It is very exciting to see that more and more people believe “Exercise is Medicine”. An increasing number of people are seeking help from exercise specialists to resolve their pain and associated clinical problems. Some people literally say “exercise is the last resort for my pain". Many of them indeed experience significant improvement in their symptoms as they improve their movement function through exercise and get more active. As an increasing number of people witness the clinical impact of exercise, terms like "active rehabilitation" or "medical exercise" are becoming popular. Along with this trend, we now see that many fitness professionals try to integrate "active rehabilitation" or "medical exercise training" into their services. As there is an increasing number of options to choose from, it is becoming more challenging to select the right professional who can best serve your specific needs.
What sets the clinical exercise specialists apart from general fitness trainers? Some say it is their university degrees and specific certifications. Even though such face values are hard to ignore, they don't necessarily represent the degree of competence of the professional. We have been helping people with injuries and pain improve their function and symptoms through exercise and active rehabilitation for more than 10 years. Many of them presented with complex issues that continuously challenged us to adopt an interdisciplinary approach to exercise intervention. This experience continuously taught us that the determining factor that leads to a long-term result is assessment. More in detail, the practitioner’s ability to not only assess movement in a systemized way but also to translate that into effective customization of exercises and timely collaboration with other clinicians is a critical factor. For this reason, your journey at Embodied Dynamics starts with movement assessment.
⭐️ We have two different streams of assessment to appropriately serve the people with different needs. ⭐️
📌 This picture briefly shows the difference between the two streams and different end results.
The investigation stream is a detailed assessment and is designed to serve people who are dealing with pain or injuries. The goal of the investigation stream is to investigate various contributors to the decreased function, which leads to precise action plans.
The prescription stream aims to help people who need simpler assessments. The goal of this assessment is to provide the clients with modified versions of the commonly used strength training movements that accommodate the client’s current postural habit. In addition, it also leads to a design of corrective exercises to improve their postural habits.
In both of the streams, we use not only physical assessment but also musculoskeletal screening questionnaires and assessments so that we don’t miss anything that may require medical attention.
📌The next picture shows how the investigation stream fits into the clinical collaboration
model. Using this assessment, we identify what issues can be addressed by exercise intervention and what issues need additional attention from other allied health care practitioners(e.g., physios, chiros, osteopaths, massage therapists) or a medical doctor.
* NWB: Non-Weight Bearing, WB: Weight Bearing, ROM: Range of Motion, MSK: Musculoskeletal
For example, if you can’t fully elevate your arms above the head in a standing position but can do that when lying on your back, it is reasonable to say that motor control strategy or strength deficit related to the movement of the shoulder in an upright position majorly contributes to the limited mobility. If both the passive and active range of motion are limited, we assess the motion,
extensibility, and stability of the individual components that make up the global movement. In case of arm elevation, these components include thoracic spine, ball-and-socket joint of the shoulder, shoulder blade, and dynamic positioning among ribcage, pelvis, and shoulder blade. If we identify restricted motion in one of these components, we apply a gentle soft tissue release technique while gently facilitating activation of specific muscle groups. If such a technique immediately improves mobility without additional pain, exercises to improve muscular balance are warranted. If this method does not improve or only partially improve the motion, further assessment and/or manual therapy by other clinicians will be beneficial. It may also need attention from a medical doctor especially if it involves pain. Pain that is unrelated to movement quality may also need further medical investigation to find out if it is related to any systematic condition or psychosocial issues. Using such an algorithm, we can clearly communicate why we refer our clients out when we connect them with other clinicians.
This system is not unique to us. We have learned and tested many systems out there for the past 10 years while collaborating with other clinicians. Those systems are combined, filtered, and evolved into our current system as we continuously scrutinize them based on what brings long-term results for our clients. And this system is still continuously evolving so that you can enjoy the maximum benefit of the “exercise as medicine” you deserve! :)
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