“Everything is connected.” We all hear this a lot. It’s a little cliché. But most times, it is very true. And in the medical field, it is very true. Dr. Charlene and I took an advanced Pelvic Floor evaluation and treatment course this past weekend, and this theme was something that came up often. In the process of evaluating and treating the pelvis, it is important to also check on a number of other things: spine mobility, spine stability, breathing patterns, hip strength and mobility, bladder habits, gait, postural habits, stress levels, and so much more. That’s a lot of medical jargon, but what does this mean for the non-medically trained people reading this? You may have guessed it, everything is connected. And this doesn't just pertain to the pelvis.
Have you gone to an Ortho Doc for a knee or hip pain, and they barely look at that joint, let alone any other part of the body? Sadly, that is the norm in the medical field, with some exceptions. “Ain’t nobody got time for that!” Right? I try not to judge, I’m sure they have a schedule to follow that is completely unreasonable. I’m sure they do the best they can with the time and the tools that they have. Maybe they’ll take an x-ray and blame something on the x-ray (that’s quick and easy to do!) without hearing the whole story, evaluating the patient’s movements, without looking at the joints and areas above and below, without diving into the patient’s history of past injuries and accidents, habits and hobbies. It’s hard to figure out why a knee is hurting now when none of these other factors are taken into account.
So, what do you do with this information I’m giving you right now? Feel overwhelmed? Feel defeated? Feel confused? No! If you’ve had a stubborn pain or injury and it has been assessed and addressed, and it’s not improving, keep in mind that maybe it’s not the part that’s hurting that is the problem. Think back to old injuries, old accidents, old issues. Did you have a series of really bad ankle sprains on one side? Did you hurt your neck or back in a car accident decades ago? Did you have an abdominal surgery years ago? These are all parts of YOUR puzzle. I’m not saying that if these things happened to you that you’re damaged and doomed to pain forever. What I AM saying is that from a history of injury or accident that wasn’t fully addressed at the time, you may have developed some areas of tightness, some compensatory patterns that just stuck with you, some movement aversion or fear-avoidance behaviors, some negative self-talk about certain activities or positions, etc, etc.
The good news? The body is very resilient, and it can heal, even years later! Sometimes it needs a little outside influence to help the process along. Correcting faulty movement patterns can help a ton, correcting compensations can help even further. Teaching your body to move in ways and directions that you’ve been avoiding or apprehensive of is very helpful. Sometimes you need a little extra hands-on treatment to help desensitize or mobilize areas of the body that have developed additional pain, spasm, or restriction.
Just know that everything is connected, and if you think you’re crazy because you suspect your 5 repeat left ankle sprains from 15 years ago are contributing to the right hip pain you’re having now when crouching and squatting, know that you’re probably right. The mind and the nervous system also contribute in a significant way to persistent, chronic pain, but that's a discussion for another day.
In good health,
Dr. Ashley Bertorelli, PT and Founder of The Green Room Physical Therapy