Published: 2009-10-21 17:54:19
Author: Katherine Hobson | U.S.News & World Report | October 7, 2009
When faced with a sore knee or a back pain, the first inclination is to look to the bones and joints. And that's appropriate in some cases. But many times, the answer lies in how all of the elements of the musculoskeletal system work together, especially those often overlooked muscles, says sports chiropractor Rob DeStefano. By taking this more global perspective, you're more accurately able to treat (and prevent) nagging injuries and aches, according to Muscle Medicine(Fireside), a new book DeStefano wrote with orthopedic surgeon Bryan Kelly and health writer Joseph Hooper. It takes you on a tour of your body's trouble spots—including the lower back and the knee—and helps you tease out the roots of common problems and possibly even how to fix them yourself. I asked DeStefano about muscle medicine in a chat; here are some edited excerpts:
If you have pain in your back, knee, ankle, or other body part, whom should you turn to for help?We're often taught to go to the top of the diagnostic chain, the orthopedist. But the truth is that most orthopedic surgeons, unless they [have some particular interest or specialty], don't want to see patients unless it's a surgical case. Otherwise, it's just evaluating and referring out. A good manual therapist who will refer out when it's necessary-whether a chiropractor, a physical therapist, or an internist who works with manual therapy—is a good port of entry.
But some of the indications to see an orthopedist [first] include tingling and numbness, an extremity with swelling or redness, edema, or pain in the area that really limits your range of motion. And anything that's a result of an acute injury should be checked out. [The book also recommends that you should immediately seek medical help if you have any injury or trauma in the vicinity of the spinal cord, progressive muscle weakness in any part of your body, or a change in your bowel or bladder function. Heat and fever are also symptoms that should make you head to a doctor.]
So many people have pain in the back. Why?
We're dynamic creatures, and we aren't supposed to sit for eight or 10 hours at a time. If you look at our muscularity, we're meant to be lower down, in a hunched position. By sitting all day, you're shortening the iliopsoas [a powerful muscle group that flexes the hip and the trunk], and when you try to stand up, it can cause a lot of discomfort [in the back muscles, which are forced to constantly pull back to keep the spine straight].
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