Load Versus Force

​Perhaps I am splitting hairs when I differentiate between load and force. However, I think it’s important to refute the common conception that fixing orthopedic problems is all about progressive loading, extreme effort, sweating hard. Most of my patient visits feel more like a visit to the doctor’s office than a visit to the gym. It’s about looking for a solution, devising a home protocol, and education.

While I use loading, what initially fixes most orthopedic problems is not loading in the truest sense. Yes, injured tendons/ muscles need load to remodel and repair. Yes, load is needed to return someone to prior levels of function if there’s been deconditioning. My experience, however, is that most problems involve a joint not moving well ... remedied quickly with movements (forces), usually requiring little muscle action at the problem site. If I diagnose a shoulder derangement, the top two movements I’ll use to reposition the joint are functional internal rotation with a belt (passive) and extension with the patient’s hand on an elevated surface (passive for the shoulder). I envision those more as different forces on the shoulder joint vs different loads. The words don’t really matter, but, to me, the implication does. -- Laura