The Importance of Addressing the Full Kinetic Chain
Here at GLS, most of our courses are divided into specific joints or body regions for ease of treatment. At each course, you’ll notice we often talk about the body above and below the region specific to the course. Our Finding Dysfunction course and Synthesis are especially good at connecting the dots throughout the whole kinetic chain. This is because we, as humans, are a complicated chain. We cannot be looked at from one small point of view such as one joint of the body. We need to address the full kinetic chain.
As therapists, we encounter difficulties on a daily basis with patient’s pain and symptoms being pigeon holed into one body part. This can become even more complicated if dealing with insurance companies. No matter what, we need to address the whole person. Please don’t limit yourself to just one body part because the script or insurance company dictate it. We can still tie great therapy above and below the symptomatic region through accurate documentation.
Personal Case Study: Addressing the Kinetic Chain
I recently had a great example of this with my dad. He lives in another region of the state and went to therapy for low back pain. My dad went to 4 sessions of therapy and saw 1 PT and 1 PTA over those sessions. He didn’t feel much benefit in these sessions and I did a quick evaluation of him the next time I saw him. Low and behold, he had an ilial upslip and innominate rotation which were not assessed. However, the key factor that I found was that he had awful glute max firing pattern and compensated throughout his lumbar extensors. I did have the benefit of knowing the men in my family are known for flat butts and I suspected he wasn’t using his glutes properly, but he stated his pelvis and glutes were never assessed.
After doing these MET corrections along with a few MFR techniques and introduction to 3 glute firing activities, he noted he hadn’t had that kind of relief in quite some time. Now the real challenge is for him to continue working on glute control to take stress off of his already arthritic spine. I can’t necessarily change his arthritis, but we can help alleviate stress placed on the spine through compensation.
This example is not meant to toot my own horn but highlights the importance of considering the whole picture. This is a local example, but we could expand further. My dad has developed very flat feet and fallen arches as he has aged, which causes stress up his chain. His foot falls into overpronation, leading to valgus stress on his knees (he already has one TKA). This results in internal rotation of his hip, and if his glute med activation doesn’t increase, it will continue to place undue stress on his pelvis and lower back.
This is a far more common compensation that we see in our daily patients. If we don’t address the glute med/max inhibition and weakness along with control of arches, we will continue to stress the pelvis and low back no matter how many spinal exercises we do.
The GLS Approach: Integrating the Kinetic Chain
Great Lakes Seminars is a fun place to take a con ed course! Though our courses will focus on one key area, the importance of the kinetic chain will continue to come up. Don’t be surprised if you hear about correcting upslips at the pelvis in the Comprehensive Shoulder course due to the clavicular jump sign. Or addressing thoracic and lumbar rotation and extension to decrease rotational stress on the shoulder and valgus stress on the elbow in our Overhead Athlete course. Don’t forget to always come back and check the spine for your patients with extremity dysfunctions, or check that shoulder or wrist for the elbow. We are one big linked kinetic chain. If we don’t address one broken link, we may be missing the driver of the symptoms that our patients come to us for.
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