite sides of a joint contract in unison to stabilize the joint. This kind of antagonism occurs all over the body. It is beneficial and necessary.
Muscle tone is normal, but it can become too intense under certain conditions and begin to cause harm. Excessive tone is referred to as persistent muscle tension, muscle spasticity, or hypertonia. Hypertonic muscles can be found in crucial places throughout our bodies and are sources of chronic pain, stiffness, and premature frailty for every adult on the planet.
The cause of excessive muscular tone and the accompanying pain we experience is multifactorial. Hypertonia can be exacerbated by bad habits, wear and tear, genetic risk factors, and injuries such as car accidents and falls. However, most of the preventable muscular pain that we suffer is derived from a low-energy injury to the tissues known as repetitive strain. A repetitive strain injury is caused by repetitious tasks or by sustained awkward positions. Almost any job, profession, or chore you can imagine involves monotonous contractions through which muscles are subject to continuous or near-continuous strain. While repetitive strain may occur intermittently, its effects build up over years, resulting in chronic conditions.
Longstanding instances of muscular tension develop pathways in the nervous system that reinforce and perpetuate them. Simultaneously, an array of cellular changes takes place within muscle cells themselves, forcing them to contract permanently, forfeiting strength and flexibility. By becoming accustomed to such burdens, we force ourselves to carry them unknowingly. This is how we come to feel the weight of the world on our shoulders. We are all hauling an invisible, intangible load, forcing dozens of muscles throughout our body to push and pull against absolutely nothing.
Refrain from Muscular Bracing
Excessive tension in any posture is called muscular bracing, and it is pervasive. We brace muscles all over our bodies every day. Squinting and the raising and lowering of the brow discussed in Chapter 4 are also forms of bracing. Mostly, we brace as a reflexive response to things that make us worried or uncomfortable. Due to the false sense of security it can afford, some researchers have termed it “muscular armoring.” Bracing is intended to prepare us to quickly initiate offensive or defensive movements as when we protect the neck by keeping the shoulders raised. Small amounts of temporary bracing are healthy and can be helpful during rough and tumble play, contact sports, falls, or collisions. Unnecessary bracing, however, keeps the body “on guard” and rigid. Thus, when you need to move, you are forced to overcome your own resistance, forfeiting grace and coordination.
Keeping our muscles tense makes us feel in control but is a dysfunctional coping tactic. People generalize bracing from physical challenges to intellectual and social ones. This is why some experts refer to instances of bracing as “neurotic holding patterns.” For instance, we tense during social encounters, especially confrontational ones. People tense their bodies during standardized tests, social gatherings, and public speaking. This hinders their performance by interfering with productive efforts and by causing discomfort and autonomic stress. As we will discuss in Chapter 22, the sensation of fear in your gut and the sensation of having your heart in your throat are also manifestations of chronic bracing.
Imagine that you are standing alone in a strange, dark parking lot with nothing nearby to grab ahold of. You hear someone yell, “Brace yourself!” What pose do you strike? Whatever pose you imagined is likely one that you commonly adopt during stress and startle. The muscles responsible for this pose are the ones you brace most often, and so they are likely currently in the process of becoming locked up. Explore this a little further using the first unbracing activity below.
There are cyclical relationships between stress, bracing, and arthritis.1 Some specialists refer to forms of bracing as “prearthritic postures.” Joints can only be braced for so many years before they become inflamed and degenerative. My mother has osteoarthritis in her hands. Some of her knuckles are larger and more deformed than others. She firmly believes that the most affected knuckles are those that she braced more during stress over decades. An extreme example is the “raised-arm babas” of India. These are men who, for spiritual reasons, have decided to always raise one arm in the air. Over the years, their shoulders become stiff as a board and completely useless. As you look over the table below, think about which bracing patterns you use.
Table 5.1: Common Forms of Bracing that Compromise Muscle and Cause Pain
Bracing belongs to a more general category known as dysponesis, or the misdirected use of energy in the musculoskeletal system, of which unnecessary tensing of the muscles is just one example.2This wasting of energy is destructive. For example, dentists and orthodontists make particular note of jaw clenching, teeth grinding, and tongue tension because those movements push the teeth out of their optimal alignment. In Chapter 13, we will discuss how bracing the back pushes the spine out of alignment. Muscular bracing is a factor in almost all joint disorders and is responsible for carpal tunnel, temporomandibular joint disorder, tennis elbow, and countless others. I believe that most chronic injuries, despite the fancy and distracting terms used by physicians, start with tension caused by bracing.
One way a mammal remembers that it just glimpsed a predator is by crouching down and becoming very tense. We often use muscular tension to keep something in mind. When I need to remember something, or when there is an urgent need to do something that cannot be done right away, I become tenser. The specific part of my body necessary to carry out the task is often where the tension manifests. For instance, I will try to remind myself to write down a thought by tensing my fingers as if I were gripping a pencil. Recognize when this happens to you and try not to use tension as a mnemonic aid.
We tend to be negligent of excessive increases in muscle tension even when we are performing simple tasks. We tighten muscles that are not involved in what we are doing and then keep those muscles tight even after we finish. If the action is built into your job or daily routine, you can start by improving the ergonomics of your workspace or taking more regular breaks. You can also teach yourself to selectively calm muscles that you are not actively using for the task at hand. The key is to constantly and creatively alter your body posture so that unused muscles are engaged and overused muscles are given a break.
Microbreaks Allow Muscles the Short Rests They Need
Not all muscle tension is bad. After all, there is no way to exercise without tensing your muscles. But bracing is very different from healthy exercise because it does not include tiny rest periods called “microbreaks.” Sometimes, all our muscles need is a few seconds, or even just a few fractions of a second, without being held taut. When the electrical activity of muscle is tracked with electrodes, these moments of downtime show up as “electromyographic gaps”—brief intervals during which the muscles slacken and relax. They are essential.
For example, every step you take involves significant exertion as you push off against the ground. However, as one leg takes over, the other is given a break during the time it takes to swing it forward again. That respite allows the muscles to “regenerate” and prepare for the next step. If you didn’t have this microbreak after every step, walking more than a few hundred meters would be difficult. In much the same way, all the muscles in your body require microbreaks.
Without momentarily reverting to a relaxed baseline tone, muscles cannot replenish and unwanted processes ensue. You have probably noticed the difference between fatigue caused by sustained bracing (hyperfatigue) and fatigue caused by exercise that contains microbreaks. The former aches and is unpleasant while the latter is both soothing and exhilarating. Indeed, the most important factor in building healthy muscle is to allow it to relax. The more relaxed your muscles are at rest, the more quickly they recover from exercise. This is why relaxed muscle responds dramatically to training, whereas tense muscle responds sluggishly. Whenever you are not using a muscle, allow it to go limp. It almost seems slothful, but it’s not; it’s the way you should live your life.
Intermittent breaks and rests can help you disrupt long periods of unnecessary rigidity. Naps can work wonders in this regard. During sleep, and especially during REM sleep, changes occur in brain signaling that cause vastly reduced muscle tone, known as atonia. This is one reason why short (10- to 20-minute) naps can be so invigorating. Short naps can also restore alertness, mental performance, and learning ability.3As you nap, you are even giving your heart a brief rest, which may be why naps have been associated with reduced coronary mortality.4 Just remember that naps of 30 minutes or more often lead to sleep inertia, impaired alertness, and tiredness. When you feel depleted, after the gym, after an upsetting episode, or whenever you start to feel stiff and sore, set your phone’s timer for 20 minutes and allow yourself a recuperative power nap. Even if you don’t fall asleep, just giving yourself a few minutes to lay down during the day provides a reprieve that can be highly beneficial in the long term.
Why don’t we allow ourselves the microbreaks that our bodies call for? Often, it is due to social pressures. Propriety and intimidation related to the status hierarchy cause us to brace, then feel guilty about relaxing. Chronic submissive signaling disallows you from claiming the microbreaks that your muscles need. When at a dinner date or in a board room, we don’t give our neurotic holding patterns a single second of downtime. Well-composed people give various muscles involved in social displays microbreaks. In fact, we can conceptualize composure as skill in microbreaking. Of course, even our breathing muscles require microbreaks.
Unbrace Your Exhalation with the Passive Exhale
Diaphragmatic bracing is the central feature of distressed breathing and a core symptom of trauma. Remember Activity 5.1, in which you held your hand like a claw and kept it tight as you opened and closed it? This is exactly what you are doing with your diaphragm when stressed. This kind of bracing could be an excellent exercise for the diaphragm if it only lasted for 30 seconds at a time, but we tend to do it for hours or days at a time. Continuously over-tensing the diaphragm and other respiratory muscles reduces their strength and range of motion, resulting in rapid shallow breathing.
The inbreath requires muscular contraction, but the outbreath does not. It is not necessary to do any muscular work during exhalation. The positive pressure of air in your lungs is enough to create the force. This effortless return of the diaphragm to its resting position is called elastic recoil. The air naturally wants to be pressed out of your lungs as it would from a deflating balloon. Unfortunately, most of us keep our breathing muscles tense during exhalation, and this ensnares us in a state of fight or flight. Stopping this requires awareness and practice. To perform a passive exhalation, all you need to do is let your breathing go limp while you are exhaling. After a minute or two of practicing this, you should actually be able to feel the diaphragm simmer down.
Imagine that for some reason you are responsible for driving a car up and down a low-grade hill, over and over again. For a while, you keep the engine on during the descent, but since the descent lasts for a few minutes, you realize that you can turn the engine off, put the car into neutral, and just let it coast without having to touch the brake, the accelerator, or the wheel. This is what a passive exhalation should feel like. After you finish your inhale, just take the keys out of the ignition.
Your inhalation is also braced; it is just much harder to notice. An inhalation requires the contraction of the diaphragm down into the gut to create the vacuum that draws air into the lungs. But this contraction is often braced beyond what is necessary, like the opening of a tightly clenched hand. This bracing impedes belly breathing and pulls the air into your upper chest. If you can interrupt it during an inhalation, you will feel your belly coming uncoupled from the bottom of your rib cage. The passive exhale will help you with this uncoupling. As you learn to sense your diaphragmatic tension during the exhale, you can teach yourself how to lessen the unnecessary tension occurring during the inhale. Once you have done this, your breathing will become much more efficient and less labored.
It is worth mentioning that aside from bracing the inhale during the exhale, many of us also brace the exhale during the inhale. This is when we keep the thoracic muscles responsible for exhalation clenched while breathing in. This is also completely unnecessary. Spend some time trying to notice these effects in your own breathing.
After performing the passive exhalation for a few days, a sense of irritation in your chest will dissipate. When this discomfort and inflammation is totally gone, you will feel a profound sense of relief. The passive exhalation is so important that I consider it the fifth tenet of optimal breathing. Expect it to increase the benefits you get from paced breathing. The passive exhale is such a fundamental routine that it is actually a reflexive response that all mammals use after a stressor has come and gone. Can you guess what it is?
Once a stressful episode has resolved, all species of mammal exhibit “deep spontaneous breaths.” They inhale very deeply so that they can then exhale passively to reset and restore equilibrium in their autonomic nervous system. We know this as sighing. Even mice sigh, and I believe that, like us, they do it to provide the diaphragm with a microbreak. However, if you provide your diaphragm with a microbreak during every exhalation, you won’t feel the need to sigh anymore. The trick is to learn to exhale limply even after a shallow inhalation. Sighing is very frequent in people diagnosed with panic disorders. I used to sigh constantly, but after diaphragmatic retraining, I rarely catch myself doing it anymore. Master the passive exhalation because it is highly de-traumatizing.
Persistent Muscle Tension Creates Trigger Points
Excessive muscle tension and the absence of microbreaks eventually produce “knots” that can be felt under your skin. They occur all over the body. They are often palpable, raised nodules tender to the touch, producing a dull, aching pain when pressed firmly. In the medical literature, these knots are referred to as trigger points, trigger sites, or spasms, and they cause reductions in muscle mass, flexibility, strength, and endurance.5 They are hyper-irritated spots in taut bands of skeletal muscle fibers created by chronic muscle overload. They usually involve a local contraction in a small number of muscle fibers within a larger muscle bundle.6
Many scientists refer to these knots as “myofascial trigger points.” The “myo” is derived from the Greek word for “muscle” while “fascial” refers to the tough outer lining that keeps muscles in place (fascia is a type of connective tissue that forms a continuous scaffold around all the muscles and tendons in the body). Myofascial trigger points are small patches of muscle and fascia that pull together in an isolated spasm. They are different from whole-muscle spasms like a charley horse or cramp, which are more transient, have a sudden onset, and involve hard contraction of the entire muscle. Although they can contribute to cramping, trigger points are different in that they are long-lasting, have a gradual onset, and involve partial contractions in small portions of the muscle.
In addition to their immediate detrimental effects on muscle function, trigger points often cluster together and pull on tendons and ligaments, causing joint problems and “deep” pain. The tension they cause at joints can result in clicking, popping, and grating sounds. Over time, they can contribute to bone spurs, pinched nerves, and arthritis.7 Trigger points can be seen in greatly magnified pictures of muscle tissue like the one below. They look like bunched-up distortions in a web-like matrix.
Figure 5.1: Knot of partially contracted sarcomeres in the muscle fiber from the leg of a dog at 240x magnification. Compare with the normal sarcomeres above and below it. This knot looks like an active contraction but has no electrical (EMG) activity and is, thus, stuck in partial contraction. Reprinted with permission from Simons and Stolov (1976).
Dr. Janet G. Travell, MD (1901-1997) is generally recognized as the leading pioneer in trigger point diagnosis and treatment. It has been said that she “single-handedly created this branch of medicine.”8Travell, who was the White House physician during the Kennedy and Johnson administrations, emphasized that trigger points are demoralizing and devastating to quality of life. She called them the “scourge of mankind.” Advanced-stage trigger points are the worst. They usually present in clusters, are the most painful, and involve highly warped muscle fibers with large numbers of molecular aberrations. In reality, most people are practically covered in trigger points from old injuries, bad posture, poor workout techniques, and bracing.
Muscle Tension Develops at the Molecular Level
To better understand trigger points, we need a little more background on muscles themselves. Muscles are composed of fibers, which are themselves made of smaller fibers. The thinnest of those hold sarcomeres, in which contraction takes place. A sarcomere is a microscopic structure built from two kinds of filament-like molecules: actin and myosin. Actin and myosin form interdigitating strands that can be activated. When active, they move past each other, quickly creating contractile force.
Illustration 5.1: A. Muscle made of fibers, containing sarcomeres; B. Microscopic view of contracted sarcomeres in a muscle myofibril. An actual trigger point may contain dozens of these tiny knots.
Millions of sarcomeres must contract to perform even the smallest movement. After they contract, the sarcomeres relax when their actin and myosin strands are uncoupled from each other and pull apart. In healthy muscle, actin and myosin wait patiently in a relaxed, decoupled state until an impulse from the nervous system tells them to pull past each other again. In unhealthy muscle, they are stuck. Many specialists believe that trigger points start to form when overuse causes actin and myosin to become fixed in an interlocked position. This interlocking puts the muscle into a static state of contracture, in which the strands no longer separate and relax.
Illustration 5.2: A. Relaxed sarcomere on top and a contracted sarcomere on the bottom with actin and myosin visible; B. Myosin curls like a finger, pulling on actin and allowing them to slide past each other to create muscular movement; C. Human neck and shoulders covered with clusters of trigger points.
Trigger points originate from a few different sources: (1) sustained low-level contraction, 2) sudden muscle overload, (3) “eccentric” contraction when a muscle stretches and contracts simultaneously, and (4) gross trauma or injury to the muscle. Regardless of the cause, trigger points slow blood flow to the muscle and cause oxygen deprivation at the affected site. The reduced blood flow then causes sarcomeres to contract further, constricting the surrounding capillaries. Capillaries normally supply the muscle with blood, so when they constrict, it leads to reduced circulation or ischemia that impairs many cellular processes.
Without blood flow, chemical waste products from muscular activity start to accumulate. Eventually, the waste stimulates pain receptors in nearby nerve endings, sending pain signals to the brain.9Active trigger points demonstrate an unusual biochemical mix not seen in healthy tissue. It is an acidic milieu containing increased levels of proinflammatory, contractile, and pain-causing substances. And remember, we draw our very breaths with muscles that are affected by these symptoms.
Muscle Shortening and Scar Tissue
A muscle can change its resting length to adapt to the length at which it is habitually used or positioned. Muscles usually become shorter due to prolonged contracture. This is known as adaptive muscle shortening and places the muscle in a state of partial contraction. It is another pervasive clinical finding that affects every person who has ever lived.
People confined to long periods of sitting exhibit debilitating shortening of the lower back and hip muscles, especially the hip flexors. Similarly, wearing high-heeled shoes causes prolonged plantar flexion of the foot, which results in adaptive shortening of the soleus muscles. Constant squinting shortens the muscle fibers of the orbicularis oculi, narrowing the eyes. Straining the sneer causes the muscles that lift the top lip to shrink, making the face appear hideous. When the muscles in your knees and ankles shorten, they leave you vulnerable to sprains and tears. Holding a hunched neck posture leads to shortening of the sternocleidomastoid and other muscles in the front of the neck, making it very difficult to stop hunching because the decreased length of these muscles pulls the head down. As Chapter 19 will explain, bracing the muscles surrounding the genitals may play a role in sexual dysfunction. There are examples of adaptive muscle shortening in muscles all over our bodies.
The pressure from prolonged contracture pulls on tendons, straining them and distressing the joints when they move. Next, ligaments and joint capsules retract. These changes perturb nerve endings within the muscles and joints, causing deep-seated pain. Muscle shortening also increases wear and tear, contributing to inflammatory and degenerative changes such as tendonitis, fasciitis, bursitis, and osteoarthritis. Many different tissue types are damaged by strain, including articular cartilages, connective tissues, tendons, fascia, menisci, ligaments, and spinal disks.
Adaptive muscle shortening can be made worse by the accumulation of scar tissue. Scar tissue is a very tough, inflexible, fibrous material that binds itself to strained muscle fibers, attempting to draw the damaged fibers together. The result is a bulky mass of stiff tissue surrounding the site. In some cases, it is possible to feel and even see this mass under the skin. When scar tissue adheres to muscle fibers, it prevents them from sliding back and forth properly, limiting the flexibility of a muscle or joint.
Scar tissue tends to shrink and deform the surrounding tissues, diminishing strength and making the body feel heavy. It tends to adhere to nerve cells, leading to chronic pain. Existing research has found that scar tissue is weaker, less elastic, more prone to future re-injury, and up to 1,000 times more pain-sensitive than normal, healthy tissue. This results in chronic pain that, under most circumstances, lasts a lifetime. In people who brace the most, these effects create visibly apparent postural distortions.
Excessive Tension is Debilitating and Constrains Your Physique
Muscles encumbered by trigger points and adaptive shortening can be conceptualized as dormant muscles. This is so because they are difficult to recruit, don’t move with the rest of the body, and are starved of blood. Dormant muscles cannot recover adequately after a workout and are resistant to growth and strengthening because they can never fully relax, and thus can never fully heal. As long as they are under constant self-imposed strain, they will continue to grow harder, more fragile, and decrepit. Scrunched-up muscles crumple your body and cause it to buckle under every movement.
Pregnancy itself does not necessarily adversely affect a woman’s physique. Rather, it is the months of prolonged bracing, absence of postural variety, and limited range of motion that can accompany the later stages of pregnancy for some women that have prominent, long-lasting effects. Moreover, although some of the natural variation in physique between humans is due to exercise, genetics, and exposure to testosterone, much of it can be attributed to differences in dormant muscle that arose due to bracing during stress.
You have significant untapped reservoirs of muscle in your body that correspond to areas you brace and have been bracing for decades. For example, think about the hunch you probably have in your neck. Starting at birth, you had a natural tendency to straighten the cervical vertebrae in your neck, stacking them in a straight line. That straight-necked, upright posture is optimal. But social pressures can affect how we carry our heads and necks; the less safe, stable, or welcoming your childhood environment was, the more you were conditioned to hunch over, communicating modesty or submission. The standard submissive neck posture is to stoop over, jut your chin out, and tilt your head back. All of those changes reduce your height and help you appear guarded. But they also introduce a slant in your neck, which is an inefficient way of stacking vertebrae against the force of gravity. The excessive tension that develops leads to the proliferation of trigger points, and those, in turn, cause muscle dormancy in your neck, shoulders, and chest, and from there on down the spine.
Chapter 13 will detail exactly how to reclaim your neck and regain its flexibility and full range of motion. But the neck is just one example of a reservoir of muscle that has been suppressed that you can tap into. These reservoirs can be found all over our bodies. Take your clothes off and look in the mirror. Any body parts that don’t appear nubile and supple have great potential. If all of our muscles were brought completely out of dormancy, we would have the physiques (if not bulk) of elite athletes.
Injuries Lead to Muscular Bracing
Injuries contribute to and interact with bracing. After getting hurt, individuals often try to avoid experiencing pain by tensing the area surrounding the site of injury. When someone sprains their ankle, they unintentionally contract many muscles in the ankle, setting it in a fixed, defensive position. This is intended to protect the injury. In fact, it is known as “splinting” because it acts as a splint to immobilize the joint. Unfortunately, it also deprives the muscles of the rest, oxygen, and nutrients they need to heal. As a result, splinting worsens the pain in the long term by overtaxing the muscles involved. This happens partly because we tend to breathe extremely shallowly whenever we injure ourselves (because as you know, shallow breathing causes bracing). This is why, whenever I experience an injury, I pull out my breath metronome immediately.
Injuries almost always result in some form of persistent muscle tension. Even major medical procedures can contribute. Iatrogenic pain is a term referring to pain caused by medical treatment and is especially common with the use of braces, slings, casts, and surgeries. Immobilizing a broken forearm with a cast can easily lead to frozen shoulder syndrome, in which a group of deltoid muscles is barred from moving through its normal range of motion as tension gradually mounts.
I had a melanoma removed from my shoulder blade in my mid-teens, and I recently found that I have a series of muscular knots under the scar from bracing the area. My brother received a large shot in the quadriceps during his appendectomy 20 years ago, and he says the same area troubles him often. Think conscientiously about past injuries, medical procedures, and other forms of trauma, identifying how they might be causing you to brace or tense muscles even today.
Stress and muscular tension also make us more susceptible to physical injury because tense muscles fail and tear under excessive force, whereas relaxed ones are more resilient. The muscles strained by sitting in a fixed position at a computer for eight hours a day are the most susceptible to damage from a fall or car accident. Thus, injury can lead to bracing, and bracing can lead to re-injury.
Tense muscle tissue can be conceptualized as an injury or as a trauma even if there was no precipitating accident. The word “injury” is defined as physical damage to a biological organism. The word “trauma” is defined as an abnormality in an organism’s tissues usually caused by injury. By these definitions, any form of persistent bracing, and the trigger points stemming from it, are both injurious and traumatic. Unfortunately, once they get bad enough, they can poison us emotionally.
The Link Between Tension, Pain, and Negative Emotion
“These mountains that you are carrying, you were only supposed to climb.” — Najwa Zebian (b. 1990)
Physical pain is an adaptive, evolved mechanism. The pain from a cut or burn informs us that our bodies are suffering damage. It gives us built-in motivation to withdraw from the source of harm and learn to avoid it in the future. But what about muscular pain, also known as myalgia? In contrast to physical pain, myalgia has more to do with restricting movement. It compels us to refrain from specific motions that might be damaging or harmful—it tells us not to over-stretch a strained muscle, not to bend a weakened joint too far. It also tells us when we approach the limits of our healthy range of motion, giving us important feedback about what our bodies can and cannot do. This would have restricted aging hunter-gatherers from movements that had proven necessary and probably also helped them save energy.10 Due to the negative emotions it creates, however, muscular pain is destructive to our well-being.
Suffering is not abstract or conceptual. It is embodied in the pain circuits of your nervous system. Nociceptive pain is pain caused by the activation of pain receptors known as nociceptors. Nociceptors respond to either thermal (e.g., heat or cold), chemical (e.g., inflammatory), or mechanical (e.g., crushing or tearing) sources of harm. They come in three general types: visceral (organ), superficial (skin), and deep somatic pain (muscle). Deep somatic pain is triggered by the activation of nociceptors in ligaments, tendons, bones, blood vessels, fascia, and muscles. It is dull, aching, and difficult to localize. Strangely, we become so accustomed to it that we don’t consciously notice its presence until a painkiller takes it away. Drugs like heroin and ecstasy induce intense euphoric states, largely by alleviating this pain.
Long-term bracing of our body parts and “chakras” causes deep somatic pain that poisons our minds. The toxicity is especially apparent in extreme examples, such as people with chronic pain. People living with long-term pain of any kind frequently display psychological disturbances and exhibit elevated levels of hysteria, depression, and hypochondriasis (the “neurotic triad”). Chronic pain patients also generally have low self-esteem11 and higher-than-average levels of anxiety, fear, and anger.12 In fact, somatic pain is known to interact with psychogenic pain, which arises from social rejection, defeat, heartbreak, and grief. These two forms of pain comingle and exacerbate one another.13 There is no telling how much the undiagnosed chronic pain from our muscular tension desecrates us emotionally.
The experience of pain is transformed by paced breathing. Try it the next time you feel either physical or psychological pain. It takes all the edge off. One of the quickest and easiest ways to create massive amounts of non-damaging pain is to submerge an arm or leg in ice water. Without paced breathing, this is excruciating for the two to five minutes it takes for the body part to go numb. For me, it is usually so bad that I end up pulling my body part out of the water 4 or 5 times before I go numb. The discomfort is so intense that I practically involuntarily retract my limb. With paced breathing, however, the pain is tolerable and I have no inclination to pull it out of the ice. When we allow pain to control our breathing rate, we also allow it to control our behavior.
Pain signals from nerve endings in tense muscles bombard our brains throughout the day. Those signals are relayed to brain areas involved in fear and grief, such as the insula, the anterior cingulate cortex, and the amygdala. These brain centers integrate pain input from anatomical landmarks all around the body to help compute the appropriate level of pained reactions: stifling, agitation, rage, dread, submission, and distressed breathing. Thus, we become tense, breathe shallowly, then respond to the ensuing discomfort with more tension.14 This cycle is depicted relative to other concepts we have addressed thus far in the diagram below.
Figure 5.2: Distressed Breathing Cycle
We feel like the emotional pain we experience originates from the content of our thoughts. But this is backward. Negative thinking is driven by the inability to take a full breath and by preexisting pain in our muscles and related tissues. These are the ultimate causes of our persistent background unease. Our thinking becomes oppositional only when it is imbued with pain. Tense muscles are leeches latched on to our souls. I believe that trigger points in our faces, spines, and internal organs are the physical embodiment of melancholy, world-weariness, ennui, and angst.
Don’t Let Your “Pain-Body” Control You
Spiritual author Eckhart Tolle has elaborated on a concept he calls the “pain-body.” According to Tolle, the pain-body is the accumulation of negative life experiences that create affective pain and discomfort.15 Tolle discusses how it is intrinsically tied to the ego and how environmental circumstances that assault our pride amplify the pain-body and its negative effects on our behavior. He advises that people “live in the present moment” so that they can recognize when the pain-body shifts from being dormant to being active. When it becomes active, it makes us act in desperation, distorting our interpretations and judgments and causing us to do things that we later regret. I believe that his assessment is correct and that a considerable proportion of the pain-body corresponds to deep somatic pain from the cumulative effects of muscular bracing. I also believe that the pain-body becomes active when latent trigger points become active.
Specialists traditionally categorize trigger points as either active or latent. An active trigger point is painful, whereas a latent trigger point is not. Latent trigger points, which are far more numerous, generally cannot be felt unless deep pressure is applied. Latent trigger points can be activated by muscular strain, especially after an abusive workout, a sudden shock, or a long car ride. Alternatively, they can be activated by shallow breathing, which is why facial tension, headaches, and back pain coincide with stress. Consider the unpleasantness of public speaking, for example. As we stand in front of a room of people with our eyebrows raised, our eyes squinting, our neck tense, our shoulders elevated, our stomach in knots, our vocal musculature taut, and our back stiff, latent trigger points in all those muscle groups become active. The resulting pain derails us, undermining our presentation and diluting our message. When latent trigger points become active, we become an inferior version of ourselves.
The pain can also provoke us to lash out. Even rats exhibit pain-induced aggression. If you place two rats on a metal grid through which they receive an electric shock, they will attack each other ferociously when the shock is delivered.16Hundreds of similar studies suggest that mammals have a tendency to displace aggression, reallocating blame for their physical pain toward other nearby animals.
This is consistent with Tolle’s account. He explains that the pain-body is born of and enticed by pain. In his words, it is a “psychic parasite” that wants to provoke pain in others and then “feed on the ensuing drama.” He says that people’s pain-bodies possess them, causing them to do bad things that they would never otherwise do, and that they react to the pain-bodies of others with either revulsion or aggression.
I believe that we constantly provoke one another’s pain-bodies (and latent trigger points) to establish social hierarchy by determining who has been debilitated more by chronic stress. Do we all do this constantly? Yes. Are we evil for doing it? No. Remember, competing for social dominance is an innate system for determining which animal has priority over resources. It is a highly preferable alternative to actual violence and represents the mammalian brain’s imperfect attempt at creating order. A considerable step toward becoming free of this evolutionary design flaw is to unburden yourself from the cyclic relationship between distressed breathing, bracing, and pain. Use Exercise 5.2 to start breaking the cycle.
The Link Between Distressed Breathing and Muscular Tension
Scientists have documented that average muscle tension, especially tension in trigger points, increases during transient stress. Muscles will tighten up during a paper and pencil examination or during and after watching a horror film. The same is true for more chronic sources of stress, like long-lasting personal or work-related stress. Stress, and more specifically heightened arousal of the sympathetic nervous system, increases the risk of repetitive strain injury—especially during repetitive tasks.17 This means that if you are stressed while sitting at the computer for hours, your body is fast at work, cementing your computer posture into your joints.
Stress causes bracing via distressed breathing. Numerous brain pathways connect shallow breathing to muscle tension.18 This is a hardwired connection that prepares mammals for physical conflict. As our breath becomes shallow, we brace more in preparation for fighting.19 Relaxed breathing, by contrast, causes us to brace less and experience less pain. So, unbrace your diaphragm and let your outbreaths become passive and limp.
Since childhood, my hands used to hurt and cramp after just a few minutes of uninterrupted writing or drawing. Since I started breathing diaphragmatically, however, my hands do not hurt or cramp even after an hour of pushing a pencil. When I do manual labor all day with friends, they all tell me the next day that their bodies are sore, but I notice that mine is not. This is because the way that I breathe now, after diaphragmatic retraining, is conducive to microbreaking. As you pursue the five tenets of diaphragmatic breathing described thus far, you will find similar examples in your own life.
Find Calm Through Visual Imagery
Imagine finding yourself alone on an inflatable raft following a nasty shipwreck. Your mind is racing, playing out the worst possible scenarios. You glance at the few remaining tins of food, realizing there is no way to know how many days you will be out on the open sea. The thought of starvation brings on a wave of panic and bodily constriction. Then, you hear a voice in your head: “Conserve your energy or you are going to die.” Imagine at that second, you have an epiphany. You recognize panic as an energy consumer that will only increase your caloric requirements. You realize that you needed a life-and-death experience to see how your familiar neuroticism is simply a metabolic state that can be adjusted. “Wow,” you say. “I’ve been carrying this frenetic tension for so long, but I can just let it go.”
Picture yourself laying your head down on the plastic surface of the raft and making a concerted effort to placate your hectic reactivity. Let your body descend to an absolute minimum of activity. Your face goes lax, your heart beats slowly but steadily, you are breathing just enough to get adequate oxygen, and every muscle you aren’t currently using unwinds. You let yourself be still as the rhythm of the ocean lulls you. Now, this was an extreme example, but it was meant to help you see that stressing out on a survival raft is counterproductive. Similarly, your baseline level of stress today is almost certainly out of proportion to your immediate physical challenges.
There is no need to return to that raft. That was an intentionally provocative example. Instead, come up with positive imaginary. In mine, I am a man foraging on a sub-Saharan savannah 200,000 years ago, well before humanity split apart into distinct races. I am moving and working constantly, but at the same time, I am impossibly calm, cool, and level-headed. Most importantly, this version of me allows every muscle in his body to go lax unless it is needed for a particular motion. With hunger and nutrition major concerns, it would have been imperative for our ancestors to conserve metabolic activity, doing only what is required. So, this Jared walks and talks with incredible ease. His stride is fluid, his face is placid, and his posture is perfect yet effortless. I would like to encourage you to spend some time creating similar mental imagery that is compatible with calmness.
Stress causes bracing via distressed breathing. Numerous brain pathways connect shallow breathing to muscle tension.20 This is a hardwired connection that prepares mammals for physical conflict. As our breath becomes shallow, we brace more in preparation for fighting.21 Relaxed breathing, by contrast, causes us to brace less and experience less pain. So, unbrace your diaphragm and let your outbreaths become passive and limp.
Scientists distinguish between catabolic states, in which energy is burned for movement, and anabolic states, in which energy is stored and used to construct necessary molecules like proteins. The parasympathetic system uses anabolism during periods of rest to build the body back up, leading to revitalization. The sympathetic system uses catabolism to burn energy for fight or flight. Catabolic breakdown that goes on too long consumes our energy stores, including important proteins, leading to depletion and corrosion. When we become stuck in anxious, stressed, or hyperactive states, catabolic pathways within our cells become overactive and place huge, unnecessary demands on our body’s other systems. Stress even burns away muscle, making it harder to stay fit and lean. We are lumbering cellular survival machines burning ourselves to the ground because we are stuck in overdrive. You need to let your body relax so that you can stop burning parts of the ship.
If you need a role model for this kind of calm, look to those who naturally breathe with their diaphragm: toddlers. I have been fortunate enough to spend time babysitting my friends’ children. One day with an imperturbable two-year-old girl was especially transformative for me. She was so sweet and pacific that my high-strung personality seemed likely to scare her. So, as we passed blocks back and forth, I worked on getting closer and closer to her level of wide-eyed peacefulness. Now, I often pretend that it is my responsibility to be a calming influence on others the way she was for me.
Some people don’t want to be calmer. They enjoy being energetic and intense. The truth of the matter is that being energetic and being calm should be two sides of the same coin. Without the ability to dole out microbreaks, exhilaration turns into exhaustion in a matter of minutes. If a person cannot balance intensity with periods of rest, then they will burn out like a sprinter running a daily marathon.
Never Be Afraid of Being Too Calm
One of the greatest barriers to relaxation is the instinct to keep alert, on edge, and ready to act. Some people are afraid that becoming too calm will result in tragedy. It is true that increasing the output of the stress system might indeed help you fight or take flight if your challenges are immediate and very severe. However, if you don’t know when the challenge will arise, then you are better off relaxing completely. This is because a chronically activated sympathetic stress system becomes a detriment in a matter of hours.
For instance, if you were convinced that someone or something was going to threaten your life in the next few minutes, maybe you would need to activate the sympathetic stress system. This is because it just might free up enough energy or accentuate a reaction that saves your life. However, if you have no grounds for assuming that a physical threat could take your life in the next hour, then you are better off turning the stress system all the way down and allowing your muscles and mind the rest they need to stay strong. Even a mixed martial artist would benefit from being as calm as possible up until minutes before entering the ring. So, stop holding your breath, stop clenching your diaphragm, and allow yourself to let go of the suspense.
Very few of us have life-threatening challenges. Most of the challenges we stress over are far from life or death and do not depend on adrenaline or split-second timing. Given our body’s design and the nature of our modern challenges, the best strategy by far is to develop a relaxed, low-energy disposition. Know that even when you are calm, you can still be strong, quick, and nimble. Let this knowledge validate your confidence in relaxation.
Don’t think of resting as something you have to earn, and never feel guilty for taking downtime. We are animals. Breaks are not a reward; they are a necessity.
Bracing Is Submissive
Another reason we are afraid to let go of our bracing patterns is that we use them as submissive displays. During an encounter or confrontation, the less dominant individual will brace more. It is a visible proclamation that exclaims, “Look, I’m wasting energy, handicapping myself during this encounter. Don’t attack me; I’m not looking to fight.” When we engage in this “social paralysis,” we strain many muscles and drastically restrict their range of motion. The more serious the situation, the stiffer we become.
Submissive people adopt tight, symmetric stances, often pinning their arms tightly to their sides. They minimize the amount of space that their bodies occupy by collapsing themselves inward as much as possible and then freezing in place. When you brace your muscles in this way, you submissively close yourself off from the world. Dominant postures, on the other hand, emerge naturally when bracing is at a minimum. Once you stop bracing, you take up space. Dominant people appear the least stifled in their body movements. Their motions are fluid and open. This is why expanding your range of expressive movement will help you convey dominance. So will asymmetry, openness, and repose in your body and limb positions.
Relaxed physical bearing and relaxed body language are highly characteristic of dominant primates. Dominant monkeys and apes are even-tempered and collected, while subordinate animals are uptight and agitated.22 Of course, none of us want to think about dominance and status when trying to relax. Still, it should be reassuring to know that your unbraced and relaxed posture is the antithesis of inferiority in primates. Whether you are at a party, at work, or passing time with friends and family, be the most carefree, laid-back, slack-muscled monkey you can be.
Find Calm Through Corpse Pose
Another way to confront tension is through physical relaxation techniques. An indispensable one is “corpse pose,” or shavasana. Corpse pose is a recumbent yoga pose in which you lie on your back and focus on the total relaxation of your muscles. Although the name is a little morbid, it drives home the reality that you must embrace some aspects of death to truly rest. You must retire certain defensive muscular contractions that are intended to keep you alive. While lying down in shavasana, focus on retiring all the defensive contractions that you use while upright, including those that keep you from falling while walking. Most people take those contractions to bed with them every night; this is a chance to let them go.
When I began practicing it, I found corpse pose to be a chore. I was so restless that trying to lie still was stress-inducing. Paced breathing changed my experience completely. As you confront individual pockets of tension, the long, slow breaths dismiss and discharge them one after the other. A week of practicing paced breathing while in corpse pose for just five minutes a day is profoundly transformative. A hot bath can do much to reduce muscle tension and increase blood flow,23 so use corpse pose while soaking. Epsom salts, aromatherapy, candles, and a breath metronome may help. I believe that diaphragmatic breathing and corpse pose similarly enhance cold body therapy, also known as cryotherapy, in which cold air, ice packs, or ice baths are used to reduce pain and tension.
There are numerous muscles in our bodies that we simply do not know how to relax. Our necks and hips are full of them. We toil all day without giving these muscles even a few seconds to regenerate. Use corpse pose to provide that time. At least three times per day, lie down wherever you happen to be, and replenish. Eventually, work toward a walking corpse pose, and then imagine extending that same kind of utter relaxation to all your waking movements.
Find Calm Through Relaxation Training and Unbracing
As we have discussed, most people are entirely unaware of the tension they carry in their muscles, even though it causes them pain.24 One way to develop awareness is by engaging in bidirectional control. Bidirectional control, or increasing and then decreasing muscle tension, is used to treat many disorders that are made worse by bracing. When you find a posture that you brace within, let it go, then incrementally bring it back and let it go again. The more familiar you become with specific instances of bracing, the better you will be at noticing them, interrupting them, and bringing them to rest.
When you first find and relax a particular bracing pattern, you may notice yourself breathing more shallowly. This is because bracing gives us a false sense of protection and security, and when we interrupt it, we feel naked and unguarded. Re-bracing the area puts us back into our comfort zone. The only way to circumvent this pattern of escape and relapse is to practice unbracing while overriding distressed breathing with paced diaphragmatic breathing. The unbracing protocol below will guide you through the process.
- Recognize a pattern of tension that you brace within. It might be in the face, neck, tongue, eyes, jaw, hands, arms, legs, back, shoulders, stomach, etc.
- Spend time discovering how to brace it further and how to bring it into a full contraction. Explore the muscle’s range of motion and degree of freedom.
- Use bidirectional control to relax it, tense it, then relax it again. Use this method to gradually identify the most relaxed resting state that you can achieve.
- Notice that when the muscle is unbraced, underlying pain and discomfort become apparent. Deep, slow breathing will become more difficult than usual. Focus on the discomfort involved as you continue to breathe diaphragmatically. The discomfort will slowly subside. This is what it feels like to heal trauma.
Bidirectional control and the unbracing protocol can be used in conjunction with “progressive relaxation,” a tool developed in the early 1920s by Edmund Jacobson. In progressive relaxation, different muscle groups throughout the body are relaxed one at a time. As a therapeutic exercise, it has been shown to lead to reductions in neuromuscular tension, breathing rate, and sympathetic activity.25 I recommend that you search online for guided progressive relaxation exercises and videos. You might also try searching for a similar practice called “body scan.” Make a record of the videos that you like and practice them weekly. We need to delve into this inner space if we are to bring peace to it. Below is a progressive relaxation exercise that you can combine with the unbracing protocol above.
Throughout the book, we will build on this concept of forcing a partially contracted muscle to contract completely and then letting it relax. Chapter 14 will detail how this can be used to reverse all the partial contraction and pain in your body using a technique that I call “anti-rigidity training.” As discussed in that chapter, this involves using physical poses that activate underutilized joint configurations. It narrows in on poses that ache and cause the joints to crack. Once you find these achy configurations in your body, you will work on contracting the muscles involved to full fatigue. It feels like a good stretch, but it is much more than that. The process of holding the contraction outside its normal range of motion encourages blood flow, unlocks trigger points, and elongates muscles to their optimal length unlike anything else—aside from massage, that is.
Massage Counteracts Partial Contraction and Dormant Muscle
Despite the growing recognition that muscle tension causes most common pain, targeting the trigger points that cause it is not part of mainstream medical education. Physicians, psychiatrists, and psychologists rarely consider muscular dysfunction despite it being a major contributor to a wide variety of diseases and disorders. The medical establishment has found that it is more profitable to direct funding toward pharmaceuticals, medical devices, surgeries, and other medical procedures than toward massage and the manual compression of trigger points. This is true, even though there is overwhelming support for the concept of trigger points and the use of massage in resolving them from distinguished medical institutions such as the American Pain Society.
I am generally aligned with and fond of the modern medical establishment, but its neglect of bracing, repetitive strain, and trigger points is unacceptable. Today, many experts worldwide recognize that muscle pain may be the biggest cause of disability and loss of productivity in the workplace. Nonetheless, clinicians focus on major surgery and on masking muscle pain with drugs rather than less invasive, safer, and more effective solutions that are already known. We can’t expect doctors to solve all of our problems. We need to let the doctors off the hook and take responsibility for our muscles into our own hands.
Physically massaging trigger points with firm pressure breaks them up, allowing blood and oxygen back into the muscle. Massage is thought to be the least invasive, most cost-effective, and safest way to reinstate circulation and reverse the self-sustaining contraction that maintains them. The next chapter will explain precisely how to perform compressive massage on your own muscles.
Trigger point massage and anti-rigidity are easy to do and work wonders. However, there is a simple explanation for why you and everyone you know aren’t already using these techniques regularly. The body only allows muscle groups to open up if the person is breathing diaphragmatically. This means that these two techniques don’t work nearly as well for people who have not undergone diaphragmatic retraining. However, combining long breaths with massage, achy poses, and contraction into the most painful muscles in my body liberated my neck, shoulders, hips, and lower back from a state of stinging rigidity. After reading Chapters 6 and 14, you will have all the knowledge you need to do this for yourself.
Chapter Five: Bullet Points
- Tense muscles with excessive tone burden us. Their tension develops from extended periods of uninterrupted use. This prolonged use is known as repetitive strain or persistent muscle tension.
- Much of the muscle tension that we experience comes from unnecessary bracing. Bracing is largely involuntary but is avoidable because we can become aware of it.
- Rest and microbreaks give strained muscles the downtime they need to regenerate.
- Deprived of breaks, overused muscles become ultra-fatigued. But, given the proper microbreaks, the same muscles could have been healthy and toned.
- Long-term strain changes our muscles physically, leading to adaptive muscles shortening, scar tissue, and the formation of trigger points.
- Adaptive muscle shortening is a form of partial contraction in which a muscle can neither rest nor contract completely. The fact that the muscle is shorter can distort posture and proper skeletal alignment.
- We have partially contracted muscles in the face, vocal tract, spine, abdomen, genitals and other areas.
- Muscles that have been in partial contraction for years go dormant. Dormant muscles limit movement, promote frailty, and lower metabolism. They are atrophied, weak, inflamed, surrounded by fat deposits, susceptible to injury, and, worst of all, painful.
- Most people have unknowingly allowed muscles in the crux of their necks and lower backs to become completely dormant to the point where they are immobilized and can hardly be contracted at all. If they happen to contract fully, as during a fall or when lifting something heavy, it would be painful and would result in injury.
- We brace our breathing muscles, including the diaphragm, when we are nervous. This can push them into partial contraction. To unbrace the diaphragm, allow your exhalations to become passive. This involves doing no work during the exhalation and letting the breathing muscles go limp. The exhalation provides a brief opportunity for all the breathing muscles to relax and receive a microbreak.
- Pain signals sent to our brain from tense muscles overwhelm our emotional lives. They cause the “pain-body” to flare up, heightening aggression, ego, and competition for status.
- Muscular tension is a fundamental medical and biological problem. Due to its relation to stress, it is responsible for a wide range of downstream pathologies and health issues.
- Several studies have shown that relaxing the muscles of the body reduces anxiety.
- Distressed breathing results in muscle tension and increased bracing. Chronic distressed breathing results in copious dormant muscle.
- Diaphragmatic breathing reduces excessive muscular tone, allowing muscles the microbreaks they need to regenerate. This makes it so that the repetitive strains of everyday life strengthen our muscles rather than weaken them.
- Your body has learned to be tense, but you can teach it to let go of the tension.
- Unbracing, which can be accomplished by allowing muscles to go limp, is an acquired skill that can rehabilitate your entire body when combined with diaphragmatic breathing.
- Corpse pose involves lying on the back and focusing on full-body relaxation.
- Progressive relaxation involves systematically scanning over the entire body, tensing muscles, then completely releasing them.
- The most dominant primates are the least affected by bracing and brace the least during confrontation and opposition. So, unbrace.
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