Movement is essential to being human. Being a fully functioning healthy human requires the ability to move properly in a few fundamental ways. Being able to maintain a neutral spine in a multitude of positions is an important ability. So, is being able to squat, balance in a single leg stance, maintaining hip and shoulder mobility, to name a few others.
Exercise is often used to improve “fitness”. Some exercise is targeted at improving cardiorespiratory fitness while other exercise is targeted to improve muscular strength. Exercise is great medicine but like any medicine it can be dangerous for those that do not have full movement competency. Individuals should be assessed for movement competency, have a corrective program to improve this competency as well as have a personalized strength program built with their competencies in mind (1). It is important to realize, that like any medicine, exercise must be safely prescribed and asking someone to load or resist weight in a movement pattern that is not functional is a great way to embed that dysfunction or worse, cause injury.
We often lose proper movement competency as we age due to things like overuse, under use, chronic conditions and past injuries. These things force us to develop compensatory, or alternate, movement patterns. We move to move but we may not move “well.” Think of a limp. Imagine that you hurt your foot, knee or leg. Worse, imagine chronic pain altering your gait. For weeks, if not months, you need to limp as it heals. You still need to get around and your body is learning how to limp very well. In fact, you may notice exactly that, the first few days you moved slowly and each day you get better at limping and therefore you become better at moving around with your injury. As the injury heals your movement competency will, more than likely, need to be retrained. Not retraining proper movement is often the root cause of reoccurring injuries. The pain of injury may be alleviated but if we do not bring back full and proper function there is an increased risk of re-injury. While the body wants to move in the way it was designed, after injury or when dealing with chronic issues it often needs a reminder of what that is or else a slight hint of the dysfunctional pattern will remain.
Things like not moving enough, or doing a certain movement all too often, like riding a bicycle for thousands of miles a year, or running a few thousand miles a year can also create the same situation. As our body does certain things too often and other things not enough we can develop imbalances and compensations due to these imbalances. Compensations to proper movement can be created by any of these conditions.
Exercise and fitness are important to health and proper movement capacity is important to making exercise safe and more effective. High quality movement equates to high quality of life.
Most individuals, if not all, can benefit from a movement assessment. Older patients that have decades of injuries, over-use, under-use, poor cardiorespiratory fitness and are dealing with chronic conditions need professional help almost always when initiating an exercise program. While exercise can be highly beneficial there is risk when these individuals are exercising. They need professional assistance creating programs and benefit from monitoring especially during the adoption of new programs. Failure to recognize these realities increases the odds of injury and other adverse effects, especially in this elderly population and in those without excellent movement competency.
Physicians should refer patients for lifestyle counseling to professionals that use an on-going, structured approach and that will monitor these patients, especially in the early phase of adopting a new way of living.
1- Cook, et.al., National Journal of Sports Physical Therapy – May 2006 – Pre-participation Screening: The use of Fundamental Movements as an Assessment of Function – Part 1 & Part 2
Summary: The research related to movement-based assessments is extremely limited, mainly because only a few movement-based quantitative assessment tests are being utilized. According to Battie et al, the ultimate test of any pre-employment or pre-placement screening technique is its effectiveness in identifying individuals at the highest risk of injury. If the FMS, or any similarly developed test, can identify at risk individuals, then prevention strategies can be instituted based on their scores. A proactive, functioning training approach that decreases injury through improved performance efficiency will enhance overall wellness and productivity in many active populations.