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Regional Interdependence

Have you ever been playing your sport and found that one week your back hurts and that the next week your knee hurts ("are they connected"?) You rest, stretch, foam roll, get your massages and have completed all the exercises from your google search but this pain won't go away. There has been much research to tell us that the area where you feel pain might not really be the culprit. In fact, distant parts away from the area you are experiencing pain can play a part.  This is known as Regional Interdependence. You can google it...it's a thing. One such study specific to overhead athletes (baseball and tennis players) found that those who had elbow pain during their sport often had dysfunctions in the legs (poor single leg stability, hip stiffness, weakness). This is because lower parts of the kinetic chain (yup, it's all connected) help with "load regulation" (1). Force is developed from the legs, through the core and to the arms, not by the local joints and muscles of the shoulder/elbow. If the load is not regulated they can create acute and chronic stresses that cause injury and ultimately decrease performance. Let me be crystal clear that this is not rare...as a clinician who treats multiple parts of the body, I see this daily!!  This is why a full body movement screen is important to assess for risk factors that may add compensations that will later lead to pain.  This is also a good example of why treating a painful area without considering any other parts is inappropriate and unhelpful.

So the next time you have a localized pain, remember it can stem from a distant site. The best treatment approach stems from a thorough exam first!

Sincerely, Dr. Sunde

Owner of C.O.M.P.E.T.E Physical Therapy & Wellness LLC

(1) Clinics in Sports Medicine. Volume 23, Issue 4, October 2004, Pages 545-552. Kinetic chain contributions to elbow function and dysfunction in sports