the science of movement exercise prescription
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The Science of Movement Exercise Prescription Phil Plisky, PT, DSc, - PowerPoint PPT Presentation

The Science of Movement Exercise Prescription Phil Plisky, PT, DSc, OCS, ATC, CSCS What is the best exercise for ___________? Symptoms of internal combustion engine dysfunction Rough idle Hesitation Engine Misfire Smoke


  1. The Science of Movement Exercise Prescription Phil Plisky, PT, DSc, OCS, ATC, CSCS

  2. What is the best exercise for ___________?

  3. Symptoms of internal combustion engine dysfunction • Rough idle • Hesitation • Engine Misfire • Smoke • Reduced gas mileage • Hard to start • Won’t start

  4. Is adding more gas the solution?

  5. What could the problems be?

  6. Is adding more EMG activity the solution? Why do we care which exercise produces the GREATEST EMG activity?

  7. Functional Training Normalize and Stimulate Don’t just Train Muscles Sensors & Train the Brain

  8. Action Point #1 Work on the inputs, not the muscle Create a sensory rich environment the elicits the movement pattern you want

  9. Lab

  10. SFMA • Cervical: FN • UE: FN • Flexion: DN - SMCD • Extension: DN – no forward weight shift - – SMCD • Rotation: FN • SLS: DN, glut drop, unable to perform eyes closed - SMCD • Squat: DN – forward lean

  11. Segmental Rolling DN - SMCD Every time she does anything she is in extension

  12. FMS SCORING SHEET FINALSCORE RAW SCORE SCREEN R/L _ ____2 _____ ______2_____ Deep Squat ____2_/_2___ ______2_____ Hurdle Step ____3_/_3___ ______3_____ In-Line Lunge ____3_/_3___ ______3_____ Shoulder Mobility ____3_/_3___ ______3_____ Active Straight Leg Raise _____1______ Trunk Stability Push-Up ______1_____ ____2_/_2___ Rotary Stability ______2_____ TOTAL 16

  13. 3 Corrective Exercises Adding Sensory Input AND what is the error detection method

  14. General Guidelines Reset Re-Enforce Reload

  15. Reset Re-Enforce Reload • Clinical Manual Therapy Techniques – Manipulation – Mobilization – PNF techniques – Trigger Point techniques – ASTYM – Active Release – Dry Needling – Laser

  16. Reset Re-Enforce Reload Clinical Manual Therapy Techniques – Manipulation

  17. Reset Re-Enforce Reload Clinical Manual Therapy Techniques – PNF techniques

  18. Reset Re-Enforce Reload Clinical Manual Therapy Techniques – Trigger Point techniques

  19. Reset Re-Enforce Reload Clinical Manual Therapy Techniques – Instrument Assisted Soft Tissue Massage

  20. Reset Re-Enforce Reload Clinical Manual Therapy Techniques – Active Release

  21. Compression/Distraction Underutilized Resets for SMCD

  22. Reset Re-Enforce Reload

  23. Reset Re-Enforce Reload Stretching and soft tissue work performed by the patient at home

  24. Reset Re-Enforce Reload Discussions and education about hydration, nutrition sleep quality/ quantity/positions, ergonomic positions, driving positions, workout modifications.

  25. Reset Re-Enforce Reload Protection……… to reduce stress and exacerbations such as footwear, orthotics, bracing, splinting and weight-bearing status

  26. Reset Re-Enforce Reload Forms of biofeedback such as leukotape and kinesio tape to provide enhanced perception and input

  27. Reset Re-Enforce Reload

  28. “Don’t prescribe strengthening for a motor control problem” Rotator Cuff Exercise?? Core Exercise????

  29. Is the best way to learn a new movement pattern to perform an exercise that mimics that movement for 8-10 reps?

  30. If your client performs a movement flawlessly during a training session – does that mean they will change that same movement in daily life or sport?

  31. As long as the client can perform the movement properly, they are training the right thing?

  32. When providing feedback to your client it is best to provide it as frequent, immediate, and as informative as possible?

  33. So What’s the Best Way to Train for the Brain? • Block Training • Random Training – Do one exercise for a – Do multiple exercises certain number of per set and one rep of repetitions per set each – Each rep has the same – Each rep has some movement different movement – No stopping between – Take time with each rep reps – Focus on feel – Focus on form

  34. Blocked vs. Random Practice Jerky Form Random Blocked Smooth Practice Shea & Morgan, 1979

  35. Blocked vs. Random Practice Jerky Form Random Blocked Smooth Practice Retention

  36. Blocked vs. Random Practice Jerky Form Random Blocked Smooth Practice Retention

  37. Illusions of Learning Jerky Form Random Smooth Blocked Practice Retention Simon & Bjork, 2001

  38. Illusions of Learning Jerky Form Predicted Random Actual Smooth Blocked Practice Retention

  39. Illusions of Learning Jerky Actual Form Random Predicted Smooth Blocked Practice Retention

  40. Functional Training Train Randomly Reduce Block Training

  41. Action Point #2 Train randomly for optimal adaptation of movement skill

  42. Action Point #3 Place person in posture and position where it can only be done correctly Don’t rely on verbal coaching

  43. SFMA’s 4 x 4 Matrix Functional Exercise Progressions

  44. Remember the Neuro-Developmental Perspective

  45. Movement was Learned in Stages • Breathing • Gripping • Head-Eye Tracking (Cervical) • Limb Movements • Rolling • Crawling • Transitional Movements • Upright Movements

  46. Reset Re-Enforce Reload Functional Exercise Positions • Non-Weight Bearing – Supine – Prone

  47. Reset Re-Enforce Reload Functional Exercise Positions • Quadruped

  48. Reset Re-Enforce Reload Functional Exercise Positions • Kneeling

  49. Reset Re-Enforce Reload Functional Exercise Positions • Standing

  50. Functional Exercise Progressions The 4X4 Matrix 1 - Non-Weight Bearing 1 - No-Resistance - PA PA = Pattern Assistance 2 - Quadruped 2 - No Resistance 3 - Kneeling 3 - Resistance - PA PA = Pattern Assistance 4 - Standing 4 - Resistance

  51. Reset Re-Enforce Pattern Assistance Reload • Timing vs. Firing • High Threshold vs. Low Threshold Strategy • Stabilizers vs. Mobilizers

  52. Functional Exercise Progressions The 4X4 Matrix 1 - Non-Weight Bearing 1 - No-Resistance - PA PA = Pattern Assistance 2 - Quadruped 2 - No Resistance 3 - Kneeling 3 - Resistance - PA PA = Pattern Assistance 4 - Standing 4 - Resistance

  53. Reset Re-Enforce Reload Functional Exercise Resistance • No Resistance – With Pattern Assistance (PA)

  54. Reset Re-Enforce Reload Functional Exercise Resistance • No Resistance – With Pattern Assistance (PA)

  55. Reset Functional Exercise Re-Enforce Resistance Reload • No Resistance – Except: • Gravity • Body Weight

  56. Reset Re-Enforce Reload Functional Exercise Resistance • Resistance – With Pattern Assistance (PA)

  57. Reset Re-Enforce Reload Functional Exercise Resistance • Resistance

  58. Reset Re-Enforce Reload Example: Kettlebell Swings 4 x 4 – Patterns (Flx, Ext, Sqt) • Standing • Resistance

  59. Reset Re-Enforce Turkish Get Up Reload • Supine – Quadruped – Kneeling - Standing • Resistance 1X4 2X4 3X4 4X4

  60. Functional Exercise Progressions The 4X4 Matrix 1 - Non-Weight Bearing 1 - No-Resistance - PA PA = Pattern Assistance 2 - Quadruped 2 - No Resistance 3 - Kneeling 3 - Resistance - PA PA = Pattern Assistance 4 - Standing 4 - Resistance

  61. Higher level postures (standing) can hide dysfunction

  62. Practical Implementation Work on the inputs, not the muscle Create a sensory rich environment the elicits the movement pattern you want Train randomly for optimal adaptation of movement skill

  63. Practical Implementation Higher level postures (standing) can hide dysfunction Work in the lowest level posture that is challenging Place person in posture & position where it can only be done correctly Don’t rely on verbal coaching

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