Chain of Events

Moving entails a certain degree of mechanics, events occurring one after the other in succession and potentially simultaneously. As soon as we begin to interact with the environment, changes within ourselves occur. We alter our shape to manage the forces involved with moving. For instance, when our foot strikes the ground joints change position and shape, musculature engages or disengages and connective tissue stores or releases energy. All pending our capabilities in achieving the desired movement at hand. This is why, when prescribing exercise, we should consider the preferred mechanics and sequence our programs to establish those mechanics.

From the foundation of movement in breathing, to knee mechanics and everything in between, the rules do not change. One thing must occur in order for the next to.

Let’s start with the fundamentals; to successfully breathe one must inflate their lungs which requires expansion of the rib cage followed by compression to exhale. That sequencing of events is paramount to accomplishing the task at hand, which is respiration. Those mechanics influence shoulder movement as the scapula rests on the rib cage, meaning if I want to bias the shoulder toward an expanded representation, then I must also consider where the rib cage is in regard to the breath. The exercises I choose to prescribe for a client with shoulder pain must consider the mechanics of the ribs, which means I need to keep in mind where they are in their breathing sequence. I can alter the shape of the shoulder by cueing particular phases of breathing because that will impact the rib cage and therefore the shoulder. Thinking along these lines provides me with the greatest probability for a favorable outcome.

A little less fundamental, but the same rules occur at the knee. If a client is struggling regaining knee bending abilities, I might consider hip and foot position that are associated with knee mobility. As the foot strikes the ground, the heel should evert promoting a rotation at the tibia, which is required for the knee to bend successfully. I can place a client in a position or prescribe a movement that facilitates the heel movement and therefore the tibia and knee position. The femur is also a large component of the knee and if I want certain mechanics to be present at the femur then my exercise prescription or manual intervention should contain that motion. The femur should rotate with respect to the tibia as I bend the knee, the intervention I select needs to contain these motions to increase the odds of regaining knee mobility.

Cues we use to influence movement should consider the chain of events.

We create motion via a sequence of movements that are fairly consistent. From the foundation of movement in breathing, to knee mechanics and everything in between, the rules do not change. One thing must occur in order for the next to. We must build and assemble those mechanics from the ground up, increasing the odds that we successfully change a clients movement patterns. As coaches we have a number of interventions available to us that can positively influence our client’s abilities. Whether it be manually applied or through exercise, considering the chain of events from top to bottom gives us the best opportunity to deliver a favorable change.

Austin Ulrich, Physical Therapist