The Wrong Movement in the Wrong Place
The analysis of individuals with mild or severe muscular skeletal deficiencies reveals essential structural deviations in comparison with healthy individuals.
Whether one is referring to the movements performed by persons with muscular-skeletal limitations themselves - or to the movements that another person or the person testing the mobility performs with or for them – it is easy to observe that the pivots of mobility have shifted from their normal placement. At the same time, when performing a movement, bodily parts that are not normally involved in a specific movement become involved. In ABR terminology this has come to be called: The Wrong Movement in the Wrong Place.
What does this mean?
We can use the example of a simple arm movement to illustrate this concept. When an individual affected with muscular skeletal - or even a child with general coordination disorders - raises his arm or uses an arm for weight bearing we can see that the shoulder blade is very unstable. Instead of being anchored on the back of the person, it shifts its position and wanders onto territories of the body where it does not normally belong. In cases of cerebral palsy, the shoulder blade can typically be seen to:
Slide upwards towards the head and often over the neck
Slide over the vertebral column
Slide onto the side of the body to the area of the arm pit
It is not difficult to imagine, that all this abnormal slipping and sliding does not provide much stability for the arms if they are to be used to lift or to carry something, for fine motor skill performance, or, especially, for weight bearing.
and Older Children
When the same movement is performed by the healthy person, the shoulder blades:
Stay anchored on the back
Pivot during movement, but do not slide to the side of the body or over the neck
Remain positioned between the second and seventh thoracic vertebrae
Photos of healthy individuals
If however we try to bring a child with unstable shoulder blades into a weight bearing position such as seen below, we can see that this unstable shoulder blade does not provide any basis for weight bearing on the elbows.
When met with the loads coming from the elbow, the shoulder blade simply slips away in the direction of the vertebral column. The shoulder joint itself, being also weak, then gives way and the child flops.
If we are to include the clavicle in this example, which is connected to the shoulder girdle as well, we would see that the clavicle normally provides the shoulder blade a stable connection on the front of the body. Due to compressional weakness however, the clavicle is positioned differently than it is positioned on the healthy person. It is found:
submerged towards the upper ribs
instead of being oriented horizontally is rolled proximally and positioned close to the neck
in level III- level V children we would typically find distal end of the clavicle visible at the back of the child
During the original arm movement of raising the arms, the clavicle – instead of holding a relatively stable position which would allow for free and unconstrained arm movement, rolls inwards and submerges even further.
In such children we typically see a blocked shoulder joint. Therefore any arm movement is coming from wrong movements at the level of the shoulder blade and the clavicle.
Manifestations of “Wrong Place Wrong Movement” can be seen throughout the body of a child with muscular skeletal disorders:
In the neck/head connections
In the vertebral column
In the sacral iliac joint
In the hip joint
In all of the distal limb joints
These structural deficiencies cannot be eliminated through typical rehabilitative measures and prevent further development and improvement of healthy motor function.
The ABR Method has recognized the inhibitive components of these deficiencies and is designed to improve Wrong Place Wrong Movement components.