Loading Dysfunction, Yay or Nay?
The topic of loading dysfunction frustrates me. It seems pretty obvious in my eyes in order to stay away from true pain but I see it over and over again. Is the movement actively or passively painful? If so, do you think it’s a good idea to put it through a weighted movement? You need to learn how to control the movement first, without pain.
Pause! Lets rewind. What is loading dysfunction? When we think about dysfunction in the movement world we mean that a person does not have full access to a movement pattern i.e. a squat. Loading dysfunction would suggest adding weight or resistance to a movement pattern that someone hasn’t mastered yet. An example would be someone that can not body weight squat correctly, but goes in the gym and does a 200 lbs barbell squat.
Whether you’re feeling pain because you’re moving the joint incorrectly, because something is “tight” and pulling your movement out of alignment, or something is weak and not keeping it in alignment — that’s what you need to figure out.
If you can’t figure that out yourself, find someone who can help.
There is no other way. For those of you who are thinking, ‘not everything can feel great,’ I agree. You need to know the difference between fatigue, pressure, “nervy” or achy pain, or sharp pain. I do not believe that you should move joints into pain, yet fatigue is a different story.
If the movement isn’t painful, yet, you do not have the full range of motion that you should, then we need to gain back the range of motion lost. You must have full access of the movement pattern with little to no compensation patterns. For example, can you retract your shoulder blade fully in all directions without use of the low back coming into extension or the neck protruding forward?
Have you had a practitioner tell you to avoid the movements because it hurts?
For example, ‘you shouldn’t deep squat because it pinches the front of the hip’, or ‘don’t do external rotation for shoulder health when it when it hurts’. If you can’t do shoulder external rotation without pain, you should DEFINITELY not be adding a band or cable to the movement.
Have you had an MRI? Have you been told something is structurally wrong and you need to give it time to heal? We need to figure out why such a movement is creating pain. On that note, even if something isn’t structurally wrong, there is a reason why there was wear and tear to that structure.
Beware …
For those practitioners who tell you “you can never ever load the joint in this way again,” they are oblivious to the rigors of the real world. For those practitioners who say, you can load dysfunction with/without pain, they fail to understand the kinetic chain of movement. (Kinetic chain = a system whereby movement at one joint produced or affected movement at another joint in the kinetic link.)
There is undoubltly a time in which we should begin to load a joint in what we may consider a “poor movement pattern”. It is unrealistic to assume we should ALWAYS be staying in “good form.” BUT, the key message here is we need to access full movement of the joint and create “good movement” patterns before we move through poor movement patterns that can essentially create pain. Loading dysfunction will not help anyone. The easiest example to this is a patellar Tendinopathy. Why is the tendon irritated? It may because it is overused at the area of the insertion. First, we learn how to move the chain correctly in “good form”, then we start to load the chain correctly. Then we start to bring the tendon into a loaded state where we can make the tendon resilient to real world rigors.
If your practitioner did not check the active and passive range of motion for the joint and corresponding joints in the chain, they are doing you a disservice. There is no reason to be loading a dysfunctional joint, especially on the first couple sessions.
Bottom line
Don’t load a dysfunctional joint until it becomes functional again. Make sure you can move through almost full range of motion. Then own that motion. Then start to load it.
Andie Bruce