BioMechanics?
Simply stated...Non traumatic Pain, swelling, irritation, trigger points, weakness etc has a functional origin.
Upper Kinetic Chain example -- R handed pitcher who has been to see the orthopedist. MRI and Xray are unremarkable. Diagnosed with Impingement Syndrome? Now what?
Physical Therapy for 6-8 weeks to strengthen the muscles of the rotator cuff, scapula and upper quarter. E-stim, ultrasound and maybe cold laser to the areas being irritated by the improper mechanics. Which are supraspinatus tendonitis, anterior shoulder pain that is difficult to locate and bicep tendonitis. After the treatment of 6-8 weeks, maybe the pain is less with raising the arm above the head, but pitching/throwing are still painful.
The next is Rest. OK, now the athlete tries to rest it for a couple of weeks to see if the pain goes away. If it does, then it's sure to be back within one week of throwing because the mechanics have never been addressed.
I've seen cases of Impingement Syndrome that were caused from a variety of Kinetic Chain impairments...One example follows:
- MLB Catcher -- Cause of Pain in Shoulder = Inability to fully straighten Right elbow!
The throwing motion...energy started in the lower body is transferred to the shoulder via the core musculature and then rapidly accelerates the arm to "whip" the ball at a high velocity.
The lack of full extension at the R elbow will decrease the effectiveness of the "whip" and will therefore be compensated for by the shoulder muscles, to attempt to still throw the ball at high velocity. This catcher originally came into my office complaining of rotator cuff Pain!