Introduction to standing in place cross crawl pattern and mobility
Over the past few years I have become interested in accessing the nervous system through manual therapy and exercise as a means to attaining better mobility in my middle-aged to senior golf fitness clients. Recently, on a hunch, I began using a modification of the neuro-developmental cross crawl pattern movement as a window to greater mobility. This idea came to me after using the pattern in standing to improve braided walking technique in older golfers. What follows is not peer-reviewed research, but merely food for thought.
Standing in place cross crawl exercise protocol
Ten males, avg age 68, were evaluated prior to commencing treatment/training. Individuals were found to have loss of joint mobility in a variety of combinations in the following joints: great toe metatarsal phalange joint (base of the great toe), talocrural (ankle) and hip via goniometric measurement. Clients were further assessed for independence in performing 20 repetitions of standing in place cross crawl pattern movement as clients falling at home during exercise is not good for business.
Those that independently mastered the task were asked to perform 20 repetitions of standing in place cross crawl pattern 5 times per day until they were seen again, an avg of 3 days later. The dispersion of the exercise sets across the span of a day is in line with enhanced motor learning (Motor Learning and Performance, Schmidt and Wrisberg). The set and repetition protocol were given somewhat arbitrarily (developed with the 10 year 10,000 hour principle) with clients ability and willingness to perform them taken into consideration.
The decision to use standing in place cross crawl over standard crawling was one of practicality as this population is often unable to crawl due to irritation of degenerative joints when loaded in the crawling position. There was a tendency toward ipsilateral rather than contralateral upper extremity and lower extremity movement that needed to be trained out and monitored for during the learning phase. This was the only task given to the clients.
Results avg pre and post standing in place cross crawl exercise
Pre 3 day HEP Post 3 day HEP
Great toe MTP Dorsiflexion
25 degrees 75 degrees
Ankle Dorsi Flexion
2.5 degrees 13.5 degrees
-15 degrees -2.5 degrees
Hip Internal Rotation
0 degrees 21.25 degrees
90 degrees 102.5 degrees
While these findings are clearly preliminary and the N is inadequate, they did give me pause. My feeling is that while this exercise may induce minor mechanical changes to the fascial network the driving force is neuro-motor. The mobility changes seem to be coming from a restoration of central neuro motor patterning toward normal and perhaps through spinal activation.I believe these changes will dissipate without continued use of the pattern and cannot fully address the often difficult mobility issues in the mature athlete. They can however, assist in providing greater access to the comprehensive mobility needs in this population, temporarily opening a window of opportunity. This type of movement pattern use may actually be of greater benefit to the sustained mobility of younger and up to middle aged athletes who have likely not developed significant mechanical mobility issues.
Conclusion: Standing in place cross crawl movement is a simple and relatively easy to perform task which may provide another valuable tool in the comprehensive training programs that older athletes need.
Please feel free to comment below.
John D’Amico MSPT, ATC, TPI Med Pro Level 3
Golf Fitness Edge