I See Pain in Your Future


About three years ago, I was on a casual Sunday morning walk with my dad’s walking group in Vancouver, B.C.
Aside from enjoying the beauty along Locarno Beach, I was observing how the people around me were walking and moving. Let’s face it, given my profession, it’s what I do.

At one point in the walk I asked one of my dad’s friends if she had back pain, because it was clear to me that she had a number of dysfunctional movement patterns.

She replied no, and was probably thinking “what does he know” (in fact, I came to learn that she was indeed thinking that).

I was thinking, “It’s only a matter of time”.

Last week I received an e-mail from my dad. This person remembered our conversation. She had developed back pain.

Musculoskeletal dysfunction and injuries are epidemic
Foot and Ankle Injuries

  • Plantar fasciitis accounts for more than one million doctor visits yearly
  • Ankle injuries are reported as the most common sports-related injury and commonly result in chronic ankle instability
  • Individuals commonly experience hip weakness after an ankle injury, which can lead to low back and knee problems

Low-Back Pain


  • Affects nearly 80% of adults and 6-15% of athlete
  • Common in jobs where people sit for prolonged periods
  • Annual medical costs in the U.S. are greater than $26 billion

Knee Injuries


  • 80,000-100,000 anterior cruciate ligament injuries occur annually (70-75% of which are non-contact, i.e. related to poor mechanics)
  • ACL injuries commonly result in arthritis

Shoulder Injuries

  • Shoulder pain occurs in up to 21% of the general population with 40% persisting for greater than one year
  • Shoulder impingement accounts for 40-65% of injuries
  • Shoulder injuries make up annual costs estimated at $39 million
  • Altered shoulder mechanics can be the primary cause of degenerative changes

Is it possible to predict and prevent pain?

Start with a movement assessment
Starting with an assessment is essential as it helps to identify postural distortion patterns (movement impairments) that affect the Kinetic Chain (Human Movement System).
An assessment helps to evaluate:

  • Length-tension relationships in myofascial structures
  • Joint function
  • Nervous system function

The Overhead Squat Assessment is an evidence-based tool that can identify dysfunctional movement patterns:

Stand facing a full-length mirror with your feet shoulder-width apart and pointed straight ahead and your arms raised overhead.

Squat three times. Hold the pose at the lowest point in your third squat and take note of your body position at the checkpoints.

Perform the movement again and have someone watch from the side and behind.
Common movement distortions include:
1. Feet turn out or flatten
2. Heels rise
3. Knees moves in or out
4. Shoulders elevate and/or arms fall forward
5. Low back shifts to one side, arches, rounds or there is excessive forward lean of the torso
The Overhead Squat Assessment gives us clues as to where to look. This assessment should be followed up with:

  • Range of motion testing
  • Manual muscle testing

Because of the interrelationship of the Kinetic Chain, distorted movements at one anatomical area will affect the entire chain. This is called “regional Interdependence”.

For example: (“The ankle bone’s connected to the Head bone”)

  • lack of mobility at the ankle joint will result in compensation at the knees.
  • Because the knees require stability, this could result in knee pain and dysfunction.
  • The knees will compensate to allow more movement (e.g. turn in or out), placing abnormal tension on muscles that attach to the pelvis and lumbar spine.
  • The lumbar spine will compensate by an increase in the lordotic curve, causing an anterior pelvic tilt.
  • This results in tension on the latissimus dorsi muscle which connects the low back to the shoulder.
  • A tight latissimus dorsi muscle will alter the alignment and motion in the shoulder, potentially leading to shoulder pain and forward head carriage.
  • At the top end of the chain, forward head carriage can lead to neck pain, headaches and other chronic, painful conditions in the upper extremities.

Once overactive and underactive muscles as well as joint dysfunction are identified, then a specific corrective plan can be created, consisting of:

James Taylor sings: “There’s something in the way she moves…”
I’m predicting that there’s something in the way YOU move that is causing or will cause YOU pain…

What do YOU think?

About the Author

Dr. Geoff LecovinNaturopathic Physician/Chiropractor/Acupuncturist/Certified Strength and Conditioning Specialist/Corrective Exercise Specialist/Performance Enhancement Specialist/Certified Sports Nutritionist/View all posts by Dr. Geoff Lecovin