Michelle Tsujimoto

Musculoskeletal Therapist



  • About Musculoskeletal Therapy

    [MUSCULO-/AR: Relating to muscles, tendons and their fascia.

    SKELETAL:  Relating to the bones, joints. ligaments, menisci, and joint capsules.]



    Musculoskelatel Therapy is the use of a variety of assessment and treaatment techniques to aid in recovery from trauma such as sprains, strains, fractures, overuse and surgery. It also targets poor posture; inflammatory conditions such as tendinitis and bursitis; and can help to relieve some of the symptoms of arthritis which is an inflammatory, degenerative joint condition.


    Poor posture is not usually high on peoples list of reasons for seeking treatment (pain is number one; with lack of mobility being number two), but chronic poor posture is usually the precursor to pain, limited range of movement, arthritis and other inflammatory conditions of the Musculoskeletal System!


    Chronic poor posture creates abnormal shortening of the chest, abdominal and hip muscles at the front; and the back of the neck; while the muscles at the back are under a continual state of tension, creating fatigue and aching in that area.  Poor posture creates joint misalignment which puts excessive strain on the ligaments and bursae; and tendons of the muscles. The misalignment also puts abnormal pressure on the joint cartilage and causes premature degeneration (arthritis).


    You have probably tried to sit up straight while you’ve been reading this, but like most people, that will only last for a short time as you find it fatiguing and maybe even uncomfortable to sit up straight…alarming considering that poor posture is supposed to be better for you, but not surprising because of the shortening in the muscles at the front, and the weakness that has been created in the ‘overstretched’ back muscles. Musculoskeletal Therapy is about redressing the balance and strength needed to maintain a good, natural posture with ease.



  • more on the musculoskeletal system and fatigue


    Fatigue is a common result of poor posture - for a couple of reasons: It takes far more energy to move our bodies when the joints are not aligned, especially the spine, pelvis and legs. These structures are particularly designed to absorb and countermand the effects of gravity, while also absorbing the impact from walking/running/jumping. When we have poor posture, it moves these structures forward of the centre of gravity, and the muscles (particularly of our neck, back, buttocks, hamstrings and calves) have to work much harder to keep us upright and not fall to the ground as gravity wants us to do. These muscles are under constant tension to make up for what the skeleton can’t do when there is poor alignment.


    Another reason for fatigue with poor posture is the effect it has on the internal organs. This centres mostly around the diaphragm (the prime muscle that we breathe with). A hunched posture compresses the diaphragm, restricting how freely and easily we can breathe (keep in mind that breathing is not just about bringing oxygen in, but about expelling carbon dioxide etc…the waste products of cellular metabolism. Waste product removal from the body is equally as important as bringing nutrition in!. This is not the end of the scenario though…all the organs below the diaphragm (Digestive, Reproductive and Urinary Systems) which are already tightly packed in the abdomen and pelvis, become compressed which restricts their blood flow and therefore their capacity to function (remembering that the Digestive System supplies us with energy amongst other things).

    So, treating poor posture is not just about aesthetics and pain: there is sound physiological reasoning behind it.



  • the musculoskeletal system is not it's own boss


    The Musculoskeletal System is highly complex. Its three main functions are to produce blood cells (in bone marrow); provide protection for the vital and delicate systems inside; and of course movement, BUT it does not act alone, and nor does it act on its own free will…it depends on, yet is integrated with all the other systems of the body.  In the body’s hierachy of all its systems, it ranks lowest because it plays the least part in the overall health and functioning in the body. In other words: nothing happens in the muscles and joints unless a directive comes from ‘higher up the chain’.


    For this reason, pain, restriction and dysfunction in the joints and muscles is often referred from the deeper, more vital systems of the body out to the musculoskeletal system. Even in the case of an overt trauma such as a fracture, or muscle or ligament rupture, those structures are dependent on the other body systems to direct the healing process, and how the body compensates thereafter (the body always has to compensate after an injury because the new repair tissue, be it soft tissue or bone, never has the same characterisitcs as the original tissue).


    This perspective on trauma and system integration is mostly absent in standard physical therapies, leaving the focus on the symptom. A deep understanding of the complexities of how all the systems are integrated; a holistic, individual approach; and ability to work with all the systems has to provide the best outcomes in treatment.


    Also refer to the sections on Vascular, Visceral, Neural Manipulation for more insight on the interaction of these systems with the MusculoskeletalSystem.