By: Tiffany Morales
Let’s take a moment and talk about the Kinetic Chain approach introduced by Franz Reuleaux in 1875. The concept of the Kinetic Chain describes the human body as a connected and interdependent system where each joint is a link. Motion at any one of these links will impact another. If there is a problem at a certain joint like the hip, you will see compensation occur at the joints above at the lumbar spine and below at the knee. We must have integrative control over our nervous, skeletal and muscular systems at all points in our Kinetic Chain to allow our joints to work efficiently and prevent pain and discomfort.
One weak link can cause the body to create compensatory patterns to overcome the issue. These patterns often lead to imbalances and maladaptive motions in the body and our Kinetic Chain. Repetitive maladaptive motion, even at an isolated joint, can carry repercussions through the entire body. It may not happen today or tomorrow, however it may manifest in the distant future. Adapting to dysfunction alters the movement of the entire chain and can harden or establish maladapted patterns. A poorly functioning Kinetic Chain is often proceeded by pain, aches, and limited mobility in the body.
It always serves the practitioner to look for interruptions in the Kinetic Chain. Start at the root and explore outward to cover all the bases. As you restore the function from gross to fine, lesser flaws will reveal themselves. If we view the body as one entity and understand that nothing is working alone, we then become aware of how much more time we may need to treat somebody. A well-established dysfunctional chain requires increased intensity and duration. Typically, a practitioner will begin by treating a localized area of concern. A typical physical therapy plan has minimal goals and constitutes acute care programs with a short timeline of about 12-16 weeks. It is not enough time to fully address the central issues, let alone any peripheral dysfunctions.
In my own experience of treating my sciatica with therapeutic interventions, this held true. Various practitioners would target the root injury in my low back, never veering further north than my mid-back or lower than my knees. There was simply not enough time for anywhere else. Yet I encountered challenges outside of these central treatment zones that were distressing. My sciatica symptoms span down from my lower limb to my feet. Sometimes the tips of my toes felt numb during certain activities such as walking up a hill or barefoot on cold sand. The numbness is what scared me the most because you can lose function or even develop a foot drop. In the context of Western medicine, these marginal concerns were merely an afterthought since they only seemed to focus on the exact location of my pain and refrained from zooming out and seeing my body as a whole.
The secondary links of a Kinetic Chain are not always exempt from pain or dysfunction. Studies have shown that with improvement of a pinched nerve, the radiating pain to the peripheral areas can decrease. Centralized care is a great starting point, but there is no such thing as an isolated injury. Thus, we should take the time to assess and correct problems, not only at the main site of pain, but also to the rest of the Kinetic Chain where we see compensatory movement patterns manifest and contribute discomfort. By doing so, we check off more boxes and address all the dysfunctional links in the chain, even if they have not yet developed symptoms of pain. Once I took care of my central pain site, I had space to address the rest of my Kinetic Chain, so I started integrating calf and feet work into my low back focused routine. I started to notice relief in my peripheries and I truly started to make breakthroughs in my rehabilitative journey.