After another hugely enjoyable 'Functional therapeutic movement' course over the weekend we decided to pull together some of the key points from the course that form the basis of the Cor-Kinetic philosophy.
- Functionality is about understanding the individual and their needs & how to bridge the gap between the two.
- Sensitivity of an area is different to tissue damage. Being able to explain the peripheral physiology and neurobiology in simple terms will help!
- You have to learn it first.
- There maybe no relation between effectivness of therapeutic movement and increases in strength or ROM
- Patients have different markers of success from therapists
- Therapeutic movement aims:
- Pain by definition involves the CNS
- We can have 'optimal loading' but also 'tolerable' loading which is completely non functional but sometimes 'optimal'
- Input does not always need to look like output.
- There is no ‘right’ way to move. We can help people to move differently and provide different strategies.
- Context is key.
- Motion is lotion.
- Movement is a whole body integrated experience.
- Movement can be used as a targeted input like any other input such as manual therapy.
- All movements are skills.
- Motor skills live in the brain.
- We all have different structures, experiences and tolerances.
- We need information from multiple assessments to form a movement strategy.
- The longer pain persists the weaker the relationship becomes with the state of the tissue. (The issue is not always in the tissue)
- Pain affects motor skills. Previous pain can affect current motor skills.
- Getting out of pain is often gold standard of treatment. Restoring a good level of movement ability is often not as important and sometimes ignored all together.
- Using movement as a treatment is simple. Pain free, free flowing, natural & varied rather than controlled and contrived.
- Exercises are different to movement. Exercises tend to be controlled and contrived.
- Pain does not equal pathology in all cases.
- Biomechanics still have a role to play in movement. 'Faulty' biomechanics maybe less relevant than previously thought.
- Posture is only important if you can't move away from that one position. See it as a starting point - Don't assume it can't move.
- Give as few instructions as possible. Allow a large element of self organization.
- Practicing movement skills can alter our cortical representations and neurotags and also create new neurotags.
- Pain is always an output of the brain.
- Try not reinforce the pain experience or pain neurotag.
- Immediate changes are secondary to long term changes.
- Discomfort is different to pain. Some maybe be normal and should be experienced in a graded way.
- People in chronic pain can have altered movement skills and cortical representations.
- The brain pays attention to novel stimulus. High level of cortical excitement. Provide different and varied movement challenges.
- Be a helpful passenger in the process not a driver. Give people tools to help themselves and not be reliant on a therapist.
- We do not ‘fix’ people but facilitate change and provide a nurturing experience for the individuals system to try and resolve the issue.
- If your strategy is not working, try something else!
- Know when to refer out to another skill set or discipline.
- Be careful with the language you use. It affects people negatively and positively.
- Movement affects nerves, skin, bones, muscles, connective tissues and the brain.
- If movement has no role in the problem then movement may not help.
- Restoring movement confidence can be key.
- Using a graded exposure to movement can be vital to movement change and toleration.
- Increasing tissue toleration, desensitising people to movement and helping people to become more robust may help reduce future issues.
- Build on pain free movement success.
- Conscious & concentrated practice is needed to change subconscious movement behaviors.
- Passive inputs may not change movement behaviours in the longer term. No associated learning process.
- A positive outcome in a single session is secondary to long-term changes.
- Helping people understand pain and specifically their interaction with it can be powerful.
- Movement variables that can be manipulated.
Range of movement
Local or global
- Many things can affect movement such as beliefs, stress, diet, mechanics, culture, disease and previous experiences.
- Provide a positive and stress free experience.