Excerpted from Page, Frank, and Lardner. Assessment and Treatment of Muscle Imbalance: The Janda Approach (2010)
“In patients with chronic musculoskeletal pain, the source of the pain is rarely the actual cause of the pain. In fact, he who treats the site of pain is often lost.” (Czech physician Karel Lewit)
In order for clinicians to identify and predict functional pathology, understanding chain reactions is essential. This requires emphasis on the clinical principle of looking beyond the site of pain and focusing on the cause of pain rather than the source of pain. Adaptations within any chain can be helpful or harmful; the clinician must decide if these adaptations are pathological or functional.
Lewit’s colleague Vladimir Janda theorized musculoskeletal pathology as a chain reaction. He was a strong proponent of looking elsewhere for the source of pain syndromes, often finding symptoms distant from the site of the primary complaint.
Chain reactions can be classified as articular, muscular, or neurological; but keep in mind that no system functions independently. The type of chain reaction that develops depends on the functional demands, and depends on interaction of these three systems. Pathology in the primary chain can be linked to dysfunction in a secondary chain, and vice versa.
- Articular chains
- Postural chains
- Structural postural chains
- Functional postural chains
- Kinetic chains
- Muscular chains
- Synergists
- Muscle Slings
- Extremity flexor and extensor slings
- Trunk muscle slings
- Myofascial chains
- Abdominal fascia
- Thoracolumbar fascia
- Neurological Chains
- Protective reflexives
- Sensorimotor chains
- Reflexive stabilization
- Sensorimotor adaptation chains
- HORIZONTAL ADAPTATION
- VERTICAL ADAPTATION
- Neurodevelopmental locomotor patterns
- Tonic chain
- Phasic chain
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