I thought I’d share a little visual help to support thinking about movement, complexity and load. This can help the movement therapist, trainer, or teacher to safely and effectively choose movements. Let us take a look at the complexity-load quadrants.
Quadrant I: movements that are low in both load and complexity.
Quadrant II: movements that are high in load and low in complexity.
Quadrant III: movements that are low in load and high in complexity.
Quadrant IV: movements that are high in both load and complexity.
(Please not that load and complexity are relative terms, and with load I mean mechanical load (and not cognitive load, nor emotional load. Please also note that none of the quadrants is inherently good or bad, life consists of movements in all 4 quadrants!)
Let us take the case of lumbar flexion for somebody with low back pain. I’ll give some of the many possibilities
QI movements: gentle lumbar flexions in 4-point-kneeling (cat-exercise), pelvic tilts while sitting (slump sitting), or a simple standing lumbar flexion (reach with hands to the floor), …
QII movements: loaded standing lumbar flexion (Jefferson curls), sit-ups (ab-curls), lifting something from the floor, …
QIII movements: seated reaching task towards points at knee level (or lower) in multiple directions, standing reaching task towards chair (or lower) in multiple directions, standing on 1 leg and reaching towards chair (or lower) in multiple directions, stepping under stick (at variable heights), a zen-archer game, …
QIV movements: catching a (medicine) ball thrown low and to (for more lumbar involvement: keep legs straight), 1-leg reach with weight in non-reaching hand, …
In therapy, I see many following the green line: start simple and low load, and then build up some load. This is a great start, but you can’t stop in QI. Fortunately, my profession has become less and less afraid of load, and therapists are more likely to follow the black line, i.e. going further and increasing the loads. Still, since for everybody, life does not consist of simple skills only, we might miss an important therapeutic opportunity when we stop in QII. We too often forget to guide our patients along the dotted black line. This dotted black line is, understandably, most used in sports. But, as said, life consist of all kinds of movements, and everybody will encounter QIV situations, you better come prepared.
My suggestion is to also follow the yellow line, parallel to the other work you do. Rather early on in your treatment, try venturing in QIII. Why? Well, there are many reasons*:
Complex movements have variety and load more tissues. This:
Spreads loads, less chances of overstimulating fragile tissues.
Spreads loads, less chances of overstimulating a sensitive and reactive protective system.
Enhances healing or stimulating all the necessary tissues.
Enhances and augments proprioceptive feedback and helps restore body maps.
Gives more information about the ‘situation’ for the protective systems, thus better and nuanced decision-making (unconscious).
Is a kind of exploration of the body and its movements, thus better conscious decision making about real movement capacity.
Complex movements also:
Practices more real life movements.
Stimulates self-organisation of the body.
Allows deep motor learning, with more chance of skill transfer to the un-practised skills.
Allows deep motor learning, with respect to the variety of each individuals body.
Are often perceived as more fun (compared to your more standard exercises) and enhance compliance.
Caveat! Complex movements can really open up the freedom of movement, but they can also be perceived as threatening. As with all therapeutic movement, dosage is very important. But if you’re careful, and educate your patient wisely, you’re not likely to encounter a lot of problems.
For movement teacher working with people without pain, I would suggest a similar approach: don’t skip the complex movements in the beginning, but use them early on, parallel to the incremental use of mechanical load.
I hope this was helpful?
Cheers,
Pieter
* It is not the purpose of this blog to explain all the advantages in more detail. I’ve written about this in other blogs…