Injuries or movement dysfunction?

Posted by Hans Lindgren DC on 29 May 2015 | 0 Comments

I would like to start this post with a brief background explanation. Six months ago I started to suffer with some minor niggling discomforts/injuries which I’ve previously been fortunate to have avoided. The problems include a right sided plantar fasciitis, heel pain, tight calf muscles, hamstrings tightness, swelling at the back of the knee, soreness at the patellar insertion of the quadriceps, and restricted rotational movement of the thoracic spine with a cramping sensation of the paraspinal muscles. Initially I regarded it as a sign of over-use and backed off the intensity of the weight training for a while. Did it help? Of course not! I consulted a couple of other practitioners and was told that I probably had a tear in my calf muscle and the lateral meniscus of the right knee.

We went for a run one weekend and I realized that my normally quite long stride length had been reduced to a pathetic shuffle, and that was when it dawned on me that I had let go of my mobility training and only concentrated on improving the strength component.

I realized then that it was time to change my approach and stop regarding the injuries as separate entities, and instead work out where the mobility dysfunctions originated from. 

The first question I had to ask myself was— What would I have done if a patient was seeking my help for the same problems?

The answer was obvious—I would go through a series of tests to find the restriction in mobility and/or insufficient stabilization. I never accept a simple local label diagnosis on others, so it was quite interesting to realize that I had fallen into that trap myself. If there is no external trauma causing an injury, the problem is most likely to be internal in the sense that the mechanics of some joints have been altered causing overloading both locally and in other areas. Adding to the picture was also the fact that both my squats and deadlifting had not only not improved, but rather stagnated or even declined for quite a while prior to “being injured”.  Things were starting to make sense!

Once I had gone through the relevant testing positions it was very clear that all my symptoms could be explained by one big dysfunctional pattern which included:

• Ante-verted pelvis due to tight hip-flexors and quadriceps, which inhibited gluteal muscle activity and tightened the hamstrings due to their attempt to substitute for gluteal inactivity.
• Posterior chain postural over-load – hamstrings, calves and back extensors. 
• Stiff kyphosis in the Thoraco-lumbar junction which dramatically impaired my thoracic rotation and resulted in cramping of the paraspinal muscles.  
• Reduced hip extension which also changed the gait and affected the foot mechanics.
• Plantar fasciitis was not a diagnosis of my foot problem, but rather a symptom of dysfunctional hip movement.

It was time to go to work on myself! I knew that just stretching the tight muscles would almost be pointless, and only changing my training to concentrate on improving gluteal strength would not have worked either.

I designed a program for myself aimed at improving my hip mobility/stability consisting of:

• Janda- type stretching for quads and hip flexors- I am not a big fan of static stretching, but I find it very effective for quads and ilio-psoas.
• Big emphasis on hip (Gluteal) work in the gym with lots of single leg exercises, and making sure that I used full range in all exercises.
• Emphasis on the hip extension phase when both walking and running
• I also designed a DNS exercises program specific for my problem which used a combination of yoga influenced exercises to improve mobility, and Postural Tai-chi exercises to activate and enhance better stabilization. I spent 30 minutes a day on the floor doing specific DNS exercises.

Did it work? Of course it did!

It took me 12 months of neglect to lose my previously quite decent mobility, and it took me two months of conscious effort to get it back. I am now back training at full pace and I have even competed in my first powerlifting meet for the season without any discomfort. I will continue my mobility training and expect the end result of my DNS yoga/Tai-chi training not only to be avoidance of discomfort but also an improvement of my squat and dead-lift capacity.

 Breakdown of my DNS program

DNS- Yoga exercises- positioning the body in postures that are slightly uncomfortable due to movement restrictions and staying there while relaxing and breathing properly until the discomfort subsides- My emphasis here was on mobility , but I knew I  had to have good support with  ideal joint centration and good stabilization, while also concentrating on active relaxation with proper breathing to achieve this.

DNS- Tai-Chi- Moving joints back and forth at full range while maintaining proper alignment and stabilization. My emphasis was on Joint centration and Stabilization

The result was relaxation of the tense muscles and a neural activation of the lazy ones. Once the proper stabilization pattern had been activated every position felt comfortable and almost effortless to maintain.