Principles of musculo-skeletal dysfunction

Cardinal rules of joint and muscle pain

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Musculo-skeletal dysfunction explained

Clinical diagnostic assessment

1.

(Trauma excepted) muscles move bones out of alignment. That's the bad news. The good news is that if muscles have moved bones out of alignment, there is a fair chance they can move the bones back into alignment. (Egoscue)

2.

For example, if one 'part' (your lower back) of the skeleton is in pain, it’s a fair chance that you have a system problem, not just a 'part' problem. Fix the system and the parts will look after themselves. (Feldenkrais)

3.

Joint pain is a symptom that the bones on either side of a joint are out of alignment. The joint (bearing) is becoming worn. Get the bones back into alignment - and there’s a fair chance the joint (bearing) will repair itself – providing it is not left too long before the realignment process is started.

4.

Back pain is a symptom that ligaments, tendons and muscles attached to the bones in the lower back have been stretched beyond their pain threshold; that intervertebral discs have become herniated and may be impinging on your spinal cord.

5.

Treat the cause of the pain and the pain will be relieved.

Mask the pain with an analgesic and the structural problem remains – and gets worse. A small problem becomes a big problem.

6.

The cause of the pain is rarely at the site of the pain.

Once muscles attached to the pelvis draw the pelvis out of alignment, the bones above and below move out of alignment 'in sympathy.' Doing the exercises that square up the pelvis are essential in getting the skeleton back into better alignment.

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Form (good skeletal alignment) follows function (the ability to successfully perform a range of postural/flexibility exercises).

9.

A high proportion of joint and muscle pain is personally-generated. In a way that’s good news because chances are it can be personally ungenerated.

10.

If you want to be pain free within the next hour or so, go to the chemist. But if you want to be pain free within the next 6 months (maybe more, maybe less) start doing the exercises that will get your skeleton back into better alignment. NOW!

11.

The more often you do the re-aligning exercises and the longer you do them for the quicker your skeleton will get back into better alignment.

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Most joint and muscle pain is a fitness problem not a medical problem. Which begs the question, 'Why are you going to a medical practitioner when you should be going to a fitness practitioner?'

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Most medical practitioners don’t know how to diagnose the underlying cause of joint and muscle pain. The best they can do is shoot their customers off to the radiologist, the chemist and the manipulator.

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Generally speaking, the advice you’re likely to receive about causation from a radiologist will be unhelpful. All the radiologist does is determine ‘what is’, not what’s caused ‘what is’. The radiologist doesn’t comment on causation, that’s the doctor’s job. You’re caught in a medical demarcation dispute, not that either the doctor or the radiologist are likely to have a firm opinion as to causation.

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If the doctor and the radiologist can’t determine causation you can be certain that the prescription to fix the problem will be inadequate in the extreme.

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The Australian National Health and Medical Council (NH&MRC) opinion on causation is particularly unhelpful:
 
‘The majority (approximately 95% of cases) of acute low back pain is non-specific; serious conditions are rare causes of acute low back pain.’
 
The term, ’non specific’ is code for ‘it doesn’t have a cause’, or ‘we don’t know the cause’. And despite that fact that ‘serious conditions are rare’, serious and expensive medical treatments, like surgery – and the dangerous practice of prescribing opioids - are becoming more and more common.

17.

The information on the Arthritis Foundation or America website is vague and useless. All it can come up with is, 'There is no sure way to prevent arthritis.' It has nothing to say about skeletal alignment or which exercises to do to restore poor alignment to good. One is left with the opinion that joint inflammation (arthro – bone, itis – inflammation) comes from ‘out of the blue’. Motor mechanics who adopted this approach to wheel alignment would be out of a job in a few days.

18.

Hippocrates said, ‘The physician speaks with more authority if he’s had the disease.’ Rarely is joint and muscle pain a disease – it’s most frequently a personally-generated dysfunction caused by a body in poor musculo-skeletal condition.

You don't need to be a physician to give people advice on relieving joint and muscle pain. Someone who has relieved their joint and muscle pain is frequently a useful source of advice. 

When it comes to the personally-generated body system dysfunctions, YouTube is becoming a better source of advice than most surgeries.

19.

The medical approach to relieving joint and muscle pain is commonly described in the literature as ‘the usual treatment’ – passive therapy that involves rubbing crunching, strapping, heating, cooling, vibrating, electronic muscle twitching, creaming, doping and surgery – none of which address the underpaying cause of the pain.

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Passive therapeutic treatments may provide relief, particularly when used in association with long, slow muscle release, flexibility exercise. To be deemed ‘successful’ the treatment must be able to restore poor function to good.

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Passive manipulative therapies often do not have the frequency, duration or intensity to restore poor function to good, - quickly and cheaply.

22.

Of the passive therapies, long, slow, deep, mechanical massage may be helpful, particularly for sore calves, Achilles tendons and plantar fascia. With the right machinery you can spend hours a day being massaged while you work.

23.

Surgery may be necessary in the case of trauma and if particular joints (hips and knees) are beyond personal repair. Research indicates that a high proportion of people who have had back surgery back feel little better after the surgery than before. Many feel worse.

24.

The missing link in the treatment process is the flexibility (and strength) exercises people have to do themselves. The treatment cannot be outsourced to a passive manipulative therapist or a chemist.

25.

For 80% of people there's an 80% chance that they can get themselves back to 80% of ‘good nick’ in around 80 days - if they're diligent.

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It’s a big ask expecting to stay in good musculo-skeletal health without a good strength and flexibility training program.

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It’s an even bigger ask expecting to get better by having someone do something to you; sooner or later you have to do something to yourself.

28.

When it comes to relieving joint and muscle pain, ‘Nothing in the world can take the place of persistence.’ (Calvin Coolidge).

The more often you do the skeletal re-aligning exercises and the longer you do them for the quicker your skeleton will get back into better alignment and the quicker your pain will be relieved.

Back in Alignment Clinic

Miller Health

7 Salvado Place Stirling ACT

Australia