In sports medicine, we’ve traditionally operated in a reactive model—wait until someone gets injured, then treat the injury. But what if we could identify vulnerability patterns before an injury occurs? What if we could strengthen the weak links in your movement chain before they become the site of your next orthopedic injury?
This is the promise of pre-habilitation (pre-hab) and movement assessment screening, and at Performance Health, it’s become a cornerstone of how we keep active adults training safely and performing at their best.
The Science Behind Movement Screening
Movement screening is based on a fundamental principle: how you move under controlled conditions reveals important information about injury risk during dynamic activities. Research in biomechanics and orthopedic sports medicine has established that specific movement patterns correlate with increased injury susceptibility.
The concept gained significant traction following research on anterior cruciate ligament (ACL) injuries. Studies demonstrated that athletes who exhibited certain biomechanical characteristics during landing and cutting movements—including dynamic valgus collapse (knee caving inward), reduced knee flexion angles, asymmetrical loading patterns, and poor neuromuscular control—had dramatically higher ACL injury rates. Prospective research found that female athletes with knee abduction moments greater than 25.25 Nm during drop vertical jump testing were 6.8 times more likely to suffer ACL injury.
These findings revolutionized our understanding: many “non-contact” injuries aren’t random accidents—they’re the predictable result of underlying movement dysfunction combined with high-demand activities.
Movement Pattern Analysis: What We’re Looking For
At Performance Health, all of our doctors have been trained in comprehensive movement pattern analysis. We use systematic screening protocols to evaluate how you move through fundamental patterns that form the foundation of athletic performance and daily activities.
The Kinetic Chain Assessment
During a movement assessment, we’re evaluating multiple aspects of your movement quality:
Dynamic postural stability: Your ability to maintain optimal alignment during movement. This includes observing frontal plane knee position (looking for valgus or varus displacement), pelvic control, and trunk stability during single-leg and bilateral tasks.
Neuromuscular control: The timing and coordination of muscle activation patterns. Delayed gluteal activation, for instance, often correlates with increased reliance on passive joint structures and elevated injury risk.
Mobility-stability relationships: The balance between joint mobility and the stability required to control that mobility. Limited ankle dorsiflexion, for example, creates compensatory movement strategies up the kinetic chain that can increase ACL loading.
Asymmetries: Side-to-side differences in strength, mobility, or movement quality. Asymmetries greater than 10-15% between limbs have been associated with increased injury risk in multiple sports.
Loading strategies: How you absorb and transmit force during deceleration and change-of-direction tasks. Athletes who land with less knee flexion (“stiff” landing strategy) generate higher ground reaction forces and increased ACL strain.
Specific Screening Protocols
We utilize validated screening tools that assess these components systematically:
Single-leg squat assessment: Reveals frontal and transverse plane control deficits, hip and core stability, and ankle mobility restrictions. This simple test is highly predictive of dynamic knee valgus during sport-specific movements.
Drop vertical jump analysis: Evaluates landing mechanics, knee abduction angles, ground contact time, and bilateral symmetry. This assessment closely replicates the high-risk positions that lead to ACL injuries during sport.
Overhead squat evaluation: Identifies thoracic spine mobility, shoulder stability, hip flexibility, and ankle dorsiflexion restrictions. Compensatory patterns here often indicate regions requiring targeted intervention.
Hip bridge and plank variations: Assess lumbopelvic stability, gluteal activation patterns, and core endurance—all critical for protecting the lower extremity during dynamic activities.
Functional movement patterns: Sport-specific assessments that replicate the demands of your chosen activities, whether that’s cutting patterns for field sports, landing mechanics for jumping athletes, or rotational power for racquet sports.
The Critical Importance of Pre-Hab: Preventing Injury Before Pain Exists
Here’s a concept that’s difficult for many people to embrace: you should be working on injury prevention even when nothing hurts. In fact, that’s precisely the optimal time to address movement dysfunction and muscle imbalances.
The traditional approach—waiting until pain or injury forces you to address problems—has several flaws:
Pain is a late-stage warning sign: By the time you experience pain, tissue damage and movement compensation patterns are already established. Addressing these issues reactively means you’re always playing catch-up.
Subclinical dysfunction progresses silently: Muscle weakness, mobility restrictions, and movement quality deficits develop gradually, often without symptoms. A 20% side-to-side strength difference or subtle dynamic valgus pattern may not cause pain today, but they significantly elevate injury risk during high-load activities.
Injury changes your movement patterns: Once injured, your nervous system develops protective compensation strategies. These patterns often persist long after tissue healing, creating vulnerability for reinjury or problems in other areas.
Performance enhancement: Optimal movement patterns don’t just reduce injury risk—they improve efficiency, power output, and athletic performance. Pre-hab isn’t just injury prevention; it’s performance optimization.
Strengthening Weak Muscles: The Foundation of Pre-Hab
Movement screening identifies the weak links in your kinetic chain, but assessment without intervention is incomplete. The cornerstone of effective pre-hab is targeted strengthening of underactive or inhibited muscles.
For ACL injury prevention, for instance, extensive research has validated neuromuscular training programs focusing on:
Gluteal strengthening: The gluteus medius and maximus control femoral adduction and internal rotation. Weakness in these muscles is strongly associated with dynamic knee valgus. Progressive strengthening through lateral band walks, single-leg bridges, and Bulgarian split squats has been shown to reduce ACL injury rates by 50-80% in some athletic populations.
Hamstring development: The hamstrings act as ACL agonists, reducing anterior tibial translation during deceleration. Exercises emphasizing eccentric hamstring strength (Nordic hamstring curls, single-leg Romanian deadlifts) are particularly effective.
Core and lumbopelvic stability: Trunk position directly influences lower extremity mechanics. Athletes with poor core stability demonstrate increased knee valgus angles and higher ACL loading during landing tasks. Progressive anti-rotation and anti-extension exercises build the stability required for optimal movement.
Neuromuscular re-education: Beyond pure strength, the nervous system must be trained to recruit muscles in proper sequence and magnitude. This requires progressive loading through movement patterns that challenge balance, coordination, and reactive control.
The key principle: pre-hab programs must be specific to the deficits identified during movement screening and progressed systematically to transfer to sport-specific demands.
The Performance Health Approach to Pre-Hab
Our pre-hab protocols are individualized based on your movement assessment findings, training goals, and activity demands. After completing a comprehensive movement screen, we develop a targeted program that addresses your specific vulnerabilities.
This might include:
- Corrective exercises to improve movement patterns and muscle activation sequences
- Strengthening protocols for weak or inhibited muscle groups
- Mobility work to address joint restrictions limiting optimal movement
- Neuromuscular training to enhance coordination and reactive control
- Progressive loading strategies that build capacity for your sport demands
- Education on proper warm-up, training load management, and recovery strategies
We reassess your movement patterns regularly to track progress and modify your program as needed. As movement quality improves, we progress exercises to ensure continued adaptation and maintain the protective effects.
Who Should Consider Movement Screening?
While we often think of movement screening as being primarily for athletes, the reality is that anyone engaged in regular physical activity can benefit:
- Athletes returning to sport after injury or a period of detraining
- Weekend warriors ramping up training for an event
- Active adults looking to stay injury-free as they age
- Individuals with a history of recurrent injuries
- Anyone starting a new training program or sport
- People experiencing persistent “tightness” or minor aches that don’t quite qualify as injury
Investment in Your Long-Term Health
Pre-hab represents a fundamental shift in how we think about injury prevention—from reactive treatment to proactive optimization. The time and effort invested in movement screening and corrective exercise pays dividends through reduced injury rates, enhanced performance, and the ability to maintain an active lifestyle for years to come.
Research consistently demonstrates that structured injury prevention programs produce significant returns on investment. For every dollar spent on prevention, studies estimate healthcare cost savings of $2-7 through reduced injury rates, shorter recovery times, and decreased need for invasive interventions.
More importantly, staying healthy means you don’t lose training time, miss important competitions or events, or experience the frustration of being sidelined by preventable injuries.
Take the First Step
At Performance Health, all of our doctors are trained in movement pattern analysis and corrective exercise prescription. We’re here to help you identify your movement vulnerabilities and develop a plan to address them before they become injuries.
Whether you’re training for a specific event, returning to activity after a layoff, or simply want to ensure you can stay active for decades to come, movement screening and pre-hab can help you achieve your goals.
Interested in learning more about movement screening and pre-hab? Contact Performance Health today—we’re happy to discuss how our prevention-focused approach can keep you healthy, strong, and performing at your best.