Issue link: https://www.massageandbodyworkdigital.com/i/68185
CHILDHOOD ORIGINS OF ADULT MUSCULOSKELETAL ISSUES CHILDHOOD IMPLICATIONS Children's tissues are not the same as adults. Compared to adults, children have connective tissues that are more mobile, muscles that are weaker and not as tight, joints that are looser, cranial bones that are less fused, and skeletal bones that are softer and more porous. As they grow, however, children's cranial bones gradually fuse, their skin and connective tissues become less mobile, their ligaments grow more rigid, and their muscles become stronger and tighter.1 While they continue to be shaped by the demands made upon them, the skeletal bones also gradually become harder and denser. During this growing process, children's bodies can easily become misaligned, fibrosed, or tight in ways that will affect them as adults. Scarring and shrinking of connective tissue around injuries or deformities can restrict movement and create faulty movement patterns (such as walking with one knee twisted inward to accommodate a frequently sprained ankle). Patterns of muscle tightness can also develop around a single contracted area. For example, a continuing chain of secondary muscle contractures in such muscles as the adductor longus, tensor fasciae latae, rectus femoris, and quadratus lumborum can stem from a chronically tense or shortened iliopsoas.2 The way children sit, move, and hold themselves upright can also shape their bodies. Trigger points can develop from deformities, pain, or injuries, while muscle-guarding around pain or emotional trauma can create deep and lasting tension.3 Children's bodies can easily become misaligned, fibrosed, or tight in ways that will affect them as adults. they may remember nothing about how it started.4 My client Mark, a So, encourage your clients to bring in their children for bodywork when they're young, before these issues become chronic. Adults often forget events from their childhood, and their musculoskeletal adaptations to an accident or injury can become so habitual that by the time they experience a chronic problem, healthy 38-year-old accountant, is a good example. Mark has seen numerous massage therapists over the past 10 years for pain in his right intrascapular area. Every few months, he had a sharp pain in that area, often when he first woke up. Mark then visited a massage therapist for two or three visits, requesting release of tension in his upper back. The pain was usually resolved for a few more months, although he always had a sensation of lingering tightness there. He reported that he never had specific injuries to the upper-back area. When I questioned him more specifically about early traumatic injuries, however, Mark remembered falling off a horse when he was 10 years old. He was not hurt by the fall itself, but as he lay on the ground, his horse stepped directly onto his chest. Mark's chest hurt a lot for a few weeks after that, but the pain eventually went away. He finally forgot all about the incident. In working with Mark, I found that his right intrascapular muscles were only moderately tense, but his first and second ribs were anterior on the right side, and there was a buildup of fibrous tissue where the ribs articulated with the sternum. His right scalenus anterior muscle contained two exquisitely tender trigger points, which not only referred pain to his right mid-scapular area, but felt exactly like the pain he had experienced for so long. Trigger-point treatment of the right scalene anterior, along with 46 massage & bodywork september/october 2010 showing Mark how to perform self- massage and stretching of the muscle, helped relieve his pain far more than when his treatments had focused on his mid-scapular region. Although Mark at first insisted on massage on his upper back alone, he left my office very satisfied with his treatment. As a working massage therapist, learning more about childhood origins of client issues will help you understand how these problems develop, and how to unwind a pattern of chronic pain or rigidity. STRUCTURAL PROBLEMS Unless severe, many inherited structural issues may not show up as a problem until adulthood. However, vigorous exercise that puts additional stress on an area may cause inherited problems to manifest themselves earlier.5 One inherited imbalance is Morton's foot structure, where the foot has a much longer-than-normal second metatarsal bone. To compensate for this problem, sufferers are more likely to toe-out at heel strike and while standing. However, toeing out causes excess weight to fall upon the great toe, placing more pressure on the medial arch and the flexor hallucis tendon, which results in tightness and strain of the flexor hallucis and tibialis anterior muscles, along with frequent ankle sprains. Trigger points in the muscles of the feet, legs, and hips can develop during childhood, and eventually foot, leg, and hip pain can