“Movement is Medicine.” This is a commonly used saying when talking about getting people more healthy. It can also apply when helping people recover from pain or injury. More research is showing that movement, activity, and strengthening can help people recover faster. In this Blog, I am going to talk about movement and whether or not there is a “right” way to move or do an activity/exercise……
Before I get into this topic, I would like to state that this discussion is going to focus on movement during everyday activities or in a rehabilitation circumstance. The information here does not apply to a weightlifting, performance-type setting where there likely is a “correct” way of doing a lift that is most efficient and may reduce your risk of injury.
One of the things that I like to tell people who work with me is that there is no “bad” movement as long as your body is prepared for it. This can apply to rehabilitating any part of the body. I ask people to think about how they moved prior to their injury or pain onset. Did they think about their movements? Did they focus on “keeping the back straight” when picking somethig up, “keeping knee out” or “not letting it go over the toes” during stairs or knee bending activity? Most people will say, “No” they did not think about these things. The goal of my rehab with them then is to get them back to this-thoughtless, free, relaxed movement.
As an example of what I mean, let’s look at the below. This is me picking up a piece of paper from a chair. You notice that I am keeping my back straight, bending at the knees to get the paper. If you have recently injured your back, this may be how you move-because it hurts to bend! However, if your back injury or pain onset was a while ago, and you are still moving like this, this is abnormal or what we call maladaptive movement-although you feel like you are ‘protecting” your back, this is not a normal way to pick up a piece of paper. In fact, this type of continued movement and protection may be slowing down your recovery! One of the goals of recovery would be to get you back to moving more normally and eventually allow your spine to bend forward in a relaxed manner to pick up the object. Our spines are designed to bend forward, sideways, straighten, and twist. Part of a full recovery is to get back to using all of the available movements that it was designed to do.
How we get to the point of moving all directions without fear, apprehension, and pain depends on each individual, but some movements we may use are shown in the two pictures at the beginning of this article. The one on the left is training your back to maintain good muscle control and is used to progressively strengthen the muscles of your back, butt, and hamstrings. The movement on the right should also be used to train the spine to bend forward again, the way it was designed to move, and the way would normally bend to pick up something light from the floor. For someone dealing with or recovering from an episode of back pain, this may be a challenge at first. However, in order to help recovery and get back to functioning normal, this movement needs to be used and trained so that you can use it in your daily life.
Let’s look at another example of movement variability as it relates to the knee. The pictures below show two different ways of doing a step down exercise. The first one shows a more hip-dominant movement pattern. The forward lean and butt-back movement allows you to use your hip muscles more and limits how far your knee goes over your toes. this may be a good option for someone dealing with knee pain. However, eventually, you need to progress to being able to do a step like the second picture with more knee-dominant motion as this is required in many everyday and sporting activities.
Not progressing to be able to tolerate both types of movement would indicate an incomplete recovery. Some might say that doing knee-dominant step downs or squats is”bad” movement. This is not true. You should be able to do both and although one may cause symptoms at the beginning if you are having pain, it can be avoided short-term, but eventually you should be able to do both type movements!
These are just a couple of examples of how some movements are thought to be “better” than others but in reality, they are normal movements that you should be able to use and tolerate to function. Knee valgus (or knee going in) is another movement that is often labeled as bad and a movement to avoid. As the picture to the below shows, it is also a movement that if you are prepared for, is normal and used in high level sport.
To summarize, you should not consider any movement to be permanently “off-limits.” Yes, during pain or injury recovery, some movements may want to be avoided and others utilized BUT, in the long-term, you should be able to get back to utilizing all movement strategies to function at your best.
If you are stuck with pain and not being able to move the way you want, please feel free to reach out, and I would be happy to talk with you to discuss options for getting back to doing everything that you enjoy.
Thanks for reading,
Bob