Musculoskeletal symptoms were the number two reason for physician visits. Approximately 31 million visits were made to physicians’ offices because of back problems including more than 10 million visits for low-back problems. Approximately 19 million visits were made because of knee problems,
14 million for shoulder problems, and 11 million for foot and ankle problems. Unnatural posture, caused by improper sitting, results in increased neck, mid, and lower back shoulder, and leg pain. Of work-related injuries, more than 40% are sprains (injured ligaments) and strains (injured tendons or muscles).
More than one-third of all work-related injuries involve the trunk, and of these, more than 60% involve the low back. These work-related injuries cost workers approximately 9 days per back episode or, combined, more than 39 million days of restricted activity. The monetary value of lost work time as a result of these musculoskeletal injuries was estimated to be approximately $120 billion.
Three most important components of successful corrective exercise selection at Mend Me
- The ability to assess clients’ musculoskeletal imbalances and evaluate the condition of their soft tissue structures.
- The ability to recognize client anxieties and build their confidence using appropriate communication strategies.
- Knowing which corrective exercises to use for each client and the order in which they should be introduced.
Corrective exercise programs will be most successful if the strategies you first recommend promote healing and regeneration of the affected structures and can also be easily adhered to.
Clients with musculoskeletal imbalances, injuries, or pain will likely feel anxious about their condition. Look for indications that anxiety levels may be rising as you discuss exercises and other program variables with them. You can adapt your strategies as needed to help keep them comfortable, confident, and focused.
The best strategies for building client confidence are:
- Speak in a straightforward manner and avoid using complex, technical terms.
- Begin a program with exercises you know they can perform successfully.
- Apply the guiding principle of gradual progression to all aspects of a corrective exercise program
Mend Me corrective exercise program incorporates self-myofascial release techniques, stretches and strengthening exercises, in that order.
Every corrective exercise should be evaluated using the SIMPLE procedure so that those you choose are appropriate, effective, and practical.
- Structure: What structures (muscles, fascia, joints, bones) are targeted with this exercise?
- Imbalance: Which musculoskeletal imbalance(s) are you addressing with this exercise?
- Mechanics: What are the correct mechanics of the exercise (so the imbalance is addressed and not exacerbated), and can the client perform it correctly?
- Practical: Will the client perform this exercise effectively and regularly? (Are the constraints of the exercise reasonable, and are the equipment needs practical?)
- Level: Can this exercise be progressed or regressed for a greater or lesser challenge to meet the client’s needs?
- Exercise alternatives: Is there a similar exercise that targets the same imbalance that is more likely to increase client adherence—that is, an exercise the client likes better or that can more easily be incorporated into his or her daily routine?
Self-Myofascial Release at Mend Me
The term myofascial refers to muscles and the fascia that surrounds them; the prefix myo- simply means “muscle.” Therefore, self-myofascial release is a massage technique of applying sustained pressure to an area of myofascial tissue that contains restrictions, tightness, inflexibility, adhesions, knots, or scar tissue, or lacks proper movement.
Benefits of Self Myofascial Release at Mend Me for patients are described below:
- Increases circulation, enabling oxygen and other nutrients to reach vital tissues, muscles, and organs
- Increases joint flexibility, preparing joints for the increased range of movement and load that accompanies stretching and strengthening exercises
- Reduces adhesions and scar tissue and improves the elasticity of muscles and other soft tissues
- Aids in the reduction of delayed onset muscle soreness (DOMS)
- Eliminates stored tension in muscles
- Releases endorphins to help reduce pain
- Relieves mental stress
Stretching
Skeletal structures that have been chronically out of alignment can cause joints to become irritated and inflamed. In response to this inflammation, muscles and other soft tissue structures may tighten up or stiffen around a joint to prevent movement and to protect it from further injury or pain. Over time, these chronically tight muscles lose their ability to contract, stretch, and relax, which not only prevents movement locally, but also restricts motion in surrounding areas.
These chronically irritated or tight muscles limit function and can cause additional musculoskeletal imbalances as the body compensates for lack of movement. Chronically irritated muscles may also develop restrictions, nodules, or scar tissue that can cause additional pain
The benefits of stretching
- Helps restore the normal pattern of movement
- for a muscle or group of muscles
- Increases range of motion
- Increases muscular strength and power output
- Helps prevent muscle injury
- Diminishes muscle tightness or spasms
- Enhances general relaxation
- Improves muscle coordination
- Retrains the nervous system to “let go” of excessive tension in a muscle or body part
Musculoskeletal imbalances have a dramatic effect on both the skeleton and the soft tissue structures. They cause myofascial restrictions that affect joint range of motion or function. Muscle length and tension are also affected, thus influencing the muscles’ liability to contract, lengthen, and relax appropriately. As various muscles and other soft tissue structures lose their ability to function correctly, other musculoskeletal structures in the body take over for these dysfunctional areas, leading to further compensations and additional imbalances.
Benefits of Strengthening Exercises
- Increases in muscular strength
- Increases in muscular endurance
- Promotion of growth and strength of connective tissue
- Improved joint stability
- Improved joint mobility
- Promotion of growth in joint cartilage
- Increased bone mineral density
- Increased muscular coordination
- Improved motor skill activity
- Improved motor unit and neuromuscular activation