A brief guide to common musculoskeletal disorders and dysfunctions

Musculoskeletal disorders/dysfunctions

What does this mean? So many things fit under the heading of aches, pains and limited function of the muscles, bones and joints:

• Osteoarthritis – the natural wearing away of joint surfaces over time, and depending on use over time. You really do earn this one.
• Degenerative Joint Disease (DJD) – a more aggressive form of the changes over time. There are many studies that show a person can have DJD on images and have NO pain at all. It’s a scary diagnosis, but it absolutely, positively does not mean you are stuck hurting. Sometimes, the process has been ignored for a very long time and things like total hip or knee replacements are done. Rehabilitation after this surgery is essential (and something Physical Therapists are great at!)
• Degenerative Disc Disease (DDD) – The spacers/ligaments and cushion between your vertebrae may be wearing a little thin. This is another thing that can be non-painful with some retraining of posture, habits and consistent exercise. No surgery has been found to help. Smart exercise and the right movements have, and even some carefully chosen manual therapy – Think of Physical Therapists as a 1-stop center of care.
• Rotator cuff tears – Injury and tears to the muscles that support and rotate the shoulder fall under this category. Some small tears often do fine with rehabilitation, other larger tears are often surgically repaired and followed by rehabilitation. With or without surgery, physical therapy can help you restore function in that shoulder.
• Disc herniations – this is another overused term. Many times it refers to a bulging disc instead of a true herniation, but either way, numerous studies and strong evidence show that having a bugle in your disc doesn’t mean that you have to hurt. It does mean that a nerve root may be under pressure, and you will need to learn the best movements to help manage your acute symptoms. This is where we come in, to help you in the beginning to not let the pains and movement become chronic - and to help if you’ve had the pains for over 3 months, you can still make changes and get back to your important activities.
• Sciatica – the sciatic nerve is about the size of a fettuccine noodle. And very sensitive. It can be sensitized at the spine, in the buttocks, in the upper thigh, and along it’s branches further down the leg to the toes. The key is to learn how to restore normal sensitivity and better movements.
• Unstable SI (or backs) – the joint between your spine and your pelvis is inherently stable. There are many thick, capable ligaments holding it together along the entire front and back of the joint. They are not unstable unless you’ve broken them in a traumatic event. Childbirth may create some sacral stress but that’s not an unstable SI joint either. What can be done? Learn better movement, restore normal function and learn what pain is all about
• SI joint dysfunction – Here again, many ligaments, strong muscle attachments. Muscles, nerves and movement patterns may be the real culprit and the poor SI gets blamed. There is loads of good research supporting movement as the answer for this. You are not broken. You are not unstable. You are not doomed to a life of pain
• Chronic low back pain – perhaps the thing that puts the most number of people out of work, off their game, awake into the night and generally miserable. There are many many causes – but what we do know from the research is that there are also many many ways to get you back to moving again and managing your own function

The biggest message here is that we can name your pain or difficulty however we want. Taking care of it really comes down to finding the thing driving your pain, and addressing that cause….

Is there a mechanical issue?

• Sometimes there needs to be some adjusting and changing of pressures.

Is there a muscle spasm?

• Let’s find out what has forgotten how to relax, or thinks it has a job to do that can never ever end.

Are there old habits/fears/postures that are affecting you?

• If you kept picking a scab on your hand, are you surprised that it won’t heal? Changing little things throughout your day can make a BIG difference in how you feel.

When you work with your therapist to find the triggers of your pain response, and identify the complex contributions of what you feel, how you think, what you know, and how your body is moving. It is with that exploration and education that we will find a way to get you moving with more ease, more fun and have you learn to care for yourself for years to come.