Welcome to the second installment of our series on locating your “pain generator” and why treating pain and injuries can be tricky business. If you did not have a chance to read Part I, please go back and do so.
Alright then, let’s move on, shall we? Remember, our goal is to avoid the trap of “chasing” pain. There are several reasons for this. We already discussed the first, and now we’re going to move onto the second big reason why only treating the spot that hurts can render your treatment ineffective. Reason #2: compensatory movements due to dysfunction upstream or downstream.
What the heck is compensatory movement? Well, let me give you a little analogy first. I want you to imagine a factory with three workers (it’s a small factory). Every day these three workers must produce ten widgets for the factory to remain in business. For those of you who are not so mathematically inclined, that’s 30 total widgets delivered daily. Now over time, two of these workers, for whatever reason, get a little bit lazy and begin to slow their production. The two slower workers are now only producing five widgets per day. If things continue like this, the factory will only put out 20 widgets per day, which is short of the 30 needed to stay in business. This scenario cannot happen, so the third worker picks up his production. This third worker is now producing 20 widgets per day to COMPENSATE for the other two dysfunctional workers.
Now some time passes, and worker #3 starts to wear out. They are working too hard, and you as the boss start to notice they seem to be in pain. It would be easy to stop and take care of worker #3 (which it’s likely they do need a little TLC), but if all you do is give treatment to the compensatory worker, are you ever going to fix the problem? No! The problem is not that worker #3 is in pain. The problem is that workers 1 and 2 are dysfunctional and in turn, causing worker #3 to burn out. We need to find a way to restore proper function to workers 1 and 2. When we accomplish that, then worker #3 will return to normal healthy function as well.
Our bodies operate much like this factory. We are a kinetic (moving) chain. Movement at one segment is dependent upon movement at the adjacent segments. When we develop tight hips or mid-backs from sitting all day, our low back in between them is highly likely to compensate for that. Eventually, you might start to develop low back pain. Another common scenario is “bad knees.” We often see knee problems like meniscal tear or Iliotibial (IT) band syndrome located in between dysfunctional hips and ankles. Your knees are probably not your problem. Yes, they hurt, but because of problems upstream or downstream along that kinetic chain.
So what? When patients come in because they are in pain. Most of the time, as part of their physical examination, they will be put through a movement assessment along with a joint motion assessment. This type of exam process allows us to locate dysfunctions and determine if their “pain generator” is due to compensatory movement patterns. You will not get this information by only taking x-rays to see what your bone alignment looks like in a static (not moving) posture. We can treat the painful area, but to get at the problem and prevent recurring episodes, we must address the dysfunctions leading to compensatory movement patterns in the first place.
When we avoid the trap of chasing pain, our outcomes are going to be much more successful in the long-term, and this means fewer patient visits, fewer dollars spent, and much happier patients. If you have been suffering from musculoskeletal pain, it is well worth your time to seek out a provider who can put you through a quality movement assessment and get to the actual root cause of your complaint. Look for providers that aren’t going to chase your pain because, “where you think it is, it ain’t.” -Ida RolfSchedule Appointment