Did you know that the pain in your shoulder might actually be coming from stiffness in your thoracic spine (upper back)? Or your low back pain might be caused because your ankle isn’t moving well, so the forces placed on your foot when you step aren’t absorbed well, then they pass the movement up to your knee, which causes compensation at the hip and painful patterns of movement through the back.
I know it’s hard to believe that your body’s site of pain (shoulder, back, knee, hip) might not be the actual problem.
Let’s talk about a few truths before I go further:
- Pain in your body always changes how you move. Sometimes you recover just fiiiiiine in your movement. But sometimes, that pattern sticks around and you don’t realize it and it’s not helpful for your body.
- Sometimes the site of pain IS exactly the cause of the problem—and that should still be evaluated and treated so it doesn’t turn into a bigger issue or make a problem come up somewhere else.
- We humans are very resilient. Our bodies can take A LOT. And they can recover INCREDIBLY well. I don’t want to discount that whatsoever. But our bodies are also incredibly attentive, intelligent, and can respond to smaller changes than we realize too. It’s a balance. It’s being human.
- Neuroscience and pain is incredibly complex. Sometimes there may not be an obvious solution and there is no guarantee that you’ll be absolutely 100% painfree for the rest of your life. BUT what if you could decrease that pain… cause it to be less frequent… and get to a place where you can do what you wanted to do? ….I think that’s worth checking out.
With those truths established, I want to emphasize the importance of being evaluated by a medical professional to find the SOURCE of your pain—because it might actually be different than the SITE of your pain.
If you don’t fix the issue that is causing that pain, you’ll be left chasing your tail, making temporary fixes, and that pain will keep coming back when it may have been preventable. Sometimes finding the solution just needs an extra set of eyes and some helping hands to bring you the knowledge about your body and relief from pain. Those are moments where we, Physical Therapists, nerd out because we love solving human movement puzzles and helping people learn more about their bodies.
If you’re interested in knowing more or have some extra time to read, I’ll share a real life example with you:
Ankles and Hips that KNEE-ded Some Help: A Case Study
I had a patient who had knee surgery over a year ago. (She gave me permission to share her story). She had recovered well initially, but then had nagging, constant pain in her knee for more than four months…. It interfered with her ability to workout, complete her job without pain, and just enjoy her life. At one point she mentioned “I don’t even know what it’s like to not have pain in my knee anymore.”
She also assumed that the pain was due to the knee surgery. (Surgery was necessary and helpful at the time due to her injuries—this isn’t an anti-surgery blog.) But also because of that procedure, she assumed her pain couldn’t be fixed because her knee “was damaged.”
However, after our head-to-toe movement analysis using the Selective Functional Movement Assessment during her initial evaluation for Physical Therapy, we discovered that her ankles and hips had some decreased range of motion, and her hips weren’t being controlled well during movement. These findings may have happened before or after the surgery. It doesn’t really matter, because we knew we could treat it.
We gave her some home exercises, a bit of manual therapy at the joints that needed it, and did some fun exercises on the equipment in the studio. Once we gave some increased range of motion to the joints AND addressed mobility (meaning control within the new range), within just 2 weeks she had significantly reduced intensity of pain, less frequent pain (she goes days without any pain now), and is able to join in pain free on group Pilates classes to keep up that mobility and strength. By giving some love to the joints above and below the knee, we reduced forces on the knee and greatly decreased her pain.
From now on, if that knee pain comes back, my patient knows what she needs to do to manage it herself and feel better! And that is the best part—finding a solution and helping empower patients with knowledge.