By: Beverly Kornides PT, MBA

As a physical therapist our job is to assist our patients in safe and effective return to activities of work and daily living. An effective treatment starts with an accurate diagnosis. With the accurate diagnosis there is a required understanding of what is causing the patient's symptoms.

In order to fix something, we need to understand why and how it is broken.  Sometimes the painful area is not the exact source of the problem. Frequently the culprit is away from the pinpointed painful site. For example, a patient may explain that their shoulder hurts and point to front of their shoulder joint (or humerus bone). However, understanding the anatomy of shoulder mechanics and proper understanding of how the shoulder works, a trained physical or occupational therapist may find the true causes is a tightened restriction of the shoulder blade muscles or fascia is the source. This source is what the manually trained physical or occupational therapist calls the "Driver" of a limited or painful symptom of the shoulder. 

This limitation may be a problem at the joint, muscle, or the fascia throughout the area. It can also be secondary to faulty posture or mechanics. Over time, this creates dysfunction and pain. An example of this is poor posture. Sitting at a desk that may not be ergonomically correct can cause an increase of injury or dysfunction due to improper mechanics. Having a forward head, rounding shoulders or an improperly placed keyboard or monitor could be contributing to this. Upper trap tension or tightness in the mid back or shoulder blade can cause restricted fascia and muscular tightness resulting in severe shoulder pain. This tension can cause the posterior shoulder muscles to be lengthened in their resting state otherwise called "Hypomobility.” In this example the hypomobile area is the patient's site of pain (front of shoulder) and the hypomobile area is the "Driver" of the dysfunction (shoulder blade). 

Finally, hypomobile areas of the body at times are the puzzle pieces that are often hidden or not recognized as the source of one's problem. Effective treatment plans in rehab includes taking a good history of the patient's habits and activities, looking at the whole mechanics of the extremity and palpation of hypomobility areas that may be influential or driving the problem.  

For answers to your pain or dysfunction that impede your work, recreational or home activities contact one of our specially trained physical or occupational therapists at CAO. Learn more about our physical therapy and rehabilitation services.