Assessing Movement & Movement when Metabolically Challenged

I believe that one of the most important components to being a sports physical therapist is being able to differentiate between quality movement and quality movement when metabolically challenged.  What I mean by that is: Can the athlete move well with his/her own bodyweight and also move well when placed under a stress or strain?  In other words, when an athlete is metabolically challenged, does form break down?  Is this a motor control problem, a lack of understanding, or a fitness problem? This is where a working with a strength coach or understanding strength and conditioning is so vital.  Furthermore, metabolic stress does not have to be limited to load but also should consider aerobic capacity.  An interesting thread through one of the Sports section SIGs brought up VO2max and tracking this in our athletes back in February.  Ideally, a sports physical therapist should understand these concepts.  

To blend some of these ideas together check out this review of the Gray Cook and Stuart McGill debate/conference by Patrick Ward a few months ago.  He does a really nice job of both giving the main points of the conference, as well as challenging the idea of quality movement using the FMS as an assessment and using metabolic stress as an assessment.  I particularly like his question and his own answer to that question during this article.  We really need to implement these concepts of metabolic stress into our movement assessments and also try to track aerobic capacity for rehabilitating our athletes.  Yes, it is tough to do in a clinic and with the way insurance pays out, but as sports physical therapist's, we can do a better job of tracking this data to give our athletic patients the best rehab to return to their sport.  

- Brian

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