Which came first?

Which came first: the movement or the pain?



This is a question you need to ask in order to figure out where your client's pain is coming from. We don't want to simply treat the symptoms. If we don't eliminate the cause, then the symptoms won't stay gone after we treat them.

I shot two videos the other day to help explain myself.

The first is a simple overhead reach, and it's pretty easy to see the compensation.



The first rep is more proper. The scapula is effectively upwardly rotating to help elevate the arm. There are other movements at work, but we're going to keep it simple.
The second rep is highly compensatory. Look closely and try to determine what you see. There is compensation evident by elevation of the scapula, as well as lateral flexion of the thoracic spine.

The second video may be a little more difficult to see, so I tried to exaggerate the compensation for your eyes.



The first rep is a mostly "proper" [albeit extrememly weak] hip abduction.
The second rep shows the compensatory pattern. Again, look and try to determine what is happening.

There is lateral flexion of the lumbar spine. There's a compensation.

And something else isn't right. The hips are rolling back, somewhat like the pelvis is "opening up" towards the ceiling...

Yes. This means that the hips are deviating into FLEXION, not remaining in extension. This takes the load off of our target muscle (gluteus medius) and places it on a muscle which is often overused (tensor fascia lata).

Let me say that again. The opening of the pelvis changes the position of the hip joint.

The ultimate lesson here is to realize that the pain often comes from the faulty movement, not the other way around.

So if you've got a lady who comes to you and says she has shoulder pain when she cooks, see what she looks like when she's reaching up to the top cabinet for plates. If it looks compensatory, teach her how to move correctly. These situations are why the coaching is half of the benefit your clients receive.

Any questions or comments, please feel free to send them my way.