published 4/12/05
I See Muscle
Shining light on the muscle tissue blind spot
by Paul Ingraham, Vancouver, Canada MOREclose
Credentials and qualifications
I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.
For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.
Credentials and qualifications
I am a writer and retired Registered Massage Therapist (unusually well-trained for a massage therapist, a 3000-hour program). I’m almost done with a Bachelor of Health Sciences degree. I am a peer reviewer for The Natural Standard, and a copyeditor for Science-Based Medicine. My most important qualification is more than a decade of workaholic post-graduate study, clinical experience, and constant conversations with readers from around the world, including many experts who have provided countless suggestions and criticisms.
For more information, see: Who Am I to Say? More information about my qualifications, credentials and professional experiences for my readers and customers.
When all you have is a hammer, everything you see looks like a nail.
Abraham Maslow
Chiropractors see joint problems, psychologists see neuroses, nutritionists see junk food, surgeons see broken anatomy. This kind of professional tunnel-vision is often considered a problem, and of course it can be, but it’s also the advantage of specialization. And it’s a particularly an advantage in massage therapy, because neither generalists nor other specialists “see muscle.”
Muscle is a neglected and misunderstood tissue. It is partly the victim of its own success: people worry less about muscle because it seems to injure less disastrously and heal more quickly than bones, tendons and ligaments. But I think that muscle is mainly underestimated and taken for granted because it doesn’t seem as structural, as integral, or as lasting as bone.
We all tend to think of bones as defining. They give us our shape. We think that muscles exist to serve bones, instead of the other way around. There are many “bone doctors,” but no “muscle doctors” — unless you count massage therapists, and look at our social status compared to orthopedic surgeons! Bones seem almost more important than muscle, as if one could do without the other. We imagine lively skeletons in our horror stories, but never deboned meat zombies!
Yet animals can manage without a skeleton! Nature is full of invertebrates, some of them very impressive (the octopus comes to mind). Muscle is actually more essential to our nature than bone, more integral and original, because the ability to move is one of the defining characteristics of life. Muscle precedes bone developmentally. Bone condenses out of softer tissues as we grow, and serves the needs of muscle. Bone is merely an innovation, a new-fangled feature that gives muscle more to work with: leverage.
While people tend to think of the skeleton as being a relatively stable thing wrapped in muscle, it’s more accurate to think of muscles as being very strongly wrapped around a rather loose assortment of levers. Bones float in muscle. Their position relative to each other is dependent on being balanced between muscular tensions applied on all sides. They are not stacked or interlocked like Lego bricks, and they cannot and do not hold together without muscle. In fact, when anaesthetized and the muscles are truly slack, many joints dislocate easily: a little known hazard of surgery.12
Bones float in muscle: they are not stacked or interlocked like Lego bricks, and they cannot and do not hold together without muscle.
It’s not “wrong” to think of bone as important, obviously, but it seems to have become my life’s mission these past few years to make sure that muscle also gets its due. Excluding muscle from medical thinking constitutes a problem in health care. Muscle problems are ubiquitous and account for some of humanities worst plagues (i.e. back pain) — yet they are largely ignored.
Further Reading
- SY Ten Trillion Cells Walked Into a Bar — A humourous and unusual perspective on how, exactly, a person is even able to stand up, let alone walk into a bar. Hint: it’s a muscle thing.
- Back pain of muscular origin is a classic example of the consequences of ignoring muscle clinically: SY Save Yourself from Low Back Pain! — Low back pain myths debunked and all your treatment options reviewed.
- And here’s another important muscle thing: SY How Many Muscles? — A (slightly tongue-in-cheek) tally of the body’s many muscles.
Notes
- Drugs used to induce general anaesthesia include muscle relaxants. Muscle relaxants work by antagonising the natural transmitter substance acetylcholine released at the neuromuscular junction. Thus, nerve impulses which would normally cause muscles to contract are prevented from reaching their supplied muscles, causing the muscles to relax. “Relax” may be a euphemism: the result is actually more like paralysis. For instance, pancuronium is used in lethal injections to paralyze the diaphragm. Examples of other skeletal muscle relaxants in use today are rocuronium atracurium and succinylcholine. Return to text.
- Casey AT, O'Brien M, Kumar V, et al. Don't twist my child's head off: iatrogenic cervical dislocation. BMJ. 1995 Nov 4;311(7014):1212, full text. From the article: “ …extreme care must be taken in the positioning of the anaesthetised and paralysed child where the normal protection from cervical musculature is lost: extremes of neck rotation in children are dangerous.” Return to text.