Joint Pain? Think Ecologically.

By Brian Fox

As a manual therapist, I have to tell stories to provide context to the concepts I am trying to achieve in treatment. Client education during a session adds tremendous value to our working relationship in helping them understand the mechanisms and systems that brought them to me in the first place.

The other day, while treating a client’s shoulder, we discussed how they use their shoulder in a particular pattern with weights or added load. Patterns like push-ups and chest pressing dumbbells. They had been doing this weekly for a few years on their own and with their trainer. “All of a sudden” they began to experience shoulder pain while doing these exercises.

This opened up the opportunity to discuss the concept of training and thinking ecologically.

Ecology, as defined by Oxford Languages, is the branch of biology that deals with the relations of organisms to one another and to their physical surroundings.

Other concepts that were prudent to this treatment and should be defined are space and workspace. More specifically, joint space and joint workspace.

The Oxford Dictionary defines space as a continuous area or expanse which is free, available, or unoccupied. Workspace, also defined from the Oxford Dictionary, is defined as space in which to work. Joint workspace then is the space that is constrained by connective tissue, creates an actual joint (two bones that articulate relative to one another), and where work is funneled into. It is not a continuous expanse. I’ll get more into the weeds on these concepts in future articles.

I explained to my client the reason for them having symptoms in their shoulder while doing these exercises is potentially due to the fact no other joint spaces are used while performing these patterns. Further, moving into and utilizing other options, ie, new spaces would likely help to relieve symptoms over time. If not given time to rest and recover properly, our biological tissues, the likes of muscle and connective tissue, can get overused and become symptomatic. Think of your joint and tissues like paddocks or pastures on a farm.

Storytelling is a simple means of interconnecting these concepts while experiencing them in time. From our dialogue, clients can mentally and physically incorporate these concepts during their treatment. I look forward to my clients saying, “yes, that makes sense” while we work together.

Imagine you have a farm, your “workspace”. On that farm you have paddocks, pastures, or zones -let’s say four of them. You put cattle in one paddock and the other three are empty. Over time, if you don’t move those cattle to the other paddocks, that one area will get overgrazed and begin to experience diminishing returns.

This is similar to only using one area of joint workspace when performing exercises over and over. Those tissues will begin to experience diminishing returns over time. This can be experienced as pain in certain ranges of motion, arthritis, degeneration, or bursitis to name a few. Try moving your shoulder joint in a different position or “paddock” and train a new or similar exercise there.

While training in a new space or “paddock” for a period of time the overused space can recover simultaneously. Before you’ve exhausted a second space, move on to another zone, and the next. By the time you’ve exhausted those, paddock or space 1 will have recovered enough to use again. This is a simple system to continuously change over time.

To this degree, you can use different exercises like different animals. Put chickens there or something that won’t be so harsh on that paddock like cattle. In other words, rather than doing pushups try chest flies. Give those tissues something different to experience for a while.

This is how we can train ecologically- creating a healthy relationship between your biology and what you’re asking it to do by systematically changing exercises and spaces. Implementing an ecological system to treat and train is more sustainable over longer periods of time, and your body will thank you for it too.

“Systems are for winners.” — Adam Scott