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What causes tissue breakdown? Hint, it’s not biomechanical loading.

Posted By Jamie Page  

You may think that physios are trained to be technicians of the human body, especially when it comes to biomechanics - we know which muscles do what, which imbalances cause problems, and how to exercise to protect your joints. However, I've learnt that our body is more complex than what lies on the surface, and the best results that my patients have, are when we explore the underlying system that is driving their problem. As the iceberg photo shows, biomechanics is often just the surface level of a much deeper problem - inflammation.

Many people think inflammation is either something that you have, or you don't. But it's better if you think of inflammation like a tap dripping. Consider it on a spectrum rather than a yes or no event. All of us are usually dealing with some level of systemic inflammation but where we sit on that spectrum is key. If our inflammation nudges up, our ability to stand mechanical loading is reduced and tissue breakdown and subsequent pain occurs. If our inflammation burden is low, we are much more biomechanically resilient and can worry less about what challenges our body faces.

So back to the iceberg photo - it shows that our biomechanics matter much more when an individual has systemic dysfunction such as inflammation present.

The next question I often get is what drives inflammation in the body? Unfortunately, this is where things get more complex. Many things ultimately drive inflammation. However, I think we can look at some major players primarily.


First, I consider the gut. The health of our gut is paramount to our overall health and it’s no wonder it’s frequently linked to nearly every disease process. We now have a gut-brain axis, gut-skin axis, gut-immune axis, gut - liver axis. If the gut can affect somewhere in the body, it will.

What has the biggest influence on our gut? Look no further than your diet. Eating a whole food ancestral diet without modern additions such as refined grains, processed sugar and vegetable/ seed oils would be a good place to start. I’m not a big fan of a diet scattered with pasta, bread, sweet treats and frequent takeaways. It’s not how we evolved to eat and we underestimate how this can link into your joint and body aches and pains. Try taking a break from grains, sugar and vegetable oils for a month and just see what happens. You may be amazed at the results you notice.

Next, I consider stress. We are in a culture of higher stress where a certain event may have tipped us over the edge. Yes, we can all handle a little stress but what is it doing to our biology? Firstly it negatively impacts our key driver, the gut - which leads to more inflammation. A bit like our gut though, stress has similar effects on multiple systems of the body. It’s quite a whole system disrupter.

Stress is a harder area to give broad advice on. What reduces stress for one person, may increase it for another. I spend my time on the tennis court, take a weekly infrared sauna and enjoy cold water swimming. Others may find those activities more stressful. My tip is to factor in a few activities in your week that are just for your own benefit whether it be a walk in the park, some Breathwork or meditation. Or just a good catch up with a friend who makes you laugh. Things are finally much easier on that front!

The next key player I would consider is sleep. Sleep is so foundational with our health and so many fail to pay it the attention it deserves. Are you watching too much stimulating tv before bed? Are you reading covid news stories on your iPad lying in bed? Or, are you getting morning sunlight rather than morning screen time? If your screen time is nudging up each week, for me it nearly always leads to poorer sleep in the evening.

These habits can creep up on us every now and then, so make it a practice to check in with yourself and return to a few principles that you believe help you sleep better. Mine is turning my phone off at least an hour before bed and reading the hour before bed rather than watching tv. My last drop of alcohol is always before 7 pm so I don’t go to bed with much of it still in my system. I also make sure my room is very dark and cool before bed. Studies have shown that even losing one hour of sleep can shift the body into a stress response and increase that inflammation response again.

The final area, I believe is quite overlooked - breathing. Much like sleep, this one is often just taken for granted as something we do without any effort required. Breathing can turn off our stress response and reduce inflammation building up. I try and make an effort to focus on nasal breathing rather than mouth breathing when I walk. I also try and keep awareness on breathing from my diaphragm rather than all in the upper chest. I also like to focus on some specific breathwork when I have 10 minutes to spare. Personally, I’ve found the app Inward Breath the best for guided breathwork exercises. They have sessions with excellent music depending on what mood and what you want. I tend to enjoy energising breathwork, so will often select something from this category. Try out one of their more relaxing sessions on YouTube in the link below.

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So what will you do this week?

Pick a couple to focus on, or try all of these simple tips:

- Remove grains, sugar, seed oils from your diet.
- Introduce at least 2 activities that aim to reduce your stress
- Have a bedtime routine
- Get some morning sunlight
- Have a daily Breathwork practice
- Go for a walk and listen to a podcast instead of watching Netflix or internet browsing