Patient Heal Thyself

“The natural history”, a phrase not too often mentioned in muskuloskeletal care, is not always given a chance.  Intervention happens before nature has completed the process of healing.  However, we cannot accelerate healing!!  We can prevent disruption or delay to repair.  We can ensure in most cases that we achieve optimal recovery of function following repair.  That process does not require treatment, it REQUIRES EDUCATION.

The tool of mechanical diagnosis allows a classification of subgroups in the non-specific spectrum of musculoskeletal pain.  There are three causes of mechanically induced pain:

1.  Overstretching of normal tissue.  Patients who experience pain arising from end-range stress of normal tissue require postural correction, interruption of end-range stress at frequent intervals, and a specific designed strengthening program.  Only the patient can correct his or her own posture, interrupt end-range stress, and perform strengthening exercises.     THIS REQUIRES EDUCATION.     

2.  Overstretching of fibrosed or adherent tissue.    Patients who experience pain arising from end-range stress of structurally impaired, contracted, fibrosed, adherent of adaptively shortened tissues, require to apply exercised at end-range to remodel the affected structures.  Only the patient can perform exercises sufficiently frequent to bring about a satisfactory remodeling of contractures.        THIS REQUIRES EDUCATION.

3. Anatomical disruption and displacement of tissue.  Patients, who experience pain arising from dislocation and displacement of intra-articular tissue in the extremities or intervertebral discal tissue, can be taught to perform movements to reduce such internal derangements.  In the majority of cases the patient can perform movements and correct postures that reduce and maintain stability in the presence of internal derangement.  THIS REQUIRES EDUCATION.

Only those patients whose application of self-applied exercise fails to reduce derangement, require therapist-assisted procedures (therapist over-pressure, mobilization, manipulation).

At ‘Back In Motion’ the patient will receive extensive education regarding underlying anatomy, needed postural and environmental changes, interpretation of their symptoms (stretch versus harm), management of their flare-ups, appropriate bodymechanics instruction.  The patient will be provided with a very specific program to his/her needs, that consists of self mobilization, strengthening and/or stretching exercises.  Follow-up visits are used to further empower the patient and modify/progress their home program to achieve optimal functional outcome.  Only when indicated, therapist assisted procedures will be initiated.

We’ve made it part of our mission that “if there is the chance that a patient can be educated in any method that enables him to reduce his own pain and disability using his own understanding and resources, he should receive that education.  Every patient is entitled to the information, and every therapist should be obliged to provide it”.

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