Pain relief

A biochemical approach to decreasing muscle pain with food and hormones.

pain and hormones

pain and hormones

A biochemical approach to decreasing muscle pain is often the last place most people look and that includes many pain specialists. Modulating pain and hormones through food and other variables can create some impressive results. Aches and pains are a common theme in every day living. Some people seek to push themselves harder with excessive training schedules, others spend more time in a seated position and other factors contribute to tissue not responding the way that it should. Pain and the concept of nociception is a system of feedback for the body that is protective in essence. You touch something you shouldn’t; first pain kicks in to remove you from the painful stimulus (lasts less than 0.1 seconds), after that and depending on severity of damage second pain kicks in.

First pain and second pain (both reside in the anterolateral system or ALS) utilise different chemical messengers and another factor for this form of feedback is that other nociceptive factors like touch, visual, auditory and other sensations of stress can be part of the problematic feedback if not resolved. All of these have the capacity to interrupt optimal motor control and functioning of joints and soft tissues and affect hormone profiles. Even a bad smell can create neurological chaos.

Another less well known aspect (in therapy based settings) of disruptive function in muscle tissue are the effects of hormones that may lead to decreased feed back and be responsible for pain. Hypothyroidism affects muscle tissue via energy and neurological deficiencies.

Hypothyroidism results in

Slower peripheral and central nerve conduction velocity Lower body temperature is a factor creating slowed velocity Decreased active cell transport in the cerebral cortex Decreased flux of sodium and calcium for contraction/relaxation Poor production of energy for contraction/relaxation Decreases depolarisation of action potential

cold body

cold body

In a nutshell a colder, slower body leads to a decreased   coordinated body that has a hard time contracting and relaxing muscle tissue. This can lead to increased incidence of injury and pain.

A slowed heart rate is a sign of hypothyroidism and the bradychardia (slowed heart rate) should serve the purpose of describing the decreased rate of function throughout all muscle tissue. Thyroid hormone can improve both rate of contraction and relaxation in both fast and slow twitch muscles but also exerts a cardio protective role on blood vessels and bowel function via smooth muscle tissue. The documented symptoms of hypertension and constipation along with the neuromuscular actions tend to resolve with adequate thyroid hormone (Gao, Zhang, Zhang, Yang, & Chen, 2013).

Prior to initiating thyroid therapy it’s essential to rule out functionally hypothyroid states induced by diet, stress, excess exercise and other environmental factors. Many clients often present with lowered temperature, with cold hands, feet and nose, altered bowel, sleep and emotional function, which can often be resolved with appropriate energy and decreased intestinal irritants.

Chronic pain increases cortisol production which decreases thyroid hormone production (Samuels & McDaniel, 1997) as does fasting or calorie restriction which induces a decrease in available T3 (thyroid hormone) (Hulbert, 2000).

This gives us two approaches 1) to reduce pain with appropriate therapy and to ensure that adequate energy modulates the suppression of excess cortisol and increases available thyroid for tissue organisation and recovery.

Hormones also affect tendons; diabetics and poor insulin profiles appear to create disorganised tendon structure but this may be a factor related to decreased available thyroid hormone. Hypothyroidism decreases available T3 within tendons, which can decrease growth, structure, and collagen production and create hypoxia of tissue leading to calcification.

Estrogen, although necessary for growth of tissue can often be found in excess creating problematic growth. Estrogen is also well known to decrease thyroid hormone and can provide an explanation why more females then men tend to be hypothyroid. The decrease in both thyroid hormone and progesterone can increase muccopolysacharides, which increase pressure in tissues, creating puffy, oedema like states. The swelling can be linked to many pain states which include carpal tunnel, which can be resolved with progesterone and thyroid in the absence of physical therapy. Progesterone also appears to induce myelination of nerves (surrounds and allows nerve conduction) and decreases inflammation (Milani et al 2010).

Energy production remains  a most potent form of therapy for decreasing pain, optimising rehabilitation and restoring tissue function.

References:

  1. Gao, N., Zhang, W., Zhang, Y., Yang, Q., & Chen, S. (2013). Carotid intima-media thickness in patients with subclinical hypothyroidism: A meta-analysis. Atherosclerosis, 227(1), 18–25. http://doi.org/10.1016/j.atherosclerosis.2012.10.070

  2. Hulbert, A. (2000). Thyroid hormones and their effects: a new perspective. Biological Reviews of the Cambridge Philosophical Society, 75(4), 519–631. http://doi.org/10.1017/S146479310000556X

  3. Milani, P., Mondelli, M., Ginanneschi, F., Mazzocchio, R., & Rossi, A. (2010). Progesterone - new therapy in mild carpal tunnel syndrome? Study design of a randomized clinical trial for local therapy. Journal of Brachial Plexus and Peripheral Nerve Injury, 5(1). http://doi.org/10.1186/1749-7221-5-11

  4. http://raypeat.com/articles/aging/aging-estrogen-progesterone.shtml

  5. Samuels, M. H., & McDaniel, P. A. (1997). Thyrotropin levels during hydrocortisone infusions that mimic fasting- induced cortisol elevations: A clinical research center study. Journal of Clinical Endocrinology and Metabolism, 82(11), 3700–3704. http://doi.org/10.1210/jcem.82.11.4376

Bin the flip-flops for better performance

I have worked with thousands of clients over the years and one of the most consistent links that I can say with certainty exists, is the link between biomechanical dysfunction from flip flop wearing. You can also lump tight shoes, high heels and other rogue foot wear that simply do not allow the feet to function correctly in that description. What I am not saying is that you can never wear those shoes that you hold so dear to your heart again. What I am saying is; that if you are engaged in an exercise regime, be it professional or someone who wants to get the best from your training regime, without injury or decreases in performance. Ditching those pesky flip-flops and other gait restrictors are probably a good idea.

If you want to wear them, then doing some kind of releases that address your own personal restrictions is key. This flip-flop release is very useful but not complete.

https://youtu.be/y1a6W86Yp8I

With the twenty-six bones, thirty-three joints and over one hundred muscles and ligaments, each person demonstrates their personal movement and dysfunction in slightly different ways.

I can tell straight away, when a client walks in whether they wear flip-flops, tight work shoes or over used high heels. So what are the common issues that I see?

  • Inability to optimally recruit the hip and thigh (glutes/hip flexors/quads/hamstrings) muscles.
  • Restriction in mobility/stability to the neck.
  • Poor core function due to overuse of the back muscles.
  • Calf strain and usually a decrease in shin muscle contracture
  • Instability of the big toe-essential for push off in gait
  • Permanent contraction of the toes

There are others and many clients often look at me like a madman as I say that their problems are coming from their footwear. Usually the improvement in function and decrease in pain relatively quickly is enough to ensure their compliance to restricting problematic footwear and addressing their muscular problems with some foot TLC homework.

From a muscular and myofascial line Myers proposition of the structural connectivity via superficial  back line the superficial back line can show us how muscular and ligamentous issues in the feet might affect the whole line where the muscles are continuous with the cranial fascia. Addressing the foot has often decreased pain and increased mobility in the neck in many clients.

A long-standing client of mine who is a competitive swimmer was reminded of the implications of flip-flop wearing and performance. Originally a back pain client that was cleared, he was complaining of a lack of ability to complete a six beat stroke with his feet. After clearing the distortion of the peripheral and central nervous system and restoring optimal muscle function (Using NKT or Neuro Kinetic Therapy and Proprioceptive Deep Tendon Reflex/PDTR), he reported a return of the function that night.

Whether exercising or just for moving efficiently you can still wear these shoes but just be aware that there is a cost. To remove the dysfunction you will need to do corrective work and more homework and lets be honest for those that do exercise, correctives are adistraction from the main event. More mobility and stability work? Come on!

Well if you just treated those feet with more respect you wouldn’t need too.

 

The difference between mobility and stability issues

Do you have an injury that keeps reoccurring? Finding the difference between mobility and stability issues can be the key to eradicating pain for good If you have ever suffered from an injury and there was no difference made between a mobility or a stability issue. Chances are you may still have the injury.

You often see many trainers and therapists focusing on mobility, mobility and more mobility. Release this muscle with that foam roller release the fascia with this ball but unless the distinction is made between whether a mobility drill or stability training or re-programming of the nervous system needs to occur, All you will end up with is one mobile injured body. It’s a simple thing to do. Just determine whether the movement can be conducted through the desired range. If it can’t, the question should be asked can this be done passively, with someone else guiding you through the movement. If the answer is yes. You have a stability or motor control dysfunction.

If you are the one of many going through the insurance/treatment mill or simply not getting any resolve from massage, exercise or whatever therapy that you are undertaking. Don’t be scared to ask the person treating you…Do I have a mobility or stability issue? It will help to cut through all the fluff. .