Corrective exercise choice should be very specific to the individual. In order to choose appropriate exercises
The Functional Movement Screen (FMS), developed by physical therapist Gray Cook and his colleagues, is used to bring out any movement dysfunction.
The FMS was designed to identify limitations or asymmetries in seven fundamental movement patterns that are key to functional movement quality in individuals without pain or injury.
These movements are squatting, lunging, pushing, pulling, twisting, bending, and gait. Corrective exercise choices should be based on the assessment of these patterns.
The FMS looks at these patterns by using 7 tests that are a balance between mobility and stability:
Deep Squat Movement Pattern
Hurdle Step Movement Pattern
Inline Lunge Movement Pattern
Shoulder Mobility Movement Pattern
Active Straight-Leg Raise Movement Pattern Trunk
Stability Pushup Movement Pattern Rotary Stability Movement Pattern
It is also important to note if a client is in pain or has pain during the Functional Movement Screen. In this case it is imperative to use the Selective Functional Movement Assessment (SFMA).
The SFMA is the movement-based diagnostic system, designed to clinically assess movement patterns in those with musculoskeletal pain.
When using the screen, it is crucial to find the weakest link in the screen. The weakest link is generally the most primary movement pattern or any asymmetry.
If you work on any other movement pattern other than the weakest link, the poor movement pattern will not change.
So it is important to focus on the primary problem. Once the poor movement pattern is fixed, the other patterns may actually fix themselves.
We also need to determine whether the problem is due to poor mobility or stability. If there is an instability in the body, it will create artificial stability by locking down on a joint nearby. This causes stiffness.
The body is smart and will help you get done what you need to do, but usually the strategy it uses will not help in the long run. To undo these compensations, we first need to determine if there is a restriction somewhere.
Once that restriction is mobilized, we can create true stability and true strength. We can look at the body in a joint by joint approach, where the body alternates between mobility and stability. Often times we have too much mobility in an area and need more stability or a particular area is stiff and needs more mobility.
For example, the lumbar spine tends towards instability. When we lack stability here we lock down in our hips and ankles and/or thoracic spine. Mobilize these areas and stabilize the lumbar and you will move better.
Poor movement patterns due to an instability are often times a motor control problem. In this case, Reactive Neuromuscular Training (RNT) is appropriate.
Dynamic stability is not a conscious process. It is our ability to react and hold a body part steady during movement. To achieve this, smaller muscles have to fire at the precise moment.
RNT is designed to restore the synchronicity and synergy of muscle firing patterns which are required for dynamic joint stability and fine motor control.
Once the poor movement pattern is determined and the appropriate corrective exercises are performed, it is important to use the new pattern. This will help the body remember the correct pattern and help the correction to stick.
Also, remember to check your work to make sure the strategy chosen to improve the pattern was the right one. So repeat the appropriate test from the screen and see if there was improvement.
As you can see, it is important to get assessed by a professional or you can choose exercises that send you deeper into your dysfunctional pattern.
That being said, there some common tendencies given that we all tend to repeat similar motions, and due to our increasingly sedentary lifestyles as technology replaces many physical activities.
Our 9-5 desk jobs cause us to have a slumped over posture, forward head tilt, poor breathing patterns, tight hip flexors, lazy gluteal muscles, and locked up feet and ankles. Here is a list of
5 common poor movement patterns and corrective exercises to combat them
1. Chest Breathing
If there is not anatomical obstruction or mobility issue blocking proper breathing techniques are appropriate.
Diaphragmatic Breathing and Straw Exhale:
Begin laying on your back. Inhale through your nose and exhale through your mouth. Allow your breath to fill the belly and the sides and back of your ribcage, like a balloon.
The first 2/3rds of your breath should be in your belly and ribs, the chest should move last. When you have this down try the straw breathing. Inhale through the nose and exhale through the straw.
Count the seconds of the exhale and try to increase the time to 30 seconds. (Oxygen is delivered to the cells on the exhale so by extending the exhale, we can try breath more efficiently.)
2. Poor Hip Mobility
Hip Flexion with Core Activation:
You can use a weight of approximately 20lbs or pull against a heavy resistance band. Make sure you keep you chest wide and the front of the ribs pulling down. Press down under the armpits to engage your lats (pulling against the resistance band is particularly good for this.)
Keep the core braced as you work on hip flexion on the working leg and hip extension on the supporting leg.
Lying with the back on the mat with knees bent and legs hip distance apart. Flex your feet so just the heels are on the ground. A.) Press down into your heels so you feel your glutes activate.
Then lift the pelvis by bringing the pubic bone to the sky and continue to roll up onto your shoulders. Make sure you are pulling your stomach in and up so you do not arch your back.
You want your hamstrings (back of thighs) and gluteals (buttocks) to do the work here and not your lower back muscles, so press down into your heels.
B.) Roll down to the starting position from the top of the spine.
Make sure you don’t tense up your shoulders and neck here. If this is going well do single leg.
3. Poor Thoracic Extension and Shoulder Mobility/Stability
Sit up tall against a chair. Look up and send your eyes, neck and upper back in an arch backwards. Hold and breathe for several seconds and then return upright and repeat.
The chair should hit right under your shoulder blades. Make sure to engage core. If you have access to a foam roller even better. Do 10-15
Shoulder Mobility with Core Activation:
Hold a stability ball between your palms while keeping the collarbone wide. As you exhale, extend the arms overhead so the ball taps the floor.
Check to make sure you have not lost the rib connection to the floor. (Imagine you are preventing me from trying to pull a towel out from under your rib cage.) Return to the starting position on the inhale and repeat.
4. Lack of Rotary Stability
Dead Bug with Stability Ball:
Think of this as an extension of the breathing exercise while maintaining braced abdominals. Keep the pressure in on the ball. Start by moving one extremity to the floor at a time. Then you can do cross body patterning by moving opposite arm and leg to the floor.
Or, if you do not have a ball:
Bring both legs up into table top and both arms straight up to the ceiling. Start with your right arm and left leg tapping the floor. Come back center and then repeat with the left arm and right leg.
Keep alternating while making sure to keep the core engaged, ribs on the mat, and shoulders down.