The two most important aspects of life are time and health. While relationships, friends, family, careers, finances, spirituality, among others play significant roles in our happiness, none of these can be truly nurtured without the time and health—both physical and mental—to support them. Everyone is granted the same amount of time each day, making health the ultimate differentiator. Without good health, performing at your best—whether in sports, fitness, or general well-being—becomes a frustrating challenge. It’s incredibly disheartening to strive for peak performance only to be sidelined by pain or injury. I’ve been there, so I understand that struggle firsthand.
Health has many dimensions, including sleep, stress, mental well-being, and physical fitness. As a physical therapist, I focus on the physical aspect, though it’s essential to acknowledge how interconnected the body and mind are. A healthy body positively impacts the mind, just as a healthy mind enhances physical well-being. In this article, I will introduce The Charlotte Athlete and our unique approach to treatment. I’ll discuss how we think as movement specialists, what sets us apart from other clinics, how we address the root causes of pain, and provide summaries and resources for each body region. These insights will empower you to avoid pain and, if you’re currently dealing with an injury, help guide you toward recovery!
A Personal Introduction
First, let me briefly introduce myself and my company, The Charlotte Athlete.
My name is Dr. Andrew Kenas. I am a residency- and fellowship-trained physical therapist with dual board certifications in orthopedics and sports. I also hold additional certifications, including CSCS (Certified Strength and Conditioning Specialist), USAW (United States Weightlifting), among others. I’ve been practicing physical therapy for over a decade, during which I’ve built a successful physical therapy business in Charlotte, North Carolina. Beyond my clinical practice, I teach advanced continuing education courses to sports physical therapists and athletic trainers nationwide through the Institute of Athlete Regeneration (IAR Education). My passion lies in helping athletes in Charlotte overcome pain and injuries the right way, so they can achieve their goals with confidence and resilience.
A fundamental flaw in healthcare worldwide, particularly regarding injuries, is the tendency to chase pain. Chasing pain means treating symptoms based solely on their location rather than addressing the root cause of the problem. While eliminating pain as quickly and efficiently as possible is a priority, ensuring it doesn’t return is equally, if not more, important. Persistent pain—whether it’s intermittent, lingering for months, or recurring over years—is a sign that previous treatments have been inadequate. Now just to be clear, I’m referring specifically to musculoskeletal pain, not autoimmune conditions, diseases, or traumatic injuries like a shoulder dislocation (although even in these cases, addressing the root cause often accelerates recovery!).
So, what is most critical in the world of rehabilitation? Identifying and addressing the underlying root cause of the issue. This is where true, lasting solutions are found.
The True Root Cause – Repeated Movements and Prolonged Postures
The muscular system is highly adaptable, quickly responding to the demands placed on it. Depending on what an individual does each and every day on a regular basis, adaptations will occur, and either positively or negatively affect their movement patterns. Everyday activities can alter muscle strength (weak or strong) and length (short or long), affecting the balance between how muscles work together to produce movement.
Recognizing changes in our routines, and most importantly, their causes is essential for long-term success when rehabbing injuries. It’s also important to note that muscle adaptations aren’t exclusive to physically active individuals. Sedentary lifestyles also lead to changes, as repeated movements or sustained postures are part of everyone’s routines. For example, desk workers often perform small, repetitive spinal movements, such as rotating or side-bending their spine while shifting between tasks like writing, using a computer, or reaching for their phone. Repeated movements, whether performed too frequently or too infrequently, and those requiring high or low tension (weight lifting vs. driving), can alter muscle strength, length, and stiffness. Similarly, holding poor postures for long periods, especially when joints are at the extremes of their range, can stress muscles and supporting tissues, leading to potential injury.
This is where most rehab clinicians fall short. Physical therapists and medical professionals often proclaim that the root causes of an injury are the imbalances found within the body, whereas we in fact need to take it one step further. It’s the athlete’s repeated movements and prolonged postures that are the true root cause. If you don’t identify and address why the imbalances and adaptations occurred in the first place, then chances are the pain will come back.
How Movement Patterns Contribute to Pain
As we mentioned, daily activities often involve repetitive movements or prolonged postures that lead to tissue adaptations and alignment issues. Over time, these patterns can result in movement impairments. For example, people engaged in rotational activities (e.g., tennis or golf) may develop increased lumbopelvic rotation compared to those who don’t. Faulty movement patterns, not pain itself, are often the root cause of musculoskeletal issues. These patterns develop over time and put excessive stress on certain joints, tissues, or muscles. Correcting these patterns is key to addressing the underlying issues, rather than simply treating the painful tissue.
Treatment methodology and concepts as movement specialists
When it comes to the common pain and injuries you hear about, day in and day out, the vast majority stem from repeated microtrauma. This microtrauma arises from stress created by repeated movements in a specific direction or sustained alignment in poor positions—often the result of our daily habits. While the pain is most often felt at a specific site, typically a joint, the true root cause lies in subtle but significant movement dysfunctions. The following list summarizes some key concepts the Physical Therapists at The Charlotte Athlete follow to create unmatched outcomes.
The Mechanics of Pain Generation
- Repeated Microtrauma and Poor Positioning
Daily activities often lead to stress on tissues through repeated motions or poor sustained postures. This stress accumulates over time, leading to irritation and eventually pain. - Pain Originates at the Site of Stress
Pain is typically generated where a joint or tissue is subjected to excessive or repetitive stress in a specific direction. - Subtle and Early Offending Motions
Interestingly, the most provocative stress often occurs during the initiation or earliest phase of a motion—not necessarily at the completion of it. This highlights the importance of addressing movement quality from start to finish.
Hypermobile Joints: A Hidden Culprit
- Accessory Hypermobility: The Underlying Cause
Pain frequently stems from hypermobility—joints moving too much. These motions are often subtle and become harder to detect with age. - Path of Least Resistance
Our bodies are naturally efficient, adhering to the path of least resistance. This tendency, combined with the laws of physics, contributes to hypermobility in specific joints. - Relative Stiffness Matters
The relative stiffness of tissues surrounding a joint determines how it moves. During activities involving multiple joints, one joint often moves more readily in a specific direction due to its relative flexibility, leading to a predisposition for hypermobility. - Reinforced Movement Patterns
Once a joint develops a tendency to move easily in a specific direction, this pattern becomes habitual, occurring across all activities—not just the one that induced it.
The Role of Muscles in Movement Patterns
- Muscle Stiffness and Flexibility Over Strength
Issues like insufficient muscle stiffness, increased resting muscle length, and relative flexibility are often more problematic than muscle weakness or tightness. - Activity Reinforces Habits
Daily activities or sports can reinforce hypermobility, creating habitual patterns that perpetuate faulty movement. - Movement Patterns Determine Muscle Use
Faulty movement patterns dictate which muscle groups are used or neglected, leading to imbalances over time. - Correct Patterns Over Isolated Strengthening
Effective rehabilitation focuses on training correct movement patterns rather than simply strengthening isolated muscles.
Pain Is a Symptom, Not the Cause
- Impaired Movement as the Primary Risk Factor
Pain doesn’t cause impaired movement; rather, impaired movement—repeated or sustained in poor positions—is the primary cause of pain. - Address the Root Cause, Not the Symptoms
Instead of solely treating the affected tissue, treatment should focus on correcting the faulty movement patterns causing the irritation. - Focus on Movement Quality
It’s not just about performing a movement but performing it correctly. Faulty strategies can compromise performance and lead to tissue injury.
Effective Interventions
- Redistribute Workload Across Joints
Exercises should aim to limit or correct excessive movement at painful joints while promoting balanced workload distribution across all joints. - Stretching Alone Isn’t Enough
Stretching a muscle contributing to impaired motion won’t stop the motion causing the pain. However, stopping the faulty motion can help muscles regain optimal length. - Training Patterns for Lasting Change
By focusing on training movement patterns, you induce muscular and biomechanical adaptations that reinforce optimal neuromuscular function. This approach leads to long-term improvements and pain prevention.
There are also several factors worth noting that influence how the body adapts to movements and postures, including:
- Age: Older adults may experience degeneration in joints and tissues, altering their response to repeated movements. They also tend to have different pain sensitivities compared to younger individuals.
- Gender: Men and women may show different movement patterns and risks. For instance, women often display increased knee abduction during weight-bearing activities, increasing the risk of patellofemoral pain or ACL tears.
- Tissue Mobility: Hypermobile individuals may have reduced proprioception, increasing their risk of musculoskeletal issues.
- Anthropometrics: Body structure can influence movement patterns. For example, women with a smaller femoral neck shaft angle are at higher risk for greater trochanteric pain syndrome.
- Activity Levels: Both insufficient and excessive activity levels can raise the risk of musculoskeletal conditions, while balanced activity offers protection.
- Psychological Factors: Mental health can influence pain perception and recovery outcomes for conditions like tendinopathy, low back pain, and ACL reconstruction.
Address the Root Cause: Transform Your Movement, Transform Your Life
The key to resolving and preventing pain lies in addressing the root cause of movement dysfunction. By focusing on how you move and correcting faulty patterns, you not only alleviate current pain but also safeguard your body against future injuries. Optimal movement isn’t just about strength or flexibility; it’s about balance, coordination, and quality. Invest in improving how your body moves, and the benefits will extend far beyond pain relief. Are you dealing with pain or an injury? Find your body region below and click the link! Each link has some of the best tips to help you start getting rid of pain TODAY.
Remember: RMPPs = Repeated Movements and Prolong Postures
Low back pain (link it) – Most common movement impairment created by the RMPPs that lead to pain: Excessive extension and rotation of the lower back (lumbar facet joints)
Neck pain (link it) – Most common movement impairment created by the RMPPs that lead to pain: Excessive extension and rotation of the neck (cervical facet joints)
Shoulder pain (link it) – Most common movement impairment created by the RMPPs that lead to pain: Insufficient elevation and upward rotation of the shoulder (scapular thoracic joint)
Hip pain (link coming soon!) – Most common movement impairment created by the RMPPs that lead to pain: Excessive anterior glide and medial rotation of the hip (femoral acetabular joint)
Knee pain (link coming soon!) – Most common movement impairment created by the RMPPs that lead to pain: Excessive rotation with valgus of the knee (tibiofemoral joint)
Foot & ankle pain (link coming soon!) – Most common movement impairment created by the RMPPs that lead to pain: Insufficient dorsiflexion of the ankle (talo-crural joint)
The Charlotte Athlete: Redefining Recovery and Movement Excellence
Health and time are the cornerstones of a fulfilling life, and our physical well-being plays a pivotal role in how we utilize our time. At The Charlotte Athlete, our mission is to empower athletes and active individuals to overcome pain and injuries by addressing the root causes of movement dysfunction. By identifying and correcting faulty patterns caused by repeated movements and prolonged postures, we aim to not only resolve pain but also enhance performance and prevent future injuries.
Remember, pain is a symptom, not the cause. Lasting solutions come from improving how your body moves—focusing on coordination and quality rather than just isolated strength or flexibility. Whether you’re struggling with an injury or seeking to optimize your athletic performance, investing in your movement health is an investment in your overall well-being. Take the first step toward pain-free movement and long-term success. Explore the resources and personalized care we offer at The Charlotte Athlete, and let’s work together to help you crush your goals.
Thanks for reading,
Dr. Andrew