These days it seems like mobility is the biggest buzz word around in fitness and rehab circles. Everyday a new way to mobilize the thoracic spine comes out. It's a great time to be in physical therapy if your passionate about continued learning. The problem with all this new information is how to properly implement it.
From what I am seeing and hearing from students and other experienced clinicians is a lack of understanding motor control (or in some circles, stability). Regardless of what you want to call it there is one thing that hold true: Adequate motor control is necessary for returning our athletes to sport. Let me first start by defining what I believe motor control is. In a nutshell, it is the ability to control in the presence of a reaction (change). Basically, having optimal motor control means an athlete has the ability to react to new stressors in the environment. Stressors can be anything from a player running at you to a hard step on the field running. By having optimal motor control you have a platform for adopting to stressors.
So how to we achieve optimal motor control in rehab? Well there are many ways to go about that. However let me bring up the importance of having mobility as a requirement to achieving motor control. For example, lets take an athlete that cannot deep squat. Now lets take that same athlete and say that he/she must be able to deep squat to get into a functional position for their sport. If the athlete does not have the mobility and cannot achieve that proper joint position, how could they have adequate motor control to combat in a game situation? They can't, which means they would have to compensate. See how this could lead to injury?
So how can we help this athlete achieve that position? Manual therapy is one avenue. We can essentially "prep" the neural system by performing some type of manual therapy to help our athletes get into the right position. And this can have good carryover to allow for proper motor skill development. Now I know what your thinking: why would any athlete need to deep squat? Well, most of them don't. But would it really be horrible if an athlete had extra proprioceptive abilities in a range of motion they typically don't use? Probably not. Remember, the goal of developing motor control is to optimize a new and more functional pattern.
So next time you are working on improving motor control in one of your athletes, consider mobility as the prerequisite. And consider using manual therapy to help provide some neural input.
- Dr. Brian Schwabe, PT, DPT, SCS, COMT, CSCS
Board Certified Sports Physical Therapist
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