Tag: compensation

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Assess the Global Picture First

An excerpt from the Dynamic Neuromuscular Assessment™ Manual:

It can’t be overstated how important it is to get the global picture of your client’s presentation before introducing correctives. The reason for this is in the nature of compensation itself.

Maladaptation is a response to stress. That stress could be emotional, physiological, or structural. The intelligence of the nervous system employs a coping strategy to meet the needs of the environment. If/when that coping strategy is unable to meet the need, then the nervous system will recruit another strategy to help. This is how multiple players become involved in dysfunctional movement patterns.

When there are multiple players involved in the compensation, there will be only one primary pair. There may be multiple secondary compensations. If we remove a secondary compensation, we are creating a void in the container. Then the nervous system will need to come up with new strategy to fill the void. This is why clients can have adverse response to treatments.

By understanding the global picture of your client’s presentation before introducing correctives, you are decreasing the risk of going down the rabbit hole.  More effective assessment equals more effective treatment!

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DNA™ takes the skills you already possess and puts them into a context that makes those skills more effective. When you employ what Joseph calls The Five Essential Skills with the corrective strategies you already use, the results of your work will have a quantum effect with your clients.  Click here to learn more!

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Ask The Right Question to Optimally Engage the Nervous System

There are a few misconceptions in the movement/bodywork community about manual muscle testing. The first being the term itself. Manual muscle testing is not testing muscles. Manual muscle testing is asking a question. Can the nervous system/structure respond appropriately to a particular stimulus. This is having a conversation with an input / output feedback loop.

The manner in which we engage in the conversation makes a difference. I like to think of the conversation as having two separate aspects. The first aspect is the conversation with nervous system. We are engaging the proprioceptive feedback loop. Can the nervous system respond to the stimulus at the periphery? The second aspect of the conversation is structure. Can the various connective tissue structures respond to vector, load, and duration?

Nervous system response and structural durability are interdependent. Without the nervous system’s capacity to respond appropriately, durability would be compromised. Motor control and neuromuscular coordination are tangible responses of our body’s ability to cope with a changing movement environment. When we feel safe during movement, we have the capacity to optimally thrive.

There is a specific attribute of the kinesthetic conversation that occurs during movement. When we appropriately cue the nervous system to the neurological disorganization of maladaptation, the opportunity to learn, or upload input /output response becomes available.  There are optimal ways and less than optimal ways this happens.

I’ve created a progression – Dynamic Neuromuscular Assessment™ — for the therapist to learn an optimal process for engaging with the nervous system of their client. There are three layers to this process.

The first layer starts with deconstructing and refining manual muscle testing. Movement assessment has the potential to accurately interpret the input/output of nervous system response. This has several sub levels and nuances.

The second layer is mapping. Mapping is a format to understand the unique presentation of our client. The symptom / causation relationship is investigated to arrive at the primary causation, or the primary layer to start employing a corrective strategy.

After we have the global picture mapped of our clients, we can employ the third layer of the DNA™ process, corrective strategies. Caution must be used when employing corrective strategies. Keeping the container safe is a primary concern when “do no harm” is the imperative. We cannot apply a corrective technique until we understand the causation and its source. If we remove a coping strategy or compensation, the nervous system will fill that void in the container. That something will more than likely be maladaptive. Instead, we need to displace a maladaptive compensation with a positive adaptive coping strategy.

Engaging the nervous system is a process of inquiry. As therapists we are learning to ask the right question.  When we ask the right question, the nervous system can be appropriately cued to the symptom causation relationship. This keeps the container safe so that the potential for change is fully realized.  Dynamic Neuromuscular Assessment™ is an assessment protocol that allows the therapist to optimally utilize the corrective techniques they already have by asking the right questions.

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Anatomy and Kinesiology: Moving Beyond the Obvious to the Profound

I’d like to talk with you about an anecdotal experience I recently had with a client.

I had a runner come to me who was experiencing knee pain. If I had stopped in my assessment at simply looking at the function of the knee, I would have missed the primary driver of the compensation pattern.  Because I linked the relationship of the Anterior Kinetic Chain, and the core cylinder, I was able to correlate an internal oblique issue to the medial knee.  It’s not uncommon for ligaments to compensate for the burden when muscular function is impaired.  My ability to move beyond the obvious to a deeper level of inquiry – which is what we learn in Dynamic Neuromuscular Assessment™ Seminars –  allowed me to get to the more profound root issue for my client.

Anatomy and kinesiology are two disciplines that give clarity to the interdependence of the structure and movement of the body.

Anatomy is the language used to describe the parts. These parts then fit together into systems that synergistically make up the whole organism.

Kinesiology is the language of movement. Through kinesiology, anatomy is given a context. If the language of movement is a symphony, the role of anatomy is to describe the source of each note of music.

Anatomy charts provide the fundamental foundation for understanding the names of bones, joints, ligaments, tendons, muscles, fascia, and so forth – the structure. Kinesiology then defines how each aspect of structure works together to create movement.

One of my teachers, early on in my career, imparted the importance of the breath, movement, and structure as being interdependent.

Movement is a translator to how the structure organizes, movement can’t lie. When the body is experiencing pain, the brain reorganizes movement so that we move around our pain instead of through it. This avoidance is a compensation to keep us in a perceived safe zone. As practitioners, our ability to see deviation in movement is paramount to assisting our clients. Often the walking gait is the lens through which we look during assessment. The 5 Primary Kinetic Chains provide a map of the gait.

The use of color in The 5 Primary Kinetic Chains illustrations imparts upon the teacher/student or practitioner/client, how the body organizes during movement. The kinetic chain charts further define how the body organizes in the optimal manner during gait.  Why the gait?  The gait is universal to human movement. From birth, our nervous system is prewired for developmental movement with the intention to get us upright and biped.  If you have interest in a more in-depth conversation on the walking gait, see my blog on the Master Template.  The synergistic organization, or sequential muscular activation, gives context to efficient movement and helps us to identify potential dysfunctional relationships that may not be obvious at first impression to the client or practitioner.

When the synergistic organization of our movement becomes less than optimal, or compensated, the result are over and underworked players. Synergistic dominance is the relationship between these over and under worked players. As a practitioner it is useful to have reference tools – like The 5 Primary Kinetic Chains Poster Set or Desktop Edition to help us dig deeper into the function and dysfunction presented by our clients.

Please leave a comment below about a powerful experience you had either as a client or practitioner where you or they went beyond the obvious to the profound!

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DNA Demystified

Dynamic Neuromuscular AssessmentTM seminars take the skills you already possess and puts them into a context that will make those skills more effective.

When you employ what Joseph calls The Five Essential Skills with the corrective strategies you already use, the results of your work will have a quantum effect with your clients.

Essential Skill #1 – Hybrid Movement Assessment:

  • Learn to seamlessly transition between direct muscle testing strategies and indirect muscle testing – Manual Muscle Testing redefined
  • We will change the paradigm of testing muscles by assessing the response to movement. Can the nervous system and structure appropriately respond to the movement environment?

The Intrinsic Kinetic Chain has many players that cannot be evaluated with direct muscle testing strategies. Hybrid Movement Assessment strategies are essential for evaluating the players in respiration – a key element in assessing clients.

Essential Skill #2 – Completing the Feed-back Loop:

  • Afferent sensory neurons relay information about how movement is responding to the movement environment: this is feed-back motor control
  • Efferent motor neurons are the motor instructions to the periphery: this is feed-forward motor control
  • Using both feed-back and feed-forward movement completes the proprioceptive feed-back loop

Compensation is learned through the feed-back loop. Adaptation is need and response, two sides of the movement equation. Motor learning requires the integration of both feed-back and feed-forward communication to and from the brain.  Feed-forward motor instructions allow the motor control center of the brain to capitalize on compensation patterns. DNA’s movement assessment strategies uncover hidden compensation.

Essential Skill #3 – The Functional Compass:

  • The functional compass provides a map for movement potential
  • Movement happens through non-linear spirals
  • Joints act in compression and distraction
  • Joint assessment using the functional compass evaluates the spectrum of movement potential

Shock Absorption of the Deep Longitudinal Kinetic Chain is interdependent with the ability of the joint capsule to translate compression to distraction over its range of motion. When the joint loses its ability to respond appropriately, compensation will show up as a symptom in ligaments, tendons, muscle and fascia.  DNA’s joint by joint assessment strategies give laser focus attention on the root cause rather than the symptom.

Essential Skill #4 – Functional Dysfunctional Movement:

  • This is analogous to non-painful dysfunctional movement
  • Movement functions can appear to be available with direct testing strategies
  • Hybrid Movement Assessment uncovers hidden layers of compensation

Movement functions can appear to be available with direct testing strategies. Challenging those movements with Hybrid Movement Assessment will uncover hidden layers of compensation: “just because you can doesn’t mean you should.”

Often, our clients are reinforcing compensation through their daily movement. DNA’s assessment strategies identify these patterns so they may be appropriately addressed.

Essential Skill #5 – Eccentric Movement Assessment:

  • Direct Concentric muscle testing is a mere snapshot of movement
  • Eccentric Movement Assessment challenges movement over a range rather than a snapshot
  • Eccentric Movement Assessment incorporates the SAID principle into assessment strategies

The rules of the SAID principle states that adaptation is specific to demand. If the motor program is not cued into the corrective strategy, it may not respond to the correction. Eccentric Movement Assessment cues the motor control center to a larger context of information. This brings up compensatory patterns that would not be revealed in standard concentric testing strategies.

DNA’s assessment strategies are unique as they incorporate both sides of the movement equation.  Concentric activation must be balanced with Eccentric stabilization. This skill set can be explored through the core subsystems of The 5 Primary Kinetic Chains.

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Muscles and The 5 Primary Kinetic Chains

Muscles produce work in the body. They come in two distinct types, smooth and striated. Smooth muscles are governed by the autonomic nervous system. Their function is automatic. Smooth muscles perform the regulatory functions. The tissues that make up organs, the GI tract, and arteries utilize smooth muscles to perform their unique functions. Conversely, striated muscles are governed by the rules of conscious motor control. Striated muscles are often referred to as skeletal muscles. Their job is to act on the skeleton for posture and movement.

Skeletal muscles have a spectrum of roles.  Highlights include: work production, multiple joint stabilization, and position sense. Muscles need to be available to do their job in the movement equation. If they can’t participate appropriately, the brain will come up with a coping strategy. This is a survival-based mechanism, and this is what we call compensation. Compensation has many flavors, and despite a bad rap, it is the intelligence of the body doing its best to keep you safe.

Muscles come in many configurations. Generally, the large powerhouse muscles are more superficial, while the intrinsic stabilizers are deeper. Some muscles are specific in fibril orientation and function while others are available for multiple roles. For example, the large powerhouse muscles of the posterior chain, the latissimus dorsi and gluteus maximus, have multiple fibril orientations that look like a fan. This gives these muscles mechanical advantage over the range-of-motion spectrum.

For simplicity, let’s categorize muscles into two sets: short and long-lever. Short-lever muscles are the dependable hardworking muscles. They have mechanical advantage on the joint. The brain likes to use them as the go-to muscle during work production. Long-lever muscles cross multiple joints and have multiple attachments. Long-lever muscles are best suited for stabilization during work production. Their role is key when movement deviates and unknown variables occur in the environment.

Compensation patterns have a common trait among short and long-lever muscles: short-lever muscles are the heroes. They come to rescue when the long-lever muscles are not responding appropriately in the movement environment.

Short-Lever Muscles:

–         cross one joint

–         mechanical advantage

–         commonly up-regulated

Long-Lever Muscles:

–         cross multiple joints

–         stabilizer during work production

–         commonly down-regulated

Common Relationships:

Short-Lever  ~  Long-Lever

Tibia Rotation

popliteus  ~  bíceps femoris

Knee Flexion

bíceps femoris short head  ~  biceps femoris long head

Hip Flexion

iliacus  ~  psoas

Spinal Extension

multifidus  ~ erector spinea

Shoulder Abduction

subclavius  ~ pectoralis major

Elbow Flexion

brachialis  ~  biceps brachii

These examples are samples of utilizing short-lever ~ long-lever muscle relationships to assess movement compensation patterns. The kinetic chain charts in The 5 Primary Kinetic Chains provide a map for investigating synergistic dominance, regional interdependence, and functional opposite musculoskeletal relationships. Muscles are in constant response to joint position in the movement environment. Can the muscles in conjunction with motor control instructions respond appropriately to the environment?

My upcoming Dynamic Neuromuscular Assessment™ workshops (learn more here) will provide an integrated strategy for movement assessment in a changing environment. Some of the key skill-sets we will employ:

  • utilizing a hybrid that combines direct assessment with indicator testing to uncover functional dysfunctional movement
  • utilizing feed-forward motor control to assess structure that cannot be directly tested
  • completing the proprioceptive feedback loop to assess both motor instructions and structural response
  • investigating long series kinetic chains because muscles do not work in isolation, they work in synergistic sequences during movement
  • investigating dynamic stability as a two-part equation: concentric action balanced by eccentric action — eccentric movement evaluation uncovers hidden layers of compensation
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Homework Cards 101

Homework Cards

We now have homework cards that complement The 5 Primary Kinetic Chain Posters. Each set has 5 cards – one corresponding card per each of the 5 kinetic chains.

The homework cards allow the practitioner to give specific homework based on their clients’ presentation. They serve as a reminder for the client to stay on track between sessions.  They also provide a template for greater client education and understanding by emphasizing both manual release and integration exercises that work in tandem for success in recovery.

The cards are easy to use. The kinetic chain illustration is on the front of the card and there are four entries on the back of the card.

Down-Regulated (Underworked):

These are the player/s not engaged. This is the part of the movement equation that needs to get back in the game of keeping the structure safe.

Up-Regulated (Overworked):

These are the player/s that are overworked by trying to do the job for the down-regulated player/s. Often, these up-regulated player/s create secondary down system effects. Good detective work discovers the primary relationship between the up and down regulated players so that the application of the release and integration is effective at restoring balance back to the structure.

Manual Release:

This is the first step in repatterning. The release of the fixated segment or inappropriate tension allows for a new pattern to be learned. There are many appropriate interventions, as well there are ways of asking the body what it needs. This is up to the practitioner and their toolbox.

Movement Integration:

There is a window of opportunity for the nervous system to learn a new pattern, and to get the player/s that have been disengaged back in the game. The manual release acts as a hack. By temporarily removing the option for compensation, the nervous system must learn a new coping strategy. Activating the down-regulated player/s give the structure the support it needs to recover balanced action.

Note:

The order of cuing the motor control center is important so that effective change and reinforcement of the pattern becomes a learned behavior. If the compensated player is not temporarily taken out of the movement equation, then subsequent movement work often will reinforce a maladaptive pattern. The idea is to displace a maladaptive pattern with a more bio-mechanically efficient pattern. Displacing maladaptive compensation with appropriate movement integration keeps the container of coping mechanisms safe.

To summarize, the homework cards are the place where you:

Identify the underworked player/s ~

Identify the overworked player/s ~

Temporarily remove the overworked player from the movement equation ~

Integrate the underworked player back into the movement equation ~

You can order your set by clicking here.

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Complementary Movement

The Five Primary Kinetic Chains rely on a fundamental principle: efficient movement requires the integration of a stable yet dynamic foundation so that the body can generate the power needed for locomotion.

The Anterior Spiral is a culmination of everything that we’ve discussed previously. As such, let’s review how the previous four kinetic chains have worked together to get us to this final kinetic chain.

The Intrinsic system is related to the nervous system and breath. The breath is a barometer for our movement. How our breath is integrated with our movement determines how our nervous system responds. If we move in a manner by which the movement breathes the body, the sympathetic nervous system can remain down-regulated, thus giving us access to refined motor control. If instead our breath reaches the threshold of cardiovascular distress, or we are holding our breath out of bracing or fear, our sympathetic nervous system becomes up-regulated and arms the body with a flood of chemistry.

One of the markers for stress tolerance is the capacity to return from an aroused sympathetic nervous system back to a calm parasympathetic down-regulated state of being. A large percentage of our population is stuck in an up-regulated sympathetic nervous system. This is a stress reaction that results in inflammation in the body contributing to decreased healing and regenerative ability. As a result, it is becoming popular to “train” the vagus nerve — the tenth cranial nerve — to experience arming and disarming the nervous system.

There are some very good modalities to specifically address an up-regulated sympathetic nervous system. Our personal practice is one way we can take responsibility for our stress levels. Tia Chi, Qi Gung, Shamatha Meditation, and Yoga are but a few examples. I personally find getting acupuncture to be very much a sattvic practice. I go very deep into meditation as I’m observing the energy shifts in my subtle body. For people that are attracted to manual therapy, Cranial Sacral Therapy is a wonderful way to engage the nervous system and the breathing apparatus. Nervous system health very well may start with the subtle aspects of how the cranial sutures are integrating with breath and movement.

The Deep Longitudinal Kinetic Chain is about how we interact with gravity and shock absorption. Our bodies are under a constant compressive force. The energy of the compressive force changes as movement and locomotion further generates kinetic energy. The energy of our bodies in motion must be absorbed and translated. The energy is distributed across the fascial fabric of our bodies.

This energy becomes a dynamic platform, the Lateral Kinetic Chain. The Lateral KC provides dynamic stability so that the appendicular skeleton has a foundation from which to work off. Without this foundation, the body would be at a disadvantage in generating stored elastic energy.

In developmental movement, the reflexive motor learning that is hard wired into our nervous system, we see that the movements are all about creating dynamic stability with the intention of getting us upright and using a bi-ped strategy of locomotion, the walking gait.

With an established dynamic platform, we have the capacity to store and release elastic energy. Elastic energy is stored in the tissues in two modes: lengthening or stretching and coiling or compressing. When tissues lengthen or stretch, the fascia’s elasticity stores energy. This would be like stretching a rubber band across your finger and releasing it; the rubber bands soars across the room. Likewise, winding up the rubber band on a model airplane illustrates the second mechanism of storing and releasing elastic energy. As the rubber band coils tightly, energy is stored; more coiling equates to more compression that stores energy to release.

The Posterior Spiral Kinetic Chain is the avenue the body uses to coil elastic energy into the fascial springs that perpetuate the energy of the walking gait. The body is utilizing both modalities (lengthening and coiling) for activating the fascial fabric to generate stored elastic energy. As the Posterior Spiral KC is coiled to release that energy, the ipsilateral anterior spiral is lengthening. It is a coiling of one side of the body and a lengthening on the opposite. The body is utilizing both pathways simultaneously, to generate stored elastic energy.

The Anterior Spiral completes the gait cycle. Elastic energy up to this point has been stored into the tissues, and now the body is poised to do something with that energy. The body will now translate the stored elastic energy into the complementary movement. The forward motion generated by the push of the posterior spiral is realized through the leg swing of the anterior spiral.

The ability to effectively store and release elastic energy is paramount to athletic performance. In the video, notice the quality of movement this athlete displays. The timing of arm drive and leg drive, the depth of absorbing kinetic energy, and how the explosive energy increases with each shock absorption phase.  Her movement is brilliant and demonstrates healthy integrated kinetic chains at work.

The 5 Primary Kinetic Chains working together create an integrated whole. If one or more of the components are unable to engage, then we need to isolate the issue and through motor learning, reengage and integrate back into the whole. The kinetic chain charts are meant to be a map for inquiry, as we explore who is playing and who is not, the charts can help us to discern what disengaged players need to get back in the game.

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The Body Map

Our choices for responding to our environment depends on the relationship between our body map and the environment. The body map is how the brain sees what movements are available to solve the movement equation. How we create integrated movement is by assembling the available building blocks to which we have access via the body map.

Integration starts with individual building blocks. To develop a complete body map, we need to disassemble movement into its smallest components. When we have conscious control of these smaller components, we can then start to assemble them into bigger blocks. This is the process of building the body map.

When we have a gap, a blind spot, a place that we are unable to access, the motor control center will come up with a strategy to move around that blind spot. This is an adaptive process, and this is a compensation.

We find these blind spots by asking ourselves where in our movement we have lost integration. We can observe blind spots in others when we observe overexertion, clunky movement, or their faces wincing in pain.

Ideally, our movement is like flowing water: smooth, controlled, and efficient. Water is always taking the path of least resistance. Likewise, efficient movement is learned by using the least amount of energy to accomplish the most amount of work.

As our body map expands, the motor control center has more choices for finding an efficient solution to the movement equation. This is how our movement becomes refined and more efficient.

How do we become the inner observer and cultivate deeper awareness of our own response to gaps in the body map and compensation?

The answer to that question is by introducing body map capacity programming.

Priming the nervous system for work capacity is a multi-step process. First we must recover the movement to which we no longer have access. This requires the disassembly of movement to its smallest components, individual joint articulation. Then we prime each joint by using the functional compass. This wakes up the mechanoreceptors that relay position and optimize kinetic chain sequencing. Priming the joints brings circulation and lubrication to the joint capsule and surrounding tissues. After the nervous system is primed, we can then expand on the individual building blocks and we start to assemble multiple movements into kinetic chain sequences.

Yoga asana and martial arts kata are examples of formats for assembling kinetic chains of movement. Individual goals, impediments and discipline of movement should be considered when developing a body map practice that is tailored for you and your needs.

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Synergistic Dominance

The charts in the Five Primary Kinetic Chains Anatomy Poster Series outline a primary physiological principle in movement: bones, joints, ligaments, tendons, muscles and fascia do not work in isolation. They work synergistically to create movement.

When movement is balanced and efficient, the players are all cooperating with each other. If movement is out of balance and inefficient, the result is compensation in the structure. This maladaptive compensation follows some specific physiological principles.

The first of these principles, synergistic dominance, is when one synergistic component of the structure is compensating for another synergistic component. More specifically, one component is overworked or up-regulated in relationship with another synergist that is underworked or down-regulated.

Synergistic dominance can show up over a spectrum of compensatory strategies. It can show up locally or globally. A local example would be the relationship of a muscle to itself. The distal end of a muscle can be up-regulated for a down-regulated proximal end of the same muscle. Synergist dominance will also show up when multiple muscles are working together. For example, hip flexion has several muscles that work synergistically. The iliacus, psoas, tensor fasciae latea, rectus femoris, adductor longus, and sartorious are the major contributors to hip flexion. If one of these muscles is up-regulated, that can functionally down-regulate the others.

Synergistic dominance also shows up globally. Kinetic chains, the manner in which the musculoskeletal system organizes itself, is not merely a local occurrence. Kinetic chains organize across the entire fascial fabric. The lateral kinetic chain provides a good example of global synergistic dominance. Throughout the dynamic platform of the stance phase of the gait, the ankle, pelvis, torso, and neck all need to play well together. If they are unable to do so, then one player will take over doing the job of the player unable to engage. Single leg stance is a great global assessment protocol to discern synergistic dominance of the lateral kinetic chain.

Synergistic dominance can also show up in kinetic chains that work in unison. For example, during the gait cycle, the posterior spiral kinetic chain is paired with the opposite deep longitudinal kinetic chain. Likewise, the lateral kinetic chain is paired with the opposite anterior spiral kinetic chain. These pairings of kinetic chains have an interdependent relationship. One relies on the other in the efficiency of storing and releasing elastic energy. If one chain has a dysfunctional component, it is going to have an effect on the other, they are in a synergistic relationship.

The other side of the synergist coin is the functional opposite. Muscles that work in opposition to one another rely on a principal called reciprocal inhibition. Reciprocal inhibition defines that the agonist, contracts or shortens, as the opposite, the antagonist, must lengthen. Simply, if one muscle is shortening then the other must be lengthening. If the muscle that should be lengthening is unable to do so, the effect is that the muscle that needs to shorten becomes down-regulated. It is unable to overcome the up-regulated muscle, as it can’t compete.

Functional opposites happen across kinetic chains just as synergists do. The foundation of understanding synergistic dominance builds the prerequisite for investigating functional opposites. As movement evolves, essentially there are two things happening:  some tissues are shortening while others are lengthening.

The charts included in The 5 Primary Kinetic Chains posters provide a map for synergistic relationships. By mapping the synergists, one can then decode functional opposites. This is a very useful learning tool as well as a visual reference for your clients and patients.

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Adaptation Creates Compensation

All movement leads to adaptation creating compensation.

The law of adaptation: The organism adapts to its environment regardless of outcome. The nervous system does not differentiate whether an adaptation is beneficial or not.

I have seen several clients over the years, seasoned yoga practitioners, that had a similar root problem with different outcomes. The problem was a recruitment pattern with the toes. The instruction to “floint” the foot is to flex the toes while pointing the forefoot. This is also known as “Barbie Feet.”

Compensation in the toes creates global compensation patterns. These patterns occur along front and back kinetic chains. Kinetic chains can be understood as muscles that link together to create integration. When one muscle becomes inhibited, the chain is broken. This results in some muscles that are overworked, and others that are underworked. When the toe flexors become dominate, two different patterns can emerge.

Patterns of inhibition along the same kinetic chain as the toe flexors, along the front of the body are known as synergists.  One client had pain just below her hip joint in the front of her thigh. The hip flexors were inhibited by her toe flexors. Every step she took exasperated the problem. Another client had pain in the back of her thigh.  She had patterns of inhibition along the back of the body. This pattern is the functional opposite to the toe flexors.

There are other groups of people that have kinetic chain imbalances due to toe flexor dominance. People that wear high heels and/or flip flops are also high risk.

Whatever activity we regularly do, will unknowingly create undesirable movement patterns. Fortunately, undesirable patterns are learned behavior. Thus, they can be unlearned and replaced by a more desirable pattern.