Thursday, December 18, 2014

How to correct movement dysfunction

When athletes move poorly, they increase their injury risk and decrease performance. Here are some simple corrective exercises.

How to correct movement dysfunction

iStockphoto

Previously we discussed how muscle imbalance leads to movement dysfunction in athletes. When athletes move poorly, either during games or training, they increase their injury risk and decrease performance. There are various systems to assess and correct movement dysfunction: Postural Restoration Institute, Functional Movement Screen, National Academy of Sports Medicine’s (NASM) Corrective Exercise Program, and Vladimir Janda’s systems to name a few.  Although these systems have differences, they all target imbalances, not pain.

Karel Lewitonce said, “He who treats the site of pain is often lost.” Although some situations do require treating the site of pain… this statement emphasizes the need to address movement dysfunction and not only focus on painful areas when rehabilitating or preventing injuries.

Evaluating movement dysfunction can be very complex; however, here are some simpler assessments and corrective exercises that can be performed. A common evaluative technique in movement dysfunctionis squatting because it is extremely functional. Ideally, with hands folded to the chest an athlete should be able to squat so they are almost to the floor while keeping their heels on the ground (similar to the way a toddler squats.) Many athletes are unable to squat correctly due to muscle imbalances.

To assess the quality of a squat, stand with your feet at shoulder level, arms straight in the air. Squat as low as you feel comfortable keeping your heels on the ground and arms straight up. Have someone take a picture of your squat from the side. Your trunk and lower leg should be parallel to each other. If your trunk leans forward more than your lower leg; you likely have tight hip flexors (front of hip) and weak gluteus maximus (rear end) muscles. Forward trunk lean is a common finding as American’s on average sit for more than 8 hours a day.

Tight hip flexors can be improved through stretching for 30-60 seconds and repeating 3 times. Stretching should be light and pain-free. Breathe deeply, allowing your belly and chest to expand, do not shrug your shoulders while breathing.

Two exercises to increase gluteus maximus strength:

1) Glute squeezes: Lying on your back or standing, start by squeezing both glutes for 5 seconds and repeat 10 times, perform 3 sets of 10.

2) Bridging: Lie on your back, squeeze your glutes and core; raise your hips off the ground until knees, hips, and shoulders are level; hold for 5 seconds and keep glutes tight. While squeezing glutes, make sure you are not tightening your back or hamstrings. If you cannot keep your knees, hips, and shoulders level, you can lower your hipsas long as your glutes continue to fire.

A second common movement dysfunction identified during squatting is an asymmetrical weight shift, usually to the right. This can be viewed with a posterior view of the squat. 

To correct, use a foam roller and stretch your Left IT Band (outside of left thigh from hip to knee) and Right Adductor muscles (inner thigh). The foam roller should be done by finding 1 or 2 sore or tight spots on the muscle, and keeping foam roller pressure on those areas for 30-60 seconds followed by stretching (30-60 seconds, 3 times). Second, activate your left inner thigh and right gluteus medius (outside of right hip) by performing tubing exercises for 2 sets X 15 reps each.

Now check your squat again. Do you feel looser?  Can you get closer to the ground? Is it easier?  If so, you corrected some of your movement dysfunction.

Look for an athletic trainer, physical therapist, or personal trainer who specializes in movement dysfunction to personalize your program as each individual is different. Corrective exercises (and stretching) will likely add about 10 minutes to the beginning of your workouts, but will help you move correctly, improve performance, and stay healthy.

For more information and to see photos of the exercises mentioned, visit
http://www.symetrixsp.com/news.html


Read more Sports Doc for Sports Medicine and Fitness.

Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
About this blog

Whether you are a weekend warrior, an aging baby boomer, a student athlete or just someone who wants to stay active, this blog is for you. Read about our growing list of expert contributors here.

Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Eugene Hong, MD, CAQSM, FAAFP Team Physician for Drexel, Philadelphia Univ., Saint Joe’s, & U.S. National Women’s Lacrosse
Martin J. Kelley, PT, DPT, OCS Advanced Clinician at Penn Therapy and Fitness, Good Shepherd Penn Partners
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Kelly O'Shea Senior Health Producer, Philly.com
Tracey Romero Sports Medicine Editor, Philly.com
David Rubenstein, M.D. Team Orthopedist for 76ers; Main Line Health Lankenau Medical Center
Robert Senior Event coverage, Sports Doc contributor
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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