Posts Tagged ‘pain-free movement specialist’

Corrective Exercise Frontal Plane Samurai Lunge

Thursday, February 11th, 2021

We have one of our Level D correctives from the PFMS library that is part of our educational website. Level D exercises are what I refer to as “top of the foodchain” in the corrective exercise world.

These highly integrated exercises carry extensive value beyond the biomechanical integrations. For some clientele, the Level D is the immediate segue to their more traditional fitness workout. For others, the Level D is an element of a workout itself.

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Functional Purpose:
Improve Frontal/Transverse Plane Spinal Alignment

Biomechanical Outcomes:

• Momentum from desired pelvic list promotes lateral spinal flexion, which is enhanced throughout the vertebral column when torso and righting reflexes resist maintaining a level orientation to the horizon.
• Arm overhead act as an extension of the rib cage, creating a longer lever and greater mass to ensure that all vertebrae contribute to the lateral spinal flexion.
• Maintaining a pure frontal plane motion with thoracic extension counters any rotational tendencies of the torso.
• Slight rotation of the intervertebral joints are coupled with lateral flexion of the spine.
• Lateral trunk musculature on the lengthening side are eccentrically loaded & decelerate mass of the trunk in the side bend, then transition concentrically to return trunk to the vertical.

Neurological | Physiological Outcomes:

• Promotes connective tissue elasticity associated with dynamically loading / stabilizing sagittal, frontal and transverse plane motions of the thorax.
• Increase connective tissue compliance and resiliency through the promotion of tissue extensibility, amplifying the viscoelastic and force closure demand to uphold lumbar spine integrity and stability.
• Extensibility of the lateral hip musculature to allow for and additional hip adduction, flexion and internal rotation.
• Elicit a heightened somatosensory response due to the simultaneous bottom-up (lateral lunge) and top-down (lateral flexion / thoracic rotation) influence.

Psycho | Social Outcomes:

• Establish a multidimensional environment involving the neural-networks associated with managing heightened emotional states (anxiety, hyperviligence, etc) during the execution of a complex, autonomic motor task.

Modifications:
• Begin pre-positioned w/ both hips abducted, greatly reducing ground reaction forces.
• Remove ipsi-lateral glenohumeral abduction.

Contraindications:
• Subacromial impingement syndrome.
• Inability to control multi-segmental deceleration of descending body weight.

Corrective Exercise Programming and Readiness

Monday, November 30th, 2020

What does readiness mean to you?

When designing the corrective exercise program for the chronic pain client, it means many things.

As you decide on your exercise selection, does a strategic sequence advance your objectives and build your client’s movement confidence?

The readiness in this case is based on many things, but at the top of the list is trust. Trust of their own capabilities without provoking pain.

This is precisely why we have created a framework for corrective exercise progressions.

Enjoy this clip and consider joining us on our mission to help those in pain live more comfortable and productive lives.

Corrective Exercise Static Wall Femur Rotations

Tuesday, October 27th, 2020

The following exercise is taken from our library available at www.functionfirsted.com

We share this example with you as an exercise that you might find useful as well as to add to your understanding of the bio-psycho-social considerations we apply during programming.

This Level B exercise can also be found in my book, The Pain-Free Program: A Proven Method to Relieve Back, Neck, Shoulder and Joint Pain.

Biomechanical Outcomes:
•Increase bi-lateral hip rotation autonomous from gravitational influence over the pelvis and entire upper body.
•Enhance transverse plane hip rotation independent from the pelvis and lumbar spine motion.

Neurological | Physiological Outcomes:
•Enhance cognitive processing mechanisms associated with the planning phase (evaluation) and motor unit recruitment involved during the execution of exercise.
•Promote connective tissue extensibility associated with internal and external hip rotation.

Psycho | Social Outcomes:
•The introduction of localized and independent hip rotation fosters a novel experiential awareness designed to help expand maladaptive appraisals and challenge any associated neurosignatures of hip rotation avoidance.

If you have not taken advantage of the 24 FREE PASS to Function First Academy to see all of the great stuff there, now is your chance!

30 – static wall with leg rotation.wav from Kevin Murray on Vimeo.

How PFMS Programming Excels

Thursday, August 13th, 2020

What drives your decision making when designing your client’s/patients exercise program? No doubt some of the decision is based on your client’s goals, as it should be. That is why they are seeing you.

But there are often many routes to a goal. And when we throw conquering pain into the equation, the route that is chosen becomes much more significant.

With the Function First Approach and its Pain-Free Movement Specialist curriculum, the sequencing of the exercises is critical. Much like a phone number, the same elements in a different order will often yield a different result.

With the client who has experienced or is experiencing chronic pain, the biomechanical, neurological and physiological characteristics of the exercise are critical. But those characteristics can be negated and potentially pain provoking if we have not acknowledged, validated and considered the psychological state (readiness, expectations, apprehensions, preconceived ideas, etc.) as it applies to the exercises we will provide.

And this is where the PFMS excels. Marrying the critical movement and mechanical needs to the psycho-social needs of the client at that time. Delivered with empathetic and confident coaching and you can see why Function First has served clients from around the globe who could not have their needs met elsewhere.

As such, I want to give you a peak into one of the many ways our Function First Academy can be a resource and support you in your mission to serve those challenged by chronic pain.
In the video below, I will walk you through a few of the aspects of the site that will change the way you program.

Corrective Exercise Floor Glides with Leg Extension

Thursday, November 14th, 2019

In this video we are bringing you a very influential exercise that does a surprisingly effective job at lower back stabilization as it challenges the mobility of the shoulders and efficiency of the the thoracic spine in extension.
As you are probably acutely aware, when working with corrective exercises and the client in pain, it is more than just the exercise, it is a thorough understanding of:

“For Whom?”

“For What?

And “When”

Insight into the biomechanics, psychological mindset of the client and social setting/implications of the movement all come into play and are critical to the client’s success.

Corrective Exercise A-P Cat and Dog Rewind

Friday, October 4th, 2019

In one of our past newsletters where we talked about myofascial mobility with rhythm, timing and amplitude, we revisited the Anterior Posterior Cat and Dog as one of the examples of applying those principles.

In this exercise, we take the A-P Cat and Dog and progress it into a surprisingly challenging core exercise. We call it the A-P Cat and Dog Rewind.

You’ll see as the clients center of mass moves forward with the change and limits of base of support, the core has to switch on in a very novel way.

The beauty of this is that the response is reflexive with no feedforward response necessary by the client or patient.

This helps us move beyond the bracing and “keep your core tight” cues that are not part of our long term goals and authentic movement.

Try it, feel it and let us know what you think.

Corrective Exercise Wall Glute Bridge

Thursday, August 8th, 2019

This version of the glute bridge is a great corrective exercise for teaching the body the sequencing and synchronization from the ankle to the lumbar spine that is associated with triple flexion and squatting.

It will certainly challenge dorsi flexion in a pseudo closed chain environment as the knee moves over the toes. There is feedback from the wall and load placed into the wall, but no vertical forces acting on the joint.

The body gets comfortable with relative lumbar flexion in an unload position because it has to go through that motion to get the buttocks of the floor. The beauty is both the novelty and very limited load placed on the spine. So even those with lower back pain will find this a helpful exercise as it reduces the threat.

Additionally, it helps create some separation and distraction of the tissue at the thoraco-lumbar junction. The upper part of the body is fixed on the floor as the lower part moves away, creating the distraction.

Put it to good use and tell us how you did!

Corrective Exercise-Half Frog

Thursday, July 11th, 2019

This simple exercise can be quite challenging for those with a history of lower back pain, as well as the deconditioned client. The ability to disassociate the hip motion from the movement of the lower back and pelvis can be very helpful in removing stress from the lower back.

This “Level B” exercise from the PFMS is both a corrective and assessment opportunity. You will be able to see, and the client will be able to feel any control and/or range of motion differences between the two sides.

The Half Frog is also an exercise, that as a Level B allows for more intrinsic focus of attention for motor learning purposes. The client is able to concentrate on what muscles are engaging and the sensory feedback of those contractions.

Corrective Exercise-Prone Single Arm Lifts

Friday, June 14th, 2019

This corrective exercise for the shoulder and thoracic spine is significantly more challenging then it appears. A great exercise to cue the thoracic spine and scapula to better “set” their anchor points for more controlled and stable motion of the shoulder.

Three different lift angles suggested to vary the position of the gleno-humeral joint and rotation of the scapula.

Neuroception, Relationships and Clients in Pain

Friday, May 10th, 2019

Originally written for ACE Certified by Kevin Murray

No doctor can write a prescription for creating relationships. They are hard-earned and complex undertakings, particularly with people in pain.

Part of what makes pain so distressing is its lack of predictability. Experiencing pain feeds into a negative reinforcing loop of uncertainty, up-regulating cognitive stressors such as fear, apprehension and anxiety. This often runs parallel with clients’ difficulties in regulating their emotions (Hamilton et al., 2004).

Woven into the fabric of all relationships is the principle of reciprocity. For the health and fitness professional, navigating the arena of pain and relationships requires one to become acquainted with the nervous systems role in analyzing risk and safety.

Neuroception: The Mind’s Mediator

Neuroscientist Stephen Porges coined the phrase neuroception to describe the neural mechanisms involved with subjective perception and evaluation (Van Der Kolk, 2015). Specifically, neuroception helps individuals distinguish whether a situation or individual is safe and trustworthy, or dangerous and distressing.

danger safety

To the individual experiencing pain, their unique view of the world is interpreted through a nervous system that has an altered perception or risk and safety. Every day situations can become fearful and ambiguous, often resulting in maladaptive appraisals of people who are unknown or unfamiliar.

Experiencing pain has one’s neuroceptive system on overdrive, constantly seeking out potentially threatening stimuli. This state of cognitive hypervigilance makes cultivating relationships exceptionally formidable. To combat such psychosocial stressors, successfully establishing relationships with clients in pain involves understanding the underlying mechanisms which enhance positive neuroception.

This process is governed by innate biological systems that once understood, becomes the inception of all meaningful, heartfelt and trusting relationships.

Mechanisms of the Mind

    Mirror me: Mirror you

Have you ever noticed that when someone is genuinely smiling (even if you don’t know them), you find yourself smiling back? What induces this instinctive mimicry? Why do we yawn when we see someone yawning, or wince when someone smacks their shin on a coffee table?

The neurobiological mechanisms responsible for such nonverbal imitation is regulated by highly sophisticated visuomotor neurons referred to as mirror neurons.

mirror neuron

This mirror neuron system (MNS) allows for two individuals, whether lifelong friends or two complete strangers, to simultaneously share neural activity as they attempt to decipher the meaning behind each others nonverbal gestures. The MNS is the gatekeeper of assurance and safety, escorting the manifestation of positive neuroception and is decisively involved in the emergence of all trustworthy relationships. As such, understanding the mirror neuron system’s innate bias towards familiarity and reciprocity becomes a crucial distinction with regards to clients in pain.

    Brain-to-Brain Dialog

For instance, when two people are in-sync and rapport is mutually harmonious, the MNS is fully engaged. People adopt one another’s facial expressions, hand gestures, postures. even acute motor movements without even knowing they’re doing so (Chartrand and van Baaren, 2009). This is known as automatic imitation. Interestingly, being deliberate and purposeful in the mirroring of others nonverbals (intentional imitation) can also facilitate this same mirrored neural activity between two people.

Similar neurobiological functioning ensues via verbal communication. As an illustration, when two individuals and their speech patterns converge, they adopt one another’s vocal qualities such as tone of voice, tempo of speech, even specific words and phrases. Once again, this takes place without any conscious awareness. These neural dynamics lead to mirrored neurological activity between the speaker’s brain and the listener’s brain. This is referred to as neural coupling (Stephens et al., 2010).

matching brains

In fact, have you ever experienced such high degrees of rapport where you almost knew what someone was going to say right before they said it? This is no fluke. Neural imagining via fMRI technology reveals that when two people are in-sync and engrossed socially, the delay between speech production and the listeners comprehension is so small that one can often anticipate what’s going to be said next (Hasson et al., 2011).

These anticipatory responses suggest as two individuals become acquainted with each others verbal propensities, the more attuned and mirrored their neurological activity is. Neural coupling highlights how verbal imitation can breed a sense of relatedness and commonality, ultimately nurturing the perception of safety and enhancing positive neuroception.

However, when two people are out-of-sync with their nonverbal mannerisms and verbal speech patterns, this brain-to-brain coupling vanishes (Stephans et al, 2010). When incongruencies are present, the perception of safety slowly fades and gives rise to uncertainty. If clients in pain fail to see aspects of themselves in their health and fitness professional, the more likely skepticism has the opportunity to settle in.

In-depth Analysis

The role mirroring plays in socials interactions is ubiquitous. In fact, visuomotor mimicry is so innately hard-wired that one-month-old infants display the mirroring tendencies of smiling, sticking their tongues out and opening their mouths when observing such behavior in others (Lakin et al., 2003).

As two people learn how to navigate the social complexities of interpersonal communication, what are the neurobiological intricacies involved in learning and interpreting the intended meaning of another individual’s linguistics / gestures? Let’s analyze the MNS in-action through a common example:

    Spoon Feeding and Neurobiology

As a mother brings a spoon to her infant son’s mouth for the first time, is the child aware of the next sequence required in this exchange? Does the baby open his mouth wide, accommodating for the size and shape of the spoon? Probably not.

Instead, a blank stare of bewilderment is undoubtedly written across the infant’s face. It’s not until the mother visually demonstrates the spoon-to-mouth action that the infant can comprehend what’s being asked of him.

    Sequence analysis

The infants MNS observes their parent demonstrate the action of spoon-to-mouth (intended outcome).
This creates a visuomotor representation and engages the infants own perceptual-motor circuitry.
The infant can then synthesize the visuomotor representation (action-potential) into motor execution, resulting in the reciprocation of the desired task: i.e. successfully transferring food from spoon-to-mouth for ingestion.

Here we witness the MNS and its architecture having the remarkable ability to transform passive observation, into perceptual understanding and then motor execution (Ferrari et al., 2005). Daily social exchanges such as handshakes, waving hello or goodbye, observing laughter or witnessing sadness all involve the MNS and neural coupling effects.

The mirroring of facial expressions can even result in actually adopting the emotions and moods of others (Lakin et al., 2003). This outcome is recognized as empathy, or having the capacity to understand the feelings of others and view the world through their unique perspective.

The interplay between biological and environmental factors requires more sophistication as our social surroundings increase in complexity. This makes congruent communication and mimicry as a medium for cultivating trusting relationships significant, particularly with clients in pain.

So how can you, the health and fitness professional apply these neurobiological insights with your clients in pain to enhance positive neuroception and ultimately establish relationships?

Integrating Neuroscience into Relationship Building

It’s essential to remember what distinguishes the client in pain from general clientele is their altered perception or risk and safety. Never forget, from the moment you meet your client in pain, they’re skeptically evaluating you and how you conduct yourself. As such, taking special care to remove as much uncertainty and unfamiliarity as possible becomes the primary focus. This process begins with the practice of adapting your own verbal and nonverbal mannerisms to match that of your clients.

For example, when communicating verbally, congruency is essential for positive neuroception. Suppose a client begins describing his story of musculoskeletal challenges with soft and gentle vocal qualities. He takes the time to articulate and pauses often. Attempting to mirror and reciprocate these vocal mannerisms follow the neurobiological prerequisites to manifest neural coupling

Should the client also be sitting on the edge of their seat and leaning forward, following suit and mimicking this seated posture engages the visuomotor neurons of their mirror neuron system. Intentionally integrating and reciprocating these verbal and nonverbal idiosyncrasies serves to enhance the possibility of cultivating positive neuroception.
Kevin coaching

IMAGE TAKEN FROM THE YELLOW BRICK ROAD: A 4-part framework for coaching clients in pain
The matrix of mirroring possibilities includes paying attention to your clients nonverbal features such as facial expressions, eye contact/gaze, body position and proxemics (personal space) and his or her idiosyncratic hand gestures.

Verbal and vocal aspects could encompass specific words or phrases they frequently use, paralinguistic qualities such as tone of voice, rate of speech, vocal modulation and volume, or demonstrating appropriate levels of silence should the client be reserved and introspective. Knowing which aspect(s) to mirror comes down to actively listening and observing the uniqueness of each clients’ communication tendencies.

As clients in pain begin experiencing coherence and familiarity in your communication conduct, their skepticism is superseded with impressions of trust and certainty. Their perception of safety and assurance increases as positive neuroception begins planting its roots.

And while the genesis of cultivating relationships varies from one individual to the next, attempting to enter each client’s world and speak their language helps to nurture the inception of meaningful, heartfelt and trusting relationships with your clients in pain.