REFLECTIONS ON THE MOVEMENT SOLUTION
6th July 2011
Isobel Warnock, Private Practitioner, UK
8 months on....
'I write this with 32 years of clinical practice behind me. It was no easy task firstly engaging ‘the grey cell’ for 5 consecutive days three times within 10months! However, when the course was suggested to me by Sarah Mottram she said it would ‘change my life!’ Well I can certainly say it has profoundly changed what goes on in my head when I first look at a patient.
This course has given me a comprehensive up to date approach to both the analysis of movement and the rehabilitation retraining processes required to restore normal movement. The revision and updated knowledge of anatomy and the ‘new’ concept of looking at the control of movement has been possibly the most valuable asset gained. The myths about ‘core stability’ were dispelled and a clear understanding of local and global control of movement was gained. The comprehensive assessment process has been tough to get to grips with but, it is amazingly revealing when applied to those difficult patients who just keep coming back with the same old problem that we have failed to ‘fix’ so far!
It has been hard work to integrate the assessment into clinical practice. It is yet to become habitual and streamlined! I meet every three months or so with a small group who attended the course with me. These meetings have been vital in helping me to embed the assessment and rehab processes into practice. We all felt a little confused about where to start assessing patients as clearly we could not go through the stability testing and relevant global and local systems in one visit to our time constrained practices.
We developed a strategy starting with stability testing at the first visit, being sure to give patients something to start working with, and then completing this if necessary at the subsequent visit and moving on to the relevant global and local system tests and rehab strategies during further sessions. It would have been helpful to have developed this strategy during the last week of the course giving us a clearer platform from which to leap when we returned to our clinics. I wonder whether some reference could have been made to the thoracic spine and ribs during the course to complete the spinal system.
Before attending this course I had a very poor understanding of the progressive rehabilitation of movement. The course has provided me with a much better understanding of the need to begin with, and gain, low threshold control before moving on to higher effort and load training. It has given me the confidence to challenge patient’s ideas about training and guide them through a more appropriate and complete rehabilitation program which may be over several months. My ‘library’ of exercises has exploded and my ability to be inventive and appropriatewith exercise is improving!
My manuals live at my side and are becoming dog eared with continual reference. I could not manage without them!
In summary, the course was extremely hard work, extremely enjoyable, of great value to my clinical practice and improved patient outcomes. The balance of theory and practice was good with plenty of time to work through these new concepts. Mark and Sarah were extremely generous with their knowledge and their differing teaching styles complement each other. It was great having Jacqueline assisting and again her generous knowledge sharing was appreciated and of great value.
I would do it all again given the time and money and would not hesitate to recommend it to all musculoskeletal therapists.
Finally, I am feeling under pressure to complete the APEL work but unsure about the benefit to my clinical practice or whether I want to allocate the time required to complete the work! I would not want to miss out on the opportunity to network with other Kinetic Control Movement Therapists which may be the driving force for me to complete the program.