The emperor has No clothes: The Dysfunctional Deciet

Thank You for joining me 

 If you have ever laid awake worrying about your client's movement patterns, you too may be an over thinker. The thought of missing something, when you see your client move, that could cost them an injury. Its terrifying !

Many of the students who work with me, want to ensure they are doing everything they can to prevent client injuries. They were taught, like myself, to be obsessed with posture correction, then fixate on muscular imbalances to help  eradicate dysfunctional movement.

While some may feel they are living the dream of being a healer, a guru fixing dysfunctional movement. Some trainers may talking about how they are preventing injury, illness, and improving performance. This sounds great.

Just getting someone to move, does all those things! So if you are doing that, you get to give yourself a pat on the back, and thats without making anyone feel rubbish about the way they move.

What we are  really talking about here is moving in optimum ways. This is where you may find the industry likes to sell techniques, and methods to clients, to overcomplicate things. It preys on conscientious trainers who are looking for more confidence, more revenue or those with an ego, and I fell for it on all  three accounts!

*I Don't think that's ethical on the client and I don't think it’s ethical on the trainer either. So let's define what a dysfunctional movement is and have a look at what we are doing when we think we are “fixing” it

Define Dysfunctional Movement ​

Dysfunctional Movement is often touted as a movement pattern that deviates from what is considered to be a  'normal' musculoskeletal function or movement pattern.  NASM, who I trained with in the US for instance, describes it as a state involving muscle imbalances, decreased flexibility, or lack of core and joint stability. Many educators say that by identifying and correcting issues like muscle imbalances and asymmetries, we can prevent injuries, alleviate pain, and enhance performance.
However, this may not be as straightforward as it seems. The terms used to describe these dysfunctions are vague and when you dig into the research (one of my favourite parts to teach on Motor Skill Application Specialist, "MSAS" as we call it!) lacks a standardised approach for measurement, which glosses over the complexities of human movement. This oversimplification neglects the unique and varied nature of individual movement patterns which makes it challenging to measure.

How ​to measure dysfunctional movement

Many different tests or screens claim to measure dysfunctional movement patterns, like, Functional Movement Screening (FMS), The Overhead Squat, and various postural assessments. These tests have a commonality, they all look for asymmetry, in an attempt to identify tightness or muscle weakness. However, these terms are vague and can overlook the nuances of individual movement patterns, skill, structure, emotion, and environmental factors. This raises questions about the predictive value and validity of such tests. It casts doubt on their ability to accurately determine what is deemed good or what is deemed bad movement that requires “fixing”.

There is still so much to unpack: My hope is you stay with me. 

Asymmetry: What the tests help identify so you can correct it. ​

These tests are looking for asymmetry or muscular imbalances: This term refers to a lack of balance between functionally opposite muscle groups, for example, the abdomen and back or between the left and right side. They claim that the originally balanced state of muscular tension is off-kilter, and some muscles are too tight or some not tight enough, leading to changes in strength and mobility. To define strength and mobility that would need another blog or you can join me on  MSAS where we delve into what strength and mobility mean to unique clients. Now lets get back to measuring dysfunctional movement through a barrage of generic tests that all aim to highlight asymmetries, and muscular imbalances to prevent, predict an injury, or pain, or enhance performance. Before addressing these claims I think it may be good to first define posture.

Posture: Both Static and dynamic

Static posture is a snapshot in time, it’s how the body maintains one alignment for a given period.
Dynamic posture is how the body holds itself in movement, like when walking and running. I love seeing someone running who is hunched over because the old me would have been thinking, posture correction, weak, tight muscles, whereas now, I just smile and say
“ You’re doing a great job! “
With that, they usually look up smile and begin to run more upright with more confidence. This little comment influences their mood, bringing them into a more upright, efficient running style ( dynamic posture). For those interested in learning more about programming to improve your running efficiency, top pace, acceleration or muscular endurance this is covered on MSAS. Back to the prediction of pain and injury: Using the research process taught on MSAS it would seem that posture in some cases can be correlated to pain.  It is essential to remember that correlation does not equal causation. That's like saying “If you eat ice cream you are more likely to die of a shark attack” 😂. ( Nope when it’s hot weather more people eat ice cream and more people swim). However, posture does not seem to have a significant link to pain ( unless of course maybe you believe it does - that's another blog). In the past, I was fearful of clients with anatomical positions like a forward neck and was taught to label this as muscle stiffness ( here we go again ). Muscle stiffness can be described as the feeling of pain or tightness in your muscles. This would have then been blamed on a muscle being overactive with a notion to “fix”. However, the perception of feeling is influenced by the central nervous system, which encompasses factors such as emotion, mood, skill and so much more ( but that's for overthinkers who want to join our MSAS community). By the way, If a forward head or *text neck * was a thing to worry about, back in the day fishermen and stone merchants would have also been in trouble! How I like to describe posture (from the studies I have read), I would say it is about the body's best way of holding itself within the context of mood and skill. For example imagine your body’s posture when entering a doctor’s surgery expecting seriously bad news, compared to leaving with a clean bill of health. Our posture dynamically reflects our emotional state, skill, and the environment, not just structure. Recognising this can offer a more effective,  and positive approach to unique movement behaviours. For those wanting a little more detail join me on MSAS.

What appears to be missing so far when looking at correcting movement patterns with these generic tests is an understanding of the complexities of individual movement, and how we learn to adapt and refine our movement skills, known as motor learning. But let's get back to injury prevention for now.

Injury and Injury Prevention ​

An injury is when something breaks down. When something snaps or straightens too far or breaks. If it is a ligament tear, a ripped tendon or a broken bone unless you are a surgeon it has nothing to do with us. Most injuries are caused by being unlucky, for example, tripping on your weights in the gym so the first big tip is to make sure you put your weights away! If your client has had a previous injury and you are already doing a basic background check such as your Par-Q, and another patient on your back, you are already establishing the increased injury risks of your client in a more reliable way than many movement screens.Then there’s the risk of doing too much too soon, too much volume, and load, or lacking the skill to handle certain movements or speeds. It’s like someone at a buffet eating more than they can handle – in the gym, don’t let your eyes be bigger than your muscles.
If someone says to me
“It is for injury prevention”,
my first response is
“Which one specifically? “
From there we can head to the specific research.
Testing movement patterns or muscular imbalances while in some cases could be a correlation to some injuries, from the balance of quality studies i read, it did not appear to be a causation. 

*It's worth a reminder that injury is different to pain. While it can lead to pain or pain can sometimes lead to an injury, they are not the same.

Pain: Acute and Chronic ​

Pain is a response to a sensation when your brain decides you are in danger whether is or isn't for another blog!
​
*Before going any further: if a client has any unexplained pain, they should first seek a diagnosis from a medical doctor. The last thing we want is to change their experience of pain to discover it has cost them 3 months of critical treatment for a disease.

Acute Pain: Something that normally happens with an injury, like that nightmare kid, skiing into my ACL ( now I’m triggered ). It can last for anything up to 12 weeks. Anything after that is usually considered chronic.
Chronic pain: is the type we more often encounter in fitness settings. To ensure we are on the same page,  pain is a response to a sensation, where your brain has decided you are in danger.
“You can have pain with damage and where there is no potential damage"
The British Pain Society.
You can dig into injury and pain in more depth on Motor Skill Application Specialist ( MSAS) where we have more time, videos and really useful ebooks on this topic.

While there may be a correlation between muscle imbalances, and pain, it is not a causation or predictor of pain or injury. Phew, and breathe, we don't need to lose sleep over it!
Many athletes are asymmetrical. Interestingly instead of this being detrimental to their performance, it seems it may well be advantageous! ​

MOTOR SKILL APPLICATION SPECIALIST (MSAS)

Improving Performance

Performance is an area we need to get right. Most trainers want to ensure their unique client can execute a specific task, to the best of their ability in a way that is challenging enough to get optimal adaptation and results. It is often measured by criteria such as strength, speed, skill level, and endurance. To get more nerdy about how you can improve performance, getting to the right inter and infra muscular contractions, all happen in the right sequence with the appropriate power you may want to join other trainers like you on MSAS. There,  we will explore how to target your client's training, towards their specific needs, such as increasing muscle strength for their deadlift, power for their punch, or over-head squat. Learning the Faster process to help refine skills through motor learning and skill development can lead to enhanced performance in any given activity.

Some sports require a move synchronised movement pattern, for example, powerlifting as any deviation from keeping the bar parallel to the floor will require more muscle activation, being less efficient. However some sports require athletes to have asymmetry, and it would seem this is not at a cost to their performance!  Usain Bolt has a unique running style and he's pretty quick! *This is an N=1, so you would be right to check the research on this yourself! So you may not need to worry about making your client symmetrical ( unless of course they are a bikini model and would get their “scores” marked down if they had one glute or calf bigger than the other ) certainly don’t worry on an account of preventing pain or injury!

Recap

My hope is that this blog helps to  challenge the fitness industry's traditional beliefs or reasons for measuring muscular dysfunctions and posture. It would seem instead of focusing on correcting, we could adopt a more nuanced understanding of human movement. Using principles of motor learning to help recognise our body's capacity for adaptation, we can enhance our client's fitness practices in a more positive, effective manner. The body adapts to various environmental challenges. For example, a football player learns to adjust their movements on different playing surfaces; this adaptability is a product of the body’s dynamic response to external factors, which can be crucial for skill development, efficiency and performance.
Using the simple research process from MSAS enabled me to write this blog, if you would like to find out more about this process or more about how  MSAS can practically help you and your clients, follow the link below.

MOTOR SKILL APPLICATION SPECIALIST (MSAS)

Having the tools to be a great researcher means you can critically  evaluate  any technique and method : without taking my or any others persons word for it!

Here are some examples of techniques I've used and then learnt to critically evaluate.  I would recommend doing your own research.
​

1.  Corrective Exercises: a concept based on the thought that natural movement variations are inherently wrong and need fixing. It’s a flawed argument that overlooks the uniqueness of individual movement
2. Foam Rolling and Myofascial Release: While they may offer short-term changes to the central nervous system, this is at a long-term cost to performance. This creates reliance on techniques that can detract from effective movement skill development.
3. Perfect’ Posture: The pursuit of an idealised posture is a myth with no solid backing in research. It can lead to a harmful fixation on unattainable standards, causing more stress than benefit.
4. Movement Screening:  Often lacks the nuance to account for individual variability in movement. It can lead to overdiagnosis and an unnecessary focus on ‘correcting’ non-issues. It should not be used to attempt to predict an injury.
 5. PNF Stretching: While it can create a short-term increased range of movement, the belief in its ability to ‘correct’ deeper muscular issues is exaggerated and not supported by robust evidence.
 6. Pilates and Yoga: I"m a big fan of moving, while yoga and Pilates are beneficial for many things including general health, the claims of ‘fixing’ musculoskeletal issues are overblown and not backed by solid research.
7. Chiropractic and Osteopathic Manipulations: Not based on sound scientific research. They can lead to a dependency on short-term fixes rather than addressing long-term movement health.
8.  Gait Retraining: The idea that everyone’s gait needs fixing is a flawed premise. It overlooks the natural variability and complexity of individual gait patterns.
9. Thomas Test (or other movement tests done lying down): Commonly used to assess muscular imbalances, claimed hip flexor tightness, but its relevance to functional movement is questionable. Conducted in a lying-down position, it fails to replicate the demands of most activities. (Reference: González-dela-Flor et al. (2023))

You’ve made it this far, thank you! This could show that you are dedication to your clients or maybe, that you want to tell me how wrong I've got this! My hope is this blog helps build  your confidence in what you are already doing well. That it helps remove some of the stress and anxiety in training your clients, by questioning a concept of needing to "fix" at the risk of taking away your clients self efficacy in movement. Either way, you’re exactly the kind of student who thrives on MSAS. If you’re keen to explore how motor learning, learning in abundance, and dynamic systems can enhance your clients’ experience, or how to learn more about the process of getting to the balance of best scientific evidence, join me now on MSAS.
​
If you think I have missed anything I would love to hear from you in the comments below.
​
Joanne

MOTOR SKILL APPLICATION SPECIALIST (MSAS)

References :
​*Dhawale AK, Smith MA, Ölveczky BP. The Role of Variability in Motor Learning. Annu Rev Neurosci. 2017 Jul 25;40:479-498.
*Shi LZ, Zhao ZH, Yang ZZ, Li ZJ, Shen XJ. [A study of the correlation between low back pain and occupational stress in coal miners]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2018 Nov 20;36(11):849-852. Chinese. doi: 10.3760/cma.j.issn.1001-9391.2018.11.014. PMID: 30646652.
* Chimera NJ, Warren M. Use of clinical movement screening tests to predict injury in sport. World J Orthop. 2016 Apr 18;7(4):202-17.
* Lederman E. The myth of core stability. Journal of Bodywork and Movement Therapies, 2010; 14(1): 84-98.
* Latash ML. Synergy. Oxford University Press, 2008.
* Moseley GL, Butler DS. Fifteen years of explaining pain: The past, present, and future. Journal of Pain, 2015; 16(9): 807-813.
* Bialosky JE, Bishop MD, Cleland JA. Individual expectation: An overlooked, but pertinent, factor in the treatment of individuals experiencing musculoskeletal pain. Physical Therapy, 2017; 97(9): 893-903.
* British Pain Society. Understanding Pain.
* National Health Service (NHS). Musculoskeletal Health.
* Reference: Cook, G., Burton, L., & Hoogenboom, B. J. (2006). "Pre-participation screening: The use of fundamental movements as an assessment of function - Part 1." North American Journal of Sports Physical Therapy.
* MacDonald, G. Z., Penney, M. D. H., Mullaley, M. E., Cuconato, A. L., Drake, C. D. J., Behm, D. G., & Button, D. C. (2013). "An acute bout of self-myofascial release increases range of motion without a subsequent decrease in muscle activation or force." Journal of Strength and Conditioning Research.
* Barrett, E., O'Keeffe, M., O'Sullivan, K., Lewis, J., & McCreesh, K. (2016). "Is thoracic spine posture associated with shoulder pain, range of motion and function? A systematic review." Manual Therapy.
* Dorrel, B. S., Long, T., Shaffer, S., & Myer, G. D. (2015). "Evaluation of the Functional Movement Screen as an Injury Prediction Tool Among Active Adult Populations: A Systematic Review and Meta-analysis." Sports Health.
* Sharman, M. J., Cresswell, A. G., & Riek, S. (2006). "Proprioceptive neuromuscular facilitation stretching: Mechanisms and clinical implications." Sports Medicine.
* Wells, C., Kolt, G. S., & Bialocerkowski, A. (2014). "Defining Pilates exercise: A systematic review." Complementary Therapies in Medicine.
* Ernst, E. (2008). "Chiropractic: A critical evaluation." Journal of Pain and Symptom Management.
* Cheung, R. T. H., & Davis, I. S. (2011). "Gait retraining in runners: In search of an evidence-based practice." Journal of Science and Medicine in Sport.
* González-de-la-Flor, Á., et al. (2023). "Validity and reliability of a new hip flexor muscles flexibility assessment tool: The reactive hip flexor (RHF) test." Physical Therapy in Sport.
* Roffey DM, Wai EK, Bishop P, Kwon BK, Dagenais S. Causal assessment of awkward occupational postures and low back pain: results of a systematic review. Spine J. 2010 Jan;10(1):89-99. doi 10.1016/j.spinee.2009.09.003. Epub 2009 Nov 11. PMID: 19910263.
* Myer GD, Kushner AM, Brent JL, Schoenfeld BJ, Hugentobler J, Lloyd RS, Vermeil A, Chu DA, Harbin J, McGill SM. The back squat: A proposed assessment of functional deficits and technical factors that limit performance. Strength Cond J. 2014 Dec 1;36(6):4-27. doi: 10.1519/SSC.0000000000000103. PMID: 25506270; PMCID: PMC4262933.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4262933/

PubMed

Joanne Groves

If you're a trainer who's tired of delivering the same generic sessions you see plastered all over social media, and you're eager to ensure that every exercise you prescribe has a unique, purposeful intent, then MSAS is for you! I'm thrilled to invite you to join me on our upcoming 12-week group motor skill application specialist course. I'm always excited to witness the impact this course has on trainers and their clients success.

Thank You for reading, I’m Joanne, a proud wife and mother to two amazing children. With over 28 years in the fitness industry, I've grown into roles including Course Director, International Master Trainer, Presenter, and an accomplished author with Faster Health and Fitness. My passion lies in guiding trainers and business owners to deliver exceptional, evidence-based experiences your clients rave about.