We are covered in tense muscles that have excessive tone due to extended periods of uninterrupted use known as repetitive strain or bracing. These muscles have taken on physical manifestations of tension and strain including trigger points, adaptive muscle shortening and scar tissue. Bracing is heightened during distressed breathing. Tense muscle limits movement, promotes frailty, lowers metabolism, is atrophied, weak, covered in fat deposits, susceptible to injury, and worst of all, painful. Pain signals sent to our brain from tense muscles influence and overwhelm our emotional lives. Diaphragmatic breathing reduces excessive muscular tone so that the repetitive strains of everyday life strengthen our muscles rather than strain them. Unbracing, by focusing on allowing muscles to go limp, is an acquired skill that when combined with diaphragmatic breathing will rehabilitate the entire body.
Chapter 5: Eliminating Muscular Tension, and Dormant Muscle
“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
“You translate everything, whether physical or mental or spiritual, into muscular tension. F.M. Alexander
Muscles and neurons evolved together in animals around 700 million years ago. Before this all of the survival machines on the surface of Earth were vegetative. But even plants, fungi and single-celled organisms, which have no muscles or neurons, have primitive ways of moving. For example, many unicellular organisms have cilia (tiny hair-like arms) or flagella (a sperm-like tail) that allow them to move by propulsion. These tiny animal-like protists (protozoans) beat their body parts against their surroundings to mobilize. The first animals appeared around 800 million years ago and are thought to be similar to today’s sponges. Sponges have no muscles or neurons, and are only capable of very slow forms of movement and rudimentary forms of information transmission between body parts.
The development of muscles and neurons in true animals (eumetazoans) took movement and information processing to a whole new level. Muscles enable structural movement such as moving bones relative to each other. Muscle movement is rapid, reversible, repeatable, and permits locomotion. It is thought that muscles first evolved to allow herbivory, permitting tiny animals to travel from plant to plant to consume them. Of course some of these herbivores evolved into carnivores and violence commenced in earnest. Animals are also the only organisms with neurons. Animal nervous systems process sensory stimuli and guide muscles, integrating movement with sensory feedback. Muscles and the nervous system that controls them can become adaptively traumatized in even the most primitive animals. This chapter will focus on a form of trauma that transforms muscles on a cellular scale: repetitive strain.
Recognize Excessive Muscular Tone
After a shoulder strain from skateboarding, a doctor prescribed me a dozen pills of meloxicam, a nonsteroidal anti-inflammatory drug (NSAID) with analgesic effects. I spent a while before going to bed trying to be receptive to the sensations of the effects of the drug. My muscles felt lighter and it quickly put me to sleep. I woke up in the middle of the night to feel my hamstrings burning intensely. I immediately concluded that this wasn’t anything new, but that the NSAID had unmasked sensations of tension to which I had become accustomed. The same phenomenon can occur in people experiencing a high fever. I had become blind to the fact that this tension went to bed with me every night. My hamstring was chronically strained from overzealous exercise. I spent an hour trying to focus on relaxing the muscles and in doing so, I found that this strain coursed all through my hips, lower back, shoulders, and neck. Similarly my recently strained shoulder was on fire. I was clenching it 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 lesson was applicable to my shoulder, my hamstrings, and my entire body.
Muscle tone (also referred to as residual muscle tension or tonus) is continuous and passive partial contraction found in all skeletal muscles. It is often conceptualized as the muscles’ resistance to passive stretch during a resting state. It helps maintain posture, and it declines during REM sleep. Muscles receive near-continuous innervation from the nervous system and even in complete rest, they remain in a semi active “default” state. Thus, there is no actual “rest state” in living muscle tissue insofar as activation is concerned. Both extensor and flexor muscles are involved in the maintenance of a constant tone, and this helps maintain muscle readiness. For instance, your bicep (flexor) and triceps (extensor) are always in a state of continuous partial contraction complementing and supporting one another, no matter how much you try to relax them. Tone is healthy and normal, but tone can become too high. Excessive tone is referred to as persistent muscle tension, muscle spasticity, or hypertonia. Hypertonic muscles are found throughout the body and are a source of chronic pain, stiffness and premature frailty for every adult on the planet.
The cause of excessive muscular tone and the accompanying pain that we experience is multifactorial. It can be exacerbated by bad habits, wear and tear, genetic risk factors, and instances of trauma, such as car accidents and falls. However, most of the preventable muscular pain that we suffer from is derived from a type of low energy injury to the tissues known as repetitive strain. A repetitive strain injury is one that is caused by repetitious tasks, or sustained awkward positions. Almost any job or profession, or any task or chore you can imagine, involves monotonous tasks where muscles are subject to instances of strain.
Repetitive strain is also caused from bad posture; holding our body improperly against gravity. Longstanding instances of muscular tension develop pathways in the nervous system that reinforce and perpetuate them. Also, an array of cellular changes take place within the muscle cells forcing them to contract permanently, forfeiting strength and flexibility. By becoming inured to such burdens, we force ourselves to carry them unknowingly. We are all hauling an invisible, intangible load, forcing hundreds of muscles throughout our body to push and pull against absolutely nothing.
When brief involuntary contractions flow through the muscles that make up our chakra-like modules we feel emotions. This flow is an integral part of feeling love, getting a rush, and enjoying happiness and excitement. When continuous strain that damages the modules the emotions become negative.
Refrain from Muscular Bracing
Excessive muscular tension in any posture is called muscular bracing. We brace muscles all over our body, yet some are much more affected than others. Because of the false sense of security that it can afford, some authors call it “muscular armoring.” Unnecessary bracing maintains the body rigid and “on guard.” This is intended to prepare us for the quick initiation of defensive or offensive movements. Bracing would be advantageous during a physical attack or an ensuing impact as it prepares the body and mind for violent exertion and potentiates reflexive motions. Small amounts of temporary bracing can be very helpful during rough and tumble play, contact sports, a fall, or a collision. Early in life muscular bracing takes place intermittently, but over the course of years, it becomes continuous.
Making our muscles tense makes us feel in control but is really a dysfunctional coping tactic. Muscles on opposite sides of a joint contract and stiffen the joint. This kind of antagonism occurs all over the body. When you try to move, you must overcome your own resistance, ruining grace and coordination. Imagine that you are standing alone in a parking lot with nothing nearby to grab a hold of, and you hear someone yell “brace yourself!” What pose do you strike? It’s likely that whatever pose you imagined is one that you commonly use during stress and startle. The muscles responsible for this pose are currently in the process of becoming locked up.
Some specialists refer to forms of bracing as “neurotic holding patterns” or “prearthritic postures.” There is a strong relationship between bracing and arthritis. 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 knuckles that are the most affected are those that she braced more during stress over a period of decades.
People generalize bracing from physical challenges to intellectual and social challenges. During standardized tests, social gatherings, or public speaking bracing hinders performance by interfering with productive efforts, and causing discomfort and autonomic stress. Distressed breathing itself is a form of bracing where the diaphragm is strained. Bracing the diaphragm and other respiratory muscles reduces their strength and range of motion. Make your hand into a claw and keep it tight as you open and close it. This is exactly what you are doing with your diaphragm when you’re stressed. It would be a great exercise for the diaphragm if it only went on for 30 seconds at a time, but we do it for hours or days at a time.
Squinting, as well as raising and lowering the brow are also forms of bracing. The term dysponesis is sometimes used to refer to unnecessary bracing or tightening of muscles or any misdirected use of energy in the musculoskeletal system (Whatmore & Kohli, 1968). This energy wasting is usually covert in the sense that it goes unnoticed by the person doing it. Patterns of bracing quickly become a part of our personality and outward appearance. They are also often involved in submissive displays. During an encounter or confrontation the less dominant individual will brace more. It is a signal that exclaims: “look, I am wasting energy; handicapping myself during this encounter, don’t attack me, I’m not looking to fight.”
Dominant people appear the least controlled (stifled) in their body movements. Expanding your range of movement and being more expressive will help you convey dominance. So will asymmetry, openness, and relaxation of body and limb position. Submissive people assume tight, symmetric stances, often pinning their arms tightly to their sides. They minimize the amount of space that their body occupies by collapsing the body inward and holding it there. When you brace you submissively close your body off, when you refrain from bracing you take up space. Dominant posture emerges when bracing is at a minimum.
Common Forms of Bracing that Compromise Muscle and Cause Pain
Muscular tension can also play a role in memory. When there is an urgent need for me to do something that I cannot do right away, I become more tense. It seems that the specific part of my body necessary to fulfill the need is often the part that exhibits tensity. 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 when we are performing simple tasks. We tighten muscles not involved in the task, and keep these muscles tight even after we complete the task. You want to identify and stop the action or posture that is feeding the tension. If the action is built into your job or daily routine, this can be difficult but may simply involve improving the ergonomics of your work space, or taking more regular breaks. Focus on learning to selectively calm the muscles that you are not actually 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.
Sometimes all our muscles need is a few seconds (or even just a few fractions of a second) respite. When muscle activity is being tracked by the use of electrodes these moments of downtime are called electromyographic gaps. These brief rest periods are also called micro-breaks. For example, widening the eyes gives the muscles involved in squinting a micro-break. Lack of micro-breaks all over the body prevents renewed blood flow and the ongoing efforts of the body to reinstate full muscle vigor (regeneration). Optimal muscle function requires that we alternate between muscle contractions and the resting baseline level of tone, or else muscle function will not regenerate and unwanted processes will ensue. You have probably noticed the difference between fatigue caused by sustained bracing and fatigue caused by exercise that contains micro-breaks. The former aches and is unpleasant and the latter is both soothing and exhilarating.
Physical pain and injury also make us brace. After getting hurt, individuals often try to avoid experiencing pain by bracing, and tensing the areas surrounding the site of injury. When one sprains their ankle they inadvertently contract many muscles in the ankle, setting the ankle in a fixed, defensive position. This is intended to protect the injury and results from learned avoidance of pain. It is known as “splinting” because it acts as a splint to immobilize the joints. Unfortunately, it also deprives the muscles of the rest, oxygen and nutrients they need to heal. This coping mechanism actually worsens the pain in the long-term by overtaxing the muscles invovled.
Injuries almost always result in some form of persistent muscle tension. Whiplash injuries are particularly bad. Medical treatments often do this as well. Iatrogenic pain is pain caused by medical treatment, and is especially common with the use of braces, slings, casts, and surgeries. An arm cast that immobilizes a broken forearm is a well-known initiator of frozen shoulder syndrome. I had melanoma removed from my shoulder blade in my mid-teens, and I recently found that I have a large muscular knot under the scar from bracing the area. My brother received a large shot in the quadriceps during his appendectomy and he says the same area troubles him commonly. Think conscientiously about past injuries, medical procedures and other forms of trauma and how they may be influencing you to brace your muscles today. Tense muscle tissue can be conceptualized as an injury or as trauma even if there was no precipitating accident. The word “injury” is defined as physical damage to a biological organism. The word “trauma” can be defined as an abnormality in the tissue of an organism usually caused by injury. By these definitions any form of persistent bracing is injurious and traumatizing.
When I was four, I wanted to grow up to be just like the superhero He-Man. I told my parents I was determined to be as strong and muscular as my favorite cartoon role model. They told me if I worked hard, I could do it. I did pushups, sit-ups, and lifted weights from age 8 onward. I didn’t enjoy it, and I imagine that I breathed very poorly while doing it, but I did it with determination. At one point, when I was 13, my mother asked me why I had bruises on my biceps. It was from doing too many curls. I was hurting my body. If I had used lighter weights and not breathed so shallowly, I could have really built a solid foundation. However, the weights I insisted on using were too heavy for me, making the process drudgery that I held my breath while doing. I actually caused my muscles to become weaker in the long run. This is why I have always had painful, lanky arms. I lifted weights more than the other boys in my class, but my physique was always unexceptional. Many of the other boys had conspicuous musculature with bulk and sinew that I didn’t. Relaxed muscle responds dramatically to exercise, whereas tense muscle responds sluggishly. Even today, my biceps are small, they feel spongy and rough with multiple nodules, and it hurts to pinch them. I probably went to bed every night bracing my biceps.
At age 14, I decided to find some literature on muscle tone. I read that muscle gain came from extreme muscular exertion, so I concluded that if I could get my muscles to be very tight – all the time – I could force them to grow faster. I imagined that the best method was unrelenting contraction. This was actually my strategy throughout my teens and twenties. In fact, the most important factor in building healthy muscle is you must allow it to relax. The more relaxed your muscles are at rest, the quicker they recover from exercise. However, I concluded otherwise, and this mindset is another reason why I became such a tense young adult. 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.
I am convinced the stress that chronic muscular tension places on our body is culpable for, or at least implicated in, a wide variety of medical and psychiatric diseases. Muscular tension is known to be involved etiologically in many joint disorders, like carpel tunnel, temporomandibular joint disorder, frozen shoulder, tennis elbow, and many others (Ward et al., 2002). Stress and muscular tension also make us more susceptible to physical injury because tense muscles fail and tear under excessive force. The muscles that strain in a fixed position at the computer all day are the most susceptible to injury from a fall or car accident. In junior high and high school I injured a muscle, tendon, or ligament almost every time I had a sport-related accident because of excessive tension. My parents were very discontented and confused because I was coordinated; yet, I would sustain a legitimate injury after each collision or fall. I was in my teens, but because of undue stress the body parts that I braced were decrepit.
You can feel the muscular knots from excessive tension under your skin. They are often palpable, raised nodules that are tender to the touch. Firm pressure will make them respond with dull and aching pain. In the scientific and medical literature these knots are referred to as trigger points, trigger sites, spasms, or cramps, and they cause reductions in muscle mass, flexibility, strength, and endurance (Alvarez & Rockwell, 2002). They are hyperirritable spots in taut bands of skeletal muscle fibers that stem from bracing and other types of chronic muscle overload. They usually involve a local contraction in a small number of muscle fibers within a larger muscle bundle. Trigger points are best found by palpation with the fingers, but can also be found clinically by measuring a heat differential between the tense muscle fibers and the surrounding healthy fibers, by electromyography, or by a modified MRI scan (Alvarez & Rockwell, 2002).
Many scientists refer to these trigger points as myofascial trigger points. The “myo” is derived from the Greek for muscle, and “fascia” refers to muscle’s tough outer lining that keeps it in place. Fascia is one of the three types of dense connective tissues (the others being ligaments and tendons), and it forms a continuous, 3 dimensional scaffolding around all of the muscles and tendons in the body. A myofascial trigger point is a small patch of muscle and fascia in an isolated spasm (not a whole-muscle spasm like a “Charlie horse” or a cramp). Although trigger points can cause cramps, cramps are more transient, have sudden onset, and involve hard contraction of the entire muscle. Trigger points often cluster together and can pull on tendons and ligaments, causing joint problems and “deep” pain. If these trigger points remain tense for prolonged periods they can be accompanied by clicking, popping, and grating sounds. Eventually they can contribute to bone spurs, pinched nerves, and arthritis (O’Sullivan, 2007). Trigger points can be seen in greatly magnified pictures of muscle tissue like the one below. They appear as distortions in a web-like matrix.
Muscle is composed of different types of fibers (such as fascicles) that contain smaller fibers. The thinnest fibers (myofibrils) hold sarcomeres, where the smallest unit of contraction takes place. A sarcomere is a microscopic structure that features 2 kinds of filament-like molecules: actin and myosin. These are long molecules that move past each other quickly to create contractile force. The sarcomere shortens when large numbers of paired actin and myosin proteins use free energy in the form of ATP to inch past each other.
A. A muscle is made of fascicles, which contain myofibrils, which contain sarcomeres. B. Trigger points in a muscle myofibril
Millions of sarcomeres must contract to make even the smallest muscle movement. The sarcomere relaxes when the actin and myosin are uncoupled from each other and pulled apart. Most wait attentively in a relaxed state for an impulse from the nervous system to tell them to push past each other again. Many specialists believe that trigger points originate when overuse causes actin and myosin to become stuck in an interlocked state. From a macroscopic perspective this puts the muscle into a static state of contracture.
A. A relaxed sarcomere on top, and a contracted sarcomere on bottom with actin and myosin visible. B. Actin and myosin molecules slide past each other to create muscular movement.
Trigger points derive from a few different sources: 1) sustained low-level contraction, 2) sudden muscle overload, 3) eccentric contraction (when a muscle stretches and contracts simultaneously), or 4) gross trauma or injury to the muscle. All of these slow blood flow to the muscle and cause oxygen deprivation at the site. These conditions activate the release of acetylcholine, causing the sarcomere to contract and constrict the surrounding capillaries. The capillaries supply the muscle with blood, so when they constrict, it leads to reduced circulation (ischemia) that impairs many cellular processes. The function of the mitochondria is impaired, reducing ATP production and release. It is thought that since ATP is necessary to detach the myosin heads from the actin, these molecules are more likely to stay attached, leaving the sarcomeres in a shortened and contracted state (Simon, Travel, & Simmons, 1999). Without blood flow, waste products accumulate. The chemicals involved stimulate the nociceptors in the free nerve endings, which send pain signals to the brain (Shah et al., 2008). Active trigger points demonstrate an unusual biochemical mix not seen in normal healthy tissue. It is an acidic milieu involving increased levels of proinflamatory, contractile, and pain-causing substances (Dommerholt, Bron, & Franssen, 2011; Shah & Gilliams, 2008).
The best way to break up trigger points is to reinstate circulation, allowing blood and oxygen back to the muscle. Massaging with firm pressure, or physically compressing the trigger point is thought to be the least invasive, most cost effective, and safest way to increase circulation and reverse the vicious cycle that maintains the trigger point. I will explain exactly how to perform compression on your own muscles in the next chapter. In addition to compression, exercising the muscle will also help to renew it. Chapter 14 will detail exactly how to locate and exercise strained muscle using a method that I call “antifrailty training.” Bringing it to fatigue and then letting it rest, stretching it, and holding a contraction outside its normal range of motion will all encourage blood flow and break up trigger points.
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” (Davies, 2001). Travell was the White House physician during the Kennedy and Johnson administrations. She emphasized that trigger points are demoralizing, devastating to quality of life, and the “scourge of mankind.” Despite her influence and despite the growing recognition that myofascial trigger points cause most common pain, trigger point therapy is not a part of medical education. Physicians, psychiatrists, and psychologists rarely consider a myofascial source for disease.
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 manual compression of trigger points. This is true despite the fact that there is overwhelming support for the concept of trigger points from distinguished medical institutions such as the American Pain Society (Harden et al., 2000). I am generally aligned with and fond of the modern medical establishment, but its neglect of excessive muscle strain is a serious oversight. Today many experts worldwide recognize that muscle pain may be the biggest cause of disability and loss of time in the workplace, and in day-to-day life (Mense & Gerwin, 2010). There is ample research on masking muscle pain with pharmaceuticals, but very little research on reversing the cellular symptoms of repetitive strain. But we can’t expect doctors to solve all of our problems. Let’s let the doctors off the hook and take personal responsibility for our own muscles.
Muscle Shortening and Scar Tissue
Adaptive muscle shortening is another pervasive clinical finding that affects everyone. Strained muscle tissue shortens due to prolonged contracture. A muscle can change its resting length to adapt to the length at which it is habitually used or positioned. For example, people confined to long periods of sitting exhibit debilitating shortening of the iliopsoas (one-joint hip flexors). Similarly the wearing of high-heeled shoes causes prolonged plantar flexion of the foot resulting in adaptive shortening of the soleus muscles. Constant squinting shortens the muscle fibers of the orbicularis oculi, causing the eyes to become narrower. Hunched neck posture leads to shortening of the muscles in the front of the neck (such as the sternocleidomastoid). Shortening here makes it very difficult to stop hunching because the decreased length of these muscles pulls the head down. There are examples of adaptive muscle shortening in muscles all over our bodies. In people that have it the worst it can cause visibly noticeable postural distortions.
The pressure from prolonged contracture pulls on tendons, straining them and distressing the joints when they move. Next, the ligaments and joint capsule retract. These changes stress 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. It is not only the muscles that are damaged from strain. Articular cartilages, connective tissue, tendons, fascia, menisci, ligaments, and spinal disks are damaged as well.
The accumulation of scar tissue is another common finding in tense muscles. Scar tissue consists of a very tough, inflexible fibrous material. The material binds itself to strained muscle fibers in an effort to draw the damaged fibers together. This results is a bulky mass of stiff tissue completely surrounding the injury site. In some cases, it is possible to feel and even see this bulky mass under the skin. Scar tissue adheres to muscle fibers, preventing them from sliding back and forth properly, limiting the flexibility of a muscle or joint. It frequently adheres to nerve cells, leading to chronic pain. It also has a tendency to contract and deform the surrounding tissues diminishing strength and making the body feel heavy. Existing research has proven that scar tissue is weaker, less elastic, more prone to future re-injury, and as much as 1000 times more pain sensitive compared to normal, healthy tissue. The result is chronic pain that, under most circumstances, lasts a lifetime. In reality we are practically covered in scar tissue and trigger points from old injuries, bodily tension, bad posture, and poor workout techniques.
In my teens and twenties I would bench press too much weight, and hold my breath while doing it. This would cause me to walk away holding substantial tension in my chest for hours. It led to the accumulation of trigger points, and the adaptive shortening of the pectorals which bowed my shoulders and chest inward. It also led to two patches of scar tissue four inches above each nipple. They were tight, sore spots, with a diameter of half dollars. I massaged them using the techniques presented in the next chapter for two minutes a day, and they disappeared after a month.
Excessive Tension is Debilitating and Constrains Your Physique
Muscles that are encumbered by trigger points, adaptive shortening and scar tissue can be conceptualized as dormant muscles. Dormant muscles cannot recover adequately after a workout. They are resistant to growth and strengthening. This is because muscles afflicted with trigger points never rest and thus can never fully heal (Simons, Travell, & Simons 1999). As long as they are under constant self-imposed strain, they will continue to grow smaller, weaker and more fragile. Pregnancy itself does not ruin a woman’s physique. Rather, it is the months of prolonged bracing, absence of postural variety, and limited range of motion that happens in many late pregnancies that has prominent, long-lasting effects. Dormant muscles cause the muscles that normally work with them to weaken and atrophy as well. The natural variation in physique between humans is due to genetics, exercise, and exposure to testosterone, but perhaps most importantly to differences in the extent of dormant muscle that arose during childhood and adulthood bracing.
You have significant untapped reservoirs of muscle in your body that correspond to areas that you brace and have been bracing for decades. Take that hunch in your neck for example. Starting at birth, you had a natural tendency to straighten the cervical vertebrae in your neck and stack them in a straight line on top of one another. The less optimal your childhood environment, the more you were positively reinforced for hunching your neck and negatively reinforced for straightening it. From a young age, you have carried your neck in a less-than-ideal way in an effort to communicate modesty or submission. You stooped over, jutted your chin out, and tilted your head back to reduce your height and appear unguarded. This introduces a slant in the neck, which is an inefficient way of stacking vertebrae against the force of gravity. The excessive tension that developed led to the proliferation of trigger points. This led to atrophy in the neck, shoulders, and chest, which in turn ran down the spine.
Chapter 13 will detail exactly how to reclaim your neck and regain a great deal of flexibility, range of motion and muscle mass in your neck. The neck is just one example of a reservoir of muscle that has been suppressed, that you can tap into. In fact, 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, and we had a few months to live in them, we would all have the physiques (if not bulk) of elite athletes.
Why Did Evolution Choose Pain?
Physical pain is an adaptive, evolved mechanism. It informs the organism that it is suffering damage, motivating it to withdraw from the source of damage and causing it to learn to avoid damage-causing circumstances in the future. But what does muscular pain (myalgia) do for the organism? It is probably correct to view the pain signals we receive from muscles as protective responses to overuse. Trigger points, muscle shortening, and the deposition of scar tissue are surely adaptive phenomena. They accomplish two things 1) they change the muscle physically so that the muscle comes to take the configuration that you habitually hold it in, and 2) they utilize pain signals to mark a site for avoidance in the future. These two developments compel the animal to refrain from specific movements in an effort to effectively remove a potentially dangerous or unstable maneuver from the animal’s motor repertoire. It is better to handicap a muscle group than to seriously injure it.
The body is betting that instead of healing a strained muscle and bringing it to its premorbid strength and flexibility, it is best to cause this muscle to become weak and stiff, forcing other, safer muscles to compensate. Dormant muscle may also cut metabolic needs. Dormant muscle imposes severe constraints on mobility and behavioral activity. This may have been good for our prehistoric ancestors because it vastly decreases deliberative movement, cutting metabolic rate and minimizing the amount of food that has to be consumed each day. This would have restricted hunter-gatherers to the movements that have proven necessary. But today cumulative strain hinders mobility, and livelihood in an evolutionary wager to increase the probability of survival.
The Link Between Tension, Pain, and Negative Emotion
Suffering is not abstract or conceptual, it is embodied within the pain modules of your nervous system. Nociceptive pain is pain caused by the activation of pain receptors known as nociceptors (absent in most invertebrates) which generally sense either thermal (e.g. heat or cold), chemical (e.g. inflammatory) or mechanical pain (e.g. crushing or tearing). Nociceptive pain is divided into visceral (organ), superficial (skin) and deep somatic pain (muscle). Deep somatic pain is initiated by 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 often don’t notice it until we experience an injury or until a painkiller takes it away. Drugs like heroine induce intense ecstatic and euphoric states simply by alleviating this pain.
Deep somatic pain haunts our minds and poisons our behavior. People with long-term pain of any kind frequently display psychological disturbances and often exhibit elevated levels of hysteria, depression and hypochondriasis (the “neurotic triad”). Chronic pain patients generally are low in self-esteem (Wall & Melzack, 1996), and high in anxiety, fear and anger (Bruehl et al., 2009). In fact, somatic pain is known to interact with psychogenic pain (which arises from social rejection, defeat, broken heart, and grief). These two forms of pain comingle and exacerbate one another (Eisenberger & Lieberman, 2004). There is no telling how much the undiagnosed chronic pain from our muscular tension dysregulates us emotionally. Complete absence of muscular pain would likely endow us with the serenity of Zen masters.
Neural pain messages from tense muscles bombard our brain from practically every muscle in our body. This pain is shuttled to brain areas involved in fear and grief such as the insula, the anterior cingulate, and the amygdala. These brain centers take pain input from all around the body to help compute the appropriate level of pained reactions: stifling, agitation, rage, dread, and self-handicapping. Thus we become tense and then respond to the tension with more suspense in what many call the anxiety-pain-tension cycle. We feel like the emotional pain that we experience originates from the content of our thoughts. In fact, emotional pain and negative thinking are actually driven by the preexisting pain in our muscles and related tissues, the ultimate cause of our continual background unease. When someone says that they are going to do something to “calm their nerves,” it is really to relax their muscles. Tense muscles are leeches on our souls. I think that in many ways, trigger points ARE the physical embodiment of our life’s angst, ennui, and Weltschmerz.
Spiritual author Eckhart Tolle has elaborated on a concept he calls the “pain body.” According to his philosophy the pain body is the accumulation of negative life experiences that create an “energy form” of affective pain and discomfort (2005). Tolle discusses how it is intrinsically tied to the ego, and how environmental circumstances that assault our pride actually amplify the pain body and its negative effects on our behavior. He advises people to “live in the present moment” to recognize the pain body, as it shifts from being dormant to being active. When it becomes active, we feel the pain. 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 large proportion of this pain body corresponds to the deep somatic pain from the cumulative effects of muscular bracing. I also believe that this pain body is dormant when latent trigger points are dormant, and becomes active when latent trigger points become active.
Trigger points are traditionally categorized by specialists as either active or latent. An active trigger point is painful, whereas a latent trigger point is not painful until it is made active. Latent trigger points generally cannot be felt unless deep pressure is applied to them, and they are much more numerous than are active trigger points. Latent trigger points can be made active by strain; after an abusive work out, a sudden shock, or a long car ride. Distressed breathing also activates latent trigger points all over the body. This is why facial tension, headaches, and back pain coincide with stress. Difficulties with stressful activities such as public speaking likely come from the activation of latent trigger points. We come to think that added tension in our muscles prepares us for demanding tasks whether social or physical. But when we are speaking in front of a room of people and our eyebrows are raised, our eyes are squinting, our neck is tense, our shoulders are elevated, our stomach is in knots, our vocal musculature is tense, our back is stiff, and other latent trigger points all over the body are active, it can crush us, undermine our presentation, and dilute our message.
The pain also provokes 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 even when shocked lightly. This strongly suggests that all mammals regularly displace aggression, reallocating blame for their own physical pain on the closest organism to them.
Eckhart Tolle explains that the pain body is a “psychic parasite” that wants to provoke others, and “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. They also react to the pain bodies of others either with revulsion or aggression. I believe that we are constantly provoking each other’s pain bodies and latent trigger points in an effort 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, it is an innate system for determining which animal has priority over resources. It is a highly preferable alternative to all out violence. It is the mammal brain’s imperfect attempt at creating order. The first step toward becoming free of this design flaw is becoming free of bracing and the painful trigger points that it has created. Again, let’s start with the breath.
The Link Between Distressed Breathing and Muscular Tension
Scientists have documented that average muscle tension and especially tension in trigger points increases during transient stress. Muscles will tighten up during the administration of a paper and pencil examination and during and after watching a horror film. Being under personal or work related stress has also been shown to greatly aggravate muscle tension (Faucett & Rempel, 1994; Sauter & Swanson, 1996; VanGalen,, et al, 2002). Stress, specifically heightened sympathetic arousal, increases the risk of repetitive strain injury particularly during involvement in repetitive tasks (Aaras & Ro, 1993; Buckles & Devereux, 200; Veiersted,1993). 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.
Shallow, distressed breathing provides the physiological link between stress and muscle tension. It is known that muscle tension and pain have a reciprocal relationship with distressed breathing (Gevirtz, 2006) They aggravate each other. As stress levels rise and distressed breathing becomes more prominent, we brace more and experience more pain (Travell and Simons 1983). Distressed breathing keeps our muscles tense, depriving them of the breaks they need to regenerate. Diaphragmatic breathing, on the other hand, causes us to brace less and experience less pain.
Since childhood my hands would hurt and cramp after 5 minutes of uninterrupted writing or drawing. Since, I have started breathing diaphragmatically my hands do not hurt or cramp even after an hour of pushing a pencil. When I paint all day with friends, they each tell me the next day that their hands are sore, but I notice that mine are not. This is because the way that I breathe is conducive to microbreaking. These are just a couple of countless examples I have experienced.
Paced breathing involves a learning curve. At first it takes a fair amount of attention to follow the cues of the metronome and regulate the breath accordingly. After just a few hours of cumulative use you will find that it takes almost no attention at all. This will encourage you to do it more often, combining it with numerous activities.
Find Calm Through Relaxation Training and Unbracing
Pretend that you are alone on an inflatable raft after a shipwreck. Your mind is racing, playing out the worst possible scenarios. You glance at the few tins of food and realize there is no telling how many days you will be out on the open sea. The thought of starvation brings a wave of panic. Then you hear a voice in your head say: “Conserve your energy or you are going to starve.” 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 clearly see how your familiar neuroticism is simply a metabolic state that can be adjusted. You say: “Wow, I have been carrying this frenetic tension for so long, but I can just let it go.” Imagine leaning into the raft and concertedly trying to tone down your hectic reactivity. Acknowledge that your baseline level of intensity is out of proportion with your immediate physical challenge. Right now, picture yourself laying your head down on the raft surface and letting your body descend to the lowest level of energy expenditure. Your face goes lax, your heart beats slowly but steadily, you are breathing just enough to get adequate oxygen, and every muscle that you aren’t currently using unwinds.
Don’t ever return to that raft. That was an intentionally provocative example. Come up with a positive imaginary scenario. In mine, I am a man foraging on a Sub-Saharan savannah, 2,000 years ago 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 Jared allows every muscle in his body to go lax, unless it is needed for a necessary motion. Back when the threat of starvation was imminent, it would have been important to conserve unnecessary metabolic expenditures. In doing so, this prehistoric 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. Know that you can simultaneously be strong, quick and nimble whenever necessary and let this knowledge validate your calm.
I have been fortunate to have spent some time babysitting my friends’ calm children. One 8-hour babysitting stint with an imperturbable two year old was especially transformative for me. This young girl was so sweet and pacific that I realized unless I did something about it, my high-strung personality was going to scare her. As we played I worked on coming 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.
We are lumbering cellular machines that are burning themselves to the ground because they are stuck in overdrive. You need to let your body relax so that you can stop burning parts of the ship. Stress raises metabolism in the short term. In fact, the sympathetic system can double resting (basal) metabolic rate. But it only does so on the order of hours. Over weeks and months stress actually leads to a lower metabolism and everything that comes with it including weight gain, visceral fat, elevated blood pressure, cardiovascular disease, diabetes and a plethora of other disorders. Scientists distinguish between catabolic states where energy is being burned for movement, and anabolic states where energy is being stored and used to construct important molecules like proteins. The sympathetic system uses catabolism to burn energy for fight or flight and leads to depletion and wearing down. The parasympathetic system uses anabolism during rest to build the body back up and leads to revitalization. Catabolic pathways within cells become overactive during persistent anxiety, literally burning the body away. In fact, stress burns away muscle, making it harder to stay fit and lean.
Upregulation of the stress system might save you 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 will kill you in the next few minutes, then maybe you should activate the sympathetic stress system. It will adversely tax your muscles and your mind but just might free up enough energy, or accentuate a reaction that saves your life. If you have no grounds for assuming that this physical threat could take your life in the next two hours, 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. Very few of us have life-threatening challenges. Most of the challenges that we stress over are not life or death, and do not depend on adrenaline or split second timing. Given the design of our body and the nature of our modern challenges the best strategy by far is to develop a relaxed, low-energy disposition. We all have this inside of us, finding it is the trick.
Most people are completely unaware of their muscle tension (Shumay & Peper, 1997; Stein, Schafer, and Machelska, 2003). There are many specialists you can visit that can help give you insight. They place electrodes on a patient’s skin and take surface electromyographic recordings to provide the patient real-time feedback about the level of tension in different muscles. They might place these electrodes over different neck muscles, confirm the existence of muscle tension and then ask the patient to try different exercises, postures and neck positioning until the person learns to hold their neck in a way that is free from tension (Harvey & Peper, 2012). This can be very helpful, but you don’t need a medical office visit to recognize and release excessive muscle tension.
Shavasana is a recumbant yoga pose where one lies on the back and focuses on total relaxation of the body’s muscles. Shavasana translates to “corpse pose.” Although a little morbid, this name drives home the reality that you must embrace some aspects of death to truly rest. You must retire certain defensive muscular contractions that are mistakenly intended to keep you alive. You also want to retire all of the contractions that you use while upright and that keep you from falling while walking. Most people take these to bed with them every night. Use shavasana to teach yourself how to be liberated from them.
There are countless muscles in the body that we do not know how to relax. Our necks are full of them. We toil all day without giving the neck muscles even a few seconds to regenerate. They barely get a break during sleep. I try to rest my head at least 3 times a day, even if I have to lie down on the floor. I lie down, wiggle my hips and my shoulders a little, and concentrate on letting every muscle go limp. Try corpse pose in a hot bath, soaking for 5-20 minutes using Epsom salt, candles, and a breathe metronome.
Have you ever exercised in the morning and then felt very frail by the end of the day? Even after an evening workout most of us will engage in a number of activities before bed. The workout weakens postural muscles throughout the body leaving them more susceptible to strain. Avoid this. As soon as you get home from work, or from a workout, you should make 5 minutes for corpse pose. It will give these muscles the respite they need to grow stronger rather than weaker.
Before I started paced breathing I found corpse pose to be a chore. I was so restless that trying to lie still was actually stress inducing. Paced breathing changes this completely. If you practice paced breathing with corpse pose for 5 minutes a day, you will find that it is profoundly reinvigorating because of the way that it softens all of your bracing patterns. After the first 5 minutes you will feel you lower back and neck start to writhe. Really focus on this tendency to writhe, but do not move. Notice the discomfort in your muscles and how it makes you want to squirm, toss and turn. Imagine that you are inhaling into them, and exhaling out of them. By not moving and focusing on the resulting sensations you are coupling proper breathing with your bracing patterns. This will quell them.
In Chapter 3 I asked you to spend a minute breathing where each breath takes less than a second. This helped to demonstrate distressed breathing and contrast it with diaphragmatic breathing. The process of voluntarily initiating a symptom, and then inhibiting it, also known as symptom prescription, is helpful because it encourages
. A similar construct called bidirectional control, increasing and decreasing a physiological function, is thought to be important in the treatment of many disorders. Practice these techniques with your various patterns of bracing. When you find a posture that you brace within, let it go, then incrementally bring it back. The more familiar you become with it, the better you will be at noticing it, interrupting it, and bringing it to rest. However, when you first notice and stop a form of bracing, it causes you to breathe 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. The only way to circumvent this is to practice unbracing while overriding distressed breathing with paced diaphragmatic breathing.
- Recognize a source of tension that causes you to brace. It might be in the face, neck, tongue, eyes, jaw, back, shoulders, stomach etc.
- Spend time in corpse pose discovering how to unbrace it and let the tension go completely. Use bidirectional control to increase it and decrease it in an effort to find the lowest possible resting state.
- Use light exercise to bring the muscle to fatigue so that you can then more easily find its resting state.
- Notice that when you stop bracing the muscle, you feel insecure. This is because unbracing makes you breathe shallowly, which instigates you to immediately go back to bracing. Avoid this by combining unbracing with paced diaphragmatic breathing.
- Notice that when the muscle is unbraced and this combined with diaphragmatic breathing, the underlying pain and trauma will become apparent. Proper breathing will become more difficult than usual and the trauma in your breath will come to light. Focus on the discomfort involved as you continue to unbrace while breathing diaphragmatically. You will notice the discomfort slowly subside; this is what it feels like to heal trauma.
In the early 1920s Edmund Jacobson developed a process called progressive relaxation where different muscle groups throughout the body are tightened and then relaxed one at a time. This is a relaxation exercise that is sometimes called “body scan.” After repeated practice, it has been shown to lead to reductions in neuromuscular tension, breathing rate, and sympathetic activity (Ditto et al., 2006). I recommend that you search online for different guided progressive relaxation exercises, make a record of the ones that you like, and practice them weekly. We need to spend time sensing and discovering this inner space to bring peace to it. Below is a progressive relaxation exercise that you should combine with the unbracing protocol above.
Relaxed physical bearing and relaxed body language are highly characteristic of dominant primates (van Lawick-Goodall, 1968; Miller et. al., 1955). The dominant ones are even-tempered and collected and the subordinate ones are braced and agitated (Reynolds & Reynolds, 1965). When I am trying to relax I would prefer not to think about dominance and status, but it is reassuring to think that relaxed posture and expansive movements are the antithesis of inferiority in monkeys, apes and humans (Mehrabian , 1971). At a party, at work, with your friends, with family, be the most carefree, laid-back, slack-muscled monkey you can be.
Chapter 5 Bullet Points
- We are covered in tense muscles that have excessive tone due to extended periods of uninterrupted use known as repetitive strain or bracing
- These muscles have taken on physical manifestations of tension and strain including trigger points, adaptive muscle shortening and scar tissue
- Bracing is heightened during distressed breathing
- Tense muscle limits movement, promotes frailty, lowers metabolism, is atrophied, weak, covered in fat deposits, susceptible to injury, and worst of all, painful
- Pain signals sent to our brain from tense muscles influence and overwhelm our emotional lives
- Diaphragmatic breathing reduces excessive muscular tone so that the repetitive strains of everyday life strengthen our muscles rather than strain them.
- Unbracing, by focusing on allowing muscles to go limp, is an acquired skill that when combined with diaphragmatic breathing will rehabilitate the entire body