The term functional arises often in clinic—when we talk about functional rehab, functional movement, and functional screening, we’re describing function as your capacity to move. Simple movement patterns such as transitioning from sitting to standing, flexing through the hips, extending, and rotating, are all related to function. Any limitations in these movements can potentially contribute to injury later down the road.
The model that we’ve developed here at Tulsa Spine and Rehab is to train movement and not muscle. Many years ago, people would work out with a trainer at the gym to get bigger muscles. The goal was to increase the size of biceps, pecs, etc., but we now understand that this essentially sets people up for injury. Instead, we should be figuring out where the person has limitations in their mobility. That way, we can focus on training movement.
We first assess the patient’s motion by asking them to bend over and touch the toes. From there, we would then move on to breakout progressions. This will allow us to determine if the patient has a limitation that falls into one of these three categories:
Motor Limitation – There may be a deficiency in the person’s motor pattern, meaning the way that their brain perceives movement. Most people would assume that a tight back or hamstrings are causing inability to touch the toes. In fact, it could be a function that the brain does not know how to perform properly. If the patent has lost the motor pattern, it can be retaught.
Elastic Limitation – This is a tissue problem, such as tightness in a muscle. If this is contributing to functional limitations, we can make a recommendation for treatment such as clinical massage, active release, mild fascial work, or manual therapy to loosen up the tissue.
Joint Mobility Limitation – In this case, functional limitations are caused by a restricted joint. Some possible recommendations for this issue would be manipulation or some form of mobilization.
Before we begin working on any fitness training or rehab, we want to reestablish and reinforce proper motion. We need to make sure that the patient has completely mastered the motion before we proceed to add any kind of resistance or weight. If the patient was unable to bend and touch the toes, we would get them on the floor to reset the brain and train it to move properly in flexion.
From there, we would get the patient into a kneeling/quadruped position. After that, the patient will be able to practice performing the motion standing up. Finally, we will be able to introduce some form of resistance. The goal is to maximize the patient’s motion in a safe environment while preventing injury from occurring. We will also give a few recommendations on how they can manage the condition on their own.
Remember, if you lack proper functional mobility, you will end up compensating in another part of the body, potentially leading to injury. If you train movement and not muscle, you will be able to make progress in a safe and effective manner.
If you would like to obtain a customized plan for training functional movement, contact us online today or give us a call at (918) 743-3737.
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