Mobility, Stability, and the Like I recently attended the FMS Level 2 course after rocking the home study. In my quest to take every con ed course known to man, I got into the functional movement people because the idea of improving movement over isolation exercise interests me. I find the way they build up to the patterns very logical, namely because they liberally use PNF and developmental principles; and they do so quite eloquently. But really, I wanted to go to this class so I could meet and learn from Gray Cook. And his segments did not disappoint. While I may not agree with everything he says, he is a very brilliant man and knows movement. The only disappointment I have to say about this course was that I did not get enough Gray and Lee. I would say I probably saw them teach 30% of the time, with another FMS instructor just running us through their algorithms. I am sorry, but if you are going to advertise Gray Cook and Lee Burton as the instructors, then I want Gray and Lee instructing me! A lot of these exercises were review for me, but there were definitely some tweaks that I liked a great deal. I think if you are new to more motor control-based exercises, this course is great for you. Just make sure you are taking it from Gray and/or Lee. Why Screen? The FMS is predominately used to manage risk and prioritize exercise selection. They look
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Chapter 15: In Conclusion
This is a chapter 15 summary of the book “Movement” by Gray Cook. The Goal The goal of movement retraining is to create authentic unconscious movement at acceptable levels. We can develop many methods to achieve our goals, but working under sound principles is paramount. Some of the principles Gray advocates include: Focusing on how we move. Look to movement to validate or refute your intervention. Movement is always honest. When designing a movement program, we must operate under the following guidelines: Separate pain from dysfunctional movement patterns. Starting point for movement learning is a reproducible movement baseline. Biomechanical and physiological evaluation do not provide a complete risk screening or diagnostic tool for comprehensive movement pattern understanding. Our biomechanical and physiological knowledge surpass what we know about fundamental movement patterns. Movement learning and relearning follows a hierarchy fundamental to the development of perception and behavior. Corrective exercise should not be rehearsed outputs. Instead, it should be challenging opportunities to manage mistakes on a functional level near the edge of ability. Perception drives movement behavior and movement behavior modulates perception. We should not put fitness on movement dysfunction. We must develop performance and skill considering each tier in the natural progression of movement development and specialization. Corrective exercise dosage works close to baseline at the edge of ability with a clear goal. The routine practice of self-limiting exercises can maintain the quality of our movement perceptions and behaviors and preserve our unique adaptability that modern conveniences erode. Some things cannot
Read MoreChapter 14: Advanced Corrective Strategies
This is a chapter 14 summary of the book “Movement” by Gray Cook. Inputs Corrective exercise is focused on providing input to the nervous system. We are allowing the patients and clients to experience the actual predicament that lies beneath the surface of their movement pattern problem. It is okay for mistakes to be made, for these errors help accelerate motor learning. Minimal cueing should be utilized, as we want to patient to let them feel the enriching sensory experience. Motor Program Retraining There are several different methods in which we can achieve a desired motor output. 1) Reverse patterning – Performing a movement from the opposite direction. 2) Reactive neuromuscular training – Exaggerating mistakes so the patient/client overcorrects. Use oscillations first, followed by steady resistance. 3) Conscious Loading – Using load to hit the reset button for sequence and timing. 4) Resisted exercise – Makes patterns more stable and durable. When you can deadlift that much, most anything is stable and durable.
Read MoreMovement Chapter 13: Movement Pattern Corrections
This is a chapter 13 summary of the book “Movement” by Gray Cook. Back to the Basics Mobility deficits ought to be the first impairment corrected. Optimizing mobility creates potential for new sensory input and motor adaptation, but does not guarantee quality movement. This is where stability training comes in. In order for the brain to create stability in a region, the following ought to be present: Structural stability: Pain-free structures without significant damage, deficiency, or deformity. Sensory integrity: Uncompromised reception/integration of sensory input. Motor integrity: Uncompromised activation/reinforcement of motor output. Freedom of movement: Perform in functional range and achieve end-range. Getting Mobility There are 3 ways to gain mobility: 1) Passively: Self-static stretching with good breathing; manual passive mobilization. 2) Actively: Dynamic stretching, PNF. 3) Assistive: Helping with quality or quantity, aquatics, resistance. Getting Stability In order to own our new mobility, we use various stability progressions to cement the new patterns. There are three tiers in which stability is trained: 1) Fundamental stability – Basic motor control, often in early postures such as supine, prone, or rolling. 2) Static stability – done when rolling is okay but stability is compromised in more advanced postures. 3) Dynamic stability – Advanced movement. We progress in these stability frames from easy to further difficult challenges. Assisted → active → reactive-facilitation/perturbations Since stability is a subconscious process, we utilize postures that can challenge this ability while achieving desired motor behavior. We can also group the various postural progressions into 3 categories: 1)
Read MoreMovement Chapter 12: Building the Corrective Framework
This is a chapter 12 summary of the book “Movement” by Gray Cook. A Whole Lotta P When we build our corrective framework, we must take into account the 6 P’s: 1) Pain – Is there pain with movement? Staying away from pain improves motor control. 2) Purpose – What movement pattern are we targeting with corrective exercise and what problem are we addressing (i.e. mobility, stability, dynamic motor control)? 3) Posture – Which moderately challenging posture is the best starting point for corrective exercise that allows for reflexive activity? 4) Position – Which ones demonstration mobility/stability problems and compensatory behaviors? 5) Pattern – How is the dysfunctional movement pattern affected by corrective exercise? 6) Plan – How can you design a plan based on findings? The goal when designing the correction is to stay in the middle ground of the autonomic nervous system while providing a rich sensory experience. Movement pattern dysfunction is a behavior that needs to be addressed and changed.
Read MoreMovement Chapter 11: Developing Corrective Strategies
This is a chapter 11 summary of the book “Movement” by Gray Cook. Autonomics All exercise affects tone and tension. This influence is the basis for movement. The autonomic nervous system determines movement as threatening or not, which determines requisite tone. It is important to nudge movement towards further nonthreatening yet advanced stimuli. FMS Corrections Proceeding to correct under FMS protocol is determined by screen results and changed via exercise. We first correct mobility, next reinforce stability, then retrain movement patterns. Stability training in particular follows a sequence: 1) Challenge posture and position. 2) Build mid-range strength. 3) Develop end-range stability. Movement patterns are corrected in the following hierarchy: ASLR & Shoulder mobility → rotary stability → pushup → Inline lunge → hurdle step → Deep squat SFMA Corrections The SFMA corrective pathway is nonlinear unlike the FMS. The breakouts will tell you which direction to go to restore optimal movement. The options are also increased. Often to gain mobility, you would utilize various manual therapies or other modalities. To alter stability, taping, orthotics, braces, or anything else to increase motor control may be utilized. Movement patterns are corrected in the following hierarchy: Cervical spine → Shoulder →multi-segmental flexion & extension→ Multisegmental rotation →single leg stance → Squat Depending on how movements present, certain therapies are utilized: DN – manual therapy and corrective exercise. DP – Manual therapy and modalities. FP – Modalities and manual therapy. FN – General exercise. Exercise Categories There are several exercise types that can be utilized depending on one’s goal:
Read MoreMovement Chapter 2: Anatomical Science Versus Functional Science
This is a chapter 2 summary of the book “Movement” by Gray Cook. Funky Muscles There are anatomically two basic types of muscles; shunt and spurt. Shunt muscles compress and produce structural integrity because the distal attachment is far from the moving joint. Spurt muscles produce movement because the distal attachment is close to the axis of rotation. While these two muscle types are present, they can vary depending on the function performed. For example, if we perform a movement in the closed chain, the spurt and shunt roles become reversed. Focusing on a single muscle group causes us to lack understanding of the supporting matrix behind superficial muscle action. Muscle function depends on body position and joint in action. We can see this point illustrated in Lombard’s paradox, which involves the coactivation of hamstrings and quadriceps when performing a sit to stand. These muscles are antagonistic to one another at their respective joints, yet movement is produced. The resultant effect is the quads and hamstrings becoming global stabilizers. Muscle activity is task specific, therefore Gray purports four types of muscles: 1) Global Stabilizers: Multi-joint muscles contracting to produce stability and static proprioceptive feedback. 2) Global Movers: Multi-joint muscles that produce movement and dynamic proprioceptive feedback. 3) Local Stabilizers: Deep segmental muscles (1-3 segments) that produce stability and static proprioceptive feedback. 4) Local Movers: Single joint muscle that produce movement and dynamic proprioception. These different muscle types require different training modalities. The example given is stabilizer muscles. These muscles cannot
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