Achilles’ heel, it is known by most as the weak link that eventually resulted in the demise of this mighty warrior. While we may not all be warriors like Achilles most, if not all of us have our own weak links. Maybe a past injury that didn’t heal right, maybe a joint that has been overused or maybe you’ve had it since birth. Not only do we all have one, we usually have a “good story” for how they came to be. Many people have accepted these weaknesses as part of their life and with some legitimacy. It has been shown that previous injury is a very significant risk factor in future injury (1-2). Gray Cook and Functional Movement Systems (3-4), through their gathering of evidence and research, have additionally identified asymmetries and (inefficient) motor control to be large contributors to future injury. At this point, you may be asking yourself: What causes these asymmetries? What is inefficient motor control? Is there anything that can be done about these dysfunctions? To briefly answer the latter, yes.
Simply put, the asymmetry in this discussion is reduced mobility and/or stability on one side of the body when compared to the other. It is caused by previous injury, sustained posture (like sitting at a desk all day or long hours watching TV on the couch) and repetitive, dysfunctional movements.
The reason this contributes to injury is best demonstrated by example: asymmetry in the lower body of a runner, say hip stability is greater on the right side, will create a need to compensate on the opposite side by contracting in an inefficient muscle pattern (inefficient motor control). Adaptation is a key component of nature but adaptation does not necessarily lead to functional results. A common pattern seen in runners is weak gluteus medius stabilization on one side that has resulted in dysfunctional motor control by the QL muscle (Quadratus Lumborum) on the opposite side and/or compensation by the IT band (iliotibial) and TFL muscle (tensor fasciae latae).
Mobility on other hand is best exemplified in something like a squat: decreased mobility in one hip joint relative to the opposite hip joint will likely cause torque through the low back when reaching the bottom of the maneuver. It’s a completely logical conclusion and one that has been suggested by Gray Cook (3) before using the example of a dead lift exercise.
Finally, what can be done? A lot. It is important to determine your strengths and weaknesses in order to identify your needs. This can be done through the use of functional movement screening as performed by practitioners certified in Functional Movement Screening (FMS), Selective Functional Movement Assessment (SFMA), Titleist Performance Institute (TPI), etc. These systems provide valuable and objective testing that demonstrates clear and obvious strengths and weaknesses which can be addressed through a variety of treatments which include but are not limited to corrective exercise, stretching, chiropractic manipulation and Instrument Assisted Soft Tissue Manipulation.
One thing to consider is that exercising with asymmetry and inefficient motor control further grooves the existing dysfunction. Functional corrective exercises before or in conjunction with running, weight lifting, golf, whatever your activity may be might save you from future injury.
“The definition of corrective exercise is move well and then move more. Most people just want to move more.”
-Gray Cook (3)
For questions or comments feel free to email me at drgamble@whiteoakwell.com or call (630) 442-0057. For more information on visit us at www.whiteoakwell.com.
-Dr. Phillip Gamble, DC, TPI CGFI
References
(1) Functional deficits in athletes with a history of low back pain: a pilot study. Nadler SF, Moley P, Malanga GA, Rubbani M, Prybicien M, Feinberg JH Arch Phys Med Rehabil. 2002 Dec; 83(12):1753-8.
(2) Review Intrinsic risk factors for exercise-related lower limb injuries. Neely FG Sports Med. 1998 Oct; 26(4):253-63.
(4) http://www.functionalmovement.com
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