An interesting question that I get quite often relating to coaching our patients and athletes is regarding the Feed Forward Mechanism. They don’t typically use the term “Feed Forward”, but it is essentially what they are asking. So, I thought for this post we would break it down little bit to understand the positives and negatives of the coaching philosophy because there is a fair amount of controversy over whether or not it is good or bad.
Using a feed forward mechanism is when you coach an athlete or patient to contract a specific muscle or area of the body as they go through a movement in hopes that they begin to move in an optimal manner, using the specific area to move in the way that we want them to. The non-feed forward philosophy is to basically put the patient in a position and ask them to perform a movement and let their body “figure it out”.
To further explain the feed forward strategy, I think that the half kneeling overhead press
gives us a great example of an exercise that can be coached in different ways. The feed forward strategy is to put them in the half kneeling position and coach them to create stability in the hip by contracting the glute as tight as possible. Many people further the feed forward strategy by instructing the patient to “tighten the core.” By contracting the glute (and/or core), you essentially lock in the pelvis to create a stable platform prior to pressing the load overhead. This is done to hopefully promote a stabilization strategy within the hip and trunk that they will eventually carry on to other movements.
The non-feed forward option of coaching this movement is to put them into the half kneeling position, tell them what we want them to do with the load (press overhead) and watch their body attempt figure out how to create the stability on their own. The argument to this strategy is that it creates a more authentic neuromuscular learning environment which will cause plastic changes more efficiently.
Feed Forward:
- Positive: Using a feed forward mechanism, we are able to teach and coach our patients with poor movement skills and neurological control to be able to create the stability and movement patterns that we are looking for. Many of our patients are with us because they have poor motor control, thus, helping them to understand how to turn on specific muscles or areas of the body as needed can work well to help them with body control and understanding what we are looking for.
- Negative: There are 2 major negatives from my perspective with regards to the feed forward strategy. First, it takes a lot of coaching and one-on-one time. Usually it involves some sort of tactile feedback to assist the athlete to improve a muscle action in a specific area. The second drawback is that it typically teaches a high threshold recruitment strategy. A high threshold strategy may be needed some of the time to create stability or movement, but most of the time it is not. Thus, teaching a high threshold strategy engrains the idea that we need to fully contract or turn on a muscle or group of muscles in order to get what we need. This doesn’t mimic how we typically move in life or sport. Can you imagine if the glutes completely turned on and off with each step that we take? It isn’t needed and would create some long term dysfunction if we did that. Our body is designed to recruit the right amount of motor units at the right time to meet the demands that are needed at that moment. Teaching a high threshold strategy just doesn’t mimic how we move.
Non-Feed Forward:
- Positive: It is easy to coach. Set them up and let them go to work. It also tends to replicate how we move better, as laid out above.
- Negative: Athletes who have poor motor control and body awareness as their underlying cause of dysfunction will struggle to make this work. To build on our half kneeling overhead press example, if someone comes in who typically stabilizes their pelvis with their hip flexors, hamstrings, and lumbar erectors, even though we have tried to minimize their contributions to stability through the exercise selection, they are almost always going to go back to what they know…dysfunction. So, expecting a person with long term dysfunction and poor movement patterns to magically make that correction with minimal coaching is a bit idealistic for most and not all that practical.
Which is better?
At the risk of playing the Switzerland card here…my answer is “it depends”. As a general rule, I prefer to use a non-feed forward mechanism whenever possible. I do believe that while it makes things a little bit more difficult initially for some with regards to motor learning, it does create a more authentic environment that better mimics how we move. Because of that and the high threshold strategy that feed forward involves, I tend to shy away from it if I can. I’m also not a big fan of constantly cueing my patients.
With that being said, I do come across patients who just don’t have the motor control and/or they have long term dysfunction that necessitates the regression strategy of the feed forward mechanism. For these people, I will oftentimes start with some cueing and feed forward type training with a high threshold strategy in order to start to engrain some level of motor control and neuro pathways to the specific area that I’m trying to improve. But, when I do this, once I begin to see a decent level of motor learning taking place, I prefer to reduce my coaching and step back from the feed forward methodology.
Overall, each patient should be treated as a research study of 1 and understanding the pros and cons of each thought process gives you more tools in your toolbox to choose from. Find what works best for them and run with it.
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