biomechanics, education, informative, research evidence

Biomechanics: This is why you can’t understand the research articles…

Arguably, when we talk about biomechanics in a clinical sense there is a tendency to use ‘qualitative’ descriptions of motion, i.e.: planes of motion, ranges of motion. As clinicians or therapists, we describe qualities in a client’s movement (i.e.: limited ROM, hyperextension, stiffness, etc). The intended outcome is often to categorise movement as either ‘good’ or ‘bad’, and/or to use these to explain a pain or injury. The main aim is for the output to inform our treatment/intervention selection. 

What is ‘Biomechanics’?

Now, we as therapists might refer to these qualitative types of visual observation as ‘biomechanics’ or ‘biomechanical analysis’. But unfortunately, when we look at biomechanical research evidence it looks like an entirely new language! Particularly if we haven’t studied biomechanics as part of a degree programme – which may often be the case. It is hard to interpret research articles when they can be so complicated to read. That’s because fundamentally, in research, biomechanics is a tool traditionally used to measure movement. More importantly, biomechanics itself is not a mode of treatment, per se. Rather it is a set of mechanical principles (i.e.: physics) that we can apply to moving tissues (i.e.: the body when it changes position or displays variations in force production) so that we can measure changes in an objective way. This is perfect if we wish to compare either performance before and after an intervention – we could use it in the clinic and/or research to monitor change. It is essentially the application of the rules of physics to movement in living things. It is a ‘quantitative’ study of movement, with numbers being processed using formulas.

… biomechanics is a tool traditionally used in research to measure movement

Biomechanical Literacy: A different language for a different audience

In many aspects of manual therapy and training we have taken some biomechanical language and used it to describe motion in a qualitative way. However, without a deeper understanding of how these terms are defined (i.e.: using physics) we have a limited ability to critically evaluate research output of biomechanical measures.

In order to make the most of the research evidence base, and to make our own decision about whether biomechanical factors (measures) in our clients’ pain or injury issues, we need to have at least some literacy in biomechanical terminology. However, a major issue here is the disparity between the ways that data in scientific studies is collected and how it can be applied in the clinic – there is a huge difference. This is partly because very little research is being conducted to represent our diverse and vast population, and partly because we still haven’t found ways to interpret the existing data in a meaningful way.

Recreating research test conditions is impossible

We are increasingly trying to bring evidence-based practice into our clinics. Unfortunately, research uses very different methods of collecting and interpreting biomechanical findings. In clinic, we are reliant on very subjective visual observations to support our clinical reasoning for a treatment – we don’t often have access to the quantitative lab equipment available in university and research facilities. This means we can’t recreate the lab conditions of the research studies in our clinics.

Other issues include the facts that:

  • The quality of the research is lacking
  • The questions being asked in the research are not that useful!
  • Most research studies are too specific to be applied broadly
  • Many researchers involved in studies are not therapists themselves

So, if we are to interpret research and influence any of these issues with research quality and relevance, the least that we can do is become as literate as possible in the language of biomechanics. 

Limited practical courses in ‘Applied Biomechanics

And herein lies the challenge. Teaching and learning. Biomechanics might be studied in the lab as a sole discipline, but in the clinic, it can rarely provide meaningful insight without being considered as part of the wider biopsychosocial model. There are many more variables that affect pain, injury and motion than just motion itself. Furthermore, it’s hard to make a meaningful connection with biomechanics when the delivery style on degree programmes is often so ‘dry’. And yes, this may be hard to hear for those of us (me included) who have taught (and do teach) biomechanics. But it is true to say, that while many undergraduate programmes for Sport & Exercise Science and Sports Therapy include modules covering ‘Biomechanics’, these are usually entirely technical from the outset. They are totally focused on demonstrating how a researcher or scientist would collect data for a lab report or assignment, without providing students with adequate opportunities for developing organic questions about movement and applying problem solving skills to measure the movement in a meaningful way. The whole person (client) is not considered in this type of learning scenario. In short, we tend to just learn the formulas for very specific scenarios ‘by rote’ in lectures and then go in the lab sessions and apply them. It’s not wrong. It’s just not that usable when we leave the lab.

It’s not wrong. It’s just not that usable when we leave the lab.

What does Applied Biomechanics actually look like in a therapy or exercise setting?

By comparison, if we were to take a biomechanical approach in a clinic setting this would most likely start with being presented with a problem (pain or injury) that forces us to look for some meaningful information that we can measure. We would then need to work out a way to process that information so that we can get some meaning from it. We might then repeat the measurement after providing an intervention. If the intervention causes a change in measurement we can only speculate that this was an effect of the intervention. We can also only speculate on the mechanism responsible for this change. Throughout this whole experience, we will need to be considering how the client feels about this approach to problem solving, as well as the time and resources available to us. It’s a lot to think about within a one hour assessment!

Move Well Workshop: ‘An Introduction to Biomechanics’

If you’ve read through everything above and you’re still with me…. I’m impressed! Not many people feel as passionately as we do about improving the standard and accessibility to training on the use of biomechanics in exercise and therapy settings. If you’d like to learn more about biomechanics (it’s definition, origins, and applications) then you might like the Move Well Workshop: ‘An Introduction to Biomechanics’. You can find out when the next online ‘pay-what-you-can’ workshop will be on just HERE.

Any questions or thoughts please drop me an email: fiona@move-well.co.uk

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