This blogpost originally appeared on theresetsytem.com blog on 11.30.15.
Written by: Shawn Sherman
SQUARE 1 is a unique system that provides value by restoring proper motor control so that the body can move optimally. This article will get into a few of the unique aspects of SQUARE 1 and why the uniqueness of the system makes it an invaluable tool for industry professionals. To begin, I’d like to lay out some very general framework so that the unique aspects of SQUARE 1 can be more easily understood.
"Motor control is the process by which humans and animals use their brain/cognition to activate and coordinate the muscles and limbs involved in the performance of a motor skill. Fundamentally, it is the integration of sensory information, both about the world and the current state of the body, to determine the appropriate set of muscle forces and joint activations to generate some desired movement or action. This process requires cooperative interaction between the central nervous system and the musculoskeletal system (commonly known as the Human Movement System (HMS)), and is thus a complex integration of information processing, coordination, mechanics, physics, and cognition."
In an ideal scenario, the body would function optimally because of the perfect cooperation of the interactions between the subsystems (nervous, muscular, articular) of the HMS. But life is rarely ideal and when the HMS is functioning less than perfectly, the body adapts for functional deficits. This adaptation is called compensatory movement.
But how does the body get into a state where the HMS is not able to operate at full capacity and needs to start compensating? When the body experiences stress, which is any stimuli that is not tolerated, we believe that a reallocation of resources that involves all of the body’s systems (nervous, immune, circulatory, etc.) occurs. For example, if the immune system is in high gear due to fighting off an infection, it will require an above-normal level of resources. All of the other bodily systems must chip in to cover the cost. For the HMS, the cost is often a new joint dysfunction.
A joint dysfunction is a planar-specific position that cannot bear or tolerate any load. The HMS senses that dysfunctional joint positions are present and creates movements without these specific positions’ involvement. The body working around a joint dysfunction(s) is compensation. Therefore, joint dysfunction is the true source of compensatory movement.
Once the body compensates for a joint dysfunction, all movement becomes more inefficient. Inefficient movement makes all physical tasks more difficult and it also increases the likelihood of becoming injured. Flawed HMS outputs such as joint instability, immobility, restricted ROM, and acute and chronic aches and pains are all biomarkers of compensatory movement, but they are not joint dysfunctions or compensation themselves. It might be helpful to think of those flawed outputs as symptoms of poor movement.
RESET identifies and removes joint dysfunctions and restores optimal motor control (sensory integration). By removing joint dysfunction, not only is compensation eliminated, but all sub-optimal HMS outputs that result from compensatory movement are also eliminated.
So now that we have some perspective on how and why the body compensates, let us look at the unique components of the RESET system that make it valuable for restoring optimal motor control and improving movement quality.
1. Restoration trumps replacement and SQUARE 1 is a restorative strategy.
Before we get into discussing the various strategies that can improve HMS performance, we must first understand the difference between the components and the outputs of the HMS.
The HMS components are the three sub-systems that comprise the HMS and are the foundational elements that must be in place before movement itself can occur. These three sub-systems are the nervous, muscular, and articular systems. The structures of the nervous, muscular and articular systems themselves can be thought of as the HMS component “hardware” while the motor control and sensory communication between these three subsystems can be thought of as the “software”or functional components of the HMS.
The HMS output is movement. Industry professionals often assess and grade the quality of movement by testing specific aspects of HMS outputs such as joint stability, mobility, strength, power, endurance, posture and compound joint movement performance such as squatting. These HMS output tests are great for picking out observable HMS output flaws/distortions and for scoring specific aspects of movement.
Improving the functional outputs of the HMS is very valuable if the goal is to help others get the most out of an active lifestyle. When it comes to improving the performance of the HMS, industry professionals have only two strategies from which to choose: replacement or restoration.
A replacement strategy is one that increases the effectiveness of impaired HMS resources through task oriented activity (exercise) while a restorative strategy is one that regains or restores impaired resources to allow for more efficient movement.
Practically speaking, how do replacement strategies commonly play out in the field? Earlier we mentioned that movement performance is often assessed through various HMS output tests that pick up observable flawed HMS outputs. Examples of this could include noticing that a patient’s hip is more internally rotated than their other hip during a posture screen, or it could be observing a distortion such as pronounced trunk flexion during an overhead squat. Based upon an observation, or more typically based upon a series of observations, an industry pro will then base their exercise intervention off of the observed distortions. These strategies typically use stability, mobility, strengthening, technique exercises,or possibly even tissue work such as interventions since their testing yields sub-optimal performance of these characteristics.
After whatever intervention was selected and utilized, the industry pro may recheck their work by re-assessing to see if there has been improvement. This whole approach may look a little different from one system to another or among practitioners but, generally speaking, this approach is amazingly pervasive within the industry. Essentially, a replacement strategy does not pay attention to HMS component status (available/unavailable), but instead improves or trains available HMS components through exercise. By training the already available resources at the exclusion of the unavailable resources, replacement strategies actually bolster how the body is currently compensating and, in doing so, they improve the performance of the HMS.
A restorative strategy, on the other hand, focuses on improving the performance of the HMS by identifying and recovering impaired HMS components. Restoring HMS “software” or motor control is what we are talking about here.
Planar-specific joint positions should be thought of as the most reduced of all HMS outputs. These reduced outputs are important transitional links between HMS component function and more complex HMS outputs called movement patterns. The existence of poor HMS component relationships will cause dysfunctional joint positions to be present. If you recall back to when we defined joint dysfunction, we stated that a joint dysfunction is a planar-specific position that cannot bear or tolerate any load. A joint position that is not tolerating load clearly indicates an impaired HMS component function.
SQUARE 1 identifies these dysfunctional joint positions and restores functionality, through isometric exercises that emphasize the pertinent plane, so that these positions can once again be fully used as a resource. Removing joint dysfunctions also removes the very reason for which the body must compensate. Less, or possibly even eliminated, compensation means improved performance of the HMS which, once again, can be verified through HMS output tests (mobility, stability, strength, endurance, power, better posture and better compound joint movement performance). Just like removing a splinter from one’s toe, removing joint dysfunctions ends up clearing the source of compensation and immediately improves HMS performance.
At SQUARE 1, we believe that removing joint dysfunctions is so integral to a restoration strategy that if you are not identifying and removing dysfunctions, we believe that you are not utilizing a restorative strategy. Restorative strategies get to the source of why we compensate and they always improve functional outcomes. Replacement strategies, on the other hand, may occasionally and accidentally restore function to dysfunctional components of the HMS. In a marketplace already flooded with replacement strategies, SQUARE 1 is a restorative strategy.
2. SQUARE 1 is simple and elegant because it is based upon the consistent and predictable ways that we move.
The terms pronation and supination are most commonly used to describe transverse plane movements of our forearms. For this definition, pronation is internal rotation and supination is external rotation of our forearms. In addition, these terms can be used to describe how our bodies integrate all of our various skeletal segments together and create movement patterns in our gravity-ruled world. These two concepts apply to every single joint and every single plane of movement throughout the body.
To understand the interdependency and interrelatedness of all of the joints, pronation and supination are the only two movements that need to be considered. Pronation is the body collapsing under gravity, while supination is the body overcoming gravity. Specific to planes of movement, pronation is flexion in the sagittal plane, internal rotation in the transverse plane, and adduction in the frontal plane. Conversely, supination is expressed as extension in the sagittal plane, external rotation in the transverse plane, and abduction in the frontal plane.
Applying the concepts of pronation and supination to all joints of the 4 quadrants (lower right, lower left, upper right, upper left) of the body would yield the two fundamental patterns of movement that are hardwired into all of our bodies: getting upright and ambulating.
More accurately, getting upright is a dynamic posture pattern more than it is a movement pattern. It has 2 phases: "stand" and "sit". "Stand" is comprehensive and simultaneous supination of all four quadrants of the body. "Sit" is comprehensive and simultaneous pronation of all four quadrants.
Ambulation, or gait, is the most fundamental movement pattern of humans. Just like dynamic posture, it also gets broken down to two phases: "right step" and "left step." "Right step" is lower right quadrant pronation, upper left quadrant pronation, lower left quadrant supination, and upper right quadrant supination. Reverse all of those and you have "left step.” We use ambulation to maintain balance and help keep our eyes fixed level with the horizon and in front of us as we move and physically negotiate our way around the world in which we live.
These two patterns form the most basic way that we move. All other patterns of movement are really just ambulation with different aspects accentuated, or slightly different sequences of limb movements or slightly different angles for our limbs to move through. For example, a right-handed boxer throwing a right cross is really just “left-step” with all of the joints and limbs working together to deliver an exaggerated and emphasized right arm movement.
SQUARE 1 uses this understanding of supination and pronation as it applies to every single joint in the body to gain a more clear understanding and identification of things such as compensatory movement patterns (which can only be Right Step, Left Step, Sit or Stand), restorative movement patterns (which can also only be Right Step, Left Step, Sit or Stand), and joint dysfunctions. Attempting to understand ideal or compensatory human movement through any other “fundamental patterns” really just ends up making things needlessly complicated because any other pattern is more theory than reality. Owning and understanding these patterns and how each joint of the axial and appendicular skeleton fits into them will have you well on the way to being a movement expert. In fact, these two patterns are the only patterns necessary to break down the body and all of its hundreds of joint movements and to utilize a motor control restoration strategy.
3. SQUARE 1 removes motor control deficits.
Flawed HMS outputs are relatively easy to observe and to measure. ROM assessments use goniometers to collect objective data. Different muscular strength, power and endurance tests measure load, time, distance, speed, acceleration, and deceleration. Functional movement tests use objective and subjective scoring systems to rate how well or how poorly a person performs certain movement patterns. Posture tests pick up distortions. and the list goes on and on.
But flawed HMS outputs are only biomarkers of joint dysfunction and compensation. This next statement will sound ridiculously simple but here goes: HMS output tests only assess and score HMS outputs. They do not identify joint dysfunctions. They do not identify compensatory movement patterns. Since a restorative strategy requires the pinpoint identification of how and why a person compensates, an HMS output test is not actually useful for generating restorative strategies. To be clear, this does not mean that HMS output tests do not serve a role in our industry. Actually it is quite the opposite. They are great for red-flagging problems that could lead to injury if a person were to continue to train in the presence of such notable movement distortions. They also provide great snapshots of HMS performance both pre- and post- corrective/restorative/rehab programs.
But since flawed HMS outputs do not consistently and accurately identify how a person is currently compensating, or nail down which joint or sequence of joint positions are the dysfunctional ones that led to compensation in the first place, they are not the right tool for generating restorative strategies.
Here is a scenario that will hopefully illustrate that HMS outputs are only biomarkers. A clinician conducts a series of ROM tests and finds that the client has a restriction moving into horizontal humeral abduction. At that point, the clinician infers that “tight” humeral adductors (pecs) are the cause. A series of pec stretches and rhomboid and posterior deltoid strengthening exercises are recommended. To many in the industry, this sounds legit and is accepted as how to utilize corrective exercise.
But what if the ROM restriction (humeral abduction) was a flawed movement output that stemmed from 3 different compensation patterns which stemmed from 17 different joint dysfunctions (6 of which are in the hips)? Can you see how attempting to stretch the pecs would be a woefully ineffective corrective strategy? More than likely, since the root cause would not be addressed by stretching the pecs and strengthening the posterior shoulder muscles, these interventions would need to be repeated over and over again in order to temporarily “improve movement.” This would mean that stretching the pecs and strengthening the posterior shoulder musculature would not be a real solution in this scenario because it was only focused on a biomarker of a sub-optimally functioning HMS.
The real solution for this particular scenario would have to involve correctly identifying and removing all of the dysfunctions that were causing the different compensations which were eventually leading to the easily observed ROM deficit of humeral abduction. Not taking the time or not possessing the skills necessary to do so would almost always leave you producing poor corrective/restorative exercise program results. Yet this is what the industry mainstream teaches. How many times have you heard stretch what’s tight and strengthen what’s weak? That advice would be like telling someone dealing with anoxeria nervosa to eat more food. It just would not get to the root of the problem.
SQUARE 1 takes a much different approach. SQUARE 1 uses neuro-proprio response muscle testing to detect stress responses within the body. These responses, combined with a comprehensive understanding of ideal joint mechanics as they relate to fundamental movement patterns, allow SQUARE 1 practitioners to properly identify how a person is currently compensating. Once a compensatory pattern is found, the practitioner can then begin pinpointing the dysfunctional joint positions that are causing the client to compensate.
Each and every joint position that is a link in the polar opposite to the compensatory pattern (we call it the reset pattern) would be loaded and then muscle testing would be conducted to check for a stress response. Once a joint dysfunction is found, isometric exercise that accentuates the specific dysfunctional plane of movement for the affected joint is then utilized in an attempt to bring the planar deficit back to a functional status. The effectiveness of the exercise intervention is then assessed by checking to find out whether or not if the client is still compensating. If the client is still compensating, the work at that specific segment is not complete and more restorative exercise is warranted. If the client’s compensatory pattern was removed, the SQUARE 1 practitioner would then have various triggers at their disposal in order to attempt to cause a stress reaction in order to draw out more compensatory layers that could then be identified and resolved.
Using HMS output tests before and after this restorative approach is a great way to score and register HMS improvements. It all comes down to using the right tool for the job. SQUARE 1 is a tool that finds and removes the motor control deficits (joint dysfunctions) that cause a person to compensate.
One final aspect to this section would be to address the flawed ideas that “training the chain” will make all links in the chain strong or that “good technique is corrective.” If you are not sure what this means, my understanding of these similar concepts is that if we use appropriate-for-the-individual training loads and excellent technique with compound joint movements (squats, deadlifts, presses and pulls, etc.), all of the “weak” links will catch up to “strong” links and the whole chain will be strengthened. I believe that training with these lifts, even in the presence of joint dysfunctions, will make a person stronger. I also believe that using the best technique possible is wonderful idea. I use these lifts with my clients and I program these lifts into my personal approach to strength. But make no mistake about it, "training the chain" and utilizing excellent exercise technique does not correct motor control deficits. Training the chain is the epitome of a replacement strategy and it actually utilizes compensation in order to improve HMS outputs. That does not make it bad or evil. It just does not make it restorative in the way that I have been laying it out in this article. What I and other SQUARE 1 practitioners recommend to our clients is starting off with some SQUARE 1 as a restorative approach to improve motor control and then following up with an intelligently progressed replacement strategy otherwise known as strength training. Restoration followed by reinforcement will take you far in the movement optimization game.
*The Human Movement System is remarkable in its complexity and its ability to solve problems. The most common problem that the HMS must solve is how to be as efficient as possible in the presence of joint dysfunctions. It does this through compensatory movement.
*Compensatory movement is a great short-term solution for the body, but over the mid- and long-term it leads to less than optimal HMS outputs such as instability, immobility, loss of strength, power, and endurance, and accumulating aches and pains, and it actually becomes a fuel for future compensatory patterns.
*A lack of understanding and an inability to distinguish between HMS components and HMS outputs leads to all sorts of inefficient choices when it comes to corrective exercise selection for our patients, clients, and athletes.
*Focusing on improving HMS outputs with no regard to HMS component status would be a replacement strategy. Replacement strategies are relatively quick to utilize and/or require little skill and they can improve HMS performance, but you will need to continually visit the “replacement strategy” drawing board since the root cause of diminished HMS performance is not being addressed.
*Identifying HMS component deficits and restoring their functionality would be a restoration strategy. This requires a little bit more time up front and more skill and understanding than does a replacement strategy, but since it addresses the root cause behind compensatory movement, the impact it has on improved HMS performance tends to be much longer and much more profound.
*Motor control restoration does not replace strength and conditioning programs, but it does supersede them and should be the first priority for all rehab/fitness/performance industry professionals.
1 Rosenbaum, David A. (1991). Human Motor Control. San Diego, CA: Academic Press. p. 411.
2 Wise, Stephen P.; Shadmehr, Reza (July 10, 2002). "Motor Control". Encyclopedia of the Human Brain. Academic Press. pp. 137–157.