PT Classroom - Is Your New Year’s Resolution Missing Its Foundation? ׀ by Nicholas W. Gigliotti, PT, DPT

 

Nicholas W. Gigliotti, PT, DPT, is physical therapist with Big Stone Therapies, Inc. at the Avera Marshall Hospital in Marshall, Minnesota. Dr. Gigliotti is an alumnus of the College of St. Scholastica’s Physical Therapy Program in Duluth, Minnesota and former Vice President of the American Physical Therapy Association’s Student Assembly. Certified in Functional Movement Systems, Dr. Gigliotti treats patients in outpatient, inpatient, and nursing home settings.

 

Is Your New Year’s Resolution Missing Its Foundation?

What is the number one New Year’s resolution? You guessed it… to lose weight. Going a step further, 38% of New Year’s resolutions are related to weight and fitness. Over 1 billion Americans make New Year’s resolutions each year. The unfortunate truth is that after one week, nearly 25% of those personal pledges are pledges no more, and by June, over 50% of all New Year’s resolutions are renounced.

So what is it that makes New Year’s weight and fitness resolutions so hard to stick with? Are we uncommitted, overzealous, or a combination? Or how about none of the above? As a physical therapist, the most common reason I see people missing out on their New Year’s health and wellness resolutions is injury.

Injuries may be newly acquired, an aggravation of an old injury, or could simply be that persistent soreness that will not allow you to continue. While there are many poorly designed fitness regimes out there that predispose individuals to injury, the root of the problem likely lies in the foundation of your movement.

Movement denotes the act of a functioning body as it changes position under it’s own power (2). Either conscious or subconscious, humans cultivate their movement by forming patterns throughout development. Movement patterns are purposeful, and require the coordination of our minds, bodies, and environments. If movement patterns are dysfunctional, we may predispose ourselves to greater risk for injury. This makes pattern recognition the first step in laying the foundation towards better movement.

The human body is a tremendously intricate and well-designed system that supports and promotes three dimensional and diagonal movements. Each individual possesses different functional capabilities, body types, and fitness goals, but the fundamentals of our movement are all the same. Yet to those outside the world of movement science, recognition of movement patterns may seem anything but fundamental. But the foundation of movement is not about strength, power, endurance, or agility. It is not about skill and performance. In all its complexity, movement patterns and subsequent dysfunctions can be traced back to two key aspects: mobility and stability.

Of the two, mobility must come first, because without mobility, we will not be able to gain the necessary motor control for stability. Does this mean that we need to stretch more? Or that your stiff hip or knee is what is causing your back pain? Not necessarily. In fact, there is not sufficient evidence to endorse stretching before or after exercise to prevent injury at all (3)! Normal motion does not guarantee normal movement. Movement also requires motor control, which includes stability, balance, postural control, coordination, and perception.

So what has proven to work? The answer is movement screening. Movement screening assesses function through a balanced approach, centered on movement patterns rooted in mobility and stability. Movement screening has proven so useful that it is used effectively by organizations such as the National Football League (NFL) (4) and the United States Military (5).

Screening establishes the baseline. Once that movement baseline is established, a personalized intervention program designed to improve core strength (stability) and/or functional movement (mobility) dysfunctions proven to prevent injuries in workers whose work involves awkward positions is warranted (6). The same can be true with your exercise regime and fitness goals.

Even though we are well into 2013, the opportunity is always there to prevent musculoskeletal injuries rather than to react and respond when they occur. Unmanaged problems will lead to compensations in the presence of pain and dysfunction and prolong activity limitations.

First move well, then move often.” – Gray Cook

For movement experts in your area, try one of these resources:
American Physical Therapy Association – Find a PT
Functional Movement Systems – Find an Expert


Last revised: January16, 2013
by Nicholas W. Gigliotti, PT, DPT

 

References
1) http://www.livestrong.com/blog/how-to-make-your-new-years-resoloutions-stick-infographic/
2) Cook, G. (2010). Movement: Functional Movement Systems. Aptos, CA: On Target Publications.
3) Thacker, S. B., Gilchrist, J., Stroup, D.F., & Kimsey Jr, C. D. (2004). THe impact of stretching on sports injury risk: a systematic review of literature. Medicine & Science in Sports & Exercise, 36(3), 371-378.
4) Kiesel, K., P.J., Voight, M. (2007) Can serious injury in professional football be predicted by a preseason Functional Movement Screen? N Am J Sports Phys Ther, 2(3), 76-81.
5) O'Connor, F.G., Deuster, P.A., Davis, J., Pappas, C.G, Knapik, J.J. (2011) Functional movement screening: predicting injuries in officer candidates. Med Sci Sports Exerc, 43(12), 2224-30.
6) Peate, W.F., Bates, G., Lunda, K., Francis, S., Bellamy, K. (2007) Core strength: a new model for innjury prediction and prevention. J Occup Med Toxicoll, 11, 2-3.



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