By: Thomas Berkery, PT, DPT, MCT

When attempting to provide participants a guide for how to integrate Natural Movement into their rehabilitation practice, I believe what would be most of service is providing a perspective shift in how to view human movement and how, therefore, we go about treating movement system dysfunctions. The largest perspective shift we can inject into our profession is looking at human movement through an evolutionary lens. Natural movements as outlined in the MovNat educational system are a way for us to look at that original baseline of natural human movement capability. It provides a lens to look at what our human physique is designed for and capable of.

So much of physical therapy and rehabilitation is looking at the dysfunction and then trying to progress onward, but onward towards what? Pushing towards being functional in current society is usually the answer; to get back to work, to drive a car, to use a laptop, to be able to walk around 50 feet indoors on flat level ground. We only have to look quickly at what being functional in modern society looks like to see that it is a far cry from being capable of moving through a full range of natural movement patterns with good quality. Sitting at a desk all day answering phone calls, driving a car, being able to just move your arms well enough to use a laptop while wearing a business suit; these are all movement patterns that we would consider “functional” for normal work practices, but are very limited compared to natural movements such as getting up and down off the ground, being able to hang from our arms, and being able to walk through uneven terrain.

We should be looking to change the baseline perspective for how we view the end goal of rehabilitation, and really the end goal should be the starting point. Natural movements should be the start, the baseline, and the norms that we progress back towards. From there we can then see how much dysfunction, compensation and regression has occurred. This, in turn, will guide the treatment process for regaining those normal Natural Movement capabilities. 

Our neurology and physiology adapted to perform these natural patterns, and that physical system is still what we use today. The movement patterns that we developed and honed as a species are still relevant and just as useful today. As we built societies and adapted our environment and daily tasks, so too did our movement patterns and frequencies change. But the neurological drivers for Natural Movement patterns created during our shared hunter-gatherer past stayed with us. In other words, as our culture and society moved past a hunter-gatherer past, our physiology did not. We are still working with hardware created to perform in that natural landscape.

As the profession of rehabilitation has developed over the years, many different techniques and theories have been created to address issues with the movement system, but none of them have successfully integrated the evolutionary context of the way our movement system originally developed. In order to reframe our profession of rehabilitation in an evolutionary context, we need to consider our Natural Movement heritage. We also need a way to reconcile our biological evolutionary movement heritage with the difference in our modern environment and the cultural context within which we all live. There is a tension between our movement lineage and our current movement environment. 

The rehabilitation field is full of specialized options for treatment with many competing theories and ideas. What was most powerful for me as I learned about Natural Movement through the MovNat educational system was not that I was learning another highly specialized, narrowly focused treatment approach, but that it was challenging my way of thinking. Learning the MovNat methodology changed the way I viewed movement, and I saw how these natural movements and their individual parts interrelate. It was a paradigm shift in my thinking that was really the most worthwhile part of the process.

I think anyone interested in relearning natural movements has an interest in this interrelated way of viewing movement and treatment. By starting with Natural Movement as our baseline, we can then break those movements down into common compensations, variations, regressions, and if needed, component parts. This helps to maintain that broad perspective of Natural Movement as the start and end of the process – as well as allowing the flexibility to apply a variety of regressions and treatment techniques for individual components as needed.

The important difference is that we aren’t just trying to toss another highly specialized narrowly focused treatment technique into the market, but that we are trying to shift the way we view human movement potential and what is considered normal. I think having a well mapped out framework will allow people to take this new perspective and integrate it with the skills and expertise they already possess.

Note: See the addendum below for an example of an expanded framework that integrates Natural Movement with other medical techniques.

By focusing on specific Natural Movement patterns that are applicable to the individual’s rehabilitation needs, we can create a path of progression that is grounded in Natural Movement. What is the Natural Movement pattern they need to accomplish? How do we break that down to get as much of it back as possible?

To understand how we regress downward from movement patterns for the sake of rehabilitation, we can quickly review how MovNat leads people through their forward progress. Learning to first become effective, then efficient, and finally, adaptable, a person can add layers of improvement into any movement pattern they are working on (1).

The first task is to become capable of producing the movement pattern, pretty or not. To be effective just means to accomplish the task, nothing more and nothing less. For example, if a patient is relearning how to walk post CVA (i.e. stroke), they will first need to become effective at walking. If a patient can walk, the movement pattern is effective. Often that initial walking pattern is slow, unsteady, full of inefficiencies and very limited. However, because our patient was able to walk, in any way shape or form, we can give them credit for effectively accomplishing that task.

After accomplishing this first layer of improvement with a movement skill, the patient can begin the long hard work of refinement. Improving the quality of the walking pattern, the patient develops a certain level of efficiency. The progression from effective to efficient shows a change in depth of movement skill capability.

The next step in rehabilitation means taking that newly honed movement skill on the road. Being able to take that walking pattern from the smooth flat surface of the clinic floor to the bumpy uneven terrain of a patient’s backyard requires an increasing level of depth to the patient’s walking skill capability.

This is just one example of how a person can progress through increasing levels of capability within one movement pattern. We can use the same way of adding layers in the opposite direction if needed. Rehab can take a movement pattern that the patient is not able to effectively produce and regress it downward, something more easily accomplished. Moving upwards we can progress a movement pattern from effective, to efficient to adaptable by adding more layers of complexity. Conversely, moving downwards we can regress through less complexity all the way down to the individual component parts that make up those movement patterns. 

Knowing the correct performance of natural patterns allows us a contrast with compensatory strategies patients typically exhibit when they come in for therapy. These compensations whether due to mobility, strength, motor control, fear/avoidance, pain tolerance, etc. are usually what we assess and try to correct for. The broad categories of natural movements can then be broken down into; the ideal performance, common compensations, variations, regressions, and component parts.

The MovNat educational system already has a fantastic and highly detailed method for describing and progressing towards the ideal adaptable performance of Natural Movement patterns. The common compensations, or the not-so-ideal performances that we typically see our patients exhibit are where the MovNat system meets up with our rehabilitative training and expertise.

We already have the eyes, hands, and education to notice when the movement pattern is not working as desired. We can take that information and use it to guide how we adjust the movement pattern and improve its effectiveness and efficiency. This may require switching to a variation, using a regressed version, or in some instances breaking the movement pattern into individual parts and addressing those in isolation.

Just like changing VIC (Volume, intensity, and Complexity) can help someone progress their Natural Movement aptitude, regressing a natural pattern can be accomplished by manipulating those variables. We can reduce the load, do gravity eliminated, decrease the range of motion, change the cuing, decrease the complexity by adding supports or assistance. If needed, we can break the movement down even further into component pieces and work on one portion at a time. Specialized techniques can be used as needed to correct component parts before reintegrating back towards the Natural Movement pattern.

If we keep our perspective focused on the natural movements, we always have the goal in mind. The goal would be to stay as close to the natural pattern as possible and use only the necessary variations, regressions and correction of individual component pieces as needed. We start by trying to improve movement patterns by addressing the most influential system of movement, the neurological system. In the therapy world we would call it motor control, MovNat has 6 teachable aspects of: Position and Breathing, Sequence and Timing, and Tension and Relaxation. These teaching tools are fundamental to improving movement performance and we use similar ideas in rehabilitation by working on positional alignment, recruitment patterns, motor control, etc. If we cannot achieve improvements with technique changes alone, we may need to regress down into more targeted interventions. 

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Addendum for Medical Geeks

Here is an example of an expanded framework for integrating Natural Movement into a medical professional’s existing skill set.

  • Correct Performance of Natural Movement Pattern
    • Neurological Control of the Movement Pattern
      • Cueing, Sequence and Timing, Tension and Relaxation
    • Musculoskeletal Control of the Movement Pattern
      • Posture and Alignment
    • Cardiovascular Control of the Movement Pattern
      • Breathing, Endurance 
    • Common compensatory patterns
      • Frequently seen compensations or inefficiencies
  • Variations on the Natural Pattern
    • Changes in Volume, Intensity, or Complexity (VIC) to reduce the difficulty of the exercise
    • Use of supplemental forces, devices, and manual support
    • Specializations
      • Yoga, pilates, NDT, McKenzie exercises, dance, Feldenkrais, etc.
      • Sports specific movements
  • Regressions
    • Modified versions of movements
    • Simplified or compartmentalized versions of movement patterns
    • Supported variations with manual or device support as needed
  • Component Parts
    • Neurological Components
      • Motor control
        • Sequence and timing
        • Muscle recruitment
        • Firing patterns
      • Tone management
    • Musculoskeletal components
      • Arthrokinematics and joint precision of motion
        • Joint integrity and ligamentous support
      • Alignment, Posture
      • Muscular strength and force production
        • Number of muscle fibers in parallel
        • Neuromuscular recruitment of the muscle fibers
        • Types of muscle fibers present
      • Muscular length
        • Shortened number of muscle fibers in series
        • Lengthened number of muscle fibers in series
    • Cardiorespiratory components
      • Cardiovascular endurance and capacity
      • Pulmonary effusion and capacity
        • Oxygen saturation
      • Breathing patterns

As you can see this framework is expansive and allows room for the full spectrum of interventions we can provide, from addressing the performance of Natural Movement patterns all the way down to addressing very specific components of the movement system. However, something this expansive is likely not easy to use in a 2-3 day course, and I would propose we use a simplified version, more along these lines:

  • Natural Movement pattern:
    • Ideal performance vs Common compensations/ Ideal vs Impaired:
      • Sequence and Timing
      • Position and Breathing
      • Tension and Relaxation 
    • Variations/Regressions
      • Reduced Volume, Intensity and Complexity
    • Component parts
      • Arthokinematics and Joint stability
      • Muscle Strength and Length
      • Cardiorespiratory capacity


1. Le Corre, Erwan. (2019). The Practice of Natural Movement. Victory Belt Publishing Inc.

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