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1st Oct

2011

Coordination: A Key to Restoring Function

Exercise can be designed in various ways, to increase muscular endurance, strength and power. However, the most overlooked and important neuromuscular quality both in rehabilitation, and in conditioning training, is coordination. Coordination is the ability to move in the most effortless fashion, where joints move in a perfect physiological pattern, stabilized by deep slow twitch muscle groups, while moved by bigger and more superficial predominantly fast twitch muscle groups, all in perfect synergy. To observe such movement perfection, one must only study many top elite athletes, or highly accomplished dancers. But excellent coordination is equally important for the non-athlete, in order to be able to handle normal daily activities and work tasks with less expenditure of energy, less strain and pain, and to prevent injury or re-injury.

Exercise equipment such as weight machines, which are built to allow you to only move in a set way, do not promote coordination. Instead, more resistance can be used to accomplish the task, which can effectively build muscle strength and bulk, but may also increase the injury risk if the person is lacking normal joint or soft tissue integrity, and which does not lead to strength that the person can effectively use during daily activities and sports. Exercises controlled by the person himself or herself, with or without free weights, or with pulley and cable machines, are much more effective. This is known by the top athletes in most sports. And it is true for the rest of us as well.

When we develop a painful condition, or as we age, we often develop weakness and atrophy of the deep stabilizing muscles. When in pain, they may also be guarded, and unable to relax. This produces a situation similar to attempting to drive a car with the break on, which certainly would prevent the car from running well, and would lead to wear and tear. Examples of such deep stabilizing muscles are the multifidus throughout the spine and the rotator cuff in the shoulder, but they exist throughout our body.

Manual joint and soft tissue techniques as well as specific exercise can inhibit or activate such muscles, and restore joint mobility necessary for these muscles to contract normally. These muscles are slow twitch endurance muscles, and they therefore need endurance training with a high number of repetitions. To establish good coordination of the movement, the exercise at first needs to be performed slowly. Gradually, the speed can be increased, as long as the motion is performed correctly. This now becomes programmed into our nervous system. The coordination must never be compromised as the exercise resistance is increased.

The final stage of rehabilitation, and ongoing fitness training, entails simultaneously contracting bigger superficial fast twitch muscles with the stabilizing muscles during more complex movement patterns in a perfectly coordinated and painfree motion. Exercises can now be designed to mimic a component of, or the entire movement, that the person would like to perform with success during daily activities or in sports. With focused repetition, the desired movement becomes automatized.

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With wishes for a healthy and safe fall,

Gunnar

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