No screening before the pain
There's no routine checkup that catches a musculoskeletal prolbem before it starts to hurt.
Imaging shows structure, not function
X-ray and MRI reveal damaged tissue. They can't show the joint dysfunction that caused it.
Relief that doesn't last
Symptoms improve. The functional cause stays. The pain comes back.
Care stops at the door
Once patients go home, no one is watching. Old habits return, and hard-won progress unravels.
Range of Motion (ROM)
Does the joint move enough?
e.g. A stiff ankle collapses everything above it.
Ref) Bennell 1998 · Konor 2012
Alignment
Is the joint tracking on its axis?
e.g. A knee that caves inward raises ACL injury risk.
Ref) Hewett 2005
Asymmetry
Is load shared evenly, left and right?
e.g. Loading one side builds cumulative stress.
Ref) Plisky 2006
Compensation
Is another region doing the work?
e.g. When the hips don't fire, the lower back takes over.
Ref) Sahrmann 2002
1) It starts at the ankle
When the ankle stops moving freely, every step sends impact up the chain.
2) The knee takes what the ankle can't.
It twists off-axis to compensate and absorbs the load — until fatigue turns into pain.
3) The back gives out last.
Once the knee reaches its limit, the spine tilts and the lumbar carries the overload.
