At Pain Away Clinic, we regularly participate in seminars and training programs in Japan and other countries. Our goal is not simply to learn new treatment techniques, but to improve how we assess the body, understand the cause of a problem, and decide what type of treatment or exercise is appropriate for each patient.
This seminar focused particularly on sports conditioning, movement assessment, injury prevention, and returning athletes to sport.
One of the most important messages was very simple:
Treatment should not start with the technique. It should start with understanding what the athlete needs.
“Tight = Release” Is Not Always Correct
When a patient or athlete feels tightness, it is easy to think that the tight muscle simply needs to be stretched or released.
However, the seminar emphasized that “tight = release” is not always the correct approach.
Before trying to increase flexibility, we need to understand why the area feels tight.
Is the muscle actually shortened?
Is the joint restricted?
Is the body creating stiffness because it needs more stability?
Is another joint not moving enough, causing this area to compensate?
Or does the athlete have enough range of motion but lack the strength and control to use it?
These questions are important because increasing flexibility in an area that actually needs stability may not solve the problem.
The goal is not to make every joint as flexible as possible. The goal is to create the appropriate mobility and stability for that person and their sport.
Need, Control and Load
Another useful concept from the seminar was looking at movement from three perspectives:
Need – Control – Load
First, what movement does the athlete actually need for their sport?
Second, can they control that movement?
Third, can their body tolerate the load placed on it during training and competition?
For example, an athlete may have enough hip range of motion during a physical examination, but this does not necessarily mean that they can control the hip properly while running, landing, kicking, or changing direction.
Similarly, an athlete may perform a movement correctly once, but problems may appear after repeated movements when fatigue increases.
This is why assessment should not stop with flexibility or muscle strength testing.
We also need to look at how the body functions during actual movement.
Different Sports Require Different Bodies
Another major topic was that each sport places very different demands on the body.
We cannot assess a soccer player, baseball player, tennis player, and basketball player in exactly the same way.
Soccer
Soccer involves much more than running.
Players repeatedly accelerate, decelerate, change direction, kick, jump, land, and balance on one leg.
The supporting leg and kicking leg also perform different roles.
Therefore, we need to consider hip mobility and stability, knee control, ankle mobility, trunk control, and the ability to produce and absorb force.
When an athlete develops knee pain, for example, the knee itself may not always be the only problem.
Limited ankle mobility or poor hip control may change how force travels through the leg and increase stress around the knee.
Baseball
Throwing is a whole-body movement.
The arm does not produce all of the force by itself.
Force is generated from the lower body and transferred through the hips and pelvis, trunk, shoulder, elbow, and finally into the hand.
Because of this, shoulder or elbow symptoms in a baseball player should not automatically lead us to focus only on the painful shoulder or elbow.
We also need to consider hip movement, trunk rotation, shoulder blade function, shoulder mobility and stability, and the overall throwing motion.
This idea of force transfer through the kinetic chain was an important part of the seminar.
Tennis
Tennis requires repeated acceleration, rotation, lateral movement, reaching, and overhead movements.
Serving in particular requires coordinated movement throughout the whole body.
Power needs to be transferred from the ground through the legs, hips and trunk before reaching the shoulder, arm, and racket.
Therefore, shoulder problems may sometimes be related to limitations or poor control elsewhere in the body.
For tennis players, we need to consider not only shoulder mobility but also thoracic rotation, hip function, trunk stability, and lower-body movement.
Basketball
Basketball has another set of physical demands.
Players repeatedly jump, land, accelerate, decelerate, and change direction.
The seminar highlighted the importance of not only producing force during a jump, but also absorbing force during landing.
An athlete may be very powerful and able to jump high, but if they cannot control the landing efficiently, the load on the knees, ankles, and other structures may increase.
Therefore, conditioning should include both sides of movement:
Producing force and absorbing force.
Understanding Ground Reaction Force
Ground reaction force was another important concept covered during the seminar.
Every time we walk, run, jump, land, or change direction, we apply force to the ground, and the ground applies force back to us.
The body needs to manage this force through the feet, ankles, knees, hips, pelvis, and trunk.
In sports, it is not enough simply to be “strong.”
Athletes need to be able to:
Absorb force → Support the body → Transfer force → Produce force
They also need to do this in the correct direction and at the correct timing.
This is one reason why isolated muscle strength alone does not tell us everything about athletic performance.
Assessment Before Treatment
The seminar also reinforced something we consider very important at Pain Away Clinic:
Assessment should come before treatment.
The course included different assessments for the shoulder, trunk, hip, knee, ankle, and other areas.
We looked at joint mobility, muscle flexibility, muscle strength, stability, and movement control.
The important point is not simply to collect many tests.
We need to understand why we are performing each test and how the result changes our treatment plan.
For example, two patients may both have limited hip movement.
One may have a true joint mobility restriction.
The other may have enough passive mobility but poor muscular control.
If the cause is different, the treatment should also be different.
Reassessment Is Just as Important
Treatment should not finish when the therapist finishes the manual therapy or exercise.
We should reassess the same movement or test afterward.
Did the range of motion improve?
Did the pain change?
Did movement become easier?
Can the patient control the new range?
This allows both the therapist and patient to understand whether the treatment produced a meaningful change.
At Pain Away, this is something we want to continue emphasizing:
Assessment → Treatment → Reassessment
rather than simply performing treatment and hoping that the patient feels better.
Sports Injuries Require More Than Pain Relief
The seminar also covered common problems involving the shoulder, hip, knee, lower leg, and ankle, including conditions frequently seen in athletes.
For athletes, reducing pain is important, but it is only the beginning.
An athlete may feel much better during normal daily activities but still be unable to run, jump, throw, kick, or change direction safely.
This means that being pain-free does not automatically mean that the athlete is ready to return to sport.
The rehabilitation process needs to gradually progress from basic movement toward the demands of the actual sport.
A general progression may look like:
Pain Control → Mobility → Stability → Strength → Movement Control → Sports-Specific Exercise → Return to Sport
The exact progression will be different for every athlete.
Returning to Sport Means Returning to Function
One of the ideas we particularly liked from this seminar was looking beyond the injured body part.
When treating an athlete, the final goal is not simply:
“The knee doesn’t hurt anymore.”
The real question is:
“Can this athlete safely perform what their sport requires?”
For a soccer player, that may mean sprinting, cutting and kicking.
For a basketball player, it may mean repeated jumping and landing.
For a baseball player, it may mean throwing at high speed.
For a tennis player, it may mean serving, rotating, and changing direction repeatedly.
This changes the way we think about rehabilitation.
Bringing This Knowledge Back to Pain Away Clinic
Pain Away Clinic treats many patients with neck pain, shoulder pain, lower back pain, hip pain, knee pain, and other musculoskeletal problems. We also work with professional athletes, amateur athletes, and people who simply want to continue enjoying their favorite sports.
The knowledge from this seminar can therefore be applied not only to professional athletes but also to many of our regular patients.
Instead of only asking:
“Where does it hurt?”
we want our therapists to think further:
Why is this area under stress?
Which movement is limited?
Which area lacks stability?
Is the patient able to control the movement?
What happens when we add load?
What does this person’s sport or daily activity actually require?
From there, we can combine physical therapy, manual therapy, mobility work, strength training, movement correction, exercise, and sports conditioning depending on what each patient needs.
At Pain Away Clinic, we will continue learning from seminars in Japan and internationally and sharing this knowledge with our therapists through our internal training.
For us, continuing education is not about collecting more treatment techniques.
It is about becoming better at deciding:
What does this patient need? Why do they need it?
