Recently I have been having quite a few conservations with both personal trainer and osteopathic colleagues of mine about selecting and integrating movement based assessments into the consultation process. The focus has been on what movement based assessments are best and how do we utilise these in regards to assessment, goal setting, re-assessment, rehabilitation and training & conditioning
Traditionally speaking a lot of therapists and personal trainers will look at static posture as one of the major assessment strategies for a client. Whilst a lot of information can be gleaned from looking at ones static posture, the issues with this is that rarely are we ever in one static posture. More often than not we are constantly changing the position of our body and adapting to the gravitational and ground reaction forces that are placed on our body at that particular time that we are doing something. This can vary depending on the activity or position that we are in i.e. sitting, standing, walking, bending, twisting etc.
A lot of therapists or personal trainers will also go through a detailed and often very specific approach to assessment in regards to muscle length, strength and assessment of joint function. The modern approach to manual therapy and assessment has lead us to developing a reductionist
approach to assessment and treatment. Often we become too focused on the assessment and treatment of just one area rather than looking at the body as a whole. Whilst these various specific orthopedic and osteopathic assessments are an integral part of the consultation process, sometimes I feel we fail to assess and treat the individual in more wholistic or global manner.
The Osteopathic Principle “The Body Is A Unit” states that we must and should always look at the body as whole, this is not just in regards to muscles, ligaments, joints, movements etc, but the person as a being also. When it comes to movement based assessments, there are many different professionals who have developed their own specific assessment processes and strategies. Various professionals that I have been influenced by that have either published or ran courses include the following: Gary Gray, Gray Cook, Shirley Sharmann, Brian Mulligan, Paul Chek, Diane Lee & Stuart McGill. There are many similarities and yet many differences between all of these professionals in regards to there assessment and treatment strategies.
Moving back to the discussion of movement based assessments and integrating this into the consultation, something that always comes up in my mind when assessing a client is the fundamental idea that the assessment must reflect what the client does in terms of function and this must be then carried out in the treatment approach. More often than not, specific assessment strategies do not show any resemblance to what the client does or requires. World Renowned Physical Therapist Gary Gray has stated on many of his DVD series that the assessment should be the test that can then be the exercise. If the assessment is true to that persons function, then using the assessment strategy to exercise will mean that the individual is likely to improve their function. A good example of 2 completely different approach to to assessing ones gluteal function is to compare the side-lying active hip abduction test and the standing single leg squat or balance reach excursion test. The side lying active hip abduction test places the individual in supported position that takes a very isolated look at how the glute functions compared to putting the individual in more functional position of standing and assessing how it functions as a movement. Both are very different strategies towards assessment and the question I always ask is that which test is best for my client and how can I have the biggest influence on helping my client in terms of moving forward with their specific complaint or overall movement. When it comes to prescribing this client exercises to improve their glute function, what makes more sense. Having them lie on their side and actively abduct their leg to try and improve the glute activation, or have them in an upright position carrying out a variety of different exercises such as single leg balance & reach exercises, lunge etc to improve their glute function. I would argue that the brain does not recognise individual muscle activation, rather it recognises and understands movement. Therefore if we can train our clients through movement to improve their dysfunctions, then we are likely to providing them with an increased ability to function.
Osteopath Heath Williams is owner of Principle Four Osteopathy, one of Melbourne City CBD 3000 leading Osteopathic clinics. Located at 29 Somerset Place, Melbourne City CBD 3000. Osteopath Heath Williams has a special interest in shoulder, back and lower limb injuries and integrates movement assessment and treatment strategies into his consultations. To speak to an Osteopath or make an appointment, please call 03 9670 9290. Check us out at www.principlefourosteopathy.com