When I talk to runners, they like to list the injury they have by name, IT band, plantar fascitis, shin splints, achilles tendonitis, hip bursitis, etc. These injuries, however, are not unique to runners. These maladies are common in all ages and walks of life.

The causes may vary depending on age and past injuries, but most injuries occur as a result of repetitive postures and repetitive motions (stress). These can occur in the work place from sitting or in sports activities such as running, for example. Past injuries, postural stresses and repetitive stress injures due to repetitive motions gradually decrease tissue tolerance and tissue capacity to loads such as running which eventually ends in an injury.

Here at NCRC, our approach is quite different whether you are a runner or not. While we care about what hurts, we are mostly concerned about why. This is why patients often times are perplexed at the order in which we examine you. Commonly, after a thorough history, we may look at where you hurt last.

The reason is this: we know where you hurt, but our functional exam will tell us why you hurt. Most likely your previous health care providers have spent the majority of their time addressing where you hurt and yet, you still have pain and decreased function and performance.

At NCRC, we examine you from a functional standpoint. We look at your mobility, static and then dynamic stability followed by movement patterns, performance and skills.

Functional movements such as a lunge, squat or single leg stance, reveal volumes of information on how your body handles loads in three distinct stances, split (lunge which mimics running), symmetrical(squat) and single leg stance (one phase of running).

Your core and stabilizers in your hips, knees and ankles work differently in these three stances. You may squat well but lunge poorly. We need to know this or we are simply guessing what is wrong and you deserve better.

What we treat and the corrective exercises we give you are based on these and other findings. Everything we do as an athlete is based on pulling, pushing, twisting, squatting and bending.

We look at your injury as an energy leak. Think of it this way. Your whole body is a 3D matrix made of muscles, bones, nerves, ligaments, tendons and fascia. It is all connected and works in sequences and with perfect timing to give you that perfect running gait and throwing and kicking motion.

Movement occurs at the joints, but movement patterns only occur in the brain on your hard drive. When we lose mobility or stability from repetitive motions, postures or injuries, we get a virus in our software and compensate to avoid pain, be energy

efficient and perform the task at hand. The longer we do this the more engrained this pattern becomes (an engram in our mind). This compensatory pattern leads to more injuries and even more compensatory patterns, I think you see where I am headed.

We as a provider must unravel the why you hurt by finding your compensatory patterns, loss of mobility and stability, essentially reverse engineering so we can treat you effectively.

So, your first visit will be something like this after a thorough history and may take 30-45 minutes.

We will put you through a Selective Functional Movement Assessment (SFMA) (www.sfma.com). This is a large volume of assessments we follow based on an algorithm of what you can and can’t do properly. These assessments are based on a hierarchy of how our body functions. We will use other functional assessments to further our findings as needed.

First we look at mobility which will show itself in poor movement patterns. Any mobility problems are addressed with Active Release Technique (ART) (www.activerelease.com), the gold standard for treating soft tissue problems. We will also utilize manipulation on the joints as warranted along with other methods. This is called the RESET.

Once we increase mobility, we will evaluate your stability, both static such as standing on one leg and dynamic which is moving the rest of your body around the joint being evaluated for stability. An example would be single leg stance while moving the other leg into flexion and extension. We may use Reactive Neuromuscular Training as another example to tap into your bodies nervous system.

Remember, we must give your body what it needs, not what we may want to give it based on our favorite treatment methods. We let the functional exam drive the methods used. We follow the principles of how the body works and apply the appropriate methods as needed.

We must look at mobility first, as good stability is driven by good mobility and good mobility provides good proprioception. Proprioception is simply the way your body recognizes where you are in space, direction and speed of movements, etc. This is why you can stand with your eyes closed or touch your nose with your eyes closed.

The body is just one big perception (sensory) and behavior (motor) machine and we must tap into that as a provider. There is no reason to reinvent the wheel. We utilize your body’s original operating system which began in the crib and followed primitive patterning. You lay on your back, followed movements with your eyes, moved your limbs and one day rolled to your stomach which was the first time you activated your core. From there you creeped, crawled, went to two knees, single knee and rose to your feet. Think of it, your first squat was from the floor up. Next you walked and finally ran.

Along the way, you fell and started again. Your earned the next step by using great mobility and adding stability and then movement patterns and finally performance (walking).

Once we have increased your mobility we will REINFORCE this with functional taping which is a way of reinforcing functional movement. We may also use orthotics and maybe give you new strategies to perform activities at work and home.

Now that we have proper mobility and stability, we move to reinforcing proper movement patterns which you need to perform your task (running) without these energy leaks.

An energy leak is simply a tissue that has been over used because somewhere upstream there has been a break down in the kinetic chain in our 3D matrix we talked about earlier. The IT band becomes sore because somewhere you are lacking proper mobility, stability and finally proper movement patterns leading to excess force being applied (energy leak) at your IT band.

Once we have reinforced proper movement patterns through corrective exercises based on YOUR movement patterns, RELOAD, we can then work on performance such as speed, strength, power and endurance and finally skills such as hitting a golf ball, throwing a ball or running.

In the end, if we do not follow this hierarchy but instead interject exercises for strength, etc before proper mobility, stability and movement patterns have been restored, we are laying fitness on top of dysfunction and going down the wrong path even faster. We are reinforcing a negative.

You MUST HAVE a solid foundation first before you add fitness.

Imagine a Prius with a Corvette engine trying to make a tight corner at high speed. It doesn’t work. Why? You have over powered the Prius frame and its mobility and stability can’t handle the performance of a Corvette engine.

We don’t want to be over powered or under powered. We want to be powered properly based on our baseline of mobility, stability and movement patterns.
So, for an entirely different experience, visit NCRC to find our WHY you hurt.

Always remember: Move Well First. Then Move More.