If you have been following our blog for any length of time, you are probably well aware that our main focus at Elite Spine & Sport is on quality movement. We have discussed what movement is, and how pain can alter it. Well today, we’d like to approach movement from a different view to better understand the reasons we treat patients the way we do.
First, think of your body as being like a computer. Your muscles, bones, and joints are the hardware while your brain and nervous system make up the software programs. When a patient presents with a complaint, it is often easy to see a problem with their hardware. Examples could be decreased range of motion of the shoulder, or tight hamstrings. Treatment of these problems is often geared towards correcting the physical dysfunction by adjusting or mobilizing restricted joints, stretching tight muscles and strengthening weak ones. All of these are great for upgrading your system’s hardware. However, it is very important to remember that your hardware is useless if you don’t have the proper software system to run it. Think about a time when your computer had a virus or was overdue for a system upgrade and could not perform properly. This is why most patients in our office will go through an active rehab process during their treatment. What proper functional rehabilitation does is “download” the movement software into your brain. We need to train the brain to use the better quality movement pattern in order to protect the hardware from future damage. What we find most often is that damage to your body’s hardware is secondary to a faulty software program.
To illustrate this, let’s take a look at a patient with low back pain. Upon examination, we check the hardware and find that he has some areas of his spine that are not moving very well, tight hips and very tight hamstrings. So to address these issues, we might adjust the restricted spinal segments, mobilize the tight hip joints and stretch the hamstrings. Now our patient’s hardware system is like brand new. However, when we do some further examining, in the form of movement screening, we find that our patient cannot squat properly. This means that every time he sits down, stands up, picks something up, uses the bathroom or climbs the stairs he is placing unnecessary and excessive stress on his low back. We also find out that our patient sits at a desk all day working on a computer. Why do we care? Well, we care because we need to upgrade his software system. We do this by adding in functional exercises such as various squat progressions that help retrain the brain to incorporate proper movement patterns into our patient’s activities of daily living. We might also address his posture and ergonomics at work to help take stress off the low back. By upgrading our patient’s software, he is likely to recover faster which means fewer office visits, and also decreases his risk of future injuries.
The following is a Ted Talk by Daniel Wolpert, a neuroscientist and engineer titled, “The Real Reasons for Brains”. Spoiler alert, the answer is for control of movement. Enjoy!