Attempting to educate pain-free clients and athletes about the fact that they are currently compensating with their movement patterns can be a tough deal. Easier concepts to sell include Icy-Hot Hemorrhoid Creme, Mint Flavored Super Glue for Kids, burlap boxer shorts and the 63 minute clock. When people aren’t incapacitated by pain, they tend to think that corrective exercise is as useless as those previously referenced fictitious products. Most consumers just don’t see the value in occasionally having their movement patterns assessed by a professional. Until their lifestyle is negatively impacted by pain, corrective exercise makes no sense to most. Even when a person is dealing with a painful movement, it’s been my experience that corrective exercise rarely becomes a consideration until a person unsuccessfully tries at least 4-5 other approaches to deal with pain first.
Actually, I don’t think the major obstacle is that the masses don’t understand the role that corrective exercise can play in restoring and maximizing an active lifestyle. I believe the problem is that most professionals within the rehab and fitness industry haven’t been introduced to a logical system to corrective exercise that consistently delivers excellent results. Additionally, many industry professionals lack general knowledge in regards to the kinetic chain and specific knowledge regarding ideal human movement.
If the majority of industry professionals are cloudy in their understanding of the kinetic chain and ideal human movement, it leads to a lack of understanding regarding why corrective exercise is needed. If fitness pro’s don’t see the need and value in corrective exercise, how will our clients ever be properly educated about the necessity and the merits of correctives? They won’t is the answer. The masses are ignorant because most of us are ignorant. This article is an attempt to shed some light on the kinetic chain and ideal human movement.
Understanding human movement requires one to have some comprehension of the concept of the kinetic chain. The structural components of the kinetic chain are 3 distinct and separate systems of the body. These 3 structural component systems are the nervous, muscular and articular systems. The articular and muscular systems are both passive structural systems in that they cannot function independently but must receive input in order to function. The nervous system is the active structural system that drives it all.
Structural integrity is the foundation of all movement. If there is a structural integrity issue with one of these systems, not only is efficient movement directly derailed at its origin, it would probably necessitate a trip to a physician. The role of assessing and addressing dysfunction at this foundational level is fulfilled by medical professionals.
The two relationships between the three component systems are the neuromuscular and the musculoskeletal sub-systems. These relationships are the functional connections between the structural components.
The quality of these interactions dictates the quality of a person’s posture and movements. If high quality posture and movement patterns is what is desired, all three systems need to be working in harmony with each other.
The brain says “go” to the muscles and then the muscles “go”. This is the neuromuscular sub-system.
The muscles say “go” to the bones and then the bones “go”. This is the musculoskeletal sub-system.
The “going” of the bones is movement.
The role of assessing and addressing neuromuscular and musculoskeletal dyfunction should fall upon many different professionals. This is exactly where corrective exercise resides and it can be implemented by medical, rehab, fitness and performance professionals.
Prioritization of the components of movement
Structural integrity and neuromuscular function are the building blocks of all movement. Physicians and surgeons are educated and experienced at handling structural deficiencies. Functional integrity is the most foundational level that rehab, fitness and performance professionals can impact movement and it is exactly where these professionals should be focused during the initial assessment and correction phase when working with patients, clients and athletes. Neuromuscular integrity needs to be prioritized above all other potentially complimentary aspects of therapy and training (electric stimulation, foam-rolling, massage, exercise, sport, etc.).
Without structural integrity, functional integrity can not be optimized. Without functional integrity, movement can not be optimized. Without optimal movement, everything else suffers. Outcomes of poor movement quality include lowered athletic ceilings, increased risk of injury, every activity becomes more difficult, longer recovery from training is needed, longer recovery from injury is required.
1 Structural Integrity (medical professionals)
2 Functional Integrity (rehab, fitness, performance professionals)
3 General Strength and Conditioning
4 Sport-specific Training
The “printed document” analogy
If we were to use an analogy of printing a document to explain the kinetic chain as it relates to movement, the nervous system would be the computer, the muscular system would be the printer and the articular system would be the paper. The computer (nervous) directs the printer (muscular) to print. The printer (muscular) prints onto the paper (articular). The end result is a cleanly printed document (movement).
For those of us that consider ourselves to be corrective exercise professionals or aspire to be so, our role is to identify and correct abnormalities with the neuromuscular, and therefore also the musculoskeletal subsystem. Neuromuscular abnormalities force the body to utilize adapted patterns of movement. These adaptations or compensations are clearly deviations from normal and natural movement patterns. So who cares?
According to “Applied Biomechanics: Concepts and Connections” by John McLester and Peter St. Pierre, 2008 p.48, when the body is compensating “(1) the task will probably now require more energy than before because it is no longer being carried out with the use of the most efficient movement pattern (i.e., the pattern that minimizes muscle force requirements); and (2) changes in force-loading patterns on the compensating links can eventually lead to musculoskeletal abnormalities in other areas of the chain. In other words, compensatory motion arising from injury or muscular imbalance not only make activities more difficult but possibly will result in other injuries.”
This is exactly why all rehab, fitness and performance professionals should care! If nearly every one of your clients and patients and athletes are compensating with their movements (and they are), not restoring normalcy to their fundamental movement patterns prior to training them will basically make their lives more difficult and more than likely YOU are setting them up for their next injury(s). We need to be the voice of reason and be not so focused on results this week or this month but be thinking ahead for our clients. We must remove compensatory movement via correctly identifying real-time neuromuscular abnormalities so that our clients and patients body’s don’t need to work around their movement flaws. Set your clients up for their current and their future success.
It’s probably not so much that we don’t care or that we don’t believe that nearly every single human being is compensating. I personally believe that many professionals are just content with their clients possessing minimally observable compensatory movement (little to no pain, good performance numbers, etc.). Out of sight, out of mind mentality. The view of “let’s move on and keep progressing” sends the wrong message to their clients. Fundamental movement flaws lead to progressively higher levels of compensation. Just sweeping movement flaws under the rug with an “intelligent warm-up” is a big mistake. Our goal should be to fully restore normalcy to the fundamental movement patterns before we start progressing our clients with traditional exercise.
Fundamental movement patterns
So if we are to ever be successful with reaching a lofty goal such as restoring clean and ideal movement patterns, we now need to get into a discussion of the actual fundamental patterns of movements and the joint by joint breakdown of those patterns. This is necessary information if we are to ever identify and differentiate between normal and abnormal motion.
Human movement, at its’ most basic, is predicated upon the body either collapsing under the force of gravity or propelling to overcome gravity. All movement patterns are rooted in either going with or going against gravity. This going with and against gravity has terms. Pronation is the when all of the joints are eccentrically controlling the body collapsing in relationship to gravity. More simply, it’s deceleration. Conversely, supination is when all of the joints are concentrically overcoming the force of gravity. More simply, supination is acceleration.
When you sensibly apply the concepts of pronation and supination to the four quadrants of the body (upper-right, upper-left, lower-right and lower-left), you will begin to understand RESET’s 4 irreducible fundamental movement patterns. We’ve termed these 4 patterns: Sit, Stand, Right Step and Left Step.
Sit is when all 4 quadrants of the body are pronating. Every joint is either flexing, internally rotating or adducting – or some combination thereof.
Stand is the opposite of Sit. It’s when all 4 quadrants of the body are supinating. Every joint is either extending, externally rotation or abducting – or some conbination thereof.
Right Step is when the lower-right and upper-left quadrants are pronating or collapsing while the lower-left and upper-right quadrants are supinating or propelling.
Left Step is the exact opposite of Right Step. The lower-left and upper-right quadrants pronate while the lower-right and upper-left supinate.
Applying these concepts of pronation and supination in an ipsilateral or a top and bottom fashion don’t resemble any “normal” pattern of movement for the human body so we don’t pay attention to these possibilities at all. The 4 aforementioned patterns are “THE” fundamental patterns of human movement.
Breaking down RESET’s fundamental patterns
The breakdowns of these patterns are extensive yet quite simple. When a segment of the body is pronating, you just need to consider all three planes of motion as it goes into collapse mode. Basically, flexion (sagittal), internal rotation (transverse) and adduction (frontal) are the motions that are associated with pronation. When a joint is supinating, all three planes of motion need to be considered for propulsion. Extension (sagittal), external rotation (transverse) and abduction (frontal) are the joint motions that belong with supination.
Let’s do an ultra-quick breakdown of the Left Step pattern. This breakdown is not comprehensive (RESET has identified 96 specific motions that comprise Left Step) but it should give the reader a sense of how movement patterns can be broken down into component pieces.
Left Step (lower-left and upper-right pronation & lower-right and upper-left supination): left toes #1-#5 distal flexion, right toes #1-5 distal extension, collapsed left arch, increased right arch, left knee flexion, right knee extension, left hip flexion, left hip adduction, right hip extension, right hip abduction, right humeral flexion, left humeral extension, right elbow flexion and left elbow extension.
Compensation versus restoration patterns
If restoring normal movement or utilizing truly corrective exercise with your clients is the goal, it is vitally important to be able to differentiate between what constitutes compensatory and restorative patterns of movement. A thorough understanding of and a series of foolproof steps to properly identify these two oppositional patterns is taught to the students that enroll in the RESET Education Program (REP). But for the purpose of this article, we will give you a brief explanation of the two patterns. A compensatory pattern is one in which every single joint motion within a particular pattern encourages neuromuscular inefficiency.
A restoration pattern is one that is the polar opposite to the compensation pattern (Sit vs Stand for example) and one in which nearly every single joint motion within a particular pattern encourages neuromuscular efficiency. There has to be at least one joint motion abnormality within a pattern in order for it to be a restorative pattern.
If every single joint motion within a particular pattern actually encouraged efficiency, there would be no reason for the body to compensate with an oppositional pattern and this would constitute a “balanced patterns” scenario. A pattern with no motion abnormalities has a mirror image pattern that also has no abnormalities. Hence, a “balanced patterns” situation would exist.
Leaks in the system
The body deviates from “normal” and “balanced” patterns of movement due to specific joint motion abnormalities that arise. These joint motion abnormalities exist because of aberrant neuromuscular connections. These aberrant connections tend to arise when the body is placed under excessive stress (joints being stretched past AROM, the body lifting excessive loads, sleep deprivation, nutritional deficiencies, exposure to toxins, dehyration, negative emotions, etc.). The body ends up essentially “shying” away from utilizing these abnormal motions and so the body begins using adapted movement or compensatory movement to accomplish tasks.
You could probably surmise that once a body possesses at least one joint motion abnormality, it tends to lead to a general unraveling of a once fully functional movement machine. Instead of having pure, uncompensated, clean, naturally efficient fundamental movement patterns in which to build more and more complex and athletic movements, the body must work harder to accomplish all tasks and there is an increased risk of injury. As it works harder, weakest links in the chain become the next joint motion abnormality for which the body must now adapt. Compensatory layers are now being layed upon other compensatory layers.
Others have used the term energy leaks as a descriptive term for joint motion abnormalities and I believe it’s very fitting. In my mind, I tend to think of a balloon with a super small hole that very slowly leaks air. Over time, the balloon loses all of it’s air and becomes deflated and limp instead of “balloony”. It’s balloony-ness has been compromised because of the leak. It’s basically what happens to the body when it has at least one joint motion abnormality.
To illustrate how energy leaks promote increasingly dysfunctional movement, let’s use an example of a person stubbing their right big toe. After the big toe has basically been compressed like an accordian (flexion), for at least a few hours or possibly even days, the last thing that it wants to do is visit a position of flexion. The toe begins favoring extension as to not further irritate the injured toe. A rewiring, if you will, is beginning to occur. As the body preferentially begins choosing extension (as it attempts to avoid flexion), the other joints in the lower right quadrant must follow suit and they too begin to favor extension. Well as the person tries to walk, the entire body continues to rewire the way it moves to adapt to that compressed toe that now favors extension over flexion. The left shoulder begins preferring extension while the right shoulder begins to prefer flexion. This person is favoring or compensating with a Left Step pattern and is generally trying to avoid the Right Step pattern. Every joint of the body is now less prepared for athletic movement and is set up to begin developing overuse syndromes. Tendonitis anyone? Can you see how, for this situation, it’s very possible to begin developing a case of right bicep tendonitis? Remember that the body is now preferring (and overusing) right shoulder flexion. Besides concentrically flexing the elbow, the bicep also functions as a shoulder flexor.
I am in no means trying to say that all cases of tendonitis in the shoulder can be traced back to a stubbed toe. But I am saying that all joint motion is related and that there are fundamental patterns of movement that we all share. I am also saying that the body automatically will rewire itself, short-term and beyond, to get tasks accomplished and it does so typically without our conscious knowledge.
All rehab and fitness professionals should equip themselves with a system that logically and accurately breaks the body down into compensatory/restorative patterns and can break down patterns of movement into their specific joint motions and then be able to correctly identify true motion abnormalities. Obviously, if your approach to corrective exercise doesn’t accurately differentiate between compensatory and restorative patterns of movement, it’s not truly corrective exercise. If your approach isn’t specifically seeking to identify and then accurately identifying abnormalities within the restorative pattern, it not truly corrective exercise but a series of guesses. These failings of other “systems” is exactly why the RESET system needed to be developed.
Basically, all of us are compensating and just throwing ice on the hot spots or breaking out the ACE bandage usually doesn’t get the job done. Periodically, our fundamental movement patterns need to be broken down and inspected for abnormalities and then corrected so that we can be in the best position for future movement success. This is what the cutting-edge RESET Education Program teaches our students.