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To brace your abs or not to brace your abs?

Sprained Ankle

As we are talking about chronic pain in this series of blog articles, it is critical to talk about how our body chooses to move in response to pain.  Let’s take an example of a sprained ankle.  When someone sprains their ankle they may start to walk with their foot turned out to the side.  This is a conscious or subconscious effort to protect the ligaments that have been damaged on the outside of the ankle.  However, this can cause more pain up the chain – in the knee, hip, low back, or even the shoulder.  What starts out as a movement pattern to protect an injured area turns into a movement pattern that causes pain in other places of the body.

Currently, we have four hypotheses to explain why these motor strategies occur.  The Suboptimal Tissue-Loading Hypothesis states that we tend to change our movement patterns over time due to habit or energy minimization.  Over time this suboptimal loading causes pain because it exceeds the tissue tolerance.  The Pain/Injury Interference/Inaccuracy Hypothesis describes altered movement patterns in response to a real or perceived threat of injury.  The Protective Response Hypothesis describes a change in the nervous system to remove or reduce the threat of pain which changes the motor behavior.  While the Conditioned Response Hypothesis states that pain may be experienced in association with movement in the absence of nociceptive discharge due to pain “memories”.  These four hypotheses often interact with each other and each person can move through different theories as they progress through an injury.

Understanding these hypotheses and how they are affecting an individual are critical to the rehabilitation of an injury.  Each motor strategy has a unique treatment regimen for optimal results.  We can help you to understand where your body is and develop a program to improve motor strategies to assure complete healing.  Please contact us at (425)658-4944 or for more information.

Dr. Amy Konvalin

Dr. Amy Konvalin

Struggling with pain and dysfunction can impact every part of our lives — it drains our energy, distracts us from our goals, and keeps us from the people and activities we love. As an Orthopedic Clinical Specialist, Dr. Amy Konvalin understands how frustrating those limitations can be — and she knows how to help get you back to the life you want to live! Beginning with a focused evaluation, Dr. Amy works to determine the root causes of your pain, as well as understanding how it affects the way you move through your world. Dysfunctional patterns of movement often grow worse with time and cause further damage if left untreated — so it’s important to address these issues as soon as possible. Dr. Amy knows there is no one-size-fits-all plan for success, and she partners with patients to identify their unique treatment goals and personal values. Using these goals as a guide, Amy uses her doctorate training in manual (hands-on) therapy and exercise prescription to treat patients with a wide variety of medical challenges and histories throughout the Maple Valley, Black Diamond and Covington areas. Dr. Amy is also a wife to a Boeing superstar/former C-130 navigator. While they lived in Germany, Dr. Amy was able to volunteer with the US Army to treat military personnel and civilians on base. She has two beautiful teenage ballerinas who keep her on her toes and educate her on all things ballet! Bailey, the princess pup, is her running partner and her napping partner. In the spare moments in between, Amy enjoys reading, yoga, wine with friends, Pilates, and walking on the beach.
Dr. Amy Konvalin

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