Defining Integration Concisely

What is “integration” that is not a definition or stock answer? Opinions may vary, but I believe strongly that integration is about functioning optimally without any unnecessary stress on the body or its neuromusculoskeletal system. There exists in our patients a state of dis-ease that comes from the stress of compensating for muscular imbalances, articular misalignments, and/or nervous system impairments that shows up long before it turns into a set of symptoms that we classify as disease or pathology or injury.

Integration then, to me, is the state that exists when all necessary components of the kinematic chain are working cohesively to maximize function and minimize stress on the system. I would like to be involved in functional medicine in that we need to be exploring the underlying causes of dysfunction rather than symptoms. We need to be proactive in addressing stressors (muscular imbalances, articular misalignments, and/or nervous system impairments, etc. as noted above) rather than reacting to injuries once they become symptomatic.

Putting Integrated Treatment into Practice

When a patient comes in exhibiting dysfunction, as healthcare professionals we sometimes end up chasing symptoms (or our tails at times). Did an articular misalignment cause muscular spasm and increased nociception? Did decreased neurological input lead to muscular inhibition and ultimately articular dysfunction? Did muscular hypertonicity lead to altered recruitment patterns and then to neuroarticular dysfunction? Integration, to me, is understanding that dysfunction is multifactorial, just as function is. We can’t have dysfunction in one system and turn a blind eye to the areas it interrelates to on a functional level. Ultimately, it should be less important which order above is at play than it is to appropriately recognize the multifactorial nature of most patients’ dysfunction and to address each factor to restore maximum function.

My opinion is that integration is the approach healthcare professionals should utilize to do just this in our patient population. We should analyze the normal integrative pattern of the neuromusculoskeletal system that leads to a maximized function with the minimum amount of stress on the body. Only through this information and learning can we recognize abnormal in all the various ways it manifests in our patients. Armed with this knowledge, we can then work to restore the individual areas of dysfunction and ultimately integrate normal movement patterns back into our patients. We can also learn to recognize dysfunction and dis-ease before it manifests as symptoms or injury. This is not only what integration is about; it is what healthcare should be about.