Vladimir Janda was a renowned neurologist and researcher from Prague. His extensive work in theories of muscle imbalance for evaluation and treatment of orthopedic and neuromuscular conditions, has awarded him the title of “Father of Rehabilitation”.
A primary concept of Janda’s approach understands functional dysfunction more than structural dysfunction. For example, structurally we are aware of knee pain due to chondromalacia patellae. But, Janda’s concept teaches us to look for muscle imbalance which resulted in chondromalacia patellae in the first place. Functional lesions cannot be identified with MRI or CT Scan, but requires detailed examination and understanding of complex interactions of the musculoskeletal system. This approach allows us to understand the cause of the pathology, rather than, focus on the pathology itself. This approach recognizes the true function of the muscle, based on the movements it creates in relation to the other structures. For example, the rotator cuff’s job is not to rotate the shoulder, but to adduct the humeral head and stabilize the glenohumeral joint.
Recognizing that joints, muscles and nervous system work together, Janda proved, with clear clinical evidence, that changes in one system will be reflected by adaptive changes elsewhere in the body. Janda asserted that many chronic musculoskeletal pain conditions result from defective motor learning, which prevents the motor system from properly reacting or adapting to different changes within body. Hence, neurological muscle imbalance can lead to chronic musculoskeletal pain.
He developed theories of chain reactions which focus on the cause of pain rather than just the site of pain. The three independent chains are; the articular, muscular and neurological chains.
Articular chains maintain posture and movement throughout the skeletal system.
Muscular chains which provide movement and stabilization through muscular synergists,slings and fascial chains.
Neurological chains provide movement control with protective reflexes, neurodevelopmental motor progression and sensorimotor system.
Collectively, these three chains from a "neuro-musculo-skeletal model" of functional movement. Impairment in one of the chains can create muscular pain and dysfunction.
As per Janda, postural observation always begins from pelvis regardless of the area of primary complaint because most chronic musculoskeletal pain is the first evident in postural asymmetries.
A Clinician should focus on the quality, sequencing/timing and degree of individual muscle activation during a movement, in order to evaluate the coordination of all the muscles involved in the movement.
At Physis PT and Rehab, our clinician, following principles of Janda, provide a whole body evaluation and exam, identifying functional dysfunctions and structural dysfunctions, followed by manual treatments designed to correct such impairments and regain coordinated muscle activation to abolish your pain.