Three Simple Rules for Patients and Clinicians

Three simple rules to help clinicians practice and assist patients in understanding what to expect from treatment come directly from the Functional Movement Systems group. 

1. Reset

2. Reinforce

3. Retrain/Reload

Reset

A reset is an intervention that creates the opportunity for successful movement to be experienced and is usually where manual therapists excel. This could include massage, manipulation, mobilisation, electrophysical agents, foam rolling, stretching, or any intervention from an exceptionally long list of options that can help alter pain experience and movement. However, the effect of a reset intervention is usually transient unless the other steps are also implemented. 

Reinforce

The purpose of a reinforcement is to reinforce or protect the behaviour or capacity acquired through a reset. This is usually the area most people miss and is distinct from an exercise prescription in that it is goal-oriented rather than sets-and-reps oriented. 

Retrain/Reload

The third stage is the provision of corrective or rehabilitative exercises, as necessary, with progression to a fully functional, appropriately loaded pattern that matches the individual's load demands. The prescription of appropriate and timely exercises is an essential step in both the therapeutic and performance worlds. However, you will often see exercises prescribed for someone who still has a mobility or stability problem that is limiting their capacity to perform them, or exercises prescribed at inappropriate loads and intensities for an individual's needs. 

For example, if your forward bend/toe touch was identified as the pattern we need to improve, and after a reset, targeting spinal flexion and hip flexion restored what we considered a functional toe touch for the individual, we could then utilise a reinforcement strategy with the goal being to maintain your toe touch capacity. We would use the baseline 'can you still touch your toes or not' to assess if you need to continue performing your reinforcement movements before commencing any retraining/reloading exercises that require the restoration of your flexion pattern.