Updated: Apr 15, 2021
In current times, online home exercise programs and high intensity work outs are on the rise and more and more people are taking the time to jump into exercise for the first time. It's great to see this change of mindset and I'm glad that the fitness industry have readily adapted and provided so much online content.
I have, however, had a few patients who have contacted me recently having jumped into new programs and ended up 'doing their backs in' or injuring themselves! So I wanted to address the topic of exercise progression and how to build it up in a sustainable way, to try and prevent injury whilst also progressing strength, power and skill.
One main tool I use within examinations is functional movement pattern assessments. We can look at performance within a pyramid of three fundamentals: Functional movement, functional performance and functional skill. The idea is that these layers are in the correct balance with each other to form a pyramid.
As you can see, functional movement is the main base, focusing on mobility and stability. Mobility is the combination of muscle flexibility, joint range of motion and segmental freedom of movement.
Stability is the ability to maintain posture and/or control motion and includes both static and dynamic stability.
We often sacrifice quality of motion to maintain quantity and can therefore develop compensatory movement patterns e.g. the knees 'bowing in' a lot or lower back rounding during a squat, especially as we start to fatigue.
Although this may not cause an immediate problem, over time if one area stiffens, another area will often compensate by becoming hypermobile and unstable and vice versa. For some people this may eventually lead to pain. (Others may have this same effect happen from day to day activities, without even thinking about exercise as such e.g patients who can just bend over at slightly the wrong angle every few months and their lower back 'goes'!)
Functional movement assessments can include tests involving the actions of:
Stepping up and over an object
Straight leg raise flexibility
Push up from the floor
Rotational trunk stability
All of these movements can be applied not only to exercise but also to day to day activities, such as gardening, picking your grandchildren up or pushing a shopping trolley.
I often use these kinds of movement screens, alongside other elements of assessment, such as joint and muscle palpation and function muscle strength/activation testing, to determine where imbalances are and where a patient therefore may be compensating.
Once these imbalances have been corrected (or at least decreased), either by hands on treatment or specific home exercises, we can be more confident in moving to the next stage of the pyramid, Functional performance. This is where power and movement efficiency come in.
Finally, after these others levels have been established, we progress to Functional skill e.g. sports specific skill.
In conclusion, my top tip would be...
Before you go from 0 - 100mph with a high intensity work out program, make sure you can activate, control and coordinate the right muscles first. You can still do the exercises, but try them slowly first, watching yourself in the mirror and making note if there's any imbalances side to side.
Even better, get a professional to do a functional movement screen on you (even via video call at the moment as a starting point!).
Then, once you feel more confident with the quality of the movement pattern itself, progress to adding in other variables such as heavier weights or a plyometric element for power e.g. jumping/hopping.
Not only may this help prevent injury, but it will also make sure you're loading and building the muscles you want to be working!
So, keep active and build up that body awareness at the same time!