When we move our body we engage not only our muscles, tissues and bones but also our brain. In fact, movements start with brain signals. Therefore, to move, tone, heal, or sculpt our body effectively, it helps to understand some of these neural mechanisms. In Essentrics, for example, if we have chronic pain such as frozen shoulder we always move gently in the pain-free zone instead of pushing through the pain to increase our range of motion. It is a classic case of co-opting the brain instead of localizing the issue to only muscles and joints. A recent discovery provides yet more support for this neuromuscular approach.
The Frozen Shoulder Paradox - Movable when Unconscious
To continue with our example, a frozen shoulder is marked by chronic pain and severely restricted motion. If we suffer from it then we can neither actively lift or rotate the arm fully, nor can we passively do so by letting someone move it for us. The shoulder would be so stiff that the shoulder capsule appears glued and stuck, hence the formal name "adhesive capsulitis." Many things can possibly lead to the condition, including but not limited to trauma, diabetes, strokes, and heart issues. Yet in many cases the cause is unclear.
The formal name "adhesive capsulitis" would suggest that frozen shoulder is purely the stiffness of the shoulder capsule, meaning tightness in the joints and connective tissues. However, some sufferers have recently shown remarkable increase in their range of motion when put under general anesthesia (read peer-reviewed study). Their shoulders were looser and appeared normal without resisting passive motion (video). This means their shoulder capsules were not tight at all. Rather, the muscles around their shoulder joint were stiff when the sufferers were conscious, suggesting some form of "muscle guarding" coming from the brain when they were awake.
"Muscle Guarding" - a Form of Neural Protective Mechanism?
Some people have argued that if passive motion could happen, then such cases were simply misdiagnosed as frozen shoulders. They argue that the condition's definition requires both the inability of the shoulder to move or be moved. However, this focus on definition misses the point. The point is, these cases suggest that our brain has certain mechanisms (perhaps not unlike reflexes) to protect us. Such "muscle guarding" coming from the brain was perhaps what has caused certain - but not all - frozen shoulder cases. It is similar to an over-protective, paranoid helicopter parent who prohibits his/her children from engaging in any physical activity for fear of injury. Defiance against the parent will result in punishment in the form of pain. Therefore, to reduce the pain and to regain full movements, we need to address both the physical and possible neural issues, ideally in a way that can tackle both simultaneously.
Gentle Movements as Solution
This is where gentle movements come in. If our frozen shoulder is indeed due to tight shoulder capsule and surrounding tissues, then rapid and/or forceful movements will only risk tearing them. If our frozen shoulder is due to neural signals guarding our muscles, pushing through the pain will perhaps only trigger more protective restrictions and more pain. The key is therefore gentle movements on a regular basis to loosen the connective tissues and to "lessen the guard."
Pain is Subjective
While we need more research to understand the "muscle guarding" discovery, we do know how gentle movements can alleviate chronic pain and improve range of motion. As Essentrics co-creator Miranda Esmonde-White has discussed in her book "Forever Painless," pain is a very subjective experience that involves not only our physical sensation/nocioception (somatosensory complex) but also our emotions (limbic system) and reasoning (frontal cortex).
Depending on our past learning and emotional experiences, and depending on our current state of emotions, we can experience the same stimulus differently. Two people can each put a finger into hot water but feel varying levels of sensation. One might minimize it while the other might amplify it.
Chronic Pain: Pain Signals Misfiring
What is worse, for reasons not fully known, pain signals can misfire. Normally when our sensory cells detect pain, they release neurotransmitters that travel through our nervous system to the spine and then up the brain. But sometimes these sensory cells misfire so that neurotransmitters explode before reaching the brain, sending the pain signal in all directions of the nervous system. Also, our brain's connective tissues comprise of glial cells. The ones that get activated by the original neurotransmitters sometimes cause other glial cells to replicate the neurotransmitters, reinforcing the pain loop.
Gentle movements are able to weaken pain loops by manipulating other connective tissues throughout the body that are cousins to our brain's glial cells. These tissues - or fascia - literally connect our whole body together. Fascia are a "living matrix" constantly communicating signals throughout the whole body. By loosening stiffness, gentle movements bring nutrients to fascia, allow them to release toxins. This allows electrical, cellular, and tissue remodeling signals to travel properly, reducing pain signal misfirings.
Gentle Movement: Less is More
How gentle is gentle when it comes to movements for chronic pain? Hear it from Miranda Esmonde-White: