Accommodative Capacity

We all have an accommodative capacity which is simply our ability to accommodate and cope with the stresses of everyday living! A great analogy for an accommodative capacity is what my good friend and mentor, Dr. Bob Jankelson, refers to as a “stress bucket”. We all have “stress buckets” of different sizes that fill up and sometimes overflow, right? One person (my Dad for example) may have a stress bucket the size of the Pacific Ocean, and another person (my wife for example) may have a stress bucket the size of a thimble! In my wife’s defense, my Dad doesn’t have two small children to raise, a business to run, nor does he have to live with me anymore! How big is your stress bucket? The larger your stress bucket, the larger your accommodative capacity…the smaller your stress bucket, the smaller your accommodative capacity. At LVI and in our practice, we refer to patients with large accommodative capacities as patients with “wide goal posts”, and patients with small accommodative capacities are referred to as patients with “narrow goal posts”.

Stress bucket sizes and goal post widths can change throughout life depending on the sensory input that we receive from the outside world. The earlier example of my Dad and my wife very simply illustrates this. My Dad probably used to have a thimble-sized stress bucket when he was trying to raise me!

Pain is a sign of too much sensory information and too many signals being sent beyond the accommodative capacity. When this happens, our bodies recognize it, and elicit postural accommodations and protective mechanisms such as forward head posture or limping to accommodate for the pain causing more muscle tension. Then, the negative feedback loop mentioned earlier kicks in again adding even more noxious stimuli and a whole new set of problems. A great analogy for this is having a rock in your shoe. The rock hurts our foot so we limp on that side which then causes our hip on the other side to hurt! This is called avoidance conditioning…we accommodate to avoid the noxious stimuli. To treat it, we don’t go to the doctor to have hip surgery, we remove the rock from the shoe! We treat the cause, not the symptom! This is really important in the treatment of TMD…taking drugs to minimize or mask the pain is treating the symptom and it is just a Band-Aid for the real problem…treating the underlying cause is what must happen to actually eliminate the disease process.