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Pain Relief From Structural Issues

Updated on January 16, 2020
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Bing Xi overcomes pain/compensations from a torn tendon using learnings from rehab courses and working at Genesis Performance Center.

Pain relief from structural issues in just 3 steps

Getting pain relief from structural issues is simple and can be achieved in 3 steps:

1. Targeted strengthening

2. Core stability works

3. Muscle balancing

The first 2 steps serve to manage structural issues. The last one serves to overcome the compensatory effects on movement caused by the structural issues.

Structural issues cause pain through compensations

Structural issues like torn/worn parts (tendon, cartilage or ligament), and abnormalities (lax joints, bunions, curved spines) result in awkward movements in involved joints and body parts, leading to over reliance on other parts, thus compensations.

These compensations lead to uneven use of various muscles, causing imbalances and leading to body misalignment. Over time, the poor posture causes tension, leading to pain.

Targeted strengthening


Targeted strengthening

Strengthen the affected joints/parts, aka the culprit, by training them to stabilize and through the full range of pain free motion.

If the affected parts are still delicate and weak, train these parts to stabilize using isometric holds with resistance levels that are challenging yet does not aggravate pain. Exercises should lead to exertion rather than discomfort.

If the affected parts are relatively strong, train them to move through full range of pain free motion with good control. Apply the stabilizing and mobilizing routine for the adjacent joints/parts, aka the astrayed. Repeat same training on the targeted joints/parts on the other side, aka the symmetrics, if applicable, through the same range of motion with same resistance level even if this other side can go further or take more weight. This is to avoid reinforcing imbalances. Take note that this is not necessary all the time, especially for cases when movement can potentially be dangerous, for example, lumbar spine movement when someone has a history of disc injury.

Using myself as an example, my torn tendon is at my right big toe's first knuckle. Due to the extent of the tear, I have no control over the first knuckle's movement at all. I had to train my second knuckle instead, to stabilize and move, on both sides.

Photo showing right big toe with torn tendon on first knuckle

I cannot bend my right big toe first knuckle, unlike my left
I cannot bend my right big toe first knuckle, unlike my left

Core stability


Core stability works

After targeted strengthening to minimize the compensations caused by the affected parts, core stability works can be used to reset the spine positions caused by the compensations.

Core stability works include variations of planks, side planks, hollow holds, superman holds, side arches and pallof presses. These are good coverage of the various spinal movements, flexion, extension, lateral flexion and rotation.

If the affected parts involve the spine, especially lumbar spine, there is a good chance that core stability works would be done as part of targeted strengthening. For people who regularly work out, unilateral exercises would also be helpful in instilling core stability.



Side planks


Hollow hold


Superman hold


Pallof Press


Summary of managing structural issues

To summarize, structural issues can be managed by targeted strengthening and core works.

Targeted strengthening involves stabilizing and mobilizing the culprit, astrayed and/or symmetrics.

Core works involve strengthening or stabilizing the spine against flexion, extension, lateral flexion and rotation.

Manage Structural Issue overview

Targeted strengthening
Core works
Lateral Flexion

Muscle balancing

Having a structural issue makes a body vulnerable to pain and muscle imbalances due to the constant compensations from moving about. This makes muscle balancing an important step in overcoming pain for someone with such an issue.

Compensations result in muscles being selectively over- or under- activated. By stretching, massaging, activating and applying a manual therapy method involving body receptor adjustment on the relevant muscles, muscle imbalances can be managed.

Personally, I find that with my torn big toe first knuckle tendon, I tend to experience pain on the feet with long walks. This is especially when I allow myself to slouch. I also find that by overcome the slouching and reactivating the relevant muscles from time to time, I am able to ease the load off my feet due to my body being in a more aligned state.

Pain relief from structural issues overview

Targeted strengthening
Core stability works
Muscle balancing
Lateral flexion
Body Receptor Adjustment

The chronic pain vicious cycle


Other possible complications

Pain and compensations can lead to other issues that reinforce each other, leading to a vicious cycle shown in the above photo. Some more other possible complications include faulty movement patterns, chronic stress, poor breathing patterns and unresolved emotions.

Faulty movement patterns are instilled by the same specific compensation patterns from the respective structural issues. Personally, I tend to have faulty movement patterns in any lower limb activities, ranging from walking to lower body weight training movements. Sometimes, even upper body movements can get affected too due to a series of compensations sent up through the spine. This is also the same reason why core stability works are crucial in pain relief from structural issues.

Chronic stress occurs from repetitive faulty movement patterns, affecting the non-physical aspects of health too. When I am on my feet for prolonged periods, I am more easily tired and moody.

Poor breathing patterns occur naturally with rising chronic stress. I find myself breathing heavily during prolonged periods of standing even in the absence of exerting myself, especially when I reached the point of being moody.

Unresolved emotions can occur from going through trauma related to the structural issues. Due to my big toe being less mobile, hard landing on my right foot often times lead to pain due to less force absorption. There were several occasions when I landed feeling a jolt up my right foot radiating up my hip. These make me overly conscious and cautious of every step I take, especially stepping down steeply. It took me sometime to learn to be cautious enough to move around without landing too hard to avoid pain but not to the point of causing more compensations.


Many people who have structural issues would face challenges in daily activities ranging from merely moving about to exercising. It is important to know what are the actionable steps to take to allow enjoyment of these daily activities and prevent more issues from escalating.

Holistic pain relief

I do work closely with individuals to holistically relief chronic and recurring pain by more than just managing structural issues, as illustrated in my other article "Permanent Relief From Recurring Pain".

Addressing muscle imbalances are illustrated in my other article "A Deeper Look Into Muscle Imbalances".

Contact me for more information if you are looking to address muscle imbalances or holistically overcome ongoing pain!

© 2018 Bing Xi


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