Gray Cook: Movement Habits and Repatterning
When trainers notice something like a tendency for people to rotate their hips more easily to one side than the other, the question is usually about how to fix it. But before we do any “fixing,” I’d like to know if there are lifestyle factors that contribute to the performance or preference of rotation to one side, particularly posture, computer use or something work related.
If we fix this thing, will the fix hold? Let’s assume the answer is “no” if there’s a lifestyle issue reinforcing a bad movement habit.
When you do this work long enough, you’ll notice things like people not mentioning they drive an hour to work each day—like they don’t notice what side the gas pedal is on. We have one hamstring that stays elongated while driving a car. The other leg sometimes even gets tucked up under in some cases. Shouldn’t this be ringing some bells?
We see sacroiliac problems that contribute to handedness, being right handed or left handed. We see the computer causing problems—where the computer screen or the keyboard are positioned.
Absolutely, these are potential problems.
It’s my position that lifestyle affects posture and performance probably equally, if not more, than the way we work out. What program do you need? Let’s look at lifestyle before we decide on exercise choices, don’t you think?
People don’t understand that, but the tendencies and habits you get your body into as you move are rarely countered by a workout. If you sit hunched over a computer for eight hours, then do back extensions for three sets of 10 repetitions—well, you do the math. I don’t think you’re going to change anything.
Lifestyle has a huge impact on posture, body position and proprioception. The choices you make are almost at an unconscious level of how you use your body. Do you bend your back first or do you hinge at your hips first? Do you rotate your spine or do you rotate your hips?
Any time you’re training, conditioning or rehabilitating your clients, the workout and their exercise preferences are a huge influence. Their lifestyle, their posture, their ergonomics, their sleep position and the other activities they do are huge influences as well.
Now, what do we do with workouts? We try to make them counter whatever it is that comes up deficient in a lifestyle. If you’re not doing enough of one pattern, people often try to reactivate that pattern in workouts. I notice this a lot.
A lot of people who are stuck at a desk really just want to get out and go for a run. But if you look at that anterior head and those rounded shoulders they get from a bent-over desk position, unless they have some great sprinting mechanics, endurance, long-distance running and posture looks almost like what they were doing earlier at the laptop.
What we would have to program for the person who enjoys running and is also ball-and-chained to a computer is for every one distance day, we need some sprint days. We need some fast 400 meters. We need some uphill running. We need some agility work.
We know this person appreciates running, but that long-distance auto-pilot cruise-control activity actually perpetuates bad posture, whereas when we sprint, run fast, do intervals and things like that, we posture right up. We pull those shoulders back.
Then we superset those sprints with some t-spine rotation and hip mobility. After these kind of between-run days, runners will enjoy the distance days even more.
You do not have to pull people off of what they like doing, but we can modify things. I’m a big proponent for people who are interested in endurance to do a lot more jump rope or at least equal jump rope to running, simply because jump rope does not feed into a rounded posture, whereas jogging sometimes does.
This is the self-limiting aspect of quality training.
The next thing to think about is repatterning. Sometimes when people hear what I say about exercise, they think I’m talking about sets and reps. No, that’s not it. I do a corrective strategy until I see repatterning. I don’t care whether it’s 10,000 repetitions or 10 repetitions. It does not matter. I’m looking for a change.
I’m not looking at my clipboard, not dispensing a program. I am watching for a response. Once I get a response, we can train for an adaptation.
That is the difference in the way I do things. I know that after I’ve screened somebody, I’m working on the most deficient, limited or asymmetrical pattern. I know it. I already checked.
Now that I am in that pattern, I have to make sure there are no mobility restrictions. If I see mobility restrictions, do I have to change them 100% before we go into stabilization or repatterning? Absolutely not. If we gain five degrees of dorsiflexion and 10 degrees of medial hip rotation, you better believe I’m going to use that in a functional pattern.
Are we going to stop doing the mobility work? Absolutely not. We are going to get some mobility, repattern, stabilize, then get some more mobility, repattern and stabilize.
The next time I see you, we’re going to start all over again until I screen you and see that pattern has changed. It may still be your most deficient pattern a month from now, but it is not going to change the game plan because as long as we’re working on the weakest link, everything else is going to get better.
The weak link is the limiting factor.
Repatterning is the way we do what we do. If you’re trying to repattern without creating more mobility, you’re not going to make a difference. That person is already pivoting and working around an unnatural fulcrum and an imposed restriction. The central nervous system is obligated to work around the restriction, not through it.
We give people opportunities to either work through things in small amounts or remove the reason the restriction is present in the first place—maybe an inappropriate trigger point or generalized stiffness about the stabilizers of a joint. Poor alignment is a common reason. We can see a dorsiflexion change just by setting the hip in its alignment.
Many times both in squatting and deadlifting we see the valgus collapse at the knee and the pronation at the foot. People usually think that’s due to a dorsiflexion restriction, but if you kick that knee out, slightly adopt a bowlegged posture while still keeping the first ray, the big toe and the heel on the ground, suddenly there’s about five extra degrees of dorsiflexion. People might think that’s because we rotated the femur and now have some tibial rotation when we clear the joint. Absolutely. That’s why it’s there, but setting up that success is more important than explaining why it occurred.
More people want to debate why something’s occurring than want to learn how to set up a squat or a deadlift to get the foot and hip positions working together. What’s wrong with that picture?
Often when people ask about corrective strategy, one of the most common questions is about dosage. I base dosage on the first positive response I see—what it takes to get a positive response.
Secondly, I am not as worried about sets and reps as I am the supersets. What do you do between sets of repatterning? In my clinic, we’re back on the ground doing mobility, whether it’s stick work, foam rolling, static stretching, dynamic stretching or whatever.
I am trying to open up proprioceptive barriers so repatterning can feel more natural and meet less restriction.
When I’m doing reactive neuromuscular training, I am not training a pattern. I’m repatterning a deficient pattern by breaking it down, by loading certain sections and by making the person react and respond with normal reflex stabilization in a different way
That body was ignorant of deficiencies. What we are doing is raising that up to a proprioceptive level so the person can do something about it.
Do habits and lifestyle influence the way we move? Absolutely. Regularly reflect on that and not just the workouts. Then remember that repatterning is about doing something correctly until correctness becomes automatic.
Both those ideas will boost your workout program effectiveness and in turn, help your clients over a lifetime of training.
More of Gray’s thoughts on training and screening can be found in his Lecture Compendium Audio Book:
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