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Movement Gone Wrong

One of the greatest things about being in this field is helping someone move better.

Watching people move, walk and perform skills or tasks you throw at them is always very interesting. Seeing what they can and cannot do is especially important as it tells you what needs to be worked on and what needs to be fixed.

There are several reasons that a person moves poorly. Some potential reasons could be weakness, lack of understanding of the desired movement pattern, flexibility/mobility problems, poor posture, sedentary lifestyle or previous injury.

It is the last one that is so critical to understand. Once we get injured, we really don’t move the same way. Our body unconsciously begins to change patterns in order to protect the area that was injured or in order to prevent us from stressing that area because when we do…IT HURTS! This creates altered movement patterns, changes in lengthen tension relationships around the joints and changes in neurological firing patterns. No longer do we operate the same way, unless we do some homework to actually fix these problems.

In the book Low Back Disorders: Evidenced Based Prevention and Rehabilitation, author Stuart McGill states (pg. 30):

“Several studies have documented a change in muscular function after injury (nicely summarized by Sterling, Jull, and Wright, 2001). These include, for example,

- Delayed onset of specific torso muscles during sudden events (Hodges and Richardson, 1996, 1999) that may impair the spine’s ability to achieve protective stability during situations such as slips and falls;

- Changes in torso agonist-antagonist activity during gait (Arendt-Nielson et al., 1995)

- Inhibition of back extensors in the presence of pain (Zedka et al., 1999) and;

- Asymetric muscle output during isokinetic torso extensor efforts (Grabiner, Koh, and Ghazawi, 1992) that alters spine loading”

While McGill’s summary here is specific for the spine (duh, the book is about the low back!) in Diagnosis and Treatment of Movement Impairment Syndromes, Shirley Sahrmann offers two different models of how movement impairments actually develop.

The “perfect world” model (IE, no injuries and no movement impairments) looks something like this:

Kinesiologic Model

Base – Modulator – Biomechanical – Support
Variety in Movement & posture
Precise movement
Musculoskeletal Health

As you can see, the movement system (the top line of the model) is all connected. The system is:

Base = muscles and bones
Modular = nervous system
Biomechanical = kinesiology
Support = muscular endurance

All 4 components of the system are in healthy working order, allowing for optimal movement.

The two impaired models look like this:

Pathokinesiologic Model

Base – Modulator – Biomechanical – Support
Abnormality or injury
Impaired components
Movement Impairment
Functional limitation/disability

In the Pathokinesiologic Model we have developed an injury (or have an abonormality in one of the components of the movement system), which in-turn changes the way we perform movement and leads to further limitations as disability (as I eluded to above).

Kinesiopathologic Model

Base – Modulator – Biomechanical – Support
Repeated specific movements or sustained postures
Impaired components or their interactions
Movement impairment syndromes
Functional limitation/physical abnormality

As you can see in the kinesiopathologic model, we have a sustained posture (IE, sitting) and/or repetitive movement (IE, typing or bending and lifting all day) and this leads to impairments in one or many of the components of the movement system, leading to our movement impairments (alterations in the way we do things) and finally limitations and physical abnormalities.

Pretty interesting stuff! If nothing more, I hope you take away from this the importance of analyzing your abilities - not just how much can you squat, bench, run a mile, etc. but how WELL can you accomplish these tasks – and determining what you need to do in order to enhance you overall movement system.

More later!