Treating Chronic Joint Pain; exercise isn’t enough when it’s too much at the wrong time.
Exercise has many benefits that are essential for achieving and maintaining great health both physically and mentally. Proper exercise builds the oxygen carrying capacity and utilization within the brain and body as it strengthens muscles and tendons. Increases in flexibility and stamina allows us to remain strong and nimble as we age. Endorphins produced by exercise keeps us feeling alert, in a better mood and may be considered ‘nature’s anti-depressant.’
Keep in mind that exercise can also exacerbate an injury, both chronic and acute. Let’s explore why this is.
It is not uncommon to see patients in our office that have gone through their own exercise program or one performed by a professional physical therapist that either failed to help or actually made the injury worse by the same therapy prescription that has helped many others with seemingly the same condition. I recently had a patient just like this. Let’s review.
A local high school athlete recently came in to the office as a new patient. He hurt his right shoulder making a hit during the football season which caused immediate pain and reduced range of motion in the shoulder. After the football season was over, the athlete was determined to get ready for the upcoming baseball season where he is a starting pitcher. His physician ordered 6 weeks of physical therapy at three times per week. The result? No relief from the shoulder pain, but now he also experienced a new sharp pain in the shoulder when throwing a baseball.
Did the physical therapist do anything wrong? No. Was a diagnosis involving the rotator cuff muscles or a torn labrum missed? No. I found no evidence of either of these common injuries on my examination. What was discovered was an imbalance of the function of the muscles that move and support the shoulder joint that is controlled by the brain and nervous system. Apparently the football injury had caused the sensory nerves in and around the shoulder and supporting muscles to misfire and communicate the wrong information to the brain. This in turn caused the brain to send messages back to certain muscles instructing them to become shortened and others to be weakened. This faulty communication resulted in an imbalance in the way the shoulder joint functions while the brain interpreted the abnormal neurological input as ‘pain.’ When this is the case, no amount of exercise will lengthen the short muscles or strengthen the weak muscles, because the length and strength of muscles are controlled by the brain.
Only when this muscular imbalance is corrected neurologically and the muscles are functioning optimally, keeping the head of the humerus in the center of the glenoid fossa (shoulder joint) throughout the entire range of shoulder joint motion, will the patient be able to throw a baseball with authority and without pain. Only then will exercise, including physical therapy, be effective to restore normal muscle strength and stamina to the previously injured muscles surrounding the joint. This is exactly what we do every day in our clinic with the use of ‘functional neurology’ and Trigenics.
Trigenics is the use of at least three different therapies applied simultaneously to stimulate the malfunctioning nerve pathways and instantly restore the normal communication between the brain and previously injured body part, in this case, the throwing shoulder of a high school athlete.
Did it work? I am happy to report that the athlete enjoyed full restored range of motion of his right shoulder impingement with a significant decrease of pain immediately following the Trigenics procedures in the office on the first day. He was given some simple range of motion exercises to do for the next couple of days and followed up another time. One week later he was able to throw a baseball for the first time since the injury without experiencing the sharp pain he had felt prior to his visit to our office. I am looking forward to cheering on his team when the high school baseball season opens very soon!
The take-away from this case study is that an assessment on how the nervous system is causing the muscles to function should be done on each patient with a joint issue and any resulting neurological imbalances should be restored before any physical therapy or other stretching or strengthening exercise program is initiated. This will ensure the best possible outcomes for people suffering with acute or chronic shoulder, knee or other joint issues without spending time and money on care that doesn’t produce the expected result or, in some cases, may actually make the problem worse. One of the great things about practicing in Traverse City is that most of the health care providers, at least those that I have had the pleasure to meet, including medical doctors, physical therapists and chiropractors, are open minded enough to work together for what is best for the patient. This level of professional cooperation is best for everyone involved within our community.
by Dr. Chris Moran