Acknowledgements

Introduction

Glossary of terms

Glossary of abbreviations

Part A Laying the groundwork for an enhanced understanding of the spine in health and disease

Chapter 1 The spine: Its role in movement and musculoskeletal pain

Chapter 2 The vertebral axis: A marriage between biotensegrity and neuro-motor control

Chapter 3 Defining the problem: What goes wrong in the spine that leads to pain?

Chapter 4 The Key fundamental patterns of the torso: The basic movements supporting healthy spinal control

Part B Getting to work re-building enhanced spinal movement control

Chapter 5 Assessment: Altered movement behavior is often hiding in plain sight.

Chapter 6 Key Moves 1: Principles and practice of movement therapy for spinal rehabilitation

Chapter 7 Key Moves 2: kinesthetic therapeutic movement exercises for spinal health and wellbeing

Chapter 8 Waking up the spine: Further aspects of control in movement therapy

Chapter 9 Constructing a class

Chapter 10 Changing movement behavior: Mindfulness, perception and felt sense

Leila Stuart, BA, LLB, RMT, C-I AYT

The title says it all. Josephine Key’s latest book lays the groundwork for medical professionals of all stripes to systematically assess and treat back pain and dysfunction. Using a multilayered approach based on the biopsychosocial model, and incorporating current research findings and the new paradigm of Biotensegrity, Key’s approach methodically builds a therapeutic framework for optimizing breath, alignment and movement. She introduces principles, concepts and research that convincingly challenge more conventional strategies for treating spinal pain. Physiotherapists, chiropractors, massage therapists, yoga therapists, personal trainers, in fact, any practitioner using movement as spinal therapy, will discover many gems in this book.

The book is laid out in an easily followed format. First, Key sets the foundation for a deep understanding of the spine and causes of spinal dysfunction, then articulates a thorough assessment process that includes the identification of “Key signs” indicating typical dysfunction. After highlighting foundational principles of movement therapy for spinal rehabilitation, and describing the fundamental patterns of the
torso, Key provides an extensive compendium of movements in which these patterns initiate and guide movements in different positions and levels. Practitioners working with back pain ranging from mild to severe will find appropriate therapeutic movements for their patients and clients. I fully agree with Key’s insistence on the necessity of restoring intrinsic three-dimensional movement before prescribing gross movements for rehabilitation of the spine. The low load repatterning of these basic motor patterns re-educates appropriate motor control and activation of the deep muscular system. I have found that the connection and relationship between the spine, pelvis and limbs is not
always appreciated in rehabilitation discussions. In addition, the value of using slow, gentle, precise micro movements is often overlooked. While I commend Key’s utilization of distal initiation of movement to therapeutically affect spinal function, I believe that there is also value in encouraging patients to develop an interoceptive, or felt-sense, of their spine and associated soft tissue structures. With interoceptive awareness, patients can consciously initiate more proximal movement from specific aspects of these structures. Both proximal and distal movement initiation will have benefit, and sometimes both are needed.

This comprehensive, evidence-based book belongs on the shelf of any practitioner working with patients or clients suffering from spinal pain and dysfunction. Key clearly articulates the often neglected role of movement reeducation in the rehabilitation of sub-optimal motor control in alignment and movement, and presents a thoughtful model that will help many people regain the Freedom to Move.

Staffan Elgelid PhD, PT, GCFP, C-IAYT, ERYT-200, RYT-500
Professor of Physical Therapy, Nazareth College

‘Josephine Key’s Freedom to Move is one of the most complete books on movement therapy for spinal pain and injuries that I have ever read. The book is extremely well organized, researched and referenced. Part A of the book starts by explaining the role of fascia, muscles, bones and the nervous system. Many books on therapy do this, but Key’s book ties it all together into how neuromotor control happens, and she does it in a way that is easy to understand and builds the foundation for Part B. Part B covers the therapy aspect of people with spinal pain. Chapter 5 on Assessment and Chapter 6 and 7 that cover the exercises/movements are extremely clear. Photos and the written description of both the assessment process and exercises/movements go hand in hand and are congruent with each other. The only complaint about this book is that Part B is so clear and well organized that I can imagine that many people will skip Part A and immediately jump to the assessment and exercises/ movements in Part B. The reader who jumps straight to Part B will get lots of new ideas that will benefit their clients, but the magic of the book is how Part A tells the story that will make the reader understand and be able to apply and adapt Part B to their clients. Everyone who buys this book should first read Part A twice and then they can let the magic of Part B happen.’

Cara Reeser, BA, MFA, Pilates Instruction (Pilates Aligned)

Josephine Key’s book Freedom to Move: Movement therapy for spinal pain and injuries will be instructive to exercise professionals and movement educators from all disciplines. It models a useful approach to movement training integrating biomechanics, neuromotor control, biotensegrity, mindfulness, and postural retraining. Key’s book is laid out in three clear, well-constructed sections. Part A allows the reader to become familiar with basic biomechanics and common postural and movement patterns that may contribute to pain and/or impaired performance. Part B offers assessment tools that will be out of the scope of practice for many exercise professionals. Even so, this information may help them glean insight into how clients may be assessed by physical therapists and other medical professionals. Part B also includes an in-depth explanation of Key’s signature ‘Fundamental Patterns’ and ‘Key Moves’ methodologies. In the third section, ‘Recommended Exercises’, Key offers a well chosen selection of exercises adapted from a variety of movement disciplines. These exercises will be an excellent addition to any movement trainer’s repertoire and they are delivered in a well organized and easy to follow manner.
Today many exercise professionals and movement educators find themselves serving clients with painful conditions, poor mobility, and hindered function. Freedom to Move offers smart and effective ways to break down movements and deliver these micro gestures appropriately. This approach will resonate with many movement educators as it is designed to enhance breath control, tension modulation and motor learning in order to improve postural and movement patterns.

Essential reference book for clinicians of spinal pain (5 star review on amazon.com from Andrea Clift, February 29, 2020)

For those of us charged with the task of pointing back pain sufferers in the right direction this is the book to digest.