Movement Impairment Syndromes

In my practice generally all I see are people with back or hip or other musculoskeletal pain issues.  As I talk with people there is a wide range of approaches that people want to use to treat the problem at hand.

Often folks just want someone to “cut out” the source of their pain.  While that would be convenient, this type of solution is not as easy as it might sound.  It also seems to be a very strong reflection of the way our society has gone.

Western medicine generally proposes a “symptom-focused approach.”  That is, we presume that a painful tissue is the source of the problem and treatment generally involves “rest and providing anti-inflammatory treatment to allow the affected tissue to heal.”  I often subscribe to this method of thinking in my approach to care and it often works well.  In some senses, though, this symptom-focused approach falls short.

With our focus on addressing the symptoms we do not necessarily address the reason why tissue involved is dysfunctional.

Shirley Sahrmann, PhD, PT, FAPTA is a reknowned physical therapist.  In her book (and other sources as well) Movement Impairment Syndromes (2002), Dr. Sahrmann proposes a “movement impairment approach.”  More specifically, in this approach “less emphasis is placed on identifying the source of these symptoms and more on identifying the cause.”  This approach “presumes that the problem occurred because patterns of movement were impaired before joint movement became painful or restricted.”

The proposed treatment that flows from such a movement impairment approach is potentially very different than a symptom-focused approach.  It is also a treatment that his hopefully more sustainable or long-term in terms of its vision.  Dr. Sarhmann writes “Addressing the movement source of pain contributes to a more complete and enduring correction than an approach in which the pain is relieved by temporary measures and the patient remains uninformed about the cause and ways to prevent recurrence.”

With future posts, I anticipate reviewing some of these common movement impairment syndromes that feed into back and hip pain.