All truth, in the long run, is only common sense clarifi ed.
—Thomas Huxley
What do some of the top teaching hospitals in the world, that specialize in diagnosis and treatment of TOS, say is the cause of thoracic outlet syndrome?
Baylor Heart and Vascular Hospital—The slim space between the collarbone and first rib is called the thoracic outlet. Blood vessels, nerves, and muscles that extend from the back to the arms pass through the thoracic outlet. If this space is too slim, the blood vessels and/or nerves may become abnormally compressed, causing shoulder pain. The compression may also cause impaired circulation or tingling and numbness in the hands.
This is known as thoracic outlet syndrome (1).
Johns Hopkins Hospital—The thoracic outlet is a bony ring formed by the topmost ribs, just below the collarbone. Threading through the thoracic outlet, from inside the rib cage, is a bundle of nerves, veins, and arteries that serve the shoulder and arm. Thoracic outlet syndrome occurs when those nerves or blood vessels become compressed, leading to pain, numbness, and circulation issues (2).
Washington University School of Medicine—Neurogenic TOS is characterized by compression of the brachial plexus nerve roots (C5 to T1) within the scalene triangle and/ or subpectoralis space (3).
I think it’s safe to say that most doctors and scientists believe that compression is the cause of thoracic outlet syndrome. Now, let me ask you two extremely important questions.
- What is the only tissue that can compress or move body parts? Answer: Muscles.
- What controls the tension on muscles? Answer: The brain and the nervous system.
The nervous system is the processing and control center of the body.
- The sensory system provides the information to the brain from the bottom, up.
- The brain is the central computer that processes this sensory information, then makes changes on the muscle tension.
The nervous system controls the muscle contraction, which changes tension across the mechanism.
This change in tension can be felt as increased tension or increased spring stiffness, decreased tension, or increased spring compliance. This is the normal control of spring tension.
The brain knows the precise amount of tension to apply to the muscles to absorb the force of you stepping down from the curb or from jumping down from a 3-foot box.
The brain knows the exact amount of tension to let off the spring so you can run barefoot on concrete safely or the increased tension on tendons to spring off fast from the ground to run faster. When the nervous system creates an abnormal, damaging internal compression force, this tension can become an overcontrol of tension of your human spring. I named this pathologic spring tension. This pathologic spring tension is the most common cause of the compression that causes thoracic outlet syndrome.
The next two chapters explain in detail how your nervous system controls this tension. I assure you it is vitally important for you to know, because it will shape all the activities of your daily life that cause and perpetuate the compression that led to thoracic outlet syndrome and other compressive disorders, such as herniated discs, shin splints, degeneration, and accelerated aging of your joints.
What you learn in the next two chapters will also help you to determine which of the 16 different treatment options available to your doctor or healthcare professional is deemed appropriate. It also gives you the information necessary to better understand the self-help treatments recommended in Chapter 13, “What Works and Why.”
In fact, it will shape every decision you make in your activities of daily living, because your brain is going to use what it learns from this reflex to either improve your health or make it worse. So, with that, let’s “spring” into learning, so to speak.
Nervous System Reflexes and Learned Behaviors
Your body is an object that is controlled by your nervous system. The nervous system controls you by way of learned behaviors and reflexes.
Following are five important functions of your nervous system, involving tensions on your body’s spring.
- The nervous system can reduce the stiffness of the muscles and tendons that support the spring to reduce stiffness to make it more compliant and better able to absorb the forces of impacts of walking and running on different surfaces. However, when the spring is more compliant, your body needs more energy to move.
- The nervous system can also adjust the tension on the spring to make it stiffer, so the spring bounces your body off the ground with more efficiency and speed. The stiffness on the spring allows the muscles to stack the bones in a more perpendicular orientation to gravity. With increased stiffness, you have less wobble of the bones on landing and when transitioning the weight across the spring too. However, the greater the tension on the spring, the less apt it is to protect you from impacts.
- The nervous system can alter the tension on the spring to adjust for the forces of gravity to control balance, posture, and equilibrium while lying down, sitting, standing, lifting, and other movements.
- The nervous system tightens the tension on the spring when the sensory system signals that it is in a stressful or injured state. Example: When your neck gets injured in a car accident, you have a stiff neck. The stiffness in the neck is a protective reflex increase of tension on the spring (the neck).
- The nervous system can help you by programming every day activities of daily life into programmed patterns, such as walking, talking, or eating.
Nervous System Reflexes
Gravity is constantly compressing your human spring. The human spring is constantly fighting gravity.
Your human spring responds to changes in tensions relative to the directional pull of gravity with reflexes.
We have seen a measurable difference in height in patients after I performed several hours of treatment to remove the internal compression of their bodies spring system. This happened only when working on thoracic outlet syndrome compression which is only in the upper body. In fact less than 2 months prior to the release of this book I had two patients gain considerable amount of height after the spring release component of the treatment.
One 31-year old woman went from a height of 5’4” to 5’5 ½ gaining a full inch and a half The other patient, a 38-year old male patient got up from the treatment table and his wife said “Oh my God! You are taller!” We actually checked his height and he gained a full 1.5 inches in height. I wouldn’t have believed it but I measured them myself and asked to see what height they put on their drivers license.
You cannot practice better reflexes. However, you can learn how gravity affects reflexes and work with gravity to improve your posture and tonus. This way you can avoid unhealthy movements and postures that trigger reflexes that can compress your body’s spring and your thoracic outlet.
Nervous System Learned Behaviors
Your central nervous system helps you immensely by storing the patterns of the most common coordinated movements you perform with your body through learned behaviors. Without realizing, you have practiced them so much, they become second nature.
Examples of these are learning to speak a language, write, drive a car, text a phone number, sing the words to a song, or hold a cup to your mouth.
Now, it’s not difficult for you to drive a car with your knee, while singing a song in English, while you tap out a phone number with your right hand, while holding a cup of coffee with the left, taking a sip periodically. It is not recommended, but it can be done without thinking. It’s called multitasking. Learned behaviors, such as learning how to stand, walk, and run, are developed in childhood and continue in adulthood. These skills are developed in a head-to-toe order. Children learn how to control their heads, stabilize their trunks, stand, and then walk.
These skills require a gradual improvement of postural control strength and tonus. My daughter couldn’t hold her head or trunk up for some time, which concerned me. However, within weeks, she could hold her head up, and in a few months, she could sit up, stand, and eventually take her first steps to walk. In fact, what your mother told you to do, “Sit up straight,” prompting you to tighten your muscles into a rigid state, goes against how the nervous system works the best. She was teaching you a learned behavior that overrides the more perfect way to find perfect, postural balance and equilibrium through nervous system reflexes that control posture.
Using learned behaviors to correct posture will cause more compression and fatigue of your body’s spring mechanism than through reflexes. Doesn’t it feel good that you did the right thing by not listening to your mom for once?
Your reflexes offer a more perfect approach to balance the tension in the muscles, for your body tension to be at a more perfect equilibrium, than for you tightening muscles you think improve your posture. The best way to explain how to achieve perfect posture with your level of resting muscle tone is what I call “stack and relax.” You stack your head on your spine. You stack your spine on your pelvis, and then just completely relax all tension in your muscles.
Most of you learned how to sleep, sit, stand, and walk by trial and error. Most likely, your parents and your doctors did not teach you the correct way to do these tasks without self-sabotaging your human spring. If you don’t understand how they work, you will not know how to work with them, and they will end up working against you.
There is an optimum posture that provides for the minimum strain on your body’s spring mechanism.
I am going to teach you correct sleeping, standing, sitting, and walking posture in Chapter 6, “Break
These Laws... Get Sentenced to a Lifetime of Suffering.”
I tell my patients all the time, “If you do not learn the right way to use your human spring with respect to gravity’s pull, it is impossible for a doctor of any kind to help you. Not even my approach stands a chance. In fact, when a patient’s posture is off perpendicular, I correct them. I don’t want to be blamed for why their treatment did not correct the TOS. That is how important this is. When the human spring has to fight the forces of gravity for a sustained period of time, muscles can weaken, fatigue, and even go into a pathological contraction state, causing a pathologic compressive state leading to compressive disorders, such as thoracic outlet syndrome and accelerated aging of the joints, called degenerative joint disease.
This was the primary point of my keynote presentation, “The Sports Medicine Approach to Anti-Aging Medicine,” delivered at the Seventh Annual Thailand Congress on Anti-Aging and Aesthetic Medicine in Bangkok, Thailand, presented in September 2015.
In this presentation, I said that pathologic spring tension, caused by predictable patterns of abnormal muscle tension, is the primary cause of compressive disorders, such as herniated discs, thoracic outlet syndrome, degenerative joint disease, and accelerated aging. No doctor in the audience disagreed. As you age, if you don’t maintain the integrity of your human spring mechanism, gravity will win the fight. This is when your spring suspension system fails, your joints lock and grind down your knee, hip, and spinal joints, requiring them to be replaced. It’s also when people fall from a lack of balance.
They might break their hip, leading to permanent disability or even death.
Once you learn how to work with these reflexes, you will finally be able to live a more stress-free and strain-free life, and your TOS will finally go away.
Reflexes
In many cases, tasks you take for granted are actually hard-wired into your nervous system. These are called reflexes. Reflexes react faster than learned behavior, which is a good thing, because they protect you from harm.
These are other examples of reflex action we take for granted that are independent of conscious input from the brain: yawn, cough, blush, sneeze, shiver, pupillary reflex, and blinking when something touches your eye.
Many voluntary learned reflexes support behavior tasks. So, it can be confusing what is a reflex, what is learned behavior, and what are both.
Poor posture has been mentioned by many top hospitals, such as Cleveland Clinic and Cedars-Sinai, and medical associations, as a primary cause of thoracic outlet syndrome. In my opinion, postural challenges are the number one most common cause of TOS and why TOS becomes chronic after an auto accident, work injury, or sports injury. Therefore, it’s vitally important we understand how the nervous system controls posture.
Can we control our posture? Is posture reflexive or is it a learned behavior?
Neurophysiologist Charles Sherrington made some significant scientific breakthroughs. His work, titled The Integrative Action of the Nervous System, published in 1906, is regarded as the founding text of modern neuroscience devoted to understanding how reflexes work. He determined that perfect balanced posture is controlled by reflexes (5).
F. M. Alexander
Sir Charles Sherrington
Posture Manual
Your nervous system controls your posture, balance, and equilibrium. Posture is so misunderstood. For example, some people seem to think that evaluating how body parts stack up when standing with a plumb line hanging at your side or front is the only way to check.
Some people think posture is only during sitting or standing. However, posture is the optimum position to be in to work with Earth’s gravity, where the least strain is placed on supporting muscles, while maintaining your head perpendicular to the pull of Earth’s gravity and the eyes level with the horizon. In reality, it is interpreted as more of a three-dimensional structure, like a human spring. Posture pertains to the optimum position of your body (static) when lying down, sitting, or standing, or the optimum position of your body (dynamic) when lifting, walking, or running.
Lessons in Neurology Taught to a Vascular Surgeon that Does TOS Surgeries
I met a vascular surgeon at a function and asked him at what point he decides to do surgery for thoracic outlet syndrome. He said, “When the patient comes back a few times with it.” I asked him what he thought caused TOS. He spewed out the typical textbook answers: “Repetitive motion, posture, and cervical ribs,” as if he was reading the book to me.
Then I asked him to put his hand on the scalene muscles of my neck, while I was sitting straight up (perpendicular to gravity). I then leaned back, which allowed him to feel my scalene muscles and other muscles contract becoming tense.
I told him, “The muscles you cut out because they are too tense are tense because they had to constantly contract to maintain my 10-pound head in a static position for as long as I was leaning back.”
He had an aha moment, and said, “You mean to tell me scalene spasms that lead to thoracic outlet
syndrome are caused by leaning back too long like that?”
Then I asked him how many surgeries he had done on patients who were never advised they could not sit leaned back or to the side for more than a few minutes, causing them to come back with recurring thoracic outlet syndrome. He said he had performed 123 surgeries in the last year for thoracic outlet syndrome.
I know that few, if any, physicians know the true cause of perpetuating thoracic outlet syndrome. That is because I have talked to hundreds of patients who have gone to other doctors before me. I ask them what the previous doctor told them was the cause of compression.
I got nothing!
So, following the advice of doctors who don’t understand and provide advice on ways you can lessen the strain on your thoracic outlet by improving your posture is not a good strategy to lessen your pain and suffering.
The only way these misconceptions can be cleared is if we understand how the body functions in relationship to the world around it—a world governed by the laws of nature, engineering, physics and, most important, common sense.
- Your posture allows you to maintain upright alignment of the floors of your integrated spring mechanism.
- Your posture permits efficient movement patterns through a recycling of the energy through a balanced spring mechanism.
- Your posture allows your joints to be loaded symmetrically, which will decrease loads and strains on your ligaments, muscles, tendons, cartilage, and bones.
- Your posture maintains the spaces between your joints and the openings and tunnels that allow your blood vessels and nerves to pass safely. The two main functional goals of postural behavior are—
- Postural orientation
- Postural equilibrium
Stress-Free and Strain-Free Postural Orientation
When you are standing or sitting, postural orientation is the orientation of the floors of your integrated spring, to stack up with the least stress on the spring support mechanism. Postural orientation involves the active control of body alignment (strain-free or strained) of the seven floors of your integrated spring with respect to gravity. When you are moving, perfect posture is the position you need it to be, to achieve the task you are attempting where your parts stack up over the center of gravity or mass with the least amount of strain.
We all know how doctors measure static posture. You stand next to a plumb line, and the doctor tells you how your parts line up to this plumb line. This is how doctors check static postural orientation.
I take postural evaluation a step further into three dimensions. I videotape your walking or running pattern. Then you and I will watch the video in slow motion to see exactly how parts line up in relation to the pull of gravity and how your spring mechanism reacts to the impact and the transition of the weight of your body, and the orientation of the parts relative to gravity. This is how I evaluate where there is abnormal strain on your human spring. This is called a gait analysis.
Postural Equilibrium
The human body is said to be in equilibrium when all forces or tensions are balanced. The body should have no strain when it is in the state of equilibrium.
- Static equilibrium is when all forces are balanced, when lying, sitting, or standing still.
- Dynamic equilibrium is when all forces are balanced, when moving, like walking, running, or other activity.
Your body is never still. In fact, it has been found that the neck moves more than 600 times per hour, whether you are awake or asleep.
Balance
Our balance system also helps us walk, run, and move without falling. Balance requires your center of mass or center of gravity to be directly over your base of support. Balance is the state of having your weight spread equally so you do not fall.
- When standing, your base of support is your feet.
- When sitting, your base of support is your buttocks.
Center of Mass or Center of Gravity
The point, about which the distribution of weights is symmetrical, is the center of gravity of the body.
Your center of mass is the exact center of your body, where every particle of your body’s mass or weight is equally distributed in all directions. When standing still, your base of support is your feet, and your center of mass is around your bladder.
Balance, posture, and equilibrium are controlled by the nervous system. The sense of balance is regulated by a complex interaction of parts of the nervous system.
The sensory system is the mouse and keyboard of your body’s computer. A sensory system is a part of the nervous system consisting of receptors that receive stimuli, which determine what position your spring is in or what movement you are putting it through.
The sensory system senses the following changes.
- Changes in light or dark (eyes)
- Changes in the environment (hot, cold, windy)
- Changes in tension (stress, strain, compliant, stiff, compressed)
- Changes in pressure (light touch, deep pressure)
- Changes in position (angled, perpendicular, horizontal)
- Changes in chemistry (normal, inflamed, toxins)
- Changes in speed, acceleration, and direction (fast, slow, accelerating, decelerating)
Your sensory receptors play an important role in the conscious and subconscious perception of your body position, body movement patterns, and outside environment.
Most people understand the concept of your taste buds sensing flavors, sensory receptors in your nose sensing odors, and the ability to interpret the information contained in visible light with the receptor cells in the back of your eye producing vision.
Many of these same sensory receptors also sense your weight, the speed movement, and the changes of tension in your muscles, ligaments, and tendons related to the positions of your bones relative to gravity. Doctors call this ability to sense kinesthesia (7).
The most important for our purposes are changes in the stress or strain on tissues with relationship to the changes in positions or movements of the human body relative to gravity.
Your brain will know exactly what position you are in and will know exactly what tension to apply to the muscles to balance your posture is when lying down, sitting, standing, and moving. It gets this information from your sensory systems.
Sensory Systems
- Skin pressure receptors
- Visual system
- Somatosensory system
- Vestibular system
- Skin Pressure Receptors
Skin pressure receptors
Skin pressure receptors, such as those located in the feet when standing, your buttocks when sitting, and other body parts when you are lying or moving, sense what part of the body is down and touching the ground.
2. Visual System
The visual system is the eyes. The eyes observe where the body is in space (that is, upside down, right side up) and also the direction you are moving.
The eyes provide the best clues on where you are in space. Pilots who fly into clouds have no idea where they are. If they do not look at their gauges, they could be flying straight into the ground and not know it.
Most important, your somatosensory and vestibular systems stimulate reflexes, called righting reflexes, to maintain your eyes gazing at the horizon, no matter what position you are in.
Visual Receptors - Eyes
3. Somatosensory System
Somato means body in Greek. So, these are the body sensory systems. The somatosensory system is one of the most important sensory systems to understand. Because it is purely reflexive, you can control how it reacts by understanding how it reacts to your positions and movements of your activities of daily life.
Also, most important, the sensory system is what you will be treating with self-help treatments to help you reduce the compression on your thoracic outlet, tunnel, and other parts of your integrated spring mechanism.
This sensory system is composed of microscopic strain sensors, called muscle spindles, Golgi tendon organs, joint mechanoreceptors, and the skin receptors. Muscle and joint sensory receptors report the level of tension, stress, or strain on your human spring. They are your body’s strain gauges.
These special receptor cells include muscle spindles (8), Golgi tendon reflex cells (9), joint receptors (10), skin receptors (11), visual and balance control or vestibular receptors (12–15), and receptors that control the flow of blood through your circulatory system and respiratory system or the control of your rib cage spring (15).
Receptors include the following.
- Muscle spindle cells
- Golgi tendon reflex cells
- Mechanoreceptors
- Joint receptors
- Hair follicles
- Glabrous skin receptors
- Nociceptors
Muscle Spindle Cells—Introduction
The Muscle Spindle Cell
Muscles don’t detect the strain on your body. Strain on muscles is detected by muscle spindle cells (strain gauges) that are interwoven between the muscles.
Muscle spindles are sensory receptors interwoven among the millions of muscle fibers in your body. They primarily detect changes in the tension or strain on muscles and sense how quickly the tension or strain is loaded on the muscles. This information is relayed to the brain and spinal cord by your nerves. When it reaches your brain, the information is processed to determine the position of the body and your spring and how much tension these body parts are putting on your integrated spring. The muscle spindle cell is the most important sensor, playing a major role in sensing tension, so your brain can make the adjustments to any stressful motion, state of equilibrium, or imbalance (16).
Muscle Spindle Cells—Density
How many do we have, and where are they?
We are born with the exact number of receptors that we have as an adult. They don’t increase as we get older. The average person has 4,000 muscle spindle cells, 2,500 Golgi tendon organ cells, and a few hundred joint receptors (17–19).
Muscles, such as the big thigh (quadriceps) and other leg muscles that perform gross movements, have a small or low density of spindle cells. Muscles that create fine movement, such as in the fingers and hands and the joints at the base of the skull, have high densities of spindle cells (20).
This is actually a small number of sensory cells. For example, the human hand alone has about 17,000 skin sensors (21).
Muscle Spindle Cells—Anatomy
A muscle spindle cell is a cigar-shaped cell with a membrane around it and fluid inside. It looks a lot like a light bulb.
Inside there are 10–12 stretchy filaments that attach on either side of the spindle cell ends. These filaments are called intra-fusil fibers. The filament is stiffer in the middle and stretchier on the ends where it attaches to the cell.
There are nerves wrapped around the filaments, which relay how much tension is affecting the strain gauge. The filaments in the spindle cell gauge the tension of about 8–12 muscle fibers, which are intertwined around this spindle cell.
Muscle Spindle Cells—Function?
While the muscles are contracting, the muscle spindles detect how much strain is, where the strain is and how quickly the strain is applied on the muscle. This information is sent to the brain almost instantaneously by your nerves while the change in the tension of the muscle is taking place. The nerves transmit when strain is loaded and when the strain is unloaded (22).
Signals from spindle cells, Golgi tendon organ cells, and skin stretch sensory cells contribute to the perception of the positions of your body parts and how much strain or tension is occurring. This allows you to FEEL your movement (23–24). This is how you know where you are, even when your eyes are closed.
This increase in tension on the filament stretches and stimulates nerves that wrap around the filament, and this turns the mechanical energy into electrical energy, creating a nerve impulse. In other words, these nerves feel and measure the strain on the filament, turn this strain into electrical signals, and send these electrical signals to the spinal cord and brain to relay how much strain is on the spindle cell and surrounding muscles. This is how the brain’s software acquires the necessary information to help control the tension and ultimately the posture of the body (25). To summarize, when the muscles are stretched or there is tension in the muscles, the spindle cell is stretched. That stimulates the nerves that are wrapped around the filament. The nerves then send this message of tension to the spinal cord, and then to the brain for processing.
Golgi Reflex Organ
The Golgi Refl ex Organ And The Refl ex Pathway To The Spinal Cord And Brain.
Courtesy of Arthur Prochazka’s Lab, University of Alberta
The Golgi tendon organ cell is another spring strain gauge. This sensor sits as a strain gauge between the muscle and the tendon (26). When a muscle is activated and contracts, this tension pulls on the Golgi tendon organ cell, which straightens out some of the tissue strands, compressing and stimulating the nerves. Then the nerves send electrical energy to the spinal cord and brain (27).
If there is strain on the muscle tendon area that could exceed the yield point leading to damage or complete rupture, the Golgi reflex organ automatically alerts the brain, and the brain reacts and shuts down the contraction of the muscle to protect the body from damage.
Mechanoreceptor Sensors
There are also strain gauge sensors embedded in ligaments. They can relay information almost instantly about the strain on ligaments, joint positions, and movements to the spinal cord.
Chemical and Pressure Sensors
Nociceptors
Intertwined among muscles and tissues are other receptors, called nociceptors. They have specialized receptors or nerve endings that sense changes in harmful mechanical pressure, temperature, and chemical changes in and around muscles.
According to the International Association for the Study of Pain, a nociceptor is defined as a high- threshold sensory receptor of the peripheral somatosensory nervous system that is capable of transducing and encoding noxious stimuli (28).
These nociceptors are sensitive to substances, like inflammation or toxins released from tissues. They are also sensitive to changes in pressure and temperature.
Nociceptors are essential for the maintenance of the body’s integrity by sensing harmful stimuli and contributing to the necessary reactions to avoid them. The body will rapidly withdraw from an unpleasant or painful sensation. Nociceptors protect you! When the central nervous system gets signals from nociceptors, it interprets these signals as an alarm that the body is experiencing an abnormal amount of inflammation, toxins, or abnormal mechanical stress in the tissues.
The brain might also interpret that you have touched something alarmingly cold or hot that could hurt you. These nerves also signal when inflammatory chemicals are seeping or soaking into your tissues, a sign of injury or chronic damage. The nerves take the messages from your sensory cells to your brain. There is another set of nerves that relays the message from your brain back down to your sensors and muscles.
Muscle Spindle Cells—Patterning of Reflexes—Position Sense
We have seen that spindles are stretch sensitive receptors that provide the brain and spinal cord with information about the muscle length, tension, and speed of contraction. They relay this information to the brain, which makes it possible for you to sense where you are in space (29) and how fast you are moving.
These functions are referred to as proprioception and, as discussed above, the muscle spindles play an essential role in providing feedback to your brain as to what movements you are making every second of the day (30) (31).
Proprioception is the ability to sense stimuli arising within the body regarding position, motion, and equilibrium. The sensory cells, such as the spindle cells and the Golgi reflex organs, also send information about the positions of your body, including posture.
Your posture should be looked at with respect to how the body parts arrange around the spring to ensure that there is no strain on any section of the integrated spring mechanism.
4. The Vestibular System
The vestibular system is in a cave in your skull.
The vestibular system consists of different sensory organs located in a cave in your skull in your inner ear (the labyrinth). It contributes to posture by interpreting changes in head position and movement with relation to gravity and the direction and velocity or speed of head and body movements. This information is sent to the brainstem, which then creates a response that allows your postural muscles to adjust your postural orientation.
The vestibular system is officially defined as: the sensory system that responds to the position of head in relation to gravity. It senses when you are moving forward, backward, and at different body and head angles.
The vestibular system consists of three semicircular ducts, the utricle, and the saccule. These are all part of the membranous labyrinth.
This sensory system monitors the directions of your motion, such as turning or forward-backward, side-to-side, and up-and-down motions. It assesses movements of the head relative to gravity, without you having to think about it. Therefore, it is a reflex.
Vestibular sense—
- Provides information related to movement and head position related to your body positions relative to gravity.
- Is important for development of balance, coordination, eye control, attention, and being secure with movement
- Maintains eye contact with what you want to see, regardless of what position your body is in
The Sensors of the Vestibular System
The sense organs of the vestibular system, like the muscle spindle cells and the Golgi tendon organs are called mechanoreceptors. The semicircular ducts are like three hula-hoops with thousands of tiny hairs all over the inside. On top of the hairs is a gel material and some crystals. When your body and head moves, the gel slides down the canal and bends the tiny hairs. This trips the nerves attached to the hairs, which alerts the brain to the exact changes in head position, speed of movement, and direction of movement.
The ability of your nervous system to detect movements of the head is dynamic equilibrium. The utricle and saccule detect the position of the head when it is not moving (static equilibrium). When the head moves, the fl ow of a gelatinous substance moves across microscopic hairs and defl ects them.
The defl ected hair cells stimulate nerves that give the brain information about your precise movement.
The brain can then determine the position of your head relative to gravity. This is all done automatically (reflexively) by your nervous system. The human utricle contains about 30,000 hair cells while the saccule contains about 16,000 hair cells.
It is more complicated than this, but that is how these sense organs determine the position and movement of the head relative to gravity. It’s like having six living spring levels (also called a bubble level) inside your head that are arranged in different angles to relay the exact position of your head and how fast and where you are moving. The primary purpose of these six levels inside your skull is to keep your head and eyes level to the horizon and also perpendicular to gravity.
The brain takes the information and automatically rights or centers your head perpendicular, and thus your eyes level to the exact horizontal position, just like a builder would when laying a foundation or the floor of a building.
The utricle and saccule hair cells detect the acceleration of the movement forward or backward or head tilt (gravity) in relation to the ground (static equilibrium). In the semicircular ducts, the hair cells detect movements of the head, such as nodding, turning the head side to side, or tilting the head left and right (dynamic equilibrium).
The vestibular apparatus is the inner ear. It serves three primary purposes in humans.
- The vestibular system plays the dominant role to maintain equilibrium to let you know where you are, where you are going, and how fast.
- The vestibular system also helps you maintain a steady focus or fixation point of the eyes providing a stable image on the retina of the eyes, regardless of the position of your head.
- The vestibular system provides information to control muscle tension on your spring to set your body position to allow for upright posture.
The vestibular apparatus provides information about the position of the head in space. These sensors can detect a change in orientation of the head of 0.5 degrees from the upright position and a change of 5 degrees from the horizontal position.
The vestibular system engages a number of reflex pathways that are responsible for making adjustments in body angle and position to gravity. This happens automatically through different reflexes.
The names of the three most important reflexes are the vestibulo-ocular reflex, the vestibulospinal reflex, and the vestibulocollic reflex. The most important reflex is called the righting reflex.
The Righting Refl ex
The body and head leans to the left.
- The vestibular system and other sensory systems sense the body lean outside of perpendicular to gravity.
- This change in posture is sent to the brain for processing
- In a split second a signal is sent to the opposite scalene muscles (and others) to pull the neck and head to the right so the head is perpendicular to gravity and the eyes are on the horizon.
Righting Reflex or Labyrinthine Righting Reflex
This reflex combines input from the vision, somatosensory, and vestibular reflexes. It can detect, within a split second, that the body is not erect, causing the head to be off perpendicular to the ground. Then it signals muscles in your neck to contract to move the head back into the perpendicular position. Then the rest of the body follows, if possible.
It’s not that simple. The brain interprets the signals from your eyes and muscle spindle receptors in the neck and the vestibular system to determine if the head is tilted or the entire body is tipping. That is how it can make split-second reflex adjustments in tension in your neck muscles and maintain your head perpendicular to gravity and your eyes on the horizon, no matter what position your body is in.
So, all head posture changes relative to your body angles are done automatically.
Posture Control by Learned Behavior
When your mom says, “Sit up straight!” you contract muscles to position your body and head where YOU think a good posture is. By tensing your muscles, you are causing an abnormal compression of your human spring. The muscle contractions will cause a compression of the spring. The longer your muscles contract to hold your posture, the deeper the brain commits this pattern of contraction to memory.
This will cause muscle contractions that can turn into reflex, trigger point, painful, compressive spasms. This can lead to neck pain, upper back pain, shoulder pain, and thoracic outlet syndrome.
Also, this abnormal compression could lead to painful conditions. Walking or running with a tense spring will cause your body to bang into the ground, rather than spring off the ground.
It is medically necessary to learn how to work with these reflexes so you can sleep, sit, stand, and walk without causing abnormal compression of your thoracic outlet and vertebral discs. Through the information in this book, I can act as your trainer and coach to teach you the patterns that cause the positive and negative effects on your body’s spring. You will learn that in Chapter 5, “The Cause of Compression!”
Static Posture Evaluation
Plumb line. 1: a line (as of cord) that has at one end a weight (as a plumb bob) and is used to determine verticality. 2: a line directed to the center of gravity of Earth: a vertical line. A line regarded as directed exactly toward Earth’s center of gravity. A cord with a lead bob attached to one end, used to determine perpendicularity.
Some doctors have you stand on two scales to see if you have uneven distribution of weight on either side of your body. These are all static or stationary checks of body posture.
This is how I do your gait evaluation on a computer.
Dynamic Posture Evaluation
My approach to checking body posture is both static and dynamic, videotaping and studying patients’
movements they do on the job and the study of biomechanics of athletes when they are performing sports activities.
Probably the single most important thing I do in my examination of patients is to check their walking pattern. What I’m looking for is whether you walk with a pattern that uses your integrated spring mechanism according to its design, in harmony with gravity, with a balance of tension or at perfect equilibrium or walking with levers, banging into the ground, and twisting off the ground.
You can watch the video of my short lecture, “Ways Physicians Can Detect the Earliest Signs of Aging via Gait Analysis,” from the A4M Thailand Congress on Anti-Aging Medicine, 2017.
The patterns of movement are stored in the brain in engram patterns.
The Engrams, Neural Development, or Brain Patterning—Your Body’s Software Programming
Brain Patterning
Complex patterns of muscle activation that produce coordinated movements can be generated in humans, within the spinal cord and the brain. A simple movement, such as lifting your arm to grab a computer mouse and move it across the table, involves the stimulation of thousands of receptors in your skin, ligaments, muscles, tendons, and even in your eyes and ears, which work together to develop patterns that become stored in your brain. As explained above, these patterns that you take for granted are developed and stored for later use in the brain. These combined movement patterns are called engrams. As I have also described, you have engrams for the pattern of your walk, run, smile, laugh, cough, singing voice, and even the pattern of how you play a song on the piano.
The existence of specific engrams is not disputed. However, doctors and scientists don’t know exactly how this mechanism works, although this has been a focus of persistent research for years.
Are the engram patterns in the software of the brain the same as muscle memory?
Many people ask me about muscle memory. They assume that by training muscles to contract and move in a specific pattern, memory is stored in the muscles. But muscle memory is just a figure of speech.
Muscles don’t have the ability to store the memories of any movements. All memories of movements are stored as the engrams in your brain.
So, when we are training athletes to execute movements and activities of daily life, such as walking or running, we are training the nervous system patterns and not the muscle memory.
Don’t think you aren’t the only one who didn’t understand muscle memory. In fact, after a presentation, “The Best Sports for an Anti-Aging Lifestyle” at the Anti-Aging Medicine World Congress in 2007 in Monte Carlo, Principality of Monaco, at least a dozen doctors met me in the hallway to share their aha moment when they learned that we are training the nervous system memory and not muscle memory when we train athletes.
You can watch this lecture on our YouTube channel. You can find it at www.thorcicoutletsyndrome.org.
You have positive engrams and negative engrams.
If you practice healthy patterns, the brain will store healthy, positive, engram patterns. It also stores destructive, negative, engram patterns. Your brain is your humble servant, in that sense. It stores the patterns you repeat, whether they are healthy or damaging to you.
The movement pattern or posture you communicate to the brain eventually becomes the movement pattern and posture your servant, the brain, considers normal and habitual to you. The stress and the strained movement you repeat will be the stress and the strained movement you will continue to repeat. It will persist this way until you reprogram your brain to replace the old stressful pattern with a new stress-free pattern.
It is a fact that these patterns can be reinforced with repetition. That is what we call “practice makes perfect” in sports—or perfect practice makes perfect execution of perfect form and technique over and over. So, your nervous system functions like any other computer: garbage in, garbage out.
The brain is your humble servant to store the pattern of every single movement you make.
We’ve seen that the body’s sensory system is constantly sending messages from thousands of sensors to your brain to provide feedback as to how your body is interacting with Earth’s gravity. As we’ve established, there is an engram or pattern of movement, such as walking, running, lying down, sitting up, standing, and activities in sport, that is programmed in your brain. This practiced movement pattern and positioning allows you to use your integrated spring for activities of daily life or sports without causing damage to it. It also represents the human spring’s highest level of protection and energy recycling. Gravity is constantly pulling us down and compressing our body’s human spring, and the sensors are reacting to any and all strain that is placed on body parts, muscles, ligaments, tendons, and bones when the body is in various positions related to gravity’s pull.
This is so important that I am constantly practicing my walking pattern to ensure it is as close to perfect as possible. I don’t want knee or hip replacements when I’m retired trying to enjoy my later years.
There is a lot more to it, which I plan on covering in my next book.
Conclusion
So, the control of the tension that either maintains a wide open thoracic tunnel and little to no stress and strain on your muscles, bones, and joints is primarily controlled by you through your posture and other habits.
Remember your nervous system will increase or decrease the tension on your human spring, depending on what you do every day.
Living a pain-free, active, healthy life requires you to live in harmony with nature, specifically Earth’s gravity.
Now that we understand fully how the body works lets finally find out what is causing that compression of your thoracic outlet and tunnel.
Spring forward!