The kinetic chain: The importance of looking globally to prevent injuries

Keeping up with the demands of our profession requires the ability to learn and grow. Our goal here at ProMet Physical Therapy is to inspire our community and give them a glimpse about what we are working on internally.

As Clinicians our highest priority is delivering high quality care and by keeping up with innovations to our field we are able to bring that to you.

When getting treated at ProMet Physical Therapy of course we look locally at the injured area but we also zoom out to the bigger picture. Looking at the body from a global perspective opens up smarter ways to focus on treating not only athletes but regular gym goers, weekend warriors, cross fitters and anyone who has to reach overhead (pretty much everyone).

There’s a term called regional interdependence, which is the concept that seemingly unrelated impairments in a remote anatomical region may contribute to, or be associated with, the patient’s primary complaint. This is saying that if you are experiencing elbow pain, although the site of pain is the elbow the real issue might be treating the shoulder although the shoulder is not painful. However, upon assessment the shoulder may be stiff, weak, moving poorly which can be causing compensations at the elbow (creating irritation/pain).

At ProMet PT we want to emphasize the importance of what “true” mobility is. Meaning that if you are moving any joint in the body, you want to make sure you aren’t compensating with your neck or low back for example. Most people think that they can reach above their head but when assessed, our clinicians at ProMet are noticing forward head position at the neck or arching the lower back. Now do this for years and we may have tightness or irritation in the low back.

A great example of this is in a research article that was just published in March 2021. Showing that a decrease in hip range of motion in external rotation on the dominant side and bilateral hip abduction strength were associated with the experience of shoulder and elbow injury in the past 3 years. The evidence suggests that a program to improve hip range of motion and strength may be used to prevent shoulder and elbow injuries. Although this was done in baseball players this is a great example in all humans on the importance of opening up other areas of the body to help with the injured site.

The kinetic chain refers to the ability to transfer energy or force joint by joint from the ankle to the knee to the hip through the core to the shoulder to the elbow and hand. Often times with any limitations in hip mobility or core strength can break this kinetic chain leading to stress in the joints and a decrease in performance.

Get assessed to see if you are using your true motion at each joint to prevent stress, injuries and headaches down the line.

Working on the foundations provides us a strong base to build upon. It’s one thing to start moving but moving with a purpose; that’s where your plan starts with us. Using intention in our approach to gradually and specifically target areas in a manner that’s useful for you.

Start today, ask questions, call us at 718 554 6610 or 516 365 2060, start being, living and take control of your body. Remember you are the driver of this vehicle.  Get more tips like this on our website at or come in to see our movement specialist here at ProMet Physical Therapy at the Atlas Mall location on Cooper Avenue, in Manhasset Community Drive or Kew Gardens. Seeing an expert in movement who can catch the subtleties of something we do every day is valued care that goes beyond words. This is a matter of bringing thoughts to action.

Antonio Colletti, DPT, CSCS



Hamano N, Shitara H, Tajika T, et al. Relationship between upper limb injuries and hip range of

motion and strength in high school baseball pitchers. Journal of Orthopaedic Surgery. January 2021. doi:10.1177/23094990211003347


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