If you don’t use it, you lose it

Life has been full of swimming, swimming and more swimming in recent weeks but I’ve also been working hard with some great massage clients. Some of my clients have done some extraordinary things this summer like cycling the South Downs Way in both directions (200 miles off road!) within 24 hours, ultra marathons, cycling from Lands End to John O’Groats, and ironman. It’s great to be able to be part of their adventures.
I’ve also been continuing to study and learn.  The professional association I belong to, the Sports Massage Association, requires its members to continually develop their skills and knowledge.  This is ongoing the whole time because there’s always something to research: particular medical conditions, talking to physios, doctors and PTs about biomechanics and different treatment approaches, new strengthening exercises etc. There’s also a huge cross over from my role as an endurance running coach.
Sometimes the learning is more formal. I recently attended a course at Imperial College Medical School about fascia – an umbrella term for all the connective tissue, tendons and ligaments in the body, in particular the filmy tissue that wraps around, through and between muscles. Think of an uncooked leg of lamb. The filmy substance that separates the major sections of muscle is fascia; so are all the sinews.  Fascia is a crucial consideration in all massage and bodywork because it is absolutely intrinsic to all tissues in the body.  Following fascial trails, you can see why the top of your head is demonstrably linked to the tip of your toes.
For our course we were in the privileged position of working with cadavers. These extraordinary people had donated their bodies for dissection and we were lucky enough to be learning from them, thanks to their generosity.  Because they needed to have died from natural causes, our subjects were very old – between 80 and 100 apparently.  Obviously they had been embalmed and so their tissues were not absolutely as they would have been in life, but other than that they were perfect.
I’ve worked with cadavers before, much earlier in my massage career, when they helped me to understand musculoskeletal anatomy in 3D. However, now that I have a few years’ practice under my belt, it was useful to look for specific attachments or muscle groups with more knowledge of how they might respond to massage.
What really struck me this time, though, was the atrophy in the musculature of these old people. One lady had clearly been bedbound for a long time. Her knees and hips were very stiff (notable despite the stiffening caused by the embalming process) with very little movement at all. Her lower back muscles though had practically disappeared.  Her erector spinae muscles in the small of her back (these are the normally-meaty long strips of muscle running up and down either side of the length of the spine) were reduced to a translucent sliver of tissue inside the fascia ‘bag’ that surrounds all muscles. There was nothing there that would have been able to provide any stability or strength to allow her to sit unaided; perhaps she had been lying down for a long time.
This is obviously an extreme case but the evidence was there. We’ll never know what happened for sure but it looked like this lady hadn’t been able to use her back muscles for years and so they had simply shrunk to practical nonexistence.

If we don’t use muscles they become weak and shrink. If we don’t use our deep core muscles and keep them strong, they won’t have the strength to hold our body upright. We’ll become slumped and our posture will suffer… which in turn will put strain on muscles that aren’t designed to take that strain and they’ll become irritable and hurt. We’ll get back ache. We’ll think it’s because we’re getting old and put up with it… but really, if we used enough of our muscles properly in the first place and kept them strong, we really can hold off some of the most debilitating signs of ageing.
I acknowledge it’s not always as simple as this for everyone, but for the vast majority of us, if we keep moving and make a bit of effort to keep our bodies in good working order, we’ll be rewarded with a life that’s active and pain-free for longer. That HAS to be worth doing some regular exercise and pilates or yoga for?