Home Exercise Program Phases

When describing the phases of your Home Exercise Program, I like to make an analogy to manufacturing and maintaining a high performance vehicle — what does it take to build and maintain a high performance vehicle? You need the highest quality component parts. Those component parts are assembled into systems: braking, transmission, steering, etc. The systems are then assembled to make your high performance vehicle.

In phase one, we focus on individual structures in your body (or your high performance vehicle component parts). For example, in order to propel yourself forward off the right foot (something you need to do every step you take), you need to be able to: move the right big toe joint, sideband your pelvis right, rotate your ribcage left, swing your right arm forward, etc. So we start by manufacturing the best components parts — getting stuck joints moving in all three dimensions.

In phase two, the parts are then assembled into systems (e.g. transmission, braking, steering). This corresponds to regions in your body. For example in your lower extremity, your hip joint needs to work well with your knee joint and foot. In your trunk, your pelvis and ribcage need to coordinate.

In phase three, the systems are assembled to make your high performance vehicle. In your Home Exercise Program this corresponds to a full body integration of your “systems.” Now that your left foot can pronate, and your pelvis can rotate right while your ribcage simultaneously rotates left, etc., let’s assemble those systems (lower extremity, upper extremity, trunk) into a functional full body movement. That is the high performance vehicle we’ve been working toward since phase one. NOTE: most of the time, this full body integration exercise is one I learned from Gary Ward/Anatomy in Motion (AiM).

Is this a linear process — phase one then phase two then phase three?

Good question! Much like a car, often it is not. Using the car analogy, if you notice uneven wear on your tires, would you simply replace the tires? You could, but if you didn’t address your suspension system (wheel alignment), you’d probably be replacing your tires all too often because you haven’t addressed the underlying issue. There are similar intricate relationships within your body structures. Perhaps your pelvis doesn’t sideband left in an attempt to slow down a right foot that pronates too much too fast. Yes, this happens! If we just restore the ability of your pelvis to sideband left without addressing why that right foot pronates too much too fast, well…it’ll be just like replacing your tires without fixing the wheel alignment.

How fast will you move through the phases?

How quickly you move through your phases depends on how many parts and systems we need to manufacture or repair. Some clients clearly have one lynchpin movement their body is missing. Simply re-introducing and integrating that missing movement achieves resolution — their car is back on the road. Sometimes clients come in and we find multiple parts and systems that could use some work. This will be influenced by several factors:

1. Your injury history. Some people come in with lengthy injury histories, many of which may have healed, but the ramifications (or compensation patterns) that resulted have gone untreated. For example, perhaps you badly sprained your right ankle at age 8, and the tissue has long since healed. At that time, avoiding bearing weight on your right foot, was an appropriate response to allow the tissue to heal. However, once healed, your brain then forgot to go back to weight bearing on the right, and ever since then you have weighted your left foot more. Then you turn 30, and all of a sudden your left knee starts hurting. Well of course, that left side has been doing more than its fair share since you were 8! Now compound that with other injuries and you get the picture.
2. Perhaps, ironically, your athleticism! Athletes tend to come in with very embedded movement patterns — patterns that have served them well, until the day they no longer did. Maybe your brain figured out how to run 50 miles despite the left side bearing more than it’s fair share of your body weight (i.e. half). Till one day, your left knee starts hurting. Sometimes, it is harder to change movement strategies that you have so successfully relied upon for so long.
3. Is one vehicle enough? I described phase three as assembling the systems into a vehicle. Maybe you need a pick-up truck for work and a small car for tooling around town. Some people only need one vehicle — i.e. one full body integration exercise addresses all the issues for which they sought treatment in the first place. However, with many clients, due to complex injury histories and layers of compensation patterns, it takes several full body integration exercises to address their issues.
4. The driver (AKA you). Everyone has a different mode of learning new movement patterns. Ultimately, when working with me, you are “conversing” with your brain, the ultimate control center of your movement patterns. A conversation is (hopefully) bidirectional. Your brain communicates to the body below instructing your joints how to move — i.e. your motor nervous system. Your body below communicates very important information back to the brain — i.e. your sensory nervous system. Some people have little or no experience consciously communicating with the movement center in their brain, and for them the first step is honing that communication skill — helping the body communicate to the brain, and helping the brain “hear.” Are my structures moving as they should? Are my structures coordinating with other structures creating well functioning systems (e.g. does my foot coordinate with my knee and with my hip)?

What does “finished” look like, or how do we know when we are done?

Typically, we know we are done when your issue(s) is resolved. However, much like a high performance vehicle, your body needs regular maintenance. When working with me, we are developing an owner’s manual, including a maintenance schedule and trouble shooting skills that ultimately you will own. We will have done our job when you know how to perform preventive maintenance and trouble shoot issues in your own moving body.