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Movement Training For Special Populations

Chuck Wolf, MSThank you for coming!!!

Create the Environment for

the client to be successfu

l

Sagittal Frontal Transverse

Scapula elevation! ABD-ADD! Int/Ext Rotation!

Spine flex/ext! ABD-ADD! Int/Ext Rotation!

Hip flex! adduction! int. rotation!

Knee flex! abduction! int. rotation!!

Ankle DF! ADD-ABD!

Subtalar eversion! abduction!

Midtarsal DF! inversion! abduction!

Tri-Plane Loading

grid use by permission from Gary Gray!VI: Opthalmic N

V2: Maxillary N

V3: Mandibular N

Dermatome MapDermatomes is a sensory mapping of nerve fibers from a

specific spinal cord segment to specific myofascial regions and

skin of the body providing sensory information.

Dermatome MapDermatomes is a sensory mapping of nerve fibers from a

specific spinal cord segment to specific myofascial regions and

skin of the body providing sensory information.

VI: Opthalmic N

V2: Maxillary N

V3: Mandibular N

Movement Big Rocks

Great Toe & Foot/Ankle Complex!

Thoracic Spine!

Hip Complex!

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The Big 3

Ankle Mobe

Wall Bangers

Wall Patterns

Low Back Pain

Level Sagittal Plane Combined Frontal Plane Transverse Plane

T1-2 4 6 9

T2-3 4 6 8

T3-4 4 6 8

T4-5 4 6 8

T5-6 4 6 8

T6-7 5 6 8

T7-8 6 6 8

T8-9 6 6 7

T9-10 6 6 4

T10-11 9 7 2

T11-12 12 9 2

T12-L1 12 8 2

Thoracic Spine Segment ROM

Flexion/Extension Frontal Plane Transverse Plane

L1-2 8/5 6 2

L2-3 10/3 6 2

L3-4 12/1 8 2

L4-5 13/2 6 2

L5-S1 9/5 3 5

Lumbar Spine Segment ROM

Health Risks

�  Cervical Spine degeneration

�  TMJ

�  Respiratory difficulties

�  Low back pain

�  Headaches

�  Shoulder girdle dysfunction

�  Shoulder pain

What is the pelvis doing?? Regression to Progression

Deep Abdominal Wall Activation

Supine Hip Lift in 3 planes

Quadruped T-Spine Mobes

Ankle & Great Toe Mobes

Functional Abdominal Gait Pattern

Wall Patterns

Wall Bangers

Lunge Patterns: Passive to Active

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Frequent Back Disorders

Disc Bilge/HerniationLumbar Laminectomy/Fusion

Spinal StenosisScoliosis

Goal: Retraction of Disc (if herniated), reduce discomfort, gain mobility of regions above & below

Strategy: Check Foot, Hip, T-Spine Function Deep Abdominal wall Activation progression Supine Hip Lift Quadriped Thoracic Rotation Lunge with reach progression

Mobilization: Ankle Mobes Hip Mobilzation 1-2 levels above and below Thoracic Spine Type I & II mobes Self Gravitational Traction

Precautions: Avoid Lumbar Rotation: get it through the hips and T-Spine

Disc Bulge/HerniationLaminectomy/Fusion

Mobilization: Ankle Mobes, if necessary Hip Mobilization Thoracic Spine Type I & II mobes Self Gravitational Traction

Precautions: Avoid Lumbar Extension: get it through the hips and T-Spine, think Transverse

Goal: Improve alignment, reduce frontal asymmetry extension thresholds, reduce

discomfort, gain mobility & strengthStrategy: Success will depend upon age & length of dysfunction Work from level hips Check Foot, Hip, T-Spine Function

Caution to Sagittal Plane Extension, work through Frontal & Transverse Deep Abdominal Wall Activation progression Supine Hip Lift often challenging, not a movement

of choice initially Quadruped Thoracic Rotation Psoas is key!!!

Staggered Stance with arm movement to create Type I & II environments

Use isometric holds at first

ScoliosisGoal: Improve extension thresholds, reduce discomfort, gain mobility & strength

Strategy: Success will depend upon age & length of dysfunction Check Foot, Hip, T-Spine Function

Caution to Sagittal Plane Extension, work through Frontal & Transverse

Deep Abdominal Wall Activation progressionSupine Hip Lift often challenging, not a movement of

choice initially Quadriped Thoracic Rotation

Staggered Stance with arm extension reach progressions

Mobilization: Ankle Mobes Hip Mobilzation Thoracic Spine Type I & II mobes Self Gravitational Traction

Precautions: Avoid Lumbar Extension: get it through the hips and T-Spine, think Transverse

Spinal Stenosis

Sample Back Reconditioning Program

Weeks 1 & 2 Goals

1. Increase isolated central unit strength

2. Kinesthetic awareness

Dead Bug with Extremity Reach

Supine Hip Lift - Sagittal Plane

Quadriped - All Planes

Wall Patterns

Wall Bangers

Sample Back Reconditioning Program

Weeks 2-4 Goals

1. Gain Frontal & Transverse Plane motion

2. Mobilize foot/ankle complex & hips through movement patterns

Movement Patterns

Supine Hip Lift - Frontal Plane

Supine Hip Lift - Transverse Plane

Core Stabilization with Step Out

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Sample Back Reconditioning Program

Weeks 2-4 Goals

1. Gain Frontal & Transverse Plane motion

2. Mobilize foot/ankle complex & hips through movement patterns

Pivotal Toe Touch

Tri-Plane Lunges

Warding Patterns - Partner

Movement Patterns

Sample Back Reconditioning Program

Weeks 5 & 6 Goals

1. Increase tri-plane motion in hips & T-spine

2.Gain integrated strength

Warding Pattern w/ Stability Ball

Cross-Over Walk - Anterior X- Factor

TRX Chest Press

TRX Lat Pull

Sample Back Reconditioning Program

Weeks 7 & 8 Goals

1. Increase ROM in transverse plane of hips & T-spine

2. Start activities for return to play

Crossover Walk- Posterior X-Factor

TRX SLB Core Stabilization

TRX Warding Patterns

Tri-Plane Lunges w/ reaches

Tri-Plane Activities

Shoulder Girdle Mobility

Shouldering the Load..... from the ground up

Sagittal Plane:

Same side shoulder ext./hip flex.

Shoulder flex./hip ext.

Frontal Plane:Same side

shoulder abd./opposite hip add.

Transverse Plane: Shoulder ext. rot./ Opposite hip ext. rot

The Assessment Can Be The Mobilizer

Frontal

Transverse

Sagittal

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Scapular Movement During Shoulder FlexionElevation & Abduction with Hip Flexion

Relative Shoulder Motion - Sagittal Plane

Scapular Movement During Shoulder ExtensionDepression & Adduction with Hip Extension

Scapular Movement During Shoulder AbductionAbduction with Opposite Hip Adduction or

same side Hip Abduction

Relative Shoulder Motion - Frontal Plane

Scapular Movement During Shoulder AdductionAdduction with Opposite Hip Abduction or

same side Hip Adduction

Scapular Movement During Shoulder IRScapular IR with Opposite Hip IR

(scap abducts & medial “lifting” off ribs)

Relative Shoulder Motion - Transverse Plane

Scapular Movement During Shoulder ERScapular ER with Opposite Hip ER

(scap retracts)

Shoulder Girdle Stability Movements

a suggested progression

Word of Caution

Progress client based upon symptoms, mobility, stability, and increasing confidence

Isolated to Integrated Internal Rotation

associates opposite hip to opposite shoulder

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Isolated to Integrated External Rotation

associates opposite hip to opposite shoulder

Shoulder Extension w/ Shoulder External Rotation

Box Stability

Stability Ball Stability w/vibration

Flex Bar

Shoulder Stability Progression

Level 1

Level 3Level 2

Warding Patterns

Tri-Plane Integrated Rotator Cuff

Sagittal Frontal Transverse

Sagittal Plane:Same side shoulder ext./hip flex.

Shoulder flex./hip ext.

Frontal Plane:Same side shoulder abd./opposite hip add.

Transverse Plane: Shoulder ext. rot./Opposite hip ext. rot

Tri-Plane Integrated Movement Patterns

MB Games Triangulated Shoulder Press

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The Knee

is the Dumbest Joint in the Body......

Reaches

Overhead: will create a neutral foot position and reduce gluteal recruitment resulting in more quadriceps involvement

Medial (opposite lateral): will enhance calcaneal eversion of the same side foot

Lateral (same side lateral): will enhance supination of the same side foot

Thank you!!!

Chuck can be reached at:cwolf@humanmotionassociates.com

or visitwww.humanmotionassociates.com

Visit us on Facebook/humanmotionassociates

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