Prior to progressing to, or starting in, the Phase 2, Movement Training, clients should exhibit sufficient stability, mobility and static balance in the kinetic chain. Movement Training incorporates dynamic movement, which places a greater demand on core function (proximal stability). There is greater potential for compensation in movement and eventual pain and injury if proper stability and mobility have not been addressed or established prior to beginning the Movement Training phase. In Phase 2, the objective is geared toward moving the entire body in multiple planes through movement patterns that are used in daily living.
Whether performed individually or together, the following are the five primary movement patterns of daily life:
-Bend and lift
Here are some factors to take into account regarding Phase 2: Movement Training:
1. Proper stability and mobility improves movement efficiency, thereby decreasing the potential for compensation, pain or injury.
2. This phase uses body weight as resistance and the body’s levers as drivers to increase exercise intensity.
3. Success in training these movement patterns is different for everyone. It is specific to the individual’s body type, past experiences, abilities, motivation, attitude, etc.
4. Consider your client’s abilities and skill level when determining a timeline for teaching movement patterns. (Note: Some clients may need more time than others.)
5. Understanding the reasons for exercises in Phase 2 requires some understanding of kinematics within the body (specifically as it relates to the lower extremity). Kinematics refers to the body in motion, in relation to the joint angle and pattern of movement, without any consideration given to the forces acting at the joints, or causes of motion.
6. You should understand how the ankle, hip and knee relate in movement. Note their relationship and how force is distributed through these joints during the gait cycle.
The Primary Movement Patterns
Bend and Lift: This is one of the most common movements, often seen in the form of squatting. Before adding external load, proper technique is paramount. Improper execution while loading the body in a squat can ultimately lead to injury.
Consider these aspects when teaching squat technique to clients:
Ankle Mobility - Evaluate your client for proper ankle mobility. Incorporate flexibility exercises if he or she exhibits less than 15 degrees of mobility at the ankle. (Even though your client may be ready to engage in the movement phase, incorporating stability and mobility exercises to address lack of ankle mobility is beneficial.)
Hip Mobility - Your client should be able to properly initiate hinging at the hip when executing the squat movement (i.e., shifting the pelvis posteriorly). Proper hip flexion reduces stress on the knee joint.
Lumbar Stability - Proper lumbar stability and thoracic mobility is paramount in squat movements, specifically when external load is added. Poor lumbar stability and thoracic mobility leads to excessive lumbar lordosis.
Single-leg: Most individuals perform single-leg movements with some degree of compensation. Before adding dynamic movement to single-leg movement patterns, your client should demonstrate the ability to stand properly on one leg (This can be assessed via the hurdle movement screen in chapter 7).
Prior to adding dynamic movement to single-leg patterns to your clients program:
-Ensure that the client exhibits adequate stability in the stance-leg, hip and torso while showing proper mobility in the stepping leg.
-Strengthen weak muscles functioning in movement through isolation exercise (e.g., side lying raise for weak abductors).
-Clients should demonstrate proper static balance.
Pushing and Pulling: In pushing and pulling movements, the scapulae should essentially remain stable, thereby contributing to the proper mobility of the glenohumeral joint. Proper scapulae stability, thoracic mobility and glenohumeral mobility allow for proper function of the muscles surrounding these joints when performing pushing and pulling movements. Lack of stability and mobility reduces the force-generating capacity of these muscles, thereby compromising muscle function. (To reiterate, if your client shows readiness for movement training, but requires some attention in these areas of stability and mobility, incorporate the necessary exercises, into their program, that address these issues.)
Rotational: Rotational movements are three-dimensional in that movement occurs in multiple planes simultaneously. This movement pattern incorporates spiral and diagonal movements. As trainers, it is critical to take care and practice caution when teaching rotational movements, as there is a greater degree of force on the vertebrae. Avoid progressing too quickly. Clients should demonstrate proper lumbar stability before you introduce these movements into their program.
It is vital that clients are successful in exhibiting proper technique in using bodyweight movements in Phase 2 before you decide to add external load. Application of Load and Performance Training will be discussed in the upcoming blogs on Phases 3 and 4 of the ACE IFT model.