The Easy Way To Improve Athletic Performance

Athletic performance can always be improved to some degree.

It doesn’t matter how old you are, what genetics you landed or what you did or didn’t do in the past, you can still improve.

All of those factors will affect your absolute potential, but the ability to improve is universal, thanks to biology.

There are many factors that go into improving athletic performance, this article will focus on those that have the biggest impact.

There Is No Easy Way

Was the title of this article clickbait? No. I meant easy in relative terms. You’ll see why shortly.

The biggest (controllable) factor in athletic performance is always going to be the amount of work done.

Hard work beats talent when talent doesn’t work hard.

This improves both skill and capacity, which are both involved in athletic performance to various degrees. However, one thing that often gets overlooked, is economy.

Being Economical Is A Good Thing

So what is economy, when it comes to athletic performance?

Economy is the energy cost of performing a task. In endurance activities, this is measured by oxygen consumption, which is analogous to fuel efficiency in a car.

In strength or power based activities, it is a little harder to measure economy, because in a matter of a single lift, throw or jump, peak values are more important than sustained values. However, you can measure maximum force production along with muscle activation and then compare it to the task at hand to get a gauge of economy.

As an aside: efficiency is not economy.

Efficiency refers to the conversion of total work done to productive work.

In a car, the engine has about 25% efficiency, which means that most of the energy is converted to heat and other forms of energy which do not propel the car forward.

There is debate among sport scientists as to how much efficiency can be improved, if at all. That there is debate, suggests it is not the easiest attribute to change, when compared to something like economy.

Generally speaking, being economical is a good thing, because it means you can sustain a higher output for longer, whatever size your total output is.

Factors Influencing Economy

  1. Skill: whatever you do, there is a skill component. Thus, the more you practice the skill of movement, the more economical you become. This is due to the law of specificity (you get better at what you do) having task specific improvements in both motor control and tissue adaptations. This is true whether it comes to running and jumping or playing a ball sport.
  2. Anthropometry: you don’t need to have a degree in biomechanics to appreciate some body types are better suited to certain activities. Tall people with long limbs and great cardiovascular systems make good rowers. Tall and powerful people make good jumpers. The better suited you are to a task physically, the more economical you will be.
  3. General movement ability: Better movers will have an easier time learning the specific task skills (motor learning is a skill in and of itself) and have less/more efficient internal resistance when performing movements. Internal resistance can be thought of as the different intrinsic factors that impede movement/output.

You can hopefully appreciate that anthropometry is hard to change, outside of gaining and losing weight (which is still fairly difficult to change beyond a certain point).

That leaves us with the skill of performing the task or general biomotor ability as our targets to improve athletic performance.

Considering that getting better at running by running more and running faster is actually quite hard work, it becomes obvious that the easy way to improve athletic performance is to improve your general movement ability, and more specifically, reduce your internal resistance as much as possible.

Performance Is An Output

Before I describe the easy way to improve performance, and give specific examples, it is important that you understand a simple model of human function.

Basically, this says that performance is an output, governed by inputs and processing.

An output that is dependent on multiple variables can be improved in multiple ways.

The typical way is to try and change the output by affecting processing.

Think of someone learning to swing a golf club with a coach. The coach might demonstrate what a swing should like like, explain the mechanics and theory of the swing and perhaps provide feedback via video.

This can work, but it is not always the most efficient way to go about things, due to the way we learn movement. When we perform a task, our brain is only concerned with whether that task is completed. However, with no reference point as to what the completed task should look or feel like, it simply doesn’t know what it needs to change in the execution to become better at the task.

If we can give better inputs – sensory information from both the external (outside the body) and internal environments – then the brain has a better time in learning the task, because it has more information it can process, which multiplies the potential for better outputs (performance).

It is usually easier to provide better sensory information to the body than it is to improve skill and capacity, hence, this is the “easy” way to improve athletic performance.

How Do You Improve Inputs?

Improving your inputs, with the end goal of becoming more economical and thus improving your athletic performance can be done in a number of ways. In my experience, these have a synergistic effect – the more you use over time, the better.

Focus On End Points

The first change to sensory input you should give yourself, is exposure to the “end points” of movement.

Continuing with the golf swing example, this would we the top of the back swing and the top of the follow through. By learning these positions, your brain builds a “memory” from which it can determine success or failure of the planned task. What happens in the middle will be inherently variable anyway (more on that later), but if you can get the end points right, you are off to a good start.

Find The Path Of Least Resistance

What happens between the end points will be determined by what your body can and can’t do.

Remember I mentioned internal resistance as a factor affecting your general movement ability? Think of the internal resistance like an anchor or handbrake – it won’t necessarily stop you, but it will definitely slow you down and effect economy.

Generally speaking, most people should have a certain range of motion available to them at each region throughout their body. There is always some individual variance, but enough people have been measured to find that we all fit within a range.

We can lose this range for a number of reasons. In the Selective Functional Movement Assessment (SFMA), fundamental patterns are assessed, and if they are painful or dysfunctional (including lack of range or poor control), these movements are further broken down to find the limitation.

These limitations can be caused by a number of factors, which are categorised as:

  • Joint mobility dysfunctions
  • Tissue extensibility dysfunctions
  • Stability/motor control dysfunctions

Regardless of the system, it becomes obvious that you probably can’t resolve a mobility issue with stability drills and vice-versa.

These dysfunctions (the term is theirs, not mine – I prefer adaptations or defensive outputs, because they are usually protective against something the brain is worried about) will contribute to your internal resistance with movement.

By addressing them, you take the brakes off and without getting stronger, more powerful, fitter or more skillful, you are free to express your full ability, and thus you improve your athletic performance.

Allow Variability

When we perform any repetitive task there is an inherent variability involved. No two repetitions are exactly the same. This is a good thing. It helps us manage fatigue and minimise loading on any single tissues.

Movement variability is a factor in economy too.

Ideally, we have low end point variability (you hit the golf ball dead centre every time), but enough variability within the movement to utilise the most effective path at that instant in time.

Reducing internal resistance facilitates variability, whilst providing feedback ensures that the variability enhances, not detracts from performance (novices demonstrate more variability than experienced athletes, by definition reducing economy).

Give Feedback

This is similar to, but not the same as learning the end points of a movement. Feedback should be objective and external initially, which progresses to a subjective and internal “calibration”.

It is easier to express this with an example.

When learning to hit a golf ball, initially you are focused on simply hitting the ball. If you make contact, then the hit is deemed successful. This is an objective and external source of feedback. You either hit the ball, or you don’t. After repeatedly hitting the ball, you begin to learn what it should feel like, which is a form of subjective and internal calibration.

Taking this further, you want to hit it in a certain direction. If the ball lands where you were aiming, you get an objective, external feedback of success. With repetition, you start to feel when you are striking the ball well and how this correlates to the direction of the shot.

With more focused practice still, you begin to calibrate the feel of the swing with the direction and distance of the ball. All of this happens unconsciously, because you are getting more sensory input about the task.

Over time this leads to improved skill and thus better economy. End result? You guessed it, improved athletic performance.

Where Do You Start?

To know what you need to do to improve your athletic performance, you must start with an appropriate assessment.

A good assessment will look at all the factors involved in athletic performance, including those related to health, and from there you will be able to devise a more specific approach targeted to your needs.

From there, you need to have outcome measures, which usually comes down to your specific athletic event. If you are a runner, then your run times are the outcome measures. If you are a golfer, your driving distance and accuracy and your handicap become the outcome measures.

Once you have established your needs, have a base of outcome measures to compare against, you simply apply the interventions as you need, with the aim of improving the sensory inputs and processing sides of the equation before you retest after the appropriate amount of time.


It is impossible to reduce performance down to one or two factors – we are human after all, and thus very complex.

What I wanted to illustrate with this article, was that to improve your athletic or physical performance, you don’t always have to push harder and harder on the output side of the equation.

Often working smarter on the input and processing side of the equation will yield much better results, with much less effort.

There is an expression in performance circles:

Strength is not built, it is granted to you by your nervous system.

When it comes to athletic performance, the concept is the same.

If you have lots of “anchors” weighing down your performance, it is going to be easier and more effective to cut them loose than it is trying to crank the engine harder in order to go faster.


Nick Efthimiou Osteopath


This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.





Movement Quality, Health and Fitness

When it comes to movement quality and fitness, nature had it right all along.

Developing movement quality before fitness is hard-wired into us.

We crawl before we walk.

We walk before we run.

First we develop the quality and control of movement. Then we start doing more of it, which develops our capacity of movement (fitness).

This is the pathway that humans have followed forever, until recently.

Now, around about the age of 5, we send children off to school, where they learn to sit still. We even give out stickers to the kids who do it best.

At this age, things aren’t too bad though. We have about 4 years of movement “training” under our belts compared to 1 year of sitting.

Fast forward to age 10, and that ratio is now 4:6, not great, but still not too bad.

Let’s accelerate to 18, when most kids, now young adults are graduating from high school.

They’ve now been sitting for the majority of their day for 14 of their 18 years.

Many would have played sports recreationally, and suffered injury as a result.

Can you see the problem?

And we are only looking at an 18 year old, who for all intents and purposes, is in the peak of youth, and physical potential.

What happens when we hit 40, 50 and beyond?

Fitness First, Then Injury?

You’d think getting fitter and healthier would be easy. Our bodies are designed to thrive after all.

The problem is, people start out with poor general health.

Think of the average person over 30. They are likely over stressed, possibly anxious or depressed. Body functions like their digestion, elimination and breathing are dysfunctional. Their physiology is impacted by poor sleep quality and quantity, and abnormal light exposure. And, they aren’t moving at all, with the average Australian clocking in at a measly 4000 steps per day. (1)

For the average person who decides to take action and make themselves healthier, it’s an uphill battle before they’ve started.

So when they start exercising with intense, and often short term programs, they are actually adding more stress on to an already stressed body. Combine this with a restrictive diet, and the situation becomes even worse.

It doesn’t take a genius to work out that this might be too much.

Get Healthy First

What should you do instead?

Before you jump head first into an intense exercise program, commit to walking*.

Sounds too easy?

That’s the point.

If you walk daily, you experience a myriad of health benefits that compound. This sets you up for more intense work in the future, if that’s your goal.

Walking is sustainable, so you can do it for the rest of your life (and you should).

You can walk outside, which is ideal, but if weather or safety doesn’t permit, you can walk on a treadmill.

The whole point of starting with walking, is that it is supposed to be mentally and physically achievable. Success breeds success.

All this walking will:

  • Reduce your stress levels
  • Improve your body composition
  • Improve your cardiovascular health
  • Allow you some “down time” in our constant “on” world

This in term will help you sleep better, so your mood improves as your brain and hormones start to balance out.

As a result, it becomes easier to improve your diet, because you aren’t fighting against a stressed out and fatigued brain that wants quick fixes of sugary, salty and fatty convenience foods.

The principles of a healthy diet are simple. Changing your diet is not, because it is about changing your habits.

For most, the best approach is to work with a dietitian or nutritionist. Because in most cases, it isn’t a lack of information that stops people making change. Everyone knows they should eat more vegetables, but most don’t eat enough.

If you can’t, or don’t want to, you can try and change yourself.

For the best chance of success, you want to change one thing at a time. This is why I recommend walking first. It establishes a healthy habit which can have a snowball effect.

With nutrition, change one meal at a time.

Check out the Australian dietary guidelines. Then, starting with breakfast, look to improve your diet one meal at a time. Once a breakfast becomes a healthy habit, move on to lunch and so on.

If you can start walking regularly, and get your diet in order, you are more than half way to a healthy lifestyle that minimises your risk of all kinds of diseases.

This also enhances your quality of life, which is often overlooked – it’s not just how long you live, but how well you live.

This process might take time. Months, even years for some. So it is important to learn how to relax, both physically and mentally.

You can’t keep putting stress upon stress and expect good results, let alone good health.

Learning how to relax physically and mentally allows your body to recover, which is when your body repairs and your health improves.

Everyone is different, but I find things like having a spa/steam, getting a massage, going for a walk and reading a book great ways to relax either alone, or with family/friends.

Again, the challenge here is more mental, the feeling of being in a “rush” to get fit.

It’s funny, because usually this rush is felt after years of doing nothing. Hence the appeal of “12 week programs”. A better approach would be a “12 month program”, but often this is felt as being too slow. The same people who feel 12 months is too long will undoubtedly be saying “wow, that year has just flown by” come December.

The simple act of getting healthier will improve your fitness, but trying to get fit when you aren’t healthy won’t improve your health, and can often harm it.

Then Move Well

Movement quality, like health, is often skipped over in the chase for capacity.

Like skipping the “get healthy” stage, skipping movement quality is a recipe for future injury.

The problem is, movement quality is hard to measure.

Doctors will be able to tell you whether you are healthy enough to exercise with intensity, they won’t be able to tell you if you are ready for a loaded squat or running.

There is no one way to move well, but there are common features on moving well. Think of watching a high level dancer. It likes smooth, controlled, almost effortless. They are moving well.

Moving well is a lifetime endeavour (are you sensing a theme?), but to start out, you can perform some simple tests to see what your starting point is like.

  • Can you touch your toes?
  • Can you reach over and under your shoulders and touch your fingertips, without straining?
  • Can you squat to below parallel without your heels rising or losing your balance?
  • Can you stand on one leg with your knee lifted above your hip for more than 10 seconds?
  • Can you perform a plank for 30 seconds? What about a push up? What about 5?

Most of these movements are simple, yet involve a lot of physical capability. If you can’t perform them, are you ready to be running for 30 minutes or performing “functional high intensity workouts”?

If you lack some fundamental movement quality, you don’t have to put your fitness on hold – remember, improving your health, in this case your movement quality, will improve your fitness.

Improving your movement quality doesn’t mean you don’t get to use load either. Load can often be corrective.

But it does mean identifying why you aren’t moving well.

If you have a mobility issue, simply adding load won’t resolve it. Likewise, if you aren’t moving well because of impaired sensory function, you will want to address that.

Moving well is a continual process, but after you have established a healthy base, you will likely want to build capacity.

Next, Develop Your Fitness

You need fitness too.

Especially later in life, when having low physical capacity becomes problematic.

The key though, is to build your fitness/capacity before you get older. The earlier you start, the better, but it’s never too late. Never.

How much fitness, or capacity do you need? Enough to do what you need to do, with a little left over.

This left-over is termed the physiological buffer zone (2).

It is basically your margin for error.

The bigger your buffer zone, the more you can do without breaking down, getting injured or ending up in pain.

A favourite study of mine showed that in US Marine recruits, those with low Functional Movement Screen (FMS, a simple screen to assess movement quality) scores and a low 3 mile run time had a much high probability of getting injured during physical training (3).

Both the run and the FMS were predictive, but the combination was much higher.

This suggests that moving well, or being fit alone is beneficial, but moving well *and* being fit has a compounding effect.

High Training Loads Protect Against Injury

Lots of recent research in sports science is showing that high training loads are protective of injury. (4)

This means, the more work you do, the more resilient you become.

However, how you get to those high training loads matters.

If there is a sudden jump in workload, that is a big risk factor for injury, so you have to build up slowly. If you look to fit people for inspiration, and try and model what they are doing, you are failing to take into account that it likely to them years to achieve their current level.

Monitoring your workload is important, so that you can know when to push and when to back off. A good personal trainer or exercise physiologist can help you, and will accelerate your progress.


This is a lifetime process.

If you do it correctly, focusing on health as your priority, then you set yourself up for a lifetime of benefits.

It’s definitely not easy.

You will have periods where you feel like it is all clicking.

You will have periods where it all seems so hard.

But, if you establish healthy habits, then you can continue with the behaviours that benefit you no matter what life throws at you.



Nick Efthimiou Osteopath


This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.






*If you are unable to walk due to disability, then a similar low intensity replacement is ideal, but for able bodied people, walking is the best option.

(1) Australian Daily Steps

(2) Movement Reserve: Enhancing the Physiological Buffer Zone

(3) FMS and Aerobic Fitness Predict Injury

(4) Monitoring Athlete Training Loads: Consensus Statement

(5) Andrew Read and Greg Dea seminar, September 2016: Advanced Program Design

How To Build Strong Legs (And Why It’s Important)

Having strong, well balanced legs are a key component of having a healthy, high functioning body.

Our legs are anatomically suited to producing both high levels of force and for walking and running long distances.

This means we need to develop both functions – strength and stability through full range of motion along with the endurance to be able to walk and/or run for distance.

You can build strong legs using expensive gym machines, time tested free weights, with your body weight or using a combination of all three.

Lots can go wrong with your legs:

  • Ankle sprains are the most common lower limb injury (1)
  • Knee injuries are common in athletes and ACL tears are one of the most debilitating sports injuries you can suffer, with females especially susceptible (2)
  • Additionally both the patellar and Achilles tendons are common sites for tendinopathies
  • The knee and hip are most common sites for osteoarthritis (3)

Strength training can be used to both prevent and manage all of these conditions, but done improperly can be a cause of injury itself.

Benefits of Strong Legs

Some of the specific benefits of developing strong legs include:

  • You live longer (4)
  • Greater independence as you age (4)
  • Decreased lower limb injury risk (5)
  • Decreased risk of falls (6)
  • Improved endurance performance (7)
  • Improved speed and power
  • Increased lean body mass – decreased risk of metabolic diseases (8)
  • Improved rehabilitation outcomes after injury (9)
  • Strong legs look good

The 3 Stances

Before we go into how to build strong legs, it helps to understand the different ways we can load the lower body, and the different effects each has.

As humans, we can essentially adopt 3 foot positions.

Most people will favour one side when standing, accelerating, jumping and landing, or just getting through the household chores, which can develop functional asymmetries.

Functional asymmetries are side to side differences in mobility or stability that are not associated with your body’s structure. Functional asymmetries are a modifiable risk factor for future injury (10).

To minimise functional asymmetries and develop strong, well balance legs, requires working in each of the 3 stances.

Bilateral Stance

Bilateral stance involves both feet being on the ground in the same horizontal plane, without movement. It is the most stable, and hence strongest position, and we can lift the heaviest loads in bilateral stance.

Split Stance

In a split stance, both our feet are on the ground, but in a different horizontal plane. Split stance requires the leading leg to be stable through the hip and knee while the trailing leg must display mobility at those joints. You see a split stance being adopted when we need a blend of stability and mobility, for example, if you were chopping wood or throwing a ball.

Single Leg Stance

Single leg stance is displayed when we have one foot completely off the ground. This can be for a moment, as in when we are running, or when we need increased mobility, like when we reach for something on the ground.

Single leg stance requires high levels of stability in the stance leg and trunk to allow you to express the mobility it facilitates.

Use Single Leg Exercises First

Before undertaking a strengthening program for your legs, it’s wise to have an assessment with a qualified and experienced professional.

A good assessment acts like a road map – showing you where you currently are and where you need to go to improve your function and strength.

Most people will tend towards either being stiffer and more stable or flexible and less stable. Typically, we will see the most benefit from developing what you lack – so a stiff person will benefit from developing flexibility and mobility and vice versa.

If the assessment reveals you have a functional asymmetry, then a good place to start your leg strength program is with single leg exercises.

Single leg exercises are a great way to develop the required flexibility and stability at the same time, and help balance out differences between each leg that may have developed over time.

It’s best to start with a split stance, which gives you a nice blend between stability and mobility, versus true single leg stance, which requires stability levels beyond what most possess without training.

Examples of split stance exercises are:

  • Split squats (where the feet remain in contact with the ground throughout)
  • Lunges (where one foot leaves the ground momentarily)
  • Step ups

You can build tremendous strength with single leg exercises alone, but it is still important to develop strength in a bilateral stance as well, in particular with the squat pattern, which is a fundamental human movement.

Squats For Total Body Strength

The squat is simply the best lower body exercise you can do, if you can do it properly.

Squatting demonstrates ankle, knee, hip and spine mobility and trunk stability in the most fundamental human movement pattern – it’s how we first get up from the ground to be able to walk.

It is well worth the time and energy to develop your ability to squat well through a full range of motion.

For rehab patients, I like to teach the squat from the bottom up, which is after all, how we first learnt it. I find that by getting someone into the bottom position of a squat comfortably, the rest takes care of itself.

Surprisingly, my older patients do really well with this method as well, as they are already close to the ground, the risk (and fear) of falling is much lower. Once they are familiar with the bottom position, it is a matter of getting strong enough to stand up.

The most common issues with the squat tend to be at the ankles, followed by the hips.

To work around this, you can begin squatting with your heels elevated while you work towards an unassisted squat.


Strong legs are for more than just fitness fanatics, they are crucial to living a healthy and active life.

It’s important to not only build strong legs, but develop balance and mobility that allows you to move freely.

To do this, it’s important to have an assessment and develop a plan that meets you where you are at, and takes you where you need to go.

While structured exercise is not essential for health, when it comes to developing strong legs, the simple truth is that the majority of Australians are not physically active enough to develop and maintain adequate leg strength throughout their lifetime, and so need a structured program to make up for it.

Not all programs are designed equally though, so for the sake of safety, efficiency and effectiveness, it pays to seek out qualified professionals to help guide you, especially in the early stages of building leg strength.
Nick Efthimiou Osteopath

This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.







(1) Incidence of Lower Extremity Injuries in US Emergency Departments

(2) Epidemiology of Lower Extremity Injuries in US High School Athletes

(3) Epidemiology of Osteoarthritis in Australia

(4) Leg Strength and Physical Function In Older Adults

(5) Strength Training Reduces Injury Rate in Elite Junior Soccer Players

(6) Effect of Leg Strength on Falls and Balance of the Elderly

(7) Effects of Strength Training on Endurance Capacity In Top Level Athletes

(8) Increased Leg Strength per Body Weight Associated with Improvements in Metabolic Syndrome in Japanese Men

(9) Merits of Exercise Therapy Before and After Major Surgery

(10) Prediction of injury by limited and asymmetrical fundamental movement patterns in american football players


3 Ways To Improve Your Movement Quality

Human Movement

Whatever you do, from high end computer programming to gardening and everything else, quality matters.

Movement is no exception.

As Dutch sports performance and motor learning expert Joep Joosten says:

Movement quality is hard to measure objectively, due to inherent differences between human anatomy, physiology and psychology, that the best we can do is quantify, and compare to norms.

However, if you ask any lay person watching anything involving human movement, from artistic dance to fast running, they will be able to tell you what looks “better”, or more easily, what’s not good.

My colleague, top sports physiotherapist Greg Dea, has this to say on movement quality:

There are certain things that leaders in the area of human movement agree on, and one of which, is that certain movements are fundamental to humans. These include:

  • Squatting
  • Bending
  • Rolling/twisting
  • Pushing
  • Pulling

We also intuitively understand that our movement quality can be compromised over time (1), be it due to factors out of our control like ageing, disease or injury.

But we also need to realise that our movement quality is very much affected by factors that are within our control, such as our environment, occupation, hobbies and our physical activity, to name a few.

Whatever you do, it is always a good option to try and move with more quality. Why? Movement is both an action and a stimulus. Each time you move, you are stimulating your brain. The better your movement, the better the stimulus, and thus the better the learning experience for your brain. (2)

So how do you move with more quality?

Make It Easier

This stems out of a training quote “sometimes you have to regress to progress”, but it applies across all forms of movement in life.

Sometimes, what you are doing, or attempting to do, is simply beyond your current capabilities.

If this is the case, you are performing at, or near, your “threshold”. Around this threshold we see survival strategies kick in, which impair movement quality.

To borrow from Greg again:

Survival strategies are great in times when survival is threatened.

They produce extra stability and rigidity, which in turn allows the expression of more power, strength and endurance than you normally would be able to produce otherwise.

In the short term, this is perfect. If a bear is chasing you down, you want to be able to run or climb to safety, it’s not so great if you are in the gym or on the tennis court, trying to enjoy yourself and be the best you can be, because then you can potentially do more than your body can safely adapt to, which is termed an injury.

If that is the case, making the movement easier by “regressing” it can allow your brain turn off the survival mechanisms, and you can execute movement more effectively.

Regressing can be done in few different ways:

  • Making the task easier
  • Doing less of the task
  • Breaking the task up into smaller chunks, and taking longer breaks between chunks

The cool thing about our bodies, is that they adapt to stimuli, so over time, you will get better and be able to do more anyway,

This is universally applicable, from sports to housework.

Stimulate Your Senses

Movement is an output of the brain. Once again, Greg puts it simply (maybe this should be an ode to Greg):

Outputs = inputs + processing. – Greg Dea

Most of the time, when someone wants to improve their movement quality, they focus on executing the output more, and perhaps changing the processing by thinking about certain cues (think stand tall, arch your back, lift your knees etc).

Very few people focus on the inputs aspect intuitively, but this is one of the biggest areas where you can have success in improving your movement quality.

Pictured above, osteopath Phillip Beach is discussing the sensory homonculus, which is the representation of the physical body within the brain. You can see how certain areas are quite big – these areas have the richest sensory nerve supply and are ripe for stimulation.

Now, obviously, when it comes to movement, we are probably not going to worry about stimulating our face or genitals, but how many times have you paid attention to how your hands and feet interact with your environment?

By stimulating your senses to a higher level, you drive increased brain activation, which facilitates better movement.

An obvious place to start, is with the feet. Encased in shoes for most of the day, by performing movements without shoes, you automatically get a richer sensory stimulus. This isn’t always practical, so a good rule of thumb is to spend as much time at home, both indoors and out, barefoot, and when you are exercising, try and perform your warm ups, or at least part of them, barefoot as well.

When it comes to your hands, whether your in the gym, gardening or riding a bike, you need to weigh up the benefits of protection to the costs of decreased sensory stimulation when wearing gloves.

The other aspect of increasing sensory stimulation is in relation to sensory input from within the body. If function at a joint is compromised, then the sensory input of that joint to the CNS is also compromised. However, compromised sensory input also impacts function. It’s a negative vicious cycle.

We can use osteopathic techniques, stretching and other self-mobilisation techniques to change the function at a joint, in order to improve it’s sensory input. Remember the equation Input + Processing = Output?

Change Your Environment

By modifying your environment, you can almost immediately change your movement.

What do I mean by your environment?

Almost everything. From the physical environment, all the way through to the social environment.

Let’s say you are a recreational runner, and your best 5 km time is 30 minutes. If you started running with 23-25 minute 5 km runners regularly (a change to your social environment), do you think you would get faster over time?

If you are a district level cricket player, and you get the chance to play a match at the MCG, do you think you would be more focused or less? Would you perform to a higher level or lower?

There’s not a clear answer to either question.

Some people rise to the occasion and others are crushed by the pressure. Either way, there is a change in their performance.

To improve your movement quality, you need to experiment with your environment to find the conditions that let you be at your best.


Improving your movement quality isn’t all about performing specific exercises or using a certain technique.

By understanding that movement is a complex brain output, that is based on many contextual factors, you can aim to change your movement by changing the contextual factors.


Nick Efthimiou Osteopath


This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.


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(1) Performance on the Functional Movement Screen in older active adults

(2) Neural Correlates of Motor Learning, Transfer of Learning, and Learning to Learn


Common Gym Mistakes: Squats

The back squat is rightly called the “king of exercises”, in fact, it’s said that if you don’t have squats in a training program, then you don’t have a program.

Now, I’d never be so absolute, but the squat is a fundamental movement pattern and forms the foundation for lower body performance training and rehabilitation.

Despite squats being such a fundamental movement, because of the amount of muscles and joints involved, there are a lot of chances for compensation.

Compensation is an interesting topic.

Some claim it leads to injury, yet the research is unclear on this.

Additionally, real world examples abound, one only has to look to the recent Paralympics to see examples of high level compensation, so it’s not necessarily a bad thing to compensate.

What Makes A Good Squat?

With the back squat, we can split lifters into two groups:

  1. Competitive powerlifters, whose goal is to lift the most weight in competition
  2. Everybody else

If you are a competitive powerlifter, you can probably ignore this advice, because your goals are so unique.

If you are like most people and you are squatting to improve your leg and core strength to assist with physique goals, health goals or performance goals, then read on.

Executing a squat optimally requires the following:

  • Adequate ankle dorsiflexion range of motion and motor control
  • Adequate hip and knee flexion range of motion and motor control
  • Adequate isometric strength of the erector spinae muscles to maintain the spinal alignment
  • Adequate abdominal strength to maintain pelvic and rib cage position
  • Adequate thoracic extension and shoulder external rotation range of motion and motor control

Unfortunately, most people are deficient in one or more of these areas, which can negatively affect their ability to squat efficiently with a barbell.

That’s not to say they can’t squat heavy loads.

It’s common to see people who are strong squatters with well developed quads, perhaps adductors and low back muscles, but with relatively underdeveloped glutes and sometimes hamstrings.

Others have extremely well developed calf muscles as well.

What is happening?

Their bodies are using a different recruitment strategy to the “optimal” one, which relies on the glutes as primary hip extensors.

Why does this happen?

Safety. Survival.

Our brains are not concerned with long term well-being when it comes to movement, but rather, completing the task at hand, at that moment in time.

When it comes to standing up with a loaded bar on your back, this can mean using whatever muscle is most readily recruited or in the most mechanically advantaged position.

When people have biomechanical limitations elsewhere in the body, this can affect the movement.

As a result, a hip extension becomes a back extension.

Analysis of My Squat

This was a set of 10 repetitions in the back squat, which I have taken still shots from at various points (they aren’t all the same rep, as you can see by the time).

To the untrained eye, my set looks pretty good, but as you’ll see, upon closer look, there are a lot of compensations occurring that are costing me efficiency.

I’m using myself as an example, as my issues are some of the most common issues I see, just in differing degrees.

Set Up:


My elbows should be further forward, under the bar or as close to as possible, facilitating thoracic spine extension and activation of the erector spinae muscles to stabilise the spine. Additionally, I have a forward head posture, again related to not getting enough extension through my thoracic spine.

Bottom Position:


This is where it gets tricky, as this bottom position looks really good at first glance. My torso and shins are greater than parallel (blue lines), my hip is below my knee, what’s not to like?

Well, for a start, my weight is too far forward – thus the centre of the barbell is in front of my toes, instead of through my midfoot (yellow line). This sets me up to use a knee extension dominant strategy to stand up.

The most likely culprit for this is a lack of hip flexion range of motion or control.

My ankles don’t have the best dorsiflexion range of motion either, which wouldn’t help.

What we cannot see in this picture is whether my low back is flexing to compensate or what is happening at my feet – they could be pronating to give me extra range of motion at the ankle.

The problem with this strategy, is that by shifting my weight forward by using spinal or pelvic flexion, I will have to extend again at some point, which takes the spinal erectors from stabilisers in the movement to prime movers.



Here you can see that my torso and shins are no longer parallel (blue lines).

My knees have extended faster than my hips, which have to remain flexed somewhat to keep the weight balanced – this is most likely due to my limited ankle range of motion, which meant my bottom position wasn’t as good as it should have been.

Another factor is the isometric strength of my spinal erectors and abdominals and their ability to maintain my trunk position.

This sets me up to have to use my lower back spinal erectors to straighten me up quickly, as in the image below.


Here you can see what has happened – my knees have extended only slightly, whilst my back has extended quite a lot in a short time.

What should have been a powerful drive from the hips ends up as a two part movement – the initial extension of my knees with minimal hip extension, followed by the compensatory back extension to get my torso more upright again.



Finally, once my knees are at almost full extension, my hips are still flexed – I’ve stood up by extending my spine more than my hips.

A Squat Is Not A Squat

This example demonstrates the effect that mobility and motor control limitations have on the execution of movement – I can get the squat done, but sub-optimally.

Now that you are aware, if you watch the video (it’s easier in slow motion) you can see that I compensate by using my back extensors (erector spinae) as prime movers, something their not optimally designed for (we have massive glutes for a reason).

Luckily, our bodies are adaptable, and even “sub-optimal” biomechanics aren’t a recipe for injury – it all depends on adaptability.

Up to a certain point, my low back muscles, joints and ligaments will get stronger to withstand the loading of squatting.

Once that point is reached, I will no longer be able to progress, or I’ll get injured.*

*I’ll get injured not because I’m moving incorrectly, but rather, our bodies are only capable of adapting so much, and inefficient movement patterns put increased demands on an area that are not as well designed to withstand them. The same is true even if I had “perfect” squat mechanics – after a certain point I will fail to progress or get injured.

Does It Even Matter?

I always ask myself, if a patient is paying me money to obtain the best result possible, does this information add value to their experience and outcomes.

In the case of what I’ve just discussed, does it even matter if you squat with optimal motor patterns or not?

As always, it depends.

If I’m not going to the gym, and I only squat occasionally to pick something up at home, then it probably doesn’t matter. As long as I’ve got the physical capacity to withstand the demands of that task, I’ll be okay.

However, if you are squatting to improve your aesthetics, performance or leg and core strength, then executing the movement optimally matters.

Sure you can get away with “just squatting” and moving weight however you can.

But is it ideal? Not to me.

The reason being, that despite our bodies being adaptable, we only have a finite amount of energy. For every inefficient movement pattern, energy cost of execution and recovery increases, thus gains (performance, health, aesthetic) decrease.

Aim High

How you do anything is how you do everything.

To me, the argument of whether you should aim to improve your movement quality and efficiency is a moot one.

Even if the benefits were neglible, I am a person who takes pride in striving for improvement.

In the case of exercise, improving the movement for the sake of improving the movement is enough of a reason to do so.

Be better. – Greg Dea, Sports Physiotherapist

I understand that this mentality doesn’t apply to everyone, so all I can say is this:

  • If you are training for aesthetic goals, and you are squatting to improve your leg and hip muscle development, an optimal movement pattern will best recruit the muscles of the glutes, quads and hamstrings.
  • If you are training for a performance goal, then an optimal movement pattern will improve sequencing of hip extension, as well as power and strength, in turn improving running speed and jumping height.
  • If you are training for a health related goal, then striving for optimal movement patterns can be an end unto itself.
  • Anecdotally, the people I see who strain their backs squatting typically demonstrate this type of movement pattern.

So How Do You Improve Your Squat?

To improve your squat, you have to identify what is limiting your performance. It could be any of the following:

  • A technical issue
  • A flexibility issue
  • A mobility issue
  • A motor control/stability issue
  • A strength issue
  • A structural/anatomical issue

To identify what your particular issue(s) is/are requires an individual assessment.

Once you know your issues, the interventions are relatively straightforward.



Nick Efthimiou Osteopath


This blog post was written by Dr Nick Efthimiou (Osteopath), founder of Integrative Osteopathy.

This blog post is meant as an educational tool only. It is not a replacement for medical advice from a qualified and registered health professional.