Why I Look at Movement Rather Than Shape

Why I Look at Movement Rather Than Shape

Would you try something.

Put one hand on your belly and the other on your chest, and breathe comfortably. Which hand moves first? And how far does it move?

This check needs no machine. It needs no image. Yet your fingertips catch something an image cannot tell you. An X-ray shows the shape of the ribs well. It does not show how those ribs open as the breath goes in.

A test looks at a still frame, and it looks well. It shows precisely whether a bone is out of line, whether a disc has pushed out, whether a joint has worn. But the moments we feel discomfort are usually not the still ones. They are while walking, while turning over in bed, while lifting, while drawing breath in.

One breath makes a wave through the whole trunk. The organs of the abdomen rise and fall with that wave. To exert force you must first hold your breath. Tissue stretches and springs back. A great deal passes through the narrow neck. These were all things that exist only while something is moving. They do not remain in a still photograph.

So when I examine, I do not stop at feeling. I keep my hand there and have the person move. There are places that are soft at rest and catch on movement, and places where it is the other way round. That difference sometimes says more than a single image.

If the image is normal and your body is uncomfortable, the image is not wrong. The image is the body at a standstill; the body in the uncomfortable moment is in motion.