Limiting re-injury and aggravation, while building stronger better bodies.
Your lower back has been achier and stiffer than usual lately?
Today happens to be a good day though.
Ultimately, you’ve accepted the tightness and achiness you’ve been experiencing the past couple months in exchange for the fact that it hasn’t “gone out” in over a year.…because that level of pain is too much to bear, and you dread the thought of it.
Since today is a “good day” you head to the gym. It’s leg day today and you know you can’t skip leg day…again. You wish you had more time to get your body warmed up and ready to push some weight around, but you have an early meeting at work you can’t be late for, so you cut the warm-up short. You head straight to back squats. Rep one feels pretty good. So does rep two. Then all the sudden you get to the bottom of your squat on rep three and a sharp, shooting pain runs from your back down your thigh. You’re able to rack the weight but your lower back is beginning to spasm…badly. It’s getting worse every minute. The next day you go to a PT. Someone your buddy went to when his back was hurting. There, you work on relaxing the spasming muscles with massage and stretching. Your physical therapist prescribes exercises designed to lubricate your joints and turn on some little stabilizing muscles that tend to get lazy when pain is present.
Just trying to get you back on your feet and not in constant pain.
After the first session you feel less tight, but not moving your best. After the second session you can tie your shoes without 10/10 pain. (The small wins are exciting at this stage) After session number three you start to feel like yourself again. You gradually return to your workouts and think you must not need PT anymore because you’re “feeling better”. Over the next few weeks, you gradually feel better and better. Then you finally are able to squat and lift the same amount of weight that led to your most recent bout of back pain. You’re back to normal now, right?
Well yes, but what’s going to stop your back from going out again? Did you really fix anything?
And are you okay that your “normal” means you’re still a little tight and achy most days? Is that the way you should have to live your life? Constantly living under this cloud of apprehension and fear of “when will my back go out again?”
No one should have to live like that. Especially if you love being active! If you don’t change anything in your routine and you don’t identify what continues to cause your back pain, then guess what…. it’ll come back. It may not be today or this week or even this year. But if you don’t identify the root causes of why your back never feels 100% or why it “goes out” every once and awhile it’ll keep happening. And this is true of any kind of wear and tear repetitive injury. Whether it’s a shoulder issue or pain in your knee or anywhere else. We must fix what is leading to the relapse of injury.
At Movement Driven, our treatment philosophy has much more to do than just getting your pain to go away. It is a patient centered and individualized approach where we look to correct poor movement patterns and postures, decrease the frequency of repetitive stress placed abnormally throughout the body and prevent the injury from returning by teaching our patients how to maintain all that they have achieved while working with us. Referring to the low back pain example. If you’re still reading this blog post then I know you can relate to the experience above. And what I always ensure is that patients understand exactly what we’re doing and why we’re doing it which ultimately leads to clients being able to maintain the health of their musculoskeletal health and live pain-free.
We practice with the I3 model in mind. This model is how I’ve always treated my patients, but we never had a name for our process. Recently I stumbled upon the verbiage another well-respected PT uses when speaking with his patients. And he laid it out so well that I had to, for lack of a better word, steal his delivery of this information. Kelly Starrett is a performance PT and coined the term, I3, and put it into an organized fashion that makes so much sense to me and to my patients as well. Having this information motivates my patients to return from injury and thoroughly enjoy their sport or activity again.
The I3 model refers to:
Incomplete mechanics Incidents Injury
This concept explains how most of us get injured and it also gives us insight into how to effectively rehabilitate our injuries and return to sport. Very few of us can be considered “physical specimen” like the athletes we see on television. And even those athletes that are just ridiculous freaks of nature often of have incomplete mechanics. So, if they have it, you and I probably have them too. Incomplete mechanics refers to anything that may lead to an inefficient movement pattern. This may be tightness or weakness of a muscle, or immobility of a joint, or poor coordination, or poor balance in a certain position. And these incomplete mechanisms are likely very minor and unnoticed by the untrained eye, but they’re certainly no negligible by any means. This minor strength and mobility deficits can lead to poor movements patterns that then puts stress on certain structures of the body that aren’t designed to absorb those loads. For instance, weakness in our glute muscles can lead to caving in of our knees when landing from a jump during sport. This then leads to increased stress going through the ACL in our knee. This repetitive stress through the ACL leads to the second “I” which is incidents.
If you play basketball and you have weak glutes which allow your knee to cave slightly in every single time to land from an attempted rebound. Then that is an immeasurable amount of stress putting tension on the main ligament in your knee repeatedly. Stress the ACL that it isn’t built or designed to endure that often. Over time the ACL begins to wear down. And then the injury is like the straw that broke the camel’s back. Eventually, the ACL wears to a point where the final “I” in the I3 model comes into play: injury.
One day when playing basketball, you go up for another rebound just like you’ve done thousands of times before. But you’re not aware you’ve been stacking straws on your camel for years and your camel is giving up…. In other words, your ACL is not able to perform it’s job any longer. Now you’re injured. Let’s say you got lucky this time. You didn’t completely tear it this time. It was just a moderate sprain.
What will the rehab process look like? We can just treat your symptoms and get you back to basketball. Just like the back pain patient above was able to return to heavy back squats we can simply do enough to resolve the pain and regain whatever attribute you lost directly from this injury. And you can return to sport that way…But if the rehab process ONLY gets you feeling better it missed the boat entirely. Your ACL may scar down and heal itself. Inflammation will go away. But if those glutes are still weak, guess what. You are a defined number of jumps and landings away from your ACL giving way again. And it could be worse next time. Surgery may be up next.The point of explaining this to you isn’t to scare you in to be a client of ours. But we want you to understand how much you can do to prevent musculoskeletal injury. At Movement Driven, we know it is paramount to address all the “Is” that make up the I3 model.
First, we get you feeling better and recovered from your injury. Of course. But we then must fix the root causes and address your incomplete mechanics such glute strength in the knee injury example. This will then reduce the number of incidents occurring. Which means you keep the injury from happening again. No need to return to PT again for the same issue, rely on medication long-term or surgery to address the injury. Take control of your musculoskeletal health before your “camel’s back” breaks from all the straw you’re putting on top of it.
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