Biomechanics – A Holistic Approach to Managing Pain

Biomechanics – The “In” Thing

Why is biomechanics an important factor to consider when treating people with musculo-skeletal complaints? Because our bodies are wonderfully made to be efficient and balanced structures. There are forces acting on the body whether at rest, sitting at the computer or moving. Good structural alignment leads to even force distribution.

Poor posture and mal-alignment are major predisposing factors in most patients with musculo-skeletal complaints. The structural framework has been compromised.

Structural mal-alignment, asymmetry and muscle imbalances lead to movement dysfunctions. A weak link can cause symptoms further down the chain.

Pain vs Biomechanical model

The traditional approach in treating musculo-skeletal conditions has been to identify the painful structure and provide symptomatic relief. This relies on a diagnosis and focuses on an isolated body part. E.g. Treating all knee pain with only heat treatments.

The current approach of physiotherapy is more global, evaluating the patient as a whole. Biomechanics is the in thing now. We are interested in the effects of physical dysfunctions on the whole body. E.g. Treating knee pain by addressing patella tracking and lower limb mechanics.

Understanding and addressing the mechanics of human movement effectively resolves pain and physical ailments.

Treatment

The challenge is to piece the puzzle together to see the big picture. This requires the clinical reasoning skills of a competent clinician.

Example 1 – Forward head posture

Habitual forward head posture increases the pull of upper trapezius muscles to support the head. Muscular tension, headaches and ligamentous strain develop over time.

Example 2 – Foot mechanics

Forces at the feet can affect the rest of the body through chain reactions up the system of levers. Pronated feet and other structural issues can predispose to plantar fasciitis, heel spurs, bunions, ankle sprains, achilles tendonitis, calf strains, shin splints, knee pain, scoliosis and back pain.

Example 3 – Low back and sacro-iliac joint dysfunction

Lower body mechanics, lumbo-pelvic alignment, joint mobility and stability, muscle length-tension and compensating movement patterns are essential factors to consider. Two patients with similar symptoms may be treated very differently depending on their specific physical presentations. Addressing posture, workplace ergonomics and body mechanics during sport, leisure and homemaking activities should be part of treatment.

Symptomatic relief does have its role in treatment, and should always be accompanied by a root cause analysis and management of contributing factors.

A model of biomechanical dysfunction requires biomechanical treatments, only by which the pain can truly be alleviated and the problem solved.

THE PYRAMID OF PHYSICAL HEALTH

In a healthy, balanced body, good posture and alignment are the foundation on which muscle balance, core stability, strength, endurance and skill are built. If not, the body lacks a stable base and dysfunctions develop. The pyramid also provides a framework for treatment of musculo-skeletal conditions and designing sports performance programs.

By PHYSIONIQUE – Physiotherapy & Rehabilitation Centre, Singapore