Regional Interdependence: Why Your Knee Pain Might Be a Hip (or Brain) Problem
The Problem with Treating Pain in Isolation
You ever fix a wobbly dining table by shoving a coaster under the wrong leg? Feels stable for a bit… until someone leans too hard and the whole thing tips over again. That, in a nutshell, is what pain treatment often looks like when we only focus on where it hurts.
This approach might give short-term relief, but if we don’t get to the actual cause, the problem keeps showing up, just wearing a different disguise. Enter: regional interdependence.
What Is Regional Interdependence?
Regional interdependence is a clinical way of saying that everything in your body is connected. A dysfunction in one area - say, your hip or thoracic spine -can lead to pain or limitation somewhere else, like your knee or neck.
It’s the idea that pain isn’t always caused by the structure where you feel it. Your body is constantly adapting, and when one part isn’t pulling its weight, another part picks up the slack. That overload eventually turns into pain. It’s less about the single part and more about how the whole system is working ,or not working.
Real-Life Examples from the Clinic
Take lower back pain. It’s one of the most common issues I see. And yet, in many cases, the back itself isn’t the root of the problem. It might be stiff hips, weak glutes, poor core control, or even shallow breathing due to chronic stress. If I just throw treatment at the back without addressing the real culprits, I’m doing a disservice to the client.
Or take neck pain. I’ve treated plenty of clients with tight, sore necks that have had every kind of hands-on therapy out there. But no one looked at how their upper back moves - or doesn’t. Many of them breathe like they’re on high alert all the time. The neck ends up working overtime to stabilise and compensate. Once we restore movement through the thoracic spine and get the breath under control, the neck eases, without needing constant massage or dry needling.
How I Apply This in My Practice
When someone comes to me in pain, I don’t just look at the sore spot. I assess the entire system. That includes:
The joint above and below the pain
Movement patterns and compensation strategies
Postural control, stability, and motor coordination
Breathing mechanics and nervous system state
Lifestyle, stress levels, and pain beliefs
From there, I work on building capacity. That might involve mobility work, nervous system regulation techniques, or breath training. I use tools like SFMA-style movement screening, dry needling, instrument-assisted soft tissue therapy, and guided movement. But the goal is always the same: long-term resilience, not just short-term relief.
The Brain’s Role in Regional Interdependence
Pain is not just about tissue damage. It’s about perception - and your brain is the boss of that.
Your nervous system is constantly scanning for threats, both physical and emotional. Past injuries, trauma, fear, and even beliefs about your pain can affect how your brain interprets movement and discomfort.
That’s why some people feel pain long after an injury has healed. Their nervous system is still on high alert. By integrating breathwork, somatic awareness, and ACT-based psychological flexibility into treatment, we help calm that system so pain isn’t amplified unnecessarily.
It’s Time to Zoom Out
If you've been treating your pain in one isolated area for months (or years) and not seeing progress, it might be time to look elsewhere. Pain is rarely just about the body part that hurts. It's often about the relationships between body regions, and the relationship you have with your own body.
Regional interdependence gives us a better lens to assess and treat that complexity. It lets us stop chasing pain and start understanding it.
Final Thoughts
You’re not broken. You’re not fragile. But if your body’s been compensating for a while, it’s probably time to reassess the whole picture, not just the sore spot.
And if no one has ever looked at how your whole body moves together, how you breathe, or how stress might be driving your symptoms... maybe it’s time we chat.
Move always & all ways.
Kai x