Exploring Structural and Functional Changes in Musculoskeletal Disorders

The causes of musculoskeletal disorders in the human body vary significantly. Some may necessitate medical intervention, while others can be resolved naturally.

Understanding the various causes of musculoskeletal disorders can be challenging, particularly for massage therapists with limited training as well as their clients. However, adopting a systematic approach can greatly aid in comprehending these issues. Moreover, grasping the underlying causes is invaluable for determining the most effective treatment strategies and predicting outcomes. In essence, having insight into the condition of the musculoskeletal system enables one to discern the necessary steps and anticipate the results.

Structure and function

To grasp the fundamental nature of the different causes of musculoskeletal disorders, it’s helpful to work with the concepts of ‘structure’ and ‘function.’ While these are complex medical and philosophical terms that may not lend themselves to concise explanations, they are intuitively comprehensible.

As an example, let’s consider a hypothetical joint composed of two bones and a muscle, a common anatomical structure (refer to Figure A for illustration).

When the muscle contracts, it initiates movement within the joint (as depicted in Figure B)

In this example, the joint, bones, and muscle are structures, and the process of muscle contraction and movement in the joint are functions.

In this example, we can consider the joint, bones, and muscle as structures, while the process of muscle contraction and the resulting joint movement represent as functions.

Structural and functional disorder

Now, let’s envision a scenario where the movement within the joint becomes disrupted. The factors contributing to this disorder can be categorized into two broad groups

• Structural disorders
• Functional disorders

Structural disorders include conditions such as muscle ruptures and bone fractures. It’s evident that when the integrity of the bone or muscle is compromised, normal joint movements become impossible. Without appropriate medical intervention to restore the structure, joint mobility cannot be regained.

Functional disorders are those where, initially, the structure remains intact, with the primary disruption occurring in function.

Take muscle fatigue, for instance. It’s widely recognized that prolonged physical exertion can lead to muscle fatigue. Initially, you may be able to push through and work despite feeling tired. However, eventually, your movements will come to a halt.

While the bones remain intact and the joint is undamaged, movement can still be impaired due to muscle overexertion. All that’s typically needed is to allow the muscle sufficient time to recover, and normal function will be restored. Medical intervention is usually unnecessary in such cases.

Fatigue serves as a signal from the body, indicating that the muscle is operating at its maximum capacity. In instances of structural damage, pain acts as another body’s signal.

Consequences of functional disorders

Thus, it’s evident that structural disorders tend to be more severe and necessitate medical treatment. It’s unlikely that someone with a freshly broken bone would seek the services of a massage therapist.

Therefore, we will focus on functional disorders. In the example mentioned earlier, there are two possible scenarios that can unfold.

In the first scenario, you took seriously your body’s signals of muscle fatigue. You allowed the tired muscle ample time to recover, avoided excessive strain, and introduced physical activity gradually. As a result, through repeated training, the muscle adapts and gains strength. Essentially, this mirrors the typical muscle training techniques employed in sports.

Furthermore, it’s worth noting that functional alterations can gradually pave the way for structural changes.

In the second scenario, you disregarded your body’s signals and persisted in overworking the muscle. Initially, you may not notice any immediate changes, aside from a persistent sense of fatigue.

However, over time, the muscle tissue’s resources will become entirely depleted, leading to adverse structural changes within the muscle. In this scenario, these changes are detrimental, resulting in a decline in the muscle’s strength, muscle fiber ruptures, and the development of acute muscle inflammation known as myositis.

Your body will continue to send you additional signals. Alongside fatigue, pain will become apparent. If these signals are still ignored, muscle function will further deteriorate, leading to muscle tissue atrophy and ultimately, complete muscle dysfunction.

Relationship between structural and functional disorders

This highlights the interconnectedness of structural and functional disorders. Structural changes typically prompt swift functional alterations, whereas functional changes, although not immediate, can eventually result in structural changes.

As mentioned earlier, functional disorders are more prevalent in the practice of a massage therapist than structural ones. Consequently, comprehending the interplay between structure and function is of paramount importance for effective care.

For example, if a massage therapist observes that their efforts to restore normal function prove ineffective, it’s prudent to anticipate an impending structural issue. Such a development can undoubtedly exacerbate the situation and prognosis. In such cases, it is advisable to recommend that the client consult a specialist and provide a clear explanation of the necessity for doing so.

This approach is routinely applied in my massage clinic. It involves assessing musculoskeletal problems in terms of both structural and functional changes, followed by the development of a tailored plan and appropriate recommendations to address the specific situation