Part 3/3 - Movement Principles of Performance Therapy
In part two of this three part series, I explored the philosophical principles that drive my decision-making process. In today’s article, I will be exploring the movement principles that guide my practice as a clinician and coach. There are a number of leaders in our field that have influenced my thinking and I have done my best to reference them where appropriate.
Physics is fundamental. Our ability to manage internal and external forces dictates goal-oriented movement. (1)
When dealing with the human system, it makes sense to break down our understanding to first principles in order find fundamental truths, then reason upwards based on logical inferences. An understanding of physics builds the foundation for all other knowledge.
We tend to place more emphasis on external forces applied to the human body, such as the impact of gravity and vectors from the task and environment. Less attention is directed towards the internal forces that our body places on itself, even though these forces are just as important. When considering how fundamental physics impacts the human body, we should place emphasis on hydrodynamics, pressure mechanisms driven by gradients, gyroscopic forces, fractal geometry, biotensegrity and helical motion. Bill Hartman has been instrumental in exposing me to these ideas, so my understanding of these concepts wouldn’t be possible without him.
In terms of hydrodynamics and pressure mechanisms, we are 2/3rds water by weight, which means we behave like water through shape change and pressure management. Gyroscopic forces become relevant when discussing our ability to manage the left precession of our viscera through active strategies. Fractals are important because biology self-organizes itself into polyhedral shapes which repeat outwards from micro to macro; nature leans towards efficiency and these geometric patterns are a demonstration of the simple rules that construct the human system. Biotensegrity is a model that better illustrates the bodies viscoelastic nature held together by an equilibrium of compression and tension. Finally, helical motion is a concept that illustrates how all movement is tri-planar even if our vision leads us to think otherwise.
Movement is a biomarker for total system health.
Movement is an expression of human behavior and can be used as a proxy measure to indicate total system health. Having movement options and showing adaptability is what we should strive for. By expanding our movement variability, we hope to expand the variability of any sub-system that may be rigid. (1)(2)
Pain is extremely complex and involves multiple subsystems of the body. Our aim should be to create systemic change through interventions that make a widespread impact. Movement-based interventions give us the opportunity to directly impact neurological, musculoskeletal, myofascial, articular, cardiovascular, respiratory, endocrine, immune and psychosocial-emotional sub-systems. In reality, this explanation is only partially true since movement impacts every aspect of the human system.
We must normalize the breath first in order to satisfy the system from a top-down approach.
We breathe 21,000 times per day – it is the most fundamental movement pattern that we have and all other movement is based upon it. It is the first thing we do when we are born and the last thing we do when we pass. Because of the natural hierarchy at play, the body will not allow us to move into positions that we cannot breathe in; we must normalize the breath first in order to satisfy the system from a top-down approach.
The mechanical aspects of breathing allows us to manipulate pressures for respiration and stabilization. Our breathing patterns will dictate the position of the axial skeleton and pelvis, which impacts the position of all other peripheral structures. From a physiological perspective, breathing manages our pH through removing excess carbon dioxide and oxygenating our tissues. It also has a significant impact on our hormonal system and stress-apparatus. As a result, breathing can change our state of mind through affecting our autonomic nervous system; it can enhance our ability to produce force via sympathetic drive or promote rest and recovery by tapping into parasympathetic pathways. It’s clear that breathing is a keystone for health and performance due to its effect on these primary mechanisms.
We should optimize proximal movement strategies before intervening distally.
From a hierarchical perspective, the axial skeleton and pelvis are the foundation for peripheral mechanics. Our first priority should be to normalize the position of our chassis in order to optimize the function of our limbs. Proximal limitations should trump distal limitations. If we ignore this logic by working on peripheral mechanics alone, optimizing health and performance may prove difficult. We also need to consider that the foot anchors us into the ground during all upright tasks; therefore, it is another leverage point that can be targeted.
As mentioned previously, I believe that our interventions need to be systemic and global in nature. By intervening proximally, we have the ability to affect multiple sub-systems of the body in addition to both axial and peripheral mechanics.
Movement is a product of the constraints on the organism, task and environment.
Dynamic Systems Theory states that behavior emerges through the interplay between an organism, task and environment (3). Changes in the constraints of these concomitant parts will dictate the movement patterns that are afforded. As a result, our therapeutic goal should be to provide control through as many degrees of freedom as possible keeping specificity in mind. By doing so, we give the human system an opportunity to choose the best strategy that is dictated by the task and environment. Having options for motion is what leads to a healthy, adaptable system.
Rehabilitation aims to expand total variability of the organism in order to recapture health, whereas performance intentionally steals variability so that all resources can be pushed towards raising an output (1). This is the main difference between rehabilitation and performance through the lens of Dynamic Systems Theory.
We need to develop fundamental movements first in order to assist with specific skill acquisition.
For the purpose of long-term athletic development, resources should be directed towards building fundamental patterns. Our body thrives when we move, but we maximize longevity by developing movement competency before capacity. Position is always the first priority and load is used as a secondary stimulus to further challenge a pattern. After these qualities are demonstrated, training can extend into movement exploration and improvisation. We should aim to be eclectics rather than purists. Through a generalists approach, we can use proven movement practices to teach athletes to manipulate their bodies in ways their sport cannot yield. Gymnastics, martial arts, acrobatics, track and field, rock-climbing, Feldenkrais and yoga are examples of practices that can develop greater body awareness and control.
Elite athletics may not allow for movement exploration as sufficient exposure is required in order to develop sport-specific skills. Even so, a broad movement base needs to be built in order to assist with specific skill acquisition. By reapplying basic patterns, we are able to reclaim movement that is lost during over-specialization. Our end goal should be to develop general athletic qualities that will lead to durability over the long term.
Movement should be restored in a logical sequence based on individual needs. Position should be the first priority, then mobility, and finally motor control. Movement should be integrated into higher level tasks in order to maximize dynamic correspondence.
Each of these four stages (position → mobility → motor control → integration) do not necessitate the use of one another; but if all four are needed, they should be applied in that order. During these stages, we should strive to create sensory-rich experiences that maximize nervous system inputs. Somatosensation is a collection of proprioception, vestibular and visual stimulus; if the body accurately feels and senses what is happening, it will produce quality motor output. Sensory in dictates motor out.
By working on position first, we give the body an opportunity to express its true mobility. This will allow us to apply mobility interventions to areas that actually need it. Since mobility issues impact the quality of somatosensory input, we must address them if we hope to regain reflexive and reactive stability (2). This is because stability is a product of our nervous system interpreting input and allocating the appropriate amount of motor output to control movement (2). Put simply, when feedback loops become distorted, the output lacks quality. Clearing mobility issues gives the nervous systems more timely, accurate and complete information which allows for better movement outcomes. Once passive range has improved, we should reinforce active strategies through motor control drills and traditional strength training. To avoid being myopic, exercise interventions should be followed up by full execution of a skill in order to re-stabilize a pattern and maximize carry-over.
Performance can be limited by fundamental qualities, including position, mobility issues, poor motor control and pain. (2)
This idea challenges the common view that the only way to improve performance is through training different bio-motor qualities like strength, speed or power. Since movement is a continuum from rehabilitation upwards, we can apply lower-level interventions to improve higher-level tasks. Recognizing the connection between fundamental qualities and performance gives us another perspective to look through. It also provides us with more assessment and intervention options since we can view the human system from micro to macro.
Injury occurs when an acute or chronic force exceeds a tissues capacity.
To leverage this principle, we must intelligently apply load to the body in order to promote progressive adaptation. Load should be applied based on the needs analysis of the sport and should replicate force vectors, joint actions, biomotor qualities, energy systems and common injury mechanisms.
The body is extremely adaptable, but the better question is: to what extent can we adapt? We should still strive to maximize variability, efficiency and capacity in that order as the breakdown of tissues is inevitable. We can create a higher ceiling of adaptability if we optimize mechanics based on an individual’s physics. By working with known movement efficiencies, we are given more room to adapt.
This concludes my three part series on the importance of using principles as the guiding force behind our interventions. The process of writing these idea’s down has been invaluable. It has allowed me to clarify my ideas and better understand why I believe what I believe. I invite you to do the same and promise that it will be time well spent.
Thanks again for reading! Feel free to share some of your principles in the comments section below. Again, disagreement and productive conversation is encouraged. These are my opinions and I am happy to discuss them if anyone has any questions or opposing views.
References:
1. Hartman B. The Intensive IX. Presentation presented at; 2019; IFAST.
2. Cook G, Burton L, Kiesel K, Bryant M, Torine J. Movement. Aptos, CA: On Target Publications; 2015.
3. Holt KG, Wagenaar RO, Saltzman E. A Dynamic Systems: constraints approach to rehabilitation. Brazilian Journal of Physical Therapy. 2010 Dec;14(6):446-63.