In the human body all systems are interconnected. From the nervous system and the musculoskeletal system to the digestive and immune system. It would be INCOMPLETE to just address one system or ONE REGION as with a shoulder injury we must address the biomechanics of not just the shoulder but the cervical, thoracic spine, the elbow, wrist and even down to the hip. The interrelationship of all areas of the body creating a movement or movement deficiency at one point.
This is also seen as a “kinetic chain” as coined by Steindler who identified the movement of one joint directly effecting the movement of other joints above and below. For example a decrease in dorsiflexion (ability to upwardly bend foot) produces biomechanical changes in the knee, hip and spine. You see when the brain is met with a limitation of movement in a functional setting it will take the easiest and most direct path to perform said movement. However this creates ALLOSTATIC LOAD (excessive stress) on the now overloaded muscles, joints and tissues.
Why is this important you ask??
This type of modality addresses the most important reason as to the presentation of injury.
The WHAT…
WHAT created your injury…
WHAT is the limiting mobility/stability problem causing you to take excessive load elsewhere…
WHAT is the primary location and underlying locations that need to be addressed…
We are not saying that the site of pain should be ignored, just that this is often the last point of “biomechanical breakdown”. Of course we will manage the symptoms from said painful area but we must look further into the limitations of surrounding tissue and if these aren’t being looked into then you need to ask questions of your health care professional.
So next time we look into your shoulder function when treating a low back pain complaint you’ll understand that regional interdependence is the relationship whether it be direct or indirect to one’s symptomatology or injury regardless of its proximity or location.
MOBILISE – STABILISE – OPTIMISE
