Fundamentals of Intervention #3: Improving Mobility, Motor Control and Stability

If this is your first time tuning into the “Fundamentals of Intervention: An Approach For Treatment” series, catch up on my previous blogs on treating pain and integrating higher level sensory systems into treatment prior to improving mobility, motor control and stability. The flow of information will make more sense when approached hierarchically, I promise!

A compression-tension relationship can be seen throughout the body and everywhere in nature. This relationship is important because compression and tension work to distribute forces across a larger surface. Buckminister Fuller, an architect and futurist and described this relationship as “tensegrity”, a combination of the words tension and integrity, and is seen throughout the soft tissue continuum. Often times, I’ve observed that a dysfunctional joint will demonstrate compression on one side and tension on the other, or through an above to below relationship with tension above and below and compression in the middle, or vice versa. Tensegrity allows for stability and mobility at each segment, which is consistent with the spectrum in which movement exists.

Clinically, I’ve found it helpful to understand if muscles surrounding a joint demonstrate an improved or impaired ability to sustain a muscle contraction following a compressive or distractive force. If I compress the joint of a patient experiencing hip impingement and the muscles surrounding the joint demonstrate an improved ability to sustain muscle contraction, while distraction of the joint impairs the ability of the same group of muscles to sustain muscle contraction, I wouldn’t mobilize (create space between bones) the joint. This is because mobilizing a joint offering stability to an otherwise unstable system could easily feed into a pain cycle. Instead, I’d choose to strengthen all the muscles surrounding the joint. This situation tends to be the patient with pain and a ‘stiff’ joint that has been stretching for awhile with no or limited overall improvement.

What is exciting about following a logical thought process directed towards creating as much neuroplasticity as possible is that it simplifies the intervention. This thought process includes first identifying the down-regulated region, and driving as much input at the threshold as possible recognizing that changing input helps to change output. Conversely, some joints respond to distraction and therefore after creating space between the bones (mobilizing) would follow a similar thought process and drive plasticity to the down-regulated region, often times after down-regulating an up-regulated region.  

For a deep dive into improving the mobility, motor control and stability of the human body, as well as my other four fundamentals of intervention, watch my new 2 hour course where I’ll share real-life exercise examples as it pertains to the Integrated to Isolated Spectrum and discuss my other four fundamentals of intervention.

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Adam Wolf, PT

Author Adam Wolf, PT

Adam is a clinician, author, and educator. His professional credentials include Licensure in Physical Therapy (IL) and Massage Therapy (IL), Fellow of Applied Functional Science (Gray Institute), Level III Neurokinetic Therapy (NKT) practitioner, Enhance Running Technician, & Functional Range Conditioning (FRC) practitioner and Functional Neuro-Orthopedic Rehab (FNOR) Certified. His professional career spans nearly two decades and includes clinical, management, consulting, education, performance/strength and conditioning , as well as ownership roles. His professional interests lie in a deeper understanding of human movement combined with manual medicine, and creating innovative therapy and business paradigms that facilitate the growth of his patients and colleagues. Adam presents internationally to fitness and rehabilitation professionals and is co-owner of REAL pt, located in Chicago, and is the author of the recently released book, REAL Movement: Perspective on Integrated Motion & Motor Control.

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