Pain, Motor Control and the Importance of an Initial Physiotherapy Assessment

Poor movement can exist anywhere in the body. Poor movement patterns exist only in the brain.

The Initial assumption of pain and motor control stemmed from basic inhibition (e.g. knee joint inflammation causing inhibition of the Inner Quad VMO muscle). When pain exists, you can occasionally get an increase in muscle activation (high threshold strategy) depending on the given role of the muscle (agonist or antagonist).

We as a society now recognise that the body will always sacrifice quality over quantity of movement and that there is a certain amount of compensatory movement that is tolerable. However, once we cross a particular threshold, that compensatory movement becomes dysfunctional movement. Dysfunctional movement, whether a result of pain or injury or causing pain or injury, is one of the missing links related to rehabilitation and injury prevention.

The consequence of this natural, protective change in motor control is altered movement. Subtle altered movement culminates into clinically observed dysfunctional movement patterns we believe contributes to injury, re-injury and reduction in performance.

A comprehensive movement assessment, which is how we assess the inability of the client to perform regular everyday movements, ie walking, running, standing from sitting, bending over, squatting, pushing off the floor ect, is essential to safe, effective and ultimately, successful programming and results in the gym environment. For example, one should question whether an individual should be allowed to perform a loaded, full-range squat if they are not able to touch their toes. (We will post about this topic in the near future).

Our role as practitioners and trainers is to remove the barriers in which can lead to pain and let the patient explore and progress into advanced functional movement, sports and play.

Ensure you have a baseline to qualify a client into certain movement progressions and micro-manage them early, then watch as they reap the benefits in the future without the consequence of pain barriers.