The heart circulates blood only in the arteries, capillaries and very slightly in the veins. After the capillaries, there is almost no pressure for the blood to flow back to the heart. So the blood needs a different motor to get back to the heart than the heart itself.

Classical theories propose rhythmic motors whereas the flow of blood in the veins is linear. Moreover, none of the solutions proposed classically is powerful enough to explain the venous return…

The costo-diaphragmatic mechanics works like an accordion that unfolds upwards and downwards. The space between the ribs will, like the space between the folds of an accordion bellows, move apart during inspiration. However, it is classically taught that certain muscles located between the ribs contract during inspiration. But this contraction would have the effect of bringing them closer together, and therefore of exhaling…

For the last 5 ribs, which are therefore lowered to increase the thoraco-abdominal volume, it is said that they are raised by the action of the diaphragm. But these last ribs, as we will see, will logically slide down to increase the total lung volume thanks to the lowering of the diaphragm inserts. The elevation of the middle ribs, up to the 7th rib, being due to the elevation of the upper ribs, as do the folds of the accordion bellows caused by the musician’s hands being spread apart. The contraction of the diaphragm does not raise the ribs. Place your hands sideways on the lower ribs and take a diaphragmatic breath, the ribs will not rise. Take a deep chest breath and the lower ribs will rise…

The last ribs, on diaphragmatic inspiration, will go down. There is often confusion, as to palpation, related to the differentiation of thoracic and abdominal

Classically, it is supposed to maintain the posture of the limbs and in particular against gravity in an erect position. But for this, a few joint receptors would be more than enough. But the receptors present at the level of the musculo-tendinous system are numerous, hyper qualified and complex and their presence presupposes a much more important activity than a simple management of muscular tension. Nothing tangible in the classical theories could explain the phenomenon of nocturnal lumbago or even tendinitis.

Much has been written and discussed about the origin of these motives. But the theories have never coincided either with the clinic or the physiology… We observe under our hands asymmetrical movements, loss of local rhythms or simply physiological mobilities that are neither taken into account nor explained by classical osteopathic theories.

It is to this set of questions left unanswered that we will try to answer with the tools of palpation (so much decried) and the clinic which will be our guides in the course of the remarks that will follow.

Normally the contractions and decontractions during PMM are symmetrical. The biceps brachialis contract and relax at the same time. However, when we put a joint in extreme rotation, for example a dorsal vertebra, we desynchronize the entire muscle chain that depends on it. Thus a right biceps can contract while the left biceps relaxes. By returning the position of the vertebra to neutrality, the muscles are automatically synchronized again.

When we do an apnea, the PMM seems to freeze. But this is not the case, in fact depending on the type of apnea (inspiratory or expiratory), depending on the muscle (antagonist or antagonist) and depending on whether it is in desynchronization lesion or not, the muscle will shorten or lengthen completely and will continue to contract and relax but with very low amplitudes (almost imperceptible).

PMM is sensitive to internal and external influences.

• Cold increases the speed of the PMM.
• Hot weather slows it down.
• The effort increases it until it triples.
• The fact of thinking of contracting a muscle (without doing it) increases its speed by about 10%, even in a tetraplegic (adaptation of the work of Ataëv), but not in case of a total rupture of the nervous plexus (only one case studied).
• The magnets will increase the speed or slow it down depending on the pole of the magnet in contact with the skin.
• Acupuncture needles will increase the speed or slow it down depending on the direction in which they are placed.

The tendons will also be permanently mobilized, thanks to this PMM, allowing the surrounding synovium to feed them. Tendinitis is the consequence of a muscle spasm which renders ineffective the exchanges of the tendon with its surrounding space due to a lack of movement (amplitude and rhythm).

Thanks to the motor that is MMP, almost all body tissues will be subjected to minimal changes in tension and length. Minimal but just large enough to affect the exchange of fluids and molecules in the tissues.

Exchanges at the capillary level

Pressure increases and decreases should in all likelihood allow better exchanges between the extracellular and intra-capillary space on the venous side. Starling’s second law applies here.

Participation in lymphatic circulation

The lymphatic circulation, these movements and pressure changes will allow the extra cellular liquid to penetrate inside the lymphatic vessels. This would explain the very good clinical results on lymph migration concerning edema due to Venous Insufficiency once treated.

Cellular exchanges

It can be assumed that cyclic pressure differentials can promote exchanges between the intra- and extracellular medium.

The PMM will intervene during thermoregulation. The cold increases the rhythmicity, the muscular pumping, so more blood will circulate under the skin, warming up the underlying areas. Heat decreases the rhythmicity, so the blood will flow more slowly, avoiding overheating the skin.

Rhythmicity can be halved for reasons of articular origin (adhesions of the periarticular tissues), muscular origin (areas of permanent intra-articular contractures) or various pathologies, diabetes, Raynaud’s disease, etc.

Venous Insufficiency (see Starling’s 1st law, adapted to the muscle), the more the heart fills with blood, the more effective its contraction is. It will be the same for the muscle. A muscle that is too short will have more difficulty filling up and it will contract more to assume its function as a pump or joint drainer. It is a vicious circle.

We’re not talking about physiological desynchronization here.

Some lesions produce an inversion of the contraction time of certain muscles. These are lesions that we call primary, that is to say, original. They can be at the origin of the lesions previously described. It is, among others, the lesion of plagiocephaly.

Other lesions or pathologies of various origins, visceral, neurological, etc., may disrupt the functioning of PMM.

Muscles work in groups of muscles and joints (the same joint can accommodate several muscles from different chains). A musculoarticular chain can include several joints. A joint can be controlled by several different muscle chains. The musculoarticular chains necessarily depend on one joint in perpetual motion. That is to say a joint linked to thoraco-abdominal respiration.

So far we can count 12 vertebro-vertebral joints, 12 vertebro-costal joints, one sterno-costo-clavicular joint, and one sterno-xiphoid joint (with or without a xiphoid appendix). Let 27 times 2 = 54 muscle chains. But there are others.

Muscles and joints in the same chain will all have the same lesional characteristic. If a 5th dorsal vertebra is out of synchronization, the 5th cervical vertebra will automatically be out of synchronization, as well as other joints and all the muscles of the same chain will be out of synchronization in the same way. Resynchronizing one of the joints will resynchronize all the others as well as all the muscles of the same chain.

A restricted joint in a part of the chain can be released by working a muscle or joint placed at a distance on the same muscle chain. That is to say that we can try to treat, at a distance, fractured joints or under plaster… Or we can treat a hyper-algic joint without touching it.

• Desynchronization of the first intercostal space = plagiocephaly, congenital torticollis, etc.
• Loss of rhythm of the 2nd rib = Epicondylitis.
• Loss of rhythm of the 5th dorsal = decreased drainage of the ethmoid = Homolateral nasal congestion, ophthalmic migraine, vector of asthma. When the loss of rhythm of the 5th dorsal fin is lifted, the nasal obstruction will most often stop within a few minutes, or else the migraine, etc.

For example, according to the principles of muscle chains, it takes two lesions to produce a hallux valgus. In this case we should have a lesion on the 9th and 10th rib. This is what we find clinically.

But the fact of freeing these two ribs will not necessarily correct the lesion morphologically, or very little, but it will stop the process of evolution or even reverse it and reduce the resulting pain.

You can also have a second lesion without suffering from epicondylitis, but not the opposite.

The same chain can be subject to several types of injuries (loss of rhythm, desynchronization, loss of amplitude) at the same time. This makes learning difficult, at least in the early stages.

Even if all the joints and muscles in a chain appear to be injured, it does not mean that all of them are the cause of the lesions. There may be several lesions, whether muscular or articular, that are involved in the lesion. If only one specific lesion is treated, we will either have no results or we will have a temporary result related to the information given to the muscle which will return to normal activity but only for a certain time (a few minutes to a few hours).

For example, the joints of C3 and D3 may have a lesion on the left, giving a tingling symptom in the palm of the left hand. Treating only one of the two lesions will not necessarily give a definitive result. If you manipulate C3 alone, the chain will not necessarily be sufficiently restored to free D3. And the symptom will reappear, with the loss of rhythmicity linked to D3 remaining blocked. In this case the treatment of the whole chain will put an end to the symptom.

Which PMM control centres can be used?

Let us note in preamble that PMM is effective in tetraplegics or even when all the nerves have been severed. The same is true in the case of ortho and parasympathetic inhibition. The muscle is therefore an autonomous organ whose function is controlled by complex upper nervous pathways (most certainly the gamma loop and the sub thalamic nuclei).

The fact of thinking of contracting his biceps allows a quadriplegic to see the rhythmicity of this one being increased by 10%. This is not true in case of a complete rupture of the brachial plexus. There is therefore a control of the upper nerve centers. But the activity of the PMM is intrinsic to the muscle, just like the heart, but in a different way.

Muscle through PMM requires autonomous and continuous activity that is not dependent on neural excitation.

Since 1978 research has been done on muscle motility demonstrated in vitro by Fabiato and Fabiato on cardiac muscle fibers. Subsequently Okamura and Ishiwata demonstrated the same phenomenon on skeletal muscle myofibrils in 1988. They then named this muscle activity SPontaneous Oscillatory Contraction or SPOC. We find many similarities in the rhythms and in the waveform we feel under our hands when we feel the muscle activity. It’s a piece of the puzzle that seems to fit perfectly into the physiology of PMM.

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