Movement Dysfunction in Sports Medicine
Paul Thawley
BSc (Hons), MSc, Pg Dip
Simple movement Patterns and
dysfunction
This an extra Lecture
You will not have a written paper on this
However sports medicine uses and understands
physical and functional movements
Movement dysfunction can be caused by a range of factors,
including:
Structural instability: which occurs when the body structure fails, usually as a result of a direct
trauma
Loss of Range of Motion (ROM): which can be due to joint stiffness, muscle tightness or motor
patterning (acts performed with less skill and in which movement is stressed)
Functional rigidity: which often develops if an athlete tries to cope with a higher balance or
stability challenge than they are capable of
Insufficient Control of Momentum: if an athlete can't control their momentum, their change in
direction will be slow, or, alternatively, will throw them off balance
Poor balance: balance requires an interplay between your vision, inner ear and body's
feedback
Poor co-ordination: Most obvious in racket sports, and golf
Timing: Poor stability is often related to timing problems
Poor understanding of the movement required: Caused by a misunderstanding
between the coach and athlete
Poor training design: unsuitable training practices
Stress: Stress from the mind can manifest itself in the body
Clinical Movement Analysis to Identify Muscle Imbalances and Guide
Exercise
MOVEMENT
is an essential component of athletic
performance. Human movement is
influenced by an individual’s structural alignment, muscle
flexibility, muscle strength, and nervous system coordination
of muscle responses to a changing environment. (Padua
2007)
The Overhead Squat Test
can be used to
qualitatively assess
an individual’s overall movement patterns. The results of this
test can then be related
to goniometric measures (muscle
flexibility)
and manual
muscle testing (muscle strength)
to
develop a comprehensive view of the individual’s movement
characteristics. (Ford et al 2003)
Observable functional test
can provide the
basis for therapeutic exercise
recommendations for stretching of potentially
overactive and tight muscles and for
strengthening of underactive and weak
musculature. To optimize function, the
individual should be progressed to an
integrated functional exercise program. (Clark
et al 2005)
The Overhead Squat
Is used regularly in screening by medical teams
It can help identify Common dysfunctional
movement patterns.
It can be linked to Muscle testing etc
After Padua 2007
Over head Squat
Two legged squat with the arms raised
overhead.
The athlete is instructed to stand with feet
hip-width to
shoulder width apart with
toes pointing straight ahead and arms
raised above the head.
The athlete is instructed to squat down as if sitting in a chair.
The observation is made from three views: anterior, lateral,
and posterior.
5 Squats are preformed whilst the clinician observes from
anterior view, lateral view posterior view (15 squats in total
The clinician notes the movement pattern characteristics by
recording whether or not a particular characteristic was
identified during performance of the test.
Method
Anterior View
:
Observations made from the anterior view of the overhead squat are
focused at the feet and knees
A common compensation at the feet is the
foot turning outwardly
When observing for the presence of toe out
assess the position of the first
metatarsophalangeal (MTP) joint in relation
to that of the medial malleolus.
The 1st MTP joint will align with the medial
malleolus in a normal foot, whereas the first
MTP joint will appear lateral to the medial
malleolus with foot turn-out.
This can identify potentially overactive/tight
muscles and underactive/weak muscles
Foot and Ankle
Anterior View
Knee
Inward movement of the patella
over the first MTP joint during the
squatting movement creates valgus
stress at the knee
lumbo-pelvic hip complex (LPHC) and upper
body positions.
Lateral View
Two common compensations are excessive
forward leaning and arms falling forward.
Trunk should remain parallel to the lower leg
during the descent phase of the squat. If the
two imaginary lines do not remain parallel,
forward leaning is excessive (Figure 4).
Arms should be held over the head in an
elbow-extended position parallel to the
torso. If the arms move forward in
relation to the torso, the observation is
designated as “the arms falling forward”
Observations made from the posterior view
include the positions of the feet and the
lumbo-pelvic hip complex.
The calcaneus should stay parallel with the
lower leg
A common compensation seen at the feet is
pronation.
During the descent phase of the Overhead
Squat Test may observe flattening of the
medial longitudinal arch with eversion of
the calcaneus in the frontal plane
Posterior View
Identifying possible causes of common
movement dysfunction
Overactive? underactive?
Overactive? Underactive?
Overactive? Underactive?
Single Leg Squat
•
Increases demand and need for balance +
control
•
Can be specific to sport / running single stance
•
Requires Rotational control
Movement dysfunction in sports medicine can stem from various factors such as structural instability, loss of range of motion, functional rigidity, poor balance, and more. Clinical movement analysis plays a vital role in identifying muscle imbalances and guiding exercise interventions to enhance athletic performance.
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Presentation Transcript
Paul Thawley BSc (Hons), MSc, Pg Dip Simple movement Patterns and dysfunction
This an extra Lecture You will not have a written paper on this However sports medicine uses and understands physical and functional movements
Movement dysfunction can be caused by a range of factors, including: Structural instability: which occurs when the body structure fails, usually as a result of a direct trauma Loss of Range of Motion (ROM): which can be due to joint stiffness, muscle tightness or motor patterning (acts performed with less skill and in which movement is stressed) Functional rigidity: which often develops if an athlete tries to cope with a higher balance or stability challenge than they are capable of Insufficient Control of Momentum: if an athlete can't control their momentum, their change in direction will be slow, or, alternatively, will throw them off balance
Poor balance: balance requires an interplay between your vision, inner ear and body's feedback Poor co-ordination: Most obvious in racket sports, and golf Timing: Poor stability is often related to timing problems Poor understanding of the movement required: Caused by a misunderstanding between the coach and athlete Poor training design: unsuitable training practices Stress: Stress from the mind can manifest itself in the body
Clinical Movement Analysis to Identify Muscle Imbalances and Guide Exercise MOVEMENT is an essential component of athletic performance. Human movement is influenced by an individual s structural alignment, muscle flexibility, muscle strength, and nervous system coordination of muscle responses to a changing environment. (Padua 2007) The Overhead Squat Test can be used to qualitatively assess an individual s overall movement patterns. The results of this test can then be related to goniometric measures (muscle flexibility) and manual muscle testing (muscle strength) to develop a comprehensive view of the individual s movement characteristics. (Ford et al 2003)
Observable functional test can provide the basis for therapeutic exercise recommendations for stretching of potentially overactive and tight muscles and for strengthening of underactive and weak musculature. To optimize function, the individual should be progressed to an integrated functional exercise program. (Clark et al 2005)
The Overhead Squat Is used regularly in screening by medical teams It can help identify Common dysfunctional movement patterns. It can be linked to Muscle testing etc
Over head Squat Two legged squat with the arms raised overhead. The athlete is instructed to stand with feet hip-width toshoulder width apart with toes pointing straight ahead and arms raised above the head. After Padua 2007
Method The athlete is instructed to squat down as if sitting in a chair. The observation is made from three views: anterior, lateral, and posterior. 5 Squats are preformed whilst the clinician observes from anterior view, lateral view posterior view (15 squats in total The clinician notes the movement pattern characteristics by recording whether or not a particular characteristic was identified during performance of the test.
Anterior View: Foot and Ankle Observations made from the anterior view of the overhead squat are focused at the feet and knees A common compensation at the feet is the foot turning outwardly When observing for the presence of toe out assess the position of the first metatarsophalangeal (MTP) joint in relation to that of the medial malleolus. The 1st MTP joint will align with the medial malleolus in a normal foot, whereas the first MTP joint will appear lateral to the medial malleolus with foot turn-out. This can identify potentially overactive/tight muscles and underactive/weak muscles
Anterior View Knee Inward movement of the patella over the first MTP joint during the squatting movement creates valgus stress at the knee
Lateral View lumbo-pelvic hip complex (LPHC) and upper body positions. Two common compensations are excessive forward leaning and arms falling forward. Trunk should remain parallel to the lower leg during the descent phase of the squat. If the two imaginary lines do not remain parallel, forward leaning is excessive (Figure 4).
Arms should be held over the head in an elbow-extended position parallel to the torso. If the arms move forward in relation to the torso, the observation is designated as the arms falling forward
Posterior View Observations made from the posterior view include the positions of the feet and the lumbo-pelvic hip complex. The calcaneus should stay parallel with the lower leg A common compensation seen at the feet is pronation. During the descent phase of the Overhead Squat Test may observe flattening of the medial longitudinal arch with eversion of the calcaneus in the frontal plane
Identifying possible causes of common movement dysfunction
Single Leg Squat Increases demand and need for balance + control Can be specific to sport / running single stance Requires Rotational control
