You are in a body. You must move. Better learn how to do it well, because it’s such a big piece of your life.

—Ido Portal

Conscious movement is the lifeblood of human health. Just as food may act as medicine or poison depending on how we treat it, exercise too can renew or destroy health depending on our approach to it.

My 80-year-old mother suffers from a number of metabolic as well as musculoskeletal issues. While many people will imagine that her treatment would necessitate symptomatic management of all her issues, it is the opinion of her medical practitioner, a well-known geriatric specialist of the city, that a majority of her problems can be controlled or even reduced with proper and controlled mobility exercises. This advice will hold true for most people unless there is a deep-rooted or congenital pathology, which is really an exceptional case. 

Move often and move well. Do not go for a generic exercise programme, as that affects your health and fitness negatively. Many keen gym-rats grind away day in and day out on a regimen that actually eats into their joints and connective tissues or has a negative stressful impact on their metabolic health.

Many people want to move effortlessly and gracefully, but are not able to do so due to a number of muscular/connective tissue dysfunctions or congenital issues. 

Postural issues can be corrected with appropriate programmes prescribed by knowledgeable coaches after conducting a full musculoskeletal assessment. Remember that increase in average life expectancy is not a marker of improved wellness and fitness.

At the root of a correctly-prescribed programme is a proper assessment effort based on scientific musculoskeletal screens. 

Members of a gym should not be put on a workout programme until a proper assessment is done of his body condition and a solution planned. Six to eight screens are usually enough to get a fair idea about a person’s movement abilities or lack of it (disabilities).

Sometimes, if the trainer suspects deeper dysfunctions, he or she can introduce a few more assessment screens. A training programme should be designed only after giving due importance to the observations at the assessment. 

Two tests that are used for assessment by trainers

SCREEN 1: MODIFIED HURDLE STEP

This examines simultaneous mobility of one limb and stability of the opposite limb, while maintaining both hip and torso stabilisation under the balance challenge of standing on one leg.

Walking and running is transfer of load from one leg to the other while maintaining stability in the other leg. Many older people fall and injure themselves. Those who do poorly in this test may have poor proprioceptive senses and trainers have to include exercises that improve these faculties.

The movement: Trunk flexion (trunk bending towards the waist) towards the stance leg (dowel dips to the same side).

What it means: Weakness in the stance leg (leg on which the subject assumes a one-leg position) abductor muscles.

The movement: Hip rotation (stance leg rotates internally).

What it means: Weakness in the stance leg lateral rotators.

The movement: Forward lean in the torso (dowel drops forward). Stance leg hip flexors (muscles that help to raise the knee up above the hips) are tight.

What it means: Weakness in the abdominal muscles.

The movement: Forward flexion in the torso with leg raise.

What it means: Weakness in the raised leg hip flexors/weak lumbar extensors (muscles that extend the lower back).

The movement: Inability to control torso movement and maintain balance.

What it means: Poor core stability.

The movement: Excessive feet pronation (feet open outwardly in relation to shin) of the stance leg.

What it means: Weakness in the gluteal muscle group of the stance leg/weakness in the shin muscles of the stance leg.

SCREEN 2: FORWARD BEND AND RETURN

This screen examines mobility in the hips and lumbar spine during a forward bend and observes neural control and movement efficiency during the return from a forward bend. 

Those who do poorly here risk hurting their lower back doing any movement that involves a bend-and-pick up action, for instance, picking up a baby from the bed. Trainers have to be careful before recommending a similar movement with load.

Normal forward bending is initiated at the hips, producing 80 degrees of hip flexion and approximately 20 degrees of lumbar flexion. The hips normally flex faster than the spine during the first 50 degrees of motion.

The movement: Trunk flexion (trunk bending towards the waist) toward the stance leg (dowel dips to the same side).

What it means: Weakness in the stance leg (leg on which the subject assumes a one-leg position) abductor muscles.

The movement: Hip rotation (stance leg rotates internally).

What it means: Weakness in the stance leg lateral rotators.

The movement: Forward lean in the torso (dowel drops forward). Stance leg hip flexors (muscles that help to raise the knee up above the hips) tight.

What it means: Weakness in the abdominal muscles.

The movement: Forward flexion in the torso with leg raise.

What it means: Weakness in the raised leg hip flexors/weak lumbar extensors (muscles that extend the lower back).

The movement: Inability to control torso movement and maintain balance.

What it means: Poor core stability.

The movement: Excessive feet pronation (feet open outwardly in relation to shin) of the stance leg.

What it means: Weakness in the gluteal muscle group of the stance leg/weakness in the shin muscles of the stance leg.

Pictures: B. Halder

Ranadeep Moitra is a strength and conditioning specialist and corrective exercise coach