FAQ: What is the most common problem I see?
In answering this question, it is so tempting to name a body area or structure as the most common - disc bulge, shoulder impingement, acute wry neck, tennis elbow, ACL injury etc etc. Statistically, a "diagnoses" like this could be counted and a "most seen" winner could be found. But that would go against my philosophy! I am after the root cause of problems, not the symptoms!
In a post about our philosophy - you can read it here -, I mentioned the Integrated Systems Model by Diane Lee and Linda-Joy Lee (no relation!).
To summarise what I look for, the key areas I assess you in are:
1. Who you are - Your Story, what has Meaning for you, how you perceive your Virtual Body, what Emotions you may have about your problems, and what your Goals of Treatment are.
2. Your different systems - Articular, Neural, Myofascial and Visceral - for each area of the body that may be part of the problem...I have been known to assess people's neck and jaw chasing down a foot/ankle problem!
3. The way you "do" the things you do in life - rest, lie, stand, sit, walk, run, exercise, work, housework, etc etc.
As you can see from the picture, it is like a 3 layered onion. The beauty of this model is that each layer can affect the other layers.
You might have a fear of bushwalking because you have sprained you ankle before (story, meaning, emotions) - this can cause you to tense up your muscles (myofascial and neural systems) which then affects the way you walk (your strategy for performance and function).
Or you may have a broken foot bone (articular), which makes you limp (strategy for performance and function) and affects how much you think about the foot (virtual body), your story and the emotions and meaning you place on the whole problem.
Or...you have learned to do a manual task a certain way because "that's how it is always done" (Strategy for performance and function), which leads to certain motor patterns developing (neural) and, depending on who taught you, you may be REALLY committed to doing a task a certain way (meaning, story, emotions) and don't want to change for some reason or another, even if it is straining your body (neural, articular, myofascial and visceral).
So what is the most common problem I see?
I would have to say that problems coordinating and controlling your joints are the most common problems I see. Some examples...
- Bending from the back instead of from the hips leading to excessive strain of the muscles, joints and discs of your back eventually leading to pain, arthritis and other associated problems
- Not being able to keep your hip "centered" in the socket leading to labral (cartilage) linjuries and eventually a hip replacement
Not centering the shoulder joint
- Not keeping your back still during a lift/exercise
- Your ribs twisting when they should stay still
- Knees coming in together during a squat
- Feet rolling in/out during exercises in an inappropriate manner
Looking back at the Clinical Puzzle picture, all of the above can be due to any of the 3 different layers being the main problem. However, I find the neural problem is the most common one I come across.
The Neural Piece of the Puzzle
Basically this piece of the puzzle is where nerves and your coordination are involved. Whilst you can have stiff joints, cartilage damage, tight muscles, pinched nerves, a funny way of doing something or a psychological reason for your problem, I find myself STILL having to retrain coordination patterns.
How do you know if you have a coordination problem?
Here are some simple ways to tell if you need an assessment or treatment for a coordination issue:
- You keep getting injuries or the same injury doesn't heal
- You can get past a certain performance point - can't lift more weights, can't do more, can't progress, etc
- Sometimes it hurts to do something and other times it doesn't, without any good reason for being different
- You are diagnosed with tendon or muscle tears without a serious accident like a fall or hearing it pop/tear
- You have cartilage issues/degeneration/tears without an accident or incident
- You are told you need to have you knee/hip.shoulder cleaned out
- You have muscle spasms that don't go even after a massage - or they come back a couple of days after the massage
- You have flexible joints and you ache all over
- You feel like you have to stretch all the time
Comment below and tell me some of your symptoms and let's see if it is a coordination problem or not...