Regional Interdependence: What Is It and Why Is It Important?
Regional interdependence is the reason why your back pain might actually be coming from your hip. It’s why your knee pain might be coming from your ankle. And it’s why your shoulder pain might be coming from your neck or upper back. It’s a fancy term, but for simplicity’s sake, it’s an approach that allows us to look at and treat the entire kinetic chain, the entire person if you will, and not just chase symptoms. Many of our clients wonder why we evaluate the body head-to-toe. This is why.
Regional interdependence is a fitness and sports medicine concept that suggests a dysfunction in one region in the body can affect another seemingly unrelated region of the body. Regional interdependence is important, especially in athletics where proper form is essential, including weight lifting, running, gymnastics, dance, and even field and court athletes. Your physical therapist must understand the ins-and-outs of regional interdependence or else he or she is just treating the symptoms of a diagnosis, not the source of your pain. Below are just a couple of fundamental examples of regional interdependence so that you further understand your rehab.
Squatting is one of the most fundamental functional movements that human beings can perform. If one joint is limited in mobility, a cascade effect occurs in which adjacent joints must overcompensate, altering form and putting the athlete at further risk for over-use or traumatic injury. For example, if an athlete suffers from limited ankle mobility in the form of decreased dorsiflexion, he or she must lean forward at the waist to achieve further depth (see picture below). Repeated and excessive heavy bending at the waist under load during your functional squat not only limits your performance but puts unnecessary wear and tear on your back. Furthermore, it can reduce glute and quadriceps activation, which will even further limit your performance and offer decreased protection for your lower extremities and back. This is just one of hundreds of examples of regional interdependence.
A visual display of how limited ankle dorsiflexion affects the back
Another common example occurs in limited mobility in your thoracic spine (your upper back) with overhead pressing maneuvers. If you suffer from limited postural mobility (aka excessive thoracic kyphosis), your shoulders will inherently be limited with overhead mobility (see below). As you progress in weight, your capacity to lift heavier will be more and more limited. Also, this increased thoracic flexion will reduce your surrounding shoulder musculature (your middle and lower traps) activation, forcing your rotator cuff, upper traps, and even your deltoids to overcompensate, also putting unnecessary stress on your shoulders.
Decreased thoracic extension (aka excessive thoracic kyphosis) can lead to decreased shoulder mobility
There are just two of several hundreds of possible combinations of regional interdependence. Just because your pain is present in one region of the body does not mean the source of the pain is somewhere else. Unless the source of the pain is addressed, the symptoms will most likely not go away. If you feel that you may require an expert to look at the “big picture,” please consider a free phone consultation with the doctors at The PATH Rehab & Performance. Here, we can discuss your symptoms, goals, and answer any questions and/or concerns you may have. The doctors at The PATH have the tools to look at your entire system to ensure that your symptoms are 100% resolved, forever!
Dr. Cody Benavides
PT, DPT, TPIc, MFDc
Co-Owner | The PATH Rehab & Performance
