Wednesday’s blog covered a brief history of how aerobic fitness has dominated public health and general Fitness Guidelines, leading to the question:  Why has our public health information been rather silent regarding human biomechanics and “structural health” maintenance?

The answer seems to be twofold; we still don’t have a complete scientific grasp of human musculoskeletal tissue properties and also because we are in an unprecedented momentum towards motionless lifestyles.  While we have poured millions of research dollars into studying fitness of the cardiovascular system for over three decades, the remaining issue under discussion is how we can also better address the skeletal conditions we are experiencing due to many hours of sedentary, repetitive behaviors.  The World Health Organization (WHO) indicates that the greatest growing disease statistic is in musculoskeletal health. Low back pain is the single leading cause of disability worldwide, and the second most common reason for visits to the doctor’s office, outnumbered only by upper-respiratory infections. Our primary care physicians are becoming more aware that they must tread carefully to rule out serious conditions while not over-prescribing pain medications nor immediately ordering expensive, unnecessary tests with avoidable radiation exposure.   Mechanical back pain conditions are more typically of a “chronic but not serious” nature, yet our existing medical guidelines are feeble.  Our medical system is designed to expertly manage acute injury and infectious disease; not chronic “diseases of affluence” like underuse of our frame as we see with too much sitting.  But, if we wait until we have an actual injury that requires a repair, we can certainly get help.  Why must we wait until we are broken?

It is hard to believe in this day and age – that we have not figured out all parts of the human body yet, but over the past decade there have been mounting scientific discoveries in the field of human tissue health and structural medicine.  Finally!  On a world stage for the first time in 2007, Harvard University united scientists from around the world at the First International Fascia Research Congress to present brand new discoveries from human dissection labs. Many of us have seen Aristotle and Leonardo da Vinci’s well-known early illustrations from their studies of human movement, as people have studied human cadavers by dissection since 3rd century B.C.

In 2001, Tom Myers and his book Anatomy Trains made a big splash in the world of biomechanics as he brought 3-Dimensions of anatomy to a whole new level.  Applying limited available dissection science proof with theory, he inferred that “fascial lines” of tension load in the body’s musculoskeletal system as a whole, not joint by joint.   Since then, scientists have discovered more about humans’ soft tissue ability to ‘remodel’ and hold shapes.  Thanks to our amazing connective tissues, over many hours of repeated positioning, we become our most practiced shape. Even for regular exercisers, repeated movement of the same workout positions brings risk of overusing some tissues, underusing others- only secondary to the fact that we execute the moves in already dysfunctional postures and movement patterns we held throughout the day at our jobs.  The dual challenge of movement and anatomy educators today is:  to continue to support public health education with the latest research on musculoskeletal science and also create fitness programs for a population who move fewer and fewer hours per day.  

Yoga Tune Up® (YTU) provides an effective fusion of evidence-based (scientifically supported) techniques including the latest research on human fascia tissues.  Effective self-care tools mobilize areas compressed from lop-sided or sedentary habits while precise movements serve to strengthen and stabilize tissues uniformly around joints.  From a scientific research perspective:


YTU balls are grippy and pliable, with just the right amount of firmness, to grab onto all of your soft tissue layers.

YTU Balls are especially effective to unglue tissues to decrease pain—Research from cadaver dissections show us that connective tissue layers underneath our skin become stuck together and dehydrated where they should be slippery and should move easily past each other. Science suggests that this can happen from an old injury, favoring use of one side, or a lack of fitness/conditioning of that body part; all of which increase joint stress.   We all experience these in our typical postural habits – so it is likely we also look like this underneath our skin!  When Jill Miller added self-massage to her programs to pry apart the stiff tissue layers, some people wanted to compare YTU therapy balls to foam rollers or other common gym tools, but they don’t do the same thing. The textures of YTU therapy balls actually fulfill scientific criteria to provide several unique benefits:

1)     The grippy surface of YTU balls catch on skin and fitted clothing to create that what scientists call ‘shear,’ a mechanical term meaning one layer (skin/soft tissue) is pulled away from underneath layers, to help free the stuck muscle and connective tissue.

2)     The combination of applying compression with the ‘shear’ action into tissues also awakens Ruffini endings (one type of nerve-ending or “mechanoreceptor” in connective tissue) creating overall relaxation in the central nervous system.

3)     YTU balls’ firmness have a gentle “give” in pliability which encourages tension release of tight tissues. Scientific evidence shows that harder tools (like lacrosse balls or some foam rollers) are less tolerable and may cause a stiffening reaction or contraction in the muscle spindles prolonging muscle tension, not resolving it.  Additionally the malleability and size of YTU balls allow access to our body’s smaller nooks and crannies and the ability to move around bony areas without bruising.

4)     YTU balls are effective for eliminating trigger points (chronic ‘knots’) that tie up a subset of fibers within a muscle, often causing local discomfort and referred pain (felt in distant areas) while subtly decreasing overall strength of that muscle. Trigger points impact a muscle’s ability to work properly which adds to deterioration at the joint.  A “mechanical intervention,” meaning some outside force, is needed to resolve these chronic knots.  Use of YTU Therapy Balls sure feels better than needles and are less expensive than a daily massage therapist.

5)     Learning how to use YTU Therapy Balls empowers students in self-care and improves awareness of one’s own body.  Instructions include a simple anatomy “tour” for proper placement of therapy balls while also helping students to locate their “blind spots” and improve the neurological connection to their own anatomy.  Underused or overused tissues tend to have “sensory amnesia” with poorly functioning nerve receptors that normally tell us ‘where we are in space’ (proprioceptors, related to balance and touch).  Decreased proprioception is common in areas of injury, tension and immobility, but YTU Balls are a great way to improve this neurological sense which also improves movement coordination.  Enhanced proprioception is known to decrease pain signals (nociception), even if temporarily. 

83_JM_Fascia_SkeletonYTU methodically uses an anatomical map to evenly stabilize and strengthen the frame – Muscle and fascia research shows our need for consistent movement and mechanical loading (weight bearing use) to maintain tissue health.  This means that congruent or equal loading in is necessary, all directions of movement, to affect every tissue surrounding the joint.  Unfortunately it is our uneven loading of our joints and tissues in modern lifestyles (e.g. in slouchy sitting, especially around shoulder and spine) that has helped to skyrocket our risk of wear and injury.  YTU’s unique therapeutic movements are fun, but also scientifically smart by systematically creating motion in all possible directions around each joint, leaving no tissue untouched.  Such complete use of our joints rarely happens in everyday activity or typical workouts.  To really ensure a healthier frame, YTU adds strengthening techniques at ends of joint movement ranges, with methods borrowed from physical therapy (isometric  contraction in closed-chain movements), adding powerful stabilization training for vital joints.

YTU provides stress reduction and self-empowerment – The central nervous system is calmed through yoga breathing and mindfulness training, coupled with improved ribcage alignment and respiratory diaphragm training.  Researchers have shown that using soft tools (YTU balls) to activate pressure-sensitive nerve endings helps to bring a global relaxation to the whole central nervous system.  Another significant finding from medical researchers is that by handing people effective tools and basic knowledge, they gain a psychological sense of empowerment which has been proven to increase healthy self-care routine compliance.

Poor musculoskeletal habits and poor ergonomics can easily become second nature, causing aggravating episodes of pain that can lead to damage of joint structures, whether you are an exerciser or a couch potato.  Fortunately, the latest research is clearly providing great information we can utilize in our own self-care at home.

Let’s not wait until we need medical attention or delays until public health “Guidelines” for Musculoskeletal Fitness are finally published.  Get rolling now!!!   Become inspired by success stories from real people who practiced self-care with Yoga Tune Up®  in Jill Miller’s new groundbreaking “how-to” book, The Roll Model, available November 4th (pre-order now on


REFERENCES include but not limited to:

  1. Efficacy of multidisciplinary pain treatment centers: a meta-analytic review  (1992). Pain (49; 2, 221–230)
  2. Technique Systems in Chiropractic.  Cooperstein & Gleberzon, Churchill Livingstone Publishing (2004)
  3. Diego, M & Field, T (2009).  Moderate Pressure Massage Elicits a Parasympathetic Nervous System Response.  International Journal of Neuroscience (119; 5, 630-638).
  4. Biomechanics Principles and Applications, Eds Bronzino and Schneck, CRC Press, 2003.
  5. Schleip, R  & Mueller, D (2012) Training principles for fascial connective tissues. Journal of Bodywork & Movement Therapies (1, 1-13)
  6. H.M. Langevin et al., (2009). Ultrasound evidence of altered lumbar connective tissue structure in human subjects with chronic low back pain, Musculoskeletal Disorders (10:151)
  7. Metzl, Jordan, MD.  Interview NPR-pilot studies:  Stretching VS Foam Rolling. Sports Medicine, Hospital for Special Surgery (HSS) NY, NY. (December 13, 2013)
  8. GZ MacDonald, MDH Penney, ME Mullaley, AL Cuconato, CDJ Drake, DG Behm, DC Button (2013). An Acute Bout of Self Myofascial Release Increases Range of Motion Without a Subsequent Decrease in Muscle Activation or Force. Journal of Strength & Conditioning Research: (27, 3, 812-821).
  9. KC Healey, DL Hatfield, P Blanpied, LR Dorfman, D Riebe (2014). The Effects of Self Myofascial Release with Foam Rolling on Performance. Journal of Strength & Conditioning Research (28,1, 61-68).
  10. Medical Massage & Pathophysiology of Connective Tissues, G. Lawton, American Medical Massage Association, 2000.
  11. Moseley, G, Zalucki, N., Wiech, K., (2008). Tactile discrimination, but not tactile stimulation alone reduces chronic limb pain. Pain. (137, 600-608).

Additional Reading:   Thomas Myers, Leonid Blyum, PhD, Jean Claude Guimberteau, MD


Read more about YTU Balls and trigger point therapy.

Get therapy balls for self-massage on the go.

Learn solutions for lower back pain from sitting.

Diane Marra

Diane Marra is an Exercise Physiologist and Biomechanics specialist with more than 20 years’ experience teaching in universities, hospitals, corporate and community settings. Diane holds a Master’s Degree in Kinesiology from California State University and numerous fitness certifications. Her scientific research, conducted for the US Army Medical Department and California State University, has been presented at international conferences and published in clinical journals. Today, Diane is creating new programs as the corporate Wellness Manager for a global manufacturing company and still teaches part-time for SUNY Buffalo State College. Since personally overcoming multiple injuries and chronic pain, Diane has a passion for helping ‘regular folks’ who sit too much, manage pain conditions, seek post-injury recovery, and/or simply want to be stronger. Current credentials include: National Strength & Conditioning Association (NSCA™-CPT), American College of Sports Medicine/ ExeRxcise is Medicine® ​Level 1, Yoga Tune Up® and TRX™ Diane is currently developing a new course for her SUNY Graduate students about Workplace Ergonomics and Selfcare, offers private training sessions and occasional workshops in the Buffalo-Niagara area while continuing to do free-lance research/ writing for Medical and Fitness publications.

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Nancy Bernhard

Yoga therapy balls are such an empowering mode of self-care, which also takes the diagnosis and treatment of everyday structural imbalances out of our broken health care system. We need a systematic change in the way we teach children to approach their own bodies and health, beginning with proprioceptive mapping at an early age. Jill for Surgeon General!


I really missed the holistic view of the body in my first yoga teacher training. While I was still in the training I discovered, that some movements caused pain (to myself& my students). Since I was always curious about “how and why” it was really unrewarding to get only unhelpful adjustments. I´m so glad, that I stumbled across this program, cause it gives me a better understanding of movement patterns…And I´m just at my starting point 😉

Isabelle Cote

Merci Diane! I understand that the repeated movements (or absence of movement !) mold our bodies and lead to the risk of pain and injury. And it give me great joy to believe that the opposite is also true! Changing habits to make new choices , with respect for our body can lead to regain mobility and well-being ! J

In addition, the Yoga Tune Up and the balls become allies that you present with conviction and accompanied with clear and beautiful explanations.

Scott McKee

Having experienced the change that YTU balls and movement can make in the body — both at the areas of most acute tightness and pain and throughout the body with a general feeling of wellness — I’m absolutely a believer. But I’m wondering how others have learned to integrate YTU into their other movement practices. I love my “normal” yoga practice and martial arts, and I don’t want to sacrifice the fun and enjoyment that I get from these activities in order to include YTU rolling and movement. So my question is how often do most people perform YTU sessions… Read more »

Melissa Melendres

Yes!! YTU IS the Secret Sauce!!! The importance of human biomechanics and the use of therapy balls aid in every aspect of living, let alone any fitness! Ive always been into fitness and have taken a variety of fitness class with many different fitness “professionals.” Some good and some awful! I feel like every fitness professional should be certified or at least tested in human biomechanics and self care maintenance. There would be so many less injuries! Im so grateful for YTU therapy balls!! Great article. I appreciate your list and research of the benefits of the YTU balls. Thank… Read more »

Crystal Fauber

It seems that musculoskeletal dysfunction does not necessarily only impact the affluent! If sitting is the new smoking then this epidemic transcends economic status.


Searching out the right places to free out is vital to get the best use from myofascial release. Tom Myers work gives us a great exploration of the lines we can follow. I was taught that if you’re working the location of the pain, 70% of the time: you’re in the WRONG place! The more we can learn on the interconnectedness, the more likely we are to gind the RIGHT place!


Yoga Tune Up is Awesomes and so are the balls! So greatful for having run into all this THANKS!


I really like your breakdown of the balls. Especially helping to reconnect the brain with injured areas, the acupressure aspect of trigger points and myofacial releases. I just loved rolling on the balls, but now, rolling is a self scientific study and practice which excites me.


Thank you for the article. Since i’ve replaced my routine cardio on treadmill to outdoor walking and rolling with the YTU balls i’ve noticed a significant improvement in my yoga practice.

Diane M

Hi Garrett, No I am not aware of any specific research that evaluated rolling “adaptively shortened tissues” VS “locked long” but it sure sounds like a good project for a thesis or a research article. Please keep me posted if you decide to pursue it!! 🙂

Garrett Plumley

Diane, you write amazing YTU articles! Thank you so much including your references. We all benefit when we cite and require references for the claims we make! Are you aware of any research that compares the affects of rolling on muscles that are ‘locked long’ vs. ‘locked short’?


Thank you Diane . I feel the Yoga Tune Up secret sauce is about to hit the market and explode into every household that believes in alternative health, self care . The number of believers is growing exponentially ,as proof, the balls recently have been on back order. I have been a believer in physical exercises as a stress reliever for many years. I was however, at a YTU training recently and had to leave early for a memorial. Prior to leaving we rolled our neck and upper back. In the past my experience at memorials has been such that… Read more »


You raise such critical questions about the healthcare system and its deficiencies in introducing self care. It’s astounding that people (both patients and doctors) expect a cure to come from a prescription medicine, which introduce its own assortment of side effects. After I started rolling on YTU balls I no longer needed to go to the chiropractor or PT, who addressed my trigger points but whose effects were not long lasting.
Given rising medical costs, I wonder how long until YTU is recognized as a viable option for patient care?

Mika Saburi

I used to be a broadway dancer and remember physical therapists who see most of the shows gave me tennis balls to do self massage. However YTU therapy balls are much better than these and working for fascia and so good after
rolling for a while you will see the difference and so easy to move and prevent injury.
Now I don’t have to go to see the specialists to fix my boody.
Also learning which muscles releasing and great tools to notice PNF.
Thank you for sharing wonderful topics!


As I sit here and read this in my wood kitchen chair, I suddenly realize that I am echoing the life of an office worker and am totally guilty of non-movement in light of getting things done that require me to be in front of a computer screen and that I have actually put off movement in light of my goal. I tend to get pain in the neck and shoulder from sitting for a long time and allowing my head to push forward. This brings up such a huge point. We are such focused individuals and if in a… Read more »


This blogs ask the question about why public health has not done more for structural health maintenance and the sedentary lifestyle. I know from working in government that the Health Departments are trying to get the word out but much more needs to be done. It is slow going but people are creating new habits and getting away from their desks to walk more. I believe it is catching on but it needs to be reach out to the populations that are resistant or uninformed.Very well written and thought out with a wealth of information. I like how it brings… Read more »


Very thoughtful post. After much disappointment with health care, including physical therapists, I have found yoga therapeutic modalities to be much more effective. I think many who seek out health care for pain related to body mechanics are often dismissed as “normal aging” or if they are otherwise healthy, are not taken seriously. My poor care contributed to otherwise rehabilitative issues becoming more chronic and damaged joints. It also eroded my confidence in those in sports medicine, physical therapists, etc. While I’m sure there are some superior providers out there somewhere, Yoga has been a lifeline and I especially love… Read more »