Who's zoomin' Who?

by Michael Griffith

Physical Therapist

Cimarron Memorial Hospital

I recall going out to lunch with an engineer friend of mine a couple of years ago. I was excited about some of the PT concepts I was learning concerning the biomechanics of the body, and how one part affects another. I was explaining how the hips play into shoulder function and the problem is usually not just the shoulder. I explained how I have been figuring out how to evaluate the hips and thus have had better outcomes with my shoulder patients. I thought I was onto something with this and his response shocked me.

“No big deal man, I do that all the time as an engineer.” he replied.

I said, “Oh yeah, what do you mean?”

He explained that as a mechanical engineer, he gets contracts to work on defective bridges. He would take his team out to look at the bridge. He then said they would do a complete structural analysis of the bridge and not just the defective part. They would apply all of their fancy math and calculate stresses and strains and come up with a conclusion. He said that 99 percent of the time the trouble is not the broken down piece, but a problem somewhere else in the structure that distributed stress to the now broken section. Had they just replaced or repaired the broken down piece they would have been back 6 months later to replace it again because they did not deal with the cause, only the symptoms.

The lights went on for me at that point and I said “Wow.” I wish I was trained to look at the body “mechanically.” There is a biomechanical model that looks at how the body functions in a similar way by looking at the causes, compensations, and symptoms. So many models just treat the symptoms without getting to the causes behind the symptoms. If just the symptoms are treated then the person will feel better for a little while. But sure enough, later down the pike, they will be hurting again.

For example, some 200,000 people in the U.S. have experienced low back pain. If you happen to be one of the lucky ones, then you have probably had some form of treatment at one time or another. I can bet that your treatment was probably aimed at the back. You say, “Of course, my back hurts.” Let's look at the back from an engineers or biomechanics perspective.

The back is caught in the middle with no place to go. Essentially, the back is stupid, it doesn't make decisions, it just reacts to what everybody else is doing. It reacts to what is coming up from the legs and what is coming down from the shoulders and trunk. It's an Indian, not a chief. It reacts to what the legs and shoulders “feed” it. If some bad things are coming up from the legs or if some bad motions are coming from upstairs at the trunk then the guy in the middle will get chewed up.

The best friends of the back are the hips. A recent research article studied a group with low back pain and a group without low back pain. A significant percentage in the group with low back pain had limited hip rotation. If the hips cannot function properly the next closest link will take the hit, the back.

It's necessary to treat the symptoms but it is more important to get to the cause of WHY the back hurts and cure that as well. A biomechanical analysis treats not only the symptoms but the causes and compensations. You can fix the broken piece in the bridge, but if a comprehensive structural analysis is not performed and the causes are not treated then the thing will break down again.