Daily Maestroism

DM #445

Friday, August 11th, 2017

DM #445: When was the last time you tore someone’s achilles tendon? How bout the last time that you were able to generate enough force and spend enough time with them to give them a bunion?
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Clearly, you don’t actually want to do this to your patients, but my point is that even if you were sadistic enough to actually want to do so, you couldn’t. It takes a TREMENDOUS amount of force to tear that thick ? achilles, and an equally incredible amount of force and time to develop a bunion. So, even for you practitioners out there with cringe-worthy techniques that leave your patients bruised and battered…guess what, you still ain’t strong enough to truly deform that tissue.
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What’s my point? Well, as a provider you don’t need the force of Thor to be able to make the nervous system feel safe, and thus allow that patient to move in a different (and perhaps better) way that will now actually load those tissues and start to impart those forces that can cause mechanical changes. Scrape that post-op Achilles tendon repair as hard as u want…it ain’t getting any thinner. OR, back off, use that tool more gently to tap into receptors within the tissue which can down-regulate that area, make that person perceive less tension and pain, and thus allow them to get further into an ACTIVE stretch which will now place some legitimate force through that tendon and allow for cellular and mechanical changes….WHOA. Let that marinate for a second.
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Take-home message: If we’re strong enough to wear down bones and need joint replacements, we’re strong enough to build up tissues through appropriate loading. Treat smarter, not harder.
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