Exercise correctly for back pain.

The new PhysioNovo training concept is based on four pillars:

  1. The glenohumero-scapulo-thoraco-cervical motor unit (Arm-chest motor skills).
  2. The coxo-iliosacro-lumbar motor unit (leg-pelvic motor skills).
  3. The abdominal motor complex which includes the pelvic floor muscles (abdominal and pelvic muscle motor abilities), which, due to its specific paradoxical motor activity, connects the arm-chest to the leg-pelvic motor abilities and makes the spinal column as a whole extremely load-bearing.
  4. Due to its great clinical importance for the leg-pelvic motor system, it is important to learn the right walking and running motor skills based on its physiological development.
  • The central joint of the arm-chest motor system is the glenohumeral (shoulder) joint. This has a decisive influence on the arm and chest motor system. A weakened function of the shoulder joint always leads to limited (active) mobility. This leads to compensatory changes in the automatically and unconsciously controlled feedforwardmotor abilities of the scapula (scapuladyskinesia), the thoracic spine (enhanced kyphosis) and the cervical spine (enhanced lordosis). 
  • The central joint of the leg-pelvic motor system is the coxal (hip) joint. This has a similarly large influence on the leg-pelvic motor system. Diminished function of the hip joint always leads to limited (active) mobility and therefore to a compensatory change in the feedforwardmotor abilities of the pelvis and the lumbar spine.
  • Both a restriction of the shoulder and hip joint leads to a weakening of the abdominal and pelvic floor muscles, as a result of which the spinal column as a whole becomes less resilient. 

Restoring the locomotion of the glenohumeral and/or coxal joint is a priority in the treatment of back complaints. Depending on the results of motor examination, postural correction and/or improvement of the gait and running pattern are also included in the treatment protocol. Effective postural correction is only possible once the mobility of joints has been (largely) normalised. 

When restoring the weakened joint function, the load-bearing capacity of joints is always taken into account. This is strongly dependent on the chosen direction of movement, the mobility of which must be improved. Axial, adaxial and finally rotational movements are used to build up load bearing capacity. Centralisation of joint parts is the easiest to achieve with axial movements, the most difficult with rotational movements.

Decentralisation of joint parts leads to inefficient and/or painful motor skills. Muscles never work alone but always together in order to move the different parts of the joint efficiently and effectively. All muscles must have equal strength, parallel but opposite to each other, in order to prevent decentralisation of joint parts. The principle of force couple is a well-designed instrument to achieve this goal. 

Restoring the feedforwardmotor abilities of the scapula and/or pelvis in everyday activities usually proceeds in parallel with the improvement of joint motor abilities. This is based on motor learning processes and is difficult for the patient concerned to put into practice. The knowledge and skills of the physiotherapist/trainer are of decisive importance here. 

Aesthetics of correct motor control

Not only the physical structure of the spinal column, but also specific active posture and the right movement determine the external appearance of the individual. In the same way that a poor posture can be aesthetically unappealing, a corrected posture on the other hand can look easy on the eye, even in the case of a poorly structured spinal column or obesity. The integration of a good posture in movement leads to an aesthetically pleasing motor control in everyday life. 

How pictures can speak volumes