Symptoms vs. Cause
Not a week goes by where we don’t see someone come in for their initial evaluation and describe, to whatever degree, some form of acute or chronic discomfort/pain in one (or several) parts of their body. Some of the more common ones, as you might expect, are the lower back, shoulders, and knees. They’ll go into detail on how long the symptoms have been present, what movements or exercises bother them most, and, for better or worse, explain how they’ve been going to physical therapy for the past several months with not much to show for it. In short, they’re no better now then when they originally started – back in 1999.
It generally (not always) goes something like this: knee hurts – lets see what’s wrong with knee. While it’s important to treat the SYMPTOMS (obviously), I think many therapists miss the boat entirely and never really get at the root CAUSE. I liken this to a leaky roof.
Sure, patching up where the leak is will be the quick fix. But it’s just that – a quick fix, and won’t necessarily resolve the issue at hand. In reality, the source of the leak itself is coming from the other end of the house. Until you get at the root of the problem, you’re just going to be spinning your wheels, and probably dropping a few f-bombs along the way.
That said, it’s important as fitness professionals that, A.) you know your scope of practice (unless you’re a physical therapist, athletic trainer, or Obi Wan Kenobi, you’re not diagnosing anything), and B.) we look at the big picture. Which is to say, what’s really causing the knee pain? Trust me, it’s not squats. Well, at least if they’re done correctly. Nope, what we need to be cognizant of is how the rest of the kinetic chain is operating. Do they have ample ankle dorsiflexion? Do their hip stabilizers function properly? Are their hip flexors short and/or stiff? Do they have piss poor core function in general? All of these can play a role, and many have nothing at all to do with the knee per se.
Likewise, we can’t neglect looking at one’s daily activities. Much of the time, the biggest culprit of lower back pain for example, is the fact that we sit for hours upon hours at a time. It’s been said that the worst “stretch” is the one you’re inevitably doing right now reading this blog post – shoulders slouched, upper back rounded, forward head posture (gotcha!). It’s called tissue creep, and honestly, it’s destroying your back. It’s not the deadlifts – although we could make a case for how much this makes me want to vomit in my mouth:
At the end of the day, it’s the cause we need to address, not necessarily the symptoms – just some food for thought.