Bone-on-Bone: When good engineering goes bad!

I am sure you have heard the term ‘bone-on-bone’ before. I have many times, usually in reference to the knee. Bone-on-bone refers to when the there has been significant loss of cartilage on one or both of the bones of a joint to the point that the bones are actually rubbing upon one another- this is often deemed a condition of overuse, however I would refine this condition as one of over-poor-use!

It is a common misconception that our skeleton is basically a set of bones stacked up upon one-another, with cartilage in between to reduce friction as they slide back and forth during movement. Our body, when functioning well, does NOT work like this.

Our body is ‘tensegrity structure’. What is a tensegrity structure? See the image below.

This amazing feat of engineering is the ‘Needle Tower’ in Washington D.C. It is an 18metre high tower composed of aluminium poles and steel cables, with none of the poles touching one-another. They are held in a uniform tension by cable ‘tendons’ running through the poles and connecting pole to pole. This structure describes how the musculoskeletal body maintains its structural integrity, when it is in balance

The bones in our body are held APART from one another via complex chains of connective tissue, known as ‘fascia. This allows for a narrow space in between our bones in which synovial fluid is able to pass through freely.

If your bones are touching one another, that is a sign of inbalance of your facial and muscular network, and thus a loss of tensegrity. Bone-on-bone is merely the end result of a cartilage-on-cartilage system wearing itself through. Cartilage-on-cartilage is dyfunctional, bone-on-bone is just that, plus time.

So what can we do about this? This loss of tensegrity is a result of some muscles losing tone, allowing bones to fall into sub-optimal joint positions, with other muscles tightening to stabilise these mis-aligned joints. A postural analysis and flexibility assessment is a good first line of assessments to discover your tenedencies in this regard.

From here, an inteligent strength and flexibility program, specific to your postural needs can work wonders in restoring balance, and hence tensegrity.

Remember, bone-on-bone is just an accumulation of time with dysfunction. Restore balance and give your joints some space!

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