Musculoskeletal pain is complex. I don’t know anyone who will tell you different. It is why being a clinician of musculoskeletal pain can be a frustrating endeavor at times. It is also why in PNMT we take a systems approach to pain. We understand that there are many moving parts, literally, in the human body; and those moving parts are constantly interacting with each other in a multitude of ways. It is important to know the parts of the system, but paramount to understand that those parts never work alone. A linear approach to pain often gives definitive causes for pain, but unfortunately they are often inaccurate. A linear approach to pain would argue that forward head posture causes headaches, a systems approach would argue that forward head posture could cause headaches. An important distinction but one that is at the heart of systems thinking: multiple factors are constantly relating with each other, changing each other and influencing each other. There are rarely one-way streets in musculoskeletal pain, but rather a complex highway system with on-ramps, off-ramps, roundabouts and cul-de-sacs.
The systems concept helps to explain to our clients why something that seemed innocuous created major harm. In systems theories a bit player can end of having a large influence on the outcome. For example, a client who deadlifts hundreds of pounds weekly gets injured when they go pick up their purse. Understanding that soft tissue outliers have effect on the system as a whole can be important when making clinical decisions. Understanding the systems approach will help you widen your scope of thinking.
Yet often times the end result of systems thinking is broad and unfocused treatment. The understanding that everything is connected leads to treatment of everything, even things that were irrelevant. Just as it is problematic to oversimplify, it’s also problematic to overcomplicate. At PNMT we focus on problem solving skills and assessments that help you determine which cogs in the system are the most relevant. We also show you techniques that help you target those specific cogs. That is why in Precision Neuromuscular Therapy we use targeted treatment interventions to help our clients with pain. That is also why in PNMT we give you many options of interventions. If there are many possible influences of pain you need many options to treat it. The wisdom is in the choosing of the target of treatment and the method of intervention.
Recently I had a client who was caught in linear thinking of her pain. She wanted to know what happened to cause her knee to start hurting. Was it the running she was doing? Was it the repetitive motion of going up and down stairs? Was it from sitting wrong when she was watching a movie? Yes at times the case may be linear, but more often than not there is no one cause to that injury and not only was it important for me to try and figure out the relevant factors in her pain, but it was also important to explain to her the idea of a systems approach and what can often be more effective than finding the causative factor, was to focus on finding the intervention that helped her feel better.
For more reading on systems approach take a look at a couple articles below.
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