IN THE REHAB ZONE

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A Comprehensive Approach to Resolving Muscle and Joint Pain

Summary of a Complete Team Approach to Ending Muscle and Joint Pain

A comprehensive sports medicine approach should include  1.) A team coach for the sport   2.)  A strength coach and/or Athletic Trainer 3.) A medical doctor who specializes in sports medicine and    4.) A Chiropractor/ Physical Therapist who is a certified ART® provider.   5.) Proper Nutrition Counseling.

Get the best care you can by incorporating all these people into your team of Human Performance specialists.

It is important to note that the human frame and human performance physiology is far too complex for any one health care professional to be able to thoroughly detect, address, and resolve all issues that need attention.

The Need for a Multi-Modal Approach

Dynamic Neuromuscular Stabilization/Postural Restoration

-The need for soft tissue work such as Active Release Techniques to release overactive muscles.

-The need for joint manipulation to reduce joint compression and correct misalignment to restore proper  joint mobility.

-The need for rehab to restore mobility and stability to the muscles and joints of the body in order to ensure optimal body movement patterns.

-The need for proper nutrition to ensure optimal physiology.

A Multi-Modal Approach

A. Manipulation and the Arthrokinetic Reflex

The most common question patients ask in clinic is “is my problem muscle related or joint related?”  Another common statement is “I think I have a pinched nerve”.  The simplest way to answer a very complex set of occurrences that surround muscle and joint pain syndromes is that most patients are dealing with a tri-factoral problem.  Barring acute trauma whereby fracture or dislocation is involved, it is important to give note that nerve involvement should take priority in a muscle and joint pain syndrome.  Let’s look at the nerve issue first.

Hilton’s Law states:

The principle that the nerve supplying a joint also supplies both the muscles that move the joint and the skin covering the articular insertion of those muscles.

Understanding the Arthrokinetic Reflex

Arthrokinetic reflex refers to the neurology of joints in which joint movement can  reflexively cause muscle activation or inhibition.[1]

Arthrokinetic Reflex of the Knee

Leonard A. Cohen 1 and Manfred L. Cohen 1 From the Department of Physiology and Pharmacology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

The prefix “Arthro-” means joint and  “kinetic” signifies motion, and a reflex in humans refers to an involuntary movement in response to a given stimulus. Thus, the arthrokinetic reflex refers to the involuntary response that happens when a joint is moved, namely that relevant muscles fire reflexively.

The joints have nerve receptors called mechanoreceptors.  These mechanoreceptors are responsible for  transmitting movement impulses from the joint to the brain for interpretation.  Depending on the stimulus or lack thereof, these  Type I and II articular mechanoreceptors inhibit or facilitate muscle tone.  The neurology and physiology behind the arthrokinetic reflex is a main reason why manipulation is so effective at treating chronic lower back and neck pain and also why it helps to improve sports and human performance.

A simple way to think about this is that “jammed joints” result in weaker muscles and mobile joints = strong muscles. Joints that are closed or compressed shut down muscles. They have joint dysfunction, either a joint has been strained or is locked up and fixed from  it’s normal motion.   Therefore, you must clear the joint motion in order to fully reflexively turn the muscle back on.

B.  Soft Tissue/ Fascia Release

They have a muscle problem, either the muscle has been “strained” or torn, or repetitively overloaded and has tightened and developed scar tissue over time.

The following link is an article by Dr. William Brady, an ART physician.  In it he discusses the importance of releasing scar tissue.  Hypoxic Fibrous Adhesion Pathway .

C. Functional Corrective Rehab

The need to retrain proper movement patterns.  3000-5000 repetitions to reprogram a movement so it becomes involuntary.
Only then can we “SAFELY” progress to strength training with proper movement and ensure optimal human performance.

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