[Part 1]

pt school

In PT school we all learned about the kinetic chain.  We learned the idea that joints and segments throughout our body have an effect on one another during movement and this creates a chain of events that affects the “system.”   This principle is absolutely true, but there is one problem.

In PT school we were never taught about movement.

Don’t you think that is crazy for me to say?  Here we are, physical therapists, the movement experts, the ones who have more musculoskeletal knowledge than anybody else in the world yet PT school does not teach us about movement!

Now I’m not talking about tangential joint glides and joint ROM, we know that very well.  I’m talking about MOVEMENT.

This begs the question, “okay, well define movement.”   The best definition I have heard regarding movement is this; “movement is a conscious action followed by subconscious reactions.” Lets apply this and make it more concrete.


A 70 year old female [Shirley] has lower back pain when standing and especially when reaching up to get a coffee mug out of the cupboard.   Shirley is consciously thinking about reaching up for that cup.  She is not aware of the following:

  • The upward rotation, protraction, and posterior tilt at the scapula
  • The extension in her thoracic spine
  • The extension in her lumbar spine
  • The extension in her hips
  • The extension in her knees
  • The dorsiflexion in her ankles

Now, since all of these motions are going on, is it reasonable to believe they could potentially contribute to her low back pain?  And since all these motions are going on, is it our responsibility to assess these motions when someone comes in to the clinic with this subjective complaint?

Shirley could have a scapula that only has 20 degrees of upward rotation so every time she reaches for something high up in the cupboard she has to compensate with the rest of her body.

Feel for yourself!

Insert Video

“stand up and do this with me, reach as high as you can like you are Shirley”

If you are a physical therapist who also desires to learn more about movement, video for the 3 areas of the body that need to be assessed when someone walks into your clinic with low back pain.   I’ll give you a hint, PT school did not cover this.

checklist image

The 3 areas you NEED to assess when someone has low back pain. 

To learn more about these areas of the body.  Check out our blog [The Friends of the Lumbar Spine]

If you, or I are not aware of the entire kinetic chain that is involved with movement, who will be? The responsibility falls on us.  Surgeons don’t have the knowledge, physicians don’t have the knowledge, chiropractors don’t have the knowledge.  PT’s do.    Gary Gray has coined the phrase “chain reaction.”  It is our job to acknowledge the chain reaction that occurs during each and every activity.   When we start having this thought process we will be able to better serve our patients and clients.

Well, now we’re going to need a strategy for assessing the entire kinetic chain.

In Part 2 we will dive in head first and talk about whats called the “Simple Side Assessment” which is just how it sounds, a simple way to assess the entire body.