After my 41 year-old brother-in-law, Joel, started experiencing sudden low back pain he sought the council of four practitioners: a massage therapist, a physical therapist, a chiropractor and an orthopedic surgeon. All of whom came to 4 very different conclusions.
The massage therapist deemed his back ‘too tight,’ the PT told him he had a muscle spasm, the chiropractor told him his pelvis was 'off' and the orthopedist sent him for an MRI and told him he had herniated a disc.
Who, if any, was right?
In a nation focused on symptoms & get ‘fixed-quick’ recipes, knowing where to go and whose advice to heed may seem elusive. One of the major difficulties is that all these practitioners speak in different exam, assessment and treatment LANGUAGE.
Getting on the same page
Fortunately, a renowned movement guru, Gray Cook DPT, standardized a system allowing various practitioners to speak the same movement LANGUAGE. His organizations, the Functional Movement Screen™ and Functional Movement Assessment™ gave us a template in which we assess a baseline for all clients.
We use these movement and mobility tests, along with many others, to gain valuable information about your movement. As we go through the movement screen, I often generalize to clients two separate, but interdependent, systems;
SOFTWARE: Allows us to impartially observe ‘programs.’ The brain, being brilliantly economical & efficient, loves patterns. DUH, we are exceedingly habitual creatures! For example, when experiencing pain, a compensatory movement pattern may occur in order to retain functionality. Our aim is to observe PATTERNS: motor control, muscle activation (the lack thereof) and imbalances in different movement planes.
- HARDWARE: These assessments also paint a picture of your personal architecture. Most people realize that we all have anatomical differences but when it comes to training, workouts, group classes, we are all taught to move with the same queues. Yet our structure heavily dictates HOW we move. For example, if we know the structure and orientation of your hips, we can give you the tools to optimize mobility in a squat or employ a pre-run training program to prevent an injury.
The baseline tests
The slideshow below shows a set of seven (7) baseline tests. Now, where do we go from here? We commonly break down further areas such as observing hip hinging, acceleration & deceleration loading to specific joints, muscle testing, orthopedic tests, etc.
The Real Dysfunction
So back to Joel's situation— which practitioner was right? I guess you could say all and none of them!? They were all speaking towards the effects of poor movement and mobility has on the body—symptoms essentially.
After flying out on a vacation in San Diego, our team examined him using these movements as our litmus test. Turns out, no one ever looked at his movement patterns and none of the practitioners diagnosed his REAL dysfunction.
Truth was that Joel had little to no ability to hip-hinge. Instead he was 'dumping' movement that should have occurred at his hips, into his low back. He also had no core-awareness, rather he relied on the deep spinal muscles to try and stabilize his movement—no wonder his discs were bulging. A comprehensive movement & mobility platform was implemented and he saw immediate results. He is well because he was taught how to MOVE WELL and he WANTED to learn, not just treat the symptoms.
I leave you with this thought from Gray Cook’s book Movement:
So why do we screen movement at our clinic in San Diego? Although we treat the immediate symptoms—in this case, relieving pain—more importantly we identify the movement and/or mobility patterns that cause the dysfunction. Do you want to fix the problem or just treat symptoms? You are invested in your body. Wouldn't you want to fix the problem before pain becomes costly, perhaps a surgery?