“Don’t Put Fitness on Dysfunction”

“Don’t Put Fitness on Dysfunction”

This is one of my favorite sayings from Gray Cook (physical therapist,). What he’s getting at, is we need a solid movement base – meaning joint mobility and stability, muscle flexibility, and balance – prior to training for strength, power, speed, and so on. Or before just going out and participating in a given sport or taking up something like jogging. Here is the Functional Performance Pyramid he came up with.

What this basically says is we need to move well before we should begin any training program or athletic endeavor. The purpose of this is not only to get better results from our training, but also to prevent the injuries that seem to go hand in hand with training and athletics.

The research is now clearly showing that the movement skills we once possessed as children, are vital to our health and performance as teenagers and adults. Research done in professional and collegiate sports, as well as in the military, is demonstrating that a base level of movement competency is necessary to prevent injuries. Not only that, but training and performance are enhanced in athletics. In the military it has been shown to correlate to drop out rates in basic training.

Do you still move like this?

Here are two factors from the research that relate how well you move to injury risk:

1) Previous injuries
2) Right-Left asymmetries

These are the two biggest predictors of injury in athletics and in those that train, run, bike, ski, etc. Previous injuries we have experienced often create compensatory strategies to allow us to continue to perform our desired activities. Something as simple as an ankle sprain provides a great example. To continue to run, just in this example, the calf muscles tighten down to protect the ankle and you lose ankle joint motion. This requires compensatory motions from the knee, hip, and up the chain into the spine. This is meant to be a short term adaptation but often becomes chronic – a new way of doing things. Over time the accumulating microtrauma can lead to overuse type injuries such as plantarfascitis, achilles tendinopathy, knee pain, or back pain. Occasionally it can lead to bigger, more devastating injuries.

Right to left differences in movement (asymmetries) can create a similar scenario. Often our work, school, and athletic activities create these side to side differences that will have much of the same affect. We move well one direction, but not the other. Repetitively moving in our more mobile direction creates excessive wear and tear on our joints and muscles. When forced to move in our not-so-mobile direction repetitively or with great force (a.k.a sports), serious injury can result.

45 degrees of hip rotation on the Left and 20 degrees on the Right = Not Good!

This is just the tip of the iceberg when it comes to movement quality and injury prevention, but I wanted to give you a little flavor of what’s to come. At Elite Physical Therapy and Sports Performance, we put a premium on enhancing your movement capabilities while rehabbing or training with us. The research is showing that we’re playing with fire by just jumping into training programs or athletics without first assessing how one moves, determining base levels of strength, conditioning, etc. I prefer using the Functional Movement Screen and Y Balance Test with all athletes and those who want to train hard, but it can be any system that takes a good hard look at how you move prior to putting you under the bar or out on the field or court.

I think this quote by world renown physical therapist Diane Lee (who has worked with the Canadian Olympic team) puts in all in perspective: “Don’t run to get in shape, you must get in shape to run”. If you move well, you can train hard. If you have a ‘weak link’ then we must address that to help you meet your goals.