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As we age, our postures worsen, and our muscles and the fascia that binds them become shorter and tighter. These patterns create weaknesses, reduce our mobility and range of motion, and cause compensations that increase the risk of injuries. There are many reasons for these changes: the force of gravity, lack of exercise, poor flexibility, stress, injuries, poor diet and life style, etc.

I find that an integrated therapeutic approach to the treatment of pain from injuries, including manual therapy Washington DC, can be quite effective. In addition to treating the presenting complaint (pain), this approach also looks at predisposing patterns that contribute to the injury and the dysfunction.

Many people who come to see me for pain after an injury have already received treatment by one or more practitioners in the health field; after coming out of the acute stage of pain, many are still having considerable problems. It is common for these dysfunctions to have preexisting postural patterns that need to be improved, through manual therapy, in order for the pain to be fully resolved.

Take “Mike,” for instance, a 40 year old man who had fallen from the lower steps of a staircase; he was still having considerable pain in his left mid and lower back. He had been seen by his physician and chiropractor. The pain medication was not sufficient to alter the problem, and the adjustments he received, although partially helpful, were not enough. Mike was about 90 pounds overweight. He walked with a slight hunch in his upper back and his feet turned out; this “duck” footed style of walking was more predominant on his left side.

Mike had a preexisting problem with sciatica; the left back side of his leg was very tight. The tightness in his back muscles and fascia was also present in his buttocks, leg and foot. There was an overreliance on his right side for stability in his walking. His gait was precarious and not sufficiently stable.

Mike recounted that as he walked down the steps, he noticed a lack of stability in his steps causing him to lose his balance and fall on his left side.

My work with Mike consisted of body work (manual therapy), acupuncture therapy, and helping him develop an exercise program to increase his flexibility. A longer-term goal consisted in helping him take better care of himself; this included weight loss and changing his depressive attitude, in particular, toward his work life. Sessions included body work to enhance flexibility in the areas involved, and acupuncture to increase his energy and mood, and to decrease discomfort. The goal of the structural body work and the flexibility exercises was not just to decrease pain but also to improve his posture. This approach can take longer than just the remediation of the pain; improvements in structure and posture also require attitudinal adjustments. In Mike’s case, his posture was also a reflection of his depressive attitude; as we used manual therapy to work on his structure, he also needed time to grow comfortable with shifts in mood and self-image.

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