Nowadays, everyone is preaching "holism". Whether it's rehab, weight loss, or strength training, everyone has become aware of addressing the entire body as a whole rather than segmenting it apart. After all, the body is multiple units that must work as one, not independently of each other.
This is a principle that rings very true. After all, minor changes at the top of the kinetic chain are always being found to affect the bottom and vice versa. When treating someone's ankle, I very likely am addressing their hip stability. Wrist pain? Correct the shoulder biomechanics. Back pain? Take a look at what's happening at the extremities.
However, I've been finding situations where segmentation plays a very helpful role. The time that I found where it may necessary to segment the chain is this: when the entire chain is screaming PAIN!
I have one client who has run into a bout of misfortune. Broken wrist, broken ankle, back pain, whiplash, concussion, neck pain, knee issues...and fibromyalgia. The intake form caused some nerves to bubble for me, to say the least.
How do you go about addressing this client? This client who has spent 20 years in pain and seeing minimal results or improvement at any of the joints that she is trying to treat? This client who's stress and depression can cause setbacks by triggering the additional pain of fibromyalgia?
The answer is this.
Right of the bat, I knew that the potential downfall of this client's recovery was that there would absolutely be no way to treat every problem at once, and so the pain at one joint could very easily overshadow any progress being made at another.
And so, what I told her was that we were going to pick one joint to begin treating and rehabilitating. Her instructions were to ignore everything else. We picked the most central and most problematic area - her neck - to begin with and she was to not dwell on the soreness in her hands and feet, for instance, as we went.
This method proved successful. Instead of going around in circles from joint-to-joint and running into constant steps back, we have been able to make leaps in her recovery by simply addressing one area at a time. My client still has a ways to go - her ankles, hands, and feet are still in pain - but we have branched to recovery of her mid- and lower-back, providing her the most pain relief that she has had in two decades.
This is a clear lesson that when problems are rampant, trying to address everything at once is going to get you nowhere. Once significant, sustainable progress in one realm is made, then it is possible to expand to the next without so much fear of regression.
This principle doesn't only apply to rehab and training. The leading experts in diet and nutrition have been proponents of this for years. Small changes at a time rather than trying to alter everything is the only sure-fire way to maintain long-term progress.