How injuries can occur? What happens when the human body goes through normal movements and what happens when our joints say otherwise?
Human motion occurs in 3 different planes; Transverse (rotation), Saggital (forward and back) and frontal (side to side)
In order to help injuries, we have to understand two types of motion:
- Real bone motion – what the bone does in space
- Relative joint motion – what movement is actually occurring at the joint
Just because a bone (thigh bone for example) is externally rotating, it doesn’t mean the joint is externally rotating. One way to explain this is if our thigh bone and pelvis is externally rotating through space (REAL MOTION) but our pelvis is rotating faster, internal rotation (RELATIVE) actually occurs at the joint. This might leave you scratching your head, but not to worry.
When we understand this as therapists, we can figure out what joint motion needs to improve. This can be very important when we are trying to improve pain.
Let’s take the golf swing for example.
Golfer A is righthanded. When he rotates the club to the right, he gets pain in his neck.
Now, you might think that as his body is rotating to the right, it is indeed right rotation which is causing the neck pain.
However, because everything below the neck (shoulders and thoracic) is moving faster to the right, it is actually causing left neck rotation (relative). Once we understand this, we can then look at ways to potentially improve the ability of the neck to improve through left rotation.
However, looking at only the painful area (the neck) limits the possibility of finding the root cause of the problem.
Golfer A has had this long-standing painful neck for some time now, whenever he swings the club.
When we are at maximal end range in the golf swing, we utilise movements from every single joint.
From the foot and ankle, all the way to the neck. We accumulatively take motion from each joint to give an overall range.
What about the stiff ankle that was sprained 9 months ago and was poorly rehabilitated?
It doesn’t want to move in the transverse plane (rotate).
This means that a lack of range provided here will cause one of two things:
- The total range of motion used to swing the golf club is less (a reduced swing)
- Other joints will have to provide more range if the same total range is achieved
This is where other joints can become sensitised and problematic. Because of the stiff ankle, the thoracic has been asked to do more work in order to achieve the same amount of rotation to swing the club. This in turn has asked for more range from the neck and this can be why a painful reaction at the neck has manifested.
This reinforces the importance of looking at the whole body in its entirety, especially when we’re watching it performing the task that is painful (the golf swing etc).
We are more likely to get an understanding of what joint motion we can improve by making a few changes to the position and what improves the situation.