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 be

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Chapter 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.

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Movement 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)      Fundamental

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Movement Chapter 8: SFMA Assessment Breakout Descriptions and Flowcharts

This is a chapter 8 summary of the book “Movement” by Gray Cook. What to Look For The SFMA breakouts are utilized to determine if one’s movement deficiencies have a mobility or stability origin. There are further possibilities in each of these categories. It Could Be a Mobility Problem There are two subsets of mobility problems that include tissue extensibility dysfunction (TED) and joint mobility dysfunction (JMD). From here, we can break it down even further in each subset. Here are some potential TEDs Active/passive muscle insufficiency Limited neurodynamics (they said neural tension; come on Gray!) Fascial tension Muscle shortening Hypertrophy Trigger points Scarring/fibrosis And here are some potential JMDs Osteoarthritis/arthrosis Single-joint muscle spasm/guarding Fusion Subluxation Adhesive capsulitis Dislocation It could be a Stability Problem These issues are also known as stability or motor control dysfunction (SMCD). Most conventional therapies would treat these complaints by strengthening the stabilizers, but this is problematic. When something works reflexively, how can we train something volitionally and expect changes? To train these muscles we must focus on proprioceptive and timing-based training. There are several examples of SMCD problems. Motor control dysfunction. High threshold strategy. Local muscle dysfunction/asymmetry. Mechanical breathing dysfunction. Prime mover or global muscle compensation behavior or asymmetry. Poor static stability, alignment, postural control, asymmetry, and structural integrity. Poor dynamic stability, alignment, postural control, asymmetry, and structural integrity. Relatedness Mobility and stability can influence one another. If I were to lose mobility at one segment, motor control can be distorted at nearby segments.

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Movement Chapter 7: SFMA Introduction and Top-Tier Tests

This is a chapter 7 summary of the book “Movement” by Gray Cook. Intro The SFMA’s goal is to assess functional capabilities. This system is based on Cyriax differentiation and grading principles. Instead of describing things as strong, weak, painful, or painless; the following descriptors are utilized: Functional nonpainful (FN): Unlimited movement and able to complete a breath cycle at end-range. Called the dead end. Functional painful (FP): Called the marker, reassessed. Dysfunctional nonpainful (DN): Limited, restricted, impaired mobility, stability, or symmetry. Labored breathing with movement also implicates this choice. Called the pathway, where treatment occurs. Dysfunctional painful (DP): Called the logical beehive because we do not know if pain is causing poor movement or vice versa. It is an unreliable place to work unless acute situations. SFMA corrective and manual therapy lie in treating the FP’s and DN’s. The order at which things are treated also matters, so the order listed below for the top tier tests is also typically where treatments should hierarchically begin. Cervical spine patterns (CSP) Upper extremity patterns (UEP) Multi-segmental flexion (MSF) Multi-segmental extension (MSE) Multi-segmental rotation (MSR) Single leg stance (SLS) Overhead deep squat (ODS) We then operate the SFMA in the following fashion:

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