Decide where the maximum bind is felt and where maximum ease occurs. These are the key pieces of information required for functional technique as you assiduously avoid bind and home in on ease. Can you feel this?
Try also to distinguish between the bind which is a normal physiological response to an area coming towards the end of its normal range of movement, and of the bind which is a response to dysfunctional restriction.
Can you feel this?
A series of similar execises (5 to 7 minutes for each exercise is suggested) can then be introduced in which you assess the response with your listening hand to side bending and/or rotation in one direction or another.
Hoover describes variations in what might be felt as the response of the tissues is palpated during these various positional demands.
- Dynamic Neutral: This response to motion is an indication of normal physiological activity. there is minimal signalling during a wide range of motions in all directions. Hoover states it in the following way, "This is the pure and unadulterated unlesioned (i.e.not dysfunctional) segment, exhibiting a wide range of easy motion demand-response transaction."
- Borderline Response: This is an area or segment which gives some signals of some bind fairly early in a few of the normal motion demands. The degree of bind will be minimal and much of the time ease, or dynamic neutral, will be noted. Hoover states that ‘ most segments act a bit like this’, they are neither fully ‘well’ nor ‘sick’.
- The Dysfunctional Response: This is where bind is noted almost at the outset of almost all motion demands, with little indication of dynamic neutral. Hoover suggests that, "Try all directions of motion carefully. try as hard as you can to find a motion demand that doesn’t increase bind, but on the contrary,a actually decreases bind and introduces a little ease. this is possible. This is an important characteristic of the lesion [dysfunction]."
Indeed he states that the more severe the restriction the easier it will be to find one or more slight motion demands which produce a sense of ease, dynamic neutral, because the contrast between ease and bind will be so marked.
Three major ingredients are required for performing this Functional exercise successfully according to Hoover.
- A focused attention to the process of motion demand and motion response, while whatever is being noted is categorised, as ‘normal’, ‘slightly dysfunctional’, ‘frankly or severely dysfunctional’ and so on.
- A constant evaluation of the changes in the palpated response to motion in terms of ease and bind, with awareness that this represents increased and decreased levels of signalling and tissue response.
- An awareness that in order to thoroughly evaluate tissue responses all possible variations in motion demand are required, which calls for a structured sequence of movement demands. Hoover suggests that these be verbalised (silently).
"Mentally set up a goal of finding ease, induce tentative motion demands until the response of ease and increasing ease is felt, verbalise the motion-demand which gives the response of ease in terms of flexion, extension, sidebending and rotation. Practice this experiment until real skills are developed. You are learning to find the particular ease-response to which the dysfunction is limited."