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Movement Restoration to Avoid Overuse Injuries

Recently, I received this question on the Art of Fitness Facebook page. This is part two to my response. You can read part one here. Here is the original question.

I run. I run for a lot of reasons. I know that physically speaking, it can/will wear on your body like any repetitive movement. So, if, you’re like me, and are unwilling to give up regular runs, what is the joint-saving balance? I have a regular yoga practice (equally important) but is there something else I should be doing? I run 20-30 miles a week (3-4, 6-8 mile runs); yoga twice a week; Pilates once a week; and if I make my way into an actual gym, I swing kettlebells, pick up heavy things, and wonder around pretending I know what I’m doing. Any suggestions?

I would like to throw a wrench into the popular belief that pain and injury are due to overuse. Chronic pain and injury isn’t caused by the movements we do too much—chronic pain and injury are most often due to the movements we don’t or can’t do enough. While issues of overuse do certainly happen, pain and injury is actually a problem of the underutilization of very specific natural human movements.

Sitting causes pain - movement restorationWe sit in our cars, desks, and couches. We don’t squat to work, climb, crawl or otherwise use our bodies the way they were designed to move. Engaging in these natural human movements provide movement balance. If you aren’t moving in these other ways, your body will adapt and compensate to the ways you do move. This creates the secondary problem of overuse. Overuse is a symptom, not the problem.  

This may seem like a subtle distinction, but I believe it is important because it changes our focus regarding how we choose to correct movement imbalances. When addressing an “overuse” injury, the traditional corrective is to stop doing the specific movement that aggravates pain, but what do we replace that movement with? While you may find temporary relief, once you begin running again you’ll be back to “overusing” those muscles.

Most often if there are any corrective exercises even prescribed (and this is a big if), they tend to be specific to the site of pain—for example, if you have elbow pain, you’re given exercises to strengthen the elbow and possibly shoulder; knee pain leads to exercises for the knee and hip, etc. The problem with this is that the injury isn’t only to the site of pain… it is to your entire body. To treat the site of pain without addressing how that part integrates with the whole is incomplete. This is the primary reason I receive so many referrals from clients after seeing multiple physical therapists without resolution to their pain.

Don’t Treat Pain. Treat movement!

No Pain - Movement RestorationSomething I tell clients during the initial consultation is, “I don’t treat pain. I treat movement.” It is out of my scope of practice to treat your pain, plus I believe that attempting to do so will render less beneficial results. Instead, I look at how you move, and more importantly, how you don’t move. My focus is on bringing back all the movements you’ve lost in order to bring balance back to the entire movement system. My assumption is that if you move well, with balance throughout the spectrum of human movement, you will probably experience less pain. I call this Movement Restoration.

Restoring Movement Will Decrease Injury

Movement restoration is the exploration, re-establishing, rewiring, remapping, and reconfiguring of your natural human movement—moving the way you were designed to move. Through Movement Restoration, we find what is lost and work to bring those movements back into your abilities: can you lift your arms over your head, squat down to the floor, unstrap your bra, get up off the floor without using your hands, crawl, and climb? And can you do these things without pain? Can you do them well? With mastery?

A Movement Restoration Practice

But how, you might be wondering. What does this even look like?

1. Focus on the micro movements.
In the larger fitness industry, there is a focus on big, sexy, intense movements. Swinging tons of weight around and pushing our body hard feels good, but if you don’t move well at the micro, foundational levels, you’re going to break your body down over time. To move well, you have to focus on the small movements first.

  • How does each joint move through its full range of motion in relationship to the joints above and below it? How does each vertebrae move in three dimensions: pitching forwards and backwards, side to side, or rotationally? Consider this like a systems check, a movement inspection.
  • If you move well in one area of your body, in one specific direction, but poorly in the opposite direction, you’ve found an imbalance. That imbalance is showing up in your movement with every step you take and it is contributing to your potential pain and injury.

2. Move all day, throughout the day.
Movement should not be relegated to a 30-60 minute class, run, or workout. We are human movers. We are not supposed to be sedentary beings. We are supposed to move constantly. Restoration movements are so low in intensity that you can’t do too much. Really, you can’t do enough! These are the movements you need to be doing all day, every day, throughout the day. Incorporating them into your home, work, and recreational routines. So how do you move constantly throughout the day?

  • Move from where you are at. If you spend time in a chair all day, then you need to incorporate movement breaks into your work… in your chair!
  • Movement is nutrition. How you move is how you feed your body movement. If you sit all day without moving, it’s the equivalent of feeding your body McDonalds. I teach my clients “movement snacks” which are specific movement tools they can use throughout the day. Here’s a video of my level one movement restoration

  • Here are some simple movements you can perform from your office chair.

Building on the Movement Restoration Foundation

As we move from the micro level to the macro level movements, we begin to focus on developing specific skills. Skill builds upon movement restoration into practical function and purpose.

For example, Shin Box, a restoration movement, moves your hips from internal to external rotation. In skill, we look at going from shinbox to standing, shinbox to knees, knees to standing. This gives you the skill of getting up and down from the floor without bracing with your hands. Cat Cow, the restorative movement, helps you develop flexion in your lower back and spine, which is the foundation for many different skills which use this flexion–lifting, walking, squatting, etc. Movement restoration asks, does the joint work? Can I move in these patterns? Skill asks, can I accomplish this task: Squatting down to pick up a child, getting up from the floor, etc.

I will discuss skill in greater detail in part three.

Want to learn more about how Movement Therapy can help you? We offer in person coaching and online coaching.

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