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Tissue in Lesion Versus Biomechanical Dysfunction

At Acceleration Physical Therapy in Spokane, WA, we have a straight forward treatment philosophy.  We believe that tendonitis and other overuse injuries do not occur without a cause.  Most of the time, a non-painful, or silent restriction causes excessive stress on another structure.  Over time, the structure that is on the receiving end of the excessive stress will become irritated and inflamed. To make things simple, we break down dysfunction into tissue in lesion and biomechanical dysfunction.

Tissue in lesion is simply the structure that is injured or inflamed. In the shoulder joint, it may be your rotator cuff. In the low back, it might be a disc irritation. It is important to identify the tissue in lesion so that we do not make it worse with manual treatments or exercise. As you might assume, different injured tissues will be irritated by different movements, postures, and loading. It is important to understand which movements and loads to avoid because the last thing we want to do is increase inflammation at the tissue in lesion. We want to decreased stress on this structure and use some modalities such as electrical stimulation and ultrasound to help calm the inflammation down.

Biomechanical dysfunction can be defined as restriction, weakness, and poor coordination that is increasing stress on the tissue in lesion. Biomechanical dysfunction may be at joints above or below the tissue in lesion, and are generally not painful. An example of biomechanical dysfunction is a foot that over pronates, or flattens too much. As the foot hits the ground, and the foot flattens out excessively, extra motion is translated to the knee. If the knee is twisted just a little too much every time you take a step, it is easy to see how it could become irritated. At Acceleration Physical Therapy, we attempt to decrease stress on the tissue in lesion by stretching tight joints, strengthening weak muscles, and improving coordination between joints so that they are working together appropriately.