Mark Comerford discusses when we need to force the issue

7th July 2016

Movement Performance Solutions’ Mark Comerford discusses ‘when we need to force the issue’

Movement Performance Solutions’ Mark Comerford discusses ‘when we need to force the issue’.  Many clinicians are comfortable with low threshold retraining for pain related to non-fatiguing functional activity however, some of our clients will need to start their management process with strength training. How do we identify this group, which Mark states make up about 20% of his clients? Mark identifies his clinical indicators of when to start with high threshold movement retraining for his patients.

Movement Control Retraining Global Strength Extended Version MP4 from Movement Performance Solutions on Vimeo.

These are Mark’s clinical indicators for strength as the first option;

  • Symptoms are linked to and only to high threshold function - No pain during sitting, standing, walking, lying or sleeping. Pain is related to speed, load or forceful, repetitive movements (playing sport or within 30 min of playing sport)
  • Provoked by direction specific activity or task – flexion, extension, or rotation related
  • Demonstrate uncontrolled movement at 40-75% maximal voluntary contraction (MVC). It is very rare for most people to be able to keep the trunk in neutral during 80% or more of MVC. During the performance of a sub-maximal lift, bilateral or unilateral, uncontrolled movement will be apparent.
  • Atrophy- both symmetrical and asymmetrical. We might see good paraspinal bulk that disappears from L3 to the sacrum, or asymmetry in the gluteals.


We need to retrain their movement control to fatigue so as to improve either their strength or endurance qualities.

Keywords: Kinetic Control, Mark Comerford, Movement Control, Movement Matters