TENSEGRITY
The Protective Function of Muscle
In the nor roo distant past, bone was considered , qua tissue, as an insignificant, even inert, body tissue that acted merely as a spacer for musculo
tendonous and ligament arrachments. As a result of new clinical information, new directions in assessment and treatment of bone pathology are being developed almost on a daily basis. This information comes from recognizing new appli
cations of "old" information, from original research, and from the creation of new and unique rehabilitative conStructs.
In a similar fashion, our understanding of the function of muscle tissue has undergone a dras
tic revision. Muscle, for example, has essentially always been identified with its movement capa
bility. Moving a person or body part from one place ro another has been seen as its primary func
tion. In our clinics and seminars, we have under
taken a closer look at an alternate function of muscle: its protective function. We have recog
nIzed the monumental importance of this func
tion and how in most clin ical situations its presence takes precedence over any considera
tions of movement. For example, consider the phenomenon of protective muscle spasm. In addi
tion ro being subjectively uncomfortable, a spasm can serve the interests of the organism, for exam
ple, under conditions of trauma by limiting range of motion, splinting a joint, and protecting against unwanted movement, all on a lower motor neu
ron level! Thanks to our awareness of this we , have applied basic neurologic constructs and self
protective patterns to upper motor neuron prob
lems and found that the body can, and o&en does, have distinct mechanics at the higher spinal cord, brain stem, and cortex that require the maximum prorection after injury. In other words, once we
25
applied our lower motor neuron concepts to upper motor neuron problems such as stroke , cerebral palsy, and TBIs, we were able to facili
tate major changes in structure and function.
Addressing the muscle's protective function first, before its movement function, leads to far more dramatic changes than the other way around.
We see this protective function of muscles in many different areas. Skeletal and smooth mus
cle protection is evident within and beyond the boundaries of many systems including the nerves, bones, blood vessels, joints, and viscera. From our clinical research we have observed, moni
tored, and treated smooth muscle spasm at the level of lymphatic chains, IJascular constriction of both veins and arteries, and IJiscera-spasm sec
ondary to ulcers, colitis, and hernias. The list of problems and pathologies that we are able to
address using this approach is extensive and con
tinues to grow.
The function of protection occurs automati
cally, autonomically and instantaneously in most cases. (Weiselfish) Giammarreo and colleagues have been focusing not only on the clinical sig
nificance of this phenomenon for over ten years at the time of this writing, but also on the struc
tural and functional sequelae of the protective activities. (Weisel fish) Giammarreo has localized over 600 individual and specific pathoanatomic dysfunctions classified as compression syndromes.
These syndromes have been found to occur within and berween systems. No tissue is immune to dys
function. It has become more apparent to us with each clinical case we examine, that the body's ability to self-protect is as great or even greater than the body's ability to heal itself. Each presen
tation must be acknowledged and assessed care
fully to see if its etiology involves the protective
26 I N T EG R ATIVE MANUAl THERAPY fOR THE C O N N E C T I V E T I SSUE SYSTEM
mechanism. Even our "learned" movement pat
terns serve as much as a developmental reflection of these core protective mechanisms as they do of our neural developmental processes.
Tensegrity
Many practitioners within the field of rehabilita
tion are familiar with the basic constructs of myofascial release techniques. An underac
knowledged concept presented by Ingber and Juhan may add a broader base of understanding to the whole spectrum of connective tissue liter
ature. The concept of tensegrity or "tensional integrity" has extensive applications to our use of connective tissue bio- physiology and mechan
ics. The term " tensegrity" was coined by Buckminster Fuller to describe a natural pheno
mena whereby a "system stabilizes itself mechan
ically via an intricate balance and distribution of compressional and tensional forces on the skele
ton." Ingber's research and application expanded our understanding of this concept.
First of all, Ingber (Ingber 1 998) noted a con
sistent organizational pattern of tissues with a well-defined hierarchy at every level of body tis
sue. He also noted that these same tissues exhibit a similar pattern of self-assembly from the small
est cellular levels to the largest organ or system levels in the body. Within this consistent
con-. '
tlguous, and continuous framework is the archi-tectural design of tensegrity. Ingber and Juhan agree definitionally thar rensegrity " refers to a system that stabilizes itself mechanically through a balance of tension and compressive forces." FN Ingber notes that the self-stabilization phenom
ena can be exhibited on all levels: microscopic to macroscopic. Clinically, this has excellent appli
cations, especially to the 3-Planar Myofascial Ful
crum techniques. In other words, the existence of tensional and compressive balance not only exists at the level of the muscles, fascia, tendons, and ligaments, but more importantly it also has been seen at the molecular level, i.e., proteins, carbo
hydrates, fats and even extracellular matrix.
Specifically, Ingber showed that cells contain an internal framework of protein polymers that he referred to as cyotoskeleton. He was able to sim
ulate how a finite network of contractile micro
filaments actually extends through the cell, pulling the contents towards the cell nucleus. He local
ized additional forces within the cell as well as within the extracellular matrix that work in oppo
sition-of-balance stress on the cell. Adhesion receptors on the cell surface known as integrins help transmit these forces from the external to the internal milieu of the cell. Ingber realized the pro
found implications of the tensegrity model. He stated that "the existence of a force balance was a way to provide a means to integrate mechanics and biochemistry at the molecular level" FN Sec
ondary to the tensegriry design, he found it pos
Sible to change the cell cyotoskeleton by altering the balance of physical forces transmitted across the cell surface. This finding is important because many of the enzymes and other substances that control protein synthesis, energy conversion, and growth in the cell are physically immobilized on the cyotoskeleton. For this reason, changing cyotoskeletal geometry and mechanics could affect biochemical reactions and even alter the genes that are activated and thus the proteins that are made. Ingber even noted that depending on rhe type of stress induction to the cell surface, reac
tions were stimulated at a cellular level.
. The profound clinical implications of tenseg
my can best be seen when examining our fascial fulcrum concept. By inttoducing minimally main
tained stresses in specific patterns, we can trans
duce forces to the level of the cell and theoretically affect its functional capaciry. Ingber's research can easily be extrapolated to both treatment tech
niques and potential outcomes. If we can change cyotoskeleton configurarions through force trans
mission from an external myofascial fulcrum, we should have an increased potential for affecting a multitude of pathological conditions. In other words, we step beyond a pathomechanical model to a pathophysiological or pathochemical model.
THE P ROTECTIVE F U N CT I O N O F M USClE: T E N I E G R I I Y 2 7
Application of this concept with our clinical skills may well explain why we have had excellent out
comes with medical conditions heretofore not addressed in this manner. These include diabetes mellitus, spinal cord injury, stroke, multiple sclerosis, cancer, radiation sequelae, attention deficit disorder, autism, pervasive developmental disorder, infection, immune system suppression, traumatic brain injury, migraines, carpal tunnel
syndrome, visceral dysfunction, infertility, scar
ring, and amyotrophic lateral sclerosis, to name just a few.
juhan's and especially ingber's insights, when combined in a functional, clinical, and practical approach, lend significant validity and objectiv
ity to a theoretical concept that has largely been based on conjecture and subjectivity to date.
CHAPTER 8