Movement Training Principles

​Most of my clients come to the clinic because a certain movement or activity is causing them pain. For example, it hurts when they go down stairs or it hurts when they are bending forward to brush their teeth. A certain way of moving and a certain pattern of muscle activation is setting off the alarm signals. In these moments, we need to unload and unwind the nervous system. Keep moving, but without triggering the pain response. The way to accomplish this is to gradually move into and around painful ranges of motion. Controlled movement around the pain slowly desensitizes the painful movements and teaches the brain that movement is safe.
 
This whole experience is a learning process. Many movement patterns become so habitual that they go unnoticed. We don’t think about how our knees bend when walking down the stairs or how the spine bends when we brush our teeth. Movement becomes automatic and subconscious. When pain occurs, movement all of a sudden becomes very conscious. Painful movements are sensitive movements, and the body develops new patterns to minimize pain. 
 
The process of identifying pain and retraining it can be complex. At times, the learning process can feel like pushing a large rock up a mountain. The more chronic the pain, the longer that rock has settled into the earth. Just as the rock doesn't want to budge, our old habits can be hard to change. To help someone out of pain, we need to identify the specific pattern causing someone’s pain and retrain a new pattern. We need to unlearn certain movement habits and engrain a new muscle memory. This entails calming things down and gradually building them back up.
 
In this post, I am going to share several of the movement principles I incorporate with my clients to help them calm down symptoms and gradually learn new movement habits to get out of pain (and prevent injury in the future).

Principle 1: Slow before Fast

​Movement gives our brain tons of input about location of our joints, amount of pressure, speed of movement, and more. This input is important for body awareness and preventing injury. If the input comes in too quickly, the body has to react to the movement and no learning occurs. One of the ways to slow down the input to the brain is to slow down the pace of movement. A slower pace helps someone feel when and where a movement starts hurting. Controlling the speed of movement helps control the speed of learning. In the clinic, I’ll use a TRX or some other form of assistance to help slow down a movement to make the learning curve easier.

Principle 2: Single and Simple before Compound and Complex

​Breaking down a compound movement into smaller parts is a highly effective strategy for retraining movement. The process of disassembling then reassembling allows us to separate the parts from the whole movement. During this process, you can identify a weakness or inflexibility that is driving the problem. For example, if someone has pain going down the stairs, we can isolate the major joints performing the motion. Instead of multiple joints receiving input, we can train each joint how to move without triggering pain. Joint by joint we rebuilt the entire sequence. 

Principle 3: Stable before Unstable Surfaces

The sensors within muscles, tendons, and ligaments are constantly providing the brain with feedback about position, pressure, pain, temperature and more. This barometer is important for how our muscles adapt and react to the outside world. Starting with a stable surface allows these receptors to find a set point. In the clinic, I’ll start on a solid, firm ground before training on unstable surfaces. I make sure the client can find their balance and center of gravity on the ground before adding a more complex variable.

Principle 4: Partial Range of Motion before Full Range of Motion

​As our movements get bigger and our tissues stretch further, we put strain on the input sensors that I’ve mentioned above. When these sensors are repetitively strained at their end-ranges, their ability to provide reliable information becomes hypersensitive. When getting out of pain, we need to start in a range of motion that doesn’t aggravate these joint sensors. Beginning in a neutral position where our muscles are strongest is typically the best way to calm down symptoms. In the clinic, I'll start people in an open joint position where there is the least strain on the joints and soft tissue. As their pain subsides and tolerance increases, we gradually start challenging their nervous system through full ranges of motion. 

Conclusion

​Using these principles (among others) allows clients to understand which movements, postures, and environments are causing their pain. By starting slow, small, and simple the learning process can occur with less distraction. This allows us to calm down symptoms while keeping the patient in control of their symptoms as they gradually retrain their nervous system!