The Holistic Philosophy
The alternative view is to look at the whole athlete. And much like a detective, it’s important to piece together the circumstances that led to the injury and accompanying symptom(s). A variety of clues may provide vital information on how the problem was created, and therefore how to avoid it in the future and how to correct the real cause of the problem. With this approach, each athlete is seen as a unique individual with specific needs that are most appropriate for his or her precise condition. Anything less tailored to the individual is an insult to the human body.
So just how does the symptom of, say, knee pain in a runner evolve? Of course, the same knee pain in a dozen runners could easily have a dozen different patterns. But let’s go back to the example of the runner putting on his shoe in the morning. That twinge in the right hamstring muscle is not the beginning of the problem. The first domino fell, perhaps, long before this first manifestation, possibly months earlier.
Perhaps it was the left foot—the opposite side of the eventual symptomatic knee—that underwent micro-trauma due to the shoe not fitting properly. This common problem results in biomechanical stress in the left foot and ankle. While this produced no symptoms, it did affect, in a very adverse way, the mechanics of the left ankle. As is often the case in the body, this type of physical stress causes the brain to sense the problem and adapt to it. In this situation, perhaps compensation takes place through the bones and muscles in the pelvis. Specifically, the pelvis tilted to modify its movement so that weight bearing decreased on the side of stress to help it heal and increased on the opposite side—where the symptom will eventually take place. But not yet.
The increased weight bearing on the right side—something that is usually measurable by standing on two scales—may cause some of the muscles in the thigh to become overworked. This compensation is also associated with the gait change resulting from the tilt in the pelvis. Due to the shifting of body weight and the physical stress in the pelvis, the quadriceps muscles may, through an unsuccessful attempt at this compensation, become abnormally inhibited, or weak. And finally, related muscles on the back of the thigh—the right hamstrings—compensate for the quadriceps problem by tightening. Bending forward to put on the right shoe requires the hamstrings to stretch. But when these muscles are too tight, even a normal stretch can cause trauma resulting in slight micro-tearing. This is what produces that slight twinge.
So what could we propose as therapy for our knee-pained athlete? Anti-inflammatory drugs? Ice the knee? The answer is obvious now that the whole picture is apparent. Find and correct the cause of the problem. In this particular case, the first domino to fall was an ill-fitting shoe on the left foot. (Of course, this doesn’t mean that all knee problems are the result of shoes.) Whether all the dominoes will line up on their own if you pick up the first one depends on the athlete and how much damage was done. Generally, the body has a great natural ability to heal itself. And in many cases, especially in those who are more healthy, this is just what happens when the cause of the problem is corrected—all the dominoes line up and in a very short time the pain is gone. This means the muscle imbalances improve, the weight-bearing problem is eliminated, and any secondary inflammation is removed because now proper muscle balance allows the joints to move properly.
