If you have been in a physical therapy clinic, fitness center, or an athletic training facility in the past 5 years you have heard the word functional. It is often used to describe strength training, cardiovascular training, and rehabilitation exercises. Because the term functional has such a wide variety of applications, more often than not it is overused in terminology and underutilized in practice. With that being said, what is functional, how do we as healthcare professionals and coaches properly use this term, and how do we successfully apply it?
What is functional?
Webster defines functional as:
- Designed to have a practical use
- Affecting the way a part of your body works
- Working properly
Webster does a great job of putting it succinctly. When all three portions of the word are combined and placed in front of the word exercise, the phrase functional exercise could be interpreted as performing a physical activity, designed with a practical use, to affect the way a part or parts of your body works to make yourself stronger and healthier. Or in the case of the phrase functional movement, the act of moving your body or a part of your body, designed with practical use, to affect the way a part or parts of your body works to ensure it is working properly. Regardless of how these definitions are spun together, the result will be the same. Functional is a movement or an exercise that is designed in such a way that is specific to how the body works, how the client/patient wants it work, and combined it will make sure their body is working properly. Now that we have gotten that out of the way, let’s take a look at these movements and exercises that we might consider to be functional.
Functional movement patterns and exercises
As I researched different topics, articles, blogs, and pod-casts regarding functional movement I found there was more opinion out there than fact. In spite of this there seemed to be a general consensus about a handful of movements or variations of the same movement that most individuals considered to be functional:
- The Squat
- The Lunge
- The Hip Hinge
- The Dead Lift
While I agree with the above being “functional movement patterns” do I consider them fully functional, no. I’m sure many of you who are looking at your computer screens just turned up your nose at that statement as it goes against many of the things we have been taught. I know it sounds crazy, but go with me for a moment as I explain. I made this statement for three reasons:
- These movements do not become functional until both an upper extremity motion accompanies them and the proper foot placement is addressed
- These movements are all sagittal plane dominant
- These movements lack specificity
Because of these three reasons I consider these movements to be great foundations of function rather than true functional movements patterns as they allow a solid base to build from, yet lack the specificity to be considered fully functional
The What’s, the How’s, and the Why’s
Let’s delve a little deeper into the “the what’s” we are dealing with first. Each of these foundations of function deserve a look into their benefits and pitfalls. First, it is very important that we look at the squat, the deadlift, the hip hinge, and the lunge from a different perspective. All of these movement patterns can be viewed as transitional movements, this is primarily because they are a way to “load the spring” in respect to the movement they precede. So let’s take a brief look at the four foundations of movement:
The squat is such a pillar in the foundation of function because it isn’t possible to go through a day without squatting, whether its picking up your groceries or sitting down. Breaking down the squat can reveal a series of dysfunctions ranging from restrictions in the foot and ankle joints all the way up the kinetic chain to the cervical spine. As a transitional movement pattern we see the squat often preceding the movements of the lunge or the jump. For example, in the pictures seen above, in order to perform a defensive slide one must squat and transition to a single leg reach into a lateral or diagonal lunge. In the picture on the right hand side, in preparation to jump one must transition from a squat with cervical extension and a posterior arm reach into a jump. In both instances of the defensive slide and the jump, barring it is a pure vertical jump, there is a tri-planar aspect that occurs in relation to squatting where a true squat remains sagittal plane dominant.
The lunge, especially in world of athletics, is a critically important fundamental movement pattern. It is the first step taken to drive to the basket, it is the action required to deliver a pitch, and in the case of the picture above it is the lunge that allows the tennis player to reach the ball. When we look at the traditional lunge it does a great job of showing the interdependence of the left side of the body to the right side of the body and reveals left side right side dysfunction when used as an assessment tool. The traditional lunge unfortunately is limited, regardless of it is performed laterally or diagonally. If we compare the right picture to any lunge you’ll notice how vastly different these lunges are from one another. As Serena attempts to backhand the tennis ball she has positioned her foot into external rotation, her thoracic spine is left rotated while er cervical spine is flexed and right rotted, and her upper extremities are reaching left lateral and inferior. Even if one were to lunge anteriorly, laterally, or diagonally the combination of the neutral spine and lack of tri-planar loading leaves much to be desired in the way of function in this instance of training or assessing a tennis player.
The Hip Hinge
Here we have the hip hinge, another great foundation of function known for its excellent ways of loading the hips by way of the posterior chain. It gives a great view of how mobile the hips are and how strong the glutes are. Put into practice we have Tiger Woods going through a golf swing motion. Notice how he must hip hinge in order to begin the motion of swinging his club. This hip hinge must evolve in order for him to forcefully drive his club into the ball. This force production requires rotation of his cervical and thoracic spine, an upper extremity reach that is superior and right lateral, and pelvic rotation driving his left femur into external rotation and his right femur into internal rotation. This significant “gapping” in utilizing the bodies full resources is where the hip hinge diverges from its ability to becoming a fully functional movement pattern.
The Dead Lift
The dead lift, the last of the foundations of function, is used to develop and assess the posterior chain primarily by way of the hamstring complex. Once again, a great tool to have in your bag of assessment and training techniques, but can fall short of true function. For example, when we look at the follow through of a baseball pitcher he must maintain cervical extension and left lateral rotation if he is a lefty, pelvis on femur internal rotation, right lateral thoracic rotation, and a left hand reach to the right inferiorly and posterior. This is so that the pitcher may decelerate the speed of his arm and upper body as well as recoil back to a ready position in order to react to the ball once it has or hasn’t been hit.
As we look at these four comparisons it is both intriguing and exciting to see how many avenues there are to reaching function. There is no, one answer to the same question. If we are to better serve our patients, athletes, and clients our approach should be individualized with a focus on how they move in a three dimensional world. In part two of this series the “how’s and why’s” of the “what’s” that was previously discussed will be addressed. Thank you for taking time out of your busy schedule to read this article, check in later this week for part two of “Is Your Functional Functioning”.