When I was a personal trainer and was beginning the journey to where I am now, there was a lot of emphasis on posture, alignment and control of movement with learned cues. However, since learning with John Hardy. Gary Gray and Dave Tiberio, I have come to realise this conscious cueing is not the best plan and there is a better way of achieving the desired effects.

The ones I hear most often are “keep the spine in neutral” (whatever that means!)and “keep your shoulder blades retracted”. I am always getting patients who have been given these kind of postural cues from varius sources, and I’m sure they do more harm than good.

The way I go about achieving the desired movement or position is through subconscious movement through an alternative goal. For example, if you assess someone and decide they are missing right hip adduction, and want to help them increase this joint motion through an anterior lunge, the conscious way would be to ask him to adduct the right hip more as he lunges forward. This strategy may lead to a little more hip adduction, but it will tend to be a highly compensated movement. The client is concentrating so hard on one joint movement he will try and achieve it regardless of what means for the position and movement of the other joints. I also believe you will get far less carry-over into their gait pattern with this strategy, as the movement hasn’t been authentically driven and it is impossible for that person to walk down the road thinking about achieving the correct amount of hip adduction.

The alternative strategy: I would avoid telling the client specifically what I am trying to achieve as I want to avoid conscious over-riding of the movement pattern, which results in massive compensation and poor carry-over. I would ask him to do the same anterior lunge but would not even mention the right hip. Instead I would give them a simple goal to focus on away from the hip, but which will drive authentic hip adduction through that right hip. My preferred choice is to ask the client to drive the right hand left lateral overhead as he completes his anterior lunge. If this is not possible for whatever reason (right shoulder impingement, for example) he can drive the left hand towards the floor, or as a last resort you can stand him close to a wall and ask him to drive his pelvis towards the wall as he performs his lunge. I say this one is a last resort as you are bringing the driver closer to the hip, which you might want to avoid if you can.

There are many reasons this subconscious strategy is of benefit, but for me the most compelling reasons are how fast results tend to be with this method, and how good the carry-over is into their normal function. If you assess your client’s gait or movement, drive subconscious movement through the joint and then re-test you should see a lasting change immediately. Another reason it is a great strategy is that this type of movement can so easily be turned into a manual therapy approach consistent with the HMACIV and therefore gait.

Neil Poulton