by Mitch Hauschildt, MA, ATC, CSCS
I have traveled the country over the past few years teaching and speaking and interacting with a number of PTs, DCs, ATCs, and other healthcare providers. As you may know, I am a big believer in a movement-based approach to rehab. Meaning, the earlier and more that you can get someone moving in their rehab process, the better the outcomes usually are. This usually involves rehabbing an area of the body that seems unrelated to the original injury site. It also means that cardiovascular fitness is an important part of the healing process and should be integrated whenever possible.
A few years ago, I began teaching a movement based rehabilitation program centered around rehabbing the post surgical shoulder. One of the major points in the seminar is that in order for the shoulder to work correctly, basic fundamental movement patterns must be in place. This includes squatting, lunging, pressing, pulling and planking. As their rehab clinician, if I don’t address these areas, then I am setting them up for failure and likely another injury.
One of the first rebuttals that I always get is “I work with the geriatric population, they can’t squat.”
To which I always reply, “I hope that they never have to poop.”
Of course I get a few laughs from the crowd, but it is an easy way to make my point. We all have to perform some level of all 5 of those movement patterns on a daily basis, regardless of our age. So, improving them within a person’s rehab process isn’t an option.
I feel strongly that we oftentimes don’t give our patients enough credit for their abilities and we are afraid to let them fail and that ultimately holds them back. We were all born with the ability to perform a good, quality squat naturally (if you aren’t sure about that, come watch my 20 month old squat – I guarantee it is better than yours). We lose the ability to squat because our society is set up to discourage it and to be lazy.
This is reinforced every time that I travel abroad. Over the past 5 years, I have traveled to Africa, Mexico and China, usually performing some sort of orphan care humanitarian work. These trips allow me to get off of the beaten path and see how people really live in their culture. What I can tell you is I have seen men and women in their 60s and 70s “sitting” in a squatting position. This is because they don’t have chairs, so that’s where they prefer to rest.
Recently during a trip to China, I entered a public restroom to find very helpful pictures on the outside of the stalls. As a lazy American, I prefer the stall with the toilet, so that would be my choice. But, the vast majority of the stalls simply have a hole in the floor to squat over. That’s because this is the norm for most other cultures around the world, not the exception. They consistently squat deeply, multiple times per day throughout their lifetime.
Everyone can and should be working to improve their squat, regardless of their age and abilities. It is a basic movement pattern that affects their entire kinetic chain. Don’t hold back your patient because of their “perceived” abilities.
As Gray Cook says, “Move well, then move often.” So, in this case…Squat well, then squat often.
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