Our bodies are incredible machines that were designed for movement. Having the ability to adapt to our environments, perform, and recover from our everyday activities is an incredible gift we all share. The problem with today’s society is that we are constantly on the go, we have various distractions, and we often move mindlessly throughout the day. We don’t necessarily associate our everyday movements throughout the day to our corrective exercises or training. It is much easier to bend carelessly when picking an object up from the floor, or slump over to brush your teeth instead of using your core, hips and knees. These repetitive movements that we perform hundreds of times a day play an extremely important role on our neuromuscular system. Awareness of these daily movements are one of the most eye opening pieces of the puzzle for patients, and can make a drastic impact on their road to recovery. Luckily for me, I get to share my passion with patients and show them how we use movement as medicine daily!
The Hinge and the Squat are the two most common movements that we utilize on a daily basis. Whether it is getting into your car, brushing your teeth (like I mentioned previously), putting on shoes, or even cooking your food over the stove, we are constantly using our hinge and squat pattern variations to move. What most people can’t seem to grasp is that we are all “athletes” in some way, shape or form. Just because you are not in the Olympics or in a professional league does not mean you are not an athlete. Learning how to squat and hip hinge will benefit and prepare everyone for the daily movements life throws at us. Getting strong in the gym and applying these concepts to their everyday activity is where patients will see massive benefit. What I love about corrective exercises as well is that they will help us address underlying instabilities once the basic patterns are mastered. We get to have fun in the rehabilitative phase and guide patients to learn on their own. We are what we repeatedly do, and our bodies were designed to adapt. We can either use this to our detriment, or to our benefit. We must prepare for both daily movement and performance/training. “Failing to prepare is preparing to fail.”
Patients will commonly want to know, “What causes my injury?” Besides suffering a direct blow (trauma), poor repetitive movement patterns that continuously pick at the metaphoric “scab” can cause injuries. The tissue capacity reaches its max and can no longer provide support, creating an unstable environment. This is exactly how I explain it to patients. When there is an injury, my first and most important goal is to get the patient out of pain. We achieve that by first reaching an accurate diagnosis and determining where the culprit of poor movement is occurring after an extensive exam. Once we establish that, we introduce proper movement patterns, most commonly the Hip Hinge and Squat! Re-learning these patterns mindfully and efficiently will not only decrease your pain levels and irritation, but it will also build the proper patterning you will need when you eventually progress to building strength. And again, everyone is different. There is no “one size fits all,” which is extremely important to keep in mind when you are teaching patients how to move. The rehabilitative goal is to reverse-engineer the process that created the injury, re-learn the proper movement pattern without pain, and to introduce sustainable movements with the minimum effective dosage of load that the patient can use in their everyday activities to build stability, mobility and strength.
Most people have trouble differentiating the actual difference between a hip hinge and a squat. When I explain it to them, I make it as simple as possible. For a Hip Hinge, think “butt back.” This is a hip dominant pattern. For a Squat, think “butt down.” The squat is a more knee dominant pattern. Pretty simple right? Teaching the Hip Hinge and Squat with the dowel is how I was taught by my mentors and it seems to be the best and most efficient way. This helps maintain a neutral spine as you move. You place the dowel on three points: one behind the head, one on the mid-back, one on your lower back. As you move, these points should move in sync and still be touching as you descend and ascend again. Be mindful of your rib cage position as well. It should not flare with either the squat or hinge. The dowel is phenomenal because it will keep you honest and can be very helpful in assisting as a diagnostic tool. It helps in identifying regions that lack mobility and will point out movement faults such as the rib cage flaring. As a clinician, my goal is to address these issues in the session, and also to give the patient an understanding of what is occurring and how the assigned exercises will help correct these sticking points and correct the faulty movement pattern.
After the hinge and squat patterns are distinguished and learned by the patient, my job is to introduce variations of these movements with load. Intelligent loading is a skill that can only be learned through experience and critical thinking, which for me is my strength and conditioning education blended together with my chiropractic education. Every patient is unique and beautiful in their own way. This is where the art of being a rehab and movement professional comes into play. This is how you differentiate yourself from other doctors. Understanding when to load and how much to progress without triggering the injury further is a vital part of introducing corrective exercises. As I mentioned previously, the goal is to provide the minimum effective dosage of load, which means just enough to challenge the patient but not enough where the body cannot handle it and cause pain. Our job is to guide the patient carefully but also challenge them to work hard. “If it doesn’t challenge you, it does not change you,” is a quote I typically use when explaining to patients why they are sweating during a session. Loading the patient to build up these new efficient movement patterns will ultimately help them in their everyday lives, and help reduce the risk of injury. Notice how I did not say “prevent injury.” I am here to help MANAGE your injury risk. We do the best we can to build a solid foundation, but life happens. “Injury prevention is a zero sum game,” as Dr. Jordan Shallows would say, which ultimately means we have no say in whether we can prevent injury or not, we just do our absolute best to reduce the risks.
We are all athletes. It is important to remember that. We all need to understand how strong and robust our bodies are. With simple modifications to our daily activities, and utilizing the movements learned during training and corrective exercises, we put ourselves in a position to succeed and progress to become the best and strongest version of ourselves. I pride myself in being a doctor who understands how to treat athletes (which is ALL of us) and having the ability to communicate the relationship between correctives, training, and daily movements. The goal for me is to educate my patients on movement and how form, technique, and daily activities all correlate. If we can relearn proper movement patterns and then get strong in these positions, we will be able to put ourselves in a wonderful position to progress and move pain-free in and out of the gym. Getting strong is a skill, and acquiring the foundation is key. My job is to build people back up with a solid foundation after they have been through an injury that they once believed would keep them from doing the things they love. From carrying and playing with their kids, to deadlifting in a powerlifting competition, and everything in between – I want to know your own personal goals and help you achieve them. Not only will I teach proper movement patterns and how to intelligently load, but I will also empower my patients and show them that they can and will recover! And that starts with learning the basic concepts and applying them into our everyday movements. I am passionate about helping people get out of pain and helping them achieve their own goals. There is no better feeling than watching patients succeed and live a PAIN-FREE life. It will not always be easy, and I will challenge you physically, but I will ALWAYS empower you mentally. You are resilient, strong, and capable of beautiful movement.