Managing Symptoms or Managing Movement?
Managing symptoms or managing movement?
Developing movement ownership
As more and more as clients seek a multi-disciplinary approach to their movement problems there is the need for all movement professionals and manual therapists to tactfully and respectfully work alongside each other’s related discipline. Amongst topics possessing the potential to illustrate differences in approach between such practitioners is the client’s perspective of who has control of the movement problem. For those clients more used to receiving a regular treatment of manual therapy to get them back on track the following case study is revealing of how clients themselves must take ownership of their movement control.
It only hurts when I run…
The client in question was regularly visiting a manual therapist due to a mix of hip pain and sensations of restriction around the musculature of the lower limb and the right side of the trunk. These symptoms were preventing the client from running, their chosen form of exercise, as this provoked discomfort. Having been informed of postural deviations focussing around an anterior tilt of the pelvis, symptoms were successfully managed yet pain free running remained elusive.
Finding the fault
Following a Performance Matrix presentation, highlighting the benefits of movement analysis, the client expressed an interest in the TPM Pro screening process. The screen revealed numerous movement compensations, possibly resulting of the client’s current restrictions, their prolonged exposure to pain or the potential long term absence of awareness of movement quality. A comparison of the manual therapist’s postural assessment and the movement screen report’s site, direction and threshold of movement deficits aided the client’s understanding of their current movement status, in addition to illustrating and respecting the complementary nature of a multi-disciplinary approach to movement health.
Writing the programme
The screening report informed a process of prioritisation, weighing up previous injury, current symptoms and the future goal of a pain free return to sport. Two retraining sessions, targeting movement deficits around the foot, low back pelvis and shoulder supplied the client with a range of exercises to be performed on a regular basis. When asked for feedback the client happily identified, ‘the plan was clearly related to the problems, but was not time consuming as the exercises were simple to implement into everyday situations’.
Owning the problem, owning the solution
The problem solving approach employed within the current scenario required exercise choice that would promote adherence to the programme, provide a sufficient volume of work to prove effective and crucially, underpin the long term development of the client’s ownership of their movement control. As in this case, once the client adopts an internal locus of movement control there could be hypothesised to be dual benefits. Firstly, client ownership of the solution to their movement issue fits well with the psycho-social model of pain management. Additionally, taking the solution out of the hands of an external source offers the chance of prolonged movement health over the client’s movement lifespan. Once the client gains greater awareness of how their movement choices influence their pain and performance status, improved movement choices are likely to be made and adhered to.
Up and running
Recently this client stated, ‘I have returned to running and I am currently symptom free. Simple exercises have resulted in an increased awareness of my running technique, improving my running style and efficiency. I am also able to be more mindful of everyday movements and therefore avoid the overuse I was previously suffering from.’ The client is now back up to running distances approaching 8km and with a rescreen on the horizon they are ready for their next movement and performance goal to be achieved.
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