Spinal Dura Mater and the 'connection' to Tendons: Anatomy and Function / CSF / Brain Blood Flow
In this education video, Dr. Hutcheson introduces tendon anatomy and function - and then elaborates on how tendinopathy, in particular suboccipital tendinopathy - influences the spinal dura mater, cerebrospinal fluid (CSF), and how this may influence the expression of many neurologic and blood flow related disorders, symptoms, and manifestations. The suboccipital muscles and the nuchal ligament connect directly to the spinal dura mater through the myodural bridge. The myodural bridge is a soft tissue connection between these muscles and ligament and the spinal dura mater (meninges). The meninges protect the brain and central nervous system (CNS) / spinal cord - encase the cerebrospinal fluid and allow for its appropriate flow - which contributes to adequate brain perfusion, prevent excessive rotational displacement of components of the cerebrum (brain), give support to nerves, blood vessels, lymphatics, and CSF, and more. The suboccipital muscles have the highest amount of proprioceptive fibers of any muscles in the human body, and in relation to the dura, act as a monitoring system to maintain dural tension. When the suboccipital muscles, nuchal ligament, etc - have undergone deformation, degeneration, tendinopathy, ligament laxity, etc - this monitoring system for dural tension may and does fail. Dr Hutcheson suspects that the obliquus capitis superior may also have some attachments to spinal dura, despite most of the current findings having difficulty confirming this due to the extreme precision required in dissection of this area. More research is being conducted on myodural bridges and hopefully in the near future there will be greater clarity.

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