Cumulative Injury Cycle

In a perfect world, the Human Movement System involves a complex paradigm of myofascial/neuromuscular systems and articular components. The epitome of optimal neuromuscular efficiency comes from proper alignment and functioning of its components - length-tension relationships, force-couple relationships, arthrokinematics and neuromuscular control.

Posture is a culmination of functional as well as structural integrity of the body. Structural efficiency is defined by one's ability to balance their center of gravity over a constantly changing base of support while performing functional movements (i.e. performing dumbbell squats on a Bosu Ball). Functional efficiency is the ability of the neuromuscular system to recruit proper muscular dynamics at the proper time, apply the right amount of force with the least amount of energy and stress on the Human Movement System. Structural and functional efficiency may come with kinks in the armor (i.e. genetics) or may develop problems over time from injury or improper biomechanics.

The Human Movement System is a dynamic and ever changing system. Impairment or injury usually involves multiple structures which promotes compensations and adaptations. Dysfunction generally leads to altered length-tension, altered force-coupling and arthrokinematic relationships. The cascade continues with altered sensorimotor integration as well as altered neuromuscular efficiency and tissue fatigue/breakdown.

When just one component of the Human Movement System is not functioning properly (muscle tightness/weakness and/or altered arthrokinematics), it presents predictable patterns of dysfunction (i.e. the upper crossed syndrome or the pronation distortion syndrome). These patterns lead to decreased neuromuscular control and microtrauma. This is what drives the Cumulative Injury Cycle - tissue trauma, inflammation, muscle spasm, adhesions, altered neuromuscular control and muscle imbalances. Any one of those components can alter length-tension relationships and joint arthrokinematics, which will decrease performance, increase the likelihood of injury and movement impairment syndromes.

Movement Impairment Syndrome states that when one of the systems is not functioning properly, others must compensate in an attempt to distribute the work load of the dysfunctional segment. For example, if the gluteus medius is underactive, then the tensor fascia latae (TFL) may become dominate to produce the force necessary to maintain frontal plane stability of the hip complex. This becomes an issue when an overactive TFL can cause tightness, iliotibial band tendonitis and low back pain.

Maintaining optimal static, transitional and dynamic posture is imperative for structural integrity during functional activities. One misaligned segment can cause impairment syndromes, compensations and cascading reactions. In order to prevent movement impairment syndromes, the body must be able to absorb shock, accept and distribute weight efficiently and transfer force properly. A NASM health professional needs to be committed to being aware of the optimal postures during certain movements and through the use of postural assessments, recognize discrepancies and will have the knowledge to correct compensations or hand off to appropriate health care professionals when it maybe beyond the scope of practice.

Pgs 61-64 NASM CES textbook 2011

#Rehabilitation #PhysicalTherapy #Injury #SportsInjury #Spasm #FoamRolling #Stretching #Dysfunction #Posture