Movement Pattern

[emad]

:idea: :idea: :idea:

what is movement pattern :?:

Some of links :
http://members.aol.com/PTdoctor/PAGE-Newsletter-Mx-Patterns-single-limb-stance.html
http://members.aol.com/PTdoctor/PAGE-Newsletter-Mx-Patterns-FBinStanding.html
http://members.aol.com/PTdoctor/PAGE-Newsletter-Mx-Patterns-Quad-3.html


:idea: :idea: :idea: :!:
cheers
emad

[BB]

Hi Emad,
You should look at "Diagnosis and Treatment of movement impairment syndromes" by shirley sahrmann.
Excellent descriptions of movement patterns.


Cory

[emad]

Hi corry :

yes; you are right .

It is very interesting issue , but sorry knowledge ,link ,journls are not concern it .

i am trying to search , i found article , how to improve muscle imbalance , i will try to provide that link.
cheers
emad

[emad]

Bernard :

you wrote
Is it practical to hunt abnormal patterns in abnormal movements?

i do not see thus , i think it is just a way to assess the abnormal pattern , for example ,if you are assessing a pateint sufferring back pain , you will ask the consumer to lean forward then you will assess where is the tightness exactly in lumbar , or upper thoracic and cervical region , you will see where is exactly the consumer used more range and flexing , i think the link is so clear ,i will read it again :idea:

cheers
emad

[bernard]

Emad,

I agree but bending forward has no real goal in a real life?

[Diane]

Tie a shoelace? Pick up a set of dropped keys? Cut toenails? Stretch out the back?
8-)
Diane

[bernard]

Fortunately not! I do not encourage my patients to do so? :?:

[Diane]

Well, there's where you and I would part theraputic company Bernard... :) Do you have servants or something to do these things for you? (Haha..)
I consider forward bending a functional part of life. I certainly want to continue to be able to cut my own toenails until I die! I know many old people lose their ability to do so, and they become less independent in their lives, lose self esteem, over simple little activities like this!

An abnormal and painful movement pattern that could prevent such an activity or at the very least strongly discourage it would be what the DO's call an ERSL at L5, or an anterior sacral torsion of the right superior sulcus over the right oblique axis, very common movement dusfunctions that practically destroy forward bend until some little muscle energy technique rights the "neuromatrix" again, and voila, patient can bend to feet and no pain. (They always appear stunned by this at first.)
Cheers,
Diane

[emad]

Bernard:

you wrote ;

What I wanted to say is that we use such movements in rare occasions and they have to be prepared because inertia can pass largely the physiological limits very rapidly?

yes , we need those rare ocassions , but what i could not opposite you in , yuor conclusion ,that this stretching posture needs preparation to take .

Bernard :
so all parts here are subjected to the same stressor /evoker/stimulus , the part which is abnormal will be so clear , we are just assessing , i know you know that we are assessing ,but why not using that posture to localise the tighten part .
ok we can prepare ,warm up ,then also are you still oppose the using of the test .

What are the criteria we are designed for by the nature ?
how do you know those criteria ?
evidence :?: :?:
:D :D :D
cheers
emad

[nari]

I am with Diane on this topic - we must be able to bend, I think it is a very natural movement that as bipeds we should be able to do.

One of the criticisms I have of the Mckenzie regime is that it teaches (unwittingly, perhaps) people to be afraid of bending. Or maybe physiotherapists install this fear, unintentionally?

Telling someone to touch their toes as many doctors do, is silly. All that is needed is to ask someone to bend forward as far as possible, so their flexibility can be observed. Setting a goal in this instance results in 'failure' and patients know it.
However, if a patient can only reach their knees and have no significant symptoms, I would leave it at that.

Nari

[Diane]

Hi all,
I'm sure the human brain is clever enough to give us whatever movement we each think we need to have, where we think we need it, and not give us more than what we really need....with the possible exception of the EhlerDanlos people or the Marfan people. They have truly impressive ranges of motion! Like rubber people.
Diane

[BB]

Hello,

Are all of your assessment movements functional movements?

Watching functional movements is by far where I get the most information from my evaluation, but using other movements that are not necessarily functional help me to "zero in" on the movement pattern and why it is occuring.

I use the quadruped rock back motion as a way to affirm or negate some of the things I see in functional movement.

For example,
Bernard, if I assessed you by watching you tie your shoes in sitting (let's pretend it caused pain in your back), I would pay attention to your method of accomplishing the task and look for where you move. If I thought that you were moving in your back beyond what it likes, and from the hips less than what your back would prefer....I would have you do the quadruped rock back and see if the same movement pattern occured again--- big time back motion and little hip motion.

Another thing I like about the quadruped postion is that it offers 4 points of contact and can be easier for the person to change the movement pattern and then apply it to the tying of the shoes.

Actually, the progression that I love to use in teaching is quadruped rock first (learn to move more from the hips), then to the chair to lean forward, then sit to stand, and then on to whatever their daily movements are.

After all that, I do agree that using the function is better, but sometimes I need to use other motions to help me alter the functional movement.

Happy Easter weekend to everyone!
Cory

[emad]

Hi :

cory ,nari,bernard and diane.

Happy easter weekend for all .

Cory
you make me remembered ,yesterday i went to the church all people surround me was praying ,leaning forward until more than thouching toes , i was assessing them all , neglecting praying :wink: :wink: :wink:

i find every one has his manner to lean forward , no one like others.most of them substitute to lean , some are stiff in their manner of leaning .

was lovely day for assessing movement pattern of more than 1000 persons.

cheers
emad :lol:

[rolf]

Hi all!
Look at the children do they bend at the waist?NO, they smothly bend their knee.Lots of my patients are complaining about backpaain during washing and hoovering their house!
WHY?Just look at them doing these activiteies!They have forgotten to bend their knee(redused body awareness),and straining their backs.
I motivate them to use their knee,because they need increased muscular strengt in their maixmus and thies to make the housecleaning easier.
Every friday its cleaning time in our home.Its no problem for my back when iam consentrated on bending my knee during this "training session",but if iam not bodily aware,my back ackes afterward!
RIN

[emad]

Hi Rin:

Is not it boring to perform all activities in such manner through bending knees?

i want to say , if accustmed to not use the full length of certain muscle, is not it with long time and daily activities performing in such manner ,will lead to muscle tightness :?:
:o :o
cheers
emad

[nari]

I would like to add:

Not all of us have knees that will happily bend and take the strain off the spinal structures. There are many reasons for incompetent knees.
One of the world's most stressful occupations for knees and spine is that of the farrier. Long sustained posturing, full weight through knees and the spine flexed - all isometric, with vigorous repetitive bilateral arm movements. Shoeing. trimming and otherwise tending the horse's hooves is worse than shearing sheep. Yet the farrier who did my horses worked for many years; went to osteopaths, physios and chiropractors to little effect; the only thing he found that worked really well was a weekly massage. It kept him going as it reduced the pain. He will probably be in trouble as he ages - but he is doing what he loves.

We have to bend, both knees and back, but in particular, the back; as as emad says: flexibility is required to achieve this in the spine, and the hips.

It does help (feels as though the strain is less) to contract transversus abdominis - it makes one feel more stable and actually stronger. I know there is not evidence that this is so; it just seems a safer way to go.

Do we all consciously contract TrAb when we vacuum, shoe horses, carry large bins, make beds?? :?


Nari

[rolf]

Hi emad!
A lot of things in life is boring but it dosent mean that its unfunctional or
might not profit your health.
What tightness are you conserned about?We are talking about the afunctional movment .As i Wrote look at the children.
Bending your knee isgood for.....

1.Less stress on the n.ischiadicus,lumbar joints and lumbar muscules.
2.lubrication,mobilisation of the "ankel "joint,knee,hip ,ISJ and lumbar joints.
3.As earlier written,strenghtening of the glut,med.min,maximus,,quadriceps and the" hip " muscles.
4.increasing lymphatic and venous reflow.

RIN

[rolf]

Hi all!
Here are some interesting scientific news on this topic!

Muscle Nerve.2004 Feb
by Sbriccioli P,Solomonow M
"Static load magnitude is a risk factor in the development of cumulative low back disorders."

Just seach on PUb Med,(fexion,bacpain)

RIN :wink: :wink: :wink:

[bernard]

Hi Rin,

Here is the text =>

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=14755497

Muscle Nerve. 2004 Feb; 29(2):300-8.
Static load magnitude is a risk factor in the development of cumulative low back disorder.

Sbriccoli P, Solomonow M, Zhou BH, Baratta RV, Lu Y, Zhu MP, Burger EL.

Occupational Medicine Research Center, Bioengineering Laboratory, Suite 400, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, New Orleans, Louisiana 70112, USA.

Occupations requiring frequent periods of static lumbar flexion are known epidemiologically to be risk factors for the development of cumulative low back disorder. The impact of the load magnitude sustained during a series of short static lumbar flexions followed by an equally long rest period on the development of a cumulative low back disorder was addressed in an in vivo feline model. Static loads of 20, 40, and 60 N were applied over 10 min of flexion followed by 10-min rest sessions that were repeated six times (for a total of 2 h) while monitoring lumbar viscoelastic creep (laxity) and reflex electromyographic (EMG) activity from the multifidus muscles. Creep and EMG were also monitored over 7 h of rest following the six flexion-rest sessions. It was found that the creep developed in the 10-min flexion periods did not recover completely during the following 10 min of rest, giving rise to a large cumulative creep at the end of the work-rest session. Muscle activity demonstrated spasms during the static flexion periods as well as initial and delayed hyperexcitability during the 7-h rest period. Loads of 20 and 40 N did not result in delayed hyperexcitability, whereas loads of 60 N resulted in delayed hyperexcitability. Statistical analysis demonstrated that increased load significantly intensified the magnitude of the hyperexcitabilities (P < 0.05). Thus, repeated periods of static lumbar flexion were found to result in a transient neuromuscular disorder with an intensity directly related to the load magnitude, which should be considered a compounding risk factor.

PMID: 14755497 [PubMed - indexed for MEDLINE]

[BB]

Something interesting that this article made me think of:

A static load on the lumbar spine during trunk flexion would cause stretching of the posterior structures.

Passive stretching can cause a temporary lengening of the tissues, I've heard lasting up to 5-6 hours.

Think about a truck driver who sits in a slumped, flexed posture for several hours while driving (stretching the posterior structures) then parks his truck and immediately begins to unload.

His spine will have decreased passive support already because of the temporary effect of the stretch when he was sitting, and then add the loaded lifting and bending!

Good idea to increase awareness of positioning and muscular recruitment...movement pattern becomes very important?

Cory

[emad]

Hi Rin ,Nari,Bernard
Thanks for repleis ,and the abstract .

repeated periods of static lumbar flexion were found to result in a transient neuromuscular disorder with an intensity directly related to the load magnitude, which should be considered a compounding risk factor

Rin , i am not encouraging static flexed positions for long periods , but i am practically in my ideas , i think physiotherapy will be lovely , if we look at the patient more practically , we are nature sons , we are living , i put myself in the position of the patient (any person) , if i am cleaning the house , i belive it is so boring to think of bending knees when looking to pick something from the groud , thus true, thus our life , thus is our daily activities ADL, we are doing things,motions,movements as we have been accustoned/habituted.

yes, it is absoultely right spendig long times of lumbar flexion is bad , but at the same time , always bending knees is not pratically and bad , so you are going always to maintain the hamstrings in a short position :!:


Bernard you wrote ;
I learn to patients to move happily in all directions without fear but attention=awareness and all can do that!

so why not to lean forwad with knees extended, but not all times :!:

cheers
emad :)

[rolf]

Hi all!
To me not bending the knee is loss of body awarness!
When iam talking about bending the knee its in ADL as picking something up from the flor or something under the knee area.

Whats the benefit just flexing in the hip compared to bending the knee?
Why do children bend their knee and not just flex in their hip?
RIN :wink: :wink: :wink: :?:

[nari]

Does any of this really matter?

We could just recommend that it is useful to bend the knees if a load is heavy.
There is no overall evidence that bending (dynamic) is bad, although lots of evidence that prolonged static bending (as in the truck driver) is best avoided.

All we can do is recommend for them to do what seems to be easier at the time - 2 options: To bend the knees or not, and suggest a preference according to their build and balance, etc.


nari

[emad]

Hi Rin & Nari:

Rin ,the benefit of NOT bending the knee at least one time a day ,at least to maintain the hamstring length ,i believe so .

the other part of your reply ,regarding children , we have a child those days in our home 4 months ,i see her all time when she is supine bring the foot to her mouth with knee extended, i have not seen kid in a standing , i belive if the kid in standing want to go in bending , he will bend kness as two reasons balance then the kid may be afraid of falling , i think so .

cheers
emad :D

[emad]

Hi All :
agood article in PDF ,needs acrobat reader .

www.janissetherapy.com/Correcting_Movement_Imbalances-Janisse.PDF - 101k -

cheers
emad :)

[rolf]

Hi emad1
This is a classic example of redused body awareness!

:wink: :wink: RIN

[emad]

Hi Rin,Nari& Bernard:

Nari
i agree with your views regarding bending knees ,when to go with loads.

Rin

you say that the article ,i have provided ,does not consider awarness of movement , i have to say you are right , the article mainly concerning how to improve the relation between working together.

Bernard :

i think i have read before in somatic education articles ,regarding the movement pattern ,to subdivide the movement patten into subdivisions ,then retrain ,reducate :!: any comments :!:

cheers
emad

[bernard]

Hi Emad,

Absolutely right, you can divide in parts the movement. It is like a piece of music, you learn few at a time and then play it in whole! But you have to know how to play the notes?

[emad]

Hi Bernard:

I like to give more attention of that topic ,examples.

cheers
emad :)