By Troy Winward, PT, FAAOMPT, Director of Physical Therapy at Sports Performance International
The majority of injuries are not caused by a traumatic event, or "acute" injury. Instead, they are caused by abnormal repetitive movement patterns or sustained postures that lead to trauma at the microscopic level. Shirley Sahrmann, Ph.D, author and a leading researcher in physical therapy at Washington University at St. Louis, states,
"There is a right and a wrong way to move the body and the individual joints. Just because you can sit the wrong way or move in a less optimal way and there is no immediate effect does not mean that there will not be one eventually."
Research demonstrates the most effective treatment of injuries is Orthopedic Manual Physical Therapy combined with exercise. Cessation of activity in most cases is NOT required because inactivity compromises healing. Other traditional treatment modalities, including ice, heat, massage, ultrasound, and electrical stimulation, have not been shown to be effective in treatment. They may help with decreasing pain temporarily, but they do not address the underlying cause.
A variety of popular generic exercise or treatment programs often include "core strengthening." It is critical, however, to understand that strengthening without consideration of alignment and movement patterns will not automatically correct the underlying imbalances that are the root cause of the injury.
Musculoskeletal health requires optimal alignment and movement to prevent progressive tissue micro-trauma that leads to overuse injury. Correction of the abnormal movement pattern is the most important aspect of successful treatment.
Therefore, complete rehabilitation of an injury requires not only decreasing pain, but also identification of the faulty movement pattern and subsequent correction of the related muscular imbalance and/or joint restriction. In order to do this, joints must be able to move and exercises must be performed properly. Each rehabilitation strategy is specific to the individual because no two injuries are exactly alike.
There are no "one size fits all" solutions to effective rehab.
About the author: Troy was born and raised in Utah. He attended Brigham Young University and graduated with his B.S in Exercise Physiology in 2000. He moved to Houston, Texas for graduate school and completed his Master's Degree in Physical Therapy in 2002. While in school, he learned about manual therapy and decided to complete a fellowship program in orthopedic manual physical therapy through The Manual Therapy Institute. He finished the fellowship in July 2007. Troy and his family have lived in Austin since 2007.