Three Pillars or Treatment

Picture of Greg Law

Greg Law

As I discussed in the Basics of Manual Therapy post, I closely follow a three-pillar approach to improving my clients’ movement efficiency. The three-pillar approach consists of mechanical, neuromuscular, and motor control treatment which is essential to restore mobility and then train the client on how to use the new mobility to maintain gains and then change movement patterns to optimize their potential. So, what do each of these pillars actually do? For the following examples, let’s look at a functional movement such as a deep squat (which also happens to be one of the more important movement screens looked at for all golfers…) Mechanical looks at a persons’ movement capacity. Can they physically get their body in a position to succeed? If not, what is limiting them from getting there? For our deep squat example there have to be a lot of things that happen together to allow for that movement. To make it as basic as possible, the client has to be able to dorsiflex their

ankle (bring their toes up towards their shin), flex (bend) their knee, flex their hip (bring

the knees closer to their chest), and maintain proper position of their trunk in order to

succeed. If they are physically unable to do any of these, it could be because the joint in question doesn’t do that movement. We need to get it moving again. Neuromuscular capacity looks at a persons’ initiation, strength, and endurance needed to complete the motions. For our deep squat, do they have proper trunk stability that

begins the milliseconds prior to the movement with adequate strength and endurance to

hold through the entirety of the movement. If they do not, we need to use directed

exercises and manual therapy techniques to train these muscles to help our client

succeed.Motor Control ensures that the client is moving the right part of their body at the right time and the correct muscles are used in order to make the movement as efficient as possible. During the squat, is the client able to load through the lower extremities with the bulk of the work being done to raise the person out of their deep squat by their

quadriceps and glutes while maintaining and efficient spinal alignment. If not, we need

to look at their inefficient movement pattern as retrain the proper squat mechanics. As you might imagine, any one of these pillars may be used in isolation to improve a client’s pain or movement dysfunction. However, it isn’t until all three are combined that you achieve a truly efficient movement pattern. If this sounds like something you or your friends could benefit from, click here to schedule an appointment with one of our highly trained physical therapists to get you back in action.

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