In the majority of cases, we can emply a basic model in the treatment and prevention of musculo-skeletal injury. By understanding this compensatory effect we can use it to our advantage in treating and preventing injury.
The best way to understand this model is to appreciate the amazing way the body is able to boost our strengths to compensate for our weaknesses. A blind person develops an acute sense of hearing, touch and smell to compensate for a loss of vision. Injury Rehabilitation can follow a similar path.
By understanding this compensatory effect we can use it to our advantage in treating and preventing injury.
In its simplest sense, any joint or musculo-skeletal structure in the body comprises of three subsystems:
- Active Subsystem: Muscles and tendons. Creates movement.
- Passive Subsystem: Bone, ligaments, cartilage. Creates structure and stability.
- Control Subsystem: Nervous system. Tells everything else what to do.
If there’s a problem with one of these subsystems, we can use rehabilitation based exercises to take up some of the slack. In this field, it is the Active Subsystem that is most modifiable.
For example:
- Degeneration in the lower back (passive subsystem) can lead to excessive loading of the discs and facet compression. By learning to activate (control subsystem) the muscles of the trunk (active subsystem) we can resist the movements which are most likely to cause aggravation.
- Damage to the supporting structures of the shoulder (passive subsystem) can cause a recurrent shoulder dislocation. By increasing the strength of the shoulder musculature (active subsystem) and increasing the ability to avoid injurious positions (control subsystem) we can reduce the chance of injury.
- Osteoarthritis in the knee (passive subsystem) can be reduced by increasing the stability (control subsystem) in the surrounding musculature (active subsystem) to once again avoid positions which are damaging to cartilage and underlying bone.
Muscle tightness and spasms are an example of your muscles (active subsystem) trying to take on the properties of bone (passive subsystem). The bone and associated joint is not doing its job so the muscles have to take over. The problem is, they do too much. There is not enough strength to compensate, so they go into an ‘overcontraction’.
If we can increase the strength, stability and control around a joint, we can reduce the load on the passive subsystems and both treat and prevent debilitating joint injury.
