Regional interdependence is a concept regularly being taught currently, that describes how a limitation in one region can affect the movement and pain in another region. For example, limited thoracic rotation may limit overall shoulder elevation mobility and result in excessive wear/pain. With a standardized mobility examination (like the Selective Functional Movement Assessment - SFMA), we are better able to pick up some of these deficiencies.
While a system like the SFMA is built more on musculoskeletal limitations, it can be useful for other systems as well. Some of you may have seen my post a couple weeks ago on my experience with visceral therapy. It is said that there is a visceral component in 80% of musculoskeletal injuries. Some of my thoracic extension mobility restrictions were secondary to visceral issues. The concept makes sense generally speaking if you think about how any tissue can theoretically resist motion. With referral patterns for pain as well, they can present with a sort of pattern. That doesn't mean visceral restrictions cannot improve without visceral treatment. However, it does mean we need to be extremely thorough with our examination. If cervical mobility is limited due to a restriction in the liver, there will unlikely be much improvement if only the neck and upper quarter observed. A system like the SFMA forces you to look at the entire body and possibly have some success through treatment. In being forced to be thorough, you will be much less likely to miss significant findings, that at first glance, appear minimal.
Be sure to check out my post on my experience with visceral therapy from a couple weeks ago. I'm excited to be signed up or the level 1 course in April! Check out www.barralinstitute.com for more details on their methods of treatment/evaluation.
-Dr. Chris Fox, PT, DPT, OCS
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