Where it hurts isn’t necessarily the source of your pain. I frequently use the victim/bully analogy to explain this to my clients.
Let’s say you’re low back hurts. Your low back is the victim. We could treat the victim & get it feeling better, but your problem would likely come back because we did not effectively address the bully (source of pain).
How do we find out who the bully is?
Before we start any treatment, I get a good history. I want to know when your pain started, why you think it may have started, what aggravates your symptoms, & what are you missing out on because of your problem?
Then, I’ll look at the big picture before delving into specifics. I’ll evaluate your posture, gait & general movement patterns.
I use the SFMA (Selective Functional Movement Assessment) as a checklist to ensure that I don’t miss anything.
The 10 movements of the SFMA will reveal any inefficient or painful movements that may have contributed to your current problem.
The SFMA allows me to best prioritize the rest of my examination & treatment.
My goal is to address the root cause of your pain rather than just treating the symptoms.
I aim to restore efficient movement patterns in pain-free areas first.
Rule #1 of rehab is to do no harm. I avoid having clients do painful movements because I don’t want to flare up their symptoms.
In cases of low back pain, there is usually stiffness in the hips or mid back that is causing excessive movement of the low back.
If the joints above & below are stiff, your low back often compensates by moving excessively. That excessive movement causes pain & inflammation due to overuse.
I would teach you strategies to keep your back safe, in an efficient position, while using manual therapy & exercise to improve the mobility of the restricted areas above & below your low back.
After each treatment, I retest your previously impaired movements to ensure we’re making progress.