Saturday, November 19, 2011

Dysfunctional Movement

After finishing my first workshop on injury prevention at the clinic this week, I thought a blogpost on dysfunctional movement would be a good idea.

In October I attended the SFMA or the Selective Functional Movement Assessment seminar.  This course was awesome, by the way!  It helps practitioners with a baseline movement assessment that can be used in re-evaluations to see if the issue has cleared up.

I was quite impressed by the way the assessment could be broken down into figuring out which muscle groups and structures were inhibiting movement and causing imbalances/asymmetrical movement.  It was also interesting how the assessment had the ability to define the dysfunction as a mobility or stability issue.  After the assessment is complete, you have a nice package of information that can be used as a baseline to show improvements post-therapy.

Trying to explain this to folks who haven't had anatomy or biomechanics training last Thursday, was extremely difficult.  The task of switching from medical terminology to understandable language and back, over and over, was very challenging.  I could barely see straight after the workshop.

My hope at the clinic is to help explain dysfunction as a performance hindering and potential risk for injury issue for athletes  and non-athletes and offer services and classes aimed at clearing up the problem.

Diving deeper into the goods of functional movement is the FMS protocol.  The FMS protocol is the non-medical SFMA screen.  Professional teams around the country use this approach to find dysfunctional movement in their athletes during the pre-season and if pain is causing the dysfunction, they evaluate with the SFMA screen and apply therapy/rehab.

The FMS or Functional Movement Screen, detects faulty biomechanics which lead athletes and non-athletes toward a greater risk for injury and poor performance.  Here is a testimonial of the FMS screen that I found explanatory and helpful:

“We now use this program with every player as a pretest and evaluation tool before we even begin to train them. This individualizes our training as we can now focus more on improving weaknesses, imbalances and asymmetries in an effort to improve functional movement patterns. Not only that, it's an integral part of our program; rehabilitating injuries, decisions on return to play, and it's a test before training camp that tells us:

1) has the player improved?
2) do we feel good about putting him on the field?”  

John Torine, Head Strength Coach for the Indianapolis Colts

If these assessments work on professional athletes that rely on staying injury free, I believe any athlete, endurance or power, can be assessed using these screens to help improve performance and prevent injury.

I have found a few road blocks in my attempt to explain this approach to the public.  One issue is that it is conceptually challenging to wrap your head around dysfunctional movement.  Without going through an actual assessment or seeing it performed on someone, dysfunctional movement sounds like a weird disease.

The way I see it is like this: the muscles of the body all have specific duties; some are prime movers, some are helpers or synergists and some are stabilizers.  If we move in a particular way or do the same activities everyday, we develop dominant motor programs that make the the particular way we move each day, easier and more efficient.  It is all about adaptation.  Now, if those particular daily movements are sitting and riding a bicycle, you can see how going for a run with these dominant motor programs could leave you at risk for injury.  Add in the body's ability to physically mold itself into postures from doing the same activities day after day, you can then see how our biomechanics can be altered.

Take a the cyclist from the example above who has a desk job.  More than likely, this person will have very tight hip flexors due to being in the seated position on the bike daily and sitting at work daily.  Looking at the time spent in hip extension each day and you can see that this person likely walks to the car to go home, walks in the grocery store and walks around the house a little, everyday.  How much time is being spent sitting versus standing?  I'd say it is 80% or more of sitting.  

This prolonged sitting creates a movement pattern that is very efficient for the activity of sitting and not so much for the pattern of standing and walking.  

Now, with this in mind, think about what happens when a muscle group becomes dominant over it's antagonist muscle group.  The opposite muscle group, the antagonist, becomes inhibited or dormant.  

The cyclist above likely has tight hip flexors from being in the flexed-hip position at work and in cycling.  If the hip flexors are dominant, the opposite muscle groups that becomes inhibited are the glutes or hip extenders and the abdominals.

What does this do to the biomechanics?  In the standing position, the person will have an anterior pelvic tilt which causes the belt line to be angled toward the feet and the lumbars or lower back will be hyperlordotic or excessively curved.  This change puts tension on the hip stabilizers, the IT bands, the knees, the ankles and even the cervical, thoracic and lumbar regions of the spine.  

Now go running with these issues and you are at risk for injury and degeneration of joint surfaces due to faulty dysfunctional biomechanics.

Clearing these biomechanics up with manual therapy and rehab strengthening for inhibited muscles, prevents injuries and helps the body function as it is supposed to with clean, powerful movement.  

I hope this all sheds light on the power of movement assessment.

All for now,

Dr. Spangler
Trailhead Chiropractic






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