There are movements we all do, some of them regularly, and some less often.

There are also movements that people fear for the risk they present in causing an injury. Bending and twisting while lifting is the most obvious example.

Yet we are able to perform these movements repeatedly without getting injured.

So is the movement the cause of the injury? It doesn't quite add up...

What else is happening?

All too often, it seems a little something extra causes injuries. A wobble, a voice you weren't expecting, the floor not being quite where you thought it was, the box being lighter than you thought. The list goes on...

So why are we advised to worry about how well we bend forwards and backwards? Why should we become paranoid about knee and hip angles, foot position and spinal posture?

What we should really pay attention to is how well we balance, how we respond to unexpected stimuli, and how accurately we sense the world around us.

Train the bad

It can be hugely valuable to introduce back pain patients back to the movements that they claim caused their injury. Tackling the fear, and proving that those movements aren't painful any longer is a massive step in recovery and something that patients with persistent pain conditions often benefit hugely from.

But we need to spread the net wider for a really good resolution across a wider cohort of back pain patients.

We might worry about whether we perform good movements badly, but we should also check if we can perform bad movements well.

Eh?

When people closely examine movements like a squat, they are looking for clean, geometric motion in one direction only - forward and back. The typical errors in these movements are ones of rotation and bending side to side, and they should be trained out as much as possible.

How can you train something out that you can't do?

Sometimes, we need to make people better at those rotation and side bending movements so that they can feel them more accurately, and then react to what they feel.

• If you don't know you're rotating, how can you correct the rotation in your squat?
• If you can't actively side bend both ways, how could you balance yourself when you start to fall sideways?

In conclusion, beware of performing the same few movements again and again and again.

Look for a richer variety, and try to be good at every movement so that with increased sensitivity and movement skill, you can correct as you go and reduce the anomalies that might cause injury.