hen analyzing a movement using only 2D video we neglect variables that can establish the root of a physical deficiency. Every move we make is a result of us interacting with the ground. According to Newton’s Third Law of Motion “For every action, there is an equal and opposite reaction.” A great example of this is bouncing a ball, you throw the ball into the ground and it bounces back up. So essentially, every force we apply into the ground results in an equal and opposite force. This force is either absorbed by the body, or used by the body to create movement. How efficiently we transfer that force is dependent on the efficiency of our musculoskeletal system. One system that is essential is the stretch shortening cycle. As our muscles lengthen and shorten they store and release energy that aids in the translation of ground force to the instrument being used (golf club, tennis racquet, baseball bat etc.). The goal is to utilize as much force as we can, which then results in higher velocities and thus more power.
As adverse to analyzing a movement by looking at that body part specifically, it is highly beneficial to analyze interactions from the original source of movement: the ground. What we then begin to see is a chain reaction of events through the body. Often, the source of the problem is found somewhere other than the area of weakness. Which is why physical screening is so useful. As Functional Movement co-founder Gray Cook says “The body works in alternating patterns of stable segments, connected by mobile joints. If this pattern is altered- dysfunction and compensation will occur.”
Our body is made up of multiple joints that alternate between mobile and stable. When a mobile joint becomes stable, or visa versa, this is when we begin to run into problems.
The subject in this case study noted a weaker left shoulder due to several previous injuries. So, we decided to analyze a very common exercise: The Press Up. When watching him perform you wouldn’t think anything was wrong, especially because he could quite happily do multiple reps. But when we looked a little deeper at his interaction with the ground we began to find the source of the issue.
As you can see in the images below, he favors his right hand throughout the movement (pressure remains between 56 – 59% on his right side).
We then used biofeedback and let him perform the movement with the pressure map in front of him so he got the visual feedback to correct his pressure application. He struggled to perform 1 rep when using 50:50 right:left. Highlighting the demand this position was placing on the stabilizing muscles of the scapula and shoulder. When we screened his shoulder (90/90 test in upright, and tilted) we discovered no apparent deficiencies.
So, we decided to look at a different movement that required his hands to be in a forward flexed position. We took the SFMA prone rocking test (on an Airex pad because he cannot kneel on firm ground due to previous knee injuries). What we noted which you will see in the images below, is that more pressure was being applied in his fingers in the forward position.
After performing another screen, we hypothesized that this was due to a limitation in his left wrist flexion.
BEFORE (57% in fingers)
Physical Therapist Dr. Suzanne Ambrose from Jupiter Medical Center performed Mulligan Mobilization with Movement techniques on his left wrist to restore functional movement. The purpose of this method is to reposition the bones so they won’t inhibit the joints range of motion. When we retested using BodiTrak the results were incredible. The pressure shift evened out from wrist to fingers and he could use the correct muscles to stabilize his scapula and shoulder.
The rocking movement was easier, and it enabled him to activate the correct muscles during a press up making that 50:50 position easier than before.
AFTER (35% in fingers)
For any athlete, being able to identify the main source of the issue is essential to preventing injuries and optimizing their functional abilities. BodiTrak’s pressure mat system works in conjunction with physical screening and manual techniques to confirm a diagnosis and correct a deficiency through biofeedback.
Suzanne Ambrose (DPT, DipMDT, TPI Certified level 3, K-Vest Certified level 3, BODITRAK Certified)
Suzanne started out her career with a degree in biomechanics and applied that to the athletic and industrial populations in New Zealand. She went on to gain her physiotherapy degree and later earned a Doctor of Physical Therapy with Distinction from Simmons College in Boston.
She has been with Jupiter Medical Center since 2010 and has over 20 years of experience working with orthopedic and athletic populations as a physical therapist. She worked as a team therapist for the 1996 New Zealand Olympic team in Atlanta and has since worked with numerous college and professional level teams and athletes.
Suzanne has been a clinical instructor for 15 years and has taught many continuing education courses to health care and sports professionals including a 2 year tour teaching division one athletic training staff throughout North America.
More recently, Suzanne has turned her sports medicine attention to the local golf community, finding a need for biomechanical analysis of the golf swing from a medical perspective along with integrative golf health services.