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Encouraging movement at individual spinal segments optimizes nutrient flow and minimizes excessive loading on a given segment. and paravertebral muscle groups reduces loading on the intervertebral disks and supports nutrient flow. Christy Cael is a licensed massage therapist and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Musculoskeletal Anatomy, Kinesiology, and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009). Contact her at christy_cael@hotmail.com. 48 m a s s a g e & b o d y w o r k m a r c h / a p r i l 2 0 1 8 the intervertebral disk and the associated vertebral bodies. These regions contain the least amount of water and greatest amount of resilient collagen fibers, providing a relatively stable connection while maintaining optimal nutrient diffusion between the disk and adjacent bony tissues. NUTRITIONAL SUPPLY Intervertebral disks are avascular (lack blood supply) and, therefore, the living cells within rely on diffusion of water, ions, and small molecules for nutrient delivery. Like all connective tissues, the intervertebral disks contain living cells within an extracellular matrix. These cells need energy and raw materials in order to assess, synthesize, and break down the extracellular matrix, which is how they continuously repair and adjust the intervertebral disk architecture for optimal function. Excessive loading—either in scale or duration—disrupts the flow of nutrients within the intervertebral disk, leading to cell death and a cascade of changes within the tissue. Decreased proteoglycan production decreases water content within the tissue. The tissue becomes less resistant to compression, showing greater rates of fluid loss with loading. Disk height reduces as the tissue becomes more fibrotic and the percentage of collagen fibers increases, causing ineffective load distribution and compromise of surrounding structures. APPLICATION TO BODYWORK Since muscle tension places the greatest amount of loading on the spine, it is essential to evenly and optimally direct that loading. Focus should be placed on correcting postural deviations that asymmetrically load the spine. Also, encouraging movement at individual spinal segments optimizes nutrient flow and minimizes excessive loading on a given segment. Balanced tension between antagonistic muscle groups and reduced hypertonicity in both the intervertebral } No Weight Weight Epiphysis Body Body Nucleus pulposus Disk Paired spinal ganglias thread through grooves of the transverse processes, becoming right and left spinal nerves The internal vertebral venous plexus supplies the orbits of the eyes, as well as the brain Posterior longitudinal ligament Annulus fibrosus Spinal cord Dorsal root of spinal nerve Ventral root of spinal nerve Anterior longitudinal ligament Nucleus pulposus Vertebral body Vertebral artery The vertebral blood vessels run through the transverse foramen The three layers of the dura protect the spinal cord Vertebral veins Superior articular facet Pia mater Arachnoid Dura mater Spinous process } } Annulus fibrosus