To start out - I'll point out that it has been a VERY long time since writing a blog post. I have never been a naturally good writer, and this has discouraged me from posting thoughts and stories in the past, or as often as I would like. I would much rather show a story through movement, pictures, and videos - as you can perhaps tell by my instagram page! (@vitalstrengthphysiology)
I'm coming out from under the rock I've been living under blog-wise, and posting a quick write up on my thoughts on movement assessments, my most recent one in particular.
Over the past year, movement assessments have become extremely popular for Vital Strength and Physiology. For us, the movement assessment is the initial touch-point with the client, and is a crucial one. Our bodies express theirselves through movement, and movement can be a major key into the client's past injuries, current pains, and future management of pain and performance.
With permission, let's look at a small portion of my bouldering athlete, Paige's assessment.
I worked with Paige in the past, and have seen her climb at competitions a handful of times. I generally know her movement well, but without any specific information about her current movement, or any details on her current aches and pains (if any), we started with the basics - an interview.
In the interview I try to collect a thorough history on any injuries, accomplishments, and current pains that are plaguing her. These stick at the top of my mind throughout the assessment, as old injuries can stay evident in movement patterns if the athlete wasn't rehabbed back to *better* than before the injury. A commonality in therapists that don't have enough time with their clients is to get the athlete moving "just good enough" to continue to play. But this is a slippery slope to re-injury, as something they were doing, or lacking, before the injury, is probably still present - or possible worse.
Here we started with global spinal rotation. We took video during her assessment, and I took these screen shots later, when I went through to analyze the video a few days later.
Paige is a 5/9 on the Beighton Hyper-mobility scale, so she has naturally more laxity than the average person. Some studies have demonstrated, though, that hyper-mobile people tend to over-compensate for the laxity by displaying more tense, less mobile, movement patterns, at least in walking gait (Alsiri et al, 2020). Perhaps we could uncover some movement compensation that had occurred from her compensation for hyper-mobility?
At the two extremes of her standing full body rotation, we can see that she can rotate a lot more to the right than she can to the left. A big hint for me is watching where the hips rotate relative to the upper body - and for Paige, she rotates a lot better through the right hip than through the left. This could indicate right hip internal rotation and left hip external rotation is better than the opposite side, with thoracic mobility potentially being better to the right as well.
When we sit Paige down to take out movement through the hips, and just look at thoracic rotation, the opposite seems to be true. This time, she rotates a lot better to the left and barely to the right. With each movement "flaw" that I see in the assessment, I mark it down, and come back to it later - to start rating and ranking the level of importance of each piece.
The shoulder FABBER test (flexion, abduction, external rotation) shows that there is only a slight difference in her shoulder FABBER mobility. The left arm is abducts slightly more than the right, but both display good range of motion. Although I am not able to post videos in the blog on my site, the videos of her attempts of these tests look smooth and un-laboured, which is a good sign that the shoulders of this bouldering athlete are healthy. Based on our initial interview, too, she is not having any issues with her shoulders at this time.
Paige's EADDIR test shows a 2 degree difference in the ability to Extend, Adduct, and Internally rotate the shoulder. It is not often that I see a movement assessment with such a good EADDIR test. This is especially true with climbers or other athletes who use their upper bodies a lot - just because you use your joint at it's end range often - does not necessarily mean you "own" this position. For Paige, her software seems to demonstrate that she "owns" this position, as once again, getting into and out of the position doesn't look laboured, and we don't see any aberrant patterns of the scapula bone poking out (flare).
The overhead squat test from Paige's assessment shows that she anteriorly tilts her pelvis as her normal mechanism of movement. The problem with an anteriorly tilted pelvis is that the muscles along the back tend to be hyper-tonic (and in this case, the athlete does mention low back pain - likely caused from this position being her default), and the muscles in the front tend to be on stretch. According to the Force-Length curve of muscle, neither of these positions are optimal for a strong torso. The Force-Length curve of a muscle shows that muscles are typically weaker when they are stretched too long, or contracted too short (both end ranges). They are strongest when they are in the middle of their length potential, not too short or long. This will be a key piece of information from her assessment that we can take in to her training, and to potentially eliminate low back pain while increase strength through her torso (super important for bouldering!!!).
The last example I'll include from Paige's assessment is her lateral wide stance slide. What we would like to see in this pattern is a perfect inverted T that stays the same angle with the ground as she slides side to side. Now, if Paige's sport was hockey or speed skating, this movement would be even more key to determining her ability and her performance. For bouldering, lateral maneuvers on the wall are also important, and sometimes the climbers are given problems in training and competition that involve jumping vertically to complete a dyno from one foot, or from a laterally loaded position.
In my opinion, good control of the spine in multiple planes of movement and not just limited to isolated exercises like a plank or squat, are key to optimizing strength, power, and propulsion for this athlete, and most athletes at that.
This is a nice short post to get you thinking about movement in more detail. Always start working with an athlete by doing a movement assessment. Because, their Beep Test, max pushup number, or vertical jump height won't tell you nearly as much as you need to know about them as their movement patterns will.
Alsiri, N, Cramp, M, Barnett, S, Palmer, S. Gait biomechanics in joint hypermobility syndrome: a spatiotemporal, kinematic and kinetic analysis. Musculoskeletal Care. 2020; 1– 14. https://doi.org/10.1002/msc.1461