If your car’s front end is out of alignment, the tires wear differently and, at certain speeds, the steering wheel wobbles. Not only do the same rules apply to the human body but these problems can significantly hinder you in your daily life.

So, what can be done?

The mechanic wouldn’t change your tires without fixing the alignment issue. Similarly, the symptoms and syndromes that result due to misalignment need to be viewed as an indication of a more central problem. In other words, the root cause needs to be addressed or your “tires” will continue to wear unevenly. Often we get caught up in treating symptoms but sorting out the “why” instead of the “what” has proved to be a far more effective approach to treatment.

Yes, we can relieve the pain and discomfort when treating the symptom—but it’s never long before symptoms return.

Some of these symptoms include Iliotibial band syndrome (ITB), Patellar Femoral Pain Syndrome, Iliopsoas tightness, Quadratus tightness (QL), Piriformis Syndrome, Sacral Iliac pain… just to name a few. If you look through any sports medicine book, you will find pages upon pages of syndromes. “Syndrome” is the label used when our knowledge is limited to the symptoms that lead to the syndrome, while unaware of the cause.

We are not talking about acute, traumatic injuries. We are talking chronic situations that persist for long periods and have gone through multiple treatment attempts without resolution.

The cause? Repetitive movement patterns like throwing, reaching, bending and general activities involved in daily life.

Hand dominance (95% of the population is right-handed) produces a predictable pattern which results in an onset of symptoms.

Differences in leg length, feet patterns and gait can all contribute to misalignment. And, of course, because athletes are especially dedicated to train and play with their dominant side, the repetitive movement involved in sport is very likely to result in misalignment.

Think of how many times a golfer swings in one direction.

An article on The National Center for Biotechnology Information states that “It has been reported that over 50% of world-class (tennis) players experience shoulder symptoms during their career and 80% of these cases stem from overuse.”

One of Canada’s top gymnasts once claimed that all gymnasts have scoliosis. They have a power side that is used for take-off, twisting and landing. They use this side over and over, creating a lumbar rotation and accommodating pelvic rotation. This change in joint position hinders range of movement to the opposite direction, causes muscles imbalances, excessive loading on structures and creates abnormal patterns to control one’s centre of mass, all leading to the aforementioned syndromes.

Running is another repetitive activity where, if the body is out of alignment, muscles react by trying to keep the center as neutral as possible. So, you get adaptive muscle reactions which could possibly turn into ITB, Piriformis, SI, QL, and Achilles problems—especially if they are unilateral in nature. The problems are magnified by leg length, foot contributions and the surface you run on.

Simply attending a workout class can play into your dominant pattern and cause issues. You often hear instructors say “And now we have to do the other side to balance you out” when, in fact, you are already out of balance!

Alignment movements are used to correct. They are usually easy and simple. They will always need to be done before and after activities or when the symptoms are felt. It is not a core problem! Your lifestyle and movement patterns are the cause.

There is a 6-stage program that helps people have better control over this malalignment. One of those stages is “education” to help the patient understand the mechanisms that contribute to the problem. This is arguably the most important stage as it validates the complaints and provides an understanding of why the symptoms are there in the first place.

Pt.2 of this series examines the 6-stage program and provides tips for misalignment prevention.