Why does my PT need to know about hernia surgery from 30 years ago when I just have shoulder pain?

In the medical world, we use terms such as ‘regional interdependence’ and ‘the kinetic chain’ when discussing how one region of the body could be to blame for an issue in a completely different region of the body. This isn’t a new theory. They’re basically just fancy terms used to describe the theory we all learned as kids in the skeleton/bones song.

My job as a physical therapist is to find "the why". WHY is the pain occurring? WHY are you not moving as well anymore? WHY is your swing speed decreasing? WHY are you having headaches? WHY is your balance diminished? WHY is the wear-and-tear present? WHY did the injury occur?

I can promise you one thing. My answer is never going to be "because you're getting old." The majority of the time, your HISTORY holds the key. That is why it is so important for each patient to be very thorough when providing their current and past medical history.

Please do not be shy or leave out any medical history when being evaluated by myself or any other doctors. Believe it or not, things like cosmetic, gynecological, gastrointestinal, dental surgeries (i.e. breast augmentation, gallbladder removal, appendectomy, hernia repair, C-section, pelvic surgery, etc.) and more are very likely to affect your body in ways that will contribute to pain, injury, and decreased mobility months or even years down the road.

Surgeries and injuries cause trauma to many surrounding muscles and other connective tissue. Scar tissue and adaptive muscle shortening (‘tightness’ due to prolonged periods in shortened or guarded positions) are two of the biggest causes of mobility restrictions later in life that basic stretching or strengthening activities are likely not to going to correct without other, more skilled interventions first being performed (unless cared for initially).

Just because your surgeon or other medical doctor may not have ordered you to do physical therapy after surgery does not mean it is not necessary or beneficial. The ‘pec’ muscles, ‘abs’, pelvic floor muscles, diaphragm, and facial muscles are the most common structures to withstand trauma during these types of surgeries. Trauma to any of these muscles will cause a series of compensations leading to problems such as poor posture, poor core stability, gait changes, etc. Many people will say, "I'll just wait until those problems arise and will have my trainer correct those problems when they occur." Unfortunately it's not that simple. You can force someone to stand up straight or do some sit ups or planks all day long, but if you haven’t taken into consideration the mobility issues that led to the poor posture or core stability in the first place, the individuals will end up right back where they started in no time.

In addition, if these structures are neglected and not returned to their previous conditions after trauma, that series of compensatory changes will continue to snowball to different regions of the body. Unfortunately, many times these compensations will go unnoticed and untreated for years simply because the brain is able to adapt to each of the small deviations as they occur and constantly adjust our perception of 'normal', 'symmetrical', 'midline', etc. In these cases, I can assure you it won't be long before this accumulation of inefficiencies/inaccuracies cause inevitable injury, pain, and/or dysfunction occurs elsewhere.

However, it’s not just prior traumas that lead to these compensatory changes and ultimate dysfunction. There can be many other contributing factors such as sudden change in physical activity levels, prolonged desk work, other jobs/activities involving prolonged, repetitive stances/postures, as well as a variety of other factors.

WHY wait until you have this nagging pain or functional limitation that could take months or years of therapy, addictive medication, or traumatic surgery to manage? Come see me today to become educated on how your body is currently functioning, learn ways to correct those inefficiencies, and stop the pain and/or limitation before it happens!