The primary reason for the body and MCC’s compensation strategies is to establish local joint and global stability when it becomes disrupted by one cause or another. A joint being unstable means a drastically greater chance of an injured or dislocated joint, herniated organ, over stretched nerve, tissue tears, or other issues of various kinds. Because our bodies are not simple constructions in the Grey’s Anatomy sense; various distinct pieces simply connected together, but as a complicated interdependent mesh of force transmitting and sharing tissues (I typically use the metaphor that our bodies are like wicker baskets instead of Lego sets) instability in one local region can cause instability in another. We all know this, this is no surprise.

The reason I bring it up tonight is for the sake of patient homework assignment. Not only should we start local and then go global if we have problems tracking down a cause, we should end up looking global in the end anyway. If there is global instability, you may or may not succeed in making corrections that stick around a local joint as the MCC may see this change as compromising its existing primary compensation strategy, and global stability is a lot more important to it than any one given joint (though note that local stability of the head/neck/spine may as well be considered global). Because of this hierarchy of stability/compensation, many local facilitators will be functioning as part of a strategy to give global stability as it is, not just local. Local compensation does happen, and it is important, but it’s rarely all that’s going on.

Bottom line? The powerhouse 5 (RA, TVA, Multifidi, psoas and QL) is vital, along with some others (I like making sure the neck is clear with every patient, especially because of the strong effects of cervical displacement globally. Article on the effects of cervical displacement has already been started.). If the ‘core’ is not secured then your corrections either will not stick, or the dysfunction that is occurring in compensation for the failed core will pop up elsewhere. The latter is what I see most often, but we definitely don’t want that either! Get the core working to keep things asymptomatic.

Filed under: The Practitioners Corner

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