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Why does my Osteopathic Practitioner not always work on what hurts?

In the early stages of dysfunction, as in a recent injury, your therapist may find something called localized compensation at the site of injury.

This means that there may be a secondary tissue that is now responding to the change in the tissue or joint stability of the initial injury. For example, you may sprain your ankle and find that not only does the ankle swell, but fluid begins to pool in the foot as well as the lower leg.

However, should the problem not fully resolve, the presentation may appear very different from the initial injury through the mechanism of down chain compensation. This would mean that while that initial injury may not be bothering you anymore, however, it may just be that something else is now compensating by trying to make up for the instability.

For example, an injury to the right ankle causes the individual to limp which shifts the weight onto the left foot and increases its load. In addition to its increase in load, the mechanics of that persons ankles, knees and hips are now different. The problem may sometimes even migrate further into the back. Hence, a secondary problem may appear in the left hip from the primary problem in the right ankle.

This means that even though you may be coming into the office with a sore hip, the initial injury to the ankle and the compensations that followed may have been what was creating the hip issue.

The appearance of a new dysfunction does not mean that the initial problem is solved. Often times in order to address the new problem we have to find and address the original problem. Therefore your osteopath may not always work in the areas that are hurting.

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