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Movement dysfunction, corrective exercise, and holistic health

In this article I’d like to cover the premise of movement dysfunctionality, how movement dysfunctionality negatively impacts the entire body’s operation, and why corrective exercise must be employed appropriately in the resolution of any movement dysfunctionality, irrespective of the client’s transient health, fitness, performance, or aesthetic goals.

To begin, in using the term “corrective exercise,” I am referring to the aggregate system employed to correct and resolve virtually any imbalance, obstruction, muddling, inappropriateness, failure, or dysfunction within the client’s collective complex relating to movement of the body (including the sensorimotor system, fascial and extracellular matrices, and the body’s gamut of electromagnetic fields).  Far too often, almost any idea even relating to corrective exercise is dismissed or scoffed at by personal trainers, physical therapists, and strength and conditioning coaches due to the abhorrent understanding they possess concerning not only the functionality of the human body, but corrective exercise’s true nature, purpose, and application.  Perhaps the most common scapegoat used is the failure to understand why true corrective exercise (I prefer the term “corrective programming,” you’ll see why by the end of this article) is absolutely essential for most individuals regardless of the goals or desires that they present to the exercise professional.

The primary reason why true corrective exercise (or corrective programming) is essential for most individuals is due to the immutable fact that true, authentic fitness, health, or athletic performance cannot be built upon a foundation of ill-health or dysfunction.  For those who work with athletes looking to optimize performance, surely optimal performance cannot be achieved when the individual’s foundation is unsound or imbalanced.  This immutable fact centers on the axiom that the human body, while existing as a system of systems, operates as a single unit.  Therefore, any imbalance, obstruction, dysfunction, or aberration from dynamic equilibrium present within the body precludes the expression of true, authentic (or optimal) fitness, health, or athletic performance.

Now, please don’t misunderstand what I have just stated.  I did not say that it is impossible for one to improve their vertical leap, 40-yard dash time, max bench press, or transient body composition without correcting their inability to perform a halfway decent, unloaded deep squat.  What I essentially stated was that the failure to correct any underlying movement dysfunction (or condition of ill-health or physiological imbalance/aberration from innate equilibrium) while forcing a fitness, performance, or aesthetic “improvement” can reinforce or augment the individual’s underlying dysfunction or imbalance, worsen their state of holistic health, and/or create new dysfunctions/imbalances through pushing the body further out of a state of equilibrium and natural health expression.  This is chiefly why it is very idiotic for an exercise professional to state “I don’t believe in or ascribe to the whole corrective exercise thing, my client’s goal is to lose fat so I’m just going to work on that with them.”  Such a goal cannot be authentically and appropriately achieved when significant underlying dysfunction or imbalance is present within the client.  To provide an illustration, this is hardly much different (even though it may seem much different) than attempting to prepare a client for a triathlon when they are fighting through a stage 4 cancerous condition.  In this case, the underlying gauntlet of stage 4 cancer and all of the complications associated with such a condition, preclude the building of a high enough degree of performance capacity to compete in a triathlon.

The same schema should (but rarely does) prevent exercise professionals from assisting their clients in the achievement of whatever goals they may have for themselves while ignoring underlying movement (and therefore health) or other physiological imbalances or dysfunctions as doing so easily paves the way for a worsening of the client’s short-term and long-term health.  Exercise professionals have a legal responsibility to ensure that their prescriptions remain in line with the best interests of the client for which their prescriptions are made, and no exercise professional should obtain immunity from this responsibility simply from ignorance, fallacious understandings, or prideful arrogance.

Moving on, proper use and movement of the body should be innate (after infantile motor development) and should be expressed by default unless a disruption to the human movement system has been instilled (which will obviously be the case with most individuals).  Such disruption may stem from, be perpetuated by, or be exacerbated by the influence of any factor capable of altering muscle recruitment patterns, motor control, length-tension relationships, force-couple relationships, arthrokinematics/osteokinematics, neural input/output, nutrient delivery/waste removal, connective tissue architecture, electromagnetic field resonance/communication, etc. including, but not limited to: incurred injuries, muscle atrophy, tissue adhesions, toxin accumulation, unresolved inflammatory pockets, emotional harboring, psychological dissonance, nutrient deficiency, poor motor programming, postural compensations, inadequate kinesthesia, hormonal imbalance, microbial infection/overgrowth, obstruction to meridian flows, imbalances in chakra activity, etc.

Accordingly, if any disruption to or dysfunction within the client’s movement system exists, failing to resolve such disruption/dysfunction not only greatly predisposes them to the suffering of a mechanical injury, but also promotes the development of new or greater dysfunction and/or the exacerbation of underlying ill-health conditions or imbalances (if present).  In other words, you cannot truly build function atop dysfunction.  Any basic or foundational movement impairment or inappropriateness will translate (at least to some extent) to any strength, endurance, performance, body composition, or aesthetic improvement achieved with a client.  Outside of the human body, this conceptualization is extremely obvious – if you were to build a house atop an unsound foundation, the entire house would remain unsound, regardless of what you build the house out of or what you added to the house.  To provide a common example in physical therapy programming, how often do physical therapists or personal trainers prescribe the performance of a handful of humeral internal rotation/external rotation exercises after a rotator cuff injury without gaining any understanding as to what lead to the injury in the first place?  Was it truly due to an isolated muscular weakness, or was the rotator cuff forced to experience inappropriate stress due to imbalance or dysfunction elsewhere in the body?

This is why exercise professionals must transcend the mechanistic, “anatomy 101” understanding of the body.  With the body operating as a tensegrity complex, the rigidity provided by the skeletal system, the tension provided by the myofascial system, the compression provided by intra and extracellular water, and the downward pulling of gravity’s influence must work in harmony in order for fluid movement of the body to take place.  When this harmony is disturbed (from such instigators as tissue adhesions, poor motor programming, poor postural carriage, toxin accumulation, injuries, dehydration, or any of the others I listed earlier), not only can the movement system break down, but so can other systems or components of the body – fostering the development of disease or ill-health conditions, in addition to increasing injury susceptibility.  To reiterate and to be more specific, essentially anything that may alter length-tension relationships, arthrokinematics, nutrient delivery/waste removal, neural input/output, tissue architecture, or motor pattern deposition (or recall), may not only disrupt muscle recruitment patterns, athletic performance, body composition, strength expression, aesthetic appearance, or other goal-associated attributes/markers, but may also disrupt neural, chemical, or electromagnetic communication; hormonal balance and function; cell membrane permeability; detoxification capacity; nutrient utilization; microbiome constitution/functionality; genetic expression and epigenetic influencing; psychological/emotional discord; and just about any other variable relating to health of the body.

While my making of the following point doesn’t stand as the main purpose behind this article, what I have just presented should at least give you an inkling as to why a holistic understanding of and approach to the human body is critical, regardless of the individual’s health, fitness, or performance goal(s).  Getting back on track, anyone qualified to prescribe exercise should (but commonly does not) understand that the elements of the nervous system involved in bodily movement organize recruitment patterns from the map of motor programming that has been instilled into one’s nervous system over a lifetime of motor learning or development.  Additionally, the collective motor system initiates movement signaling from the body’s center of gravity outward.  By this I basically mean that the body’s center of gravity (located near the navel) will normally be stabilized first before other synergist, agonist, and antagonist actions will be invoked.  While vastly simplified, you can view this fashion of inner-outer recruitment as stemming from the body’s center of gravity being located at the center of the body’s tensegrity complex (if it helps, visualize Buckminster Fuller’s cuboctahedron).

Such recruitment patterning provides one of the bases for why any postural, kinesthetic, or neuromotor dysfunction present somewhere within the body or within the nervous system’s “movement map” can translate throughout the body during the performance of static postural or dynamic movement actions.  It’s critical to understand that these kind of dysfunctions can quite easily be masked by various fitness or performance measures.  Remember that proper and authentic movement functionality cannot be valued with a single variable (such as a bogus sit-and-reach score), proper and authentic movement functionality encompasses a myriad of utilities such as normal sensory awareness, adequate kinesthesia, adequate stabilization ability and timing, ability to maintain postural alignment, neuromuscular efficiency, connective tissue freedom, and innervation efficiency.  Furthermore, many different factors can impair the operation or normalcy of any of these utilities.  For instance, psychological stress alone could impair kinesthetic awareness, connective tissue freedom, neuromuscular efficiency, etc.  Again, a holistic understanding of the human body is a requisite for the exercise professional.  Imagine an underlying H. pylori infection or aluminum toxicity is responsible for translated inflammation and breakdown within a client’s supraspinatus muscle (to use the rotator cuff example from earlier).  Do you think some humeral TheraBand™ work is going to truly correct this individual’s etiology?  Obviously it would not.

Lastly, to reiterate again, not only do underlying movement impairments or dysfunctions obstruct immediate performance or health expression, but they also obstruct the body’s proper response and adaptation to exercise imposed upon the body in the future.  This precept is alluded in the following quote of Gray Cook’s: “Exercises that produce poor movement-pattern responses reinforce poor movement-pattern adaptations” [1].  Therefore, ignoring movement dysfunction and instead focusing solely on performance or aesthetic goals short-circuits the appropriate and authentic achieving of such goals.  Also, because each movement pattern performed by an individual is unique to their performance of it, be careful with the interpretation of tests, screens, or assessments which simply look for the exhibition of certain “symptoms” in declaring whether or not there is movement dysfunction present in the subject.

The blossoming of detrimental (and even pathological) viscero-somatic reflex, spinal facilitation, and “neurogenic switching” (see the work of William J. Meggs) pathways from movement impairments or dysfunctions ignored by exercise professionals can easily promote the development of significant ill-health conditions, in addition to simply impeding the achievement of health, fitness, or performance goals.  Therefore, simply because a physical therapist knows nothing of bodily detoxification, a personal trainer knows nothing of fungal infections, or a strength and conditioning coach knows nothing of the influence the major spinal chakras command over the primary endocrine glands, does not mean that ignorance validates the false belief that true corrective exercise is unnecessary or is a “waste of time” due to the exercise professional assuming or perceiving that any identified movement dysfunction is “asymptomatic.”  There is no such thing as asymptomatic movement dysfunction, so if you’re considering working with an exercise professional, make sure they know what they’re doing before you hand your money over my friends.

I wish you success in achieving all of your health and fitness goals, have a good one.

Author bio:

Denton Coleman is an Exercise Physiologist and is the founder of Satori Institute, an online holistic health, wellness, and fitness academy.  You may visit the Institute at www.satoriinstitute.info or connect with the Institute on Facebook, Twitter, Pinterest, YouTube, or Google+.

Reference:

1.  Cook, G. (2010). Movement: Functional movement systems: Screening, assessment, and corrective strategies (p.225). Aptos, CA: On Target Publications.

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