Applied Functional Science Chain Reaction Skeletal: Real creates Relative. Presented By David Tiberio, Ph.D., PT, FAFS Dean, Gray Institute

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1 Applied Functional Science Chain Reaction Skeletal: Real creates Relative Presented By David Tiberio, Ph.D., PT, FAFS Dean, Gray Institute 1

2 How Movement is Created Total body movements are made up of multiple bone segment movements Joint motions are created by the movements of adjacent bone segments 2

3 REAL and RELATIVE MOTION BONE MOVEMENT = REAL MOTION in 3D SPACE JOINT MOTION = MOTION BETWEEN ADJACENT BONES 3

4 AFS PRINCIPLE: MOTION IS THREE DIMENSIONAL JOINTS ARE DESCRIBED AS EITHER UNI-AXIAL, BI-AXIAL, or TRIAXIAL THIS IS BASED ON THE NUMBER OF INDEPENDENT MOTIONS DURING NON-FUNCTIONAL ACTIVATION ALL JOINTS MOVE IN EACH OF THE THREE PLANES ALL JOINTS ARE 3-D 4

5 3-D KNEE EXAMPLE DESCRIBED AS BI-AXIAL SAGITTAL AND TRANSVERSE PLANES DURING WEIGHTBEARING FUNCTION, THE KNEE MOVES INTO DIFFERENT POSITIONS (VARUS and VALGUS) THESE POSITIONS ARE CREATED BY MOTION IN THE FRONTAL PLANE (ADDUCTION and ABDUCTION) 5

6 FUNCTIONAL APPLICATION: 3-D KNEE on the AIR BAPS THE CHAIN REACTION CREATED BY GRAVITY AND GROUND REACTION WHEN LANDING CREATES FRONTAL PLANE MOTION OF THE KNEE THE AMOUNT OF FRONTAL PLANE MOTION DEPENDS ON THE DIRECTION OF THE LUNGE THIS MOTION OF THE KNEE ACTIVATES THE HIP MUSCLES WHICH PROTECTS THE KNEE 6

7 COMBINING THREE PLANES IN EACH PLANE THE JOINT CAN MOVE IN EITHER OF THE 2 DIRECTIONS or NOT MOVE AT ALL SINCE THE JOINT HAS 3 OPTIONS IN EACH PLANE, THERE ARE 27 DIFFERENT BONE MOVEMENT COMBINATIONS (1 COMBINATION RESULTS IN NO MOTION) 7

8 FUNCTIONAL APPLICATION: 27 HIP COMBINATIONS THE HIP JOINT HAS 3 INDEPENDENT AXES SAGITTAL PLANE = FLEXION, EXTENSION, NO MOTION FRONTAL PLANE = ABDUCTION, ADDUCTION, NO MOTION TRANSVERSE PLANE = INTERNAL ROTATION, EXTERNAL ROTATION, NO MOTION 8

9 FUNCTIONAL APPLICATION: 27 HIP COMBINATIONS WITH BOTH FEET ON THE GROUND USING HAND REACHES THE RIGHT HIP HAS 26 MOVEMENT COMBINATIONS (1 NO MOTION) COMBINATION A = FLEXION, ADDUCTION, And INTERNAL ROTATION COMBINATION B = FLEXION, ABDUCTION, and EXTERNAL ROTATION 9

10 AFS PRINCIPLE: MOVEMENT IS DRIVEN TOTAL BODY MOVEMENTS ARE CREATED BY FORCES = DRIVERS PHYSICAL DRIVERS GRAVITY, GROUND REACTION FORCE, MOMENTUM PHYSIOLOGICAL DRIVERS MUSCLES, LIGAMENTS, FASCIA BEHAVIORAL DRIVERS PAIN, FEAR, GUILT 10

11 AFS PRINCIPLE: MOVEMENT IS DRIVEN BONE MOVEMNTS ARE DRIVEN BY BODY PARTS STEP EXAMPLE = FEET REACH EXAMPLE = HANDS LOOKING EXAMPLE - EYES 11

12 AFS PRINCIPLE: MOVEMENT IS A CHAIN REACTION THE BODY IS MADE UP OF CONNECTED PARTS A DRIVER EFFECTS THE ENTIRE BODY THE CHAIN REACTION OCCURS ON A SUBCONSCIOUS LEVEL CONSCIOUS OF THE TASK, but NOT BONES, JOINTS or MUSCLES 12

13 AFS PRINCIPLE: MOVEMENT IS A CHAIN REACTION THE GOAL IS TO GIVE YOUR CLIENT A TASK BASED ON THE PRINCIPLES Of APPLIED FUNCTIONAL SCIENCE IN ORDER TO CREATE THE DESIRED CHAIN REACTION STRATEGIES BASED UPON THE PRINCIPLES SUGGEST THE TASK TO USE 13

14 FUNCTIONAL APPICATION: DRIVING EVERSION of CALCANEUS IMPORTANT FOR LOADING THE ENTIRE LOWER EXTREMITY EXAMPLE = EVERSION OF RIGHT CALCANEUS A. RIGHT FOOT, ANTERIOR LUNGE B. LEFT FOOT, LEFT ROTATIONAL LUNGE C. RIGHT HAND, LEFT ROTATIONAL REACH D. LEFT HAND, LEFT ROTATIONAL REACH 14

15 FUNCTIONAL APPICATION: DRIVING EVERSION of CALCANEUS THERE ARE MANY WAYS TO DRIVE THE CALCANEUS INTO EVERSION ONE OF THE DRIVERS MIGHT BE MORE FUNCTIONAL BASED ON THE TASK YOUR CLIENT DESIRES TO DO THE MORE TASKS THAT CAN BE CREATED THAT DRIVE THE CALCANEUS INTO EVERSION THROUGH A CHAIN REACTION, THE MORE SUCCESSFUL YOUR CLIENT WILL BE 15

16 AFS PRINCIPLE: LOAD and EXPLODE IN ORDER TO ACCOMPLISH ANY TASK THE BODY NEEDS TO LOAD MOVEMENT IS REQUIRED TO LOAD THE SYSTEM THE BODY KNOWS IT NEEDS TO MOVE OPPOSITE THE DESIRED MOVEMENT YOU CREATE TASKS TO PRODUCE THE DESIRED LOAD 16

17 AFS PRINCIPLE: LOAD and EXPLODE FAILURE TO ACCOMPLISH THE GOAL (EXPLODE) OFTEN IS CAUSED BY THE FAILURE TO LOAD EFFECTIVELY LIMITATIONS OF MOTION AT ONE LINK IN THE KINEMATIC CHAIN WILL INHIBIT THE LOADING CHAIN REACTION 17

18 FUNCTIONAL APPLICATION: LIMITED ANKLE DORSIFLEXION MOTION BLOCKED IN 1 PLANE WILL INHIBIT MOTION IN 3 PLANES AT MULTIPLE JOINTS LOSS OF RIGHT ANKLE DORSIFLEXION WILL ALTER THE WAY A SQUAT IS PERFORMED KNEE CAN T MOVE FORWARD DUE TO ANKLE LIMITATION, SO THE BUTT MUST MOVE BACK TO LOWER THE BODY 18

19 AFS PRINCIPLE: LOAD and EXPLODE LACK OF MOTION TO LOAD CREATES GREAT DEFICITS IN SPITE OF GOOD MUSCLE STRENGTH GOAL: USE AUTHENTIC BODY PART DRIVERS TO CREATE A 3-PLANE LOAD ASSESS THE LOAD and EXPLODE AT THE PLACE WHERE THE LOAD CHANGES TO THE EXPLODE 19

20 REAL BONE MOTION RELATIVE JOINT MOTION AUTHENTIC MOTION IS DRIVEN MOTION WHERE IS THE DRIVER THAT IS CREATING THE CHAIN REACTION? DRIVER MAY COME FROM ABOVE = TOP-DOWN DRIVER MAY COME FROM BELOW = BOTTOM-UP CAN HAVE BOTH TOP-DOWN and BOTTOM-UP 20

21 REAL BONE MOTION RELATIVE JOINT MOTION FOR EACH SINGLE MOTION IN A SINGLE PLANE AT A SPECIFIC JOINT THERE ARE 5 DIFFERENT BONE MOVEMENT COMBINATIONS THAT CAN CREATE THAT SINGLE MOTION 21

22 REAL BONE MOTION RELATIVE JOINT MOTION HIP ABDUCTION EXAMPLE: A. FEMUR ABDUCTS, PELVIS NO MOTION B. FEMUR NO MOTION, PELVIS ROTATES OPPOSITE C. FEMUR ABDUCTS, PELVIS ROTATES SAME, FEMUR MOVES FASTER D. FEMUR ADDUCTS, PELVIS ROTATES SAME, PELVIS MOVES FASTER E. FEMUR ADDUCTS, PELVIS ROTATES OPPOSITE 22

23 FUNCTIONAL APPLICATION 5 REAL CREATE 1 RELATIVE RIGHT HIP EXTENSION EXAMPLE: A. FEMUR EXTENDS, PELVIS NO MOTION B. FEMUR NO MOTION, PELVIS ROTATES OPPOSITE C. FEMUR EXTENDS, PELVIS ROTATES ANTERIOR (SAME), FEMUR MOVES FASTER D. FEMUR FLEXES, PELVIS ROTATES POSTERIOR (SAME), PELVIS ROTATES FASTER E. FEMUR EXTENDS, PELIVS ROTATES P0STERIOR 23

24 FUNCTIONAL APPLICATION 5 REAL CREATE 1 RELATIVE RIGHT HIP EXTERNAL ROTATION EXAMPLE: A. FEMUR EXTERNAL ROT., PELVIS NO MOTION B. FEMUR NO MOTION, PELVIS ROTATES OPPOSITE C. FEMUR EXTERNAL ROT., PELVIS ROTATES RIGHT (SAME), FEMUR MOVES FASTER D. FEMUR INTERNAL ROT., PELVIS ROTATES LEFT (SAME), PELVIS MOVES FASTER E. FEMUR EXTERNAL ROT., PELVIS ROTATES LEFT 24

25 REAL BONE MOTION RELATIVE JOINT MOTION LEFT KNEE INTERNAL ROTATION (IR) A. LOWER LEG IR, FEMUR NO MOTION B. LOWER LEG NO MOTION, FEMUR ER C. LOWER LEG IR, FEMUR IR, LOWER LEG MOVES FASTER D. LOWER LEG ER, FEMUR ER, FEMUR MOVES FASTER E. LOWER LEG IR, FEMUR ER 25

26 FUNCTIONAL APPLICATION: BONES MOVE OPPOSITE SHOULDER in the TRUE STRETCH EXAMPLE: WHEN THE BONES MOVE IN OPPOSITE DIRECTIONS, IT CREATES A POTENTIAL FOR INJURY BUT IT ALSO IS A FUNCTIONAL SOURCE OF GREAT POWER TO EXPLODE INTO THE TASK DURING FUNCTION, BONES SWITCH DIRECTIONS IN A SEQUENCE THAT MAXIMIZES THE LOAD 26

27 FUNCTIONAL APPLICATION: BONES MOVE OPPOSITE SHOULDER in the TRUE STRETCH EXAMPLE: AS THE EXPLODE IS INITIATED FROM THE PELVIS, THE TRUNK AND SCAPULAMOVE FORWARD WHILE THE HUMERUS IS STILL MOVING BACK THE STRETCH ON THE MUSCLES ALLOWS FOR STORAGE OF ENERGY TO EXPLODE IF THE MUSCLES FATIGUE, THIS STRETCH HAS THE POTENTIAL TO INJURE MUSCLES OR JOINT CAPSULE STRUCTURES 27

28 REAL AND RELATIVE SPINE MOTION MOTION IN THE SPINE IS DRIVEN THE SAME WAYS AS IN THE EXTREMITIES HOWEVER, THE RELATIVE MOTION OF THE JOINTS IS NAMED BY WHAT THE SUPERIOR BONE DOES, RELATIVE TO THE INFERIOR BONE, REGARDLESS OF WHICH BONE MOVES MOTION CAN BE DRIVEN TOP-DOWN, BOTTOM-UP, or BOTH 28

29 REAL AND RELATIVE SPINE MOTION RIGHT CERVICAL ROTATION EXAMPLE: A. HEAD ROTATES RIGHT, TRUNK NO MOTION B. HEAD NO MOTION, TRUNK ROTATES TO LEFT C. HEAD ROTATES RIGHT, TRUNK ROTATES RIGHT, HEAD ROTATES FASTER D. HEAD ROTATES LEFT, TRUNK ROTATES LEFT, TRUNK ROTATES FASTER E. HEAD ROTATES RIGHT, TRUNK ROTATES LEFT 29

30 FUNCTIONAL APPLICATION CERVICAL SPINE SAGITTAL PLANE EXTENSION EXAMPLE: A. HEAD EXTENDS, TRUNK NO MOTION B. HEAD NO MOTION, TRUNK FLEXES C. HEAD EXTENDS, TRUNK EXTENDS HEAD MOVES FASTER D. HEAD FLEXES, TRUNK FLEXES, TRUNK FLEXES FASTER E. HEAD EXTENDS, TRUNK FLEXES 30

31 FUNCTIONAL APPLICATION CERVICAL SPINE FRONTAL PLANE LATERAL FLEXION TO THE RIGHT EXAMPLE: A. HEAD LATERAL FLEXES RIGHT, TRUNK MOTIION B. HEAD NO MOTION, TRUNK LATERAL FLEXES TO LEFT C. HEAD LATERAL FLEXES RIGHT, TRUNK LATERAL FLEXES RIGHT, HEAD MOVES FASTER D. HEAD LATERAL FLEXES LEFT, TRUNK LATERAL FLEX ES LEFT, TRUNK MOVES FASTER E. HEAD LATERAL FLEXES RIGHT, TRUNKL LATERAL FLEXES LEFT 31

32 REAL and RELATIVE LUMBAR SPINE MOTION WHEN DRIVEN BY THE FEET, THE PELVIS IS OFTEN MOVING, CREATING LUMBAR SPINE MOTION WHEN MOTION IN THE LUMBAR SPINE IS DRIVEN FROM BELOW, THE REAL BONE MOTION OF THE PELVIS AND THE RELATIVE JOINT MOTION IN THE LUMBAR SPINE WILL BE OPPOSITE 32

33 FUNCTIONAL APPLICATION LUMBAR DRIVEN FROM BOTTOM RIGHT FOOT LUNGE EXAMPLES: SAGITTAL PLANE POSTERIOR LUNGE PELVIS ROTAES ANTERIOR = RELATIVE LUMBAR EXTENSION FRONTAL PLANE LEFT LATERAL LUNGE PELVIS LATERAL FLEXES TO RIGHT = RELATIVE LUMBAR LEFT LATERAL FLEXION TRANSVERSE PLANE RIGHT ROTATION LUNGE PELVIS ROTATES TO RIGHT = RELATIVE LUMBAR LEFT ROTATION 33

34 FUNCTIONAL APPLICATION LUMBAR DRIVEN FROM BOTTOM ASSESSMENT OF LUMBAR SPINE NEEDS TO INCLUDE BOTTOM-UP DRIVERS SINGLE LEG BALANCE REACHES WITH THE OPPOSITE FOOT WILL DRIVE THE PELVIS, CREATING LUMBAR SPINE MOTION 34

35 REAL AND RELATIVE 1 REAL CREATES 3 RELATIVE WHENEVER OUR EYES SEE A SINGLE BONE MOVEMENT, WE OFTEN ASSUME THAT THE REAL BONE MOVEMENT AND THE RELATIVE JOINT MOTION ARE THE SAME THERE ARE ACTUALLY 3 RELATIVE POSSSIBILITIES AT THE JOINT WITH ANY SINGLE BONE MOVEMENT 35

36 REAL AND RELATIVE 1 REAL CREATES 3 RELATIVE FEMUR REAL BONE INTERNAL ROTATION EXAMPLE: A. FEMUR INTERNAL ROTATION, PELVIS MOVES EXACTLY THE SAME = NO MOTION B. FEMUR INTERNAL ROTATION, PELVIS ROTATES THE SAME DIRECTION, BUT FEMUR MOVES FASTER = RELATIVE INTERNAL ROTATION C. FEMUR INTERNAL ROTATION, PELVIS ROTATES THE SAME DIRECTION, BUT PELVIS MOVES FASTER = RELATIVE EXTERNAL ROTATION 36

Table of Contents. Module 1 Applied Functional Science. Tour Guide #1 Applied Functional Science (5:03) Principles & Truths (10:51)

Table of Contents. Module 1 Applied Functional Science. Tour Guide #1 Applied Functional Science (5:03) Principles & Truths (10:51) Table of Contents Module 1 Applied Functional Science Tour Guide #1 Applied Functional Science (5:03) Principles & Truths (10:51) Module 2 The Functional Spectrum The Functional Spectrum (6:28) Physical