created 11/12/09

Body Types and Body Pain

Some speculation about what kind of body types might hurt the most, with shameless use of cute dog photos to illustrate

by Paul Ingraham, Vancouver, Canada

This article is a bit fluffy. (Like the dogs in the picture below?) But not everything can be profound.

The idea of body types has minimal clinical importance in the treatment of muscle pain. However, my Vague Professional Impression™ is that lean and skinny folk — ectomorphs — seem more likely to suffer from body pain than the other body types. I have no idea why this might be the case, but it’s been a pretty consistent observation over the years: I have seen more lean people with widespread and severe body pain than thickset or muscular people. It’s certainly not that large and muscular people don’t ever have pain, but they do seem to have quite a bit less. Lucky them!

The popular classification of body types into the three “morphs” — ectomorph, endormorph and mesomorph — came from the American psychologist William Herbert Sheldon in the 1940s. Sheldon also associated the body types with personality — that was really the heart of his idea — which has never been considered useful by anyone but Sheldon himself. However, his idea for the naming of body types really stuck, and to this day you hear them tossed around by manual therapists, even though there doesn’t seem to be much point except that we humans like to classify things. The three types are:

Ectomorphs are fine-boned and have long, slender muscles and low fat, and are usually called slim, lean or skinny.
Mesomorphs have medium bones, low body fat, wide shoulders and well-defined musculature, and is the body type of the hunks of the world.
Endomorphs are big-boned and have higher body fat, usually referred to as either fat or heavyset or thickset.

Again, my impression is that ectomorphs are not only cursed with somewhat more muscle and/or body pain, but also more interesting pain: more variable and unpredictable symptoms, more vivid and complex referred pain (pain that “radiates” to locations other than the cause). On the other hand, endomorphs seem to be the more immune to muscle pain, and even when they do have it seems to be more stable and predictable, more “straightforward,” with minimal and simpler referred pain.

Mesomorphs seem to be the compromise body type, neither being as immune to muscle pain as the endomorph, nor as prone to it as the ectomorph.

It’s nothing short of wild speculation, but there could be a neurological explanation for these relationships. In extremely oversimplified language, ectoderms may be “nervier” people — more prone to pain system dysfunction. The body types are named after the three basic tissue types in embryonic development, and ectoderms are named from the tissue that develops into the skin and nervous system. Just as the dominance of these tissues types affects to appearance of the individual, perhaps it also affects function and sensation.