Movement Mechanics: Get it Right, Then Get it Done

I’ve Swiped Some Really Cool Info for You

My personal training days are behind me and now I mainly work on projects building tools and educational materials for PT's worldwide. These last few months have been a bit special though as I've been working on a project that’s had so many 'OMG' moments for me that I just had to swipe a whole lot of content and make it available to you on ptdirect.com. Don't worry, I asked nicely and to my surprise got free reign!

Now, before we get in to the nuts and bolts, I have a couple of quick questions for you to think about. These relate to the 'penny drop' moments I had when I was working with this information.

 Have you ever:

• Had to modify or avoid any of the 'big bang' exercises like squats, lunges or bench press because your client couldn’t perform the movement without losing their balance or posture?

• Had your client experience pain during certain exercises and movements but couldn’t work out why?

• Wondered why your client just doesn’t seem to improve on certain exercises no matter how much you work on technique?

• Been unsure of what to do when your client has tightness, pain and limited range in certain exercises?

If you’ve answered yes to any of these questions, I totally understand. I experienced all of the above early in my PT career so I know how frustrating it can be, especially when you know that if your client could only perform those ‘big bang’ exercises a little better they’d progress towards their goals soooo much faster!

Well, don’t fret – as I said, in the coming posts I'm going to lift the lid on how to address these challenges showing you how you can:

• Easily analyse movement and prescribe correctly for virtually all of your clients
• Eliminate risk for all of your clients and rapidly improve their results
• Work with clients that other trainers have failed to help
• Become the preferred choice for rehabilitation and performance

So, let’s get underway on the first 'penny drop' topic - Movement Mechanics. Enjoy!

Why is it important to understand movement mechanics?

One of the fundamental principles of exercise is overload. Overload simply means to do a little more than you did last time, for example increasing your squat from 50kg to 55kg. It's overload that provides the stimulus that creates acute responses within the muscles and systems involved. When overload is repeated over time the muscles and systems involved adapt, becoming stronger and more able to cope with the increasing demands.

However, before we can provide overload to a client, it is vital that we understand their movement mechanics (how their body works to complete a movement) through observing them during exercise instruction and from carrying out some basic movement assessments, such as raising their arms above their head. This will allow us to assess when and how to overload clients safely, reducing their risk of injury, allowing safe progression of exercises and increasing the client’s self-confidence.

In this article we'll take a closer look at movement mechanics and assessment, and explain some of the key principles that you can use when instructing and working with clients. This knowledge will help you check your clients’ ability to perform certain movements and exercises so you can provide an overload stimulus safely.

What are primary movement patterns?

The brain is very efficient. One of its aims is to record and recall patterns that make life easier allowing it more capacity to deal with life’s little anomalies.

An example is that your brain learns how to walk and continually refines that pattern in your first few years of life, thereby allowing you to concentrate on everything else you are seeing while you’re walking along as a three year old.

Your brain, through your young life, records and refines several primary movement patterns that it will need again and again. These patterns, once ingrained, allow your brain to quickly put them in to action and modify them slightly as the environment dictates.

Again using walking as an example, your brain is recalling the basic pattern known as ‘gait’ and could modify this to uphill or downhill, or over uneven surfaces, or in a crowd with shorter steps than usual. The primary pattern being used is gait, with adjustments coming from other brain centres based on what is happening in the environment.

The primary patterns of human movement are;

1. Gait (walking, running, sprinting)
2. Lunging
3. Squatting
4. Twisting
5. Pressing (above the head)
6. Pulling
7. Pushing (in front of the chest)

How do we learn these patterns and when do we use them?

Because primary movement patterns are used in daily life and in sports, they are often the focus of conditioning in the gym as well. They are compound (use lots of joints and muscles), familiar to us, and necessary throughout life.

Once the brain has formed a pattern it will repeat it over and over in the same way. Changing the pattern once ingrained requires more work than establishing the pattern in the first place (it’s been estimated that it takes about 300 repetitions to bed in a new movement pattern depending on its complexity, and 3000 to change it!)

The implications of this are that spending time getting a pattern right early on saves a mountain of extra work later if you want to change a problematic pattern.

The primary patterns are used in many variations but to the brain the primary pattern is always the same. A tennis serve and a badminton serve are replicas in the brain. What changes is the speed at which they occur, the loading in the movement (due to the weight of the racket for example), and other minor refinements (where the target is and the timing of the start of the movement).

With a primary pattern the relative timing of the body segments stays the same.

In the tennis serve if the action took one second the timing and sequencing of the joint movements would all be proportional to that one second. If in a badminton serve the action took half a second the timing and sequencing of the joint movements would still be in the same proportion as in the tennis serve.

This allows us to ‘slow down’ and perfect a movement if someone is having trouble with it, and as if by magic, when we speed the movement up again the improved movement should prevail. This is one reason that getting it right is more important than getting it done. The purity of the movement greatly increases the forces that can eventually be produced and can significantly reduce the injury risk as well.

The more you speed up or load up an imperfect movement pattern the more the imperfections will show. This is because the errors in the movement pattern, or the hardware (musculoskeletal system), cannot be masked as the time allowed to ‘correct’ the faulty initial pattern has been reduced by asking the person to move quickly.

A video is a great way to capture this. Video usually captures 25 pictures every second. If a person is asked to jump it may take them only 0.5 of a second. But you will have at least 12 pictures of it. Looking at the video of an adolescent female jumping slowly, you may not see much. But ask them to jump quickly or to jump as high as possible (increasing loading) and the dysfunction in the pattern may show through more. You might see knocked knees (medial rotation of the femur) and weight being transferred to the insteps.

This is a sign of hip instability usually caused by the muscles that hold the hip in line not being strong enough yet. This often happens as young girls grow, their hips broaden and femurs lengthen and their musculature and connective tissue strength takes time to catch up. Conditioning the adolescent female into a good squat pattern can help with performance and prevent knee and back injury in the future.

Similarly, if someone is completing front squats as an exercise and you progress the load to quite a high level for them, you may see some of their movement errors begin to show.

What causes movement error?

There are several possible causes, and many more we won’t talk about here – but primarily there can be;

1. Errors in the pattern being sent down from the brain
2. Proprioception (feedback from nerves in the periphery, around the muscles, tendons, ligaments and joints, to the spine) and responses not being well ‘automated’ for this pattern
3. Problems with the hardware (musculoskeletal system) causing a good pattern to be skewed when it is delivered to the muscles
4. Fatigue of the muscles from either a lack of ATP (energy system fatigue) or lack of neural input (neuromuscular fatigue) which can be caused by less neurotransmitter being available, or inhibition due to the GTO (golgi-tendon organ) response.

Let’s take a look at each of these sources of error in a little more detail.

How can an initial movement pattern in the brain be wrong?

Fundamentally initial movement pattern errors are either from;

1. A lack of refinement - it could be that the person is still learning the movement
2. The incorrect refinement taking place - it can be that the movement they have learnt is incorrect.

In the first situation, it’s possible the correct pattern hasn’t been practiced often enough to be ingrained. This means lots of slow and careful execution of the movement, lots of repetitions and concentrating on technique to bed the right pattern in.

In the second situation a movement may have been refined when either the brain has had:

1. To work around a musculoskeletal problem (pain, stiffness) or ;
2. Has had the wrong movement aim given to it or;
3. Has achieved a movement aim without the movement being of quality

In the first case, where pain is present for instance, the brain will work the body into a position where it can complete the task, but it may be the wrong position to be in over the longer term. The danger here is that the body learns the new position and locks it in to the pattern.

An example is someone with low back pain. In order to walk they will sometimes shift their spine away from the pain (a lateral shift) which makes them look like they are walking in a western movie, slinging one leg around the other with their belt line all tilted. If they do this for a while, even after the back pain is gone, they may still retain some of this new posture when they are walking.

In the second case, where the movement result meets the stated aim for the brain, the brain may have been given the wrong aim. You can see this with resistance exercises.

If you tell a person to get their legs parallel to the ground in a squat, they will. They may not have the strength to do it correctly, with the trunk upright and neck in a neutral position, but they could do it by flexing forward at the waist. Because you’ve given them one aim, get your thighs parallel to the floor, their good old brain has set that as the movement aim and has achieved it. Problem is you have created a very unsafe squat pattern and in just ten gym sessions (with say 30 squats in a session) this pattern will be influencing their primary squat pattern, particularly when they see a bar and weight plates in front of them.

In the third case, where a good result is achieved but the movement quality is poor, the brain is fooled by the outcome.

Think of the weird golf swings you might see that actually result in quite a good shot. Or, the person who shoots a basketball with their elbow out to the side. The outcome may be favourable (i.e. the shot goes in) but how reliable or desirable is the pattern in the long term. What happens when the person has to shoot the basketball on the move, will they be able to control the ball well with the elbow out?

The upshot of all this is that people should only train independently when they are:

1. Pain free
2. Properly warmed up (full range, nervous system primed, movements as part of warm up etc)
3. Correctly patterned
4. With movement limitations prescribed for (that is, any ‘aims’ given for the movement are considerate of the limitations you’ve established through your movement appraisal)

This final point is not to be overlooked. Some people will be able to maintain a healthy primary pattern only within certain ranges due to musculoskeletal limitations (connective tissue tightness for instance). Usually a brain will pick up within a few days what is being asked of it, but it will take time to achieve the correct movement if it is faced with hardware (joints, connective tissue and muscles) that really isn’t in good condition.

So, when you prescribe exercises keep in mind the need to limit ranges and allow the tissues time to lengthen and strengthen to cope. Get the person correctly patterned and instead of setting ‘more weight’ as a goal you may instead ask for ‘more range’. Again, as a trainer you are thinking long term value as well as short term gains.