Proximal-to-Distal Treatment

In the Achilles case, improving proximal hip control enabled a single-leg heel raise without local Achilles treatment. In the wrist case, proximal and axial work improved wrist motion and reduced pain before more distal activity was added. Distal restrictions can partly reflect proximal or systemic organization rather than purely local tissue pathology. The article recommends addressing proximal orientation, axial skeleton position, and axial motor control before aggressive distal treatment.