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Theory HFM
Also the manner in which the subject uses biomechanical principles appears to have diagnostic value in relation to centric positionality as well as to eccentric positionality from where the behaviour of movement takes place. It’s sufficient to state here that the written remarks about biomechanical principles are based on a built-up ‘library’ of elaborate researches via video-recordings, which by means of advanced techniques (such as speed reductions, combination of successive movements in one image) have been thoroughly analysed.
On the base of these analyses we discuss the following three items:
A. For every movement the point of support from where it is put into motion should be situated outside the body.
B. The organisation for the maintenance of poise plays an important role in it.
C. The principles mentioned in the sections A and B have substantial consequence for the therapy.
A. For every movement the point of support from where it is put into motion should be situated outside the body.
However, with patients who persistently function from an eccentric positionality, was discovered that the point from which they put the movement into motion was always situated inside the body. With the patient with an eccentric attitude the body part that was in interaction with its environment was ‘steered’ from a non-conscious rigid-kept part of the body.
This discovery gave us insight how important it was for a vital, adequate functionality of motion, that the point of support from which it was moved had to be situated outside the body and that at the same time one should consider that in upright position the starting-point for it was always situated under the ball of the big toe.
With vital actions deep-seated musculature of the back is drawn on by the take-off movements of the foot. This musculature of the back takes care of the unilateral contractions such as the lateroflexion and rotations, the function of stretching and the stabilisation of separate movement segments of the spinal column. Owing to the deterioration of the vital functionality an appeal is made to the muscles of trunk and shoulders, the trunk-upper arm muscles, the costal muscles of the spine and the superficial back muscles and many other muscles to steer the posture. Through this the musculature regulating the ‘turnabout’ of the upper limbs served for maintaining the posture. If the chosen movement forms eventually resulted into non-self-correcting positions of the movement segments of the spinal column or parts of it, a wrong, eccentrically-controlled movement pattern came into being.
So bone moulding, distortion of intervertebral discs and changed bone positions in the joints are not always the causes in a complaint-pattern, but rather the consequences of a wrongly regulated movement. Activities, social circumstances, traumas and ageing can bring about that the posture and movement are controlled from an eccentric positionality, this also is the case with a trauma, with which the control of the joint ‘only’ drops down.
B. The organisation for the maintenance of the poise should take place in accordance with the biomechanical principles.
The initial phase of the movement showed us the point of departure of the movement segments of the spinal column and provided us by this with information about the quality of the ability to function. When the movement segments of the spinal column could not make a turnabout movement from a stretched position the movement didn’t work out optimally. The optimal action in standing posture must be characterized by such an organisation of the body that an adequacy arises between the necessary vigour, rapidity and accuracy to deal with the object.
Well then, the gradation in how far one can maintain the poise is also a determining factor for those qualities of action, in orientation towards an environment object, evaluated by the individual.
In what way is this interaction between optimal movement and the maintenance of poise organised? The leg which realizes the take-off movement when throwing a ball takes care that the poise remains the same by positioning the general centre of gravity above the plane of support of the supporting leg. By frequently moving the general centre of gravity of the body on the hip-head of the supporting leg the poise is realized for the action with the manipulative arm and hand.
In case of deterioration of movement quality is attempted to stabilize the poise as much as possible above the supporting leg, by which the general centre of gravity of the body gets a more steady place. Through the fact that the accent for functional actions is put on the maintenance of the poise there develops a reduction in the adequacy of the stretching of the spinal column for the realization of the turnabout movements. The body functions then as much as possible from a stable-kept balance.
Flowing movements are characterized by the fact that one unstable balance is changing over into another. In trying to keep the balance stable as long as possible, the movements become wooden, and are controlled from an eccentric positionality.
C. Consequences for the therapy
It may be clear that the cause of most complaints is thought of being a loss
of quality: the patient can no longer function spontaneously, in no way.
It is a circular process in which a multitude of function-defining factors seize upon movement segments of inferior quality, which are fragile. Owing to that a (normally unconscious) watch-function arises which leads to all kinds of steered interventions on the entire patterns of posture and motion. These interventions evoke autonomic body reactions. There arises a fairy-ring of dysfunctional muscular tensions, wrongly charged joint structures and a dysfunctional position of the vertebrae, as an inevitable, necessary adaptation to that controlled posture and motion. The eccentric positionality which was already present or which developed owing to the above-mentioned causes, now gets clear attention as the maintaining source of complaints.
The adaptation-immobility is not directly dealt with symptomatically, it needs a total approach..
The therapy should not be limited to the correction of joints, but in the first place be directed to the re-instatement of a centric positionality in posture and motion and thus in such an intentional orientation towards the world that the functions of posture and motion are de-passed and can pass off as routine actions, in harmony with the biomechanical principles.
Centric positionality supposes that the individual can lose oneself in the communication with others and other situations. This always calls up an optimal breathing-movement and an optimal tension of the muscles as a condition for the realization of total communication.
As a rule the therapy starts with the use of the written principles mentioned in the subsections A and B, so that the patient experiences how it feels to take off in the proper way, linked to the correct organisation of the balance of the body. After that the therapy is a touching tactual therapy, which initially is directed to the spinal column. Not any of the usual forms of treatment in the physiotherapy and in the so-called Dutch ‘manual therapy’ are utilized. So vigorous and compulsory action is out of the question.
Repeatedly the vertebrae , one by one, are tactually appealed to so that with the lapse of time a spontaneous reaction arises in a play of light pressure (by the therapist) and a counter-pressure (by the vertebrae). This becomes a form of body-communication with the ‘outside world’ (in this case the therapist), in which there is no control from the patient himself / herself. The body itself puts the vertebrae in their functional position, in which the joint can realize its supporting power in the best way and in which the freedom of movement is optimal.
In this way the body acquires in communication the chance of reacting safely in centric positionality.
In order to make this form of communication-possibility permanent, it is sometimes useful to continue to utilize a similar communication-form on the tissues of the patient in a domain that for the patient hasn’t any relation to earlier communication-forms in which reactions in eccentric positionality had become a rule. The calf often appears to be an ideal place for that.
Copyright: C. G, de Graaf / A. J. A. Verberk / Institute for Human Functionality of Motion