Get up and move people!

By: Melanie Brewer, PT, DPT, OCS

Human movement is incredible. What seems simple is really quite remarkable. Whether the movement is simple or complex, there is a significant amount of communication and synchronization required to perform it. There is such a diversity of movement across people and I love to watch the different patterns in how people move…yes I'm weird like that. I'm a mobility nerd. Have you ever been surprised by how well some "big" people move and appear light on their feet? Movement has very little to do with athleticism. Some "fit" people cannot move well while some "unfit" folks move really well. Look at a crowd of people…some move with grace and fluidity, some are slow, mechanical, and deliberate and just appear "stiff" while others look "loosey-goosey", and some just look like they just plain hurt to move.

Mobility and stability are both required for good movement patterns. Poor movement patterns lead to compensation which lead to injury and then fear of movement. It's a vicious cycle. Mobility is not the same as flexibility. Mobility is the freedom to move without pain and dysfunction. Flexibility refers more to a length/tension relationship of the soft tissue in our bodies. Mobility and stability have to occur together for us to move with freedom. Stability is our ability to control our movement—it's where the brain and nerves come in. Our bodies are made up all kinds of tissues: skin, muscles, tendons, ligaments, bones, and nerves. Freedom of movement requires a balance of tension and compression between those tissues, our ability to be aware of our body positions and postures, maintain those postures against gravity, and breathing patterns.

Good quality functional movement patterns enhance our strength, power, endurance, and speed. Poor quality movement patterns have the opposite effect eventually. Can you get stronger without moving well? Yes, but you gain strength in that poor movement pattern. Keep loading up weight while moving poorly and eventually your body adapts and holds onto that poor pattern. Your brain and body adapt to the excessive loads in a dysfunctional pattern and you create imbalances and compensation patterns thus increasing your risk for injury. It's quality over quantity…improve the quality and the quantity has no bounds.

So move better! Seems easy, right? No, not always. Watch a toddler squat…it's perfect! When my three year old squats, he drops low into a perfect ass to grass squat with his knees tracking appropriately over his feet, spine is neutral, chest is up…We all did this perfect squat at one time in our lives! Watch an adult squat who has been scared to move for a prolonged period…OUCH!!! No wonder they hurt…that adult has somehow patterned their brain and body to avoid movement at their hips and thus created a poor awareness of how to correct this pattern. But if they start to move better, guess what? Pain is better and quality of life improves.

Basic mobility and stability training involve dynamic and functional movements such as rolling (yes actual rolling from your belly to back and vice versa…try it…not always so easy), crawling, bridging, half and tall kneeling, hip hinging, squatting, and lunging. The hips, low back, and upper back areas are prone to stiffness if you sit a lot and do computer work. Specific stretches to these areas coupled with diaphragmatic breathing and dynamic functional activities yield better movement patterns and less pain. So get up and move people, you'll feel better.

Melanie Brewer is a Doctor of Physical Therapy at KORT - Kentucky Orthopedic Rehab Team.