Functional movement is a term that is often thrown around and is of course becoming super trendy. It seems if you chuck the word functional in front of it, you can get a way with any type of exercise from crawling around like a bear to swinging off a pole. But what does “functional movement” actually mean in terms of injury prevention and promotion of an active lifestyle?
What is it?
Functional movement training originated with functional rehabilitation (mostly in Occupational Therapy), where the intervention is designed specifically for the person according to what is meaningful for them to gain functional independence. The overall goal may be to return to work or return or to full function in all activities of daily living.
Functional movement training mimics activities in your daily life, for example; walking, one handed carry (carrying a bag), squatting/kneeling (to pick things up, tie your shoelaces, reach into a low cupboard), pushing/pulling (a trolley, a pram, a wheelbarrow, opening a door).
The other way to look at functional movement is, movement that is required for you to be functional in your daily life. For example, you may need functional strength in your legs to walk up and down a flight of stairs at home. Functional movements are usually those which are natural to the human being. Walking is a natural movement pattern, running, jumping, bending, squatting are all normal movement patterns.
Functional movements are generally multi-directional, utilising postural stability, multiple joints and multiple gross and fine motor patterns. In other words, it involves the whole body, and the whole person.
Because functional movement utilises natural movement patterns, there is an in inherent lower risk of injury and in fact, if we “practice” these natural movement patterns it can help with injury prevention because we improve neuromuscular postural stabilisation and joint centration.
Conversely, if we utilise movement patterns that are not natural, especially under load, we are much more prone to injury.
Case in point
Recently an office worker presented to me on a Monday morning with acute right sided neck pain. His neck rotation to the right was restricted to approximately half range and he reported the right side of his neck was painful and tender to touch. Upon questioning, he reported he had first noticed the pain following a gym session on Saturday morning and on further enquiry, he remembered that he felt his neck strain when he was doing weighted shoulder shrugs.
At this point in the consultation I had to refrain from saying “you idiot, what were you doing that for”, because of course, as a health professional I would never even think that would I! But I did explain to him that these types of weight lifting exercises were born out of the bodybuilding era of making all your muscles look big and they don’t really convert into anything that is in fact functional. Furthermore, it usually just leads to a lot of dysfunction… like when your upper traps become so big and tight you can’t relax your shoulders and can’t move your neck, or when you do an acute injury, as he did.
Injuries are often the reason people become sedentary
As I was saying, the more we can make movement patterns more natural, the more we can prevent injuries. There basically really is never any need for a human being to shrug their shoulders under a heavy load, nor is there any need to lift a really heavy item above head height, nor extend your arm against resistance, nor pick something up with your legs straight and your eyeballs popping out of your head (think dead lift). While I never want to discourage anyone from engaging in physical activity, I see it is extremely important to minimise the risk of injury when exercising, as this is often the reason people stop moving. It’s the classic story of someone who got motivated to “get fit” and embarked on a gym program only to wind up with an elbow injury that takes 12 months to heal. In that 12 months the person is unable to do any “functional” tasks like carrying a bag, pouring a jug of water, mowing the lawn, even driving a car. They become more sedentary than they were before their attempted gym program and worse, more unmotivated to do any type of exercise.
What about functional movement for Lifestyle Medicine?
We often look at the consequences of sedentary work behaviours, but what about sedentary lives. And when I say this, I don’t mean those who don’t exercise. I mean, the lifestyles that do not incorporate movement. Those lifestyles that see us sitting down more often than standing up. The lifestyles that see us utilising all modern technologies and conveniences and forgetting to literally get up off our butts. Think about the consequence in terms of functional movement if you eat pre prepared food verses making something from fresh ingredients yourself. Even more so, think about sitting down and having someone wait on you, bringing your food to the table and all you have to do is eat. Think about the functional movement implications of increased screen time verses engaging in other activities. Even shopping has become sedentary, ordering food and clothes on line rather than having to walk up and down the aisles, rather than having to visit a market and carry some bags. And yes, I am going to say it, what about all the times during the week you use an escalator or elevator rather than walking up the stairs.
When it comes to chronic lifestyle diseases, I would propose that our main issue is lack of functional movement, not lack of exercise. When Dan Beuttner teamed with National Geographic to study people in what he termed the “blue zones”, he noted they didn’t actually perform any exercise per sae. Their lifestyles nudged them into constant movement. They were just performing functional movement as part of their everyday life. They often walked to work or to visit their neighbours, most of them had gardens that they tended to and they were generally just engaged in life with a strong sense of purpose and community involvement. Some of them hiked, some of them played sporting games together. But generally, none of them were engaging in strenuous workout routines… certainly none of them felt the need to do 20kg shoulder shrugs!
What does this mean for us as Lifestyle Medicine practitioners?
Exercise prescription is certainly required, however, a life full of functional movement would be the ultimate solution. It is the harder question to ask, but we should be enquiring about how we change the day to day, moment by moment choices in everyday life to totally shift a lifestyle towards from sedentary to active.
Essentially we need to start raising awareness that the small things matter. The moment by moment choices we make to either be mobile or sedentary shape our lives and literally change our biology, physiology and neurology.
Here are a few small tips to get started.
Tips to make exercise more functional:
- Use the general principle of using your own body weight to create resistance and use your whole body. For example, plank position with your arms straight. This keeps spine in neutral alignment, engages postural or core stability, keeps shoulders, elbow and wrists in a centrated position. It also engages postural control mechanisms to keep your balance.
- If using weighted loads, perform a functional movement such as lift and carry, keeping the load close to the body.Perform bilateral carry and unilateral carry with a lighter load.
- Perform exercises on different terrain such as undulating grass, or hills to allow the body opportunity for slight changes in postural control and adaptation from proprioceptive feedback.
- Use your whole body rather than isolated muscles or muscle groups. For example, 4 point crawling on feet and hands (like a bear), forwards and backwards for strength and endurance training, combined with co-ordination and agility training, and, mobilisation of the hips, shoulders and spine.
Tips to make functional movement part of your daily lifestyle:
- Walk – It is simple, and it is obvious, but we must look for opportunities to walk more. Whether that be walking around your home, walking around your office. Think about how many times you stay sitting down rather than get up because it’s easier, or because you can send a text message instead to communicate. Think about opportunities to walk around a market, walk around a shop rather than order on line. What about opportunities to walk to school with your children, or to the bus stop, or even just an extra 100 meters from the car to the classroom. Position things in your house to create more movement, walk to the laundry to put your clothes away every morning and night rather than save it up to the end of the week. Only fill your glass up half way before sitting down to have a drink….then get up to fill it up. Position things in your office to create more movement. Br creative and remember that it is the moment by moment tasks and choices that add up over a week, month and year, rather than the 45 minute walk once per week that makes a lifestyle change.
- Stand up – What are you doing right now. Are you reading this sitting or standing. When in your life can you stand rather than sit. There are so so many opportunities to stand rather than sit.
- Wait standing up – When you can, do all your waiting standing up.Wait for the kettle to boil standing up, wait for you coffee to be made at the cafe while standing. Wait for your kids at pick up standing outside the car. Wait for your next meeting standing up. Think of all the things you do that require waiting, and instead of sitting down and scrolling through your phone, stand up (and even better still, walk around).
- Phone use – Every time you take a phone call either at home or work, stand up to talk. And, if you can, walk around. Most of us now use these amazing things called mobile phones, but, somehow they have made us more immobile. And, further to that, stand up when you are on your phone scrolling social media……that could add 1 to 2 hours of movement in your day!!
- Garden – Follow the lead of the people in the “blue zones” and build a garden at home, or if you don’t have space, use planters or pots. By the time you water the garden, weed and tend to it a couple of times per week, you have added a couple of hours of incidental movement (and hugely added to your nutrition).
This article has been written for the Australasian Society of Lifestyle Medicine (ASLM) by the documented original author. The views and opinions expressed in this article are solely those of the original author and do not necessarily represent the views and opinions of the ASLM or its Board.
Jacqueline Edser is a qualified Occupational Therapist, Certified Lifestyle Medicine practitioner and offers Lifestyle Medicine Coaching.
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