Loaded and Unloaded Movements are Not the Same

Joints behave differently loaded (weightbearing) versus unloaded (non weightbearing). This applies to extension, flexion, etc. - all planes of motion. Just picture your ankle: if you are moving your ankle while lying down, you are moving your foot as your leg is stationary. But if you are squatting in standing your leg is moving as your foot stays stable. These are quite different ankle joint movements, with different forces.
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I assess and treat patients using repeated movements. I am SPECIFIC with the exercise I investigate as well as with the one I prescribe a patient, which includes whether the movement is performed loaded or unloaded. Loaded knee flexion may have no effect for a patient, but unloaded knee flexion may prove beneficial. Loaded lumbar extension may make a patient’s symptoms worse, yet unloaded lumbar extension may work. Because I consider loaded and unloaded movements different, I have more movements available to me. While that may seem overwhelming, it’s not. There are patterns and clues in the history and mechanical exam that lead me (by implementing the method) to explore one movement compared to others. --Laura