Pain is often a symptom of the outworking of physical imbalance within our bodies. There are physical thresholds of tolerance within each of us that, once exceeded, result in symptoms of pain. These tolerances can be exceeded through a variety of ways including prolonged physical stress, prolonged postural stress, or physical injury. We can raise these physical thresholds of tolerance through active rehabilitation so that you recover quickly post injury, minimise pain, prevent future injury and improve overall body function.
Active vs Passive Rehabilitation
What is the difference? Why does it matter? What’s best for me?
In broad terms, passive therapy is when an “external stimulus” is applied to your body – usually by a physical therapist such as an osteopath or physiotherapist – in order to assist in returning the body to normal function.
Active rehabilitation is aimed at producing positive change through “internal stimulus” and adaptation of the neuromuscular and skeletal system. This is achieved through well directed resistance & cardio based exercise prescription. For example, an individual presenting with back pain resulting from poor posture may be prescribed a specific exercise program to strengthen their back muscles and improve mobility. This may not only reduce the back pain but may also reduce the risk of re-injury.
There is a growing body of evidence to suggest that passive therapy alone does not produce the long term results that can be achieved with a combination of passive and active therapy.
If you are injured or have been injured in the past, it is important that you receive well directed rehabilitation to:
– speed recovery;
– limit long term pain and mobility disorders; and
– prevent relapse.
Both passive and active rehabilitation can play a role in restoring a patient to full function. A suitable program for management & rehabilitation should be determined for an individual patient depending on the type and degree of injury. A complete assessment should be conducted to establish the nature, severity and best treatment prior to commencing the rehabilitation process. Recovery timeframes will vary for each individual, and the correct choice of rehabilitation should require the consideration and assessment of the following:
1. Asymmetry of body movement
Your body needs to move well with even loading of joints, muscles, tendons and bone. Asymmetry may arise from prolonged stresses on the body, poor postural awareness, or direct trauma. A person’s pain, discomfort or weakness can lead to compensatory movements that in turn create further asymmetry of body movement.
Left unchecked, there is potential for ongoing pain, inflammation and joint complex adaptation that limits mobility, strength, and overall body function.
2. Neuro-Musculoskeletal imbalance
Your nervous system is what drives and keeps your musculoskeletal system in check. In order for there to be optimal function, their needs to be the appropriate “signals” from your brain to exercising tissue. Nerve entrapment, heightened or reduced signals to the muscular skeletal system can result in imbalance that in turn leads to loss of function and strength. Non invasive clinical tests are performed to determine any altered “signals” within the nervous system.
3. Spinal and Peripheral Joint Mobility
Proper joint mobility allows for better posture, better joint nutrition, reduction in the symptoms of degenerative arthritis, and overall improvements in the ease of movement. Maintaining mobility is essential and “pushes back” at the ageing process.
4. Functional Strength
Strength is essential in protecting the muscular skeletal system. If you wish to limit your risk of injury you must be functionally strong, and your body needs to be conditioned in the movement and strain patterns to which you are exposed.
For example, an olympic weight lifter is not conditioned for long distance running and would be at a higher risk of injury undertaking this type of exericise. Likewise, an elite marathon runner engaged in a heavy deadlift or back squat would increase their risk of injury as this is not the type of exercise that they are conditioned for.
An important part of active rehabilitation programming is ensuring the individual program is designed to build strength within the movement patterns being rehabilitated and the movement patterns that the individual undertakes in every day life.
5. Neuromuscular and Skeletal Nutrition
1. General Nutrition.
As with all aspects of health, the importance of good general nutrition in influencing neuromuscular and skeletal health should not be underestimated.
A poor diet may increase the risk of injury and slow the rehabilitation process, while good nutrition will assist in strengthening and protecting your body.
It should also be noted that obesity, while not always associated with poor nutrition, can also place significant stress on your muscular skeletal system.
2. Neuromuscular Nutrition.
Compromised function can result from impaired circulation and drainage of exercising or damaged muscle. Likewise the nerve supply to an area of the body can result in altered function of those structures in which they control. Osteopathic treatment coupled with appropriate resistance exercise can assist you with poor neuromuscular function.
if you wish to “bulletproof” your body, you need a rehabilitation program that addresses these key areas. It should be grounded in the best evidence based practices and be designed specifically to target your dysfunction.