Biological Tissue Change and Adhesions

but how do you biologically with the tissues like what were you what were you explaining earlier yeah okay so let's look at all right so we have like bones bones coming together what's what we i call a joint right so you have a couple of bones or a group of bones that come together and in order for those bones to move properly then the muscle the brain has to direct the muscles on when the shorten when the length then how to how to fire like motor sequencing of being able to get into certain positions if the brain doesn't like what's happening. So let's say you start closing subacromial space in the shoulder. And every time you abduct, abduct and externally rotate, you get an impingement, you go into flexion, you get an impingement, the brain is going to try to do what it can to read to retain some type of function. So it's going to give you some pain. So you stay out of those areas. And it's going to reorganize the tissue in order to protect the joint. So by that time, you've, you've basically taken you've laid down collagen in a disorganized manner, right? And a lot of the the laying down of collagen is going to be based on stress lines, right? So if we look at a stress line, like for the biceps, stress lines should come through here, right? Now, if your bones get a little off and get a little bit torqued, those stress lines, they start to deviate a little bit. And so the muscles start, you start getting like a, almost like a twisting contraction, and that's going to alter the positioning of the bones. So then your brain goes, okay, I don't have enough space here. I don't like this. And every time we go to here, that hurts. So I'm going to cause pain. So you stay out of that and i'm going to i'm going to lay down collagen instead of it being like this i'm going to lay it down like this to try to prevent some of this movement and motion and that's where we build things like adhesions or what people call like knots now you have this tissue where the tissue outside of that knot can kind of sort of function but that knot's not extending and it's not contracting so it's basically like sticking glue in there so to protect the joint from being pulled even further out of where it needs to be. Right. So we, you do, you can do manual therapy to try to start irritating that and dry needling microcurrent stimulation. But the biggest thing is movement. So we have to start reestablishing movement, which means we have to look at strategies for range of motion. We have to look at strategies for load management and how do we work back into that position so that you can re regain that function and then start to progress forward. What would these strategies be specifically? Yeah. So there's a lot of people out there with shoulder issues. Yeah. A lot of a, a lot of us figuring out like, okay, what is the actual problem? So there's a couple of different ways to look at that. A most people will look at individual muscles. So they'll go, okay, like, let's say it's your hip. Uh, it, it, you, you have symptoms of piriformis syndrome, but you, you don't really know, like that's the most likely culprit, but it could be your piriformis quadratus femoris could be your go-go's could be could be your glute it could be anything in that area or even unrelated like indirectly related to that so instead of thinking about attacking muscles and trying to diagnose what muscle it is because even physios a good physio or an osteopath will tell you they'll do orthopedic assessments it's just an educated guess we have no we actually have no idea why it's happening but one thing we do know is i can either get into a position or i can't. So if I have somebody go into flexion and they get an impingement, it's less important to investigate what muscle that is. It's more, it's more productive to focus on what's preventing me from getting there. So it might be a simple length tension issue. So you might have, you know, something's going on with your lat, maybe Terry's major, some internal rotators that's creating lack of joint space so that you can't actually go further. It could be too much tension on the front side and it's closing that joint early. So it's in order to start working around that, we go, all right, if it, if it is like your lats or Terry's major internal rotators, let's train those at length and positions so that they give the joint some space. It might be on the opposite side. It could be your shoulder flexors creating in joint enclosure early. So now you have to do something different. So you have to stretch the other direction.