If the Tail Wags the Dog
Anatomy and movement are fascinating from the lens of a how each part of us interacts to create a complete person. Traditionally we look at different aspects of anatomy from a myopic point of view and reduce each segment as much as possible to learn of its role in the system. There are times when we zoom back out and look at the forest for the trees, and when this happens we have the opportunity to see how small changes can make big impacts. This is where we can see if it happens to be the case that the tail may be wagging the dog.
Every set and subset of our anatomy has some influence on the whole that is our body. Large muscles move large bones, small muscles move smaller bones. There are times when small regions have a big influence on the system at large. For example, a shoulder problem can create neck issues, headaches and low back pain to name a few. If a person has a training environment that involves overhead pressing for instance, shoulder pain may reduce typical mechanics to avoid increased pain. That compensation involves neck muscles/joints/nerves etc. That induces a neck problem, which may trigger headaches and the ball keeps rolling downhill. What initially appears to be a minor issue can create a snowball effect that leads to additional problems.
Although this may sound like a dire scenario, the silver lining is that sometimes altering the initial deficit can clear up the more recent developments. When working with my patients I very often look for the foundation of a problem at hand. Typically clients arrive with a primary complaint, but that complaint is the outcome of a more fundamental deficit. If that base level problem can be identified and changed, many times the original complaint subsides. For example, if a patient seeks treatment for low back pain and upon examination it becomes apparent that their foot shape is suboptimal, we can start there. By altering the shape and movement at the foot, mechanics upstream adapt and the lower back pain may then take care of itself.
The body is incredibly complex and genuinely fascinating. There are times when apparent low-level deficiencies arise and lead to bigger problems. The inverse can also true, in that small modifications can create compounding positive effects. Tuning in to the signals provided and creating the right environment for adaptation to occur can reform how we move.
Austin Ulrich, Physical Therapist
