This pattern begins with hip extension which initiates the roll and leads to pelvic rotation/lumbar extension and culminates in trunk extension/rotation, completing the roll.
This pattern helps to identify altered motor sequencing, timing and force expression of gluteal muscles by isolating hip extension/lateral rotation. Patient lies prone with legs extended and slightly abducted; arms flexed overhead, also slightly abducted. Head is in neutral rotation. When rolling toward the left side of the body the axis of rotation is formed by the lower extremity of the side that the individual is rolling toward and the upper extremity of the side the individual is rolling from, or in this case the left lower extremity and right upper extremity, respectively.
Attempt to perform with a fully extended lower extremity, but if unable to complete the roll, the client may flex the knee if needed in order to initiate the roll. Cue to extend at the hip and then at the knee.
This pattern begins with isolated shoulder flexion, leading to trunk extension/rotation, culminating in pelvic rotation that allows for the completion of the roll. The client lies prone with legs extended and slightly abducted; arms flexed overhead, also slightly abducted. When rolling toward the right side of the body, the axis of rotation is formed by the upper extremity of the side that the individual is rolling towards and the lower extremity of the side the individual is
rolling from, or in this case the right upper extremity and left lower extremity, respectively. The head should extend and rotate toward the opposite side. Remember, the head and neck are connected to the core, therefore where the head and neck lead the body will follow.
During this form of the test, the lower body should not contribute to the roll.
The body will always follow the head.
This pattern isolates shoulder flexion/horizontal adduction, which leads to trunk flexion/rotation, culminating in pelvic rotation/hip flexion that allows for completion of the roll. The patient lies supine with legs extended and slightly abducted; arms flexed overhead, also slightly abducted.
Head is in neutral rotation. When rolling to the right, the axis of rotation is formed by the upper extremity of the side that the individual is rolling towards and the lower extremity of the side the individual is rolling from (right arm and left leg). The client’s head and neck should flex and turn toward the right axilla. Remember, the head and neck are connected to the core, therefore where the head and neck lead the body will follow.
The lower body should not contribute to the roll. Cue the patient to resist the temptation to push with the left lower extremity.
This is Coach Cam Elliott demonstrating one of his favoured mobility techniques for upper hamstring tightness.
To self treat the upper hamstring, particularly reducing resistance created by the hamstring or hip.
Sit on your favourite treatment ball or device, eg. a spikey ball or lacrosse ball. Loop a superband around the foot, securing it by hand on the mid-thigh, across the front of the knee. Using the band to assist, straighten and bend the knee.
Use a reassessment movement to evaluate the effectiveness, such as a passive straight leg raise, active straight leg raise, sit and reach or toe touch in standing.
To influence the tissues around the ankle whilst actively mobilising.
Have the person assume a half kneeling or split stance.
Using an interface like facial tissue, apply pressure in each of many directions to gain a feel for which direction feels less mobile. The skin and superficial connective tissue should have some stretch over the deeper tissues. Once you've found the main direction that has a restriction, apply a manual pressure in that direction and have the person actively lunge into dorsiflexion.
As always, assess and reassess after each treatment to gauge effectiveness of the chosen direction.
To express ankle and subtalar inversion, eversion and anterior/posterior glides in a weight bearing stance.
Stand on one foot. You may hold on with hands for balance. Swing a leg across the body in large movements, as well as forward/backwards.
Stability is reflex driven and context specific. The reflex-driven stability is enhanced by first having a sensory rich environment so that the mechanoreceptors in the skin, ligaments, muscles and tendons can detect movement and respond quickly (and subconsciously). After mobilising the lower body, the leg swings provides a static stability (control of movement whilst another body part moves) drill for preparing to train.
The purpose is to improve thoracic rotation via self-directed accessory rib cage mobilization, in a non weight-bearing position.
Start with hips flexed to at least 90 degrees, preferably as high as possible to create lumbar tension to limit lumbar rotation.
Grab the underside of the rib cage. As you lay back, thus rotating and extending the thorax, pull upwards on the ribs. After 3 breaths, perform a double reach - one hand reaches back along the floor whilst the other reaches to the sky.
Thoracic rotation/extension is not a pure intervertebral motion. It involves costo-transverse and costo-vertebral mobilization also. The accessory rib cage mobilization provides distraction to the costo-transverse and costo-vertebral joints. The pulling action, coupled with scapulothoracic retraction, inhibits anterior torso activity, thus freeing up rotation mobility.The double reach creates an extension force on one side of the spine with a flexion force on the other side - creating rotation.
Common errors and corrections:
A loss of scapulothoracic stability on the “pulling arm”. If this occurs, cue shoulder packing. Another error is a loss of hip flexion, leading the lumbar spine to mobilise, reducing the targeted thorax mobilization. If this occurs, cue more hip flexion.
To express thoracic extension and rotation with diaphragmatic breathing.
Best suited after mobility reset of the thorax.
Start in prone. Assuming the thorax has been mobilised and diaphragmatic breathing is competent, on an inhale, actively extend and rotate the head, neck and thorax, lowering on exhalation.
Holding your breath during movement may be a sign of motor control dysfunction.
Even after pain is gone, or mobility limitations are removed, an individual may hold their breath in anticipation of pain or movement. This is a conditioned response that is best overridden in a safe position such as prone.
Someone with a neck, thorax, lumbar or hip extension mobility limitation may also have an inhalation restriction. Someone with a flexion restriction may also have an exhalation restriction
Breathing restrictions/dysfunctions may also cause restrictions in shoulder mobility, dysfunctional rolling patterns, and balance impairments.
In “dirty and difficult” movement patterns, that is, those movement patterns with dysfunctional motor control, we often see a segment move out of sequence. This is controlled best by locking the segment in a position that prevents it from moving out of sequence.
In motor control training, where there is movement instead of stability, change the task or environment to lock out unwanted movement.
An example is an overhead press performed with excessive lumbar flexion and/or anterior pelvic tilt. The lumbar spine can be locked in a position that prevents this compensatory out-of-sequence movement by placing one or both hips into full flexion, causing posterior pelvic tilt. This looks like a seated overhead press, or a single leg stance overhead press. Preference should be given to those tasks that are higher in the neurodevelopmental hierarchy, ie single leg stance with full hip flexion. The foot of the flexed hip can be placed on a seat/bench, or held for balance purposes.
To challenge postural integrity under load
Carry a weight on one hand, in one of three positions:
Overhead; in the racked position just in front of the shoulder; or in the "suitcase" position by the side. Walk a set distance.
Add a weight in the other hand, in another position, to create asymmetry in load and randomness in context.
Walk a narrow beam for more challenge to postural integrity and processing of environmental inputs.
Add obstacles to increase the processing of the nervous system.
Hold the kettlebells "bottoms up".
The weight perturbs the postural alignment of segments, forcing motor control of said alignment, whilst moving. Small adjustments to posture are required constantly, with alignment errors magnified at the hand, creating instant feedback to balance. Constant movement via walking ensures global stabilisers, ie prime movers, can not play a part in joint alignment integrity, leaving segmental stabilisers to reflexively control posture from the foot through the lower leg, pelvis, spine and to the upper limb.
The ability to traverse the course, whilst nasal breathing, indicates the nervous systems competency in motor control. The individual can be measured for motor control using the Lower Quarter Y-Balance Test, Upper Quarter Y-Balance Test or the Fundamental Capacity Screen's Carry test. (see www.functionalmovement.com for more details)
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