In the recent Journal of Electromyography and Kinesiology, author Paul Hodges attempts to explain the changes we see both in the acute and chronic stages of pain syndromes. Pain creates condition specific patterns of excessively tight or weak muscles. In essence, the brain modifies movements and muscle activation to ‘‘protect’’ the painful tissue from further pain or injury. Changes to the motor system may be complementary, additive or competitive and provide short-term benefit. However there are potential long-term consequences due to factors such as increased load, decreased movement, and decreased variability to the locomotor system. It is proposed that if the motor adaptation is excessive or fails to resolve after it is no longer helpful it may contribute to the perpetuation or recurrence of injury and pain. The clinical conclusion is that clinicians need to identify aspects that may be excessive/inappropriate and develop a strategy to train the patient to restore more optimal control.
Take Home Point: Pain will cause many changes to protect the body from future damage. We need to remove the painful attributors (movement, job, posture, etc.) as soon as possible to prevent long-term consequences to the musculoskeletal system.
It is our mission at ChiroUP to provide simple solutions to complex problems. It is important to remember that pain syndromes are a case study of one. Each case is unique, however, there are common findings and rehabilitation strategies that we can all use to get our patients back to doing what they love.
Paul W. Hodges Pain and motor control: From the laboratory to rehabilitation Journal of Electromyography and Kinesiology 21 (2011) 220–228
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