At Cor-Kinetic one of our foundational concepts is that of the relationship between stability and mobility.
Stability is a component part of mobility. The body needs to move in a mobile AND stable manner. Stability without mobility is RIGIDITY. Rather than a sign of functionality of the system I would see it more as a sign of dysfunction. The inability of our motor system to effectively control movement will create a rigidity in the system as the body chooses stability over mobility and closes down the system's ability to move.
It maybe that much of what we are able to access in terms of movement is limited by the ability of our motor control system and not fibrotic changes or tissue extensibility. Motor control simply being the ability of our nervous system to control movement.
This is often highlighted by people's inability to perform motor patterns but with additional stability can vastly improve their performance. I see this all the time with exercise regression in the gym. The rigidity in the system came from the inability to perform the task in a mobile AND stable way. Often this can be apparent when we are learning a new skill or motor pattern.
So how does this information affect us as practitioners? Well it means that assessment that maybe table based or more static in nature will give us more information about our bodies structural ability to move through a ROM and the capability of our connective tissue. What it does not tell us is our bodies capability to access this ROM. Simply this means that what impression we may get of someones movement in this specific situation will not give a true picture of their capability to move dynamically. More specific than that it may not give a true indication of their ability to move dynamically and functionally specific.
This is because motor patterns are pretty specific things. We know that because learning new motor skills can be tough. Perfecting them can be tougher. Rarely do we perform new motor skills perfectly first time.
So we need to realise that for a true picture of someones movement we must be true to the picture! The functional testing must be specific enough in terms of movement pattern to show our ability to move through it successfully in a stable and mobile way. Going above and beyond this can we control function related movement when destabilised or with an increase range, speed or load. These additional functional variables also give a picture of our motor control under increased demand.
So by using a "contrived" functional test that is generic rather than specific to an individuals function are we just testing a "test" rather than testing their function? Would the answers or improvements from solutions to that test only relate to the specific mechanics/motor pattern of the test. What answers does it give us about anything else? Can we screen for injury or dysfunction is such a generic way? Certainly not in the Cor-kinetic thought process. A simple understanding of biomechanics tells us we can create the same joint motion in 5 different ways. So would we not want to create the desired joint motions we are testing in an authentic manner? An appreciation for the specificity of the motor patterns would also lead me to want to be authentic in my testing or screening process.
At Cor-kinetic we focus heavily not only on functionally authentic assessment but also how we can go beyond this and better understand the body's ability to control its movement and what may affect this in terms of structure, skill and the motor control system. Many things feed into this efferent control including afferent signals from the various receptors in the body and also the ocular and vestibular systems. An issue in any one of these sensory systems may impair our motor control ability.
This may not become apparent when passive, static or table based. We must ask the question what is creating instability within the integrated system and causing it to become rigid? A movement impairment or what some may label a "threat" will also create a rigidity.
This then throws up the question about manipulations without any post manipulation motor pattern integration. If we create mobility in a joint would we not want to teach the body to use it in a stable manner through controlled specific movement directly after and also as part of an ongoing plan? Without this integration into our motor patterning does the system close down this mobility as instability. This is why many people get regular manipulations without much change in their overall movement long-term. It provides short-term relief from compressive pain perhaps?. Could this also be true of non specific or non authentic stretching, especially static. Any change in joint mobility is not reintegrated into three-dimensional functional motor patterns for the body to learn and use on a daily basis for long-term change.
Why then do we tend to challenge the body with surface instability as part of a foundational program?? Any unstable surface will create joint instability that the body will become rigid in response to. This rigidity is a sign of inability to move and unlikely to enhance any neuromuscluar movement/motor patterns. How many people move better standing on a bosu, not many, so how has that enhanced our movement except from a rigidity standpoint? Much of this rigidity comes from the hips, exactly the place we need most stable mobility from in an integrated unit. The freedom of movement in a ball and socket joint is huge! In fact how much do rigid hips contribute to back pain? More motion may have to come from the lumbar spine to compensate for the lack of motion at the hip, especially rotation when driven top down by the spine. So are we feeding dysfunction?? Instead could we challenge the mobile stability of the joint through a movement demand on a stable surface. For me this is much more functional.
How much of performance or strength gains are motor control based?? This also brings into question our current view of the generic nature of strength. Sale and Macdougal (1981) said "increased performance is primarily a result of improved neuromuscular skill" and "increased strength is apparent only when measured using the same type of movement used in training". Both these statements point towards the need to use applicable functional movement and motor patterns to create significant changes in strength and performance. However strength training involves set "lifts" rather than specific motor/movement patterns relating to the function wanting to be improved. Classic strength and conditioning training would appear to be its own function rather than a reflection OF the function!
At Cor-Kinetic our strategies, assessment and training reflects the specificity of motor skills and how they affect and are affected by specific functional activities. This involves looking at the body dynamically and looking at the body function specific. Moving on from this our assessment and training strategies involve looking at dynamic stability and the bodies ability to perform motor tasks. *Click Here* for our courses for trainers and *Click Here* for our courses for physios/osteos/sports therapists to find out more about what we do!
As always the blog is merely a reflection of my opinion and cannot be classified as fact but hopefully is some food for thought.