You might be familiar with this old joke. A patient tells the physician, “Hey, Doc. It hurts when I do this.” The doctor replies, “Well, don’t do that!” This is such a missed opportunity. 

          In an ideal scenario, a healthcare practitioner would analyze the painful movement, looking for problems such as motion glitches, abnormal muscular balance, and tissue restrictions.  These underlying issues could then be resolved with the right course of treatment and the patient exclaiming, “Doc, this doesn’t hurt anymore!”  

  Unfortunately, many folks don’t ever experience lasting relief from movement-induced pain. Instead, they adjust their routines to manage the issues. They stop certain activities because they can’t seem to perform them without discomfort. However, with the right interventions, these painful motions can often reveal the root cause underneath them. In our office, we carefully examine abnormal movement patterns to look for these root causes—and most often, we find them in restrictions of the connective tissue called fascia.  

    Fascia is a fibrous connective tissue formed in layers that cover our other tissues, including muscles and joints. Nerve endings in this fabric-like network are stimulated by stretch and pressure, constantly telling the nervous system how each part of the body is positioned, and where those body parts are in space.   

    In other words, fascia gives our brains the internal picture that we need for coordinated motion and upright posture. This position sense helps us maintain optimal alignment and stability—both at rest and in motion—which we need to protect ourselves from injury. 

    Sometimes areas of fascia become tight or restricted because of a past injury or other causes. This confuses the body’s vital position sense, which can lead to misalignment, instability, and subsequent pain. Fortunately, such problems often leave clues about the source of confusion.  Below are some examples from our clinic’s patients (names changed for privacy). 

    George felt a sharp pain in his right thumb and hand whenever he held anything with a forceful grip, although he couldn’t recall an injury that might have caused the pain. Just pressing into the joints and muscles of his hand was not enough to recreate the pain.   

     However, when I asked him to squeeze a therapy ball and maintain the pressure, it was a different outcome. George had intense pain, and I saw the cause: Unstable (too much) motion in several knuckle joints, as well as spasms in the muscles of his forearm. I traced these problems back to restrictions in the fascia of his forearm muscles, palm, and the right side of his neck.  After releasing the restrictions, his joints became stable, and the spasms went away. George could squeeze the ball firmly without pain. 

    In Laura’s case, she beat me to the problem by asking, “What if you examined me while I was in a handstand?” This made sense—she was an active person who only felt shoulder pain while trying to perform handstands in her yoga practice.  

      She had not shown any obvious problems during the earlier examination, but while in a handstand, there was noticeable weakness in her shoulder blade muscles and restriction of motion in her acromioclavicular (AC) joint. Now that I knew how the dysfunction was showing up, I could trace the problem to nearby fascia restrictions. Releasing these with gentle manual therapy restored optimal joint motion and muscular balance, which relieved the pain.  Handstands once again became a favorite part of her workout. 

       Sarah’s lower back only hurt when she was driving her car. Sitting in a chair or even riding in a vehicle as a passenger caused no issues at all. What’s more, an examination showed no pain anywhere in her spine—even with motion. When I asked her to sit while extending her right foot forward to push on a foam wedge, used to mimic a gas pedal, even this position showed no change in her spinal joints or muscles.   

      Finally, I asked Sarah to hold a clipboard up in front of her with both hands as if it were a steering wheel.  Sure enough, the shift in her posture activated that familiar tension and tenderness on the left side of her lower back.  From there, I was able to locate the real problem— an unstable hip joint on her right side.  

       Why would hands on the steering wheel cause hip instability? It comes down to the complexity of fascia and the movement patterns it helps to guide. In the body’s fascial web, everything is connected to everything else. If one area becomes restricted, the faulty tension pattern can spread to other areas of the body, sometimes in unpredictable ways. In this case, hip dysfunction became tied to Sarah’s arm and shoulder posture.  

      Knowing where the problem came from made it possible to identify the fascia restrictions at the root of her difficult pain. After a few treatments to release those restrictions, Sarah was able to drive long distances pain-free.  

Whether it’s discomfort when someone swings their golf club, or an achy elbow when they use the computer, often the solution can be found with a bit of detective work.  If a patient says, “It hurts when I do this,” the best answer is to find treatment with a healthcare professional who knows how to evaluate the movement. A provider who is well versed in the connection between human biomechanics, muscle anatomy, joint function, and fascia therapy could be the first step to achieving that sense of, “It no longer hurts when I do this!”  

Eric Winder, D.C., and his massage therapy staff use gentle manual therapy and rehabilitation techniques to help patients with a wide range of pain and injury problems. Dr. Winder’s clinic and GentleBay Massage are located at 7246 S Beneva Road, Sarasota. For more information, call 941-957-8390 or visit https://gentlebay.com/