Regional Interdependence

The Right Hip’s Connected to the Left Knee

The concept of regional interdependence (RI) is a term that has been coming to the forefront of Physical Therapy and rehabilitation over the past several years. RI is the concept that seemingly unrelated impairments in a remote anatomical region may contribute to or be associated with a patient’s primary complaint. The RI model focuses on impairments present in proximal or distal parts and is separate and different from referred pain.

I feel that it is the responsibility of the Physical Therapist to establish a differential diagnosis (DD) after thorough evaluation. My definition of DD is the establishment all factors that contribute to a dysfunction. This includes all parts of Paradigm’s “paradigm”: Biomechanical, Postural, Neuromuscular, Neurodynamic/Neurochemical ( Biopsychosocial) and Educational. This “paradigm” is a Venn diagram, and is a metaphor for the concept of RI, with all aspects contributing to the system. These components can also be broken down, which refines the DD even further.

We established our “paradigm” years ago, and like all things I feel the need for some refinement. What I did not include is the concept of movement. As an example, Gray Cook has been exploring this through SFMA or Selective Functional Movement Assessment. It is basically a movement screen that biases movement parts to rule out contributing factors. I have always said that PTs are movement specialists and movement assessment plays well into our strengths to treat appropriately and establish precise exercise prescription. Our goal is to have our patients “move well and move often” (Cook). Finding out how to do that is always our goal; whether that is a 21 year old athlete or a 65 year old female wanting to garden. There are many sited articles on these subjects and we at Paradigm Physical Therapy and Wellness look forward to furthering this discussion to further enhance treatment and help patients.

Physical Therapy is always a great adjunct to surgery preoperatively and after. It is prudent to see a PT who can aid in determining all contributing factors to the movement dysfunction to assist in rehabilitation and work towards injury prevention. Requesting a referral from your primary doctor or specialist to a good PT may help avoid a costly and possibly unnecessary procedure and to reduce recovery time. For more information, stay tuned to our blog and you can always contact us here or call one of our 4 locations at the numbers located here.