The Baby Get-Up Assessment
By Perry Nickelston, DC, FMS, SFMA
Leonardo DaVinci is quoted as saying, "Simplicity is the ultimate sophistication." So very true, and the baby get-up, which is one of the most powerful and simple movement assessments you can perform, proves it. Inspired from a regressed version of the Turkish get-up used in the world of kettlebell training, this pure maneuver divulges information about movement symmetry, durability factors and injury risk.
An individual with a keen eye for assessing movement and why neural sequencing matters in every aspect of daily living will find the BGU an essential tool. It can be a foundation in your examination process to create the most effective recovery strategy for your patient.
Evaluation of movement patterning is essential for determining functional causes of chronic musculoskeletal pain. Traditional anatomical isolation-focused testing helps formulate a diagnosis; however, movement-based assessment correlates pain to real-life activities. Last time I checked, patients have to move in many different vectors when they leave your office to accomplish activities of daily living. It is our responsibility to discover the weak link in their movement system to help prevent recurring injury.
The BGU helps determine if an individual has the proper neuromuscular sequencing pattern to accomplish a fundamental transition pattern of movement. The baby get-up is the great equalizer! It is designed to level the playing field by removing the body's ability to compensate. The beautiful part of the get-up is that the assessment is also the primary corrective. You don't have to pick and choose corrective exercises to fix it. Just do the movement with self-assistance.
This article includes a video demonstration of the baby get-up. Watch the video and then read the how-to's below, watching the video again. Remember, there are no absolutes in any assessment and the history of each individual must be taken into account when introducing this movement.
Movement Setup and Cueing
Dysfunctions and Compensations to Look For
Watch for smooth downward motion. The downward leg should always be in line with the upper torso. For the last repetition, the patient should move into the side plank at top of movement. Observe for torso rotation; flexion at waist; losing the plank line; dipping in the center; neck going into flexion (not packed) The head should be in line with the body.
Have the patient hold for as long as they can with good form. When and if they dip in the center three times, the test is over. In a normal side plank, the individual should be able to maintain 60 seconds on each side. If they struggle maintaining the baby get-up plank for 60 seconds, they should not be doing a traditional side plank. Regress to progress!
If someone struggles with the baby get-up, they have difficulty performing rotational patterns, loaded or unloaded. They will power through movements using improper muscle activation to accomplish the task. The body will compensate any way it can to reach the goal you are asking it to hit by taking the path of least resistance.
The movement brain will do it in a functional or dysfunctional way, depending on what it has to work with. It could care less if it gets there the right way or the wrong way. It has one mission: get to point B. Facilitated muscles get overloaded and inhibited muscles get weaker (from a neural activation point first, strength second, and endurance third).
You want precision of movement and quality of execution. The neural groove of sequenced movement must activate first. If a patient can master the baby get-up, you know the body is now prepared to own the pattern. Then you can take the patient to the next progression in active therapy.
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