A Must Read for All Athletes!!

If you are an athlete (at any level), I am about to tell you something you NEED to know, that few people in the medical community talk about, address, or even think about: The difference between Structural and Functional problems. And more notably the often overlooked importance of functionality!

The reason I am writing this is because all too often I observe first hand (or from afar) athletes being misinformed, misguided, mistreated and incompletely diagnosed.  Ultimately, this has a negative affect on the athlete’s performance level and longevity!  As a functional specialist, I look forward to the day that teams provide their athletes with more complete medical management. But until that day comes, the onus is on the athlete to become more informed and aware of their own health, even if that means that the solutions they are seeking may be outside what is traditionally provided to them!

Simply put:

A Structural problem is when something is broken, missing, or out of place. I.e. a torn muscle, torn tendon, torn ligament, herniated disc, broken bone, dislocated/separated shoulder etc.  A structural problem is most often diagnosed through medical imaging (x-ray, ultrasound, MRI, CT scan, bone scan, etc).

A Functional problem is when a body part or a series of body parts are not working properly, and more specifically, not working properly when the body requires movement/motion.  This can not be seen on an image because there is nothing structurally wrong with their body and it is actually a problem that involves the MOVING parts (remember, images look at things statically, in a stationary position). A functional problem is best diagnosed through a proper examination which involves the practitioner taking a patient’s history AND running the patient through specific orthopaedic tests (see my previous blog in November 2011, “A proper diagnosis: the key to fixing a problem”).

So herein lies the problem with traditional medical management of athletes, and what I often observe within teams’ management of their players’ health….

If a player or athlete sustains an injury or is experiencing pain…. in most cases they are then sent by the overseeing medical doctor for imaging (which is often the correct move). At this point there are 2 possible results:

1) A structural problem is seen, in which case the medical doctors will devise the correct treatment to fix the structural problem (and in most cases they are the right ones to fix it!!). Or…

2) No structural damage is seen on the image, in which case the athlete is typically told that nothing is wrong; that it’s probably just a “strain”, “tweak”, “bruise” or something minor, and to just rest it or work through it; that it will resolve… NO IT WON’T!!!! This is exactly why you see the same players experiencing the same injuries over and over and over again!! (I will address functional problems in greater detail in my next blog).

So lets say you are diagnosed with a structural problem and the doctors tell you what is needed to correct it; surgery, cast, rehab, injections, etc. In most cases, the suggested treatment is the answer to the structural problem…but they missed something crucial to full recovery – the functional problem!!!  Although you can have a functional problem without having a structural problem, you can’t have a structural problem without having a functional problem!  For example, if you have a tear (structural problem) of a tendon, you will have a deficit in the way the adjoining muscle functions (contracts, relaxes, range of motion, strength, endurance, etc).  Simply repairing the torn tendon (structure) will only get you so far…and will leave you feeling and performing at a fraction of yourself! It will also leave you susceptible to more structural problems down the road (remember, you can tear something more than once!).

In order to fully recover from an injury, a portion of the treatment MUST be targeted at ensuring that the body part(s) are functioning properly, which is most often overlooked and neglected.  This, by the way, is exactly why you see players return from an injury that required surgery but they struggle to perform at the level they did prior to the injury. Yes, conditioning plays a factor. But the biggest issue is due to lack of functionality…and until the muscle has regained proper functionality, the player’s performance will be hindered.  

Bottom Line: If you have experienced a structural injury which has fully healed but you are wondering why you still don’t feel 100 %….it’s likely because no one has diagnosed and treated the functional impairments to ensure that all the moving parts are working the way they need to.

Stay tuned for my next blog when I better describe functional problems, the way they can be corrected, and what will happen if you leave them untreated!


Stay informed! Stay Healthy!


p.s. sorry for the long read ;)


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