Functional training means that we train the muscle in a way that mimics its function during movement, in real life. For example, gluteus medius controls the knee in the frontal plane. The abduction machine is not going to train the gluteus medius to prevent the knee from collapsing inward (knee valgus) if the person never trains the muscle in that manner. A muscle without neural input is paralyzed, and in order to train the muscle to perform its function accurately the central nervous system needs to be integrated into training. For a movement to occur, appropriate muscle activation pattern needs to exist in the motor map so that the accurate muscles are recruited at the appropriate time in an appropriate sequence. There is ample evidence that patients who report low back pain also display altered core muscle activation (timing and coordination). Therefore treating pain is not sufficient to achieve proper recovery. Previous injury is the greatest risk factor for future injury, and the reason is likely that rehabilitation has not been complete. A program that does not take into account a possibility for motor control dysfunction and a way to correct it, is going to fail.
The four stages to return to training after an injury are:
1. Decrease swelling
The best ways to decrease swelling are rest, icing, compression, elevation (RICE) and with therapy retrograde massage. Frequently, injured individuals forget about consistency and only use the RICE principle when the foot is already puffy and painful.
2. Mobility
Due to immobilization or inhibition, the joint that communicates with the injured musculature (or the hurt joint itself) becomes stiff and lacks the typical range of motion. Self-mobilization and physical therapy are the best routes to take. Returning to strength training without proper mobility is a perfect recipe for re-injury
3. Stability
Stability is a big piece of the puzzle that most people overlook. For example: The function of the core is anticipatory: creating a stable base for the movement to occur, particularly in the appendicular skeleton. In fact, there are studies about patello-femoral pain syndrome or PFPS that demonstrate how proper core activation results in cessation of pain at the knee due to increased stability of the knee in the frontal plane and decreased valgus forces.
4. Strength (functional)
Strength training is not and should not be just about the bench press, squat and pull-ups. Key component of functional training is regional interdependence. To create a comprehensive rehabilitation or training plan the professional needs to understand how the whole system interacts to create movement, and include in the plan the training of the movement pattern instead of focusing solely on isolated structures. For example, the quality of glenohumeral joint mobility relies on scapular stability as well as on thoracic spine mobility. The later is due to scapulothoracic articulation and muscle attachments to the spine. Trapezius, rhomboids and serratus anterior muscles need to depress and downwardly rotate the scapulae, which creates a base for the rotator cuff to stabilize the head of the humerus in the fossa, enabling the movement to occur. Thus, an overhead kettle bell hold with a shift from half kneeling to standing and reverse would be an example of functional training for the shoulder.
Specificity of training does not apply only to “for strength lift heavy” or “for power add plyometrics”, but also “for better movement, train movement.” The fundamental component of a successful bounce from an injury (and to avoid re-injury) as well as gaining global strength is understanding:
A. the neuromuscular interdependence
B. identification of faulty recruitment patterns and
C. application of corrective exercise to re-learn the proper motor map or in other words: functional training!
Bounce back from injury with this information!
Almost every time I workout at the gym I see people doing pointless lifts. The rule of thumb is that if one is stopped in the middle of a set and asked why a certain movement with that specific weight is performed, a clear answer should be given. For example: to build strength, to build power, or to restore function. However, due to so many different methods in the fitness industry claiming to be the next best thing to build a “beach body” people seem to be confused with what, when and how to perform in the gym. Ever since the concept of functional training came around I see biceps curls being done while standing on a foam, or bench presses laying on a swiss ball. Why? Functional training is NOT exercise on wobbly surfaces. In fact, research conducted on baseball players who practiced hitting a ball while standing on unstable surface showed a decrease in performance.
