This was very enjoyable for me, because Ken Miller and I go back so far. Ken came to one of my very first mentorships back in the late 90’s and is one of only a handful of PFMS Level 4 practitioners.
Both Ken and Wendy are NASM Master Trainers and have made significant contributions to our industry in their own right.
The short clip we are sharing here is very relevant to you, our Function First professional community. We discuss some of the evolution of our views on the functional anatomy. We also talk about why it is not only OK, but imperative that fitness professionals work with clients in pain within our scope of practice.
I just recently came across this video even though it is a couple of years old. It is a great summary of the mysteries around chronic pain. I often suggest to many of my clients that they view Lorimer Moseley’s TED talk, because he is such an entertaining AND knowledgeable speaker. I’ll start recommending this one too.
It was interesting for me to see in this video that two of the examples he uses to help explain pain are two examples that I have used for years in my professional presentations. The construction worker’s boot and the blue/red cold study are the two that have helped me communicate these concepts.
The animation below is entertaining, and the content is scientifically accurate. Enjoy!
The couch potato takes 2-3000 steps per day. That’s a lot of repetition. Imagine the repetition for those who get their 10,000 steps per day?
Since the majority of our clients walk, the Single Stance is an insightful way to see how the body responds to the forces acting on it during midstance in the gait cycle.
In this video, we are going to dive deeper into what we can observe from the back view of this assessment, particularly as it relates to the coupled relationship of the pelvis and lumbar spine in the transverse plane.
I’ll show you a quick review of the key points, and then share some actual client assessments of what we found. It will make sense why this assessment can be so insightful.
It’s always an honor to be invited to speak on a podcast, and even more so when that podcast is for IDEA Health and Fitness Association. The interviewer, Sandy Todd Webster (Editor in Chief at IDEA) and I have known each other for years and Sandy was a client of mine at one time. Sandy truly knows the fitness industry inside and out and had some great questions that led to a fun exchange.
This is a short clip of our conversation where she asks me for any word of advice I would offer to fitness pros working with or wanting to work with clients dealing with chronic pain.
A client favorite, this exercise has multiple benefits to the upper extremities, thoracic spine and neck region. Utilizing the arm positioning and the cueing of the radial-ulnar and gleno-humeral joints, the motor system can access the peri scapular muscles in a very efficient way.
Lengthening through the chronically shortened muscles of the wrist and forearm and isometrically contracting the middle trapezius and rhomboids produces a noticeable change in the tissue tension and posture of the upper body.
The following is a Level B in the Pain-Free Movement Specialist Levels of Designation
The Dead Bug is a popular and effective core stabilization exercise. And although it is done supine on the floor, it has a level of difficulty that may be underestimated.
When working with chronic pain clients, particularly those with lower back related issues, the many common versions of the Dead Bug may actually be too challenging. With the version we share below, the degree of difficulty can be self regulated. This means the individual has a degree of control over the intensity of the exercise by way of the force that they apply with the upper body.
With this control, the client/patient has the ability to choose a level of difficulty within their capacity and reduce the sense of threat of further hurting themselves. They will also be able to better assess their success or lack their off with fewer moving parts to the exercise.
Following the PFMS A-D Levels of Designation, the Half Kneeling “Hula” is a Level “C” exercise. Besides the points of contact and relationship to gravity, this corrective exercise requires some kinesthetic awareness and movement coordination and is an excellent progression to the standard, static kneeling hip flexor.
Adding variability not only provides superior outcomes, but it also often exposes restrictions we didn’t know were more prevalent.
The pain itself is almost always the primary focus. But their are multiple inputs that can lead to a downward cascade in the quality of life of those challenged with chronic pain. And equally, the sum of many inputs can also lead to a positive cascade and opportunity for improvement.
This clip taken from a live webinar I did with the American Council on Exercise, sheds some light on how the right exercises, for the right person, at the right time can be a catalyst for positive change.
If we can appreciate and impact through exercise, more of the dynamic systems involved in the pain experience , we provide our clients with a path to positive change.
Looking beyond the primary movement in a corrective exercise offers tremendous opportunities and insight into ways that we can influence our clients’ global movement needs. Here, I use an example of a familiar corrective exercise for the shoulder girdle and apply our Levels A-D strategy to demonstrate the different considerations when selecting a working posture/position.
It is common to focus on a joint or body segment only, when choosing corrective exercises for your client. Disregarding the implications (positive and negative) of the posture or position from where the exercise is initiated, means that we are not recognizing the integrated, functional biomechanics involved.
Don’t be fooled. This exercise has nothing to do with strengthening the quads or the provocative slump test for neural tension. Both of those exercise look similar at first glance, but the nuances of this exercise give it a completely different objective.
Sitting Leg Extensions is an incredibly effective exercise to introduce a lumbar stability strategy that does not involved bracing or conventional core work.
The goal is not terminal knee extension. The goal is to generate enough internal tension from above and below the lower back, that the tensegrity forces help to de-rotate and stabilize the lumbo-sacral-region.
This is a self limiting exercise, meaning that the breakdown of the form and execution will be a result of the individual’s own internal force generation.
Give this one a try and let us know what you think.