Healthcare professionals have acquired their professional identity through specialization in one of the body’s systems, i.e. orthopedists specialize in the musculoskeletal system, cardiologists in the cardiovascular system, and neurologists in the nervous system. As Physical Therapists at Performance in Motion, we are continually working to become experts in the Movement System. As discussed in a prior blog post, movement is essential to life. Therefore, as movement specialists, we strive to optimize movement by identifying the root cause of an individual’s pain or dysfunction; we call this the movement impairment.
Dr. Shirley Sahrmann, the chief architect of the Movement System, provides additional insight here.
When we are approached with a specific pathoanatomical diagnosis, for example Achilles tendonitis, or a general body region diagnosis of low-back pain, it is clear that the source of the pain is identified. However, our goal in the initial evaluation is to discover the cause of the dysfunction and the associated contributing factors. The source is the involved tissue structure that is symptomatic whereas the cause is the mechanical component that elicits tissue damage.
Movement System diagnoses are named for the movement direction that causes symptoms, the movement impairment (Ludewig et al., 2013). For example, a movement system diagnosis of “lumbar flexion” would characterize an individual who prefers to flex (round) at the lumbar spine versus their hips in sustained postures such as sitting or during movements such as squatting and forward bending. Diagnoses of the Movement System do not require identification of a specific tissue structure (source), because the symptoms already provide this information and correcting the movement impairment usually correlates to a decrease in symptoms. By defining the movement impairment, we are able to develop a plan of care directed at the cause of the dysfunction instead of just treating the source of pain.
Naming the movement impairment also provides valuable information for the patient, helping them to understand how the repetitive movements and sustained postures they perform in their daily activities relate to their pain. Being able to modify these activities and alleviate their symptoms, not only allows them to improve their function, but also allows them to take an active role in their recovery.
As Physical Therapists, our primary tool in preventative medicine is in altering movement dysfunction. If we can correct the movement that leads to tissue damage, we can prevent the source of pain from presenting. Our athletes benefit from these diagnoses, as identifying and correcting the specific movements that causes mechanical stress to their tissues reduces overuse injuries and helps to improve their overall performance.
Lastly, diagnosing movement impairments enables Physical Therapists to better collaborate with other healthcare professionals. For example, when working with physicians, we are able to provide additional context and insight to what they have determined to be the source of the pain through their medical diagnosis. It also provides fitness professionals more clear direction to help guide exercise programming. When the whole team is working towards the same goal, the athlete always wins.
Author: Jacob Brueck PT, DPT, ATC, CSCS