Case for the Turkish Get Up in Rehab

As rehab professionals we are all well aware at how many (most) individuals, especially those in pain/ chronic pain, lose the ability to perform movement patterns that toddlers so easily perform.  Watching the movements of a toddler will show efficient and seamless  positional transitions including to and from prone, supine, quadruped, half-kneeling, reaching, and effortless full squatting.  These motor patterns remain ingrained in the adult motor-sensory brain maps but they are often shrouded in movement dysfunction as years of motor-sensory neglect compounded on top of concomitant structural changes.  This is why when you try to have the average activity-naive adult perform a full squat it often looks terribly awkward, a far cry from the aesthetic perfection of the toddler squat.  Had the individual continued to reinforce and practice the motor-sensory pathways for their squat during the time periods of structural change their patterns would have adapted to allow for efficient squat despite bodily changes.  As a physical therapist one of my favorite treatments for poor movers and those in pain is to expose them to developmental positions and movement strategies.  For reteaching proper trunk and upper extremity integration I use the Turkish get up exercise, or at least a partial variation of it.  The full Turkish get up can be thought of as the most efficient way to stand up with a weight held overhead in one hand.  There are several small idiosyncrasies in the form used but generally the full movement is observed as in the video below.

So what is going on at the beginning of the movement that I like is the shoulder flexion, linked to scapular protraction, linked to contralateral thoracic rotation.  This is the perfect set up for practicing reach and upper extremity/ trunk integration in a developmental position.  Think of a baby on its back with some object in front of him, just out of reach.  The most efficient way for that baby to try to reach that object is the initial portion of the Turkish get-up, that is shoulder flexion, scapular protraction, and contralateral thoracic rotation.  For rehab purposes, I tend to have patients end the movement when they are in the pseudo-oblique sitting position with arm overhead and weight through the contralateral elbow.  Give it a try!