Have you currently been in a rehab program for several years and have plateaued in your recovery? Are you still in a lot of pain? Do you find that your pain comes and goes and you don’t know the root cause? What if you could learn about your own body? How to stretch it. How to move it. How to perform day to day tasks ergonomically without pain. More importantly, how to take an inventory or checklist of movements that you should have as an injury prevention tool.
If any of the above applies to you, you are ready for a treatment that works.
This is a sneak peek into my process when I work with patients. My ultimate goal as a Kinesiologist is to make patients better in a timely manner. The more the patients have tools to manage their injury, the faster they get better.
Who is this for –
- For People who have plateaued in their recovery
- For those who are still in pain
- For those who want to know the root cause of their injury
What will you get by the end of this blog –
- How I analyze injuries
- What kind of injuries I deal with
- What kind of exercises I use to empower my patients
Disclaimer: Keep in mind that the same injuries are different from one person to another. The content of this blog is based on my experiences with different patients.
Let us get started.
What kind of problem (neck pain, lower back pain, etc.)
As a Kinesiologist, I deal with a variety of problems. The common denominator is that they are all related to movement. The symptoms could vary from a sore neck and shoulder limiting shoulder movement to tightness in the back and hips that limit crouching, forward reach, and stretching. To put it simply, we as a Kinesiologist treat the systemic and underlying issues, not just the symptoms to achieve long term sustainable solutions.
The most common type of problem that we deal with and the best reason to see a Kinesiologist is if you have a recurring injury. Usually, when you first get injured and decide to see a therapist for your injury, you want to relieve the pain instantly and the default is to always go to passive modalities such as massage, acupuncture, dry needling to name a few.
There is nothing wrong with going to passive treatments but at some point in the treatment process, people start to falsely think that once the pain is gone the problem is fixed. More often than not, the pain comes back, and sometimes it comes back with a vengeance. When patients neglect to address the cause of their initial injury, one of two things will happen, either the same injury will keep happening or a different but related injury will happen.
This is the reason why sometimes patients who initially experience a knee injury will keep having knee pain due to repetitive strain on their knee and sometimes the strain will spread to other areas of their body (i.e. hip, back, neck, and shoulder) depending on their biomechanics and activities they are involved in. To address recurring injuries, Kinesiologists take a more holistic approach and look at the mechanism of the injury. We correct the deficiency of movement by creating exercises that are client-specific and build body awareness to stabilize and create mobility in the injured and related areas.
The second most common problem that we deal with is motor vehicle accidents (MVA). The patients who suffer MVA injuries experience a rapid flexion and extension of their spine (Whiplash) which for the most part is the cause of their symptoms. Their usual symptoms are neck and back pain but can vary in degree and can be anywhere in the body depending on the nature of the MVA. Usually, after the MVA, people seek passive treatments initially because they are in immense discomfort and intense pain. Once the pain has somewhat subsided to where they can move their body with reduced pain, we will step in to help with their active rehabilitation.
As Kinesiologists, we would ask questions relating to the accident such as:
- Where did the car hit you?
- How fast was the car going?
- How was your body positioned when the accident happened?
We will also perform postural and movement assessments to isolate the areas causing symptoms and compensations as a result of the MVA.
Our goal for their active rehab clinically is to help the injured or immobile areas of the body get stronger as we concurrently help them achieve their own rehab goals. These goals could be anywhere from being to reach behind their back towards their opposite shoulder to being able to run again and play sports. Ideally, it is better to see patients right after their MVA but it doesn’t always happen that way. Sometimes patients will see us several months after their accident for the following issues related to their MVA.
- Limited Joint Range of Motion of the neck, back, and hip
- Poor Posture
- Frozen Shoulder
- Chronic Knee Pain
- Recurring neck, shoulder, back, and hip pain
Is it treated before a major injury or after:
In a perfect world, addressing musculoskeletal issues (like muscle tightness and soreness) before a major injury is a preferred route but unfortunately, people place more importance on the problem once it materializes into an injury. Injury Prevention is definitely what I like to promote as a Kinesiologist as the biomechanical issues are easier to address and may prevent future injury, prevention also tends to be the most cost-effective. Injury prevention is also something that most people don’t value (in terms of the time and expense they invest in it) as much as Injury management. Believe it or not, there are factors that make you susceptible to an injury such as:
Static work posture
Job demands such as bending and twisting
Frequency of previous passive treatments
How do you help make sure the problems do not re-occur in the patient?
- The simple answer is building body awareness.
When I start to work with clients, I teach them about the weight distribution of their feet. How and when to move their weight towards their toes and heel during specific movements like walking, squatting, crouching, leaning, sitting, the applications are endless. Being able to understand and apply the weight distribution principles will bring us to the second thing I teach patients, which is creation and awareness of tension and stretch. By stabilizing and building tension and stretch in their feet all the way to their neck, you will encourage movements organically in a way that it reduces the wear and tear on the body. With the promotion of moving organically, you will improve the body’s movement sequence and timing, your body will be able to rotate and counter-rotate with the structure above and below it without any jamming or compression.
For example, Let’s take the loading phase of a squat, if you were to move your weight towards your toes while standing, your toes should curl naturally. Once you have successfully transferred your weight towards your toes, try bending your knees. How does it feel? Do you feel a stretch in your outside hips and the top of your toes? After you have bent your knees, try hinging your trunk forward until you feel a stretch in your glutes, back thighs, and low back. Do you feel safe and stable? This is an example of the awareness that I build with my clients to understand and feel comfortable with functional movements such as a squat. Understanding how to shift your weight and increase awareness of the tension and stretch will not only make it easier to get down and stand up from a squatted position, more importantly, these principles will significantly decrease your chances of injury.
What makes you different from other Practitioners? – I look at the whole picture during patient assessment
When taking in client history, I listen to the injuries they have had in their lifetime as these injuries whether big or small, can affect how tight different parts of their body are. This will almost always affect posture and movement. Clinical assessments can be anywhere from a basic postural assessment to a muscle endurance test to observe how the body adapts when certain stresses are applied. More importantly, when seeing a new patient, we have to identify their current ability and motivation to make a personalized program that is safe and effective for the patients’ needs.
What exercises do you give? – gait-related exercises.
For me personally, I like to take it a step further and give stretches that are based on gait because walking is probably the most natural and dominating movement as human beings. In terms of homework that I give to patients, the more organic and less rigid the movement is, the more our body will adapt to the input of a new or improved motor pattern. Specifically, gait-related stretches optimize a normal stretch by adding one or more movement(s) above or below the muscle or joint that is being stretched initially. If you take a pigeon stretch on the L hip as an example, to turn this into a gait-related stretch, I would turn the neck and head to the right, pull the knee down towards the ground, and pull the forefoot up towards the ceiling. You should feel the stretch amplify and extend from your L hip to your neck.
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