We’ve all grew up hearing the little jingle about how the “knee bone’s connected to the thigh bone” (if you haven’t or just want a trip down memory lane, click here)
But is the ARM bone connected to the HIP bone? And how does this relate to physical therapy?
Let’s be clear, this post isn’t going to try and convince you that you’ve been thinking about your general anatomy all wrong your whole life and that these bones are truly connected at one joint. You haven’t and they’re not. However, through an interconnected system known as Myofascial Chains, there is evidence to support these claims.
What are Myofascial Chains?
The idea behind Myofascial chains assumes that the muscles of the human body do not function as independent units, but rather they are regarded as part of a body-wide network of muscle, tendon, and fascial structures acting as linking components based on their ‘line of pull’.
A recent systematic review (evidence regarded as high quality) found that there is strong evidence for the existence of several continuous chains connecting the humerus (arm) to the femur (thigh). Specifically, these myofascial chains include the ‘Frontal Functional Line’ and the ‘Back Functional Line.’ You might have heard of these simply referred to as the Anterior chain and Posterior chain.
^Anterior chain^ ^ Posterior chain^
Prior to this study, the idea behind these chains was only postulated through anecdotal evidence. But now there is strong evidence to confirm their existence.
**Be aware though that there was an assumption of 3 other myofascial chains that were found to have limited supporting evidence for their existence through this systematic review.
What does this mean for me?
Well this is where it becomes tricky. While research has confirmed the existence of the Anterior and Posterior Chains there is limited (read: poor) evidence explaining how this information should be used in the clinical setting or during sport performance. Should patients with hip pain strengthen their shoulders? If we have tight hamstrings, should we expect to see tight back muscles? If I only work on my anterior chain will be posterior chain be at a higher risk of injury?
Questions are being asked but right now there just isn’t enough answers. But don’t worry! Leading researchers are working to find out the answers to your/our questions. Like everything else, good things take time!
While it may be common sense to some, It’s important to understand that your individual joints of the body (the shoulder, the hip, the knee, etc) affect other regions. Having your physical therapist only focus on your involved/painful region may take the pain away but may not provide you with lasting relief. You should, at the very minimum, be prescribed exercises that work the joints above and below your involved region.
On the flip side, it’s also key to not get caught in the traps of sales pitches and marketing gimmicks where professionals describe how they are going to relieve all of your pain with treatments focused elsewhere or with passive devices such as ultrasound.
That’s why at Action Potential, we work to find the kinks in your myofascial chains (see what I did there) all the while providing direct attention locally to your involved area. Best of both worlds? We think so!
Do you or someone close to you have pain that’s limiting daily function and quality of life?
Stop in for a consultation or evaluation with one of our trusted physical therapists!
Wilke J, Krause F, Vogt L, Banzer W, What is evidence-based aboutmyofascial chains? A systematic review, ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION(2015), doi: 10.1016/j.apmr.2015.07.023.