I Hurt My Ear and Now My Toe Hurts

Kinteic Chain PainWe have all had that moment where you stub your toe in the middle of night getting up to get a drink of water, right?! A few days go by, the toe still doesn’t feel great, but doesn’t hurt and you get this weird pain in your knee or your hip starts to hurt.  You look around for the first person who is willing to hear you talk about yourself and you say, “Dude my hip is killing me and I didn’t even do anything!”  They reply, “Sorry Bro!”

What is going on in this situation and is it preventable?

The term used to describe the underlying issue is called the kinetic chain.  There are two types of kinetic chain: Open Kinetic Chain and Closed Kinetic Chain.

The kinetic chain comprises all the muscles, tendon, ligaments, bones and everything that is connected during a movement.  The song “Head, Shoulders, Knees, and Toes” is a great example of how these things are all aligned.  When we walk, we don’t just move out big toe with extensor halusus longus.  We move a TON of different muscles to make the walking movement happen.  Not only is the leg moving, but the upper body has to move as well to help balance and propel us forward.

Closed Kinetic Chain

If you are sitting right now, STAND UP.  Do a squat.  Be careful not to get injured.

In this movement, your legs are doing a closed kinetic chain movement.  The distal (farthest away) segment [your foot] of the limb [your leg] is securely placed during the activity.  In your arm this would be like a push up; Hand securely on the ground and arm moving.

Open Kinetic Chain

For this one I want you to stand up and grab your mouse.  Start doing some curls and show off them guns!

So this is an open kinetic chain movement.  The distal segment [your hand] of the moving limb [your arm] is NOT securely placed during the activity.  In your leg this would be like kicking a soccer ball (the leg kicking the ball).

Kinteic Chain
As it relates to the Foot A) Open Kinteic Chain B) Closed Kinetic Chain

Putting it together

Now that we have some definitions out of the way, how do these affect each other?  Well any time you have to correct for one issue it affects the whole chain, especially in a Closed Kinetic Chain activity.

Back to our toe example:  If it was your big toe that you hurt, you would naturally start to walk on the outside of that foot.  This would force you to put your weight more on the outside of your knee, which would require you to externally rotate your hip.  Once you have all your weight on that leg, your opposite hip has to overcompensate for the weird body position.  In as little as a day or two, your body understands that it doesn’t like this new gait pattern and says STOP by causing you pain.

This is very similar in the open kinetic chain.  Think about throwing a baseball if your shoulder hurts.  You change the way you are throwing, which could affect how your back compensates for the movement.  This can lead to knee injuries.

Because of these issues it is important to understand that while you may have pain somewhere, it is VERY possible that the root cause is somewhere else.  As the title suggests, it may be possible to have a “random” pain in your toe because you hurt your ear

If you or a friend has had an experience with this kinetic chain pain experience I would love to know about it and how you fixed it. Quiz time: In the picture below is this an open or closed kinetic chain activity submit your answer below?

Tim is the CEO of CoolEFitness. He has a degree in Athletic Training from Northern Arizona University and a Master’s in Sports Medicine from the University of Utah. He has worked as an Athletic Trainer in different roles, with Northern Arizona University, University of Arizona, University of Utah and the San Francisco 49ers.

If you want to learn more about this check out this research article: http://bjsm.bmj.com/content/42/2/99.abstract


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