Physical Activity

Two Ways to Make Sure Your Rehab Works

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As a Corrective Exercise Specialist, I believe that the majority of chronic muscle and joint pain problems people experience today are mechanical or non-organic in origin. This means that pain is not caused by a genetic condition or acute trauma, but simply due to postural imbalances causing stress on muscles and joints.

What I teach and offer my clients is a non-surgical, exercise based approach to resolving chronic muscle and joint pain. Corrective Exercise programming is a simple, yet powerfully profound way to help athletes and desk-jockeys alike eliminate chronic muscle and joint pain, improve posture and enhance activities of daily living and athletic performance without the intervention of medication, manipulation or surgery.  

At it’s simplest, corrective exercise teaches our clients how to use movements to re-position their bodies to allow for proper muscle-length tension relationships, joint position and movement to minimize or eliminate compensations and dysfunctional movement patterns. It is through the reduction and elimination of the compensations and imbalances that creates the opportunity for the body to heal. 

In my experience I believe that if you give the body and mind the right 

  • Movement stimulus
  • Psychological and emotional support
  • Nutrition
  • Rest 
  • Time

While also empowering the person with the theoretical and practical knowledge of how the body should be aligned and function, it can heal.

Given the right circumstances, healing is what the human body is naturally designed to do and I’ve been grateful to be the CES who’s had the opportunity to see clients achieve a pain-free status and return to their activities of daily living and athletic pursuits.  

However, that’s not always the case. Unfortunately there are many who do not achieve the kind of success just described.  

Ever Wonder Why?

It’s been my professional experience that individuals who’ve had rehab failures and find themselves stuck in a perpetual chronic pain cycle make common mistakes.

There’s a saying that mistakes are the stepping stones to learning. If you’re caught in the chronic pain cycle, it’s my sincere desire that I can shed some insight and professional experience in the hope of helping you correct them and truly achieve success in your rehab programming.  

Two Ways to Make Sure Your Physical Therapy Works

1.  Your posture matters!

Learn about the difference between healing your symptom versus your condition and get a rehab program that teaches you how to put your body back into proper alignment and balance.

Sadly, many individuals caught in the chronic pain cycle are not educated about the relationship between posture (body position) and pain (symptoms). There is a direct link between your static body position and your condition. In my professional experience, if you are not educated on or understand the connection between the two, pain may be reduced for a period of time, but it will come back because the underlying root cause of the problem was not identified and corrected.

For example, did you know that imbalances in the muscles affecting foot position and ankle function can be directly correlated to low back pain symptoms (1)?

Low back pain is very often the symptomatic result of joint dysfunction and or muscle imbalance issues stemming from the feet and ankles upward through the kinetic chain.

Muscular imbalances and joint dysfunction problems in the feet and ankles can result in a myriad of tension and friction in all of the structures that sit above them. The ankles, knees, hips, shoulders and spinal joints are all susceptible to pain, joint degeneration or acute injury. Take over-pronation of the foot/ankle complex. Someone who over-pronates in general also over plantar flexes. As a result, the dorsal flexors become weak, the knee drops inward, the IT band and muscles with fascial connections to it tightens, the hip flexes and pushes the acetabulum back causing the pelvis to forward tilt with a corresponding elevation or rotation. Voila! Low Back Pain.

And that isn’t all.  Once the pelvis moves out of alignment, the compensations and muscle imbalances cause further kinetic changes in the position of the lumbar spine, and this radiates upward through your spine resulting in increased curve of the mid-upper back (kyphosis), shoulders rounding and internally rotating and the head jutting forward.

So if you are dutifully doing rehab for chronic low back pain but not proactively correcting the underlying root problem of foot and ankle position, you can clearly see in this example how returning to your life and exercise activities will eventually land you back at square one. It is worth the time to get both a full postural assessment, and rehab program that addresses muscle and joint imbalances above and below your pain site.

2.  You Started To Feel Better so You Quit Your Rehab Program.

Admit it. How many of you started the process of rehab, did a handful or less of scheduled rehab with a PT, CES or Posture Specialist and found some effective and immediate symptom relief. The lure of thinking “I’m better. I don’t need to go back” is certainly one that leads people to quit rehab. Unfortunately, I see a lot of clients who made this mistake more than once. Rehab is designed to help your body heal. But the problem is that the absence of pain does not mean that you have corrected the way you move.

A couple of problematic scenarios occur with this: 

  1. Although you feel better and have reduced pain after a few sets of prescribed corrective exercises, it’s critical to understand  that true healing takes more than just a couple sets of corrective exercises to truly unravel and correct the accumulation of muscle and joint imbalances throughout your kinetic chain. Think of it this way, if it took 25 years to get into a lot of postural imbalances before pain brought you to a screeching halt, it’s probably going to take more than a couple of sessions to unravel it all.
  2. You jump right back into your normal programming without addressing the steps or changes required to reduce your risk of re-injury. At most, all you’ve done is mitigate symptom without implementing a training progression back from static to active movements under load, speed, etc. 

It is very important that imbalances and dysfunctions are fully corrected and your newly corrected posture and function has a chance to learn how to perform the activities of daily living and athletics you desire. Going back to your regular training routine requires change. When you really correct your posture and body mechanics, your function in movement changes. This requires stability to maintain the newly corrected positions, mobility of the joints under load and then practicing the technique until it’s as I like to say “your new normal.”

You need a period of transition to re-learn how to do certain movement and this all requires time, patience and sequencing. The most promising injury prevention studies in the sports world come from neuromuscular training programs which emphasize learning how to move better (2).

You can heal and recover, but it is vital that you understand how you got into this condition in the first place and what needs to be done to actually resolve it versus simply mitigate the symptoms. When you’re empowered with that information, know that it will take some time to re-train your body to learn better postural habits and positions, but the end result is worth investing in.

Resources

1.  Jensen M, Brant-Zawadzki M, Obuchowski N, et al. Magnetic Resonance Imaging of the Lumbar Spine in People Without Back Pain. N Engl J Med 1994; 331: 69-116.

2.  Moreside, McGill (2013) Improvements in hip flexibility do not transfer to mobility in functional movement patterns, Journal of Strength and Conditioning Research

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