The Importance of Movement Pattern Re-Training
Here is a somewhat common scenario that can accompany getting older: we suddenly find that certain activities, such as climbing stairs, or getting up and down from a chair becomes more difficult. When searching for a solution to this problem, many older adults will first think that strength deficits are to blame, and that a strength training program will make these activities easier. Is this the single best approach? Well, the short answer is no. In fact, it is better to first address faulty movement patterns and regain both mobility and stability in both squatting and stepping activities if one wants to improve functional ability.
What kinds of faulty movement patterns can cause difficulty in stepping up and in squatting? Lack of stability in the core, paired with an inability to properly contract the gluteal muscles, can make these movements challenging. In addition, knee and back pain can be caused by or exacerbated by faulty movement. This pattern is referred to as gluteal inhibition, or gluteal amnesia (McGill, 2007) and usually means that the hamstrings are being used instead of the glutes for hip extension. It is common in anyone who sits for long periods of time, and this pattern cannot be fixed simply with squatting/strengthening exercises. Rather, a combination of learning how to tighten the core musculature (core bracing) and also engage the gluteal muscles will help to reduce back and knee pain and make squatting and stepping easier.
To create healthy movement patterns, first learn how brace your core in daily movements, and integrate core bracing with gluteal engagement (contraction). You can learn this from a physiotherapist, kinesiologist, exercise physiologist, or functional aging specialist. Both mobility and flexibility exercises should accompany stabilization exercises, so be sure to perform appropriate stretches. With gluteal inhibition, it is usually a good idea to stretch the psoas, calves and quadriceps in addition to motor pattern training. Train frequently, as learning new motor patterns (‘groove motor patterns”) requires consistent, daily practice a few times a day. As you get better, you can reduce the frequency to once a day. If you have back/spinal pain, you should obtain clearance from your physician, as not all exercises will be appropriate for certain spinal or musculoskeletal conditions.
Here are two beginner exercises to help re-train gluteal and hip muscle recruitment:
Clamshell Exercise: Lie on your side with your hips at 45 degrees and your knees bent to 90 degrees. Your heels should be in line with your buttocks. Tilt your hips forward towards the ground slightly. Then, lift your knees apart (like a clam opening), performing 10-12 repetitions per side
Standing Hip Press: Stand beside a wall, balanced on one leg (that should be the leg furthest from the wall.) Bend the knee of the leg closest to the wall, and press the knee in to the wall and hold 5 seconds, breathing throughout. You should be contracting the muscles of the hip and gluteals. Repeat 5 times and then switch sides.
Sources: Stuart M. MGill, Ph.D Low Back Disorders, 2nd Edition; Ultimate Back Fitness and Performance 3rd Edition. www.backfitpro.com
McGill, S.M. 2007. Low Back Disorders: Evidence Based Prevention and Rehabilitation (2nd ed.). Champaign, IL: Human Kinetics.
McGill, S.M., et al. 2003. Previous history of LBP with work loss is related to lingering effects in biomechanical physiological, personal, and psychosocial characteristics. Ergonomics, 46 (7), 731–46.