As therapists, we’ve all experienced this frustration: a patient arrives with chronic right-sided neck pain. You do all the right things—massage the trapezius, release trigger points in the levator scapulae, perhaps even perform a precise HVLA manipulation to C4-C5. The patient gets off the table, rotates their head, and says, "Wow, much better!" But they return a week later with the exact same pain. Then again two weeks later. You start asking yourself: "What am I missing?"

 

The answer, in most cases, is that you aren't missing the treatment; you’re missing the source. You are treating the "victim" who is screaming (the neck), while the true "criminal" is hiding quietly in a completely different part of the body. In this article, we will dive into the world of the Kinetic Chain and understand how the integrated approach of Manual Therapy and STB can help you evolve from a technician to a "Biomechanical Detective."

 

Chapter 1: The Body is Not a Collection of Spare Parts – Regional Interdependence

For years, anatomy was taught like a car manual: here is the biceps, here is the shoulder joint. This led to symptom-focused treatment.

But the human body operates through Regional Interdependence. This revolutionary concept states that dysfunction in one anatomical region can cause pain or impairment in a completely distant area. Our joints function in a sequence known as the Joint-by-Joint Approach:

• Stability Joints: Designed to provide a stable base (e.g., Midfoot, Knee, Lumbar Spine, Scapula).
• Mobility Joints: Designed for a wide range of motion (e.g., Ankle, Hip, Thoracic Spine, Shoulder).

The rule is simple: If a mobility joint loses its range (e.g., a stiff ankle after a sprain), the stability joint above or below it must "pay the price" by becoming hyper-mobile to compensate. Over time, this compensatory movement leads to wear, inflammation, and pain.

 

Chapter 2: A Sprained Ankle That Became a Headache – A Case Study

Let's trace the "Kinetic Domino Effect":

1. The Event: A patient sprains their right ankle. It "heals," but they lose full Dorsiflexion (lifting the toes).
2. The Compensation: During walking, the tibia cannot move forward properly over the stiff ankle. The body compensates by collapsing the knee inward (Valgus) and internally rotating the hip.
3. The Pelvic Tilt: This hip rotation causes the right side of the pelvis to drop forward and down.
4. The Spinal Shift: To keep the shoulders level, the lumbar spine side-flexes and the thoracic spine compensates in the opposite direction.
5. The Neck (The Victim): Due to the Righting Reflex, the brain insists that the eyes stay level with the horizon. If the entire spine below is tilted, the neck muscles (Levator Scapulae, Upper Trapezius) must work overtime to hold the head straight.

The patient arrives with "neck pain," but the source is the ankle.

 

Chapter 3: The Fascial Web – Giveon Peled’s Communication Network

This is where the STB method expertise comes in. The kinetic chain is not just bones; it is a continuous web of connective tissue—the Fascia. Fascia creates Myofascial Lines (as mapped by Thomas Myers in "Anatomy Trains") that cross the body from head to toe. Tension in the fascia is like a pull in a wool sweater; pull a thread at the bottom, and the distortion reaches the collar. Using STB techniques, we release the "fascial glue" along the entire chain to allow the system to return to its natural length.

 

Chapter 4: The Diagnosis – Finding the "Criminal"

Eyal Feigin emphasizes moving from static to dynamic assessment:

• Gait Analysis: Looking for pelvic drops or lack of thoracic rotation.
• Overhead Squat Test: Identifying if heels lift (ankle stiffness) or knees collapse (gluteal weakness).
• Isolated Mobility Tests: Checking for significant asymmetries between right and left.

The Golden Rule: Look for the "quiet" area. Usually, the site of pain is hyper-mobile (moving too much), while the source of the problem is hypo-mobile (stuck).

 

Summary: Being a Movement Architect

Understanding the kinetic chain is the moment a therapist levels up. You stop chasing pain and start managing the system. The Manual IL approach combines:

1. The Biomechanical Detective: Identifying the mechanical source.
2. The Tissue Wizard: Using STB to release the compensatory fascial chain.
3. The Precise Fixer: Using HVLA to restore motion to the source joint and the "stuck" compensatory vertebrae.

 

Want to learn how to see the body as one integrated system? Want practical tools for diagnosing compensation patterns? Join our flagship course: Manual Therapy STB+HVLA.