by Dr. Robert V. Duvall
I remember back in physical therapy school the importance of evaluating and treating people with various problems that were often directly related to poor posture. We remember as children hearing from our mothers and grandmothers to "sit up straight", or "don't slouch". Little did they know that we physically could not do what they wanted us to do. For whatever reason, whether it was tight muscles, weak muscles, crooked spines, long or short legs, we just couldn't do what they wanted us to do. Then over time, these minor malformations continued to persist and even in some cases worsened as we grew older.
The purpose of this article is to provide you with some basic information regarding your body. Most of you have had minor aches and pains, while others may have experienced, unfortunately, more severe injuries. It's easy to understand when we have a fall or trip and land funny on our knee, or twist our ankle from uneven pavement, but it sure is quite confusing when we awake one day with that little annoying hip pain. The truth of the matter is that the surprising hip pain has been developing for quite some time. It just decided to show its ugly head at this point in time. But why am I having this pain now? I've never had this pain before. Why all of a sudden does my hip hurt? I haven't done anything out of the ordinary. The importance lies within the body's own adaptive potential.
The basic premise here is that the body functions as a single unit with many components. Each component influences and is influenced by other components. Efficient and normal motion occurs from the complex integration of all components. Human movement is achieved through the relationships of the kinetic chain. The kinetic chain includes all bones, muscles and joints of the human body, but more specifically the lower half; the feet, ankles, legs, knees, hips, pelvis, and low back. This linkage system is made up of many component parts, each with their own set of specifications. These specifications are similar to what you might find for certain machine parts. In a way, the human body can be thought of as a machine. However, unlike a machine that is comprised of right angles and nuts & bolts, the human body has the capacity to compensate for a malfunctioning part, and in most cases, in more than one area. The human body seeks symmetry. It will do whatever it takes to achieve that and in doing so will compromise tissue health. In turn, it will wreak havoc on the proper biomechanics of human movement, which will greatly affect performance. The human body is the "great compensator". It will seek and follow the path of least resistance.
The goal of any movement should seek the minimum amount of energy expenditure and maximum joint stability. In human walking, the wide variety of structure and control requires complex integrations for an efficient motor program. The most observable sign of this is a smooth progression of the body's center of mass during ambulation.
Healthy tissue needs force in order to remain healthy. It requires an optimal amount of stress. Too much or too little can be destructive! Remember we talked about how a tissue's specifications are similar to those of a machine? Well, when a tissue's tolerance to absorb force is exceeded, tissue breakdown occurs and inflammation and pain follow. When inflammation and pain are present, one's performance will surely suffer the consequences.
One significant condition that impacts healthy tissue is a leg length discrepancy. Oh, but that's normal isn't it? Everybody has one leg longer than the other. Don't they? Sure, not everybody has exact proportional measurements when they compare the right and left sides of their body. First of all, how much is significant? This question has been the source of much debate in recent decades. There have been numerous studies in the medical literature that examined the eff