Chapter 1

GETTING TO KNOW THE PLAYERS

Watching a basketball game is enjoyable when I know the players and their capabilities; however, what I really like is that element of surprise which comes from an unknown player performing 'like a Michael Jordan.' Wow! Did you see that guy? I didn't know he could do that!"

I'd like to familiarize you with some of the "players" in the chronic headache/migraine game. The most surprising players to us will be muscles. What we'll discover is that some muscles are capable of much more than we realize. Muscles are responsible for the majority of the aches and pains from which we all suffer. Without realizing it, most people have a general understanding of how muscles work, and we know through painful experience what happens when they don't work correctly or have worked too much.

We'll use an example to demonstrate typical muscle dysfunction and the resultant symptoms. Clench your fist as hard as you possibly can. Now, decrease your intensity to at least 50% of maximum and remain clenching for at least ten minutes. After three or four minutes, you may find that ten minutes is a bit longer than you realized, so try to go as long as you can. While you're doing this, use the opposite hand to feel your forearm. Your forearm should feel stiff and may start to burn and ache. Your fingernails may be digging into the palm of your hand. What does it feel like when you finally finish? Even if you didn't participate in the exercise, you probably know. Your fingers feel stiff and tend to remain curled. Your forearm is fatigued and perhaps sore. What would it feel like if you did that same ten minute exercise every two hours for the rest of the day? Tomorrow or the day after, your fingers would be stiff and curled, your forearm painful, stiff, and tender to the touch, even when your fist is not clenched. Additionally, normal use of your forearm may result in a spasm or cramping of the muscles, which is very painful. These are typical symptoms of a muscle in a dysfunctional state.

In order for a muscle to do its required job and not become dysfunctional, it must receive adequate oxygen for metabolism, adequate blood flow to transport waste products out of the metabolism site, and enough rest between contractions. And even more importantly, the muscle must not participate in activities that it's not designed to do. But first, what is a muscle's job? A muscle moves one bone closer to another bone by shortening itself (i.e., contraction). A muscle is attached at one end to a stationary bone and at the other end to a moveable bone or structure. Once a muscle has completed a given task (e.g., moving the bone), the muscle ends the contraction and relaxes.

During the contraction, de-oxygenated blood and waste products build up within the muscle while the oxygenated blood trying to flow into the muscle is restricted. Once the contraction has been completed, the muscle relaxes and oxygenated blood rushes in. During our fist-clenching exercise, the forearm muscles remain contracted, preventing an adequate supply of oxygen and allowing a buildup of waste products (which wouldn't be so bad if we did it only once or twice for a minute or two). Chronic and intense fist-clenching, however, is not an activity the forearm muscles are designed to do. As a result, the forearm muscles become dysfunctional (i.e., painful and stiff). When this condition is allowed to continue, the muscles may tend to cramp or spasm. Therefore, if someone had this peculiar habit of clenching their fist, discovering how their forearm became so painful and their hand so stiff would be easy...just watch them. Treatment would be easy, too. Just figure out a way to prevent them from clenching their fist (which may not be so easy after all).

The fist-clenching example demonstrates a situation in which the muscular contraction has no specific purpose. Usually, the fingers and forearm would be working together to hold an object for a particular task. Once the task is completed (e.g., setting the object down), the muscles relax and await the next task. Chronic and intense muscular contraction without specific purpose and the resultant symptoms can result in a condition known as myofascial pain dysfunction (myo means muscle and fascial refers to the connective tissue that wraps around muscles).

"I had been hospitalized for a week of observation and tests at a special institute, but they still couldn't help me. It's a blessing that something so simple has made my life so wonderful!"      Marvel Mayer, Troy, MI

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