Monday, March 8, 2010


As you can see from this video, I have very, very limited range of motion in my right elbow, so much so I am getting surgery to remove some bone spurs and take out bone chips in the joint on Thursday. My elbow has never been fractured, (micro fracture possibly). But I had noticeable range of motion loss each year since I was about 23. Basically I've always chalked it up to a life of football, rugby, weight lifting, mountain biking, bobsled and more weight lifting! But I also have some diminished range in extension now on my left. Nothing even close to what my right may be, but in ten years I'm not interested in having surgery on it like I will on my right.

Warren Hammer recently wrote an article about osteoarthritis. The article states that the tendino-periosteal attachment of the muscles and ligaments is very susceptible to injury from trauma. These areas are called entheses. They are structurally flawed, richly innervated and metabolically active areas that are the "weakest links" and most reactive sites in the musculoskeletal system.

From the paper. "Enthesis organ is the term used to describe the insertion area since it is no longer considered just a tendon or ligament attaching to a bone. Most insertions have a fibrocartilaginous insertion (some are just fibrous). Rather than considering only its attachment to bone, all of the complex anatomy surrounding the tendon-ligament must be considered.
For example, the enthesis organ for the lateral epicondyle includes the tendon, collateral ligament, annular ligament, adjacent circumference of the radial head and humeral articular cartilage. These tissues are related and fuse with each other. The same is true throughout the body regarding enthuses insertions."

The inflammatory response is triggered at these sites. Genetic susceptibility plays a role along with microtrauma. So an important thing to do is to evaluate areas that are tight, weak or tender. Entheses areas that are tender should be evaluated for local and distal restrictions within the surrounding fascia. In the early stages of osteoarthritis, the joints may be painless with stiffness or minimal nodular areas that should benefit from joint adjustments, friction massage,, ART and fascial release methods. This should be applied to the muscles, collateral ligaments, fascia and tendinous insertions. Applying mechanical load to abnormal tissue sets up a whole cascade of healing. Reducing the continuous stress on our musculoskeletal system is definitely preventative.

So basically getting your joints checked for proper alignment, getting some soft tissue work done to remove tender nodules to regain proper muscle length will go a long way in helping to prevent osteoarthritis


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Glenn said...

Interesting post, thanks!