A Doctor’s Perspective on the Clinical Applications of Natural Movement
By Dr. Phil Lombardo, Level 2 MovNat Certified Trainer
The medical community is failing us when it comes to movement disorders and musculo-skeletal pathologies.
There. I said it.
In medical school, we attempt to hold on to definitions and are given the impression that medical treatment will simply come down to an algorithm. But again, we’re working with a complex human being that has a nervous system, emotions and in actuality, not all moving parts are the same (different sizes, shapes and developmental processes). And that person (your patient) is living in an extremely variable world. Read that again and remember what a complex human being truly entails. This view, in the medical field, would truly encompass the bio-psycho-social environmental medical model. And the leaders in our field of medicine know this. Just read the works of Dr. Shirley Sarhmann, Brian Mulligand and Dr. Kelly Starrett. They all touch on this topic.
From what I’ve seen in 20 years of practice, the medical community has become very focused and isolated. I’ve enjoyed being able to spread my wings and soar a bit as I grow and develop, specializing in movement and biomechanics. I’ve greatly enjoyed becoming proficient at identifying movement disorders, movement inefficiencies, and how they contribute to a patient’s pathology. I used to get excited thinking about body parts as similar to machine parts (gears and joints were the same in my mind), and mechanically, I could solve almost any problem. It was simple, just figure out how to make the parts work. But I’ve learned that there’s so much more when we consider a human being’s nervous system, emotional contributions, and the complexity of their movement patterns. Human beings are truly an extremely complex thing of beauty and cannot be simplified down to the parts.
Of course, it’s absolutely imperative to learn and comprehend isolated joint motions and overall arthrokinematics throughout the body. Planes of motion, degrees of motion, how muscle fibers work, axons and dendrites, action potentials, Wolf’s Law, what causes a tendon to fail, and healing times are all pieces of the puzzle. Each one is also such a small component of the entire movement pattern of a person as a whole. Think of how many planes of movement, bones, joints, fascia, and miles of nerves (and how many times those nerves fire every second) there are throughout the human body. In medicine, it really is a disservice and overall saddening to focus our treatment on one isolated structure or movement.
Now, I’m not saying that there’s never a place for that, but I believe from my experience, that 99.5% of the medical field practices this way, in isolation. And that makes me sad.
I like to think about doctors of physical therapy and doctors of chiropractic as having a very special super power. Not only do I have the ability to teach people about Natural Movement, we can use advanced manual therapy techniques and our knowledge of pathologies to help them overcome obstacles and become more capable humans. What an amazing skill and opportunity we have as doctors. As a MovNat Certified Trainer, I’ve learned so much from my instructors, Danny Clark, Stefano Tripney, Kellen Milad, and Erwan Le Corre. I teach MovNat skills and concepts to my patients every single day (e.g. efficiency, Base Of Support (BOS), counterbalance, tension and relaxation, etc). But what I think is special and unique are the joint mobilizations, neuro-muscular techniques, and other manual therapies that assist people to overcome pathologies and become proficient in skills they gave up on long ago. Somewhat like Mr.Miyagi, we cure people with our hands and touch. And as Uncle Ben once said “With great power, comes great responsibility.”
In my humble opinion, too many people/patients accept that as they age they continue a downward spiral of decline in their physical capability. Call me a hopeless optimist, but I believe that everyone can change course. We need to maintain a bit of realism. And that’s where my medical training and experience helps me to trust my instincts. Every day we are helping our patients stop the vicious cycle of declining physical capability due to osteoarthritis, herniated discs, tendinosis, myofascial pain, muscle strains, and other pains of unknown origin. We are allowing them to reclaim freedom in movement and realize what they’re capable of achieving in a very short period of time. Remember, often times fear is “False Evidence Appearing Real.” And who do we trick most with false evidence? Our own brain. Once a patient achieves one or two goals that were once truly unbelievable, it’s incredibly rewarding to see the hope that emerges and the potential realized within themselves and within the MovNat paradigm.
Perhaps one of my favorite victories that I like to share is the opportunities to help my runners with the ongoing battle against IT band problems. Being able to relieve them of that relentless burden and discomfort with the Side Bent Sit Reverses, Rotational Reach, and Bridging variations is incredibly rewarding. It’s been tremendously successful and runners tend to enjoy it a lot more than static stretching or foam rolling. And I can sleep well at night knowing I’m reversing the joint deterioration that comes with excessive running on concrete by increasing joint surface contact, increasing capsular mobility and improving a little lumbar mobility and control along the way.
We have to acknowledge that introducing Natural Movement into your practice adds to traditional medicine an ability to very easily come up with long-term solutions for patients that are often coming to you for acute problems. Oftentimes, current medical practice focuses only on the acute injury or isolation of a specific group of muscles or joint that is undergoing a pathology and needs attention. However, a pathology rarely, if ever, exists in isolation. What about the nervous system, pain avoidance, and emotional contributions? More likely the pathology is the symptom of certain movement patterns or lifestyle choices. Ah ha! So, if we adjust lifestyle and movement patterns, will musculoskeletal pathology significantly decrease? Of course it will! Think about it. It’s called Natural Movement. Imagine the full scope of ROM, planes of movement, strength, coordination and endurance it encompasses. And if you can’t envision that, start reading or take a course.
The MovNat principles and techniques have contributed to and enhanced my own professional practice every single day. When I talk to a patient about how they move as a human being and not just as a person with pathology such as tendonitis or arthritis, their eyes are wide open. They’re attentive and I can see the appreciation for the understanding that I’m giving them. I believe that our nervous systems are literally becoming in sync. Again, there’s that under appreciated and under acknowledged nervous system. Together, we can connect to the ideas of hope and optimism, as well as the instinctual feelings and desires to move with comfort and ease that are fundamental to who we are as human beings. If you have any doubt that this enhances every other single area of my medical practice, then just come and watch for a day and get a sense of how much better my outcomes are because of that connection between nervous systems. This comes directly from understanding all of the components (including emotional) of movement for humans. And you don’t get that by seeing the person as only their injury in isolation.
I would strongly encourage any medical professional to gain a deeper knowledge base than what they were handed in typical medical school. And I encourage medical programs to add the practice of Natural Movement to their curriculum. The MovNat certification will rekindle your connection to functional movement (beyond what is currently out there and somewhat lacking). I am personally aware of how within my specialty area as a doctor of physical therapy and sports clinical specialist, many of my colleagues struggle with teaching movement. We commonly go through monotonous, isolated exercises. They are often boring (causing poor participation with self care in a home treatment program), and honestly, they are very often taught wrong. MovNat explores a person’s base of support, points of contact, center of gravity, overall position, breathing, tension and relaxation in the full spectrum of natural human movements that our body’s are designed for. It’s so much easier for patients to grasp, and much easier to teach. Why? Because it’s in our human nature; it’s instinctual.
I’ve met so many health care practitioners that utilized MovNat within their medical practice. The most obvious ones are doctors of physical therapy and doctors of chiropractic. And there are others. But there’s no doubt that these two professions often spend the most time with their patients and teach movement practice more so than any other medical professionals that I’m aware of. That said, anyone who develops a deeper connection and is interested in teaching their patients to restore lost capabilities and skills in order to overcome pathology, I encourage you to delve into this practice. It is a powerful tool for educating your patients and giving them a very structured framework on how to rekindle their functional capacity as a human being through efficiency and adaptability. And that leads to more freedom for our patients! It will undoubtedly change our future.
“As living beings, our human morphology, physiology, and anatomy are elements of our biology that come from our common past as an animal species. Likewise, human movement behavior, comprising our fundamental movement reflexes, movement aptitudes, and movement needs, is a component of our biology so significant that it greatly affects our physiological functions, physical appearances as humans, and – originally at least – our chances of survival. As such, Natural Movement is the outcome of evolution or, in other words, of life and survival in nature over an extended period of time.” Erwan Le Corre, the author of The Practice of Natural Movement (pg. 16)
Spreading my wings as a medical professional is incredibly fulfilling. Tap into your subconscious, instinctual and evolutionary Natural Movement skills. You know there’s more than what we learned in medical school. You know there’s more to connecting with another human being. They are not their pathologies in isolation. To hear a person’s intrinsic desire to move and then to see what they gain from an ease and diversity of movement is far more fulfilling, and yes, more successful with medical outcomes than treating in isolation. I implore you to consider your own inner desires as a human being and as a medical practitioner. What would you really prefer to do? Why are you stuck? What is holding you back?
About The Author
Dr. Phil Lombardo, PT, DPT, SCS, CSCS, PES, CES, NFHS, USATF, MCT, EMRT
Dr. Phil Lombardo is the director of the MovNat Medical Program, which he developed with the help of an international board of advisors from diverse medical professions. Phil has extensive experience in the care of both sports injuries and general musculoskeletal injuries for patients of all ages. He is the Clinic Manager and Vice President of The New Jersey Centers of Physical Therapy, the largest privately owned PT practice in NJ.
In 2007, Phil joined the top one percent of the Doctors of Physical Therapy in the country by becoming an APTA Board Certified Specialist in Sports (SCS). He is also a Level 2 MovNat Certified Trainer and has participated in all of the MovNat Certifications. Dr. Lombardo has integrated his MovNat practice into the clinical setting from day one and has also participated in teaching several MovNat Elements Workshops and Level 1 & 2 Certifications. He has also taught at Columbia University, Dominican College, as well as numerous continuing education courses and speaking engagements at dozens of local high schools.
Phil’s expert knowledge and experience as a Doctor of Physical Therapy (DPT), a MovNat Certified Trainer (MCT), a Certified Strength and Conditioning Specialist (CSCS), a Sports Performance Enhancement Specialist (PES), and a Certified Corrective Exercise Specialist (CES) has distinguished him as a provider of choice in Sports Medicine.